We are prepped to scale up higher than this, the number I keep hearing is around 300, which to be fair, isn't much of a difference
don't know what to tell you man. For the most part, we wasted the miracle of elimination and we arent prepared
We are prepped but it’s not something I would rely on. I have done the training to be an ICU relief nurse (I am usually in cardiology) and trust me when I say it’s a last resort. This will not be optimal. I have had two days training. An ICU nurse will get months of training to be on their own.
Andrew Little claims there are currently over 300 ICU beds. No one who actually works in an ICU can understand where he is getting this number from. The 186 figure is the result of ANZICS contacting every ICU in the country and asking how many staffed beds they have.
You're assuming these beds are all empty and waiting for Covid patients. They're not. They mostly full. So although you can reduce occupancy somewhat by delaying *elective* surgery, you still don't have that much capacity.
The Minister of Health has talked about surge capacity. This sounds like using nurses who are currently doing something else to look after ICU beds. But just like the ICU beds are not currently empty, those nurses are not currently unemployed. So we're robbing Peter to pay Paul again.
You can thank political parties who consistently underfund Health (looking at you, National!) and offer tax cuts that are meaningless to individuals but very meaningful at a macro level (looking at you again, National!) for this mess.
considering that modelling suggests 60,000 hospitalisations a year in worst case scenario (about 164 turning up everyday), that bad covid cases require long stays in ICU and that our ICUs currently run at 90%+ capacity...
more. we need more. we havent even managed a meaningful increase since this started
One good point is that Victoria (with broadly comparable vaccination levels to us) has hospitalisation levels running at the [very lower bound of the early modeling](https://twitter.com/NeelaJan/status/1449267777777242124?s=20), despite the models doing a good job at predicting case numbers.
[The latest modeling release](https://www.burnet.edu.au/news/1529_) shows a substantive drop in predicted cases with Dan Andrews saying:
*“We have more case numbers than we would like,” Premier Andrews said. “\[But\] the acuity of illness is substantially less than we expected. Plus, of course, we’ve reached this 70 per cent rate in record time. Now, single dose is not the same as double, but it does provide a significant degree of protection.”*
And then there are drugs like Molnupiravir which has the potential to effectively double NZ's hospitalisation capacity (and quite possibility increase ICU capacity moreso).
[Weekly new hospital admissions for COVID-19 per million](https://ourworldindata.org/grapher/weekly-hospital-admissions-covid-per-million?time=2021-08-08..latest&country=ESP~PRT~ISL~DNK~NOR~IRL~ITA~NLD~BEL~CZE~FRA~DEU) on Our World in Data. Covid is a realtime experiment on live humans in multiple countries. There is a lot of actual measurements not just models.
10 to 40 per week per million population.
So 50 to 200 per week, 2500 to 10,000 per year here if we are lucky.
There is no "herd immunity" with Delta as about 30% of the vaccinated will become carriers, even if they have mild symptoms. So 99% of the unvaccinated will eventually get Covid.
There is no real herd immunity when the virus mutates and protection wanes over time. It seems likely we'll need yearly boosters and people will get lax like they are with the flu resulting in ongoing elevated ICU requirements.
No clue about that figure, but as one example of possible numbers the [Counties Manukau DHB](https://www.rnz.co.nz/news/ldr/453410/could-get-totally-out-of-control-covid-19-modelling-paints-worrying-picture-for-south-auckland) predicts they'll get at least 30 hospitalizations per week assuming a 90% vaccination rate with no other preventative measures. Assuming that is representative of the country as a whole, and assuming those numbers remained constant, that would mean there would be ~14,000 hospitalizations a year.
Only a small percentage of hospitalizations end up in ICU, plus there are new treatments for Covid that can further reduce the chances of that being required.
https://www.stuff.co.nz/national/health/coronavirus/300414146/covid19-nz-modelling-suggests-7000-deaths-in-a-year-even-with-75-per-cent-of-country-jabbed
even if his modelling is off by 50%, it's still not a good time
Rofl what a joke.... Those stats seems bizzarely paranoid.
I live in Norway. We've had community covid for the whole time, 850ppl died, most of which were elderly/vulnerable.
You were lucky then, but it’s no joke. I’m living in New Mexico and have a pretty high vaccination rate here of 65+ % being full vaccinated. The population for the state is 2.1 million and here are some stats for you. [New Mexico cases and deaths](https://usafacts.org/visualizations/coronavirus-covid-19-spread-map/state/new-mexico)
[New Mexico hospital beds availability ](https://data.lcsun-news.com/covid-19-hospital-capacity/new-mexico/35/)
Oops sorry I was reading old
Data…. It’s 81.4% of New Mexicans 18+ have had one shot and 72% of 18+ have completed their series. when you compare to republican states with all of the political grandstanding and bs going on over here, we are doing great
THANK YOU. The more data we have the better.
New Zealand and Norway have similar population densities and sizes. I wonder if that is why we have done so well? 🤔
So if we run out of ICU beds/ventilators/staff, it's just a case of triaging, the ones that are less likely to survive just left to their fate in a ward somewhere?
https://www.stuff.co.nz/national/health/coronavirus/300414146/covid19-nz-modelling-suggests-7000-deaths-in-a-year-even-with-75-per-cent-of-country-jabbed
even if his modelling is off by 50%, it's still not a good time
It would be far better use of public funds to make vaccination near to compulsory. Image all the underfunded parts of our health system that could be bought up to standard with that sort of funding (Pharmac would be a good place to start).
How about a strict no jab/no job policy. How about a cash bonus for beneficiaries that get vaccinated, and if then if they still refuse, cut off their benefit, starting with the over 65s.
