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.

Warnings there isn’t enough data to make lockdown level decisions

Today the Government is going to describe in detail what a change to Level 3 and Level 2 lockdown levels will mean for us, and on Prime Minister Jacinda Ardern has committed to announcing a decision on whether to lower the alert level on Monday, two days before the initial 4 weeks on level 4 expires.

But experts are warning there isn’t enough data to make the decision.

RNZ: Data on contact tracing, tests, borders needed to inform lockdown level – scientists

Epidemiologist Michael Baker, who is on the Health Ministry’s Covid-19 technical advisory group, said some of the data he needed to see to be confident of going to alert level 3 may not exist yet.

“There’s a whole suite of data I would like to see, to make it really clear that we’re ready to … drop down our response level,” he said.

Prof Baker told RNZ he had been asking the ministry for weeks for certain key data about border control, contact tracing and testing but had not received it, nor had the advisory subgroup he was on with four other epidemiologists.

“I don’t think any of the epidemiologists I know have seen data covering all of these key measures.”

The public deserved to see that data before the Cabinet decision on Monday about changing the alert level, Baker said.

“Someone needs to see these data to say, yes, the system’s all performing adequately. I think that’s really vital.

“I’m hoping these data will appear very soon, because I think it is a critical input for making a decision of this magnitude.”

I would have thought that Prof. Baker would know if the data was going to be available soon or not.

Border control systems may be effective, and the data for them may exist, but it might not exist yet in the right form to be analysed properly, he said.

“It’s possible. I know getting the data into a robust form is a real challenge for our system because it has been under-resourced, progressively for many years. And this is really a massive increase in capability and expectations.”

He said clear data showing whether contact tracing was good enough to loosen restrictions should be available, but he had never seen it despite asking the ministry repeatedly for it.

It’s a bit alarming that a top Government adviser is not getting information and  data he requires to give informed advice.

Auckland University Professor Shaun Hendy is expected to submit to the government tomorrow his team’s modelling on the risks of an outbreak from easing the lockdown.

The team had about three-quarters of the data they needed, after improvements in how it was coming through in the past week, he said, but some of the contact tracing data was “really weak”.

He said the quality of data on testing was about eight or nine out of 10, but it was not easy to compile.

“Some of that information is still sent around by fax these days, so you can imagine that’s quite hard to transcribe. But we we are starting to get that information now”.

They send  data around by fax? Good grief. Not only is it ancient technology, it raises the risks if data has to be manually transcribed. I’m gobsmacked by this reliance on obsolete last century technology.

However, the team was struggling to get good data on contact tracing.

“We’re at the bottom end of the scale,” Prof Hendy said. “I understand the demands on the contact tracing operations at the moment, they’re working as fast as they can. But that’s a bit of a bit of a blind spot for us in our modelling.”

“We have some really weak idea of how much that capacity could be scaled. So let’s say we had another regional outbreak in a few weeks’ time, how much resource can be deployed to one of the regions to contain that outbreak.”

He was not confident they knew enough to make a call on going to alert level 3 region by region.

“If you’re going to relax that region earlier than the rest of the country, then there’s things you’d like to know about the way that public health is being deployed in that region that would minimise those risks,” he said.

“I think that’s a difficult call to make.

This doesn’t encourage me that information is sufficient or robust.

It also doesn’t sound  promising for a relaxation of alert level next week.