Covid 19 coronavirus: New Zealand's intensive care unit capacity revealed

A just-released stocktake shows there are only 153 intensive care units beds in New Zealand public hospitals, with current space and equipment to look after another 80 patients.

But the survey, which was put before Cabinet ministers last week but only released by the Ministry of Health yesterday, also indicated there were another 330 beds that could be used to take severe coronavirus patients.

That included 231 bed spaces outside ICU capable of looking after ventilated patients, and 99 beds which could be repurposed for ventilated patients, such as in high dependency units and gastroenterology units.

Altogether in public hospitals, there were 563 potential ventilator beds – and 520 ventilators, which included 237 anaesthetic ventilators.

In private hospitals, there were another 22 ICU beds, 24 ventilators and 194 anaesthetic machine ventilators, along with seven ventilators and eight transportable ones that could be sourced from elsewhere.

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Asked by the Herald how it was going to meet a potential surge in cases, a Ministry of Health spokesperson said it was working hard to expand capacity, "both in terms of facilities and staff, and working directly with ICUs managers in each DHB".

This week, Ministry of Health director-general of health, Dr Ashley Bloomfield, said he was "encouraged" by figures.

"The idea there is to not just be prepared, but complement measures we are putting in
place to reduce the risk of that worst-case scenario."

He pointed to new modelling, which indicated an ICU overload could mean the difference between projecting case fatality rates of 1 and 2 per cent.

Potentially tens of thousands of lives could be at risk if no hard measures were taken to control Covid-19, and a surge in cases hit hospitals.

Bloomfield said hospitals had already put in place plans to scale down activity such as elective surgeries and outpatient appointments.

Large numbers of booked elective surgeries were being cancelled across the country to make way for demand.

Dr Craig Carr, the New Zealand chair of the Australian and New Zealand Intensive Care Society, told the Herald hospitals were similarly racing to triple the number of staff trained to use ICU equipment like ventilators.

"You also need to have staff to look after these patients. Up and down the country, we are taking note of registrars and doctors who have moved through intensive care as part of their training schemes in the last three or four years."

Hospitals had also begun running "train-the-trainers" sessions where nurse educators were upskilled over two days, before training their own colleagues.

Anaesthetists, too, had undertaken intensive care training and would prove helpful in meeting demand.

"They use ventilators and look after sick patients in operating theatres every day, plus they're familiar with the same principles we use in intensive care."

New Zealand entered the coronavirus crisis well behind other countries for ICU capacity.
Its number of ICU beds per population had fallen steadily over the past 20 years, with the country now well behind comparable countries, including Australia.

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Doctors have also raised concerns about their ability to cope with the heavy demand.

"There is absolutely no fat in the system in terms of extra staffing and you can't just conjure up more doctors overnight," Association of Salaried Medical Specialists executive director Sarah Dalton said last week, after the Government announced an emergency cash injection for the health system.

"The situation will be exacerbated if hospital doctors themselves fall ill or are forced to self-isolate.

"Senior medical professionals are fully committed to caring for people with all disease, but in the case of a major Covid-19 outbreak, we have ongoing concerns about the pressures they and hospital services will be put under, and the ongoing effects of burnout and fatigue."

According to infectious diseases expert Dr Siouxsie Wiles, about one in every five or six people will need to be hospitalised if they contract Covid-19, and about 5 per cent will need intensive care.

About one in 100 are expected to need a ventilator to help them breathe.

The percentage of those who could catch the virus is highly variable, but many estimates fall around 40 to 60 per cent of the global population.

• Covid19.govt.nz: The Government's official Covid-19 advisory website