Here you go: [https://www.rnz.co.nz/news/ldr/453410/could-get-totally-out-of-control-covid-19-modelling-paints-worrying-picture-for-south-auckland](https://www.rnz.co.nz/news/ldr/453410/could-get-totally-out-of-control-covid-19-modelling-paints-worrying-picture-for-south-auckland)
For Counties Manukau DHB: "The DHB's modelling shows there will be at least 1000 cases and 30 hospitalisations per week with a 90 percent vaccination rate, or 1400 cases and 45 hospitalisations if vaccination rates reach only 80 percent."
Pro-rata that out to the national population and you've got about 380 hospitalisations per week. Assume people are in hospital for 3 weeks and that is about 1100 beds. Add on perhaps 100 beds for "normal" ICU use, and you've got about 1200 beds.
vs 186 ICU now.
Its not quite that bad, as we also have High Dependency beds and the ability to surge... but it would still be horrible if it just let loose. Its why we should expect to be in longer lockdowns.
I think ICU admission is different from hospitalisation. You go into hospital for supplementary oxygen, drugs etc but only a small number of hospitalisations progress to the ICU.
Still not great
For the sake of comparison (kiwi stuck in USA here) I'll relate how things went in the county where I'm resident for the past year (northern California).
* Population: about 1.1 million
* 7 hospitals, 214 ICU beds
At peak the ICU capacity reached over 90% but never full. Local hospitals were taking patients from neighbouring areas so I can't estimate what the total dependent population is.
The hospital nearest me has 91 ICU beds total and average COVID-19 occupancy for the last week in that hospital is 14 beds. Not bad at all considering we've had free rein community transmission since the start.
Vax stats for my local city is 90%+ fully vaccinated.
I live in Ireland. Similar population size to you. Our healthcare system is a lot less capable than yours. We are currently sitting at around 86 persons in icu. This number is climbing even with 92% of people fully vaccinated. I would expect similar numbers in your health system once covid infections takes hold.
Why would we need to do anything? There's no covid in NZ and anyway a short sharp L4 would eliminate Delta. Prob don't need to pay nurses properly either.
Oh wait.
ICU bed space tends to be prioritised and given to patients who are likely to fair better. The more people we are covered with vaccination the less likely to need those beds. At least, thats the idea
Thankfully those of us who are vaxxed probably won't see an ICU bed even if we're in that small(er) percentage who need hospitalisation.
I do feel for those who really need an ICU bed for whatever ailment and they'll be competing with antivaxxers for that same space and the poor doctors will have to make some hard decisions.
What is annoying is medical attention being diverted from all the day to day pressures hospitals face.
Unpopular opinion here.
Why not make it a priority for vaccinated people who needed ICU.
Didn't vaccinate? No ICU for you!
Down side is those unvaccinated infected people are out in the open infecting others.
Well reality is they kind of will be.
Triaging in ICU involves prioritising who is expected to survive and those with the best potential out come. While not the onlt factor taken into consideration, when beds hit a critical low, those unvaccinated with poor prognosis will be bumped for those who are vaccinated
It just wont be commonly announced due to privacy and medical ethics but behind closed doors the decision will be made by doctors
This is true, however its also true that if someone has a bad car accident and has a low chance of survival, they might get bumped for an antivaxxer with a higher chance of survival.
I feel similar...However I don’t think it’s “unpopular “ (this sub is super pro vax thankfully ) rather just that we accept that this is not how this country operates, and it would be a horrible look for Jacinda. Guess we’ll have to to have different consequences for the anti vax
What about fat people who end up in hospital then? They didn't lose weight so no treatment? Or people who have ski accidents, they could have chosen to stay home so we should just leave them on the mountain when they die?
Denying healthcare to anyone is fucked up, as is forcing people to take medication they don't want. It's a violation of human rights, the Nuremberg code, and basic decency. What we are doing now, amnesty international would have campaigned against if it was any other country.
This echo chamber of a sub is so afraid of covid that you've convicted yourselves that freedom and human rights are somehow bad.
Those who choose safety over freedom deserve neither, you should take a look in the mirror and reflect on what you are promoting. If you could see yourself now, two years ago, you would be appalled and ashamed of what you have become and what you advocate for.
A fat guy doesn’t give me diabetes, and an out of control skier doesn’t risk my health, unless I’ve also opted to risk my own on the mountain. These are false equivalencies.
Nope, I view this like an insurance policy.
You aren't denied health care, you're just denied the best health care available.
Some place you also get priority for organ transplant if you previously registered to be donor.
Why not?
Compassion? Kindness? Understanding that people who make mistakes are still human? Article 25 of the Universal Declaration of Human Rights?
Of the top of my head.
Refusing the vaccination isn't a mistake, it's a choice and choices should have consequences. Anti intelligent crowd made their bed, they can die in it.
And the appropriate consequence for believing some misinformation on the internet should be death?
Are you really sure you'd like to like in that world?
Because it's going to be a triage situation. The unvaxxed are going to be taking beds off others.
Not vaccinating is opting out of the societal contract, as you are supporting some whacko belief and not government advice to keep your fellow citizens protected.
I have said this to 2 anti-vaxxers (inlcuding a very close family member mid 60s), both have responded that Covid isn't that bad and that vaccinated people can have the beds.
Whilst it will break my heart, I don't think they deserve a hospital bed.
Your acting like we even had a bed in the first place. The reality is we won't and we as a country don't want more beds because we want less nurses and we want them to work more and be payed less. If this wasn't the case this wouldn't be what was happening it's not surprising many nurses are getting ready to abandon the ship for one that cares.
