DHBs around the country are placing travel restrictions on staff to maintain staffing levels during the Covid-19 coronavirus outbreak as an expert warns hospital resources could be stretched.
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Staff at Auckland and Northland DHBs have been told if they go on holiday overseas and have to self-isolate on return, they'll have to take unpaid or annual leave and will be unable to use sick leave or special paid leave.
Association of Salaried Medical Specialists executive director Sarah Dalton told Morning Report it was reasonable for DHBs to talk to staff about leave plans but "personal leave should be dealt with on a case-by-case basis".
"We've been concerned about a lack of staffing [at hospitals] for a long time now."
She said there weren't enough senior medical doctors and dentists in hospitals.
"We're already stretched. An epidemic or pandemic is going to cause real stress."
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Dalton said it came down to both parties being reasonable about taking annual leave.
Patients waiting on elective surgeries might be pushed down the list to prioritise Covid-19 cases, she said.
"We've already got surging acute demand, putting pressure on elective lists, a lot of people are waiting a very long time to be seen. We already know that women with non life-threatening gynaecological conditions just aren't being seen or not getting the treatment that they need. I don't think that's acceptable for a public health system.
"I think we need more investment. It would be great if we could get some political consensus around this because a lot of that development requires more than one electoral term to fix."
"An epidemic is going to cause real stress" - Salaried Medical Specialists executive director Sarah Dalton
University of Otago senior lecturer in infectious diseases Ayesha Verrall told Morning Report public health management to prevent or contain a large outbreak would need to be managed over a couple of years.
"It is very difficult for any country to have enough ICU beds to cope with a large outbreak like this," she said.
"One of the worrying things about coronavirus is that the rate of people who have severe illness, critical illness, that need to go to intensive care is high at 6 percent, so that's much higher than other comparable illnesses.
"It would put a stress on any health care system as it did in Wuhan, China, and as is now in Italy."
"This looks like an illness that needs a prolonged time in hospital" - University of Otago senior lecturer in infectious diseases Ayesha Verrall
She said maintaining flu hygiene and getting flu shots were some of the ways to contain the infection.
Apart from the health management, on the administrative side of things she said the system would need to be able to ramp up contact tracing if and when 20 or 40 cases cropped up.
"Those should be manageable scenarios with the right public health resources in place ... that's where we need to focus now."
She said work was underway to increase capacity and availability of ventilators at hospitals.
"This looks like an illness that needs a prolonged time in hospital. Some people are in ICUs for a week or over a week, and needing hospital stay after that."
- If you have symptoms of the coronavirus, call the NZ Covid-19 Healthline on 0800 358 5453 (+64 9 358 5453 for international SIMs)