Twenty-nine staff at Middlemore Hospital are close contacts of a Covid-19 case and have been stood down for 14 days, the Ministry of Health said tonight.
Eleven of the 29 staff are doctors, 13 are registered nurses, two healthcare assistants, and the others a phlebotomist, cleaner and ward clerk.
Four wards are closed to any new admissions and all patients are being managed under strict infection and prevention control measures, including the full use of PPE, and treated as Covid-19 exposed.
A patient went to the Middlemore Ed at 5pm on Saturday with abdominal pains. When asked questions, the patient denied having contact with Covid-19 or having been in a location of interest, the ministry said.
The patient later developed a fever, was confirmed with Covid-19 and was shifted to a dedicated Covid-19 ward (see timeline below).
Three patients who initially shared a room with the case are now in single isolation rooms.
One patient has been sent to a managed isolation facility - the other two will remain in hospital in isolation rooms for treatment for their conditions plus swabs as appropriate.
Potentially exposed patients currently on the wards are being checked daily for symptoms and tested on days 3, 5 and 12.
On discharge, they are being managed according to ARPHS guidance.
All patients have received further information on the ward.
ED, the Radiology room where the patient had his scan and room where patient stayed on the ward have been cleaned.
In a statement this evening, the ministry said a "national process" was under way across all DHBs to identify and send staff to Auckland to support the Covid-19 response.
"Middlemore Hospital are actively reviewing staffing daily and, like other DHBs in the region, are experiencing significant shortages of both Registered Nurses and Health Care Assistants."
The ministry was working with metro-Auckland DHBs to match available staff to needs and would continue to deploy staff as required to ensure they had the necessary resources.
"Metro-Auckland DHBs are working closely together to manage the Covid-19 positive cases needing hospital level care. The hospitals have been constantly updating their planning for surge capacity which includes preparations for staffing and resourcing additional beds in dedicated Covid-19 wards."
But Kerri Nuku, Kaiwhakahaere of the New Zealand Nurses Organisation, believes this will have a knock-on effect with staffing shortages around the country.
"It's important we don't deplete regions from having access from their own staff," she said.
"A month ago we were prepared to strike, and our members were prepared to take strike action because of the chronic understaffing and there is no difference.
"All that we've got is that we've got a tense situation under incredible pressure and we've still got this chronic staffing."
Yesterday, the Herald reported all patients and staff working in two affected Middlemore Hospital wards were being regarded as close contacts of a patient with Covid-19.
The hospital was taking a "precautionary approach" to potential patient exposure.
"All patients and staff who were potentially exposed between 0635hrs and 1630hrs are classed as contacts."
Four wards were closed to any new admissions and all patients were being managed under strict infection and prevention control measures, including the full use of PPE, and treated as Covid-19 exposed.
"Middlemore Hospital are following the advice of ARPHS for isolation and testing."
Middlemore has investigated the ventilation systems in the affected area.
"The outcome of the investigation suggests that the likelihood of virus being spread to other wards is extremely low. IPC and ARPHS are reviewing these findings and will advise accordingly."
CMH was seeking advice about reviewing screening questions at the front door to include abdominal pain as an indicator of Covid-19 risk.
Auckland Regional Public Health Service (ARPHS) said yesterday it was undertaking a case investigation to identify and isolate close contacts.
"All patients and staff working in the two affected wards between 6.30am and 4.30pm on Sunday 5 September are currently being classed as close contacts until we have done further investigations," Counties Manukau Health added.
A ministry spokesman said he understood Counties Manukau DHB would undertake a debrief and internal review of what occurred, including their processes, which was normal procedure.
"The Ministry also understands Counties Manukau Health has already updated its Clinical Assessment Tool, which clinical staff should refer to when assessing all patients, to increase the range of symptoms that warrant Covid-19 testing."
Speaking with members, Nuku said nurses are scared as they may possibly infect their families and friends with covid-19.
"They are really scared of taking something home and being responsible for spreading this,"
Timeline of events
• 1700hrs a patient presented in ED with abdominal pain. When asked screening questions, patient denied having contact with Covid-19 or having been in a location of interest
• He was triaged into main ED assessment where staff are in full PPE (N95s and goggles). He stayed in an open curtained room and seen by ED staff
• 2039hrs he was moved to Adult Short Stay into a four-bedded room, where he awaited test results
• 2242hrs he had a CT scan and returned to Adult Short Stay.
• 0305hrs he was seen by the surgical registrar
• 0700hrs was admitted to ward 34N. At this stage there were no symptoms that gave teams reason to consider he may be Covid-19 positive, based on HIS indicators. He was admitted into a four-bedded room at the front of ward 34N. Ward staff were wearing appropriate PPE for a surgical ward (ie surgical masks).
• He developed a fever during this time. There was still no cause identified for the abdominal pain.
• 0955 the consultant surgeon ordered swabs observing fever symptoms; clinical documentation records no cough, no loss of taste or smell, and patient had not been to any locations of interest
• Patient remained in the room post-swab because there were no isolation spaces on the ward. On advice from IPC the patient wore a surgical mask and curtains remained closed
• 1500 test result received with a low CT value
• 1620 patient moved to Ward 7 for Covid-19. Full PPE was observed.