Saturday, November 27

Covid patients at Middlemore Hospital will soon be classified in a tent

Middlemore Hospital plans to set up a tent to classify Covid patients starting next week as Auckland prepares for a spike in cases.

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Photo: RNZ / Jesse Chiang

The number of daily cases in the city is expected to double within a fortnight to three figures, and the government said the outbreak was increasing faster than anticipated.

Middlemore Hospital emergency department and ICU clinical director Vanessa Thornton said the hospital was preparing for an increase in cases, including a tent in the emergency department to classify Covid patients.

“We are monitoring day by day, but we are planning for the tent to be ready by next week based on the predictions,” he said.

And a second Covid room was ready to go if needed.

The existing one had 17 beds and yesterday there were 11 patients, he said.

If necessary, additional nurses would be called in from other parts of the hospital and they were really stepping up to help the cause, he said.

Middlemore had a lot of experience treating Covid patients and knew what to do.

“It’s going to be a challenge if it gets very, very high, but we just hope that people will respond to things like the Vaxathon and other events to get vaccinated,” he said.

It was difficult to say exactly when the additional room capacity will be needed, he said.

The Middlemore teams looked at daily case numbers, had their own modeler, and received advice from colleagues abroad, including Australia.

All Auckland public hospitals have built additional negative pressure intensive care wards to prevent spread.

Patients will be moved around the city where there is space and there are plans to use operating room nurses and other staff as backup if necessary.

The Vice President of the Faculty of Intensive Care, Rob Bevan, who works in Auckland, said the UCI teams were eager for the predictions for the increase in cases.

Support staff from other parts of the hospital would be helpful, but Covid patients were particularly difficult, so fully trained intensive care teams would always be needed to provide supervision.

“Usually we have to admit these patients because they have difficulty breathing, because they are short of breath, which is a particularly distressing phenomenon,” he said.

“People will find themselves gasping for air with minimal effort, and that’s a scary situation.”

It was difficult to predict how busy intensive care would be in the coming weeks, and much depended on how many people got vaccinated as cases increased.

If intensive care were busy, there would be even more patients in wards, in emergency departments and in general practice in the community, he said.

Other hospitals have been preparing for that influx.

At Auckland Hospital, they built 18 negative pressure isolation wards for their Covid ward in about 10 days; There were only four when Delta arrived.

Both Dr. Thornton and Dr. Bevan wanted to assure people that they would receive good care if they had to go to the hospital, for Covid or other conditions.

But it was better to get vaccinated, which might help avoid the need for hospital care in the first place, they said.

Dr. Bevan said it was not too late to get protection for this outbreak; even one hit lowered the risk, but two made a big difference as to whether someone was likely to need intensive care.

Number of cases in Middlemore ‘gradually increasing’

Middlemore Hospital Medical Director Pete Watson said the triage tent outside the Emergency Department will help with the flow of patients, who will be screened for Covid-19 and placed in the appropriate area.

“Most of the people are getting [Covid-19] test, we are using the rapid antigen test as well as the PCR test.

“We are putting layer after layer of screening there now, so we continue to improve our ability to detect Covid at the front door and start treatment early.”

The number of Covid-19 cases in the hospital is “gradually increasing” as six appeared yesterday and four were admitted, he said.

When asked if he supported Auckland returning to alert level 4 to buy time for more people to get vaccinated, Watson said he supported any effort to increase vaccination rates.

“We don’t have a particular opinion on what the alert levels should be,” he said, but vaccination was “the key.”

“I think it is worth considering what we can do to increase it, because as we are seeing in Auckland, the numbers are increasing.”

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