ZB

PM's plan to re-open NZ: Home isolation, shorter MIQ if vaccinated

Author
Claire Trevett, NZ Herald,
Publish Date
Thu, 12 Aug 2021, 10:41am

PM's plan to re-open NZ: Home isolation, shorter MIQ if vaccinated

Author
Claire Trevett, NZ Herald,
Publish Date
Thu, 12 Aug 2021, 10:41am

There are eight new Covid cases to report today in managed isolation.

The latest cases are travellers from Malaysia, India, Japan and the United Kingdom.

There are currently 43 active cases of Covid in New Zealand.

There is one historical case to report today. The traveller arrived on August 9 from Serbia via United Arab Emirates. The person tested positive during a routine day 12 test and are currently in a quarantine facility in Christchurch.

The Ministry of Health today confirmed that 73 people went onboard the Rio De La Plata ship in Tauranga between last Wednesday and Saturday. This was one more than previously reported.

The ministry said this person had now been tested and returned a negative result.

All workers at the Port of Tauranga, who were associated in some way with the container ship had now returned at least one negative test.

Today's case numbers come as the Government today outlined how the country should navigate the next chapter in the global pandemic.

Prime Minister Jacinda Ardern has set out a plan to start re-opening the borders, starting with a trial this year of home isolation or shorter MIQ stays for selected travellers.

That would be followed by the phased resumption of quarantine-free travel in the future.

The plan would eventually see three "pathways of travel" into New Zealand.

For vaccinated travellers from low-risk countries, no isolation would be required.

For vaccinated travellers from medium-risk countries, some isolation would be required – but it could be a shorter stay in MIQ or home isolation.

A pilot will be run between October and December this year to trial that, and businesses and organisations which needed to send staff overseas could apply for that.

Unvaccinated travellers and all travellers from high risk countries would still have to do 14 days in an MIQ facility.

Testing requirements would apply to all groups.

Ardern set out a four-step plan re-open the borders at a forum on reconnecting New Zealanders to the world this morning – from the current situation to quarantine-free travel for all vaccinated travellers in the future.

She set out changes to the vaccines rollout, including speeding up the first dose by allowing people of all eligible ages to book by September 1.

The gap between shots would move from three weeks to six weeks, a move Ardern said would ensure more people had at least had one shot in case the Delta variant arrived.

"Getting vaccinated is the number one thing everyone can do to be protected against Covid-19, help accelerate our economic recovery, reduce the risk of lockdowns, and safely allow New Zealand's borders to begin re-opening next year."

Elimination approach has come at a cost: PM

In a speech this morning, Ardern said the elimination approach had served New Zealand well, and it was faring much better than many other countries both economically and on the health impacts of Covid-19.

However, she said it had come at a cost.

"The impact of border closures has been tough. Very tough. It has impacted on loved ones - family and friends being separated, industries accessing skilled employment, or Kiwis just missing that personal sense of connection.

"It's just one of the reasons I believe this year has felt so hard. In 2020 we knew what we had to do. In 2021, we want to know that things will get back to normal - eventually."

She said keeping the elimination approach of trying to stop Covid-19 reaching New Zealand - and "crushing it" if it did come - was the best approach for the next six months.

She said one of the risks of a partially vaccinated population was of more dangerous variants and vaccine resistancy.

Regarding when the border reopening steps announced today could be implemented - and whether they could be pushed out from the first quarter if vaccination rates were low - Ardern said it would not be like "clipping a ribbon" and would be managed.

She said it would not be a "political decision", however.

On the decision to change the vaccines rollout from a three-week gap and getting two doses into people quickly to the six-week gap, and ensuring more people had at least one shot earlier was because many of those most vulnerable had been fully vaccinated now and overseas studies showed a longer gap was more effective.

Those who were vulnerable were still encouraged to get fully vaccinated as soon as possible, but having one dose would offer at least some protection in the event Delta arrived.

Ardern said she did not believe a definitive threshold for vaccination was needed.

She said the markers she was looking for included a good regional spread of vaccinations "so we don't have large pockets of unvaccinated people."

Secondly, she wanted to see high vaccination rates in high risk populations - older people, and the immune-compromised.

Third, she said that young adults had been identified as "strong sources of transmission".

