Questions on Covid testing in managed isolation

The source of the Auckland outbreak of Covid this month is still unknown (and as time goes on the chances of finding out where it came from diminishes), so questions continue to be asked about the effectiveness of New Zealand’s border controls.

It is known that the testing of people working at border jobs – airports and ports – and also at isolation and quarantine facilities has been inadequate and not up to the standard the Government (Prime Minister Jacinda Ardern and Minister of Health Chris Hipkins) claim to have demanded. How this came to happen is still to be determined or disclosed.

So this is one area where the Opposition has been questioning the Government.

Yesterday a response to a written question was promoted by National:

It perhaps shouldn’t be a surprise that the 3 day test isn’t compulsory. This and similar has been pointed out: “You can be required to stay a total of 28 days if you refuse to a Covid-19 test or are not considered a low risk by a health practitioner”.

Image

But that doesn’t address al the concerns raised by the Hipkins response. He said “The Ministry of Health does not hold the specific information requested…”

This may need clarification but it appears that the Ministry and the Minister don’t know how many people refuse the 3 day test. This raises further questions about the management of isolation facilities.

At a minimum I think the Ministry should know exactly how many people enter isolation or quarantine and how many people have the 3 day test (and also the 12 day test).

In particular they should know those who don’t have the test – they must know this to enforce their ‘up to 28 day’ requirement.

So either Hipkins is avoiding answering the question properly, or there is a serious problem still with the management of isolation facilities.

Dr Reti tried to address the issue in Question Time yesterday:

5. Dr SHANE RETI (National—Whangarei) to the Minister of Health: Does he stand by his statements and actions around coronavirus testing in isolation facilities?

Hon CHRIS HIPKINS (Minister of Health): Yes, in their full context.

Dr Shane Reti: How does he reconcile his answer to written questions that day-three testing has not been compulsory in managed isolation, despite the national testing strategy requiring day-three testing, and is this another hole in the border?

Hon CHRIS HIPKINS: No, there’s been no issue with the compliance with day-three testing, as I’ve said to the member many, many times.

Dr Shane Reti: Is day-three testing compulsory in managed isolation facilities?

Hon CHRIS HIPKINS: No, it is not, under the order. But as I’ve said to the member many, many times, people are doing it.

Dr Shane Reti: How does he reconcile not testing everyone around day three, with Dr Bloomfield’s comments five days ago that “if you have 14 days, plus the day three and day 12, plus … good infection prevention and control, that seems to be the best way of ensuring the lowest risk of someone leaving managed isolation who is infectious.”?

Hon CHRIS HIPKINS: Because those are the things we’re doing.

Rt Hon Jacinda Ardern: Can the Minister confirm that aside from there not having been compliance issues, if someone refuses testing, they have to stay in a managed isolation facility for longer?

Hon CHRIS HIPKINS: Yes, and as I’ve indicated many, many times to the member opposite, people are doing their day-three and day-12 tests.

Dr Shane Reti: How, then, does he reconcile not testing everyone in managed isolation around day three, with Dr Bloomfield’s June comments that “Everyone in our managed isolation facilities will be tested around day three.”?

Hon CHRIS HIPKINS: I would encourage the member not to stick to pre-scripted questions, and listen to the answers I’ve already given.

Hon Dr Megan Woods: Can the Minister confirm that since 17 June, no one has left a managed isolation or quarantine facility without returning a negative day-12 test, the test most important to the protection of New Zealanders?

Hon CHRIS HIPKINS: Yes, I can confirm that. I’d also note that one of the reasons the day-12 test is so important is that we have had people who have tested (positive) on day three that have subsequently tested negative on day 12. This virus can have quite a long incubation period.

Dr Shane Reti: Are hotel isolation staff put at risk if day-three testing of arrivals in managed isolation is not compulsory?

Hon CHRIS HIPKINS: No.

Dr Shane Reti: Have the Government’s border policies been informed in any way by modelling that formally assumed day-three testing was compulsory, when we now know it is not?

Hon CHRIS HIPKINS: I’m not entirely sure what the thrust of the member’s question is. As I’ve said, day-three testing is happening.

Hon Dr Megan Woods: Can the Minister confirm that staff at managed isolation facilities are not put at risk, because within our managed isolation facilities, we behave as if everybody has COVID, and there are strict protocols in place to protect both returnees and staff, and that is why we’ve had 40,000 people through these facilities and one positive case in a staff member?

Hon CHRIS HIPKINS: Yes, I can confirm that, and I can also say that I visited several of these facilities myself and saw firsthand the great lengths that the people working in them are going to to keep themselves and the people who are staying there safe.

Dr Shane Reti: Given that answer, was the maintenance man at the Rydges shown on CCTV to be wearing a mask?

Hon CHRIS HIPKINS: My understanding is that they haven’t yet been able to identify exact footage of the lift trip in question.

Dr Shane Reti: Does he agree that New Zealanders believe and have been reassured that testing of all arrivals into managed isolation occurs around day three?

Hon CHRIS HIPKINS: I’ve just given those answers. People are being tested at day three and day 12. There is no issue with compliance.

