Daily Media Update - Thursday 2 April 2020

Lakes District Hospital update

No further staff at Lakes District Hospital have tested positive for COVID-19, with around three results still pending.

Medical Officer of Health Dr Susan Jack says the absence of any further cases builds confidence there has not been community transmission from within the hospital workforce. It is noted that there are a number of COVID cases in the wider community in Queenstown.

All close contacts of the two nurses remain in isolation and will be retested should symptoms develop.

Case Numbers

The Ministry of Health announced 10 new COVID-19 cases in the Southern region today, bringing the region’s total to 118 as of 8am this morning. Confirmed and probable cases are combined for this and future totals, to match Ministry case reporting.

MEDIA INQUIRY – abuse of nurses or security staff

We have received a media inquiry asking whether Southern DHB has experienced incidents where nurses and hospital security staff have been spat upon by members of the public during the lockdown.

Southern DBH Security has not received any reports of this type of incident at Southern hospitals.

MEDIA INQUIRY – STI Testing

We have received a media inquiry about whether COVID-19 testing is affecting the testing for STI’s in the Southern district.

In the Southern District, an average of 5,000 STI tests are carried out in a month. 

We had planned to restrict testing on asymptomatic patients for Chlamydia and Gonorrhoea in line with the New Zealand Microbiology Network’s policy recommendation, however, we are still managing to test all these samples without restriction.   This may change in time.

Other tests are being restricted; for example, Herpes PCR will only be performed on babies, pregnant women, and CSF.

Testing for STIs and SARS-Cov-2 are performed on different platforms, but many of the reagents they require are in common.  Therefore, we are prioritising the use of these reagents to conduct COVID-19 testing at this time.

People who suspect they may have been exposed to an STI should contact their GP, student health, or sexual health clinic.

MEDIA INQUIRY – COVID-19 testing

We have received media inquiries about COVID-19 testing in the Southern district, regarding numbers of tests and Community Based Assessment Centres.

Test numbers

 In the Southern district we averaged 199 tests per day over the last week.  Yesterday (Wednesday) we performed 333 tests.  Our capacity is now 450 tests per day.

We know there is a huge global demand for consumables such as reagents and all suppliers are currently working hard to increase their manufacturing capacity.   All New Zealand labs, including ours, are working hard to develop ways to increase the national capacity.

Further inquiries about testing should be referred to the Ministry of Health.

Community testing in Southern

Response from Dr Stephen Graham, Medical Director, WellSouth, primary health network:

Covid-19  testing is carried out based on case definition criteria set by the Ministry of Health, with regional input decided by Southern’s Medical Officer of Health.  WellSouth is working closely with the Public Health South and SDHB addressing the COVID-19 pandemic in this district, ensuring people meeting the criteria can access testing quickly and safely.

We’re continuing to support general practice teams in the district. WellSouth has led the establishment and staffing of Community Based Assessment Centres (CBACs), for example, and we help ensure that general practices have the PPE and testing equipment needed to safely test and care for their enrolled patients.

WellSouth CBACs in Queenstown, Invercargill and Dunedin operate seven days a week, 9am to 5pm.  These are not walk-in clinics, but patients should call their GP or Healthline to be assessed and referred for testing if appropriate.

Overall, I think practices feel they have flexibility to either test their own patients or refer to a CBAC.

Again, testing is defined by the Ministry.   Practices have indicated that they have capacity to increase testing and the CBACs can all increase their testing rates.  The testing rate in this district is the same as the national rate at 5 per 1000 patients, which is amongst the best internationally.

I would say that general practitioners want what is best for their patients and our community. We’re listening to what practices have to say and feeding that information to the DHB and Ministry when we are able.

WellSouth is surveying our practices weekly and the feedback we have received so far is that they feel prepared and supported. We also have a practice network team that is working with GP practices in the district, offering support and advice where ever we can.

The emergence of COVID-19 is an unprecedented health event. General practice teams and the whole of the health system in the Southern district are working together and rising to the challenge.

We certainly agree that testing is a priority.

Testing is determined by the case definition criteria set out by the Ministry of Health with input from Southern’s Medical Officer of Health and I have provided input as well, advocating for general practice in the Southern district.  In addition, GPs have been directed to test if their clinical discretion is that it should be done.

We have put a number of measures in place – CBACs and ensuring that practices have appropriate Personal Protective Equipment (PPE) and COVID-19 testing kits – to ensure that anyone who meets the Ministry’s case definition can be tested.

And we are communicating with practices daily, and sometimes multiple times a day, to ensure we hear what they need and respond where we can, as quickly as we can.

Again, CBACs have been established in Dunedin, Invercargill and Queenstown as a resource to help general practices manage their regular business and provide the routine care to their patients while we take pressure off, if they need that help.  

Has widening the criteria increased the demand for testing?

No doubt there will be an increase but we’re confident we have planned well, and a broadening of testing capacity is a scenario we are planning for.  I can’t promise it will be perfect immediately; a sudden influx of people wanting to be tested puts pressure on the teams on the ground and may mean that people will have to wait to be assessed and tested. But we will get the right solution in place as quickly as we can.

Clinical staff are doing an amazing job assessing and testing patients, managing expectations and answering CO-19 questions, all while doing their day-jobs of keeping people well. 

There have surely been frustrations along the way as we have had new processes put in place sourcing and distributing PPE and testing swabs. I think we have worked through this now and I hope that if a general practice team member has questions or concerns, they would reach out to the WellSouth.

We established an Emergency Operations Centre (EOC) early in March to coordinate our response to the COVID-19 outbreak in the district and to better support general practices and patients. This helps us to ensure lines of communications are clear and we can get them the help and the information they need as quickly as possible.  

Everything is happening so fast that staying informed is a challenge. But I would say that everyone is in the same boat. We are working together to get information out to practices and the public as quickly and accurately as we can.

We’re also promoting to the public that practices are still open, though operating slightly differently in some cases, and that they should continue to call their GP, in the first instance, if they need care.

A CBAC was set up in Queenstown on 24 March to provide extra support to practices, as this is an area where there has been a cluster of cases associated with the World Hereford Conference and Wanaka A&P show. There are also many international tourists and people working in the tourism sector.

The CBAC, now located the Queenstown Memorial Centre, is busy but manageable and we are able to scale up and down as demand requires.

General practice teams in Queenstown and Wanaka have been incredible.  They have leapt in to provide assessment and testing from the very start, they have mobilised staff to help in the CBAC, they have shared knowledge and lent equipment.  If there have been problems, we have solved them through cooperation and communication.

The public should be reassure that we are working together and that the care they need from their general practice team is available.

UPDATE: Reminders for the general public

 We would appreciate the media helping us get the following messages out to the general public:

Disclose symptoms

Southern DHB staff are reminding members of the public it is imperative that patients disclose any potential symptoms of COVID infections when asked, especially when entering any healthcare facility or attend for treatment of any sort.

These symptoms include: cough, fever, runny nose, blocked nose, loss of smell, sore throat (scratch throat/tickle in throat), headache, myalgia (muscle aches) or fatigue.

We appreciate that this may be confronting or uncomfortable but is vital to protecting yourselves, the staff in our facilities and family.

DIY precautions

Southern DHB has noticed an increase in the number of orthopaedic presentations related to DIY activity around the home.

Please can we remind everyone to take care when undertaking DIY tasks and using power tools and to ensure the correct safety equipment is used.

ENDS.