Wellington's overcrowded emergency department could not cope with a Covid outbreak, let alone the Delta strain, says an ED nurse.
The emergency department of Wellington Regional Hospital has been operating at capacity for months on end, with health, safety and security concerns officially lodged with management last month.
Patients are being treated in corridors as wait times for a bed have reportedly blown out to more than 15 hours at times.
The hospital says it has robust procedures and protocols in place.
But a nurse who has worked at the hospital for a number of years spoke to the Herald on the condition of anonymity, and said ED did not have the facilities to manage a Covid outbreak.
"Even if it wasn't Delta, I think Wellington would struggle to cope," she claimed.
"We don't have the isolation space that would someone with Delta would need. We'd need fair warning, which you don't get."
She said the ICU and ventilator capacity was not the issue, but the lack of space in the emergency department, which would be unable to limit exposure to the virus.
On July 6 the ED's health and safety representatives issued a Provisional Improvement Notice (PIN) to Capital and Coast DHB (CCDHB), which formally tabled health and safety issues such as overcrowding and feelings of unsafety.
The nurse claimed on the night the PIN was issued, there was just one nurse responsible for triaging more than 30 patients.
She said this staffing ratio made it hard for nurses to "have a full handle on what's going on."
She was concerned this level of overcrowding left the hospital vulnerable to virus outbreaks.
"If on the night the PIN was issued, a patient with Delta arrived, Wellington would have an outbreak of Delta," she claimed.
"If they sat in the waiting room for two hours, with those 35 other patients and their family members, all those patients would be close contacts.
"The swab would be out within daylight hours the next day and all those patients would have been exposed, with their family members".
Wellington Regional Hospital screened for Covid-risk at the door, but the nurse said this depended on the patients' honesty.
CCDHB Board Provider services director Joy Farley said all people presenting to the emergency department first had to undergo Covid-19 screening in a separate structure before they are able to enter.
"Screening is based on the Ministry of Health risk and case definition for Covid-19," she said.
"If someone meets the case definition during screening they are immediately masked, assessed, and taken to a designated area for triage."
CCDHB had "robust protocols and procedures in place" across its facilities to manage outbreaks of Covid-19, she said.
"These would be activated across our services, including in ED, in the event of an outbreak of the Delta strain of Covid-19."
Farley also confirmed there had been one nurse responsible for triaging on the night the PIN was issued.
"ED has two nurses undertaking triaging during the day, two in the evening, and one at night.
"On the night of 6 July we had one triage nurse on the night shift, as per normal, as well as a clinical initiatives nurse trained in triage covering the waiting room."
Since the PIN was issued last month there had been an increase in security in the waiting room, and nurses on shift to assist with triage.
Last month 11 nurses resigned within 10 days while the health and safety issues were being addressed.
Safe staffing is one of the key reasons nurses around the country are taking strike action next week.
New Zealand Nurses Organisation (NZNO) lead advocate David Wait said the PINs issued at emergency departments reflected staffing issues for nurses across the entire health system.
"In a way the EDs are the canary in the mine because they are the place that get completely overrun first," he said.
"But when they get backlogged they push patients into the rest of the hospital and the rest of the hospital suffers as well.
"You see it first in ED but it's happening in pretty much every area of the DHB system."