"So uptake there matters."

She said "short, sharp" lockdowns would remain the response to an outbreak in the next few months.

"But if everyone heeds to call to be vaccinated by the end of 2021, it is our goal to reduce and then eventually remove the need for lockdowns."

She said then New Zealand would be in a position to adopt "the measles approach to Covid-19" - contact tracing and isolating. That would mean the Government boosting the public health tools at its disposal.

Borders the biggest challenge: Ardern

She said the borders were the greatest challenge.

"We cannot keep border restrictions on forever, and to be absolutely clear we do not want to either."

She said even after most of the population was vaccinated, the borders could not simply open.

A phased approach was needed because the global vaccination effort would still be continuing and vaccination rates would still be low in many other countries.

She said it was also known that a vaccinated person could still pick up Covid-19.

She said in Canada, of 17,000 vaccinated people to cross its borders, eight had Covid-19.

She said that was the equivalent of 35 cases coming into New Zealand each week if travel was at pre-Covid levels.

Risk-based pathways

She said from next year - once everybody had been offered a vaccine and there was "reasonable coverage" - the risk-based pathways of travel system would kick in.

That meant vaccinated people from low-risk countries would not have to do any isolation.

Countries would be grouped according to risk - based on the number of cases they had, the variants, vaccination rates and the way the country was handling outbreaks.

The Government would develop a "traveller health declaration system" to assess vaccination status, and rapid border testing technology.

Customs, the Ministry of Health, Ministry of Transport and other agencies would start a work programme with airlines and airports to set up a "safe and smart" re-opening of the borders, including pre-departure, en route, arrival and in country.

Travellers from medium risk countries could face "modified isolation."

"That means if you have been to a country where there is Covid but pretty decent rates of vaccination, and you yourself are vaccinates, rather than going into MIQ, we will be looking at either isolation at home and/or shortened isolation periods."

As preparation for that, the PM said a new day five test would be introduced to MIQ from now on, and data would be collected on vaccination status of those in MIQ.

That would give some indication of the numbers of vaccinated travellers who had Covid.

"If we get information that tells us that cases are coming through in that early period, we can then confidently reduce isolation periods in quarter one next year."

Home isolation trial later this year

Home isolation was also being looked at, but Ardern said that would not happen widely this year.

Instead, a trial would take place from October to December of a limited number of vaccinated travellers. It would allow the Government to test the logistics at the border under a self-quarantine model, and the ease of monitoring compliance.

It would only involve New Zealanders who were vaccinated in New Zealand and had travelled for a short period of time to an approved list of countries. They would have to provide self-quarantine plans.

Specific details would be confirmed in September, including an expressions of interest process.

The intention was to work with employers with employees who needed to travel. This provided some extra assurances with some "skin in the game".

Ardern said to those Kiwis overseas wanting to come home the most important thing was that it could be done safely.

There was some extra capacity they were looking to bring on in the short term, but the main systems were outlined in the plans unveiled today.

It was hoped those options, for vaccinated travellers from medium risk countries, would be under way in the first quarter next year.

The proposal would be "vastly different" to self-isolation as in the early days of the pandemic. This meant people during the trial would not be able to isolate with friends or family members, or even people travelled with.

"It will be very tightly run."

The transtasman bubble

On the transtasman bubble, Ardern said they were waiting on further advice and would not make further decisions until near the end of September. It would not reopen if there continued to be risk to New Zealand from uncontrolled outbreaks.

They were willing to treat Australia state by state, but the current situation showed just how hard it was to contain an outbreak by state.

Regarding vaccinating younger age groups under 16, there would be a decision in the near future, Ardern said.

How that would rollout would be designed around what worked best for families. This could include utilising schools but it would not be the default.

Parents and children being vaccinated at the same time could help with uptake, and also any consenting issues, Ardern said.

Purchasing MIQ facilities

Covid-19 Response Minister Chris Hipkins said in the longer term they were looking at purchasing and building MIQ facilities.

Ardern and Hipkins were responding to the findings of an independent panel of experts who yesterday provided advice to the Government on its ongoing Covid response strategy.

Ardern has not set firm dates or vaccination targets for each step, saying the situation remained uncertain and the "curve ball" to the plan could come in the shape of new variants, as Delta had shown.

