An infection prevention and control expert says in a perfect world a dedicated team of nurses would be caring for people in COVID-19 managed isolation and quarantine facilities.
It's been revealed that nurses - some being paid as much as $500 a shift - have been working in managed isolation and quarantine facilities while also employed at district health boards and private health providers.
Sally Roberts is a clinical microbiologist at the Auckland District Health Board and an advisor to the COVID-19 taskforce on infection prevention and control.
Dr Roberts said the fact there was no such team was a reflection of the limited pool of healthcare workers available in New Zealand - but does not mean there is an elevated risk of the disease being transmitted into hospitals.
She said it was not uncommon for nurses to work across multiple employers and it should not present a problem if all the correct procedures were followed.
"As long as the staff are trained and demonstrate competency in best practice for infection prevention and control then that's all that's required.
"Each of those facilities has to have procedures and policies around what's required and then they need to be able to demonstrate that their staff are competent."
Dr Roberts said there were not enough suitably qualified healthcare workers to go around.
"Ideally we would have a dedicated team of skilled staff that just worked in these isolation facilities, but in New Zealand we just don't have the workforce capacity to be able to do that.
"These facilities were set up very quickly and I believe there's over 20 of them now and they require 24/7 nursing which is very difficult to find from people who are not already involved in some kind of nursing role."
Kate Weston is the acting associate professional services manager at the New Zealand Nurses Organisation - which represents about 50,000 nurses. Weston said the chance of transmission via the healthcare workers was minimal.
"The risk is not a zero chance, but it is a very low risk and it is a very well-managed risk.
"If we go back to when we had COVID cases in our hospitals, we had staff providing to them and they did that safely, and they did it very professionally and very well."
She said parallels could not be drawn with the situation at Waitakere Hospital where seven nurses got infected with COVID-19 after a group of patients were transferred there from St Margaret's rest home.
"That was a situation that was an urgent and very rapidly changing situation with actively unwell, very vulnerable older adults and the reviews have shown there was not adequate PPE [personal protective equipment].
"There were a lot of things in the planning that were missing and from all of those things we've learnt from that. The health sector has learned from that."
Weston is more concerned with nurses taking on too many shifts, getting tired and becoming a health and safety risk because of that.
The Nurses Society of New Zealand represents 5000 nurses and director David Wills is not convinced.
"We certainly have some concerns in the sense that we said at the very least that if you are working at a quarantine facility or in a managed isolation role and also concurrently working in another facility, you should get sign-off from that other facility so that they are at least aware of it. They can make a risk assessment and maybe impose some conditions."
Wills said the current situation is not the best case scenario.
"Ideally you could argue taking a belt and braces approach that all of those facilities should really have dedicated people who are working solely in those facilities and not also going back into other areas."
Wills understood that the district health boards would take over management of managed isolation and quarantine facilities next month, which he welcomed.
Health Minister Chris Hipkins was not available for an interview, but in a statement said nurses working in managed isolation and quarantine facilities were skilled professionals who understood infection control and were using all the appropriate PPE.
However, Hipkins said policies and procedures to ensure everything was being done to keep New Zealanders safe were being constantly reviewed and he was awaiting further advice from the Director-General of Health on this issue.
RNZ
