COVID-19: Advice for all health professionals

Guidance and factsheets to support health professionals managing COVID-19.

Vaccine information

For guidance and the latest information on the COVID-19 vaccine, go to: COVID-19: Vaccine information for health professionals.

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 – 8pm every day, including weekends and public holidays.

The clinical advice line is staffed by 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.


COVID-19 Community Response Framework

The COVID-19 Community Response Framework provides some guidance and considerations for primary care, community-based health services, residential care, community pharmacy, maternity, population health services and ambulance services.

The Framework has been updated following the introduction of the Government traffic light system on 3 December 2021. It recognises that 100 percent of the health workforce and almost 90 percent of the country are vaccinated against COVID-19.

It is important that health services continue to be delivered at all levels, with the least restrictions and in a safe environment.

Find full details on the COVID-19 Community Response Framework page.


Guidance for critical health services during an Omicron outbreak

All health and disability services continue to operate in the COVID-19 Protection Framework, also known as the ‘traffic light’ system. This remains true at all levels - Green, Orange, and Red.

If the community spread of Omicron causes significant disruptions to services, we have defined critical health services that will be required to ensure their critical workers follow guidance at each phase of the response to Omicron. This guidance will be in relation to periods of self-isolation and Rapid Antigen Tests (RATs). 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.


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.


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. 

Once public health has released a person with COVID-19 from isolation they are no longer infectious. They are also considered highly unlikely to be able to be reinfected with COVID-19 during the following three months. 

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:

  • EXPANDED access criteria included for antiviral treatments in early COVID-19
  • a link to the access criteria assessment tool
  • a NEW recommendation to consider Paxlovid (nirmatrelvir + ritonavir) in patients with advanced kidney disease and dialysis
  • a NEW recommendation to consider remdesivir for patients with moderate COVID-19 within 7 days of symptom onset
  • a NEW recommendation for Evusheld (tixagevimab/cilgavimab) after recovery from COVID-19 in eligible patients
  • a NEW recommendation against use of sotrovimab given currently circulating SARS-CoV-2 variants
  • amended wording of therapeutics for COVID-19 in patients not requiring oxygen
  • added link to Pharmac antiviral access criteria calculator
  • removal of link to previous MOH definition of incomplete vaccination as part of definition of ‘high risk’ individuals: currently defined as ‘incomplete primary vaccination series’
  • addition of reference to persistent SARS-CoV-2 infection in severely immunocompromised 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 the treatment of 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. Read more about the Therapeutics Technical Advisory Group.

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.

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.

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.


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.


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

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


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.


Cluster investigation and control guidelines

This document provides guidelines for the identification, investigation, reporting and control of clusters of COVID-19 infection.


Keep people in your home safe

Guidance on keeping you and your whānau and family safe when you have finished work during the COVID-19 pandemic.


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.


Students completing training placements during COVID-19

The following policy applies to students from all health professions who are completing training placements or undergoing face-to-face training assessments in any setting (ie, DHB or non-DHB) while nation-wide or regional COVID-19 Protection Framework restrictions are operating:


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

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.

Clinical guidance on testing for possible COVID-19 reinfection

This guidance provides clinical advice to healthcare providers about how to manage patients who present with symptoms consistent with COVID-19, or a positive COVID-19 RAT, after a previous COVID-19 infection. 

If you have any clinical queries relating to this guidance please email [email protected] 

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