"What comes through in the evidence is that Delta may be the variant of the day, but it won't be the only one."

"I think people have come to appreciate that while the future is uncertain, and the plan can change, that doesn't mean we can't make one."

However, Ardern said vaccine uptake would be critical.

"Once enough people are vaccinated, we will be able to start the next step in the plan: a phased introduction of an individual risk-based approach to border settings in 2022."

Ardern said the remainder of 2021 would be used to keep vaccinations under way and to prepare for the re-opening, including working on a vaccinations declaration system, new testing technology for rapid testing at the airport and reliable pre-departure testing, as well as other measures such as contact tracing.

She said a key priority for moving through the steps was maintaining the elimination strategy.

"If we give up our elimination approach too soon, there is no going back and we could see significant breakouts here like some countries overseas are experiencing who have opened up early in their vaccination rollout."

Ardern said the plan was informed by scientific and public health advice.

"It will allow us to capture the opportunities vaccination brings, while protecting the gains New Zealanders have worked so hard for."

The plan to re-open the border.

The four step plan:

Under the plan, step one was restricted travel and 14 days MIQ, as had applied up until now.

Step two would involve a pilot scheme for some travellers between October and December, trialling alternatives to MIQ such as home isolation or shorter periods in MIQ.

There would be additional testing requirements and lockdowns would still be a response to outbreaks.

Step two also required the Government to boost ICU capacity and contact tracing in case of an outbreak once the borders started re-opening – two flaws identified by the report of the Covid-19 health advisory group report.

Step three would see the introduction of the three categories of travellers, depending on whether they were vaccinated and the extent of Covid-19 in the countries they were coming from.

The alerts levels system would remain in place, but "lockdowns are less likely."

Step four would be quarantine-free travel for all vaccinated travellers who returned a negative test. Unvaccinated travellers would have to do 14 days in MIQ, and testing at the border and other health measures, such as masks and QR code scanning would remain in place.

Virus 'still winning the war'

Speaking to media, Skegg said the Government's plan accorded well with their advice.

Speaking earlier today, Skegg said despite vaccine development the virus was "still winning the war".

New Zealand had been let down by allies, Skegg said. They could have pursued the elimination strategy, but chose not to.

Many of the countries that could have eliminated Covid-19 either never tried, or threw in the towel."

Each country had done its own thing. The independent channel chaired by Helen Clark showed a weakened World Health Organisation unable to provide the leadership required.

There were also new variants, including Delta, making the virus more difficult to control.

Referencing Winston Churchill, Skegg asked how he could have had a detailed plan to defeat the enemy at the beginning of the war.

"Nor can we pretend to have a detailed plan with how we can reconnect with the world over the next year or two."

The priority was to get as many New Zealanders as possible protected by vaccination by the end of the year. But by then there could be a new variant, more challenging than Delta.

There would be though more known about vaccine efficacy, better testing, and even potentially anti-viral technology that could "completely change our attitude to this virus".

There however still needed to be a strategy, he said. The first question his group looked at was if elimination was still viable. Many people had said elimination was impossible.

"Well they were wrong," Skegg said.

He compared the New Zealand situation with that of Scotland, which had a similar population. Here 26 people had died; there over 10,000.

"We dodged a bullet," Skegg said.

But reopening borders and new variants raised further questions. The experts concluded that at this stage elimination was not only viable but the best option.

"It allows us to enjoy a lifestyle relatively unaffected by the ravages of Covid-19 and protect our health service and economy."

The United Kingdom had a great vaccination rollout, with 84 per cent of adults having antibodies from vaccination or past infection. Yet last week they still had 627 deaths from Covid - equivalent of 48 a week here, based on population.

There were also heavy social and work restrictions, with enforced mask use and a fear of contagion.

This was a real thing in the world today.

"I hope not to spend the rest of my life shielding from others. I don't want to spend the rest of my life looking at beautiful faces covered by masks. We are going for gold and we may not succeed, if we don't achieve high vaccination."

Along with high vaccination there also needed to remain precautions at the border.

The group had suggested a gradual reopening with quarantine-free travel from low and medium-risk countries, with proof of vaccination, testing and contact tracing measures.

This would occur from the beginning of next year, when everybody had a chance to be vaccinated.

