The Health Minister has admitted there were gaps in hospital preparations for the Delta outbreak and that frontline workers are under "extraordinary pressure" in the latest phase of the pandemic.
In an exclusive interview with the Weekend Herald Andrew Little acknowledged the strain could continue even if high immunisation coverage is achieved, because variants like Delta will put the unvaccinated minority at significant risk.
The workforce is "not only having to deal with and adapt to responding to the Covid virus, but also, it is an understaffed system, there are a large number of vacancies, and public expectation about being kept safe is very high," Little said.
"I get very disturbed when I get the stories, and there have been a lot of them, of nurses and other clinicians finishing their shifts absolutely exhausted, and finding it really hard to go back to work the next day.
"There is a lot of thinking about how we effectively respond. But actually what we need to do is build the workforce to the level it needs to be, and work on procedures that will keep them safe, both physically and mentally as well."
Overall, DHBs had done extraordinary work preparing for the current and future outbreaks, the Health Minister said, but "some things I think could have been done a little better."
That included increasing intensive care capacity.
The Government has bought more ventilators and funded extra ICU beds, but specialists say actual day-to-day capacity hasn't improved since the pandemic began. That's because each patient needs one-to-one by an ICU nurse. They need years of training and experience and are paid more overseas, including in Australia.
DHBs have emergency plans to scale up ICU capacity, including by seconding other staff to help under supervision. This week Auckland hospitals asked for up to 30 ICU nurses to be sent from elsewhere in the country to help manage workload increased by Delta.
"There was extra funding provided last year, and an online module for more nurses to do ICU learning, so that they could go into an ICU environment if they were called for," Little said. "Some DHBs got on top of it. Others haven't so much.
"And I have been working with the ministry in the last couple weeks just to make sure that we have a programme of work in the months ahead."
Another area that will be a focus is ensuring DHBs fit their staff for respirator masks, Little said. The Weekend Herald recently revealed nurses at Auckland City Hospital who were yet to be fitted for a mask were nonetheless being asked to wear them. The fitting process takes about 20 minutes and is important to make sure airborne particles can't get through.
Covid-19 Response Minister Chris Hipkins confirmed last month to the Herald that he had asked officials for advice on making the Pfizer vaccine mandatory for health workers in contact with confirmed Covid-19 cases.
Little indicated that mandatory order could be much broader and encompass much of the frontline health workforce. A decision would likely be made in the next few weeks, he said.
"We have been talking to health unions about that. When you just think about the level of risk, particularly in hospitals and other healthcare facilities, and now with these new variants upon us, and we have seen the impact of the Delta variant, we do have to take seriously the way we protect that frontline health workforce."
National's health spokesperson Dr Shane Reti said yesterday the Government should explain why more ICU bed spaces weren't secured in the five months since Delta first appeared in MIQ facilities.
"Labour has clearly failed to listen to experts and the international experience in dealing with a Delta outbreak," Reti said. "Despite the country now in the midst of such an outbreak, it still doesn't have a plan to build up our ICU capacity, putting New Zealand lives at risk."
National also wants visa categories to be re-opened and residence applications prioritised for critical healthcare workers, as well as offering residence class visas on arrival to experienced nurses.
Shortly before the current outbreak nearly 30,000 New Zealanders were waiting too long for hospital treatment or appointments. DHBs have estimated more than 4500 planned procedures have been postponed so far this lockdown, a figure that doesn't include first specialist appointments and follow-up consultations.
"Even before this lockdown there were still some postponements that had to be managed. And this lockdown will cause some more," Little said. "The DHBs are, as I observe it, coordinating a lot more with the help of the ministry as well, and are trying to get through those procedures."