Covid-19 testing criteria expanded to boost number of tests

The number of tests being done for Covid-19 has been an issue in many countries, including here in New Zealand.

This came up in the first day of operation of the Epidemic Response Committee in Parliament.

Newshub: Sir David Skegg urges Government to show clear plan to eliminate COVID-19

Professor Sir David Skegg, an epidemiologist from Otago University, appeared in front of Parliament’s Epidemic Response Committee on Tuesday.

He said the Government did well to put in place early border restrictions and raise the national alert level to 4 but that it appears to lack a concrete, long-term strategy to stem the spread of COVID-19.

With the Government assuming the majority of those infected would have links to overseas travel – and therefore focusing its testing on them – it was hard to gauge the true extent of community transmission, he said.

“The actual number of people who have been infected will be far higher than the 589 notified and we really have no idea of the extent of community spread,” said Sir David.

“I’m afraid that only complacency can have allowed our authorities to imply that the virus would behave differently here than everywhere else.”

The number of tests done here has increased substantially over the last week (currently averaging 1,777 per day over a week) with a total of 21,384 done to date. The criteria for tests is to be loosened so more tests are done.

Newsroom: More testing needed, Ardern says

The number of tests for coronavirus is set to ramp up, with health officials relaxing the testing criteria as Prime Minister Jacinda Ardern called for more testing to be done.

The matter was at the fore during the inaugural meeting of the epidemic response committee earlier on Tuesday, where Director-General of Health Ashley Bloomfield indicated a change was coming.

Now, Ardern has confirmed the technical advisory group overseeing the case definition of Covid-19 had agreed to expand it to include people who had symptoms potentially indicative of the virus, but without a link to overseas travel or a close contact who had tested positive.

The new advice would be circulated to Healthline, GPs and community clinics, with the Prime Minister expressing a desire to see testing levels ramp up further.

“I want more tests, we’ve built the capacity for more tests, more tests will only allow us to get a better picture of the spread of Covid-19.”

However, she pushed back when asked why the Government had not made such a change earlier, saying New Zealand had already been conducting a high level of tests relative to other countries.

The more tests the better the data to with which to model and base decisions on, but so far with a very low death rate (still just 1) it appears there hasn’t been a critical shortage of tests done.

Wider testing will be needed to determine just how much community spread there is  and where in the country there are problems as we get towards the end of the 4 week lockdown period and decisions will presumably be made on whether the alert level is reduced and restrictions eased, either countrywide or regional.

Skegg:

Suppressing the virus was only the first step in eradicating it, he said, adding that it was “worrying” the Government wasn’t clearly talking about eliminating it completely.

“A lockdown on its own is not enough. It’s like pressing the pause button on your device.”

Tackling a virus of this kind took a willingness to be transparent and change tactics when necessary, he said.

“If elimination cannot be achieved, when and how will we know that? And what will be the next goal? Those are the kinds of things I would expect to see in a strategy document”.

The Government and their health advisers will have been very busy but there is obviously a lot more work to do still.

 

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22 Comments

  1. Reply
  2. Duker

     /  31st March 2020

    People seem to find resistance from GPs taking the swabs for test ing. GPs are mostly self employed and sheltering behind locked doors and hearing the hype thinking they too will be struck down and forced into isolation. No wonder they are telling patients over the phone , no matter what Heathline says we’re aret testing you at the Surgery

    Reply
    • Griff.

       /  31st March 2020

      Nope if they let patient with Covid in they risk infecting more patients.
      Keeping potential Covid victims out of GP doctors surgery’s is just good medical hygiene.’
      Your local doctor is not set up to deal with an extremely virulent and risky virus.
      Oh and Duker Doctors have their own networks of professional information far more reliable than what you read in the MSM .

      Reply
    • Conspiratoor

       /  31st March 2020

      Duker you are talking rubbish

      Reply
      • Gezza

         /  31st March 2020

        I not sure Duker’s entirely incorrect. Might depend on the GP. I get the distinct impression from Managemyhealth group messages that some of our GP’s here would rather diagnose over the phone & send likely infected patients to Kenepuru Hospital for testing. I’m booked for a flu shot at the Med Centre tomorrow morning. They’re done by practice nurses. Might be done in my car, they said. I’ll see if I can find out whether any Drs there are doing SARS-COV2 diagnosis tests.

