Staff in MIQ hotels are being told not to walk alone - and getting security escorts to visit certain guests - because of an increased risk of violence.

Their unions say they're being lashed out at, and abused through the hotel phones.

A health and safety report presented to the board of Counties Manukau DHB yesterday noted the MIQ hotels were housing a higher rate of people with substance dependence and other social issues.

It said there were now fewer health staff supporting them, as resources pulled from health boards around the country in September go back to their own work areas.

The remainder were reporting more violence and aggression from guests.

"Just lately, in the last month or so, they've had people who've made them feel quite frightened and angry," said Shanna Reeder from Unite Union, which represents MIQ hospitality workers.

She said that cohort of staff don't have to interact with guests in person, but they were fielding tricky phone calls from people requesting deliveries to their rooms, then swearing and threatening them.

"Some of the requests are not reasonable, or its not possible to help the guest with that particular issue - then unfortunately, the guests can become quite abusive towards the staff members," she said.

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"It's worth bearing in mind that these are hospitality workers, hotel workers. They're used to dealing with people who might be difficult. But this is a whole other level where people are actually feeling frightened and quite intimidated by some of these guests."

Last month it emerged some guests had been directing violence at their surrounds, with five rooms damaged at the Jet Park Quarantine Hotel.

One had several appliances broken, a curtain rail ripped down and holes left in the window and door.

Nurses Society director David Wills said an increase in people being moved abruptly into MIQ was at the root of the issue.

Unlike returnees, he said they couldn't spend weeks or months preparing for their stay.

"They're people who don't wish to be there, and in part they're people who are there through difficult circumstances. A high proportion of them are in there because they're contacts of people or because they're, alternatively, positive themselves. And many of them are anti-vaxxers - they wouldn't be in there if they had been vaccinated in the first place. They have some of the aggressive behaviour we are seeing," he said.

However, New Zealand Nurses Organisation organiser Sharleen Rapoto said it was "really shocking" to learn violence against nurses had continued, having first became a problem months ago.

She said there had already been many "quite concerning" cases of violence against nurses.

"They've been shouted at, sworn at, they've been spat at, kicked, punched, grabbed aggressively and just hurled abuse [at], called names. I know some of our members have experienced some racist comments," she said.

Rapoto said MIQ health and safety representatives and wellness advisers had been appointed to combat the increased violence.

Yesterday's report to the Counties Manukau District Health Board set out further changes.

It said health staff had been "informed not to walk the floors alone" and each day they were getting a list of persons of interest or 'POIs' in the hotel, to watch out for.

They "must be escorted by an AVSEC or other security person when checking the vital signs, or other face-to-face interactions with a POI," it said.

The report said more staff were being recruited and rosters "managed".

Police said they had also deployed more staff at MIQ hotels in recent weeks in response to the Delta outbreak, but it wasn't in response to increased violence.