20th August 2021
Intensive Care Beds and Pandemic Preparation in Aotearoa New Zealand
The College of Intensive Care Medicine (CICM) and the Australian and New Zealand Intensive Care Society (ANZICS) recognises that since April 2020, ICUs around Aotearoa New Zealand have developed plans to deal with a significant and sustained rise in the numbers of patients who may need life support as a result of the COVID-19 pandemic.
For critically ill patients in Intensive Care Units (ICUs) to have the best outcome, they need a highly trained team of nurses, doctors and other healthcare workers, with access to the right equipment and technology, working together in the right setting.
In consultation with the senior clinical staff of ICUs around the country, the Government has purchased an additional number of ventilators as part of these plans.
Whilst having this life saving equipment available is important, it is only part of what is needed to increase capacity in an ICU setting. Every patient on life-support requires 24-hour care from a dedicated and trained ICU team. It takes 7-8 years to become a specialist ICU doctor and 4-5 years to become a senior ICU nurse. Numbers are in constant flux, particularly with nurses leaving the Aotearoa New Zealand workforce for better pay in Australia. Therefore, focusing on the number of beds or ventilators alone does not define our capacity to care for critically ill patients nor accurately represents the available resources.
As highlighted in Sir David Skegg’s recent report, Aotearoa New Zealand began the pandemic with much less ICU capacity than most other countries in the OECD, and half the
capacity in Australia. This is one reason why the Intensive Care community was, and remains, strongly supportive of the government’s elimination strategy and vaccination programme. Although the population of Aotearoa New Zealand has increased significantly over the last ten years, the number of staffed ICU beds has not; no additional ICUs have been built and much of the funded increase in staffing to open more beds within existing units has been partially offset by increases in staff turnover.
Dr Rob Bevan, College of Intensive Care Medicine Vice President and Auckland-based Intensive Care Specialist said:
“Aotearoa New Zealand-based ICU teams have been called upon to respond to several significant events and contribute to the survival of those affected by earthquake, mass-trauma, the Whakaari eruption, and numerous waves of previous infections- all whilst caring for those who require our care after becoming severely unwell from other illnesses.”
“Whilst we have and continue to work with the Ministry of Health and the Minister of Health to advise on how best to address a chronic and unsustainable shortage of equitable ICU capacity in NZ, we acknowledge this requires a commitment to a coordinated and long-term investment and cannot be rectified in the space of a few short months. That’s not to say that ICU teams lack the ability to improve and innovate. It is what we do”.
Dr Craig Carr and Dr Alex Psirides, ANZICS Spokespeople from New Zealand said:
“We want to reassure the Aotearoa New Zealand public that Intensive Care teams have planned on how to increase capacity in the event of a significant COVID outbreak. New Zealand does not have the buffer of empty beds or staff that other countries may have had, but we have learned many lessons from our colleagues overseas.
We believe it is vitally important that people follow the advice of the Public Health experts, observe lock-down rules, wear masks in public spaces, continue social distancing, maintain excellent hand-hygiene and use the Covid-tracer App wherever they go. Getting vaccinated is the best way to avoid needing an ICU bed at all and keeps everyone safer from Covid”.
Detailed data on ICU bed numbers and staffing in Aotearoa New Zealand and Australia can be found in the ANZICS Critical Care Resources (CCR) reports, available online here: https://www.anzics.com.au/annual-reports/
The College of Intensive Care Medicine of Australia and New Zealand (CICM) and the Australian and New Zealand Intensive Care Society (ANZICS) are the organisations that train Intensive Care Specialists, set professional standards and advocate on Intensive Care issues and resources.
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The Age, May 6 2016
The Age, July 8 2015
The Australian Hospital and Healthcare Bulletin, October 16, 2014