        Reply
        • Conspiratoor

           /  31st March 2020

          G, yes duker is not always entirely incorrect. Just a little too dependent on what he’s managed to google up to support whatever sweeping generalization he wants to conjure up. GPs are human just like the rest of us and if they have concerns it’s mostly because the protective equipment they need hasn’t yet reached them.

          Here is one who would be happy for duker to get off his bum and swing by her practice. No hesitation at all in pushing a swab so far up his nostril he’d have to shit it out before it could be tested

          Reply
  3. Maggy Wassilieff

     /  31st March 2020

    So now Ardern admits we need more and wider testing… but she wasn’t having a bar of this 2 weeks ago when Simon Bridges queried her in Parliament about our paucity of tests.

    Hansard Oral Question 2 Tuesday 17th March .

    Reply
    • Two weeks is a long time with Covid. Remember way back then we hardly had any cases and no hospitalisations. I suspect they didn’t have the capacity to do more testing two weeks ago, and have been building capability since then. They can obviously do quite a bit more now.

      It’s always easy to suggest things from Opposition when you don’t have to deliver on what you demand.

      Whatever it was it looks like we might have got away with how things have progressed, for now at least. Now isn’t a bad time to be finding out how much spread there is around the community, it would have not been a lot of use before lockdown with a lot of people movement going on..

      Reply
      • Corky.

         /  31st March 2020

        To find out what the spread is in the community we would need random testing. Outside a supermarket would be a great way to cover huge areas of the community.

        Reply
      • Maggy Wassilieff

         /  31st March 2020

        Oh Rubbish, Pete.

        Your Otago University specialists were screaming out for more testing from the beginning of March.
        Crikey, even the head of WHO was saying test, test, test… in mid March.
        https://www.bbc.com/news/av/world-51916707/who-head-our-key-message-is-test-test-test

        Ardern played games 2 weeks ago in Parliament and now she is trying to paint over her neglect.

        Reply
        • Gezza

           /  31st March 2020

          It’s not neglect. She’s got a comms (arts?) degree not a stats or science one. If her health bureaucrats fed hed her bs she may not have had accessxto contestable advice. Her job & bsckground is PR.

          Reply
          • Gezza

             /  31st March 2020

            And after being a victim of the NZ education system that fell into decline after our time, the poor woman can’t even read properly either. She reads the words something, anything, and nothing as sumpthink, anythink & nuthink.

            She can’t distinguish between d’s & t’s.

            These childlike pronunciation disabilities still haven’t prevented her from rising from the abject wreckage of a crashed tractor to become the Pry Minisda of New Zealand, so give her some credit for ability & grit, Maggy.

            Reply
    • Corky

       /  31st March 2020

      Sssh, Maggy! Lurchy may hear you. He’s on a rampage at the moment against everything he considers RIGHT. Hell, he’s even refusing to go around right corners on his scooter.

      Reply
    • Gezza

       /  31st March 2020

      17 March 2020

      Question 2
      Hon SIMON BRIDGES (Leader of the Opposition) to the Prime Minister: Does she stand by all her Government’s statements and actions?

      Rt Hon JACINDA ARDERN (Prime Minister): Yes, especially the announcement made by finance Minister, Grant Robertson, earlier today that we are introducing a $12.1 billion package to cushion the impact of COVID-19 to support Kiwis’ jobs and, of course, the domestic economy. Relative to other countries, this is a far greater package, but we also know that the impact, as we have been advised by Treasury, is likely to be greater than the experience New Zealand had through the global financial crisis and therefore our focus must be on getting in front of those impacts: supporting businesses, jobs, and employees against the worst impacts of this pandemic.

      Hon Simon Bridges: Why are people being denied coronavirus tests when they are displaying symptoms?

      Rt Hon JACINDA ARDERN: I reject the assertion they are. I want to read—

      Hon Simon Bridges: Well, they are.

      Rt Hon JACINDA ARDERN: I would like to read from the case notes provided to doctors. Under the case definition, it says, “Note”—this is for clinicians—”that due to the ongoing changing global and domestic situation, clinical judgement should apply as to whether someone who doesn’t quite meet the current case definition should be tested or not.” Any person who a clinician thinks needs a test should get a test.

