Decision due today on Covid alert levels

Cabinet is due to announce today whether the Covid alert levels will be reduced or not. Auckland is currently on level 2.5 with the rest of the country on 2.

It had been looking promising for a lowering of levels, with several days of no new community cases – until yesterday when the Ministry of Health announced: 4 new cases of COVID-19

There are four new cases of COVID-19 to report in New Zealand today; two community cases and two cases in managed isolation.

The two community cases are household contacts of the case reported yesterday, which is not connected to the Auckland cluster. The case reported yesterday is a recent returnee who arrived in New Zealand from India on August 27 and completed managed isolation, returning two negative tests at the facility in Christchurch before returning home to Auckland on September 11. 

The case reported yesterday was tested after developing symptoms on September 16, and returned a positive result. He and his household contacts self-isolated when he developed symptoms. They were all moved into the Auckland quarantine facility on September 18, when the first case returned a positive result. 

All identified close contacts have been isolated and tested. 

The source of the case’s infection is still under investigation, but genome sequencing is consistent with two confirmed cases from the same flight from India to New Zealand that landed on August 27.  

It is possible that this case was infected during that flight and has had an extremely long incubation period – there is evidence that in rare instances the incubation period can be up to 24 days. This person developed symptoms 21 days after he arrived in New Zealand.  If this is the case, it sits well outside the standard incubation period of the virus. 

The vast majority of people who are infected with COVID-19 will become unwell within 14 days. Having returnees stay in managed isolation for 14 days remains the gold standard, and this is also the approach adopted by other countries. Our own modelling confirms that 14 days spent in managed isolation with two tests leaves a very low risk that someone will leave managed isolation with COVID-19.

Another possible scenario is that the case may have been infected during the flight from Christchurch to Auckland – other passengers from that flight are currently being contacted and assessed as a precautionary measure in order to exclude them as the source of infection.

This sort of uncertainty must weigh on the Cabinet decision, but Government advisers and allies are downplaying the implications.

Newshub: Fresh COVID-19 community cases lead to call for border restrictions review

It’s prompted the question – do we need to keep returnees in isolation for longer?

Director-General of Health Dr Ashley Bloomfield…

…says there are two most likely ways the man could have become infectious.

“Could be the person was actually infected before they left India, on the flight from India, during the period of managed isolation or subsequently even on that flight from Christchurch to Auckland.”

But he says there’s no risk to the public

Auckland University Professor Shaun Hendy:

“There’s a low likelihood that the new cases have led to unknown cases so I don’t think this will affect their decision tomorrow,”

Otago University epidemiologist Professor Michael Baker…

…says the chances of incubating the virus for longer than two weeks is low.

“It’s between 1 and 2 percent,” he says.

But Prof Baker says border restrictions need to be reviewed.

“If we find that some countries have such intense transmission that we’re seeing a lot of imported cases from there I think we’d want to think hard about that and how to manage that risk,” he says.

He wants returnees to isolate at their homes for a week after leaving quarantine facilities.

So perhaps we will lower levels but with another tweak to the rules.

While Jacinda Ardern says that decisions will be based on expert advice and science she received increasing criticism last week over the alert level being maintained outside Auckland. Cabinet Minister and deputy PM Winston Peters broke ranks with her.

I expect she will have one eye on expert advice and one eye on the election when making the decision today.