DAILY MEDIA UPDATE – Tuesday 24 March 2020

Two further COVID-19 cases in Southern district
Two Dunedin men have tested positive for COVID-19.  This brings the total cases in the Southern district to 15, 14 confirmed and one probable.

One is a man in his 60s, who had recently returned from travel to the United Kingdom. The other is a man in his 30s who returned recently from Austria.

Both men are mildly unwell and are at home. Contact tracing has commenced: close contacts are asked to self-isolate for 14 days, and everyone is asked to monitor their health and contact Healthline should they experience cough, fever or have difficulty breathing. Both went into isolation immediately so have a very small number of close contacts.

Again, we call upon the community to provide support to and respect the privacy of the affected people, and we thank everyone who for cooperating with requests to self-isolate.

Alert to public
Southern DHB alerts in locations across New Zealand that they may have come into contact with people who tested positive for COVID-19 this week.

As part of its contact tracing process, it is important for public health teams to notify the public about the movements of infectious cases to maintain awareness of possible transmission and ensure everyone monitors their own health. 

The following locations relate to possible casual contacts by members of the public that can’t be identified through contact tracing. Casual contacts are people who may have come into contact with the individual, but for less than 15 minutes and/or at a distance of more than two metres. 
  
The risk in these instances is considered to be low. Those who believe they may have come into contact with the case are advised to monitor their health and call Healthline on 0800 358 5453 if they develop symptoms such as a cough, fever, sore throat or difficulty breathing.

Again, we thank everyone who has supported the public health response, whether through patiently and responsibly undertaking self-isolation, or taking other steps in their community and daily routines steps to stop or slow the spread of this disease.

*Correction: In yesterday’s location alerts we referred to Integrated Health and Physio at Dunedin Hospital. This was an error, the facility is not at Dunedin Hospital.

UPDATE: Oral Health Services
All non-essential Southern District Health Board community oral health services for children aged 0-12 years have been closed from today.

The Oral Health Service will maintain two emergency hubs for essential oral health treatment, one in Dunedin and one in Invercargill for children 0-12 years.

Parents and caregivers should telephone the Service, where staff will carry out telephone triage and a decision will be made about whether the child needs to be seen.  If they need to be seen they will be given an appointment at a clinic.

The Oral Health telephone triage numbers are Otago 0800 672 543, and Southland 0800 570 300.

For adults in the Southern district, if you see a dentist privately, please contact them in the first instance as usual.

In Dunedin, essential dental care for adults will be provided by the School of Dentistry.

In Southland, essential dental care for adults will be provided at Southland Hospital.  Patients need to ring the Hospital and they will undergo telephone triage.

Walks-ins are not accepted. 

An indication of what constitutes “essential” relates to uncontrolled facial swelling, uncontrollable bleeding, facial trauma, and pain that can’t be managed by pain killers.

UPDATE: Maternity Services
We are focused on keeping health care providers and pregnant women and families safe, and reducing the risk of spread of COVID-19.  Part of the COVID-19 plan is to keep people out of hospital if they do not require urgent care.

All of our maternity facilities have plans for responding to COVID-19, developed with the input of Infectious Diseases, Public Health, as well as our midwifery and obstetric leadership, and in line with Ministry of Health maternity guidelines.

Pregnant and birthing women who need maternity care and who are affected by COVID-19 will be cared for in our base hospitals in Invercargill and Dunedin separately from other patients.

At Alert Level 3 and 4, we have also made other changes to keep mothers, babies, midwives and other maternity providers safe. 

Anyone receiving maternity care or entering a hospital will be asked about their recent travel, whether they have had contact with a COVID-19 infected person, or COVID-19 symptoms.  Anyone in this category is asked to contact their LMC midwife or Healthline PRIOR to presenting for care.

Well women without pregnancy complications and without COVID exposure are encouraged to receive their maternity care out of hospital, and talk to their midwife about birthing at home or in a primary maternity facility.

Women who need urgent maternity care and have been exposed to COVID or have suspected/confirmed COVID will receive care in separate areas from the rest of the maternity ward.    

Visitors to Dunedin Hospital, Southland Hospital and Lakes District Hospital are allowed ONLY to support a woman giving birth (one nominated person).  Limiting the number of support people is not something we would do in normal circumstances, but in these exceptional circumstances we feel it is the responsible thing to do.

