School holidays and winter ills are being blamed for an influx of patients at Rotorua Hospital's emergency department that has caused long delays.
People have had to spend "many hours" in the waiting room or stay up to 24 hours in the emergency department (ED) waiting for a ward bed to free up, a hospital leader says.
The hospital's chief operating officer Alan Wilson said the emergency department has had "a very busy two weeks".
"The hospital has had several days when we have needed to keep patients in ED much longer than desirable."
Wilson said there had been more patients than usual arriving at the hospital.
"Many of these patients have needed to be admitted, and many patients have been very unwell and have needed longer lengths of stay in wards.
"On several occasions and on many days over the last week, some less urgent patients waited for many hours in the waiting room, and some patients needing a ward bed stayed 24 hours in ED until there were beds available on the wards.
"The delays have been much longer over the last fortnight than usual."
Wilson said it was not one single thing causing the rise in patient numbers, but factors included "school holidays so more people in the district and some increases in winter bugs affecting particularly elderly and vulnerable people."
"We are expecting a heavy winter with the borders opened, more influenza, potentially measles and with Covid re-surge likely over the next six months."
Wilson said hand hygiene, social distancing, mask-wearing and immunisation would all help lessen the burden of disease in the winter.
He said the hospital could open 10 additional beds in winter if needed, on top of the 13 winter beds that were always available.
Wilson said the DHB encouraged people to contact their GP, pharmacist, or other health provider early in their illness to minimise the need to visit the emergency department.
"Seeking medical health [advice] early often stops patients becoming so unwell so that if they do end up need to go to ED they will not need to be admitted to hospital – which is better for everyone."
He also said getting the Covid-19 booster shot and the flu vaccine would reduce the likelihood of needing emergency care.
"The Rotorua Hospital ED usually functions very well – there are good people, systems and processes in place, and we monitor both the time people spend in the waiting room and the time people spend in ED before being discharged or admitted into a ward.
"The clinical team works hard to see the highest urgency patients immediately, but we aim for the least urgent patients to be seen within two hours.
"We need everyone to be patient, kind and respectful when they come to ED – our staff are doing their best and we really want patients to have the best and most timely care that is possible."
Royal New Zealand College of General Practitioners medical director Dr Bryan Betty said the country could be in for a "more pronounced" flu season this year.
He was not surprised to hear Rotorua Hospital was having capacity issues.
"We're getting reports of this happening all over the country."
He said it was "a combination of the pressures that we've been under with Covid, the pressures that we've been under in general practice ... and the upswing that starts to occur with other viral illnesses" in winter.
Also, he said there was "real concern" about children's vaccination rates against diseases such as measles and whooping cough, which he said had dropped back considerably due to Covid pressures.
He said viral illnesses such as flu and colds often arrived from overseas.
"That traditionally puts a lot of pressure on hospital services and general practice services in winter."
He said there was concern the last two years of having reduced flu infections could lead to a "more impactful" comeback this year.
"It's potentially going to be a more pronounced flu season this year.
"Potentially our natural immunity to flu is reduced, same with other normal colds and flus ... we are concerned about how bad it will be this year."
He said it was "incredibly important" to get the flu vaccination if you can.
"If you normally don't get one, this is certainly the year I'd be recommending it.
"I can't stress it enough."
He also encouraged parents to catch up on their children's vaccinations which they may have had to delay due to lockdowns or difficulty getting GP appointments.
He said the vaccination rate for children nationwide was 82 per cent, and needed to be 90 per cent for the population to be protected.
"We're certainly having sleepless nights over that at the moment."
He also advised people to continue wearing masks, social distancing, hand hygiene and coughing/sneezing into their elbow to protect against all viral illnesses.
David Honore, a pharmacist at Unichem Central, said he had not seen an increase in people presenting with cold or flu symptoms.
"Most people who've got symptoms don't come in - we don't want them in the shop if they've got symptoms ... so we're not going to be seeing them.
"They probably present up in Accident and Emergency more than they would at pharmacies and medical centres."
He said people with symptoms should phone the pharmacy instead of coming in.
"It's normal at this time I think for flu to be prevalent - we haven't had it for the last couple of years."
He said staff were doing a lot of flu vaccinations at the moment, and people could walk in at any time to get one.
Toi Te Ora Public Health's medical officer Dr Neil de Wet said "with the onset of the colder months we do expect increases in viral infections like influenza".
"This year we're likely to also have ongoing Covid-19 in our communities."
He said the most important thing people can do is get their Covid vaccinations and boosters and the flu vaccine, "especially if you are 65 or older (or 55 and over if you are Māori or Pasifika) or if you have an underlying health condition".