The health sector is preparing to tackle a backlog of elective surgeries after the Covid-19 lockdown. Photo / File
The health sector is preparing to tackle a backlog of elective surgeries after the Covid-19 lockdown. Photo / File
Medical experts say now is time to "get on with it" and clear the backlog of tens of thousands of surgeries put off under lockdown as the country moves to alert level 2.
This afternoon Prime Minister Jacinda Ardern announced the move from alert level 3 would take place on Thursday, allowing retail, malls, cafes, restaurants, cinema and other public spaces, and all health services, to restart.
Under level 2 health and disability care services should be able to operate normally where possible. Like level 3 and 4, primary care consultations should be done over the phone or via video call if possible.
Under level 4 restrictions, most electives (medical or surgical services that aren't required immediately) were postponed, as hospitals diverted resources and capacity to prepare for any surge in Covid-19 patients.
Urgent and semi-urgent elective surgeries resumed under level 3 and more of these, including non-acute cases, are likely to be carried out at both private and public hospitals during level 2.
Australasian College for Emergency Medicine president Dr John Bonning said health departments had heavily reduced their workloads over the past two months in anticipation of a flood of Covid-19 patients.
This came after the Ministry of Health acknowledged its intensive care unit and ventilator capacity, found to be needed in five per cent of Covid-19 cases overseas, was not up to scratch.
With about 5 ICU beds per 100,000 - including the private sector - the country paled in comparison to Australia with 9, and the European average of 11.5.
"There have been a lot of missed elective procedures and cancer diagnostic appointments," Bonning said.
"I've heard of some catastrophic situations, so while we need to still be sensible we are really looking forward to ramping it up again to address the backlog."
To plug the shortage, the Ministry sought to triple its ICU capacity, and since March has increased it from 176 to 358 as of April 29, pledging to increase that further to 552 by July.
There are also now 334 ventilators available.
Under level 3, some elective surgeries and cancer screenings had resumed, and this would start to pick up even more at level 2, Bonning said.
It was important the backlog was cleared in the most equitable manner possible, with measures such as prioritising Māori and Pacific patients - as discussed by northern region DHBs.
"There are people who are really suffering from not getting the services they needed, and as we start picking up again we need to think wisely about how equitable is, and those who are really in need, not the 'worried well', are the focus."
While the country had "done well" in keeping Covid-19 at bay and reducing avoidable injuries, it was important this continued.
"We're pretty keen to get on with this stuff, but we need everybody to be sensible, to play their part of the team," Bonning said.
Dr Rawiri Jansen, co-leader of Te Rōpū Whakakaupapa Urutā, a national pandemic group formed by Māori medical and health experts, said it would be "extremely negligent" if district health boards returned to a business-as-usual approach.
"Taking an evidence-based approach to the resumption of services is necessary, and wherever required, Māori access to diagnosis and treatment prioritised to ensure that the backlog of treatment does not see Māori at the bottom of the list."
Seeking healthcare at level 2
According to the Ministry of Health, telehealth and virtual appointments are still the preferred option for medical treatment at level 2.
In most situations people should phone their GP for advice.
Extra caution is urged for vulnerable groups seeking treatment.
Clinicians can only see patients face to face if they have proper Covid-19 symptom screening, physical distancing measures, and infection prevention control measures including PPE where required.
The basic principle is if patients are sick, they must stay home and get tested.
Clinicians will be able to travel within and to neighbouring regions to provide care to patients and receive training.
Group treatment – such as exercise classes - can occur so long as physical distancing is in place.
Clinicians must keep accurate clinical notes to aid contact tracing if required.
Employers are responsible for conducting risk assessments for staff moving back into work premises during level 2.
This may include individual discussions with each staff member prior to returning to work.
There could also be a further relaxing of rules in regards to visitors to hospitals, although these have not yet been clarified. Under alert level 3, patients were allowed one visitor a day.
Previously the Government had indicated at level 2 people could attend gatherings of no more than 100 people, including weddings, tangi and funerals, but today Ardern announced the country would have to wait another two weeks.
The Funeral Directors Association called the level 2 announcement "cruel and without compassion".
President Gary Taylor said they were led to believe that level 2 would allow for funerals of up to 100, and they had already worked with its members with advice and guidance on how to manage them safely.