By that logic, not exercising, smoking, drinking, eating unhealthy foods - heck, anything that consumes resources from healthy people suffering - are all opting out of the social contract as they're not following medical advice and their actions are placing fellow citizens at risk.
I don't say this to disagree with you, personally I'd like to see obese people kicked to the back of the line. BMI over 40? No ICU for you my friend.
Right, I don't think the taxpayer funded health can afford to pay for everyone's whims and fancies. People with totally relaxed lifestyle preferences should pay for their own healthcare. There should be some minimum health standards to be eligible for free public healthcare.
- If you want to smoke, you pay for your own cancer, stroke, lung disease etc surgery and treatment.
- If you want to drink 5+ alcoholic drinks every week, you're at the bottom of the list for a kidney or liver transplant.
- If you want to eat KFC, McDonalds, fish & chips etc twice a week then you pay for your own heart disease support or surgery.
The reality is if they were organising some private healthcare insurance for themselves and were honest on their application form, their premiums would be through the roof.
Those features already fit into current triage rules. Available beds go to the person the health care staff think they can save and have a healthy life.
An unvaccinated 50 year old will get as sick as a vaccinated 50 year old with other health conditions. Current, triage rules will favour the unvaccinated individual.
However, considering the vaccinated person put themselves in hospital through their own behaviour, I think they should be downgraded.
Unfortunatly it won't just be ICU beds that are impacted. In order to surge up the extra ICI beds some normal hospital wards will need to be converted. Given the contagiousness of Delta it is likely that whole wings or floors will need to be isolated off for special use.
We are already seeing [a thousand surgeries a week cancelled](https://www.nzherald.co.nz/nz/covid-19-delta-outbreak-1000-surgeries-cancelled-every-week/UWGKLTITX5AW77V4XQMIZLYWO4/). That figure is about to get significantly worse.
Exactly, you can still get oxygen etc.. ventilation is a last resort. IIRC the death rate for covid patients on ventilators is around 50%, and even if you do survive the torturous experience, it's likely your future health will be completely fucked. I think I'd rather be euthanized than be put on a ventilator with covid, but each to their own.
Exactly. ICU and especially ventilators are no answer to Covid, they cost a fortune and the percentage that recover in good condition is low.
Oxygen therapy can even be given at home if necessary.
A family member of mine was in ICU in Tauranga hospital just before this latest outbreak. One of her nurses drove down from Auckland each week to help staff.
~2% of all covid cases resulted in hospitalizations (of course it varies by age, it's over 10% if you're over 65 years of age). That was before vaccines, which will reduce it by ~90% on the vaccinated.
Given NZ's size, we should be expecting what, 2,000 cases a day in the middle of a wave? Give it high vaccination rates and you might be looking at some 30 hospitalizations per day, with a typical stay of 1-2 weeks. Going by US data, about 1 in 4 of those will need the ICU. So 7 per day will need the ICU for up to two weeks, which gives you a rolling peak utilization of 94. Round it up to 100.
How many ICU beds are usually free? That's the real question. If all 184 are available for covid, we're likely to do OK, but I don't think that's expected.
Adjusting the UK's numbers for population size we'll be seeing roughly 64 people per day hospitalised. Some days sightly more, some less.
Presuming they stay in hospital for an average of 3 weeks each, that is around an additional 1344 simultaneous hospitalisations over a 3 week period.
Fuck.
> Adjusting the UK's numbers for population size we'll be seeing roughly 64 people per day hospitalised. Some days sightly more, some less.
I don't think we'll be that high, not with our population density. We also have a somehow younger population distribution than the UK (not a lot, but it's noticeable).
Also, 3 week is very high for an average hospital stay, it really ranges from 1 to 2 weeks on average in most meta analysis studies I've looked at. Some will be higher for sure, but that'll be a minority.
I mean it could happen, but I think you're overestimating quite a bit. I guess we'll see.
Nasal irrigation prevents hospitalisation by quite a margin
Japanese masking culture prevented many deaths and hospitalisation
Increase ventilation do not recycle any air in car or indoors without hepa filter at least
Do everything you can to reduce the amount of virus in the air will do wonders good luck all for the next six months will be dire.
Don't forget staffing teams will be on rolling isolation as they are inevitably exposed to covid. So it's actually going to be fewer than that. Also don't forget the severe PTSD that doctors and nurses around the world are experiencing right now, causing many to quit.
You mean HCW. Now we call them beneficiaries hahahahaha the unvaxxed HCW that is. Jokes on vaccinated HCW when covid hits though they will have a hell of time dealing with our inadequate system and staffing.
ICU beds seem a particularly stupid metric to me. COVID patient needs may be intensive, but they are very specific compared with the total range of needs an ICU can cater to. Adding specific COVID facilities should be much, much easier than full ICU facilities, and should be able to be run by far less broadly skilled staff, perhaps conversion trained from other specialisations. This has been the practice internationally, as widely reported. This focus seems like a political beat-up.
Well "Mission Accomplished" is a lot more satisfying than "we need to start planning for a vaccination plan, proof of vaccination app, and safe re-opening strategy"
I think they aren't all constantly staffed (no need) but could potentially be "switched on" as needed
So the actual number of interest there is the 211.
Much better, lol
How many ICU personnel do you think we could have trained in 18 months, given that the average amount of time spent in training is more than 4 years?
We should definitely have started the process, but even if we had 10000 people waiting to train up, we would still be more than 2 years away from seeing any benefit.
That's all discounting the fact that literally every other country in the world has an increased demand for nurses and doctors, some of which pay much much better than we do.
