Imagine for a second that Hawke's Bay has 400 Covid cases in the community, more than six cases requiring intensive care, and more than 10 needing hospitalisation.
It doesn't, but Hawke's Bay District Health Board said it had been planning for this scenario since Covid first hit our shores.
Its updated September pandemic paper, called the HBDHB Covid 19 resurgence plan, provides an insight into how it will manage an outbreak in the region.
The plan, authored by the DHB's covid response team, would begin with contact tracing.
In the hypothetical scenario of 400 community cases, the DHB estimates it will need an additional 50 staff from the Public Health Unit for case and contact tracing.
The DHB said this is currently being worked on, and training schedules are being developed and implemented. It also plans some form of staff accommodation.
ELECTIVE SURGERIES CANCELLED
The plan states the Emergency Department would also be split into "hot and cold" patients - those who presented with Covid-symptoms and patients who didn't.
The hospital would create a separate isolation ward, a split emergency department, and a Covid ICU would be created.
There would be regular testing of staff in "hot areas" and rapid testing with less than two hour turnaround "will be required" to maintain differentiation of patients in ED, the plan says.
The DHB would test at least 2000 people per day if there were 400 cases in the community, with some tests sent to Canterbury to be processed due to potential backlog.
Some pharmacies could close temporarily for 48 hours to help process Covid-19 testing numbers, and 14 days if a sole-pharmacist operator had to enter self-isolation.
Elective surgeries would be "stopped", the plan said, and there would be an increased use of phone consultations.
VACCINES AND MEDICINES
The DHB's plan is to continue vaccinating, even in a significant outbreak scenario, but it may require a "shift in focus", depending on where the rollout is at when an outbreak occurs.
"General principles to be applied in the event of an outbreak are to ensure that those most at risk of infection from the outbreak are vaccinated immediately," the plan said.
"In a widespread outbreak, shifting the focus first to vaccinating people at risk of serious illness if they contract Covid-19.
"In either approach, an overall acceleration of the roll out plan may be desired, as might some reallocation of available vaccines to areas affected, should supplies of vaccines be limited."
The DHB plan notes it will also prioritise the delivery of medicines. The plan would be for them to be provided to at-risk people via a funded taxi service for short term while long term options are stood up, and long term if no other options are available.
That service would be run by willing community pharmacies for the short term, and long term if the DHB is unable to redeploy staff.
A last option is to redeploy DHB staff to provide delivery service for medicines via the use of a DHB vehicle.
As part of making emergency accommodation available for those who need it the plan also includes the confirmation that a managed isolation facility would be created at Kennedy Park Resort in Napier.
The plan also notes that the DHB is in the process of "identifying and confirming" an MIQ site in Hastings.
The other scenarios the DHB has planned for include one community case, 50 community cases and 200 community cases with 2 to 6 people in ICU, and 2 to 10 in the ward.
At 200 community cases the plan assumes Hawke's Bay would move to alert level 4 and the DHB would consider opening quarantine facilities in both Napier and Hastings.
The DHB expects at 200 cases there would be a 50 per cent decrease in elective surgery.