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The entire health system and not just ICU capacity should be our focus under omicron. (Image: RNZ/123RF)
The entire health system and not just ICU capacity should be our focus under omicron. (Image: RNZ/123RF)

The BulletinFebruary 24, 2022

‘The whole system is under stress’

The entire health system and not just ICU capacity should be our focus under omicron. (Image: RNZ/123RF)
The entire health system and not just ICU capacity should be our focus under omicron. (Image: RNZ/123RF)

The country’s hospitals, from the front door to the ICU, are struggling to keep up with omicron, Justin Giovannetti writes in The Bulletin.

Omicron will be a severe test of the country’s health system. Before omicron hit, a number of the country’s hospitals were at near-capacity the NZ Herald reports. Since Sunday, over 10,000 community cases of Covid-19 have been reported in New Zealand. What was witnessed when omicron appeared in other countries is now happening in New Zealand. While omicron often creates milder symptoms compared to earlier variants of Covid, the sheer number of cases can overwhelm healthcare systems. That sharp increase in cases is now being mirrored in hospitalisations, with 179 people in hospital as of yesterday. That’s nearly twice the number of hospitalisations reported during delta’s worst day and omicron is likely nowhere near its peak yet.

The Spinoff’s Covid data tracker has the latest figures.

The healthcare system has largely done all it can to prepare at this point. According to RNZ, some DHBs like Northland are preparing to erect field hospitals to deal with case numbers that could overwhelm existing wards. One positive bit of data is the lack of people in ICU, with only a single case reported—and that patient unfortunately is from the delta outbreak. There’s been a lot of focus on ICU capacity and what resources are available in the healthcare system. To get a better understanding, I spoke with Alex Kazemi, a doctor and formerly the clinical head of intensive care at Middlemore hospital about what’s happening. He made two important points.

Our focus shouldn’t just be on ICU at this point. With the high number of cases under omicron, every bit of healthcare from GP offices to hospitals will be tested. “The whole healthcare system operates close to capacity all the time and there’s not much slack, unfortunately. The whole system is under stress,” said Kazemi. “The focus has always been on ICU capacity because it was seen as a crunch point, but the strain is borne not just by the ICU, it’s across a hospital, from the front door up to the wards. It’s a system-wide issue without an easy, short-term fix. These have accumulated over years and there’s nothing that can be done to turn it around quickly.”

Beds aren’t a good metric of what we’re facing in the coming weeks. Data from the OECD earlier this year showed that New Zealand has one of the lowest number of per capita hospital beds measured in the group. It was the second worst, only slightly better than Mexico. While that’s a sobering statistic, buying beds won’t make a difference in this pandemic. ICU doctor Alex Psirides has written for The Guardian about the missed opportunity to prepare New Zealand’s healthcare system for today’s challenge.

Here’s Kazemi again. “People become fixated on physical beds and physical infrastructure when the issue is human resource. It’s about staff. Healthcare is delivered by people, not machines. Those numerical arguments about beds don’t reflect the system and that’s what everyone within the healthcare system is trying to say. Valuing those people is the important part of the system,” he said. That already limited human capacity is likely to fall over the coming weeks as health staff catch Covid-19 and stay home.

His advice: Get vaccinated, get boosted, follow health advice.

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