Eighty-seven people have died in their homes from Covid-19 since March 2022 and public health experts want the deaths investigated.
The majority of people who died at home from Covid were over 60. Photo:
On average, four people a week have been dying from the virus in their homes since the Omicron outbreak hit New Zealand, according to Te Whatu Ora/Health New Zealand figures released to RNZ.
The new health agency did not respond to questions about the circumstances of each death, prompting calls from doctors for insights into the data.
The vast majority of people who died at home - 92 percent - were over the age of 60. Just over half were classified as European/Other, with Māori accounting for 18 percent and Pasifika 19 percent, according to data between 1 March and 31 July.
Just over a fifth (22 percent) were unvaccinated, 25 percent were fully vaccinated and 49 percent were boosted. (Less than about 6 percent of the population, who are 12 and over, are unvaccinated, according to Stats NZ population estimates.)
In all cases the death certificates listed the virus as a contributory or underlying cause of death. This differed from people who died with Covid, where the virus did not contribute to their death.
An additional person died at home in April 2020, taking the total of home deaths during the pandemic to 88. There were no home deaths in 2021, Te Whatu Ora said.
The deaths of two Auckland Māori men self-isolating at home in Auckland last year were not included in the figures because their cause of death was still to be determined by the coroner, a spokesperson said.
Te Whatu Ora care in the community clinical advisor Dr Joe Bourne said there were many reasons people may have died outside of a hospital setting.
"Some may have been under palliative care, while others may have had significant pre-existing conditions which contributed to their deaths, such as cancer, kidney disease, or severe psychiatric disorders," he said in a statement.
"Additionally, people may have chosen to remain at home or had previously opted out of being cared for in a hospital setting," Bourne said.
The 88 home deaths were not included in the 447 who had died at a rest home or residential care from Covid-19 since March 2020, Te Whatu Ora said.
It did not respond to RNZ's questions about the circumstances in which patients died at home, including how many of the 88 had reported a positive test or had contact with the health system while sick, and whether they lived alone or were receiving palliative care.
University of Otago public health professor and epidemiologist Michael Baker said each home death needed to be investigated by health authorities so they could learn from them.
"If we are wanting to lower deaths from Covid-19 infection we need to know a lot more about the circumstances of these deaths.
"The context is really important. Someone who's terminally ill and dying in a hospice and has Covid-19, that's very different from an otherwise healthy person dying from Covid where that death could have been avoided if they'd had access to urgent care and antiviral treatment, for instance.
"These are data that need to be collected and analysed to see if some of these deaths can and should be prevented."
It was particularly important as Covid-19 became one of the leading causes of death in July and August, Baker said.
Pasifika GP Network chair Dr Api Talemaitoga said the number of home deaths were "very surprising" and agreed further analysis, particularly into the circumstances involving Pasifika patients, was needed.
"In general, this is a population that interacts with healthcare, but as we know from areas like cancer diagnosis and screening, they interact late so they have worse outcomes with treatment. I'm really keen to understand that in terms of this data."
Talemaitoga, who practices in Manukau, South Auckland, said it would also be important to know how many of the patients who died at home had access to anti-viral treatments as many of his patients did not know they existed until he told them.
College of General Practitioners president Dr Samantha Murton said the number of home deaths was not surprising given that, generally, about a third of all deaths occurred at home or an in-patient hospice unit.
But it was a reminder that people with Covid-19 could become very unwell, very quickly she said.
"It could be they didn't know they had Covid and didn't have a test. Or they progressed really rapidly because sometimes with Covid you're fine and you get sick quite fast.
Since November, people isolating at home with Covid-19 have been looked after by one of 53 local and regional care coordination hubs as part of the Care in the Community programme, Bourne said.
"The hubs are involved in ensuring people with increased healthcare needs and who are isolating at home, have access to clinical care via a general practice, iwi provider or an alternative clinical provider.
"Every care coordination hub has a clinical governance structure to ensure adverse events are detected and to discern learnings from these events as an integral part of quality and safety improvements in patient care," Bourne said.
Te Whatu Ora did not respond to RNZ's questions about whether it was investigating any deaths of Covid-19 patients who died at home.
*Correction: An earlier version of this story said less than 6 percent of the population, who are old enough to be vaccinated, are unvaccinated. This should have said about 6 percent of the population aged 12 and over are unvaccinated. This has been corrected and clarification that the calculation is according to Stats NZ population estimates has been added.
