Middlemore Hospital has been the epicentre of the Delta outbreak in Auckland with up to eight hospital admissions per day since the outbreak began. Eight weeks into the Delta outbreak there have been 1,200 cases* in the Counties Manukau region, which is over a third of all reported cases in New Zealand.
Auckland is the gateway to New Zealand and many of the managed isolation spaces available to support the border restrictions are in the Auckland region. The Middlemore team have provided the clinical support for the provisions of health services to the managed isolation facilities.
At every level the Counties Manukau Health teams’ work has been impacted by COVID, from providing care for patients with the highly contagious virus, adapting how outpatients care and services are delivered, revising the patient and visitors policy to the hospital, implementing infection prevention and control measures like PPE and pathways for patients with COVID, to following Ministry of Health isolation and stand down advice of its own staff.
The team have kept up to date with what treatments and challenges international clinical counterparts have experienced and implemented, and meetings to manage patient pathways with specialists in intensive care, infectious diseases, and respiratory care occur daily at Middlemore.
To ensure the safety of patients and staff, special processes have been set up such as streamlining the pathways for COVID patients, establishing respiratory wards and increasing staff levels where needed, like the patient and visitor screening.
“Most patients we have treated in hospital during the first weeks of this outbreak were not vaccinated,” says Deputy Chief Executive and Chief Medical Officer Dr Pete Watson
“Patients can get very sick with COVID - it’s a respiratory disease that can require intensive care and ventilation for the most unwell.
“We have set up a respiratory adult ward so we can isolate COVID patients from others, concentrate the equipment needed and monitor these patients in one area”.
“The work has been challenging and our people have worked tirelessly with constant change. Our values at Middlemore have been the foundation of how we work with Manaakitanga, kindness, and Kotahitanga, together, key to how our teams have coped with the one constant in this pandemic, change.”
The teams experience is now being applied to how services and patient care will be provided in the future. The ability to surge hospital capacity for COVID admissions and at the same time ensure the diverse community can access and receive the health services they need is the current challenge.
The focus is to ensure the entire system is well prepared as COVID patients require isolation, good ventilation, negative pressure and high levels of skilled nursing and other clinical care.
Long term planning at Middlemore includes capacity preparedness such as beds available, workforce planning, infrastructure, hospital pathways for patient entry and transfers, infection prevention and controls such as PPE, mask wearing, visitor policy and contract tracing. Service level planning such as cancer screening and testing for COVID prior to high risk aerosol procedures, birthing plans for patients with COVID, and the expansion of Telehealth for outpatient care are examples of how the services Counties Manukau Health delivers will be impacted as we learn to live with COVID.
“We need to be able to care for all patients in a safe way and scale up to deal with COVID admissions when we need to.
“Some projections estimate we could see over 1,000 COVID new cases a week in the Counties Manukau community during the peak of this COVID surge. The growing case numbers will lead to greater numbers of hospital admission resulting in pressure on our emergency and intensive care teams, and also stress on other hospital inpatient services, outpatient, maternity and mental health”
“COVID will eventually become like seasonal influenza where people do get sick every year and unfortunately some people will die from it. It will impact on how we provide health services for some time yet, and it means our determined focus on infection prevention will continue”.
The health advice is simple – get vaccinated to protect yourself, your whaanau, and community.
*Sourced Ministry of Health website: Total cases by Location 12 October 2021.