Acute Covid cases to be sent to Nelson

Wairau Hospital can care for Covid patients, Marlborough health bosses say, but acute cases needing specialist care will be transferred to better equipped hospitals.

Blenheim’s smaller, level one intensive care unit (ICU) is not equipped for long-term mechanical ventilation – care needed for the worst cases of Covid-19.

Barring a super-spreader event, it is expected that high vaccination rates in the region mean most people who test positive for Covid-19 will be able to be cared for at home or in the community, through a community coordination hub.

Wairau Hospital emergency medicine specialist Andrew Morgan says they are anticipating cases and a small number of people being admitted to hospital this summer.

“We are able to manage Covid-19 at Wairau,” he says.

“We do have ventilators in Marlborough. We haven’t lost any and we still have the capacity.”

Caring for the worst cases of Covid is a specialty, he says, and at Wairau, there isn’t the number of patients to justify having someone specialise or keeping them competent.

There are three levels of ICU, and Wairau is level one, the lowest.

Chief medical officer Nick Baker says it’s a standard problem in health care – getting the right balance between quality, sustainability and access.

“Yes, it’s managing the services out there. But there’s no way to offer every service everywhere,” he says.

Andrew says Covid patients would normally be ventilated at Wairau for up to 24 hours.

“Either that’s all they need, or we would transfer them to a tertiary provider,” he says.

Most patients that require specialist care are already transferred to other hospitals; premature babies or pregnant women requiring specialist care usually go to Wellington’s neonatal intensive care unit, burn victims are transferred to the National Burn Centre at Middlemore Hospital in Auckland, and spinal injuries are often transferred to the Burwood Spinal Unit in Christchurch.

Wairau Hospital is also preparing to support patients who present to hospital for reasons other than Covid, but who have Covid-19.

“If a person’s condition deteriorates to the point they need intensive care they will be transferred to the most appropriate intensive care unit such as that at Nelson Hospital or our tertiary partners at Wellington intensive care unit,” Andrew says.

Andrew says while there aren’t plans to move all Covid patients to a central hospital, those in major centres will have a lot more experience caring for people with Covid.

“Having dealt with no Covid yet, we’re anticipating getting experience as we go.

“We’re well linked up – we have webinars out of our ears about lessons learned from overseas and Auckland.”

He says it is reassuring to see the hospitalisation data coming from the Auckland outbreak demonstrating the impact of high levels of vaccination coverage in limiting hospital and ICU demand.

Overall, vaccinated people are less likely to get Covid or get sick, with less than 10 per cent of those contracting the virus needing hospital care, he says.