      Hon Simon Bridges: So does she deny the email to me from a Wellingtonian and his partner who had all the symptoms and were denied the tests yesterday?

      Rt Hon JACINDA ARDERN: Again, as I’ve just said, that decision sits with doctors. I will read, again: “due to the ongoing changing [environment], clinical judgement should apply as to whether someone who doesn’t … meet the … case definition should be tested or not.” I cannot be clearer. Any person a doctor believes should be tested can and should be tested. We have the capacity to do up to 1,500 tests a day. My understanding is that we have hundreds of tests currently being processed for which we will have the results tomorrow.

      Hon Simon Bridges: Why doesn’t she just guarantee that those who show the clear symptoms will get the testing, as Prime Minister of our country?

      Rt Hon JACINDA ARDERN: I’ve just given you the exact advice that is for doctors. Doctors make those decisions, not politicians, but what they have been told is that anyone who they believe should be tested should be tested. I cannot be clearer than that. I cannot make those judgments, but they can, and they should.

      Hon Simon Bridges: Why is she only suggesting ramping up tests now after the World Health Organization has called for countries to test, test, test?

      Rt Hon JACINDA ARDERN: The member is utterly incorrect. We’ve had the capacity to test up to a thousand a day for a very long time.

      Hon Simon Bridges: Is she concerned that a comparable country like Norway has tested 8,000 people and we’ve tested less than 600?

      Rt Hon JACINDA ARDERN: Again, the member seems to be upset about where our global standing currently is in terms of case profile. We have, currently, a small number of cases, that have been confirmed through testing. But I expect that we will have many hundreds more tests conducted. In fact, I understand we have hundreds currently being processed this very day.

      Hon Simon Bridges: Isn’t the reason we only have a dozen confirmed cases and not dozens and dozens and dozens because under her Government, since the start of the year, we just haven’t done many tests?

      Rt Hon JACINDA ARDERN: That is an appalling, appalling statement to make. The implication that tests are being determined by politics is appalling. Doctors are making the call, and they are being told that if they believe they should test, they should. I cannot be clearer about the advice that has been provided by the Ministry of Health; it is in black in white—in fact, it is in bold.

      Hon Dr David Clark: Is the Prime Minister aware that Norway currently has 1,200 confirmed cases of the virus, and is in Europe, which has been described as the epicentre of the outbreak?

      Rt Hon JACINDA ARDERN: Yes. In those cases, you would expect, therefore, that the contact tracing and symptoms would therefore lead to the other testing outcomes that they have. It seems extraordinary to me that the suggestion seems to be that there is disappointment about where we are. Hundreds of tests are being processed today. Very unfortunately, we will see—[Interruption] We will see more—

      SPEAKER: Order! Order! Can I just ask members on both sides—this is a very serious issue, and petty calling back and forth from both sides ill behoves the House.

      Hon Simon Bridges: Does she accept that the reason, say, Norway has many more confirmed cases is because they have done many, many thousands more tests, and that’s where we needed to be weeks ago.

      Rt Hon JACINDA ARDERN: No, I reject that, and I again confirm I have just been advised there are 500 tests currently being processed. That capacity has always existed, but we have allowed doctors to make that decision, not politicians.

      Hon Simon Bridges: Will she apologise to New Zealanders who have been previously denied a test under her Government last month, the month before, and as little ago as yesterday?

      Rt Hon JACINDA ARDERN: No one who a doctor believes should be tested should have been denied a test.

      Reply
      • Gezza

         /  31st March 2020

        From PG’s post:

        Newsroom: More testing needed, Ardern says

        The number of tests for coronavirus is set to ramp up, with health officials relaxing the testing criteria as Prime Minister Jacinda Ardern called for more testing to be done.

        The matter was at the fore during the inaugural meeting of the epidemic response committee earlier on Tuesday, where Director-General of Health Ashley Bloomfield indicated a change was coming.

        Now, Ardern has confirmed the technical advisory group overseeing the case definition of Covid-19 had agreed to expand it to include people who had symptoms potentially indicative of the virus, but without a link to overseas travel or a close contact who had tested positive.

