Level 2 in doubt? Top expert says outbreak's tail 'very resistant'

Author
NZ Herald,
Publish Date
Wed, 29 Sep 2021, 7:18AM

Level 2 in doubt? Top expert says outbreak's tail 'very resistant'

Author
NZ Herald,
Publish Date
Wed, 29 Sep 2021, 7:18AM

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Daily case numbers dropped to single digits yesterday, but Aucklanders are being warned not to expect level 2 next week because the last embers of the outbreak could still flare up. 

Epidemiologist Professor Michael Baker said Auckland remained on a "knife edge" because the virus was still stubbornly circulating in marginalised communities where people were less likely to get tested. 

"The tail has been very resistant to whatever we're doing. The difficulty now is whether you can even think of moving out of alert level 3 until we're getting no more of these unexplained cases." 

He called for a more targeted "neighbourhood" approach to detect and stamp out the remaining cases, which continue to pop up despite alert level restrictions. 

"The numbers have stayed in this range, hovering at around 20 per day with a slight downward trend for four weeks. That means despite the trend looking slightly positive, we're not going to get there on the current pattern."706 doses on Monday, September 27 

There were eight cases yesterday, the first time daily case numbers dropped to single digits since Friday last week, and all but one were linked. 

The unlinked case was a person who presented to the ED in Waitakere Hospital on Monday evening - one of seven unlinked cases in the past fortnight. 

Prime Minister Jacinda Ardern says the number of daily cases continues to be volatile. Photo / Mark Mitchell

Prime Minister Jacinda Ardern says the number of daily cases continues to be volatile. Photo / Mark Mitchell 

Prime Minister Jacinda Ardern said the lower number of cases was pleasing, but there was "a bit of volatility at the moment". 

'90% for Auckland is not enough 

Epidemiologist Rod Jackson said today that a 90 per cent vaccination level in Auckland was "not enough". 

He told Newstalk ZB's Mike Hosking that unlinked cases was still the key consideration for moving the city to level 2. 

The Government had moved Auckland to level 3 because residents could no longer cope with level 4 lockdown. 

"We have to stamp them out or else it's a Melbourne or Sydney." 

National to unveil MIQ policy today 

National leader Judith Collins said today that her party had a plan for a people overseas trying to get back into the country which it would make possible for Kiwis who have been double-jabbed to get home by Christmas. 

"We are so excited about this." 

Collins suggested the Government adopt the policy in its entirety and Kiwis would be able to be home and "you will be able to travel". 

National's policy will be unveiled at 10am today. 

National is being careful about revealing who peer-reviewed it as they didn't want them to be attacked by the Government. 

When asked if people could die from National's proposed policy, Collins told The AM Show that New Zealand could not stay in this situation forever and "living in a hermit kingdom" (a phrase former Prime Minister Sir John Key has used to criticise the Government). 

She said people died in car accidents, but that didn't stop them driving. There were also other consequences of lockdown such as medical treatments being delayed, mental health concerns and businesses collapsing, she said. 

Three active subclusters 

Director-general of health Ashley Bloomfield said there were only three active subclusters, "largely" in south Auckland, where cases were still emerging among people who weren't contacts. 

Two of them were households linked by genomic sequencing, while the third centred on transitional housing - a boarding house. 

He said there had been some targeted testing in Clover Park, one of eight Auckland suburbs of concern. 

Health staff had knocked on about 100 houses on four streets, but only nine households had agreed to be tested. Half of those who declined a test had already been tested. 

Public health teams were also looking at testing people in other transitional housing, he said. 

Professor Michael Baker says the tail of the virus remains despite alert level restrictions, and a more targeted approach is needed to finish it off. Photo / Supplied

Professor Michael Baker says the tail of the virus remains despite alert level restrictions, and a more targeted approach is needed to finish it off. Photo / Supplied 

But Baker called for mass testing in relevant neighbourhoods, following appropriate dialogue with community leaders and health providers. 

"We've got this brief window of opportunity to extinguish these remaining lines of transmission." 

Of the 203 active cases in the cluster yesterday, about 80 per cent of them were Māori or Pasifika. 

Top Māori GP Dr Rawiri Jansen said the virus was still present in communities that were less responsive to traditional public health messages and contact tracing approaches. 

"Low income, housing stress, over-policed, over-incarcerated - these communities require a specialist approach." 

It was important to use appropriate health services who don't come across as "police knocking on your door to interrogate you as to whether you have any symptoms". 

"We do want to do more testing in particular suburbs and particular communities. Some of it's happening, using providers that are culturally concordant and taking a respectful relationship-building approach. 

"It might be that we need to see more of it to really get it under control." 

Baker said the impact of moving to level 3 would continue to be seen in daily case numbers until the end of next week - and it was "hard to imagine" case numbers not tracking up. 

"There are still hundreds of thousands of unvaccinated people in Auckland. These marginalised groups are connected with other people through a whole lot of channels. 

"If their kids start going back to school from these households, we'll start to see more transmission of the virus out of those communities." 

Baker said he was less concerned about the extra freedoms for more travel out of Auckland, because there was no widespread transmission. 

From today, people relocating out of Auckland permanently are allowed to leave the city, as long as they have had a negative test in the previous 72 hours and had proof of the reason for their travel. 

Legit reasons included moving to a new home, starting a new job, caregiving obligations such as childcare, or tertiary study outside Auckland. 

Dr Rawiri Jansen says the south Auckland communities where the virus remains prevalent are less responsive to traditional public health messages and contact tracing approaches. Photo / Dean Purcell

Dr Rawiri Jansen says the south Auckland communities where the virus remains prevalent are less responsive to traditional public health messages and contact tracing approaches. Photo / Dean Purcell 

Ardern said about 77 per cent of the eligible population had had one vaccine dose, but upping that to 90 per cent would be "really tough". 

"Even at 90 per cent [of the eligible population vaccinated], you end up somewhere around 75 per cent of your population vaccinated," she said. 

"That's why it's not enough just to say, 'We'll give everyone a chance to be vaccinated, if I'm vaccinated, I'll be fine.' When 25 per cent of your population isn't vaccinated, that does require management to ensure that outbreaks don't impact your health system, and don't impact people like children." 

Of the 1185 cases in the outbreak so far, 260 of them are children under 12 who aren't eligible to be vaccinated. 

Bloomfield said there had been positive wastewater results in Tauranga from a September 23 sample. More tests were being done to see whether it might have been from a recovered case. 

He asked people in the greater Tauranga area to get tested if they had any symptoms or had been at a location of interest.