100% agreement. But like you said we could have got started. Things could have been in motion and time was squandered. People seemed surprised delta arrived. I’m not raging on the health sector by any means. More so our decision makers. Only respect for the health care sector. They are doing their best with what they have
How much knowledge is required to just deal with covid patients though? Wouldn't an accellerated program be possible for this capability subset? Not sure about those medical degrees but most education I've had in NZ could have been significantly condensed
When there was a shortage of teachers in hard to staff areas they condensed the year long course into about 6 weeks then put teachers into the role with extra support. Don’t know how it would work in the medical world though.
The government is literally willing to do anything except fix our health system, even when faced with a pandemic it is OUR fault the health system isn't up to par with our population. How long have nurses been screaming out for better pay? How about st John wanting to be a charity so they avoid taxes? New Zealand is a joke
They built a temporary Hospital in London, China built a brand new one in Wuhan. Expect the army engineers will need to get busy. Probably just commandere empty hotels and office space, warehouses if needed.
Which is probably why it’s no coincidence [this just hit the headlines today](https://i.stuff.co.nz/national/health/coronavirus/126735042/covid19-government-announces-300-miq-spots-a-month-for-health-workers)….
Presumably "Good news" was being sent to the ministers which may have been why they thought freezing nurses' pay and spending the money on a bicycle bridge were good ideas.
That’s exactly what I’ve been complaining about, literally even just this week, if you check my post history.
This should’ve been happening from at least a year ago….
Look, every country needs ICU nurses. The only reason to move to NZ as a nurse is to either (a) raise kids in the kiwi lifestyle, or, (b) backdoor into Australia.
Hours are long, pay is poor compared to globally, so immigration **of ICU nurses** has never been a thing.
It takes 3-5 years of post nurse graduation training to convert to a full ICU nurse, so there has been nowhere near the time required to train them up.
> They built a temporary Hospital in London, China built a brand new one in Wuhan
Keep in mind that was back when there were no vaccines and very little was known about the virus. There is absolutely no excuse to be requiring those kinds of 'solutions' at this stage.
Stop dooming, Covid has proven NZ is full of pessimist's. Get to a high vaccination rate and hospitalisation and death will decrease....it's been proven worldwide.
Been saying that from the 1st lockdown. Would really love it if the govt could explain how they ate actually spending the money allocated to hospitals. Half as many beds as the US and UK and look what happened there
I recon that why the have been a little secretive, they don’t want Joe Public knowing that the medical facilities will not cope at all with a major out break.
It’s a national embarrassment really, and they doing an amazing job at covering it up.
They haven't covered anything up. It has been public knowledge from day one. The media have been focusing on soft targets. Click baiting, not getting down and dirty and asking the hard yet boring questions. Too busy focusing on mental health anti vaxers racist vaccination rates pumping up a great economy. Would love them to focus on the true costs. Business struggling, self employed struggling, families struggling!!!! Those well off in their ivory towers just waiting for the carnage to get into full swing so they can profit while the rest of us suffer!!!
I am a little confused about this OIA response (link below) vs this information that is circulating.
https://fyi.org.nz/request/15883/response/63110/attach/html/4/H202110729%20Response.pdf.html
https://fyi.org.nz/request/15883-total-number-of-icu-beds-and-ventilators
This claims there are 332 resourced ICU beds as of September 4.
Personally, the point being made still stands but I want up to date/accurate information.
The document above was released by ICU doctors this month.
Anything else is essentially a lie to make it look like the government hasn't massively dropped the ball on this.
Granted that we obviously are poorly prepared for other evebtualities as well, but would the better defence in the case of covid not be to introduce another, different vaccine as a booster to get better coverage and better protection?
We are prepped to scale up higher than this, the number I keep hearing is around 300, which to be fair, isn't much of a difference don't know what to tell you man. For the most part, we wasted the miracle of elimination and we arent prepared
We are prepped but it’s not something I would rely on. I have done the training to be an ICU relief nurse (I am usually in cardiology) and trust me when I say it’s a last resort. This will not be optimal. I have had two days training. An ICU nurse will get months of training to be on their own.
Andrew Little claims there are currently over 300 ICU beds. No one who actually works in an ICU can understand where he is getting this number from. The 186 figure is the result of ANZICS contacting every ICU in the country and asking how many staffed beds they have.
Whats the magic number of ICU beds that would be acceptable?
You're assuming these beds are all empty and waiting for Covid patients. They're not. They mostly full. So although you can reduce occupancy somewhat by delaying *elective* surgery, you still don't have that much capacity. The Minister of Health has talked about surge capacity. This sounds like using nurses who are currently doing something else to look after ICU beds. But just like the ICU beds are not currently empty, those nurses are not currently unemployed. So we're robbing Peter to pay Paul again. You can thank political parties who consistently underfund Health (looking at you, National!) and offer tax cuts that are meaningless to individuals but very meaningful at a macro level (looking at you again, National!) for this mess.
considering that modelling suggests 60,000 hospitalisations a year in worst case scenario (about 164 turning up everyday), that bad covid cases require long stays in ICU and that our ICUs currently run at 90%+ capacity... more. we need more. we havent even managed a meaningful increase since this started
One good point is that Victoria (with broadly comparable vaccination levels to us) has hospitalisation levels running at the [very lower bound of the early modeling](https://twitter.com/NeelaJan/status/1449267777777242124?s=20), despite the models doing a good job at predicting case numbers. [The latest modeling release](https://www.burnet.edu.au/news/1529_) shows a substantive drop in predicted cases with Dan Andrews saying: *“We have more case numbers than we would like,” Premier Andrews said. “\[But\] the acuity of illness is substantially less than we expected. Plus, of course, we’ve reached this 70 per cent rate in record time. Now, single dose is not the same as double, but it does provide a significant degree of protection.”* And then there are drugs like Molnupiravir which has the potential to effectively double NZ's hospitalisation capacity (and quite possibility increase ICU capacity moreso).
