Twenty-nine staff at Auckland's Middlemore Hospital are being treated as close contacts and have been stood down for two weeks after a patient who tested positive for COVID-19 visited the hospital.
The COVID-positive patient went to Middlemore at 5pm on September 4 with atypical COVID-19 symptoms. After routine COVID exposure questioning, they weren't identified as a risk and were moved to an adult short stay ward from the emergency department.
At 7am on Sunday, they were moved to a surgical ward - 34N - where concerns about their condition resulted in them being tested for COVID-19. They then tested positive at 3pm and were moved to the respiratory ward dedicated to COVID patients.
Of the 29 staff that are stood down, there are 11 doctors, 13 registered nurses, two health care assistants, a phlebotomist, cleaner and ward clerk.
Middlemore Hospital is actively reviewing staffing daily and, like other DHBs in the region, is experiencing significant shortages of both registered nurses and health care assistants.
"A national process is underway across all DHBs to identify and send staff to Auckland to support the COVID-19 response," the Ministry of Health says.
"The Ministry of Health are working with metro-Auckland DHBs to match available staff to need and will continue to deploy staff as required to ensure they have the resources they need.
"Metro-Auckland DHBs are working closely together to manage the COVID-19 positive cases needing hospital-level care. The hospitals have been constantly updating their planning for surge capacity which includes preparations for staffing and resourcing additional beds in dedicated COVID-19 wards."
Four wards are currently closed to any new admissions and all patients are being managed under strict infection and prevention control measures, including the full use of PPE, and treated as if they have COVID-19.
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Concerns were also raised that ventilation in Ward34N - the surgical ward - could've spread the virus to other parts of the hospital. But after conducting airflow tests, the ministry says this wouldn't have happened due to the direction of airflow.
"The tests also suggest that the likelihood of virus being spread to the level below (33N and 33E) is extremely low. IPC are reviewing this advice and will advise accordingly," it says.
"The Ministry also understands from Counties Manukau Health that they will undertake a debrief and internal review of what occurred, including their processes, as per normal procedure.
"Counties Manukau Health has updated its clinical assessment tool, which clinical staff should refer to when assessing all patients, to increase the range of symptoms that warrant COVID-19 testing."
The three patients who shared a room with the case before it was considered they had COVID are all in single isolation rooms now, the Ministry of Health says. One has been discharged to a managed isolation facility for the rest of their managed isolation and the other two will remain in Middlemore Hospital in isolation rooms for treatment for their conditions.
Timeline of COVID-positive patient's movements in Middlemore, from the Ministry of Health
- 1700hrs a patient presented in ED with abdominal pain. When asked screening questions, patient denied having contact with COVID-19 or having been in a location of interest
- He was triaged into main ED assessment where staff are in full PPE (N95s and goggles). He stayed in an open curtained room and seen by ED staff
- 2039hrs he was moved to adult short stay into a four-bedded room, where he awaited test results
- 2242hrs he had a CT scan and returned to adult short stay.
- 0305hrs he was seen by the surgical registrar
- 0700hrs was admitted to ward 34N. At this stage there were no symptoms that gave teams reason to consider he may be COVID-19 positive, based on HIS indicators. He was admitted into a four-bedded room at the front of ward 34N. Ward staff were wearing appropriate PPE for a surgical ward (i.e. surgical masks).
- He developed a fever during this time. There was still no cause identified for the abdominal pain
- 0955 the consultant surgeon ordered swabs observing fever symptoms; clinical documentation records no cough, no loss of taste or smell, and patient had not been to any locations of interest
- Patient remained in the room post-swab because there were no isolation spaces on the ward. On advice from IPC the patient wore a surgical mask and curtains remained closed
- 1500 test result received with a low CT value
- 1620 patient moved to Ward 7 for COVID19. Full PPE was observed.
All patients and staff who were potentially exposed between 6:35am and 4:30pm are classed as contacts.