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COVID-19 clinical advice line

The National Telehealth Service provides a COVID-19 clinical advice line for community health providers (including primary care, pharmacy, midwives, aged residential care providers, and home and community health care professionals).

The service offers clinical support and advice 8am to 8pm every day, including weekends and public holidays.

The clinical advice line is staffed by doctors, registered nurses, and paramedics, and there is at least one doctor available on every shift.

The service is not a source of information about or access to equipment, staffing or funding – these will continue to be managed through the usual channels.

It provides clinical staff with a valuable additional resource to help them navigate the range of information available and to support them in making local decisions to protect their patients and populations.

Details of the 0800 clinical advice number have been circulated to stakeholders within New Zealand.

Primary Care COVID-19 Quick Reference Guide

This is a summary of information for community healthcare providers involved in: 

  • assessing and managing COVID-19
  • queries regarding COVID-19 risk and need for testing (including general practice, community pharmacy, Hauora Māori, and urgent care providers).

This guide aims to help primary care providers to develop their policies and procedures.

View the Primary Care Quick Reference Guide

Risk score for COVID-19 call prioritisation

Care Coordination Hubs have access to the Risk Score for Call Prioritisation to identify people at higher risk of hospitalisation. It is used when a person with COVID-19 does not submit a health survey within 24 hours after uploading their result. Once their risk score is estimated they may be prioritised for a phone call.

The data used to estimate the risk score is based on an algorithm. The Ministry of Health is a signatory to the Algorithm Charter

Guidance for critical health services during an Omicron outbreak

If the community spread of Omicron causes significant disruptions to services, we have defined critical health services that will be required and have guidance for critical workers to follow. The guidance covers periods of self-isolation and testing. Where operational changes need to be made, these will only apply to critical workers where face-to-face service delivery is required.

Find full details on the guidance for critical health services during an Omicron outbreak page

Guidance on managing community cases and contacts

This guidance provides information for health practitioners for assessing and managing COVID-19 cases and contacts. It is reviewed and updated regularly. New additions or changes are shown in red.

Clinical guidance on testing for possible COVID-19 reinfection

Clinical and operational guidance on testing for possible COVID-19 reinfection has been amended and simplified and is now included in the COVID-19 Testing Guidance

Case definition and clinical testing guidelines for COVID-19

Access to health services and testing after having COVID-19

People who have had a COVID-19 infection may have persistent positive COVID-19 PCR tests in the three months after recovering. This is because it takes time for viral fragments to be cleared from the body, despite no longer being infectious. 

In the three months following recovery from COVID-19, people who need to access healthcare of any kind, including residential facilities, should be able to do so without the need for a negative COVID-19 test.

Clinical management of COVID-19 in hospitalised adults

This guideline is intended to be an accessible summary of key components of hospital management of adults (including in pregnancy) with confirmed or probable COVID-19.

This update includes:

  • amended comment to reflect emerging evidence of clinical benefits of molnupiravir treatment 
  • added reference to REMAP-CAP convalescent plasma arm for immunocompromised hospitalised patients. 

This document is reviewed and updated periodically, or in response to significant changes in evidence and/or recommendations by international guideline groups.

Therapeutics for COVID-19

The Therapeutics Technical Advisory Group (TAG) was established by the Ministry of Health in August 2021 to provide expert advice on existing and emerging medicines for use in the management of COVID-19. This group prepares and provides a range of advice for health professionals on the use of COVID-19 therapeutics. 

Oral therapeutics for the treatment of COVID-19

Information and guidance have been developed for health practitioners to aid in the provision of oral therapeutics Paxlovid and molnupiravir to treat COVID-19. These medicines are given to people who have been diagnosed with COVID-19, have symptoms, and are at a higher risk of hospitalisation including Māori and Pacific peoples, those with complex health needs, older persons, unvaccinated populations, and people with disabilities.

Access criteria for Paxlovid and molnupiravir is set by Pharmac.

Information and guidance have been developed for hauora and Māori health providers to aid in responding to patients with questions about their eligibility for oral therapeutics to treat COVID-19, including advice for providers who are not able to provide eligibility assessments for patients or prescribe these therapeutics.

Guidance on advance prescriptions for oral COVID-19 antiviral medicines

Te Whatu Ora has released guidance on advance prescriptions for oral COVID-19 antiviral medicines. The document provides guidance to relevant appropriately qualified prescribers and pharmacists to support safe and timely access to oral therapeutics for COVID-19 to reduce the risk of hospitalisation and poor outcomes. Read more about COVID-19 medicines.

Antiviral Options for COVID-19 Infection in patients with Chronic Kidney disease

This advice a position statement from the Therapeutics TAG to provide guidance relating to the use of antivirals in patients with Chronic Kidney Failure.

Pre Exposure Prophylaxis (PrEP) (Evusheld)

Guidance has been developed for health practitioners to provide Pre Exposure Prophylaxis (PrEP) to people who do not mount an adequate immune response to the COVID-19 vaccine due to comorbidities or other health conditions, or when COVID-19 vaccination is contraindicated.

The Ministry of Health published new information and guidance on Evusheld.

Information relating to the plan for delivery of Evusheld to consumers:

Information and guidance for secondary care clinicians: antiviral agents for treatment of COVID-19

The Ministry of Health has published new information and guidance on antiviral agents for treatment of COVID-19 for secondary care clinicians from the Therapeutics Technical Advisory Group.

Position statement: Inhaled Budesonide for adults with COVID-19

This Position Statement provides advice on use of inhaled budesonide in non-hospitalised patients with COVID-19.

