Health experts believe the Government has responded well to Auckland’s outbreak but want to see more work done on preventative measures in the future, Marc Daalder reports
Over the past week, the Government has responded quickly to news of four community cases of Covid-19 with no obvious links to the border, putting Auckland into Level 3 lockdown and moving the rest of the country to Level 2 to blunt any chains of transmission that might have escaped our largest city.
Since the Prime Minister’s announcement on Tuesday evening, more than 135,000 Covid-19 tests have been conducted. More than one in every five of the tests that New Zealand has processed since Covid-19 testing first came online on January 31 has been carried out in the past week.
Before Tuesday, the greatest number of tests ever conducted on a single day in New Zealand was 10,436 on June 24. Every single day for the past six days, we have conducted more tests than that record-high. In fact, on five of the past six days, we have more than doubled the figure.
The contact tracing system has also surged into action. With some 76 cases identified outside of the managed isolation and quarantine system, 1,983 close contacts of those cases have been reported to Public Health Units, who have so far tracked down and reached out to 1,861 of them. Those people have been instructed to self-isolate for 14 days and get a Covid-19 test.
The number of people using the NZ COVID Tracer app has skyrocketed. By Wednesday morning, 1.5 million people had registered to use the app and there had been 7 million poster scans. That’s up from 648,000 users and 2.1 million scans last Tuesday.
At 13 checkpoints around Auckland, police have processed 86,685 vehicles since August 12. Another 4,781 have been turned around in that time.
Health experts spoken to by Newsroom say the response has shown the systems built up over previous months for surge capacity in testing and contact tracing are working well. However, they caution that there’s still more work to be done in shoring up border systems and thinking proactively about preventing the next outbreak instead of responding to it.
“I would give the response an A+. Or how do they do it nowadays? Excellence,” Siouxsie Wiles, a microbiologist and infectious diseases expert at the University of Auckland, said.
“It’s been incredible. Absolutely incredible. The ramping up of testing and the amount of contact tracing that’s going on is absolutely phenomenal.”
“There’s strategy and there’s delivery and I think the strategy’s been very sound. I can’t imagine anywhere in the world that would have responded as fast and decisively to an outbreak. At that level, it’s very good,” said Michael Baker, a member of the Government’s technical advisory group on Covid-19 and a professor of public health at the University of Otago, Wellington.
“We’re also taking advantage of the fact that we’ve got more interventions than we had in March. Better high volume testing, contact tracing and masks. That means we’re trying the more nuanced approach of a regional approach and not going straight to Level 4.”
David Murdoch, an infectious diseases expert and Dean of the University of Otago, Christchurch, said it was about “getting that bit in the middle.
“You expect the absolute best, which is what New Zealanders deserve, but you know no system’s absolutely perfect, that just doesn’t happen in the world. So you’re planning for the eventuality that something does slip through.”
“What you want to see is it is rapidly identified and followed up and ring-fenced. I think we’re seeing that. Hopefully we’ll have learnings at every step about continuous quality improvements. You always aim for the absolute best but of course that never happens, so you just need to have a system that will be as good as it possibly can be and then will constantly strive for improvement as more information becomes available or things change. And that’s what I’m seeing.”
That just 76 community cases have been identified in more than 135,000 tests is a strong indicator that the outbreak is being ring-fenced.
However, Baker said there were some concerns around the delivery of prevention measures prior to the outbreak.
“While you’ve got the outbreak management, which is pretty sound, you’re also back to the prevention side – What caused this outbreak, how do we stop this from happening again? Looking at that more critically is showing some of the real inconsistencies in how we’re managing those risks,” he said.
The failure to operationalise testing of border and managed isolation staff more than seven weeks after such a policy was first announced was one example of this, but the issues ran deeper than that, he said.
“It’s more fundamental than that. It’s about moving away from this reactive mode to being far more strategic and prevention-focused. We’ve been in this mode for six months of having the virus in New Zealand for periods and then out, have we used this time enough to really analyse the potential weaknesses in the system rigorously and try and close them down?”
This could look like the creation of intermediate alert levels or a stricter Level 1, as Director-General of Health Ashley Bloomfield mooted on Monday. It should also entail a broader review of the coronavirus response thus far and the vulnerable components of the border and managed isolation and quarantine system. Baker pointed to the exemptions for international airline staff as something that might be worth a second look at.
“I would just hope that someone – or a group of people – are lining up all these scenarios for how the virus could come in,” Baker said. He also wants to see more investment in research and development to identify and solve issues with the response.
“A single error can cost us hundreds of millions of dollars. So we should be spending tens of millions of dollars on research and development, have a research strategy and get a whole lot of the nation’s scientists and entrepreneurs focusing on these challenges,” he said.
“From where I sit, it’s an excellent response. But we still need to move into a far more proactive approach.”