This year we are likely to see a multitude of circulating respiratory viruses (including Covid-19) many of which will impact patients, hospital staff, visitors, and specialists.

Te Whatu Ora (Health New Zealand) continues to recommend isolation of Covid-19 cases for a minimum of 5 days.

Health policies involving surgical hospitals in Australasia are united in that the most important component of minimising perioperative complication risk to patients who have been affected by Covid-19 is the consideration of the length and severity of symptoms of respiratory disease, rather than the presence or absence of any particular test result. In line with TWO/HNZ guidance a negative Covid-19 test result is not required to access Braemar Hospital provided patients have symptomatically recovered. Current guidelines from ANZCA (PG68(A) Guideline on surgical patient safety for SARS-CoV-2 infection and vaccination 2023) are that:

  • All patients with ongoing symptoms (and those with a history of moderate-severe infection): non-urgent surgery delay 7 weeks
  • Patients who are asymptomatic and low risk (vaccinated, <70 years, no comorbidity) having minor surgery and endoscopy: delay beyond infectious period. As cases are advised by TWO/HNZ to avoid visiting high-risk settings (including hospitals) for at least 10 days following their first positive test, Braemar expect that the minimum delay will be 10 days
  • For most other patients who remain asymptomatic, it is safe to proceed with surgery 2-3 weeks (>14 days) following infection

Patients who have persistent symptoms after 14 days and are scheduled for an operation that cannot wait (for prognostic reasons in the opinion of the surgeon, and who are willing to accept the elevated peri-operative risks after consulting with a willing anaesthetist) will be discussed at the earliest available opportunity on a case-by-case basis with GM-Clinical Services. These cases may be required to test in order to contribute to their own risk assessment, and will generally require a higher nurse/patient ratio, more PPE, and generate overall higher costs than if they were asymptomatic.

Prospective patients who are household close contacts of Covid-19 cases, and whom are asymptomatic, are not expected to isolate and thus are able to access scheduled surgical services at Braemar Hospital. These patients are expected to wear a mask while in hospital outside of their own room. RAT testing for people who become symptomatic whilst at Braemar Hospital will continue to be made available.

 During the winter of 2023, Braemar Hospital managed very few patients who became symptomatic and tested positive for Covid-19 whilst inpatients following surgery. The consideration of transfer for patients who test positive for a new infection whilst at Braemar Hospital this year remains an individual patient risk/benefit calculation that will occur between senior nurse managers, clinicians, and patients as cases occur. This will also take into account the relative ability of TWO Waikato Hospital to receive patients based upon their own occupancy and the ability for the patient to be managed at Braemar hospital vs being discharged safely.

 We will continue to monitor the situation over the coming months, and will update this page if we need to make any changes with pre-operative testing should there be an increasing prevalence of disease in the community.

This guidance is Braemar’s minimum requirement. Individual clinicians are of course welcome to apply more stringent rules to meet your own risk preferences.

Should you have any queries regarding the above please contact your specialist.