General practitioner vaccinating old patient in private clinic with copy space. Doctor giving injection to senior woman at hospital. Nurse holding syringe and using cotton before make Covid-19 or coronavirus vaccine.

As I write, Hawke’s Bay reports 75.8% have received their first vaccine dose; 49.9% have their second as well. The Government is now releasing vaccination rates by neighbourhood, so we can see at a granular level where we’re doing well and where not so well – e.g., Havelock North Central at 87.2%/66% (1st/2nd) compared to Flaxmere’s 64.1%/40.6%.*

Overall, not good enough should a resurgence strike our region.

Like other DHBs, the Hawk’s Bay DHB has prepared a Covid-19 Resurgence Plan for the HB Health System.

The Plan, in its 17 September version, updated to reflect heightened awareness and risks associated with the Delta variant and the outbreaks in Australia, comprehensively addresses equity, staff health and safety, scalability, training, communications alongside the basics of testing, hospital operations, vaccinations, support for priority populations.

At the outset is this arresting national statistic of relevance to Hawke’s Bay: COVID-19 infection fatality rates (IFR) vary by ethnicity, health status and age with estimated IFR for Māori more than 2.5 times that of New Zealand European, and estimated IFR for Pasifika is almost double that of NZ European. That said, to date HB fortunately has had only 44 confirmed cases and no deaths.

This plan “operationalises an elimination strategy that seeks to eradicate or minimise cases of COVID-19 from Hawke’s Bay to a level that is manageable by the health system and covers vaccination to achieve population-level immunity.”

The Plan indicates that the HBCDEM Group is the lead agency to coordinate of the regional operational response to COVID-19 resurgence in Hawke’s Bay. It is supported by the HBDHB, Territorial Local Authorities, HB Regional Council, the Emergency Services Coordinating Committee ESCC), Welfare Coordination Group (WCG) and Network of Networks (NoN). 

The Plan notes that “COVID-19 is, at least during the response phase, primarily a health issue. Locally this means responsibility sits with HBDHB. The wider social and economic impacts, however, require an all-of-government approach, which at a local level is coordinated by HBCDEM and the Regional Leadership Group.”

Some noteworthy points in the Plan:

  • Once the borders of Aotearoa open, it is likely that we will see cases in Hawke’s Bay. 
  • In order to minimise the impact on the Hawke’s Bay population we would need to get to greater than 85% vaccination rate in the general population and greater than 95% in priority populations such as Maori and Pasifika whanau, people over 60 years old, those with chronic conditions such as heart disease, respiratory conditions, diabetes, those who smoke and particularly those whanau with a combination of these factors. 
  • Social issues, including domestic violence will increase.
  • Demand for mental health services will increase.
  • Health workers will be suffering fatigue which will need to be managed. It is highly likely that public health staff will be called upon to be surge capacity for other regions impacted and that HB will need to call on other regions if we have a significant outbreak. 
  • GPs will be doing telephone triage/consults.
  • There will be stockpiling of PPE in various areas.
  • Appropriate balance will need to be struck between pausing health services to prevent the spread of infection and harm caused to people who are unable to access timely healthcare. 

This last point is made several times in the Plan. A serious COVID-19 outbreak in HB would jeopardise not just those with the virus, but everyone else in the region requiring major medical treatment.

The Plan is a piece of paper – 64 pages to be exact. To my layperson eyes, it seems both comprehensive and detailed. The planners have planned and exercises have been done to test the planning. We seem ready on paper. Here’s the link to the Plan … judge for yourself.

Readiness at the coalface can only be judged by insiders. Perhaps someone ‘in the know’ reading this article might comment — hopefully reassuringly, but if not, then tough questions need to be put. Keep in mind this is a DHB where Emergency Department nurses have just filed a formal complaint against the hospital regarding unsafe and dangerously stressful conditions … and this is before  any ‘resurgence’ (as BayBuzz reported here).

One Appendix walks though the escalating steps that would be taken and issues that would arise as increasing levels of COVID-19 Delta cases overran capacity in our community – where the patients would be cared for, stopping of elective surgery, how many tests would be done and where analysed, staff refusing to work. 

The chart stops at 400 community cases. Pretty chilling scenarios.

Only one preventive measure … vaccinations!

And that responsibility rests with no one but we individuals … thinking about our own personal safety and security and that of our families and community.

*Thanks to The Spinoff for a superb interactive map you can search neighbourhood by neighbourhood anywhere in Hawke’s Bay … or NZ.

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