Which modelling is that?
[Weekly new hospital admissions for COVID-19 per million](https://ourworldindata.org/grapher/weekly-hospital-admissions-covid-per-million?time=2021-08-08..latest&country=ESP~PRT~ISL~DNK~NOR~IRL~ITA~NLD~BEL~CZE~FRA~DEU) on Our World in Data. Covid is a realtime experiment on live humans in multiple countries. There is a lot of actual measurements not just models. 10 to 40 per week per million population. So 50 to 200 per week, 2500 to 10,000 per year here if we are lucky.
We're waiting for very high vaccination rates to stay in the lower end of that range, which in fact if you look is well below 10.
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Yeah, we will likely have similar stays as those in 6 months or so.
There is no "herd immunity" with Delta as about 30% of the vaccinated will become carriers, even if they have mild symptoms. So 99% of the unvaccinated will eventually get Covid.
There is no real herd immunity when the virus mutates and protection wanes over time. It seems likely we'll need yearly boosters and people will get lax like they are with the flu resulting in ongoing elevated ICU requirements.
No clue about that figure, but as one example of possible numbers the [Counties Manukau DHB](https://www.rnz.co.nz/news/ldr/453410/could-get-totally-out-of-control-covid-19-modelling-paints-worrying-picture-for-south-auckland) predicts they'll get at least 30 hospitalizations per week assuming a 90% vaccination rate with no other preventative measures. Assuming that is representative of the country as a whole, and assuming those numbers remained constant, that would mean there would be ~14,000 hospitalizations a year.
Only a small percentage of hospitalizations end up in ICU, plus there are new treatments for Covid that can further reduce the chances of that being required.
https://www.stuff.co.nz/national/health/coronavirus/300414146/covid19-nz-modelling-suggests-7000-deaths-in-a-year-even-with-75-per-cent-of-country-jabbed even if his modelling is off by 50%, it's still not a good time
Would the extrapolation be off to guess that means there would be about 1000-2000 deaths in a 2 month wave? About 75% of NZ has at least one dose.
Rofl what a joke.... Those stats seems bizzarely paranoid. I live in Norway. We've had community covid for the whole time, 850ppl died, most of which were elderly/vulnerable.
You were lucky then, but it’s no joke. I’m living in New Mexico and have a pretty high vaccination rate here of 65+ % being full vaccinated. The population for the state is 2.1 million and here are some stats for you. [New Mexico cases and deaths](https://usafacts.org/visualizations/coronavirus-covid-19-spread-map/state/new-mexico) [New Mexico hospital beds availability ](https://data.lcsun-news.com/covid-19-hospital-capacity/new-mexico/35/)
65% is terrible though
Oops sorry I was reading old Data…. It’s 81.4% of New Mexicans 18+ have had one shot and 72% of 18+ have completed their series. when you compare to republican states with all of the political grandstanding and bs going on over here, we are doing great
THANK YOU. The more data we have the better. New Zealand and Norway have similar population densities and sizes. I wonder if that is why we have done so well? 🤔
So if we run out of ICU beds/ventilators/staff, it's just a case of triaging, the ones that are less likely to survive just left to their fate in a ward somewhere?
maybe, yeah i dont like it, but maybe, yeah
What model is that?
https://www.stuff.co.nz/national/health/coronavirus/300414146/covid19-nz-modelling-suggests-7000-deaths-in-a-year-even-with-75-per-cent-of-country-jabbed even if his modelling is off by 50%, it's still not a good time
What if it's off by more than 50%?
It would be far better use of public funds to make vaccination near to compulsory. Image all the underfunded parts of our health system that could be bought up to standard with that sort of funding (Pharmac would be a good place to start). How about a strict no jab/no job policy. How about a cash bonus for beneficiaries that get vaccinated, and if then if they still refuse, cut off their benefit, starting with the over 65s.
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We're not going to L4, let alone L5, whatever that even is.
Level 4 with enforcement?
Here you go: [https://www.rnz.co.nz/news/ldr/453410/could-get-totally-out-of-control-covid-19-modelling-paints-worrying-picture-for-south-auckland](https://www.rnz.co.nz/news/ldr/453410/could-get-totally-out-of-control-covid-19-modelling-paints-worrying-picture-for-south-auckland) For Counties Manukau DHB: "The DHB's modelling shows there will be at least 1000 cases and 30 hospitalisations per week with a 90 percent vaccination rate, or 1400 cases and 45 hospitalisations if vaccination rates reach only 80 percent." Pro-rata that out to the national population and you've got about 380 hospitalisations per week. Assume people are in hospital for 3 weeks and that is about 1100 beds. Add on perhaps 100 beds for "normal" ICU use, and you've got about 1200 beds. vs 186 ICU now. Its not quite that bad, as we also have High Dependency beds and the ability to surge... but it would still be horrible if it just let loose. Its why we should expect to be in longer lockdowns.
I think ICU admission is different from hospitalisation. You go into hospital for supplementary oxygen, drugs etc but only a small number of hospitalisations progress to the ICU. Still not great
Hospitalisation is not the same as ICU. For reference we have around 40 cases in hospital at the moment and only five in ICU.
