The University of Otago epidemiologist isn’t entirely reassured by Jacinda Ardern and Ashley Bloomfield. David Williams reports
In the whack-a-mole attempt to stamp out the Delta variant there are different views on how the country is faring.
The official line, from the Beehive theatrette podium, goes something like this: The seven-day rolling average of Covid-19 cases is dropping, the number of active cases is dropping, and most clusters are now considered contained or dormant.
As Auckland approaches a week at Alert Level 3, Director-general of health Dr Ashley Bloomfield said yesterday there were encouraging signs chains of transmission were being broken, and a circle was being drawn around the outbreak. The intention, still, is to reach zero cases.
Another line comes from University of Otago epidemiologist Professor Michael Baker, who has spent several days agitating for door-to-door testing and a new approach to marginalised groups.
“Actually, what he’s suggested we’ve been doing both for some time,” Prime Minister Jacinda Ardern said from Wellington yesterday, noting there has been door-to-door testing in two Auckland suburbs, including Clover Park.
“Our biggest priority right now is public health,” Ardern said. “We want to know where cases and contacts might be. This is not about pursuing criminal cases or criminal convictions and so it’s a very different approach here where we work really closely with those individuals who have Covid, just to find out where they’ve been, who they’ve been with and to make sure that it’s all about public health.”
“I’d love to be proven wrong, but unfortunately this is just how this virus behaves.”
– Professor Michael Baker
Baker tells Newsroom he’s not trying to be alarmist. Rather, he’s asking what he believes are obvious questions.
Where the Beehive talks of encouraging trends, Baker says there’s been a “flat tail” for four weeks. He’s concerned about people with coronavirus turning up at hospital, and positive tests from those being arrested.
The effects of Alert Level 3 conditions won’t be felt until the end of this week, he says. “That’s slightly ominous because it’s telling us there are these chains of transmission in the community that haven’t been stamped out at Alert Level 4.”
Baker asks, is the response good enough and intense enough to stamp out the virus? “Because if it isn’t we will see this outbreak start to accelerate at Alert Level 3.”
He adds: “I’d love to be proven wrong, but unfortunately this is just how this virus behaves.”
Baker saw yesterday’s post-Cabinet briefing, and admits Ardern and Bloomfield will know more than he does about the Covid response in Auckland.
“If they’re confident that enough’s being done that’s reassuring, but when I talk to people in the field I’m definitely not reassured at the moment that we are on top of this.”
He’s receiving emails from Auckland raising concerns about people with high-risk behaviours – he’s talked about those with drug and alcohol dependencies, or mental health issues – who don’t adhere to alert level systems and who aren’t really engaged with the Government’s Covid-19 response.
“I actually had people from two different gangs contact me … and they said, yes, there are issues with the behaviour of some of their members.
“From their perspective, there was a view that the police had still not adjusted what they’re doing … to basically make it easier for them to take precautions.” (Those precautions, he explains, are testing, contact tracing, self quarantining, mask use and vaccination.)
“I just wonder if we are getting enough engagement from gang leadership.”
Minister backs Aucklanders
In a statement last night, in answer to Baker’s cynicism, Covid-19 Response Minister Chris Hipkins said: “There is a massive effort across Government to stamp out Covid-19, and I am constantly impressed by the hard work of those doing this work on the ground.
“Alert Level 3 means more businesses can open – for contactless pickup and delivery – but people are still required to stick to their bubbles. Aucklanders in particular have been doing the hard yards for the rest of New Zealand, and I back them to get us to the finish.”
On Sunday, Hipkins said the situation was tracking reasonably well. “We’ve not seen a significant increase in case numbers as a result of the move down alert levels,” he said on TVNZ’s Q+A programme. (He also said Covid-19 had been stamped out previously at Alert Level 3, but that wasn’t the more transmissable Delta variant.)
With high levels of vaccinations, Hipkins foreshadowed a different response to the virus. “We can’t keep using Level 3 and Level 4 restrictions; the level of restriction that we have at the border … we will have to allow for greater movement at the border in the future.”
Bridget White, the Ministry of Health’s deputy chief executive, Covid-19 health system response, said in a statement last night the Auckland Regional Public Health Service and other health agencies were working with iwi and Pacific social service providers, non-government organisations, and other government agencies to reach communities.
“Where appropriate, a variety of community leaders are assisting in building engagement with the aim of assisting to identify cases and improve contact tracing. There is a good level of engagement and co-operation between these providers and the communities they are working with.”
Baker, the University of Otago professor, says testing needs to focus on where cases and their contacts are expected to be found.
“This geographic neighbourhood-by-neighbourhood testing is being used, and some door-to-door testing.
“Setting up a pop-up clinic and encouraging people to come isn’t enough. You may wind up just testing a lot of the worried well and not the people you really want to reach.
“You have to have something that is quite active, to go in and identify a high proportion of the people who might be infected and their contacts, and get ahead of the virus.”
(Darryl Carpenter, Ministry of Health group manager of Covid-19 immunisation, testing and supply said symptomatic and asymptomatic tests were taken at testing centres in suburbs of interest: Clover Park, Mt Eden, Massey, Māngere, Favona, Papatoetoe, Ōtara, and Manurewa. Community tests processed and reported by laboratories, categorised by DHB of residence, do not include tests taken from border workers or MIQF returnees.)
It’s tough, Baker says. Most cases actually don’t infect many others but some will infect quite a view.
Despite his concerns, he says it’s still possible to stamp out this outbreak. “But it just needs a different approach.”
That means connecting with relevant community leaders and ensuring all government agencies are coordinated with a harm reduction or harm minimisation approach.
“I think we could win and the prize is enormous,” Baker says.
“If we stop transmission of this virus in Auckland, that’s good for Auckland and the whole country, and we can rapidly descend down the alert level system.”