Almost half the Covid cases isolating at home not given oximeters

Source: 1News

Almost half of the people isolating at home with Covid-19 have not been given pulse oximeters, which are used to monitor a person’s oxygen levels.

It comes as the US and UK investigate whether the devices are equally accurate for all people when oxygen readings are at a very low level.

Health Minister Andrew Little confirmed the detail on Wednesday after questions from ACT Party’s deputy leader Brooke van Velden.

Little said about 900 pulse oximeters have been given to households with a Covid-positive patient. To date, approximately 1700 people have isolated at home with the virus.

Whether someone received the device was determined during their initial clinical assessment, he said.

“Most people will not require a pulse oximeter to safely monitor their health. People who would benefit from having one are identified during their clinical assessment,” Little said.

He said people who were more likely to need a pulse oximeter included those who weren’t fully vaccinated or faced more risk because of their age or other medical conditions.

In most cases, a person’s GP would undertake that assessment and make sure it was safe for someone to recover from home, Little said.

“If it is the person's GP, then that GP will have access to that person's health records,” he said.

“If it is not the person's GP, it will be for the clinician, through questioning and assessing that person, by and large, over the phone, to work out what is in the best interests of that person.”

An oximeter is a device that clips onto a person’s finger to estimate how much oxygen is circulating in their blood.

Ideally, a person’s blood oxygen level is between 95 and 99 per cent. Patients are told that if the reading drops below 95 per cent, they need to contact a health professional.

Van Velden questioned why 800 people had gone without the device when it could potentially save lives.

She said ACT wanted everyone isolating at home to have a pulse oximeter.

“Ontario in Canada has been issuing these routinely since March. How are we so far behind?” she said.

“The Government needs to get these devices out to Covid-positive patients before more people die at home.”

It comes after varying statements from the Government about whether or not someone isolating at home would receive a pulse oximeter.

Oximeter (file photo).

There are also some concerns that not everyone who needed the device was getting it in a timely way. Papakura Marae’s Dr Jason Tuhoe told Q+A on Sunday that getting oximeters to isolating whānau was proving difficult. Meanwhile, some found isolating at home a struggle.

A Ministry of Health spokesperson told 1News if a person was needing a pulse oximeter, it would usually arrive in a health pack within 24 hours of someone testing positive for Covid-19.

However, the spokesperson acknowledged there were “a small number of delays” with some deliveries in instances where addresses had been incorrect or people couldn’t be contacted.

“Pulse oximeters are one of a number of measures used to ensure Covid-19 cases can safely isolate at home – it’s important to note that they shouldn’t be viewed as a definitive piece of equipment for monitoring health status."

The use of the devices for some patients is also being assessed overseas because of some evidence that suggests it could overestimate the amount of oxygen in people with darkly pigmented skin at lower readings.

That’s because the device works by shining a beam of light through the blood to get a reading of someone’s oxygen levels, and the colour of a person’s skin could affect how light is absorbed, according to some experts in the UK.

In the UK, the NHS is advising patients who may have darker skin, including people of Asian and Black ethnicities, to seek advice from health professionals.

In the US, the Food and Drug Administration said more investigation was needed about the pulse oximeter’s accuracy depending on a person’s skin colour.

The FDA’s statement was in light of correspondence from doctors to the prestigious New England Journal of Medicine. The FDA noted some limitations to the retrospective study, but said it was enough to take a further look at the matter.

The Ministry of Health said it was aware of some concerns internationally about the efficacy of pulse oximeters to take readings in people with darker skin.

“Based on several peer-reviewed studies and ongoing review of the literature, there is no conclusive evidence to suggest that pulse oximeters are inappropriate for Covid-19 cases isolating at home with dark skin pigmentation,” the spokesperson said.

“A small number of studies have found some evidence that pulse oximeters may give inaccurate readings for darker skin pigmentations at very low oxygen saturation levels below 70 per cent.

“At this level, blood oxygen levels are considered dangerous and a person would experience severe difficulties breathing – we would expect a case isolating at home to call either the 0800 number or 111 before this happened.”

The spokesperson said the Ministry would continue to monitor international evidence and change its response accordingly.

“At this stage, the Ministry considers pulse oximeters an effective tool for monitoring health, among a number of measures used to ensure Covid-19 cases can safely self isolate at home.”

Of New Zealand’s active cases, 33 per cent are Māori, 29 per cent are European or other, 22.5 per cent are Pasifika, 12 per cent are Asian, and 2.5 per cent are in the Middle Eastern, Latin American and African grouping.