Healthcare staff shortages are continuing to bite at Auckland's managed isolation hotels, where existing staff have agreed to more restrictions on their freedoms.
Unions say nurses are having to work overtime, or take on double workloads, to fill the gaps.
No visits to places where vulnerable people might be present, like hospitals, retirement villages or prisons - and no taking up any second jobs - are among the new terms of employment signed by MIQ healthcare staff last week.
Nurses Society director David Wills said they were sensible precautions for stopping the spread of Covid-19, already agreed "in principle" by most staff, with major implications for some nurses' day-to-day lives.
"People that have flatmates who work in healthcare facilities and other settings, or have vulnerable family members, those people have to move into hotels. They're living in the hotels not for 14 days like the guests, but for nine months - the duration of the contract," he said.
Wills said the gradual increase in restrictions on people's freedoms was narrowing the pool of potential employees for Auckland's managed isolation hotels.
A month ago the Nurses Organisation said a switch in employment contracts had prompted some staff to resign.
The DHBs said shifts were being filled with nurses from agencies, or other managed isolation hotels, while more staff were being recruited.
Since then, Wills said there had been some progress in terms of recruitment, but not enough.
"There are challenges. People are having to work longer hours - some people are working overtime, and the nurses have heavier workloads than would be desirable. Gaps are having to be filled by agency staff from time to time still, and in situations where there might have been two nurses normally for a floor, there's one. So these are significant."
The Northern DHBs declined to comment on employment contracts due to confidentiality and did not comment on the extent of the shortage - other than to say agency staff currently make up 15 per cent of healthcare workers in Auckland's managed isolation hotels.
But in a statement, a spokesperson said just 6 per cent of the hours paid to DHB staff in Managed Isolation and Quarantine Facilities last pay period were for overtime.
The DHBs didn't say if staff were taking on extra workloads, but said they were in a "transition period" - and thanked them for their patience and professionalism.
Meanwhile, Wills fears ongoing concerns about surgical masks being provided in the hotels - rather than more robust N95 face masks - will also put more people off the job, or prompt existing employees to leave.
He said there had been little progress in two weeks, since Covid-19 Response Minister Chris Hipkins said he'd sought further advice from the Ministry of Health about the use of the N95 masks.
The Nurses Organisation is also keeping a close eye on it, and its kaiwhakahaere, Kerri Nuku, said members had been threatening to walk off the job if their concerns aren't heard.
"That's still pretty much on the table... this is a crisis point, this is a critical situation."
Nuku said approaching a Christmas influx of returnees, it was vital the facilities were well-resourced in terms of both equipment, and people.
Her union has asked the government for an urgent review of managed isolation working conditions.