A South Auckland health clinic has been hit by theft of precious protective equipment and soaring demand for appointments after Covid-19 arrived in New Zealand. Now, its doctors fear community transmission could be devastating for their patients.
Covid-19 could "rip through" South Auckland because of the high rate of overcrowded homes and underlying health conditions, a local GP says.
Dr Matire Harwood, from Papakura Marae Health Centre, said doctors in the area were worried about the potential for quick, harmful spread among their patients.
"We'll be very concerned once it gets into the community," she said. "I think it will go through areas like Papakura, areas of deprivation where overcrowding is an issue. I think it will just rip through those sorts of places really quickly."
The average household occupancy for most South Auckland suburbs is four, compared to 2.7 nationwide. Around half of Harwood's appointments are for patients with respiratory conditions, which are a risk factor for Covid-19. There are also relatively high rates of heart disease and immune-deficiency conditions.
Harwood met with a group of Maori doctors last week to discuss their options once community transmission was confirmed in New Zealand. They agreed that it would be crucial to be able to remove infected people with mild symptoms from crowded houses.
"It worked well in China, but we don't really have the infrastructure here, we don't have the funding and resources to set those up very quickly," Harwood said.
"People can have mild disease for the first seven or eight days but it's for the day nine or 10 when they deteriorate very, very quickly and desaturate. You've got to have medical staff there monitoring people and we're all struggling, we don't have enough people to be able to do that."
The group considered asking marae to take infected people in - as they did during the 1918 influenza pandemic - but decided this would place too much pressure on them.
Another option for crowded houses, which was being considered, was to require any positive cases to isolate themselves within their bedroom, only coming out briefly when other occupants were outside.
Harwood usually works two days a week at the small, prefabricated health centre, but has increased her shifts to four days to cope with overwhelming demand. The clinic has not had any positive Covid-19 cases, but it has had a surge in "medium-level anxiety" cases, she said.
"We are inundated in the clinic with people with flu-like symptoms. There's been more people who have had things for years and years but have decided on a Friday afternoon it needs to be diagnosed right now.
"It's anxiety in the community. It's made Maori worry about not just becoming infected but their health in general."
After the Prime Minister's recommendation to reduce physical contact on Saturday, the clinic shifted to phone consultations. Video consultations have also been used, but many patients in the area did not have internet access.
The group of Maori doctors' biggest concern was that Covid-19 cases would overwhelm Middlemore Hospital's intensive care unit. Difficulty in accessing ventilators has been one of the primary contributors to deaths overseas.
New Zealand has around 180 intensive care unit beds. Hospitals are racing to treble this number, and to train enough staff to be able to use ventilators.
Another concern was the quickly-dwindling stocks of protective equipment.
When the number of positive cases starting to grow two weeks ago, large amounts of masks and gels were stolen from the Papakura clinic. Patients could no longer be left alone in doctors' rooms out of concern for further thefts.
"People were obviously panicking and thinking they should have stuff at home," Harwood said. "I wouldn't be surprised if we start seeing more of that behaviour."
The doctors at the clinic were also holding on their used masks and gowns in hope that they will be able to be cleaned and recycled.
"What we have got from the DHB isn't enough. But I understand that's across the country."
Director General of Health Ashley Bloomfield said today that supplies of personal protective equipment (PPE) in New Zealand were sufficient, but that they were being distributed to the places which needed them most.
Demand for the equipment would reduce as drive-in testing places increased, and as more consultations moved online, he said.