Second wave rides in to a system tearing at the seams
The Government can’t claim it wasn’t warned; a year ago Hawke’s Bay DHB chief executive Keriana Brooking warned of ‘‘critical workforce issues’’.
Like a fever-dreamed, hallucinatory Groundhog Day, Omicron’s second wave is here, its rise confirmed with a 26% increase in the rolling average of case numbers from the previous Sunday to Sunday of last week.
This time Omicron has arrived all gussied up as several new variants: BA.5, which is more contagious and better at evading existing immunity than its predecessor BA.2, followed closely by BA.75.
If, in the dog days of winter, this is the last thing you want to hear as you grapple with paying the mortgage and putting petrol in your car, you are not alone.
Attitudes to Covid range from let it rip, to those who’ve adjusted to the responsibilities of maskwearing, vaccinations and keeping our distance, to those who demand even more vaccine and mask regulations.
However, Omicron’s second wave has intersected with rising flu cases, a hospital system tearing at the seams and the biggest restructure of the health system in 21 years.
The scrapping of the country’s divergent DHBs to be replaced by a centralised authority, Health New Zealand, working alongside the Ma¯ ori Health Authority, removes much of the Ministry of Health’s old responsibilities, including the Covid-19 response.
As a nascent authority in only its first week, how will Health NZ cope if this wave peaks like the first, and case numbers climb to 20,000-plus, as they did in March?
The short answer is, much like the old authority, because that’s what it has inherited: a system with not enough ICU beds, long wait times at emergency departments that led to one woman dying in Middlemore Hospital in June, and a nursing shortage numbering 4000.
The Government can’t claim it wasn’t warned; a year ago Hawke’s Bay DHB chief executive Keriana Brooking, representing the 20 DHBs, warned of ‘‘critical workforce issues’’, with some hospitals at ‘‘code red’’.
It’s also a nursing shortage arguably of the Government’s own making. In May, immigration policy changes created a two-tier system, which saw surgeons, GPs, anaesthetists and psychiatrists fast-tracked straight to residency, leaving nurses and midwives having to work for two years before they can apply for theirs. The thinking behind this? Migrant nurses might up and leave for better-paid jobs once they got residency.
They might also leave Aotearoa altogether, lured to better pay and conditions in Australia.
This week newly minted Immigration Minister Michael Wood was in explaining mode in the education and workforce select committee. When asked for evidence on why nurses must wait two years, Wood replied the policy was ‘‘based on logic and common sense rather than any particular evidence’’, before explaining the more specialised the sector, the less likely they were to leave their jobs.
Which, in the sexual politics of our times, is more akin to the 50s thinking of ‘‘well, you’re not as well qualified as the men, are you?’’ than 21st-century expectations that in the health hierarchy a femaledominated profession is as important as a male-dominated one.
And straight from the page in the politician’s manual headlined ‘‘I’ve-gotprinciples-and-if-youdon’t-like-those-I’ve-got-others’’, Wood gave himself an out in select committee, claiming he’d be open to making adjustments ‘‘as we move forward to get to the outcomes’’.
With new Covid cases topping 10,000 a day by week’s end, a figure which put the country into the red light setting in the first wave, this second wave has demonstrated that the traffic light system is no longer fit for purpose.
It also presents the prime minister with a conundrum. Having spent a lot of time recently out of the country announcing to the rest of the world that New Zealand is open for business, putting it back in the red light setting, which includes number restrictions for restaurants and gatherings, indicates that it’s closed.
The fact that this wave is expected to affect older generations more than the last is one spurious reason why returning to the red setting has been ruled out.
Another factor is a population where anger and frustration have turned to despair, with business confidence at its lowest level since before the pandemic began.
Politicians rule with the consent of the public they serve; if Kiwis don’t comply with the red light setting, the failure will be seen to be the prime minister’s.
The fear Covid presented Kiwis with two years ago has been replaced by other anxieties, such as putting food on the table and keeping a roof over their heads.
But the strongest indication of how the traffic light setting has turned into a semantic, nonsensical exercise came with Covid-19 Response Minister Ayesha Verrall’s contention that, instead of going back to red settings, there would be ‘‘tweaks’’ to the orange. Was this demarcating it as more burnt umber or tangerine perhaps, rather than orange?
If New Zealand isn’t going to be plunged back into a red setting, then why have the traffic light system at all? After all, if we’ve told the world we’re open for business then we should be.