The number of people in hospital with Covid-19 is on the rise in New Zealand, and is projected to increase further, raising the question: how many can we handle?

Modelling last month showed peak hospital admissions could range from 200 to 800 per day, and peak demand for hospital beds ranging from 800 to 3300; with RNZ today reporting we could have 800 Covid in-patients in under a week.

While the overall number of people in hospital with Covid-19 is rising, the hospitalisation rate among active cases (the number of people hospitalised compared with the wider number of community cases) has been relatively steady over the past month.

Stuff asked the Ministry of Health for data on what our hospital network looks like, as the outbreak continues to gather steam.

It is important to note this is a snapshot in time. Hospital occupancy fluctuates every day, and at different points in the day, but this provides a picture of what our hospitals look like on Wednesday, March 2.

What do we have?

Ward beds

There are 7505​ ward beds in public hospitals dotted around the country.

As of Wednesday, 6023​ of these had a patient in them – making for an average occupancy rate of 80.3 per cent.​

As you’d expect, the number of beds at each hospital varies widely depending on the area and its population.

While there are 1075 ward beds at Auckland DHB, and more than 800 at Counties Manukau and Waitematā, three DHBs have fewer than 100 ward beds each: West Coast (42), Wairarapa (75), Tairāwhiti (88), which ranged between 64-74 per cent full on Wednesday.​

On Wednesday, 519 of Canterbury DHB’s 575 ward beds were full (90.3 per cent).

At Capital & Coast DHB in Wellington, 392 of 433 beds (90.5 per cent) were full, and 238 of 261 beds in Hawke’s Bay (91.2 per cent) were occupied.

Intensive care/high dependency care beds

As of Wednesday, 10 people were in an intensive care or high dependency care unit with Covid-19.

The ministry says high vaccination levels will mean only a small proportion of people with Omicron are expected to end up in hospital, while the “vast majority” will be cared for in the community.

It is important to note that most Omicron hospitalisations will not require ICU/HDU-level care, however as the sheer number of overall cases rises, so too will the number of people ill enough to need this level of intervention.

The ministry said that of 296​ ICU/HDU beds across New Zealand’s public hospitals, 168 were occupied – 56.8 per cent on average.​

However, a better picture emerges by breaking things down by district health board.

In Auckland, Counties Manukau and Waitematā DHBs – which are currently treating the largest numbers of Covid-19 patients – ICU bed occupancy was currently 60.7 per cent, 44 per cent, and 18.2 per cent, respectively.​

These DHBs also have among the highest ICU/HDU bed totals, with 56, 25, and 22.​

However, Lakes district, which is seeing a growing number of cases, was at 100 per cent capacity for ICU today, with four of four ICU beds occupied.

Five of six ICU/HDU beds in Whanganui were occupied, 10 of 11 in Hawke’s Bay, and 17 of 21 in Canterbury.​

Nine of the country’s 20 DHBs have fewer than 10 ICU/HDU beds, with just four in Hutt Valley, Lakes and West Coast.​

An editorial in the New Zealand Medical Journal by intensivists Paul Young, Alex Psirides and Stephen Streat in November found there were 176 staffed ICU beds in 24 public hospital intensive care units across Aotearoa. Of these, 15 were dedicated paediatric ICU beds.

An additional 104 physical beds within ICUs that were not staffed were identified.

The NZMJ data suggested that – when the survey was completed between October 15-November 1, 2021 – New Zealand's staffed ICU bed capacity was approximately 3.5 staffed ICU beds per 100,000 people.

By comparison, Australia’s staffed ICU bed numbers varied, by state, from 6 to 10.8 per 100,000 people.

The Ministry of Health says that if required, hospitals could surge to approximately 550 ICU/HDU-capable beds, but clinicians have queried the validity of this figure.

Ventilators

Ministry data showed there are 425 ventilators across the country. Fifty-two were in use as of Wednesday – 12.2 per cent of those available.

However, these are also not distributed evenly across the country.

Seven of the country's 20 DHBs have fewer than 10 ventilators each, while the rest of the health boards vary from dozens in stock to 81.

What officials say

On Wednesday, Covid-19 Response Minister Chris Hipkins said hospitalisations linked to the virus currently make up a “very small fraction” of the overall occupancy numbers.

“There is still capacity there.”

When asked at what threshold hospitals will become overwhelmed, Hipkins said this depends on how quickly things shift.

The “slower the build” (of cases), the more time the health system has to adapt and respond

If there is a “sudden spike”, that becomes more challenging.

However, he maintained the health system was “well prepared” to manage an increasing number of Covid-19 hospitalisations, and had planned for different scenarios.

Hipkins acknowledged an increase of hospitalisations will put the hospital system under pressure. This happens periodically, particularly over winter, and hospitals and staff “adapt to deal with that”.

However, he accepted it will be a “challenging next four to six weeks for the hospital system”.

A spokesperson for the Ministry of Health told Stuff that “significant work” has been undertaken by all DHBs to prepare for the increase in Covid-19 cases both in the community and in hospital.