Health Minister David Clark has announced hospitals across New Zealand are repurposing buildings so Covid-19 patients can be cared for separately from other patients.
At North Shore Hospital in Auckland, an entire building had been repurposed - its former Elective Surgery Centre - to treat solely Covid-19 patients, Clark said.
The Herald last week revealed the hospital would use the centre to do so and that wards would be cleared and triage tents used as hospitals prepared for an influx of coronavirus patients.
Tonight, Clark confirmed the move and released footage from inside the building showing the rapid transformation.
Fifty-one beds are waiting to treat infected patients at North Shore Hospital, including 37 ward beds and 14 additional intensive care unit beds.
"This work has been done very quickly and the public can be reassured that we are well prepared and ready to care for any patients with Covid-19 who need to be admitted to hospital for inpatient care," said Waitematā DHB CEO Dr Dale Bramley.
"The Elective Surgery Centre is a separate building to the main North Shore Hospital tower block, connected by an enclosed bridge that allows us to transfer patients between the two as necessary.
"This means we are able to keep COVID patients physically separate from other patients in
the main hospital."
He said staff had been running "intensive training" sessions in theatres to prepare staff for how to manage the particular needs of Covid-19 patients.
"Our people and our facilities are ready should we be needed.
"We have used the last week of the lockdown wisely, reconfiguring our services and
planning accordingly. We must prepare for all potential possibilities. We hope that those
preparations will not need to be fully activated, however we are prepared."
Clark said he was confident the repurposing would allow the country to be well prepared for any potential increase in Covid-19 patients needing hospital level care.
"Most DHBs [district health boards] are at around 50 per cent occupancy, and they have taken the opportunity to run intensive theatre training sessions to upskill staff on how to manage the particular needs of Covid-19 patients.
"The North Shore Hospital, and many other hospitals, have also been using the time provided by the lockdown and the reduced number of elective surgeries to prepare staff.
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"North Shore Hospital have also doubled their intensive care capacity, as we know from overseas experience that Covid-19 outbreaks put particular pressure on ICU beds."
If most of a hospital was dedicated to treating Covid-19, it was likely other patients would be sent to private and nearby public facilities. Auckland's major hospitals include North Shore, Waitakere, Auckland City and Middlemore, and other facilities such as the Manukau SuperClinic and Greenlane Clinical Centre.
Capital and Coast and Hutt Valley DHBs were working with private providers to ensure non-deferrable elective surgery could continue, Clark said.
"These include some cancer and cardiothoracic surgeries."
He said facilities were also being adapted across both DHBs to assist with any escalation in the care provided.
"For example, at Capital and Coast DHB they have created special spaces for Covid-19 with the ability to change bed numbers, depending on demand."
Stopping Covid-19 from spreading within a hospital is essential to protect other patients and staff. If the latter fall sick, workforce shortages and burnout can quickly become a crisis.
Some DHBs had ordered around-the-clock building work to construct more negative pressure facilities, which use lower air pressure to stop internal air from reaching the rest of the hospital, allowing patients with infectious conditions to be isolated.
Sarah Dalton, executive director of the doctors' union, the Association of Salaried Medical Specialists, said it was a "really sensible" move to designate Covid-19 only areas where there was capacity to do so.
"It just makes sense that if people are known to be unwell but not with Covid, where possible it's much better to be able to put them somewhere else."
Dalton said the most important thing was that all New Zealanders continued to maintain physical distancing and hygiene.
"In some ways there is a risk as the weeks go on that people will be tempted to be a bit slacker ... yes people will continue getting sick but the better we all are at physically distancing the better off we will all be and that will ensure that hospitals don't get slammed."
Richard Whitney, president of the Private Surgical Hospitals Association, told the Herald last week New Zealand's 39 private hospitals were stopping elective surgeries to create capacity to take public patients.
"A number of DHBs have already commenced referring their non-discretionary surgeries, such as cancers and the like, to private facilities for them to do on their behalf. Others are in discussions with DHBs to do similar," said Whitney, also chief executive of Mercy Hospital Dunedin.
Private hospitals have 174 operating theatres, 31 procedure rooms, 37 ICU beds and 44 high-dependency unit beds.
Using private ICU beds for non-Covid public patients would free-up capacity in public hospitals. Huge efforts are also under way to treble the number of ICU beds in the public system, with staff, including anaesthetists, preparing to work in intensive care.