Plans are in place and now health officials in the MidCentral District Health Board region are waiting to see if their preparation will be the bedrock to surviving a summer period of learning to live with Covid-19.
Palmerston North Hospital, Manawatū. Photo: Jimmy Ellingham, RNZ
For so long the Covid-19 Delta outbreak was something for other regions to worry about, as far as people in Palmerston North and surrounding districts were concerned.
Then a fortnight ago, two cases were confirmed in the Tararua District town of Woodville.
Then there was one in Ashhurst, one in Palmerston North and, after days of wastewater tests finding Covid-19, a positive case in Pahīatua, southeast of Palmerston North.
Covid-19 has arrived and locations of interest are regularly released. Meanwhile, alert systems are about to be replaced by the traffic light system, while internal borders to the north reopen.
Amid this MidCentral DHB chief executive Kathryn Cook said officials were confident their resilience plan's surge response would work.
"That's really a plan which shifts us from an emergency response to Covid in to more of a living-with-Covid approach in our community.
"We started with a pandemic plan way back in 2019, then we had a Covid resurgence plan. Now, it's our Covid resilience plan," she said.
"Initially, it would be fair to say that we thought this would come and then it would go. We're now living with Covid so we've moved out of that emergency response where you think you will address it.
"Now, we're very much thinking about how do we live with Covid. That's where the plan has changed to how do we care for people safely in their own homes, and then how do we care for them in the hospital and different settings."
Cook did not go into detail about numbers, but said modelling for projected cases was regularly updated, taking into account factors such as vaccination rates and internal border reopenings.
The board had put in plenty of work getting Palmerston North Hospital and its staff prepared, including Covid-specific training for nurses.
At the hospital, a dozen beds, including eight in intensive care, have ventilators, and there are other ventilators onsite for children and for when patients are on the move.
"We've done quite a lot of work in the hospital. It's an old hospital... but there are things that we have been able to do to future proof it for Covid," Cook said.
"We've got a specific ward that we're doing some work in at the moment - in fact it starts on Monday for three weeks - where we're upgrading the oxygen supply actually for the whole hospital, but the first priority is for that ward to give high-flow oxygen, and that's the ward where we would care for any patients that might need to be admitted to hospital."
At the heart of MidCentral's strategy is getting vaccination rates as high as possible. For the wider region they sit at 91 percent for first dose and 82 for second.
Should a hospital patient die, there is a refrigerated container at the hospital for bodies.
MidCentral also has isolation facilities for people who need them.
"We're constantly refining our approach, but we feel as well-prepared as we can be. We'll be learning as we go, but we feel that we're in a good position," Cook said.
Civic leaders say people are carrying on as best they can.
In the Tararua District, testing sites are busy after the positive Pahīatua case.
District mayor Tracey Collis said everyone is prepared as much as possible and bracing for what would happen next.
"Our communities are very closely connected. I think we've watched it go from Woodville to Pahīatua and we're just waiting to see where it travels next, so that testing in imperative."
Since the positive cases were announced business had quietened, Collis said.
"What I've noticed in Woodville you've still got spare car parks available. In Pahīatua yesterday it was very busy at the supermarket in the morning. The minute that the location of interest [there] was announced that dropped right off, so people are just waiting for those businesses to be cleaned and to get that information."
In Palmerston North, where the first-dose vaccination rate is 96 percent, deputy mayor Aleisha Rutherford said people were still out and about.
"What I've seen certainly is not a decrease in activity in the city centre. Perhaps habits have changed around how long people are staying out, but I'm still seeing town is full. There's lots happening."