A premature baby, whose mother came into Auckland Hospital's neonatal intensive care unit with Covid-19, has died.
The parents were allowed out from quarantine to farewell their baby - but the nurses' union say staff were told only shortly before they arrived, and that's created "mistrust and lack of confidence" in protocols designed to prevent infection.
The visit to the neonatal intensive care unit (NICU) happened on Thursday night. It's understood the mother and partner returned from quarantine the next day, and were able to be at the hospital when their baby died.
The baby was born prematurely and did not have Covid. No other babies, parents, and staff have tested positive.
Nurses Organisation kaiwhakahaere Kerri Nuku said losing a child in such circumstances was extremely sad and difficult, and she extended her condolences to the family.
However the union was also concerned with how the visits were communicated to staff, and says this reflects a wider problem around Covid protocols at the country's biggest hospital being made with little consultation with frontline workers.
NICU nurses were told of the impending visit about 15 minutes before the couple arrived late on Thursday night, the Herald on Sunday understands.
"No nurse or anybody in the health sector would want to limit anybody's opportunity to be at the bedside with a very sick child. What is concerning our members is the poor planning and poor engagement," Nuku said.
"It was a really short notice that [nurses] were made aware that the parents were visiting. And this sort of poor communication and planning just puts everybody at risk, and therefore creates this mistrust and lack of confidence."
Auckland DHB Covid-19 incident controller Alex Pimm said comment wouldn't be made on individual patients for privacy reasons. However, the safety of staff, patients and visitors was the utmost priority.
"I would like to express my heartfelt sympathies to the family involved. Our thoughts are with them at this difficult time.
"As general comment, our NICU team provides high quality intensive care for very sick and often very premature babies and their whānau. We know that it is important for whānau to be able to be with their baby during what can be extremely difficult circumstances."
The DHB has robust infection prevention and control measures in place, Pimm said, and the NICU team had provided exceptional care during a "challenging and fast-moving week - we thank them for all they have done to keep our babies, whānau and each other safe".
"We routinely care for and safely move Covid-19 positive people around our hospital sites on dedicated pathways. We are confident our processes and measures are appropriate to keep everyone safe."
Auckland DHB referred questions about the exemption to the Ministry of Health, which declined to comment, citing privacy reasons.
"Exemptions are considered by public health officials on compassionate grounds and in exceptional circumstances when the safety of patients, staff and family can be ensured," a ministry spokesperson said.
Last Sunday Auckland DHB announced a parent of a NICU baby had tested positive for Covid-19, and that movements in and out of the unit would be restricted, with all staff, whānau and babies in the unit tested as a precaution.
The mother who tested positive for Covid and her partner were taken to the Jet Park quarantine facility. She was not an inpatient at the hospital and had visited NICU before learning she had the virus.
All NICU access was stopped for 48 hours, to allow cleaning and while all babies were tested. Parents who weren't inpatients weren't allowed in until they returned a negative test, and a large number of staff, including 19 nurses, stood down.
A hospital source said the parents arrived about 9pm on Thursday night, and stayed with their baby for several hours.
There was no time to ask those on duty if they were comfortable being there during the visit, the source said, and a volunteer to be in the baby's room would have been found, had that process happened.
They claimed there was an overall lack of planning and protocols in place to keep both staff, babies and families safe, despite Delta spreading in Auckland and beyond: "This is not going to be the only Covid-positive mother in hospital. If we don't have firm goal posts, we're going to end up killing a staff member."
On Friday afternoon NICU clinical leaders sent an email to staff, acknowledging how stressful the past week had been, and praising their "incredible" work.
Several NICU nurses from Waikato DHB had offered to come and help, they said in the email, which addressed the overall response since the Covid case, and not the parents' subsequent visits.
"Our approach to Covid exposure events is constantly changing as we understand more about spread in different environments, vaccination status changes and as we have access to other tools like rapid antigen testing," staff were told in the email, seen by the Herald on Sunday.
"I also want to acknowledge that, because managing this has needed our teams to move fast, we haven't managed to keep up as well as we should with communication. So apologies about that."
The Ministry recently purchased 100,000 rapid antigen test kits, which produce a result in just 15 minutes and have also been piloted at Middlemore Hospital. The Government had previously been sceptical of the technology, citing concerns they are less accurate than the standard nasal swab PCR tests.
Rapid antigen testing started for parent visitors to Auckland Hospital NICU on Wednesday, and for staff on Thursday, and will be used until at least October 18.
Last month Auckland DHB tightened its overall visitor policy, after the Nurses Organisation accused them of playing "Russian roulette" with patient and staff safety, because of rules that allowed 600 daily visitors during the Delta outbreak.