The need to have cases of Covid isolating at home should have come as no surprise to anyone once Delta conquered the elimination effort.
As the 221 rooms at the Jet Park Hotel reached capacity, those infected and unwell would need to be sequestered elsewhere. Inevitably, the Government was forced to swivel away from the managed isolation and quarantine (MIQ) system, due to the sheer volume of people testing positive for Covid-19 in Auckland, to an self-isolation quarantine (SIQ) system.
By the second week of November, 2000 infected people were living at home and those supporting them raised concerns the public health system was obviously struggling.
By then, we also had the results back from the Government's self-isolation trial for 150 business travellers, who variously described it as "shambolic", "disorganised" and "confusing".
One businessman received a text from the Ministry of Health, advising him to get a nasopharyngeal swab. After going out in his car and doing, he was sent a follow-up email, reprimanding him for leaving his self-isolation accommodation and warning of "associated offences and penalties for non-compliance".
Other examples were conflicting advice within the same instruction packs, such as when to be tested and even how long the self-isolation should last. All the warnings were sounded that this was a system in disarray.
However, much worse ensued when people began getting ill in self-isolation.
Under the SIQ protocols, people required to self-isolate at home and told to monitor their symptoms, using supplied pulse oximeters to monitor the level of oxygen in their blood. People embarking on SIQ are supposed to have an initial assessment from Auckland Regional Public Health and then be monitored by Healthline, with daily phone calls or emails to check on their condition.
Reports soon emerged of people with Covid-19 isolating at home who received no emails or phone calls or were asked to report oxygen levels even though they had no pulse oximeter and being offered throat lozenges and paracetamol as treatment.
One family watched as a loved father's condition rapidly deteriorated over five days until his death. They said they were told by Healthline his symptoms were normal and to offer him over-the-counter pain relief.
So far, there have been three deaths associated with people in the SIQ scheme. Retired Health and Disability Commissioner Ron Paterson calls the reported failings "a moral and legal failure of care".
Broadcaster Duncan Garner describes his current SIQ treatment as a "bumbling mess".
It is not everyone's experience. There are undoubtedly hundreds of people who have, and will, self-isolate through the infection and come out relieved and restored to relatively normal health.
But it is clear the SIQ system was launched without being fit-for-purpose.
There is plenty of international documentation on the sudden onset of serious outcomes with Delta. Shortness of breath is a frightening condition, without knowing when or whether normal oxygen levels will be restored.
Paterson is critical that DHBs and GPs have been left out of the SIQ scheme and he is right. This is no time for territorial agendas. Every available support agency should be deployed.