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Hospitals are already short-staffed. Covid-19 could stretch them to the limit

It’s difficult enough caring for coronavirus patients, but when healthcare providers become sick themselves, or are forced into self-quarantine, it becomes even harder to cope. So how is New Zealand preparing for staff shortages in the health system?

News that 43 hospital staff have been put into self-quarantine after coming into close contact with a patient who tested positive for Covid-19 has highlighted the enormous pressure the health system could find itself under as a result of the virus. If one patient can put more than 40 healthcare workers and other essential staff into quarantine, how will hospitals cope with a serious nationwide outbreak? That was one of the big questions at a media conference on Saturday, when the Ministry of Health’s director-general of health Ashley Bloomfield attempted to allay fears about the ability of the health system to cope.

Warnings that New Zealand’s hospitals are understaffed and under-resourced are not new. The Public Services Association, the union representing workers in a large number of healthcare sectors, has repeatedly argued that chronic understaffing is putting patients at risk, while healthcare professions including GP, lab technician, emergency medical specialist and anaesthetist have remained on Immigrations NZ’s skills shortage list for years.

As DHBs prepare for Covid-19, those concerns remain. “We are stretched. We are really stretched,” Dr Deborah Powell, national secretary for the New Zealand Resident Doctors Association, told Stuff. “It’s not just our doctors and nurses, it’s our laboratory staff and our radiologists.”

Covid-19 experts agree. “We have excellent public health professionals in New Zealand, but we have to be honest that we don’t have enough for this task,” wrote Dr Ayesha Verrall, an infectious diseases physician and epidemiologist at the University of Otago.

A number of vulnerable frontline staff, including those who are pregnant or immune-compromised, have already been put on special leave so they aren’t exposed to the virus.

Auckland Hospital and Starship Childrens Hospital (Photo: Phil Walter/Getty Images)

So what is the government doing to ensure DHBs have the people they need – not just to cope with the increased workload, but to replace staff forced into self-isolation by exposure to the virus? Bloomfield said that a range of responses were being formulated, including talking to the Medical Council and the Nursing Council about ways to accelerate the recertification process for both doctors and nurses, to allow those who have recently retired from the profession to quickly return to their jobs if required. He did not mention any plans to up the numbers of lab staff and other technicians, a more difficult task given that there is already a nationwide skills shortage in these areas.

If a British survey of recently retired staff in their National Health Service is a guide, however, willingness among former staff to return to work is not to be taken for granted.

It’s not only DHBs that are facing staff shortages – rest homes could find themselves under severe strain if Covid-19 takes hold. The risk of death among those aged 70 or above is around three times the overall death rate and residential care homes are likely to be ground zero for any full-blown coronavirus outbreak. Kerikeri Retirement Village chief executive Hillary Sumpter told RNZ Checkpoint that beyond the known risks to residents, sickness and quarantine pose a real threat to safe staffing levels.

“A lot of our people are at hospital level care which means they need two people to assist them in their daily living at all times. So we would have people in very dire circumstances if we didn’t have staff,” she said.

Aged Care Association chief executive Simon Wallace told Checkpoint that while rest homes had plans in place for outbreaks of influenza or norovirus, Covid-19 is a whole new ball game, one that required a national-level response plan for the aged care sector. But there had been little communication from either DHBs or the government, he said. To put it bluntly, “they are ignoring us.”

The Ministry of Health says it has asked individual DHBs to liaise with rest homes in their area, and include them in their planning.

There’s another sector of the health system where a lack of staff could make a real difference to how well New Zealand deals with the outbreak. Healthline – 0800 358 5453 – is the most frontline of all ‘frontline’ services in the fight against Covid-19. This is the number to call if you are concerned you have been exposed to the virus, or worry you may have it already, or just want information on what symptoms to look out for (although it’s recommended that you visit the Ministry of Health’s Covid-19 information page first). As the general public’s first line of defence, the service is under strain already and could become even further stretched in the case of a widespread contagion.

However Bloomfield said he’s confident that Healthline will be able to cope. A significant number of new recruits are currently being trained up to take calls, he said, and the service can also call on DHB staff as back-up advisors. Pointing to the increased demand on Healthline’s mental health service following the Christchurch attacks, and during the recent measles outbreak, he said that the service has shown it could quickly “surge up” capacity if needed. One reason that’s relatively easy to do: Healthline staff can take calls from wherever they are, including from the place they live – making it perhaps the ideal job for anyone finding themselves unexpectedly marooned at home for up to 14 days.



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