Demands for Covid-prevention measures to be dropped as the outbreak escalates are ill-placed, distracting and, frankly, confusing, writes Elspeth Frascatore, an emergency department doctor in Auckland.
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As an emergency medicine specialist in Auckland, I have experienced the same pervasive feeling of foreboding that every other New Zealander has felt over the last few months. The knowledge that, at some point, it will be our turn to grapple with Covid. We have watched as the US, the UK and Australia took their turns, using different techniques and with varying degrees of “success” (whatever can be considered “success” in Covid times), and waited with bated breath for that first case of omicron on our shores.
It first arrived in our MIQ facilities on December 16 2021, and knocked patiently at our doors for two weeks before it made it into our community. By January we had an average of 20-45 daily cases, and we held the line with surprising success until February, when omicron finally spread its wings and soared through our community. Today Aotearoa New Zealand has one of the highest R values for omicron in the world. As I said, clearly it’s our turn.
It’s easy to quote numbers. Seven thousand daily cases. Ten thousand. Fourteen thousand. But what does that mean in reality? Or most importantly (this is a pandemic after all), what does that mean for our healthcare system?
Ironically, the status of the healthcare system seems to be getting lost in the noise. And there is a lot of noise. There’s the banging of the drums down on parliament lawn in Wellington, demanding an end to mandates, along with myriad other things. There are people marching across the Harbour Bridge, blocking traffic and a major thoroughfare to Auckland hospital, the major trauma centre for the city. The “occupation” has spread more recently to Auckland Domain, a stone’s throw away from where Auckland City Hospital is currently treating 100 Covid inpatients. Meanwhile opposition politicians (and ex-politicians) emerge – most recently with Act leader David Seymour calling for an end to most Covid restrictions*.
We currently have 82,105 active Covid cases, with 14,633 in only the last 24 hours. Fifty-six people have died, 344 people are in hospital, and all these metrics are disproportionately affecting Māori. Categorically, now is not the time to lift all restrictions. Such calls for a complete U-turn in Aotearoa’s extremely effective Covid response are ill-placed, distracting and, frankly, confusing.
Any healthcare worker in a GP clinic, urgent care or emergency department across the motu will tell you: Covid is not finished with us. It’s just getting started. While the protesters protest and the politicians politick, Covid is rearing up right under our noses. Ask any healthcare worker, they will tell you what the “truth” of Covid is.
After our alarm goes off and we wipe the sleep from our eyes, we mentally prepare. We remember anew that fate has decided we must practise medicine during a global pandemic. On arrival to work, we RAT test ourselves. Ten minutes later, we know if we will stay on at work today, or whether we will become another Covid statistic and have to go home. If we are Covid-free, we get to work. Our team is often thinner than normal (an increasing proportion of our staff have Covid), and we often have to work harder to cover for the absences, but we put our heads down and do it.
As expected, an increasing proportion of our patients have Covid too. They are anxious and sometimes scared, understandably feeling isolated in their single rooms. We don our PPE, for the umpteenth time that day, and head into their rooms to assess them. If they are well enough to go home, we work through their needs – how will they cope self-isolating? Do they have a working phone? Pets? Do they have enough medications? Do they have children or are they a carer? Do they have enough food? Money? Do they feel safe at home? This is vital work, but it takes time, and we do our absolute best.
Meanwhile, more patients arrive and our senior doctors and nurses work hard to make sure every patient is triaged and placed safely. At times, the sheer volume of patients in our hospitals or arriving at our doors makes that task hard, but we keep working to provide the best care we can. A lot of patients have Covid, but that doesn’t mean that all other medicine stops. A lot of patients also have heart attacks, strokes, appendicitis, trauma and mental health crises. Some have both – Covid and a broken arm? Yep, that happens. At times the enormity of what we are being asked to do is overwhelming, but we adapt and keep going, as that’s what we’ve been trained to do.
We can’t eat or drink at work, as we are in N95s at all times. Occasionally we step off the floor to have a drink or snack. Perhaps we take out our phone and look at Facebook or Twitter. It’s in that circumstance that we will see it. Standing in the coffee room, N95 in hand, drinking a glass of water for the first time in hours. “Remove all restrictions!” or “Masks are useless!”. What do we feel? That’s hard to describe. Dejected? Frustrated? Hopeless? Yes. But I think the best descriptor is this: unseen. We feel unseen. Ask us. We will tell you.
We need some restrictions. We need masks. We need physical distancing, open windows, self-isolation of Covid cases and household contacts. Why? Because without that, we are overwhelmed. Not just “the healthcare system is overwhelmed” but we, your nurses and doctors, are overwhelmed. We need the people of New Zealand to help us get through this. We can control what happens when someone arrives at our doors, but that’s where our control ends. We are relying on the people and politicians of Aotearoa to help us, so that we can do our job: helping people.
*This article previously stated that Seymour was echoing the protesters’ demands. The claim has been removed and Seymour has provided Act’s full Covid-19 policy.