A coughing, feverish 2-year-old boy "gasping for air" waited nearly 10 hours to be fully assessed in Rotorua Hospital's emergency department as demand for medical services surges.
Bernice Hill-Albert took her grandson to hospital on June 18 after she discovered that morning he had a high temperature, was coughing and "gasping for air".
During the 10-hour period in the emergency department, he was seen by nurses, a doctor and a practitioner to ensure he was drinking fluids and his fever was going down, she said.
After arriving at the hospital at 9.45am, he eventually got into a room at about 8pm.
Despite the wait, Hill-Albert said she knew "how much pressure" doctors and nurses were under and did not mind waiting.
Staff were "constantly apologising" for the wait time, to which she told them there was no need to apologise as she understood the pressure they were under, she said.
"I knew he was in a safe place so I really didn't mind how long it was going to take."
Hill-Albert's experience comes as Lakes District Health Board says its emergency departments are under "significant pressure" due to influenza and Covid-19 in the community, and the impact of illness on staff.
It also comes as an outbreak of 27 Covid-19 cases at a Rotorua Hospital ward forced its temporary closure to visitors and new admissions yesterday.
Rotorua GP practices are also experiencing "high demand", with some doctors and nurses working seven days a week.
On the morning of June 18, Hill-Albert was getting ready for work when she realised her grandson was sick.
"I knew something was wrong with my grandson because he [had a] quite high temperature, high fever and he was sweating.
"We knew straight away ... he had the flu because he started coughing and gasping for air.
"My quick instinct was [to] take him to the hospital."
They first went to Lakes PrimeCare Accident and Urgent Medical Care Centre but were told it would be a two-hour wait and they would have to wait outside, so they went to Rotorua Hospital.
Hill-Albert said they arrived at the hospital at around 9.45am, where there were already a few people waiting. She knew "straight away" they would be there all day.
"I knew how much pressure the nurses and the doctors are all going through at this time.
"I knew he was in a safe place so I really didn't mind how long it was going to take."
Hill-Albert left the hospital at 6.30pm when her daughter-in-law and son arrived at the hospital.
Her grandson got into a room at about 8pm and stayed overnight, as he had croup and the flu. He was discharged the next day.
"That was a long day for him, but he just slept."
Hill-Albert said staff did "a great job".
Lakes District Health Board chief operating officer Alan Wilson said its emergency departments were under "significant pressure" due to the impact of illness on staff and the types of illness patients were presenting with.
"Circulation of influenza remains high in the community and this has led to multiple admissions to hospital of both adults and children. Covid also remains high in the community."
On June 28, 14 people were in Rotorua Hospital with Covid-19. On June 23, there were just two people in the hospital with Covid-19.
Asked what a normal wait time in the emergency department was, Wilson said there were no normal wait times as it depended on how sick a patient was when they presented, how many other patients were waiting, and staffing levels.
"We try to treat people as quickly as we can ... We see patients in order of urgency so some patients may be waiting much longer than others.
"Unless it is an emergency, we encourage patients to contact their General Practice or to ring Healthline before coming to ED."
Asked how the pressure this winter compared to previous winters, Wilson said Covid-19 was now widespread in the community and New Zealand had a high level of influenza "that we have not had for the last two years".
Many staff had been getting Covid-19, catching influenza and needing to stay home for themselves or to look after sick children, Wilson said.
A statement from Lakes PrimeCare said it was experiencing "unprecedented demand" this winter.
There was "significant pressure on the whole health system" due to Covid-19, influenza, RSV and other respiratory infections which predominately featured in winter, the statement said.
This occurred in addition to the usual accident and medical volumes that Lakes Prime Care expected to see.
"Complicating this picture is the fact that our staff work at the front line of this infectious disease pandemic and have been susceptible to these illnesses themselves.
"Our staff are working incredibly hard to meet the current health demands for the Rotorua community during these extremely difficult times."
A Rotorua Area Primary Health Services spokesperson said its practices were experiencing "high demand" with some GPs and nurses working "extremely long hours", often seven days per week, to cope.
In March, Rotorua Area Primary Health Services practices delivered more than 31,000 GP and nurse consultations. In March 2019, the number of consultations was 19,179.
"This is an enormous additional workload for a general practice workforce that has not increased in size during this period."
Rather, it was "quite the opposite".
"We now have fewer GPs than ever before."
The spokesperson said more people were going to practices with symptoms similar to Covid-19.
"In the past, a great number of people with cold and flu-like symptoms never presented to general practice.
"Now with concerns for Covid and the need for testing, the numbers of people engaging with general practice are considerably higher."
To lower the number of patients presenting to the emergency department unnecessarily, its practices offered either drop-in clinics or had appointments set aside each day for patients requiring acute care, the spokesperson said.
Lakes District Health Board chief operating officer Alan Wilson said mask-wearing, hand washing and getting immunised against Covid-19 and influenza was "the best defence" for preventing illnesses going around.
A second Covid-19 booster was now available for people who are immuno-compromised as those working in healthcare.
From July 1, children aged three to 12 can get a free influenza vaccine, and the board encouraged all parents to take advantage of this.
"Flu infection rates are generally highest in children, and they're a major source of the spread of influenza. The flu virus may be found in respiratory secretions (breathing, coughing and sneezing) for two weeks or longer in children.
"If you're ill, stay away from people. The principles of social distancing are very sensible in stopping the spread of winter virus which was proven over the last two years with a major reduction in people needing to be hospitalised for viral illnesses."
'The clean-up was thorough and there is no ongoing risk.'