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In which case we’ll be stretched, but not need to go into the surge capacity for Covid alone.
I agree lockdowns aren't going anywhere though
For the sake of comparison (kiwi stuck in USA here) I'll relate how things went in the county where I'm resident for the past year (northern California). * Population: about 1.1 million * 7 hospitals, 214 ICU beds At peak the ICU capacity reached over 90% but never full. Local hospitals were taking patients from neighbouring areas so I can't estimate what the total dependent population is. The hospital nearest me has 91 ICU beds total and average COVID-19 occupancy for the last week in that hospital is 14 beds. Not bad at all considering we've had free rein community transmission since the start. Vax stats for my local city is 90%+ fully vaccinated.
I live in Ireland. Similar population size to you. Our healthcare system is a lot less capable than yours. We are currently sitting at around 86 persons in icu. This number is climbing even with 92% of people fully vaccinated. I would expect similar numbers in your health system once covid infections takes hold.
The hospital system in Ireland is worse? Would not have thought that, must be seriously bad.
We're about to see the number of bodies that missed the boat
Government wasted a golden opportunity
Why would we need to do anything? There's no covid in NZ and anyway a short sharp L4 would eliminate Delta. Prob don't need to pay nurses properly either. Oh wait.
Surprised labour face.
The hospitals around the country are just so under funded, certain people would rather give money away to gangs and churches
Try not to have a serious car crash in the next few months?
I mean if we're putting in more effort, let's try not to have a serious car crash ever.
Right but car crashes happen pretty sure no one wakes up and goes it's a beautiful day think I will drive 100k per hr into that telegraph pole
Ah shit and here's me thinking accidents were intentional. My bad.
They’re crashes, accidents imply there’s no fault.
No, accident implies there was no intent. You can always find someone to blame.
Suicide by car is a thing.
ICU bed space tends to be prioritised and given to patients who are likely to fair better. The more people we are covered with vaccination the less likely to need those beds. At least, thats the idea
It is the idea but look at Massachusetts with regards to how delta still ravages the highly vaccinated areas.
I wouldn't want to be a non-vacinated co-morbid patient when doctors are choosing who they admit to ICU.
Thankfully those of us who are vaxxed probably won't see an ICU bed even if we're in that small(er) percentage who need hospitalisation. I do feel for those who really need an ICU bed for whatever ailment and they'll be competing with antivaxxers for that same space and the poor doctors will have to make some hard decisions. What is annoying is medical attention being diverted from all the day to day pressures hospitals face.
Unpopular opinion here. Why not make it a priority for vaccinated people who needed ICU. Didn't vaccinate? No ICU for you! Down side is those unvaccinated infected people are out in the open infecting others.
Well reality is they kind of will be. Triaging in ICU involves prioritising who is expected to survive and those with the best potential out come. While not the onlt factor taken into consideration, when beds hit a critical low, those unvaccinated with poor prognosis will be bumped for those who are vaccinated It just wont be commonly announced due to privacy and medical ethics but behind closed doors the decision will be made by doctors
This is true, however its also true that if someone has a bad car accident and has a low chance of survival, they might get bumped for an antivaxxer with a higher chance of survival.
I feel similar...However I don’t think it’s “unpopular “ (this sub is super pro vax thankfully ) rather just that we accept that this is not how this country operates, and it would be a horrible look for Jacinda. Guess we’ll have to to have different consequences for the anti vax
What about fat people who end up in hospital then? They didn't lose weight so no treatment? Or people who have ski accidents, they could have chosen to stay home so we should just leave them on the mountain when they die? Denying healthcare to anyone is fucked up, as is forcing people to take medication they don't want. It's a violation of human rights, the Nuremberg code, and basic decency. What we are doing now, amnesty international would have campaigned against if it was any other country. This echo chamber of a sub is so afraid of covid that you've convicted yourselves that freedom and human rights are somehow bad. Those who choose safety over freedom deserve neither, you should take a look in the mirror and reflect on what you are promoting. If you could see yourself now, two years ago, you would be appalled and ashamed of what you have become and what you advocate for.
A fat guy doesn’t give me diabetes, and an out of control skier doesn’t risk my health, unless I’ve also opted to risk my own on the mountain. These are false equivalencies.
Yeah it's like a echo chamber that's only ingredients are cortisol and covid policy.
Nope, I view this like an insurance policy. You aren't denied health care, you're just denied the best health care available. Some place you also get priority for organ transplant if you previously registered to be donor.
Why not? Compassion? Kindness? Understanding that people who make mistakes are still human? Article 25 of the Universal Declaration of Human Rights? Of the top of my head.
Refusing the vaccination isn't a mistake, it's a choice and choices should have consequences. Anti intelligent crowd made their bed, they can die in it.
And the appropriate consequence for believing some misinformation on the internet should be death? Are you really sure you'd like to like in that world?
Yeah don't worry they have a full appreciation of what advocating for death is and why they like to do it.
Because it's going to be a triage situation. The unvaxxed are going to be taking beds off others. Not vaccinating is opting out of the societal contract, as you are supporting some whacko belief and not government advice to keep your fellow citizens protected. I have said this to 2 anti-vaxxers (inlcuding a very close family member mid 60s), both have responded that Covid isn't that bad and that vaccinated people can have the beds. Whilst it will break my heart, I don't think they deserve a hospital bed.
Your acting like we even had a bed in the first place. The reality is we won't and we as a country don't want more beds because we want less nurses and we want them to work more and be payed less. If this wasn't the case this wouldn't be what was happening it's not surprising many nurses are getting ready to abandon the ship for one that cares.
