Modelling shows there could be 5300 cases of COVID-19 in the community in 2022 and the Government has confirmed most people will recover at home.
Health Minister Andrew Little held a press conference on Thursday to illustrate how the Government plans to cope with thousands of cases of coronavirus once New Zealand opens up in a vaccinated world.
"The reality is, the vast bulk of people who end up being infected with COVID in the future won't go to hospital and won't go to ICU. They'll be cared for in the community and the vast majority of them will recover at home," Little said.
"If you're unvaccinated and you get COVID, you will get sick and you will likely get very sick, and that raises the probability that you will wind up in hospital and possibly ICU.
"If you are vaccinated, you are less likely to get sick, and you will be able to be cared for at home or elsewhere in the community."
Karori GP and chair of General Practice New Zealand Jeff Lowe, who accompanied Little, said modelling shows there could be 5300 cases per week in the northern region at the peak of the outbreak in 2022 - and that's with 90 percent of the eligible population double vaccinated.
But Dr Lowe said it's predicted that 5270 of those cases will be managed in the community.
"It essentially starts with a positive case being identified. It may be in a COVID testing station, it may be a respiratory clinic, at a general practice or surveillance swab," he said.
"That is then notified to public health and public health then do two assessments of that to define the risk - one is their medical risk which is based on ethnicity, age and other medical conditions that person may have.
"It also looks at the social risk of that patient - are they able to manage or self-isolate at home? Are there needs for their family in terms of food, clothing, education?"
Those patients will be risk-assessed by health professionals to decide whether they need hospital care or can recover at home.
Dr Lowe said 90 to 95 percent of people who get COVID-19 will have a mild viral illness which requires no treatment, but will need monitoring at home.
To do this, the Government plans to provide pulse oximeters to those who test positive. It's a contraption that sits on your finger that will provide readings for health professionals to observe a patient's oxygen levels.
"We know that from about day five to day 10, a number of people will develop more severe COVID illness and that's when it affects their lungs. Essentially, they start producing a whole lot of fluid in their lungs," Dr Lowe said.
"When the body is trying to cope with that, you can detect that deterioration trying to breathe through that fluid by their heart rate because their heart's got to work a bit harder, their breathing rate because they've got to breathe a bit harder, and also monitoring the amount of oxygen that they're delivering into their bloodstream and that's where the pulse oximeter comes in.
"For most people it's going to be monitoring them at home for a two week period, and once they're through that, a matter of discharging them and monitoring them for complications such as long COVID."
Therapeutic drugs such as the antiviral molnupiravir - which the Government's drug-buying agency Pharmac has negotiated a deal for 60,000 courses - will help to ease symptoms of COVID-19.
"There will need to be daily, possibly twice daily, checks on people recovering at home," Little said. "For people whose homes have a lot of people, we will have to find another facility for them to recover in."
Pharmac's chief executive Sarah Fitt said other COVID-19 treatments are being secured, but the names of them cannot be disclosed just yet.
But ultimately, vaccination is the best protection, Dr Lowe said. More than 5 million doses of Pfizer have been administered across New Zealand so far, but only about half the population is fully vaccinated with two doses. Nearly 90 percent of Aucklanders have had one dose.
As for the readiness of the health system to cope with a large outbreak, Little said he expects hospitals will be able to. The current ICU or high dependency unit utilisation is roughly two thirds, he said.
"I know there's been some discourse that we're all maxed out at the moment. That is not correct. Even if you look at the northern hospitals, particularly the Auckland metropolitan ones, they're not fully maxed out.
"There's also some debate about what an ICU bed is. This is about ICU-capable beds that can be used right now. It changes from one day to the next depending on what's happening in a hospital but it's anywhere between roughly 320 and 340 ICU-capable beds across the hospital network."
Little said there are roughly 7600 beds across New Zealand's hospital network, currently at 83 percent utilisation.
"We tend to hover between about 80-85 percent."
District Health Boards (DHBs) have informed him they can surge up to 550 beds, though that would take beds from other patients. It's meant additional training for nurses to be able to work in an ICU environment
In terms of ventilators, there are roughly 430 across the network with 250 kept in reserve. Ventilator utilisation right now is about 16 percent, Little said.
"So in terms of capacity to respond for additional patients, I'm confident that it is there."
Little acknowledged it can't all be about COVID-19.
"Making sure the health system meets all the other demands on it because it cannot just be about COVID."
But the virus is "here to stay", according to Dr Lowe, and Little said the Government knows it's time to start preparing for life beyond lockdowns.
"Now that there is a vaccine - an effective vaccine - and we're getting vaccination well underway, people want to return to something that looks like life is normal. We owe it to everybody to do that. We've got to do that in a way that minimises the risk of harm to people."
