As numbers of Covid-19 cases in Bay of Plenty continue to rise, health authorities are in full preparation for the situation to deteriorate.
Surgeries have been postponed, facilities have been transformed and more beds and resources have been brought in as part of Bay of Plenty District Health Board's preparations for an influx of patients with Covid-19.
Director-General of Health Ashley Bloomfield announced on Friday that New Zealand's confirmed and probable cases of Covid-19 had increased to 868 cases. That included 39 cases in the Bay of Plenty and Lakes District Health Board areas, made up of 27 in the Western Bay of Plenty, one in the Eastern Bay of Plenty, seven in Rotorua and four in Taupō. The patient in Tauranga Hospital is in a stable condition.
The health board's incident management team incident controller Dorothy McKeown said they had increased bed numbers, better access to ventilators and were looking at increasing capacity through private hospital resources in their fight against Covid-19.
Tauranga Hospital's intensive care unit has an additional six beds and Whakatāne's has an extra four beds. Tauranga Hospital has 10 ventilators and Whakatāne Hospital has two.
"In addition to ventilator machines, patients can be cared for and ventilated using anaesthetic machines and transport ventilators. The capacity to ventilate a patient includes all of these options at both DHB and private provider, and is included in contingency planning.
"Tauranga Hospital has relocated its Coronary Care Unit to an adult inpatient area to create additional capacity in ICU. Both Tauranga and Whakatāne hospitals have made facility changes to ensure safety of Covid-19 and non Covid-19 patients, and have more areas that are capable of negative pressure air flow."
As of April 2, there had also been 200 elective surgeries deferred as a result of the pandemic and to help hospitals prepare for a further increase in cases.
Part of preventing the spread of the virus is ensuring anyone who shows symptoms is tested as soon as possible. Between March 24-April 1, 1176 people had been seen in the Bay of Plenty district's community based assessment centres.
"Case and contact management is a routine function of any public health unit," McKeown said.
"This work involves administration staff receiving notifications of a suspected or confirmed infectious disease, medical officers of health overseeing the case management to prevent infection spread, and health protection officers and communicable disease nurses who perform the actual case and contact follow up.
"As part of our local response to Covid-19, Toi Te Ora Public Health Unit is operating within a Coordinated Incident Management System (CIMS) structure, and all staff (approximately 45 staff members), are now focused on the Covid response or other essential business. At present our priority is case and contact tracing."
Bay of Plenty District Health Board incident management team incident controller Bronwyn Anstis said the Tauranga community-based assessment centre was relocated from the Tauranga Racecourse to Trustpower Baypark Stadium, 81 Truman Lane on Friday.
"The new location has got much greater capacity for scaling up should that be necessary, and provides more protection from the elements. Staff at the CBACs are following Ministry of Health guidelines for the use of personal protective equipment (PPE) for the essential service they are providing."
Anstis said people should have confidence in the preparations being made on their behalf by their healthcare professionals.
"We're seeing the very best of our people in this situation. Everyone is going the extra mile, putting their hands up and taking on responsibility. For me, it's been quite a humbling experience. People are going above and beyond and we've seen the results of that in terms of planning and preparedness as a health system across the Bay of Plenty."
• Covid19.govt.nz: The Government's official Covid-19 advisory website
Planning for the BOPDHB's Covid-19 response began in early January and intensified as the threat developed to the point where on Monday, March 16 an Emergency Operations Centre (EOC) was set up.
"The EOC is our control centre for major operations of this sort and was last activated in response to the Whakaari – White Island eruption in December. Essentially it gives us a model by which we can coordinate such a huge operation," she said.
"This is a seven-day-a-week response so as part of our planning we have two EOC teams rostered to ensure our staff who are fulfilling these roles get sufficient breaks to recharge. The nature of this incident is that it is likely to be a lengthy response so managing people's welfare is key.
"We are linked in with our GPs and community healthcare providers and they are all doing such incredible work for the communities we serve. Again it's an attitude of getting the job done whatever that takes."
On Thursday, Toi Te Ora Public Health medical officer of health Dr Phil Shoemack said four of the confirmed cases in Bay of Plenty were not related to overseas travel but were related to outbreaks elsewhere in New Zealand.
"We do not yet have evidence of community transmission in the Bay of Plenty and Lakes districts," Dr Shoemack said.
However, investigations on the additional 13 cases since then are not complete.
"Once a case has been identified, the Ministry of Health and district health boards track down people who may have been exposed to the virus through a process called contact tracing. Health services use contact tracing to find people who may have been exposed to an infectious disease. There are two types of 'contacts' – close contacts and casual contacts. Health services give advice to both of these contact types on what they need to do."
A Ministry of Health spokesman said all cases were interviewed to assess the likely source of infection and potential people that may be infected from the case.