#15,679
New Zealand, an island nation with a population of roughly 5 million, has taken pandemic planning seriously for decades. They are one of the few nations that has seriously entertained the notion of imposing a full quarantine for the duration of a severe pandemic (see 2008's New Zealand: Testing Pandemic Quarantine Plans).
New Zealand began pandemic training exercises back in 2001, with Exercise Virex, and in he mid-2000s followed up with Exercise Makgill and Exercise Cruickshank, becoming in many ways the first national poster child for pandemic preparedness.
While New Zealand never fully closed their borders in 2020, they did act swiftly last March when the first community spread of COVID was deteted (see NEJM Successful Elimination of Covid-19 Transmission in New Zealand), enacting a 5-week level 4 lockdown, followed by two more weeks of Level 3.
Which, along with years of planning and the advantages inherent in being a remote island nation, may help explain how New Zealand has managed to keep COVID-19 pretty well contained this past year. To date, they've reported fewer than 2200 cases, and only 25 deaths.During that time they aggressively tested and isolated cases, and increased their border-control measures, including testing and quarantining of new arrivals.
The last `community' case of COVID was reported on November 18th, more than 6 weeks ago.
But of course, new cases continue to enter the country, and there are grave concerns that one of the more transmisible variants (e.g. B.1.1.7 or 501Y.V2) might slip in, and threaten their success.
Today (Jan 3rd) New Zealand has announced their first detections of the B.1.1.7 variant - first discovered in the UK - but now spreading widely around the globe. Between Dec 13th and the 25th, 6 infected arrivals (5 from the UK, 1 from South Africa) tested positive for the B.1.1.7 variant.
19 new cases in 3 days of COVID-19 in managed isolation
Media release
03 January 2021
There are 19 cases of COVID-19 in managed isolation to report in New Zealand since our last media statement on 31 December 2020.
There are no new cases in the community.
(SNIP)
UK variant detected
The Ministry of Health can confirm that six positive cases of COVID-19 have been found to match the recently identified UK variant of COVID-19 known as 20B/501Y.V1 (Lineage B.1.1.7).
All positive COVID-19 tests in New Zealand are sent to ESR for whole genome sequencing as part of our overall elimination strategy. As part of routine sequencing of these particular cases, matches to the UK variant were confirmed.
The six cases, five of whom travelled from the United Kingdom and one who travelled from South Africa, arrived into New Zealand between 13 and 25 December and underwent routine testing in managed isolation as part of routine surveillance testing or because they developed symptoms. Once confirmed positive they were transferred to the Auckland quarantine facility.
Four of these cases are now recovered and, after a final health check, were able to leave the facility.
The cases are all cared for with the same high level of infection prevention measures as all COVID-19 positive cases, with daily health checks and use of PPE. Infection prevention control protocols are in place for all staff and we can assure the public that there is no increased risk to the community.
The UK variant is more transmissible than other variants of the virus but there is no evidence at this stage that the length of the infection period is any different to any other variant of COVID-19, nor is it more likely to produce severe illness.
All cases detected in managed isolation must meet the recovered case definition before being allowed to leave the facility as assessed by the medical team. This includes a period of at least 72 hours without any symptoms and a minimum of 10 days since symptom onset or a positive test.
New testing for high risk countries now in place
New requirements for people arriving from the UK and US came into effect as of 11:59 pm on 31 December 2020. Anyone arriving into New Zealand from the UK or US is required to: have a COVID-19 test on day 0, i.e. within 24 hours of arriving into managed isolation and stay in their rooms until a test result is available.
If they are symptomatic on arrival, they will go straight to a quarantine facility.
In addition to this, as announced by the Minister for COVID-19 Response today, from 15 January, travellers from the United Stated and the United Kingdom will be required to get a negative test result for COVID-19 before departing for New Zealand.
The Ministry of Health continues to monitor overseas developments very closely through the holiday period. The added day 0/1 testing and pre-departure COVID-19 test for travellers from these countries are extra precautionary steps which provide another layer of protection for New Zealand from COVID-19.
It is not clear when NZ authorities realized these six patients carried the variant virus, but it was likely determined long after they had been quarantined. Genomic testing takes time, and so it will be up to routine surveillance and testing procedures to isolate additional variant cases that may arrive.
Whether, and for how long, New Zealand can successfully interdict these new variants is the $64 question. In some ways, New Zealand provides us with a semi-controlled field experiment testing the aggressiveness of these new variants.
If they are able to prevent the entry, or failing that - can significantly control the spread - of these more transmissible variant viruses in the months ahead, then they provide useful evidence that stronger NPIs can still reduce their impact.
If New Zealand is less than successful, at least we'll have a better idea of what we are up against.
Stay tuned.
