The Government yesterday stopped even pretending that it could stamp Covid out.
The Prime Minister had almost conceded as much on Monday when she said no one around the world had eliminated a delta outbreak.
But yesterday, Ministers began preparing the country for more cases and possibly as early as within a fortnight, for a rationalisation of who goes into Managed Isolation and Quarantine because they are likely to run out of space.
Caroline McElnay, the Ministry of Health’s Director of Public Health, said yesterday that she would expect a doubling of Covid cases in the Auckland outbreak over the next 14 days.
Yesterday there were 71 new community cases in Auckland.
In two briefings, one from Health Minister Andrew Little with officials and the other with Deputy Prime Minister, Grant Robertson, doing the daily Covid update, there was confirmation that the Government expected a long term rise in case numbers.
It seems one of the main consequences of this is that the demand for spaces in Managed Isolation and Quarantine could become well beyond the system’s ability to cope.
The Ministry of Business Innovation and Employment does not break down MIQ occupants based on whether they are arrivals from overseas or locals in there because they have tested positive for Covid.
They did report that there were 4105 in MIQ facilities and 374 in quarantine.
MBIE has obviously been scrambling for more quarantine space and on Sunday announced it was converting the Distinction Hotel in Hamilton into a quarantine facility.
“This change will mean the region has 110 quarantine rooms available for community cases, dedicated to the local community,” said the Joint Head of Managed Isolation and Quarantine, Brigadier Rose King.
But apart from adding rooms, the other plans to relieve pressure on the MIQ facilities when case numbers rise will be to allow people to be cared for at home and for changes to the MIQ requirements for overseas arrivals.
That comes with a realisation that most Covid cases do not require hospitalisation, in part because of the impact of the Pfizer vaccine.
That impact is seen in figures from Auckland, which show that of the 1622 cases recorded there in the current outbreak, 1285 were unvaccinated, and of the 129 in hospital, 100 were totally unvaccinated, and only three were fully vaccinated.
So as the cases arise, to relieve pressure on MIQ, many of those cases will now be cared for at home.
Karori GP and chair of General Practice NZ, Jeff Lowe, said the community care plan had been developed over several months.
“Covid is in our community, and it looks as though it’s here to stay,” he said.
“Currently, every positive case is sent to MIQ to manage, and when the case numbers rise to what is predicted, we’re not going to be able to send everybody to MIQ, so we need to manage it in the community.”
Last week, another Wellington GP, Dr Louise Poynton, the medical director of the Compass Primary Healthcare Organisation that the current goal was that practices who wanted to care for their own patients would do so.
But we will also develop a locality-based or surge workforce that can be called upon to assist where a patient is not registered or where practices need support due to large clusters enrolled with their practice,” she said.
Modelling by Te Punaha Matatini suggests there could be approximately 5546 cases weekly, 311 hospitalisations, and 33 deaths.
The current outbreak in Auckland, Northland and the Waikato has seen a total of 1622 cases since the outbreak began on August 17. Then only 38 per cent of the population over 12 had received their first dose of the Pfizer vaccine. But the country has been at various levels of lockdown since.
Yesterday, 83 per cent of the population over 12 had received their first dose of the vaccine.
Dr Andrew Connolly: Chief Medical Officer of the Ministry of Health, told the briefing the modellers looked at the worst-case scenarios.
“So as clinicians, we really have to worry about the worst-case scenario because if we plan for that, that means everything below that is broadly taken care of,” he said.
“We don’t want the modelling to scare the public.
“But it does emphasise that the huge value of the vaccination
“Every single jab we give means that we all have much better access to the health care we all need for any condition.”
Health Minister Andrew Little said the vast bulk of people who end up being infected with Covid in the future won’t go to hospital and won’t go to an Intensive Care Unit (ICU).
“They’ll be cared for in the community, and the vast majority of them will be cared for and recover at home.
“So we know that the importance of vaccination; if you’re unvaccinated, then you will, and you get Covid, you will get sick, and you would be likely to get very sick.
“And that raises the probability that you will wind up in hospital and possibly ICU.
“If you are vaccinated, you are less likely to get sick, and you will be able to be cared for at home or elsewhere in the community.”
The Compass email to Wellington GPs suggested community care after a patient tested positive for Covid might involve an initial assessment with public health, who would then make the decision about where they underwent isolation.
The majority would be likely to isolate in their home and would undergo daily telehealth checks.
Some patients (those who could not isolate safely at home) would be cared for in DHB run facilities.
But Robertson said yesterday that work was also underway on reviewing the placement of overseas arrivals in MIQ.
“At the moment, we have enough MIQ space to deal with the cases that are coming to it,” he said.
“But if they continue to come through at higher volumes, then we will need to start to move to a different process.
“Decisions about that are being worked on now so that they can be deployed as soon as they’re needed.
“Part of that decision-making process is a risk assessment process that would look at the risks of people coming across the border versus the risks of people in the community.
And he indicated the Government might have to move sooner rather than later.
“If the cases keep rising on the curve that they’re on and you look at the number of MIQ places that we’ve got, we will need to move in the coming weeks,” he said.
“But we’re doing that by working our way through what is effectively a risk-based process; looking at the border, looking at where we’ve got cases in the community and looking at what self-isolation looks like.
“Bear in mind; self-isolation was always part of the plan.
“We’re now needing to bring some of that work forward, but it is most definitely part of the plan.”