New modelling suggests Auckland will face well over a thousand daily omicron cases at the peak of a potential outbreak, but some are concerned the projections are underestimating the real risk.
If omicron breaks into the Auckland community at the start of February, cases will hit a peak of 1500 to 1800 a day within four weeks, before falling to 150 to 330 per day from May, according to district health board modelling.
The projections, prepared by Counties Manukau DHB’s director of population health Dr Gary Jackson, show the city will also face 175 to 190 hospitalisations on any given day at the outbreak’s height, with at least 10 to 20 cases requiring intensive care on any given day.
But based on overseas data, Jackson says there will be 50% less death from the omicron variant, compared with delta.
“People are describing omicron as a mild illness – if you’re vaccinated and boosted, but if you’re unvaccinated, you’ve still got the potential to be hit quite hard.”
But Jackson says the avalanche of cases isn’t an overly daunting prospect for the DHB’s staff, who have been at the forefront of previous outbreaks.
“We know it’s coming, but we’re prepared for it, and I don’t think it’s going to overwhelm us,” he says. “We’ve got the contingency plans for it, we’ve gone through it, like we did in October and November, and we can see how we’ve coped and we’ve developed some really good systems.”
He says there are currently around 180 ICU beds across Auckland’s three main hospitals, and Middlemore is working on establishing a more streamlined triage process in its emergency department to handle the influx of cases.
“[This outbreak] will take us up to our capacity, so we expect, like the delta outbreak, we’ll have to cancel a bunch of elective surgery, but we’ll try to keep the urgent surgeries going as we’re still playing catch up from last lockdown.”
But Jackson admits there could be “double or triple” the numbers he’s predicting.
“I’ve assumed that we will have a lower rate of cases than Australia, as we’ve had in previous outbreaks,” he says.
“Part of that is because our population is a bit more compliant and a bit more thoughtful about what’s needed around wearing masks and doing things like that, so I’m assuming that behaviour will carry on.”
However Dr Collin Tukuitonga, associate professor of public health at the University of Auckland, says if these predictions prove to be too low, the region could find itself caught out.
“I’ve been really surprised by the numbers in Australia, so 1800 a day seems a bit on the conservative side to me,” he says. “If these are the figures they are using to plan for the numbers of beds and workforce required, then it could lead to South Auckland being exposed if we find that we don’t have enough people to do the job and we don’t have enough beds.”
Tukuitonga says that while the outbreak in Australia has caused fewer hospitalisations than for previous variants, disruption has been felt in many other ways.
“In NSW we’ve seen even sectors like transportation affected, as bus drivers and taxi drivers have been getting sick, supplies to supermarkets aren’t getting delivered, and so that’s the other concern,” he says.
“We could see up to 25% of the health workforce being absent because they are sick themselves, so that’s the other side to this. Given that the health system is already stretched, omicron could still hit really hard.”
Tukuitonga says extra staffing for social service and community health providers is where the focus needs to be.
“While there will be fewer people needing to go to hospital, what that means is the pressure will be more on the community care, on GP practices and on community nursing, so that’s where the surge of staff and planning needs to be happen.”
Middlemore’s clinical director for acute critical and central services Dr Vanessa Thornton admits existing staffing shortages means “our hospital system will be under pressure due to the large number of people likely to be infected”.
“Health sector workforce issues that existed prior to the commencement of this pandemic remain … and like all employers in New Zealand we do expect workforce disruptions.”
Jackson reiterates that getting vaccinated remains a key tool for keeping this outbreak contained.
“As places like Spain and Portugal have shown, where they have similar vaccination numbers, vaccination rates won’t stop us getting lots of infections but it will stop us getting lots of serious illnesses and being boosted makes a big difference.
“So if it doesn’t come for another month that would be good, as we would have more people boosted, and more children vaccinated.”
But with the prime minister only providing scant details on the government’s plans for how it will deal with an omicron outbreak, and ongoing shortages in crucial medical supplies like N95 masks and rapid antigen test kits, the risks from an impending tsunami of cases can not be underestimated.