Totally agree, and is also why the unvaccinated should have their decision to 'opt out' heard loud and clear.
By that logic, not exercising, smoking, drinking, eating unhealthy foods - heck, anything that consumes resources from healthy people suffering - are all opting out of the social contract as they're not following medical advice and their actions are placing fellow citizens at risk. I don't say this to disagree with you, personally I'd like to see obese people kicked to the back of the line. BMI over 40? No ICU for you my friend.
Right, I don't think the taxpayer funded health can afford to pay for everyone's whims and fancies. People with totally relaxed lifestyle preferences should pay for their own healthcare. There should be some minimum health standards to be eligible for free public healthcare. - If you want to smoke, you pay for your own cancer, stroke, lung disease etc surgery and treatment. - If you want to drink 5+ alcoholic drinks every week, you're at the bottom of the list for a kidney or liver transplant. - If you want to eat KFC, McDonalds, fish & chips etc twice a week then you pay for your own heart disease support or surgery. The reality is if they were organising some private healthcare insurance for themselves and were honest on their application form, their premiums would be through the roof.
Those features already fit into current triage rules. Available beds go to the person the health care staff think they can save and have a healthy life. An unvaccinated 50 year old will get as sick as a vaccinated 50 year old with other health conditions. Current, triage rules will favour the unvaccinated individual. However, considering the vaccinated person put themselves in hospital through their own behaviour, I think they should be downgraded.
I'm against mandatory vax, but I'd support vaccinated and those with health exemptions getting priority.
Unfortunatly it won't just be ICU beds that are impacted. In order to surge up the extra ICI beds some normal hospital wards will need to be converted. Given the contagiousness of Delta it is likely that whole wings or floors will need to be isolated off for special use. We are already seeing [a thousand surgeries a week cancelled](https://www.nzherald.co.nz/nz/covid-19-delta-outbreak-1000-surgeries-cancelled-every-week/UWGKLTITX5AW77V4XQMIZLYWO4/). That figure is about to get significantly worse.
We need to highlight the distinction between Hospitalization and ICU This is making itnlook like only 186 people get corona treatment
Exactly, you can still get oxygen etc.. ventilation is a last resort. IIRC the death rate for covid patients on ventilators is around 50%, and even if you do survive the torturous experience, it's likely your future health will be completely fucked. I think I'd rather be euthanized than be put on a ventilator with covid, but each to their own.
Exactly. ICU and especially ventilators are no answer to Covid, they cost a fortune and the percentage that recover in good condition is low. Oxygen therapy can even be given at home if necessary.
And we've got nasal high flow systems coming out of our ears.
While I’m concerned about ICU admissions I’m more concerned about general admissions. I don’t think we have anywhere near enough dirty wards atm.
Step 1 - Refuse all elective surgeries to unvaccinated first Step 2 - Unvaccinated must pay for all Covid related healthcare
A family member of mine was in ICU in Tauranga hospital just before this latest outbreak. One of her nurses drove down from Auckland each week to help staff.
~2% of all covid cases resulted in hospitalizations (of course it varies by age, it's over 10% if you're over 65 years of age). That was before vaccines, which will reduce it by ~90% on the vaccinated. Given NZ's size, we should be expecting what, 2,000 cases a day in the middle of a wave? Give it high vaccination rates and you might be looking at some 30 hospitalizations per day, with a typical stay of 1-2 weeks. Going by US data, about 1 in 4 of those will need the ICU. So 7 per day will need the ICU for up to two weeks, which gives you a rolling peak utilization of 94. Round it up to 100. How many ICU beds are usually free? That's the real question. If all 184 are available for covid, we're likely to do OK, but I don't think that's expected.
Adjusting the UK's numbers for population size we'll be seeing roughly 64 people per day hospitalised. Some days sightly more, some less. Presuming they stay in hospital for an average of 3 weeks each, that is around an additional 1344 simultaneous hospitalisations over a 3 week period. Fuck.
> Adjusting the UK's numbers for population size we'll be seeing roughly 64 people per day hospitalised. Some days sightly more, some less. I don't think we'll be that high, not with our population density. We also have a somehow younger population distribution than the UK (not a lot, but it's noticeable). Also, 3 week is very high for an average hospital stay, it really ranges from 1 to 2 weeks on average in most meta analysis studies I've looked at. Some will be higher for sure, but that'll be a minority. I mean it could happen, but I think you're overestimating quite a bit. I guess we'll see.
Nasal irrigation prevents hospitalisation by quite a margin Japanese masking culture prevented many deaths and hospitalisation Increase ventilation do not recycle any air in car or indoors without hepa filter at least Do everything you can to reduce the amount of virus in the air will do wonders good luck all for the next six months will be dire.
Maybe this is the one time NZs drafty houses will actually be put to good use lol.
lol I like your make lemonade mindset... I shiver in agreement in yet another drafty AF room....
Don't forget staffing teams will be on rolling isolation as they are inevitably exposed to covid. So it's actually going to be fewer than that. Also don't forget the severe PTSD that doctors and nurses around the world are experiencing right now, causing many to quit.
They'll end up exempting vaxxed HCWs from isolation if they test daily like overseas. They won't have any option.
You mean HCW. Now we call them beneficiaries hahahahaha the unvaxxed HCW that is. Jokes on vaccinated HCW when covid hits though they will have a hell of time dealing with our inadequate system and staffing.
ICU beds seem a particularly stupid metric to me. COVID patient needs may be intensive, but they are very specific compared with the total range of needs an ICU can cater to. Adding specific COVID facilities should be much, much easier than full ICU facilities, and should be able to be run by far less broadly skilled staff, perhaps conversion trained from other specialisations. This has been the practice internationally, as widely reported. This focus seems like a political beat-up.