Practical guidance on the use of Ronapreve (casirivimab/ imdevimab)

Guidance for temporary prioritisation of remdesivir for early COVID-19 in people not requiring oxygen

This advice provides guidance for temporary prioritisation of remdesivir for early COVID-19 in people not requiring oxygen.

Clinical rehabilitation for people with long COVID

This guideline is intended to provide clinical guidance on long COVID conditions in both children and adults in Aotearoa New Zealand.

It is an evidence-based summary that covers the definition and diagnosis of long COVID. It seeks to provide the best evidence currently available to assist informed decision-making to improve the health, vocational and social outcomes for individuals with long COVID.

There are also two summary fact sheets available – for clinicians, and for individuals and whanau.

View the guidance on clinical rehabilitation for people with long COVID

COVID-19 Infection Prevention and Control - Interim Guidance for Acute Care Hospitals

View this guidance on the COVID-19: Infection prevention and control recommendations for health and disability care workers page

Ministry of Health position statement on pre-consultation testing of unvaccinated individuals in healthcare settings

The Ministry of Health has made a position statement on the management of unvaccinated individuals in healthcare settings. This statement focuses on the core issue of routine pre-consultation testing of unvaccinated patients in both community and secondary care settings.

Clinical guidance for responding to patients with an intellectual (learning) disability during COVID-19 in Aotearoa New Zealand

People with an intellectual (learning) disability are at a heightened risk of having a poor outcome from infection with COVID-19 in comparison to non-disabled people. These guidelines are being provided to ensure equity for people with an intellectual disability.

talkingCOVID

talkingCOVID is designed to help health professionals have conversations about what matters most to patients and their whānau. The talkingCOVID pages are based on sound principles, evidence and experience.

Older adults, and those living with chronic or life-limiting conditions, are at increased risk of experiencing severe or critical symptoms associated with COVID-19 infection and are more likely to die. They may also experience non-COVID-19-related deterioration in their health status during this period. Advance care planning is critical for this cohort and should form a key part of our health system's COVID-19 response strategy.

Advance care planning guidance, specific to the COVID-19 context, has been developed for health practitioners. The guidance is optional, and aims to support conversations and planning with patients.

Visitors to New Zealand who require treatment for COVID-19

The only groups that automatically qualify for the same COVID-19 healthcare as New Zealand citizens and residence-class visa holders are:

  • Australian citizens or residence-class visa holders; and
  • citizens of the United Kingdom.

Travellers are encouraged to check (before they travel) their insurance covers them for the treatment of COVID-19, and the cost of changing flights, or self-isolating in suitable accommodation.

Currently, visitors who are not citizens or residence-class visa holders and who are not covered by any reciprocal healthcare agreements will only be eligible for publicly funded COVID-19 healthcare if they meet the requirements of the Health and Disability Services Eligibility Direction 2011. The assessment of an individual’s circumstances will be made at an operational level.

Any private care provided under the Health and Disability Services Eligibility Direction 2011 should be billed to the Ministry of Health in the same way as funded care provided to overseas visitors.

Vaccinations and COVID-19 testing for symptomatic people will continue to be provided for free, regardless of their reason for being in the country, or whether they are eligible for funded healthcare.

Travellers who are COVID-positive should expect to pay to self-isolate in suitable accommodation. Currently, if they are unable to find any suitable accommodation to self-isolate in, they can contact the regional care coordination hub, which in exceptional circumstances may help with sourcing suitable accommodation. The visitor will be invoiced for their stay, which will be booked by the coordination hub via the Orbit system.

Ventilator capacity

The following table shows ICU-capable ventilators in public hospitals by DHB as at 14 July 2021. Anaesthetic ventilators are not included in these figures as they are generally not considered suitable for use in ICUs.

The Ministry’s COVID-19 equipment reserve, which is referenced in the table, is located in Auckland. As well as ventilators, it holds a range of respiratory equipment (CPAP/NIV/HFNO), ancillary equipment (mainly pumps and monitors) and related consumables. The reserve is managed for the Ministry by New Zealand Health Partnerships Ltd.

ICU-capable ventilators in public hospitals as at 14 July 2021

ICU-capable ventilators in public hospitals as at 14 July 2021

Region DHB Quantity
Northern Auckland 107
Counties Manukau 56
Northland 25
Waitemata 29
Total 217
Midland Bay of Plenty 23
Lakes 8
Tairawhiti 7
Taranaki 13
Waikato 55
Total  106
Central Capital and Coast 61
Hawkes Bay 29
Hutt Valley 12
Mid Central 20
Wairarapa 4
Whanganui 6
Total 132
South Island Canterbury 82
Nelson Marlborough 18
South Canterbury 8
Southern 64
West Coast 2
Total  174
Held in DHBs 629
Held in National Reserve 133
Grand Total 762

ICU bed capacity

Between April and October 2020, the Ministry received daily updates from DHBs (manually reported) on the number of ICU beds in their region.  The definition at that time was based on ICU beds and ICU capable beds.  These beds could all be staffed and able to accept a ventilator if required (for example, the bed may have been in a high dependency unit but could be ventilated to lift it to ICU capacity).  The beds were predominantly within DHB hospitals, but also included ICU beds available for use in private hospitals. 

This manual reporting stopped in October 2020, as the COVID-19 situation was relatively stable and daily reporting was not required.

During that period, DHBs continued to plan for any ‘surge’ capacity needed, and it was determined that ICU capable capacity could be lifted to over 550 beds if required.

In February 2021, the Ministry completed a stocktake of ICU capacity in DHBs.  The capacity at that time was 284 beds, and this is still the current estimate.  However, this figure relates to ICU beds specifically, in public hospitals only, and which are already staffed.  It does not include all ICU capable beds across public and private.

It should be noted that ICU bed capacity in New Zealand changes daily, depending on local need, planning and staffing.