Covid 19 coronavirus Delta outbreak: Middlemore Hospital not unique in lacking isolation space for patients awaiting Covid test results

A lack of isolation facilities in hospitals means it’s a “reality” patients awaiting Covid tests will sometimes be put in a ward with other patients, a Nurse’s Union representative says.

This week one of Auckland’s main hospitals has been at the centre of two Covid scares – most recently after a patient walked out of the hospital before her Covid test came back positive, potentially exposing 36 other patients.

Earlier this week, a man at Middlemore tested positive for Covid-19, after being initially admitted for abdominal pain. A decision was made not to remove him from a ward with three other patients, while he was awaiting a Covid test result.

New Zealand Nurse’s Organisation (NZNO) Wellington representative Jo Coffey said hospital staff sometimes have no choice but to put suspected Covid cases in a ward with other patients.

“When wards are full, they’ve got no choice but to put patients with suspected Covid in wards with other people – they did it in Wellington last time.

“If the beds are full, they have to put them somewhere, they can’t just put them back in the community.”

“The problem is, for privacy reasons they can’t also disclose that to everyone else that’s in the ward with them.”

She said a patient awaiting a Covid test was not necessarily suspected to have Covid, and may have been deemed low-risk.

“Just because you’ve had a Covid test doesn’t mean they think you have Covid,” she said.

“It’s not always that someone is coughing and spluttering and putting people at risk.”

Coffey said most hospitals around the country were working with limited facilities.

“People seem to think there’s all these negative-pressure rooms just sitting there waiting for people with suspected Covid – that’s not the reality.”

Emergency departments in particular were not set up for isolating patients, she said.

Last month an ED nurse told the Herald Wellington ED did not have the space or facilities to manage a Covid outbreak, let alone the more infectious Delta strain.

The designated isolated spaces of the ED did not have an area outside for staff to remove PPE, something Coffey said she had raised with the DHB.

“They have a yellow line and they go out and just de-robe there,” she said.

“There’s patients in corridors around them, and there’s staff walking past continuously.”

“And that’s only if you know you’ve got someone with Covid coming through ED – it’s just not set up for it.”

A spokesperson from CCDHB said they were not aware of any specific concerns but recognised the potential for the issue and were “exploring options”.

Hutt Valley DHB and Capital & Coast DHB chief executive Fionnagh Dougan said all patients admitted to Wellington and Hutt Valley hospitals, including those for planned care, were screened for risk of exposure and Covid symptoms.

“The screening will guide testing and what isolation precautions that are used,” she said.

“The risk assessment takes into consideration whether there is Covid-19 transmission in our community and the national transmission risks.

“Patients who screen as higher risk for Covid-19 infection will be managed in a single room under appropriate precautions until tests are negative, and a review has been undertaken confirming that there is no ongoing reason for isolation precautions to continue.

“For patients with confirmed Covid-19 infection, we follow Ministry of Health recommendations on the type and duration of isolation precautions.”

She said the Covid-19 case hospitalised last week in Wellington was a known case, and their transfer was managed from MIQ directly into an isolation room at Wellington Hospital. They did not need ICU care.

During the 2020 Covid-19 outbreak, nine cases in the region required hospitalisation at Wellington Regional Hospital – one in ICU, and the others on a ward.

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