The group did not favour setting a vaccination target, rather aiming for getting everybody vaccinated.

Lockdowns destroy business confidence: Rob Fyfe

Rob Fyfe told media that today's announcement gave business some hope.

Businesses wanted some commitment and clarity around opening the border. There was not today that about timing, but there was the intent.

Businesses would be happy to front costs associated with the quarantine-free travel trial, Fyfe said.

They are "desperate" to get their people away to do business around the world, he said.

He had earlier told the press conference that, looking through a business lens, what destroyed confidence and viability was lockdowns.

"Businesses need to do everything they can to support people to be vaccinated."

There were many tools, including border measures, but lockdowns were the inevitable consequence where they failed.

Businesses could help people be available to be vaccinated and create understanding.

They could also encourage QR scanning and testing.

Sir Brian Roche said there still needed to be greater capacity around contact tracing, particularly with the looming threat of Delta.

The number of unvaccinated border workers was high risk and unsustainable and had to be addressed. It needed to be much closer to 100 per cent, Roche said.

The key was in communication.

"Collectively, we live and breathe this stuff so we all think it is very rational. Vaccination is pretty painless, augmented with saliva testing it is not intrusive. But something has been lost in the language."

Strategies need to recognise Māori community

Dr Maia Brewerton said in terms of the Māori response, it was important the strategies and vaccination rollout recognised community.

"At the heart of being Māori you put your whānau and community ahead of yourself. That was very much what happened around New Zealand. It is not unique to Māori ... but it is very important what we do is led by our communities."

It was clear from the rollout not one size fit all. The rollout needed to be dynamic, adapt where needed, especially to reach out to the marginalised and vulnerable.

"We need to focus on those who are not accessing the vaccine, change the rollout if need be to meet those people, ask what we can do differently. Nobody knows a community like that community, a whānau like that whānau. People want the vaccine, but are not able to access it."

The Pasifika perspective

Dr Api Talemaitoga said equity needed to be at the heart of the vaccination rollout.

From a Pasifika perspective, there needed to be greater focus on education, location of vaccinations, but also on community.

It was worrying hesitancy was used as a blame, and took away the focus from education.

In terms of venue, Talemaitoga said it needed to be centred around the community and what those communities value.

Talemaitoga said rather than herd immunity, Pasifika has been talking about "community immunity".

This was a community that loved and protected each other, socialised. People got tested, got vaccinated, because they did not want to take the virus home.

'If we do our jobs well we will get high rates of coverage - Bloomfield

Dr Ashley Bloomfield said he never felt vaccine hesitancy was the problem.

"We know most people if they have information from someone they trust, offered a vaccine in a setting by someone they trust they take up that offer. If we do our job well we will get high rates of coverage."

Skegg said it was important as many as possible were vaccinated, because if not it would be less effective.

It could mean the health service would be swamped, meaning delays for elective surgery, and for things like cancer, heart attacks and stroke.

"I hope we can be unselfish and care about each other, we also need to care about the whole.

"I hope we can beat the world at vaccination as well."

Asked about 12 to 15 year olds being vaccinated before the school holidays, Bloomfield said "watch this space".

They were still awaiting trial results and evidence around efficacy and safety.

"We are watching like a hawk," he said.

'We have to open up': John Key

Meanwhile, former NZ Prime Minister Sir John Key says the government should adopt a telethon-style approach to boost vaccination numbers and open up our borders by Christmas.

Key told Newstalk ZB's Mike Hosking this morning that, rather than aiming for elimination, the focus should switch to relaxing travel bans and getting everyone a double jab in the coming months.

"We have to open up. We can't sit back forever where businesses and families can't get in or out of New Zealand."

With the elimination strategy being abandoned in countries across the globe, including Australia, the Government should admit it was no longer a viable strategy, Key said.

Instead, it was important to get the population fully vaccinated and live with the virus.

Key said the way to achieve this was to set vaccination targets that were constantly screened, very much like telethon target totals.

"If you sit there and are going to say we are going to open up the borders by Christmas and we're going to give everyone the chance to be double jabbed by Christmas why wouldn't you just be constantly running it on the corner of the TV every single day between now and then with the days left and the number of people jabbed?" he asked.