Hipkins repeated:
“…as I’ve said to the member many, many times, people are doing it”.
“as I’ve indicated many, many times to the member opposite, people are doing their day-three and day-12 tests”
“As I’ve said, day-three testing is happening.”
” People are being tested at day three and day 12. There is no issue with compliance”.

Those are definitive answers. So why did Hipkins say in response to the written question that the Ministry of Health does not hold the specific information requested? That doesn’t make sense too me.

Also, the lack of information on lift data is concerning. It should have been an urgent matter trying to determine how the maintenance man at Rydges may have contracted Covid. It must be important to know if he wore a mask when in the lift, because if he did and still contracted Covid in the lift that suggests it was by surface contact. This must be important information.

The maintenance man first had symptoms two weeks ago, on 11 August, and returned a positive test on 16 August.

Media release 18 August: Results of COVID-19 positive cases under investigation returned

The second case is a man who works as a maintenance worker at the Rydges Hotel managed isolation facility in Auckland who does not have any routine contact with guests. His partial genome sequencing results indicate his case is not linked to the community cluster.
 
No other cases linked to this person have been identified to date.  

Further genome sequencing and matching is being completed today and fuller analysis is expected later. 

The person returned a positive result for COVID-19 on Sunday 16 August with symptom onset on 11 August. He was transferred to Jet Park Hotel quarantine facility on Monday 17 August. It has taken till this morning for genomic sequencing results to confirm the origin of the case. 

Genome sequencing shows a returnee from the USA with the same sequence as the maintenance worker was at the Rydges Hotel from 28 July to 31 July before they returned a Day 3 positive test and were immediately moved to the Jet Park quarantine facility on 31 July. 

At this stage there is no obvious person-to-person connection between the worker and the returnee from the USA but investigations continue. 

Initial reviews of CCTV footage and swipe card movements so far show no interaction between the two people including no entry to physical locations occupied by the returnee from the USA.

So CCTV footage was initially reviewed over a week ago. Yesterday Hipkins said “My understanding is that they haven’t yet been able to identify exact footage of the lift trip in question.”

I think Hipkins should know by now exactly what is known about any lift footage, whether there is any, and exactly what has been determined.

If he doesn’t know I think that is a serious failing. If he does know he is not being open about it, in fact he would have failed to disclose it in Parliament.

Also of note is that the person arrived from the US and was at Rydges Hotel from 28 to 31 July. The maintenance man has acknowledged the onset of symptoms on 11 August. That seems like a long incubation period for Covid, which obviously makes containment and tracking challenging.

Basic information like how someone could contract the virus from a lift should be gathered with urgency, and the Minister should be right on top of all of this. Unfortunately Hopkins doesn’t give me confidence he is dealing with his responsibilities adequately.


This exchange yesterday also points out “an administrative error” resulted in inaccurate information being given in a written question.

8. Dr SHANE RETI (National—Whangarei) to the Minister of Research, Science and Innovation: What are the latest waste-water testing results for coronavirus in Auckland?

Hon Dr MEGAN WOODS (Minister of Research, Science and Innovation): Waste-water testing is taking place as part of a research project led by Environmental Science and Research (ESR), with funding from the COVID innovation fund that I established in early April. Positive results for viral RNA have been received from four of the five collection points in Auckland. The latest results are the Jet Park Hotel, with strong, positive results on 18 August, which is to be expected, given it is our quarantine facility; the Southern Interceptor, where waste water from the Jet Park Hotel mixes with waste water from 100,000 households, a positive result on 18 August; the Central Interceptor, a weak positive result on 17 August; the Rosedale Interceptor, a weak positive result on 13 August. There have been no positive results from the Western Interceptor collection point. These results correspond with what we know about the location of cases across Auckland. These results tell us that there is COVID-19 in these areas but do not give us precise information about the number of people infected or the stage of infection. One-off testing was also carried out in Christchurch and Queenstown in early August, returning negative results. This is another useful tool that can help us in the fight against COVID-19, and I look forward to providing further updates as the research project progresses.

Dr Shane Reti: When was the first positive test in sewage outflow testing in Auckland?Hon Dr MEGAN WOODS: The Jet Park Hotel started weekly testing on 12 July. As you would expect, given this is the facility where we house people who are COVID-positive, that that would have started in early July. One of the reasons why ESR, with the research money they have, is concentrating the efforts around testing of the Jet Park Hotel, and the interceptor associated with the Jet Park Hotel, is because we have such low levels of COVID in New Zealand, getting the sensitivity of the test is proving a challenge. So the first test would have been in early July.

Dr Shane Reti: How does she reconcile that answer with written questions received last week saying that weekly testing at Jet Park had been negative?

Hon Dr MEGAN WOODS: My understanding is that there has been a correction to the written question from the Minister of Health that was put through today, that the question did say that it had been daily, since the beginning of July, at Jet Park, returning negative results—that has been corrected to say “usually return positive results as expected”. This was put down to an administrative error.

That error also does not give me confidence in Ministry of Health information.