        The new advice would be circulated to Healthline, GPs and community clinics, with the Prime Minister expressing a desire to see testing levels ramp up further.

        “I want more tests, we’ve built the capacity for more tests, more tests will only allow us to get a better picture of the spread of Covid-19.”

        However, she pushed back when asked why the Government had not made such a change earlier, saying New Zealand had already been conducting a high level of tests relative to other countries.

        Prima facie there seem to be several possibilities:
        1. She was deliberately telling porkies answering that question, while trying to muddy the water
        2. Bloomfield or Clark or whoever was advising her what the testing criteria were & who could decide if tests were needed were telling porkies or didn’t have a clue what was actually happening out there in NZ
        3. She was doing a Trump & making shit up, to confuse the Opposition.

        Reply
        • Alan Wilkinson

           /  31st March 2020

          I think she was making it up to confuse the press gallery and public. I don’t think the opposition were at all confused.

          Reply
          • Gezza

             /  31st March 2020

            No. They were onto Bloomfield today at the Special Committee meeting. He said the testing criteria had already been changed so that GP’s could also decide who needed testing. He got asked if that was the case why were the MOH testing criteria on their website still dated 14 March? There seem to be some disconnects in the Health Dept COVID19 Team – Director General of Health comms chain.

            This issue has been around and messy for at least two weeks, possibly longer.

            Mind you, MoH & the Covid19ers have a huge bloody job to do when I look at all the Covid-19 signs & info sheets & other comms material constantly coming out. Like changing requirements notices all over ma’s rest home before they finally locked it down to no visitors at all on MoH instructions.

            Decisions have had to be made – likely sometimes by policy wonk people in Wgtn with little or no recent front line experience – before any detailed planning was possible. And reporting to a Noddy like Clark?

            Reply
          • Blazer

             /  1st April 2020

            this is crystal clear..’That capacity has always existed, but we have allowed doctors to make that decision, not politicians.’

            Note the opposition will not criticise…doctors.

            Reply
  4. Maggy Wassilieff

     /  31st March 2020

    Well done Geeza..

    Why can’t our MSM expose the petty games this woman has been playing?

    Keep well,
    wash those hands.

    Reply
    • Gezza

       /  1st April 2020

      Well, going by those present at her briefings, I guess because the majority seem to be lightweight thinkers, primarily youngish women & millennial girl/boy reporters, whose written or tv presented journalistic efforts afterwards suggest they are repeaters, not reporters.

      They have bugger-all life experience & don’t represent a cross section of ages of the population, so their questions aren’t the sort of questions that might occur to older folk who’ve put up with lots of politicians & bureaucrats & learned to be pretty skeptical.

      They mostly seem to suck up to her & she controls them by favouring the ones who ask patsy questions.

      She doesn’t debate them. When she avoids a straight answer or deflects from an awkward question, they let it go because – like Trump, interestingly – she then ignores them & indicates with a hand gesture & / or a name, who gets favoured with the next question, if they behave.

      There are two Jacinda’s, I’m noticing. The strong, caring, kind-hearted one, the one that especially women & girls like – & the less-visible calculating, ruthless one. She is developing her craft very well. She’s not intellectually grunty, but she definitely is not stupid, as some of her critics keep making the mistake of thinking & saying. She’s getting smarter. She is becoming a master media manipulator.

      Did I hear on 1News tonite that ScMo is now going to pay at least some money to Kiwis in Aussie who can’t work during their lockdowns? If so, that’s her doing. And that is going to gain her (well-deserved) acclaim. She didn’t just roll over & let ScoMo tickle her tummy like John Key might’ve.

      But, watching some of Bridges’s performance chairing that Special Committee virtual meeting today, he was doing a pretty good job there – he might learn a thing or two from it in developing his style too. Be interesting to see. Other members of his team did well. And I don’t usually like them.

      And even that decision to let that Special Committee be stacked with and chaired by her opponents was a surprising & seemingly fair-minded decision by Jacinda that was politically smart.

      My thoughts, anyway. Just my opinion at this stage of developments in an unusual & crisis situation for our country.

      Reply
      • Alan Wilkinson

         /  1st April 2020

        There is a pay-walled Herald column on the select committee hearing yesterday but nothing on Stuff that I could find wading thru the drivel there.

        Reply

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