The Government’s announcement of an extra $644 million for hospital upgrades (including 23 new Intensive Care and High Dependency beds) is welcome, but it will not help the potential 45,000 COVID positive patients per week that could be isolating in the community by March 2022. That’s according to GenPro (The national association for providers of general practice services), whose objectives include improving the health of the population of New Zealand and advocating for high-quality, accessible and equitable patient care.

GenPro’s Chair, Dr Tim Malloy, said “Early evidence from South Africa, where the Omicron variant was first detected, shows that Omicron infections appear to have less serious symptoms than previous COVID variants and result in fewer hospitalisations. That means our COVID response should immediately shift to ensuring our front-line, community based general practice teams are resourced to be able to manage the inevitable surge that is coming.

“Omicron is already in New Zealand and if we look at what is happening with COVID cases in the UK – a country now with broadly similar vaccination rates to ourselves – we need to plan for, on average, each general practice in New Zealand providing tailored daily care and support for over 45 of their patients, plus their immediate whānau, who will be isolating at home with a COVID positive infection”.

For many months GenPro has been offering to work with the Ministry of Health to develop a robust community response plan and has been seeking clarification of their responsibilities and the availability of the resources which will be required. “Only in November 2021 did we have sight of the Ministry’s draft proposals for managing COVID positive patients in the community, and even then there were essential patient care requirements missing from the plans and significant patient care expectations that simply would not be able to be provided due to lack of funding. We provided immediate and detailed feedback on the draft proposals in November but have heard nothing since”, said Dr Malloy.

The Ministry of Health’s own COVID data* for the period from 26 February 2020 to 16 December 2021 shows that only 5% of New Zealand’s 13,238 COVID positive cases (656 cases) have needed hospital care and with less than half of 1% requiring ICU care (54 cases).

GenPro emphasises that, to date, New Zealand’s COVID response has primarily been undertaken in front- line community and general practice settings and any direct pressure on hospitals has been limited. It also says that the future response will similarly be reliant upon general practice and community health professionals to continue the vaccination (including booster) programme, testing, swabbing, and now, managing the significant rise in COVID positive patients who will mostly need community care rather than hospital admission.
 
Dr Malloy advises that the Government’s response seems to underestimate the predictable community impact of COVID and Omicron whilst surprisingly committing significant funding to non-COVID priorities during the pandemic “..the Government is putting hundreds of millions of dollars into re-structuring layers of health management whilst essential front-line services are being underfunded. The system simply cannot provide services for which there is insufficient funding, and for which we have been unable to plan logistically – for example, we are on the verge of the Christmas and New Year holiday period and staff leave has already been booked for health professionals who are already worn out by the mammoth vaccination and swabbing effort that has been undertaken on top of business as usual. Yet Omicron is already here and we can no longer say that we are protected by our closed borders”.

GenPro is concerned that the impact of the lack of agreed plans and required funding will mean that COVID positive patients will be referred directly for hospital-based care and support which is neither the most convenient for the patient nor the most efficient for the system.