By Hamish Cardwell, RNZ
Doctors fear New Zealand's health system could quickly collapse in the event of an outbreak of the Delta variant of Covid-19.
An expert report on the reopening the borders released yesterday said an outbreak similar to what's happening in New South Wales was likely this year - despite the borders remaining closed for now - and that the health system was poorly resourced to deal with it.
It comes as the Government announced yesterday that it would plunge the country into a "swift and severe" lockdown if even only a handful of cases of the virus are detected in the community.
College of General Practitioners medical director Dr Bryan Betty said an Australia-like outbreak of Delta would overwhelm the healthcare system very quickly.
"We couldn't afford a situation in New Zealand to have it out of control in the community because it would risk collapsing or compromising our health system."
Sir David Skegg's report out yesterday states this country has the second-fewest intensive care beds per capita in the OECD.
College of Intensive Care Medicine chair and Hutt Hospital ICU director Dr Andrew Stapleton said there were not enough beds to cope with even a modest-sized outbreak - despite the ability to scale up capacity.
"Because hospitals are ageing, and because our resilience to a pandemic situation is poor, because of the design of elderly hospitals with poor ventilation of wards, inadequate numbers of negative pressure rooms."
Stapleton said on a normal day only about 25 of the roughly 220 ICU beds were free.
He said New Zealand's ICU capacity was more like India's - where hospitals were overrun - than Australia's, and it needed to be doubled as the virus would become endemic in future years.
Stapleton said the real pinch point was the lack of ICU nurses.
"One thing that would be useful [would be] to make sure that we hold on to the staff that we have got.
"Many of whom come from abroad, and reducing bureaucratic barriers such as visas to these staff having to leave the country - that would be a quick win."
Stapleton said he understood Cabinet was looking into this.
Director general of health Ashley Bloomfield said additional nurses had been trained to help out in ICU since the pandemic.
"All DHBs were required to train up additional nursing staff to be able to do that.
"That's part of going back to district health boards to look at the readiness and preparation in the light of the Delta variant, they will have another look at that as well just to make sure that is still current."
Yesterday the Government announced the danger posed by the Delta variant of the virus meant it would swiftly put parts or all of the country into the highest lockdown levels if even only one or two cases are detected in the community.
And according to the report, the border will remain firmly shut for the foreseeable future.
Importance of vaccination
Betty said vaccination levels would need to be at 80 or to 90 per cent before he would be comfortable starting to loosen border restrictions.
"One of the things I've been surprised about talking to patients about the Covid vaccine is when I mentioned to them that once we open the borders Covid will come into the country and for those ... not protected will be at risk.
"They're actually very surprised to hear that Covid will enter when the borders open. I think because we've been so successful at the elimination strategy and having no cases in New Zealand."
Betty said misinformation about the vaccination was putting some people off getting the jab, but he was confident ultimately New Zealand would get a high vaccination uptake.
The vaccination rates for Māori and Pasifika have dragged behind the rest of the population.
But yesterday the Government said today uptake has improved - with rates for Māori over 55 now similar to non-Māori, though the stats for Māori under 55 still lag behind.
Maori pandemic group Te Rōpū Whakakaupapa Urutā co-chair Dr Rawiri McKree Jansen said Māori were particularly vulnerable and it was crucial they were vaccinated.
"If Delta variant travels in Māori communities it will be catastrophic, there will be deaths.
"So we must [have a successful vaccine rollout]."
Covid-19 Response Minister Chris Hipkins said Delta outbreaks had overwhelmed health systems overseas.
"There's something we've avoided here in New Zealand and we will do everything that we can to continue to avoid[it].
"That's not to say that we haven't got our DHBs looking and planning for what they would do in the event that we did see a sudden surge in Covid cases and they had to deal with it.
"Of course we expect them to be doing that, but our primary focus is on making sure that that doesn't happen."
The Government said it hit a new daily vaccination record yesterday, and 2.2 million doses have now been administered.
About 16 per cent of the population - 850,000 people - are fully vaccinated.
It is expected tomorrow the Government will announce an extension of time between Covid-19 vaccinations to "eight weeks".
"We still want to get people fully vaccinated as quickly as we can," Hipkins told Checkpoint.
"But as we'll set out tomorrow, there is emerging evidence that actually getting the maximum protection can be enhanced with a slightly larger gap."
The Government will also respond to Skegg's plans to how to reopen the border.
Hipkins said vaccination may be required if the transtasman bubble reopened.
"It may be there are vaccine requirements put in place as part of the reopening of safe travel zones.
"People being fully vaccinated is likely to be a really important part of any liberalisation of movement at the border in the future.
"We're still a way away from that but we'll talk more about that tomorrow."