New Zealand Covid-19 resurgence - A timeline of events. Video / NZ Herald
A nurse wearing protective equipment tending a Covid-infected person at a quarantine facility was exposed to the deadly virus when a mask was removed during treatment.
An official investigation by the Counties Manukau District Health Board has determined the likely cause of the first healthcare worker to contract Covid-19 at the Jet Park Hotel in September, and detailed how the breach happened despite strict quarantine conditions.
The South Auckland region's top health official has described the infectious incident as "unlucky" and said she was confident the worker followed correct procedure.
Counties Manukau District Health Board chief executive Fepulea'i Margie Apa said a report traced the likely source of infection to the period when the healthcare worker was treating a Covid-positive returnee who became very unwell and needed immediate treatment.
During the medical emergency, the sick person needed to remove their mask.
Apa said the nurse was with the returnee for "some time".
The nurse was wearing full personal protective equipment (PPE) including a mask, and investigators found there were no breaches in the way she used her gear.
Her infection was picked up during routine border workforce testing.
"This worker was unlucky to be the first healthcare worker in almost six months of Jet Park's operation to become infected," Apa said.
"The healthcare worker did everything right by the patient, but their subsequent infection shows how tricky this virus is and how easily it can be spread."
The nurse was praised for her good subsequent infection prevention and control processes and for not spreading the virus to a single person.
A worker in full PPE at the Jet Park Hotel quarantine facility in Mangere, Auckland. Photo / Dean Purcell
The woman's close contacts were all cleared after completing their 14 days of self-isolation.
"She deserves our sincere thanks for her commitment to protecting us, the care she provides to New Zealanders as they return home, her professionalism and high standards," said Apa.
Jet Park, like all managed isolation and quarantine facilities, had a dedicated workforce, and this staff member was not working anywhere else at the time she became infected.
Apa said healthcare workers at managed isolation and quarantine facilities had high standards of infection prevention and control as a result of their general training and experience, which in many cases included hospital emergency departments.
All health professionals underwent training specific to Covid-19 before they took on the quarantine work - including how to protect themselves and their friends, family and community.
She said the nurse's infection at the border provided an opportunity to revisit protocols and emerging evidence to see what else could be done to protect everyone.
"What is most important is that where this happens, we see it as a chance to find ways to further strengthen our systems," said Apa.
"It's important to remember that managed isolation is still a learning environment as not only is the virus new, but also the managed isolation programme has only started up this year. In addition, hotels are not designed for the delivery of healthcare.
Despite the breach Apa said the quarantine and managed isolation systems were working well and health managers continued to learn more about the virus and how to best protect workers.
Even so in the past week two healthcare workers in Christchurch in contact with the infected Russian and Ukrainian seamen have succumbed to the infection.
So far, it has been contained to the two female workers. It's suspected the two women may have caught Covid-19 as infected foreign seamen were transferred from the isolation to the quarantine wing of the hotel.
Other contagion scenarios being explored include the women catching the virus from particles in the air while treating the fishermen or touching a contaminated surface.
But questions are being raised around the healthcare workers not using N95 masks to protect against the smallest infectious airborne particles.
A report released in September revealed almost 100 healthcare workers were infected with Covid-19 while they were doing their jobs during the country's first outbreak - equating to 10 per cent of all local cases.
Ministry data showed 167 healthcare workers contracted Covid-19 up until mid-June, with 96 of those "likely to have been infected" in their workplace.