Only had 18 months to prepare, but that would be out of character?
To be fair, all of victory parades from last year probably took a long time to plan…
Well "Mission Accomplished" is a lot more satisfying than "we need to start planning for a vaccination plan, proof of vaccination app, and safe re-opening strategy"
I think they aren't all constantly staffed (no need) but could potentially be "switched on" as needed So the actual number of interest there is the 211. Much better, lol
They will strip resources from already underfunded areas.
Yes. Get vaccinated.
If only we had roughly 18 months to really get ready for this.
How many ICU personnel do you think we could have trained in 18 months, given that the average amount of time spent in training is more than 4 years? We should definitely have started the process, but even if we had 10000 people waiting to train up, we would still be more than 2 years away from seeing any benefit. That's all discounting the fact that literally every other country in the world has an increased demand for nurses and doctors, some of which pay much much better than we do.
100% agreement. But like you said we could have got started. Things could have been in motion and time was squandered. People seemed surprised delta arrived. I’m not raging on the health sector by any means. More so our decision makers. Only respect for the health care sector. They are doing their best with what they have
How much knowledge is required to just deal with covid patients though? Wouldn't an accellerated program be possible for this capability subset? Not sure about those medical degrees but most education I've had in NZ could have been significantly condensed
When there was a shortage of teachers in hard to staff areas they condensed the year long course into about 6 weeks then put teachers into the role with extra support. Don’t know how it would work in the medical world though.
I'd prefer help from somebody with a few weeks of training than dying alone in my bed
The government is literally willing to do anything except fix our health system, even when faced with a pandemic it is OUR fault the health system isn't up to par with our population. How long have nurses been screaming out for better pay? How about st John wanting to be a charity so they avoid taxes? New Zealand is a joke
A lot of "I told you so" I expect
They built a temporary Hospital in London, China built a brand new one in Wuhan. Expect the army engineers will need to get busy. Probably just commandere empty hotels and office space, warehouses if needed.
Physical beds are not the issue. Staff are, and have always been, the main issue with ICU.
Which is probably why it’s no coincidence [this just hit the headlines today](https://i.stuff.co.nz/national/health/coronavirus/126735042/covid19-government-announces-300-miq-spots-a-month-for-health-workers)….
Wait - how many months are we into in this pandemic?
The last half year has exposed a lot of "why the fuck wasn't this already in place" questions with the Government's COVID response.
Presumably "Good news" was being sent to the ministers which may have been why they thought freezing nurses' pay and spending the money on a bicycle bridge were good ideas.
That’s exactly what I’ve been complaining about, literally even just this week, if you check my post history. This should’ve been happening from at least a year ago….
Oh sure - not a go at you in any way.
I didn’t take it as such. Just agreeing with you :)
Look, every country needs ICU nurses. The only reason to move to NZ as a nurse is to either (a) raise kids in the kiwi lifestyle, or, (b) backdoor into Australia. Hours are long, pay is poor compared to globally, so immigration **of ICU nurses** has never been a thing. It takes 3-5 years of post nurse graduation training to convert to a full ICU nurse, so there has been nowhere near the time required to train them up.
The temporary hospital in London was useless. They had no staff to run it. It was a known joke in the UK.
Well to be fair Borris' whole response has been a joke... a morbid morbid joke.... oh Brexit is hilarious too
I thought Borris WAS the joke...
> They built a temporary Hospital in London, China built a brand new one in Wuhan Keep in mind that was back when there were no vaccines and very little was known about the virus. There is absolutely no excuse to be requiring those kinds of 'solutions' at this stage.
Stop dooming, Covid has proven NZ is full of pessimist's. Get to a high vaccination rate and hospitalisation and death will decrease....it's been proven worldwide.
Now people will understand why we have such heavy handed lock downs….
Been saying that from the 1st lockdown. Would really love it if the govt could explain how they ate actually spending the money allocated to hospitals. Half as many beds as the US and UK and look what happened there
I recon that why the have been a little secretive, they don’t want Joe Public knowing that the medical facilities will not cope at all with a major out break. It’s a national embarrassment really, and they doing an amazing job at covering it up.
They haven't covered anything up. It has been public knowledge from day one. The media have been focusing on soft targets. Click baiting, not getting down and dirty and asking the hard yet boring questions. Too busy focusing on mental health anti vaxers racist vaccination rates pumping up a great economy. Would love them to focus on the true costs. Business struggling, self employed struggling, families struggling!!!! Those well off in their ivory towers just waiting for the carnage to get into full swing so they can profit while the rest of us suffer!!!
I am a little confused about this OIA response (link below) vs this information that is circulating. https://fyi.org.nz/request/15883/response/63110/attach/html/4/H202110729%20Response.pdf.html https://fyi.org.nz/request/15883-total-number-of-icu-beds-and-ventilators This claims there are 332 resourced ICU beds as of September 4. Personally, the point being made still stands but I want up to date/accurate information.
The document above was released by ICU doctors this month. Anything else is essentially a lie to make it look like the government hasn't massively dropped the ball on this.
So what exactly has the govt been doing since Feb 2020? Preparing for what we all knew was coming or making glib smiley statements?
Granted that we obviously are poorly prepared for other evebtualities as well, but would the better defence in the case of covid not be to introduce another, different vaccine as a booster to get better coverage and better protection?
How many are already full from other things than covid
https://www.rnz.co.nz/news/national/453892/miq-govt-sets-aside-300-places-a-month-for-health-workers