An unprecedented shift of cancer and other surgeries is taking place as hospitals send patients to private facilities to free-up space to fight Covid-19.
Hundreds of elective surgeries are being postponed, including for hip and knee replacements. Others that can't wait are being sent to private hospitals.
Richard Whitney, president of the Private Surgical Hospitals Association, said New Zealand's 39 private hospitals were stopping their own elective surgeries, to create capacity to take public patients.
"A number of DHBs have already commenced referring their non-discretionary surgeries, such as cancers and the like, to private facilities for them to do on their behalf. Others are in discussions with DHBs to do similar," said Whitney, also chief executive of Mercy Hospital Dunedin.
Funding would follow work undertaken, he said, which would likely be managed by a "mix" of public and private systems.
"The public and private sectors share a number of staff, specifically the medical staff. So it may well be that doctors public time might be used in the private sector, to do some of that.
"But generally there would be the intention of a private facility providing all that's required, so the public system isn't distracted or reduced in capacity."
Private hospitals have a total of 174 operating theatres, 31 procedure rooms, 37 ICU beds, and 44 high-dependency unit beds.
The public system's intensive care units already run at about 80-90 per cent capacity, without any Covid-19 cases. That means there are few beds available to cope with any influx caused by the virus.
Using private ICU beds for non-Covid public patients would free-up capacity in hospitals such as Auckland. There are also huge efforts underway to treble the number of ICU beds in the public system, with staff including anaesthetists preparing to work in intensive care.
Some have chosen to live away from their families for the foreseeable future so as to limit the threat of transmission, and Auckland DHB and others are looking at providing accommodation.
Stopping Covid-19 from spreading within a hospital is a huge challenge and essential to protect other patients and staff. If the latter fall sick then workforce shortages and burnout can quickly become a problem.
Some DHBs have ordered around-the-clock building work to construct more negative pressure room facilities, which use lower air pressure to stop internal air from reaching the rest of the hospital, allowing patients with infectious conditions to be isolated.
Sarah Dalton, executive director of the doctors' union, the Association of Salaried Medical Specialists, said it made sense to go further and designate as much of a hospital as possible for coronavirus patients, if the situation demanded it.
"If people are known to be unwell but not with Covid, where possible it's much better to be able to put them somewhere else. It's much better for the health staff as well."
New Zealand has 283 confirmed or probable infections. Seven people are hospitalised and are stable. None are in ICU.
Dr Andrew Stapleton of the Australian and New Zealand Intensive Care Society has pleaded with New Zealanders to respect the level 4 restrictions: "Most of us are going to get Covid and be fine ... but we mustn't all get it at once, because the few resources we've got will be overwhelmed. And then people who could have been saved, won't be saved."