What we face: NZ doctor’s view from Covid-hit Canada
Rail at our leaders if you like, but if you shun masks you’re in a glasshouse throwing stones, writes
After nearly two years of looking at how best to set up health systems to tackle Covid-19, I let it walk through my front door in Canada — and you are probably about to do the same.
This week’s announcement covers some of what needs to happen in Aotearoa — but there’s more to be done.
I caught Omicron when my daughter’s boyfriend gave it to me just before Christmas. Fortunately, key policy and personal decisions kept me out of the ICU and stopped me from giving it to my 2-year-old granddaughter.
I was fully vaccinated and boosted. Vaccines are by far our best defence against becoming critically unwell and avoiding hospitalisation and death from Covid-19.
Recent studies from the US show that the third booster vaccine shot is 90 per cent effective at preventing hospitalisations because of Covid during the Delta and Omicron periods.
So, Aotearoa needs another Super Saturday or a new initiative to get as many Kiwis boosted as possible because booster shots are required to protect against the Omicron variant.
Far too many eligible New Zealanders have yet to get their boosters. As of yesterday, only 29 per cent of Aotearoa’s population had received a booster shot.
Also, if New Zealand wants to let children return to school in the red light setting, we need to push hard to get as many 5- to 11-year-olds vaccinated as fast as possible. Current recommendations are for children aged 5 to 11 to have two shots of the Covid vaccine and immunocompromised children to have three shots (two plus a booster).
I also benefited from my uncomplicated access to the Rapid Antigen Test (RAT) in Canada.
Within 15 minutes of feeling unwell with a mild cough and fatigue, I knew I had Covid and wouldn’t spend Christmas with my extended family.
New Zealand is playing catch-up with respect to the availability of rapid antigen testing. We need to find ways to get RATs to all Kiwis. This will alleviate the situation before cases surge — as it has done in so many other countries already. When that surge comes, there will not be adequate access to PCR tests.
We all want to see the end of the Covid era, yet unfortunately, the virus just does not care about our wants and needs. We need to plan for any contingency, including the high chance of more variants after Omicron.
None of this overrides the importance of adhering to the fundamental public health measures.
You can get annoyed with the Government all you want. But if you aren’t wearing a mask, washing your hands, and avoiding close contact with others where possible, you’re in the glasshouse throwing stones.
Simple public-health measures helped Kiwis get through Covid in 2020 and 2021; it’s also what eventually got us past the Spanish Flu in 1918. The same actions are effective against all variants of Covid-19.
I know masks are annoying, but they very effectively reduce the spread of this virus, and that’s what truly matters. If we could get everyone to wear a mask in all situations, the disease would come under much better control in a matter of weeks.
Get good quality N95 or KN95 mask if you can, don’t touch your face, practise handwashing and maintain social distancing, especially when indoors.
Omicron will likely surge in New Zealand and ultimately become endemic. Though Kiwis have had the luxury of a near Covid-zero situation until now, we cannot assume that will be the case in future. Assuming Covid becomes endemic, Kiwis must turn our attention towards how we want to live with the virus.
A critical aspect to this will be resourcing and right-sizing our health systems to cope. In Canada, the impact of Covid- matched with already unsustainable clinical workloads is proving too much for many clinicians. There is an exodus from the profession by doctors and nurses.
I fear we’ll see a similar exodus in New Zealand when Omicron takes over. The Association of Salaried Medical Specialists recently estimated New Zealand was already short 1500 hospital specialists, 1400 GPs and 12,000 nurses to match Australia’s per capita level of clinical staffing. So if you know someone working in health, make them dinner one night during this outbreak.
At a systems level, we need to do much more.
The best global healthcare systems incorporate technology that allows practitioners to spend more time with their patients. This helps every doctor, nurse and allied health practitioner focus on solving health problems instead of admin.
Additionally, there’s a growing international movement to empower patients to take more pre-emptive care of their health. Appearing in many guises, including “patient-centred care” and “let patients help”, the most promising recent development is the Digital Front Door. This changes the dial from reactive sick care to preventative, proactive and even predictive peoplecentred healthcare. Valuable clinician time, already in short supply, is then reserved for those who need it most.
As the Government reforms an overloaded health system, the right technology will be crucial in addressing the multi-faceted problems highlighted by the pandemic.
Aotearoa has had the gift of time for the past two years. Now Kiwis must make the best use of everything in our tool kit to address a gamechanging foe in the Omicron variant of Covid-19.
Get boosted, get tested, wear masks and wash hands. With this, we will reduce the burden on hospitals, flatten the curve and protect more of our most vulnerable people.