We are particularly conscious of the safety of midwives, particularly those working in the community.  We are providing midwives with personal protective equipment and information about COVID-19 and how to keep themselves and the families they are providing care to, safe.

Routine midwifery care will be conducted out of hospital, and LMC midwives will be assessing their clients’ needs on a case by case basis.  

Pregnant women, along with the rest of the country, are encouraged to stay at home as much as possible, keep themselves safe with hand hygiene, and ring their LMC midwives with pregnancy-related concerns.  Reassuringly, there does not appear to be an increased risk of transmission to pregnant women, and only one documented case of transmission to a new born.   

We appreciate the cooperation of all our healthcare providers and pregnant women and whanau to keep everyone safe.

UPDATE: Lakes District Hospital, Queenstown
Lakes District Hospital is currently receiving a high level of Covid-19 related enquiries and is urging the general public to seek the most up-to-date information and recommended guidelines dictated by the Ministry of Health from the official Covid-19 website (https://covid19.govt.nz/).

Southern DHB Service Manager for Rural Health, Debi Lawry, says it’s critical the public follow and respect the latest Covid-19 guidelines, as we enter into Alert Level 4 across New Zealand.

“There is a lot of information out there right now - and misinformation as well - and, understandably, people have a lot questions. We ask the public to follow the guidelines outlined by the government, so health providers in the Queenstown-Lakes area can continue to care for our patients and whanau who are most in need. The official Covid-19 website (https://covid19.govt.nz/) is the best resource and it is updated regularly.”

Lakes District Hospital are asking the public to please take note of the following:

• A Community-Based Assessment Centre (CBAC) is being established in Queenstown. This is a dedicated clinic for assessment and testing of Covid-19. Patients should not self-present. They should contact their GP or call HealthLine, who will determine whether Covid-19 testing is indicated.
• Hospital services: The emergency department remains open for acute emergencies, along with inpatient ward beds and an isolation room. This is part of a wider network of care.

• We ask people are mindful of activities that could place pressure on health services. Yes, you can still go for a bike ride while under lockdown, but please don’t choose treacherous trails and keep a two metre distance from others.
• For the latest Covid-19 information, visit https://covid19.govt.nz/

UPDATE: Outpatient Appointments
Patients who have an outpatients appointment at Dunedin, Southland or Lakes District Hospital are asked NOT to come to their appointment unless they are phoned by the outpatient clinic to do so.

We are actively working on plans with regards to outpatients appointments and these will be communicated as soon as we can.

We understand this is a difficult and uncertain time, but please know that we are working through these plans with the safety and wellbeing of our patients, staff and our entire community in mind.

UPDATE: Outpatient support people
Support people for radiology appointments and any other essential outpatient appointments will only be permitted if they are required on compassionate grounds.

UPDATE: Hospital Visiting Guidelines
The SDHB is following national guidance for visitors and is applying them as is appropriate to different settings.

Visitors in self-isolation
Anyone that is under self-isolation (due to close contact with a confirmed case or due to recent overseas travel) will not be permitted to visit.

Visitors register
Names and contact details of visitors will be recorded in a sign in book at the points of entry. This will be in use shortly.

Dunedin and Southland Hospitals:
Visitors to high risk areas: (ED/ICU/NICU/SCBU/Maternity/ Aged Care or any ward with COVID-19 positive patients
Visitors with known COVID-19 contact or symptoms will not be granted access and will be directed to CBAC or to contact Health line or GP.

Visitors with no suspicion of COVID-19 will be able to enter. A maximum of one visitor at a time will be allowed, for one visit per day.

For maternity services: where there is no suspicion of COVID-19 for either the patient or visitor, one nominated support person is allowed into the maternity ward.

Visitors to all other areas
Visitors with known COVID-19 contact or symptoms will not be granted access and will be directed to CBAC or to contact Health line or GP.

Visitors with no suspicion of COVID-19 will be able to enter. A maximum of one visitor at any one time may visit a patient at the hospital or clinic.

Formal visiting hours are adhered to, unless by prior arrangement with the ward.

No non-essential visitors.

Lakes District Hospital
As Lakes District Hospital only has one ward and therefore does not have a designated COVID-19 ward,  there is no visitor access unless on compassionate grounds.

Wakari Hospital
No visitors are allowed at Wakari Hospital. Alternative arrangements will be made for visitors to communicate with patients via telephone/ Facetime/skype or similar.