The three triage tents outside the emergency department at Whangārei Hospital. Photo / Michael Cunningham
The three triage tents outside the emergency department at Whangārei Hospital. Photo / Michael Cunningham
On the eve of a major public health overhaul, patients wait in tents outdoors and are treated in corridors as virus infections surge amongst chronic staff shortages and the poor state of Whangārei Hospital.
The response towards the twindemic of Covid 19 and the flu thrashing hospitals is a farcry from "go hard, go early."
One emergency doctor is calling out the inaction.
Emergency medicine specialist Dr Gary Payinda is tired of hearing Health Minister Andrew Little say the health system is coping. He's also tired of National not acknowledging the system was underfunded and in crisis 10 years ago when it was in power.
Payinda says these are just words and what he wants to talk about is the safety of Northlanders who need emergency healthcare. Which could be any of us.
"Let's talk about how many patients are kept out in a cold tent in 10-degree weather sitting on hard plastic chairs, waiting to be seen because we have no room available indoors for them in an emergency department that we outgrew 20 years ago.
"We have not enough staff, nurses, doctor or healthcare assistant wise to see them because of staff sickness which is due to chronic understaffing."
Northland emergency doctor Dr Gary Payinda is concerned about the quality of care Northlanders will receive as Covid and the flu worsen.
Payinda said he was an advocate for the triage tents outside Whangārei Hospital at the start of the pandemic because indoor seating in a waiting room creates infestation and infection with Covid.
The three small tents decrease respiratory infection risk because they have open ventilation.
Two and a half years later, Payinda said the hospital is still using those tents as an extended waiting room because they don't have enough room or staff.
"I think that sort of tent triage care would be absolutely 100 per cent fine if we were in our first month of the pandemic response... you'd say we're doing the best we can.
"But, to be here two and a half years later, asking ourselves why we have insufficient room to treat respiratory infection patients. It's insane."
We've effectively battled the virus and protected the health system and its workers before, at the beginning of the pandemic. So for Payinda, it's all about priorities.
"It's all preventable. That's the worst thing.
"If we want to prevent respiratory infection, and ongoing waves of hospitalisations, masks, boosters and ventilation are how we achieve that," said Payinda.
Northland DHB surgical and support services general manager Mark McGinley said all four NDHB hospitals - Whangārei, Kaitaia, Dargaville and Bay of Islands - are "experiencing a sustained period of extremely high levels of pressure," like many DHBs around the country.
"The ongoing issue is in part an after-affect from the Covid-19 pandemic, where we had to delay some non-acute care and surgeries."
"Our length of stay is longer than usual because demand is high and flow across our inpatient areas has slowed, with a higher number of long-stay inpatients."
McGinley said a portable cabin that will replace the ED triage tent arrives next week and work under way to increase the size of the ED waiting room is expected to be finished by the end of August.
"Our Emergency Department is a third of the size it should be for the population that it serves."
GOING HARD THEN GOING SLOW: WHAT'S TO COME
As a nation, we followed the "go hard, go early" approach led by the Government and the Ministry of Health when the pandemic began in 2020.
New Zealand was put into a lockdown far stricter and for far longer than the rest of most of the world. There was a massive push to get all homeless people off the streets and into emergency and transitional housing.
Instead of looking at the decisions that made our response "one of the best in the world" as a way forward, in 2022, the path we are on seems quite different.
"We've accepted it because it's the reality. But I would just like to point out it doesn't have to be," said Payinda.
Otago University virologist Dr Jemma Geoghegan warned the summer RSV outbreak was an idea of what was to come when restrictions were lifted.
"Not just with RSV, but other viruses like influenza, human metapneumovirus (HPV), enterovirus and adenovirus.
"There's a risk disease like measles might come back, because, having had other priorities, our vaccine rates for them aren't as high as we'd like them to be."
In June the Herald asked, "Is New Zealand about to see a winter 'twindemic'?", as health experts track a rise in flu cases at the same time that newly-arrived Covid-19 subvariants look set to begin a second Omicron wave.
The Herald noted the mix of flu and Covid was "spelling an especially tough winter for hospitals."
Payinda warns the return back to normal isn't going to happen. The new normal is going to be worse.
"We've accepted it because it's the reality. But I would just like to point out it doesn't have to be."
The real-life consequences of a historically underfunded health system dealing with a pandemic without restrictions.
"We're just years into this and acting as if things are going to be okay they're not going to be okay. Covid is going to come back again and again and again," said Payinda.
DHB ADVICE FOR NON-URGENT PATIENTS
There are a number of ways people can get health advice before deciding to go to the Emergency Department.
For 24/7 health advice and guidance for when to seek medical care, freephone Healthline on 0800 611 116 or download and check the Emergency Q app.
Do you have cold or flu symptoms? If so: The best treatment is to stay home and get plenty of rest, fluids and medicines that ease your symptoms. You don't need antibiotics (they won't fix your cold, flu or Covid-19). To check for Covid, take a RAT test and isolate if needed.
