Tuesday, August 11, 2020

New Zealand Reports 1st Domestic Cluster Of COVID-19 in Over 100 Days









#15,409

As any paramedic, firefighter, ER nurse or doctor will tell you - no matter how quiet a shift has been - you never utter the `Q' word until you have punched out on the time clock and have safely left the premises.  

Which is why, when I saw the NEJM article three days ago entitled `Successful Elimination of Covid-19 Transmission in New Zealand', I got a bad feeling about it. 

Not that New Zealand doesn't deserve tremendous props for going 100+ days without a domestic COVID case.  They do, and there is much that can be learned from their rapid and comprehensive pandemic response that has kept their COVID tally to 1,570 cases and just 22 deaths.     

But with the virus circulating globally, maintaining any country's virus-free status is a pretty big ask, even for an island nation with a long history of pandemic planning (see Can Island Nations Effectively Quarantine Against Pandemic Flu?).

Overnight, via a press conference,  New Zealand's Prime Minister Jacinda Ardern announced that four members of a family in Auckland have tested positive for COVID-19, and that for now, the source of their infection is unknown. 

(Click Image for Video - 49 mins)

Auckland will go into a level 3 lockdown for the next 72 hours, while contact tracing and testing are ramped up, while the rest of the country will go to level 2 (details below).  

Given their past successes, New Zealand will likely get a handle on this latest outbreak in pretty short order.  But it is a reminder that while getting to zero cases is extraordinarily difficult in a pandemic  - staying there is nearly impossible. 

A transcript of the PM's statement follows:

11 AUGUST 2020
PM comments on Auckland COVID-19 case

After 102 days we have our first cases of Covid-19 outside of a Managed Isolation or Quarantine facility in New Zealand.

Shortly I will ask Dr Bloomfield to set out the details of the case.

While we have all worked incredibly hard to prevent this scenario, we have also planned and prepared for it.

We have a resurgence plan that we will now activate.

That plan is based on everything we have learned to date, and what we have observed of resurgence overseas.

Those plans are based though on what we know, so I will pass to Dr Bloomfield who will set those details out. Then I will set out the initial decisions that have been made in response, and what it means for everyone.

[Dr Bloomfield speaks]
As you will have heard, our first cases in the community still leaves questions to be answered, the most important of which is tracing the case back to its origin.

When we’re able to do that, we can be much more certain about tracing and isolating close contacts. When we can’t do that, it means we have to take a precautionary approach.

At this stage, we have not yet been able to determine the source of the case. There is no immediate link to an MIQ facility that we are yet aware of, or to border staff.

Therefore we need to take a much more precautionary approach until we can find the source and access the risk of wider spread.

One of the most important lessons we’ve learned from overseas is the need to go hard and go early to stamp out flare ups to avoid the risk of wider outbreak.

As disruptive as it is, a strong and rapid health response remains the best long term economic response.

In line with our precautionary approach, we will be asking Aucklanders to take swift action with us.

As of 12 noon tomorrow, Wednesday August 12 we will be moving Auckland to level 3 for a period of 3 days, until midnight on Friday.

Three days will give us time to assess the situation and gather information, including contact tracing, so we can find out more about how the case arose and make decisions of how to respond after that.

Let me set out what that means for Aucklanders and the rest of New Zealand.

We are asking people in Auckland to stay home to stop the spread.
This means doing the simple things that you will all be familiar with to prevent picking up the virus or passing it on to others.

First, act as if you have Covid and if the people around you have Covid.

At level 3 you are asked to stay at home in your bubble other than for essential movements such as going to the supermarket or local recreation.

If you are in Auckland, you must work from home unless you are an essential service worker.

All schools and child care facilities in Auckland are closed as of tomorrow morning except for the children of essential service workers.

All public facilities, bars, restaurants and businesses must close by midday tomorrow.

Gatherings of more than 10 people in Auckland are not allowed and are restricted to funerals, tangihanga and wedding services only. In the rest of the country gathering are restricted to 100 people with physical distancing requirements back in place.

Travelling into Auckland is prohibited, unless you normally reside there and need to get home.

If you are currently in Auckland but do not normally reside there you also can leave to go home, but we are asking you to be conscious of your health and if you begin to exhibit any symptoms please get tested.

We are defining the area covered by the level 3 restriction as the geographic boundary of the Auckland super city, which extends from Wellsford in the North to Pukekohe in the south. Police will be issuing further guidance on parameters, including on road blocks, in the morning.

As you will recall, all key services including supermarkets, pharmacies, medical centres will remain open so food and supplies will be continue to be readily available. Food delivery is available at Level 3.

Please do not rush to the supermarket tonight. As everyone will remember from last time, Supermarkets will be open, there will be ample stock on the shelves.
If you operated as an essential service under level 4 and 3 last time then you;; recall reverting to those settings again. If in doubt stay at home tomorrow until you have clarity from your employer.

That then brings me to what we are asking the rest of New Zealand.

We will be moving the rest of the country, outside of Auckland, to level two. This will come into place from midday tomorrow, and run through till midnight on Friday, so the same period of time that we have moved Auckland.

That means social distancing applies, and mass gatherings in that time will need to be limited to 100 people, as will all of the other guidance we are familiar with at level two.

I know that this information will be very difficult to receive. We all had hoped not to find ourselves in this position again, but we had also prepared for it. And as a team, we have also been here before. We know if we have a plan, and stick to it, we can work our way through very difficult and often unknown situations.

Before I finish I want to talk briefly about some of the additional plans we have in place.

As the Director General has set out Auckland regional health will be standing up a mass testing programme across the Auckland region where we will seek to test tens of thousands of people over the coming days in order to understand any potential cases unidentified in the community.

It’s our intention to test everyone who works at the border, and everyone who works in managed isolation facilities with a focus on Auckland.

We will also be undertaking wide testing of those who are symptomatic in Auckland. Please do not visit your GP or a community testing station if you are well.

More details of the location of these CBACS and guidance on who should get a test will be provided in an update tomorrow.

And a final word on mask use. We know now that these can be effective in reducing spread. If you are in Auckland, we ask that you use a mask when you are accessing essential services. For the rest of the country, we advise their use if you’re in a place where social distancing is difficult.
Let me finish by saying this. We have planned for this event.

While this initial 3 day lockdown will mainly affect the Auckland region, I am asking the team of 5 million to stand ready again.

Together we have beaten the virus before and with fast action, and by acting together, we can do so again.

We have come too far to go backwards.

I’m also asking New Zealanders to be strong and be kind.

If you know someone in Auckland, give them a call.

If you are in Auckland, please make sure that your neighbours and ensure they are looked after and supported.

We know what to do. We have done it before. Stay home, stop the spread.

I’ll now take your questions.