COVID-19 media update, 4 June

Dr Ashley Bloomfield: Kia ora katoa. Welcome to today's update.

Once again, no new cases of COVID-19 to report in New Zealand. Good news. Our 13th consecutive day of no new cases.

So, the overall number of confirmed cases remains at 1,154.

And we still just have the one remaining active case.

Also no additional deaths to report, and no-one is in hospital.

Yesterday, there were a total of 2,649 tests processed at laboratories around the country. And the total number of tests completed now is 286,174.

Now, 495,000 registrations on the NZ COVID Tracer app, so increasing by 8,000 since yesterday, continued uptake and I continue to encourage people to use this. The app will remain important and useful into Alert Level 1, and I encourage everybody to make sure that they either download that app or a similar one, or keep a record of where they're going to be.

And, likewise, an increasing number of businesses are using either the new process, expedited process, or the full MBIE process to download the QR code and print that and make it available for people.

I just want to have a quick update on the situation with COVID-19 internationally, and why that matters to New Zealand.

It's easy for us in our very privileged situation here in the country, hard-won, to forget what is happening internationally. It's important to recognise that the highest number of cases reported to the WHO since the pandemic started in any one day was just three days ago, with 124,139 cases of COVID-19 reported on June 1. And in total, countries have reported nearly 6.3 million confirmed cases of COVID, and internationally there have been around, unfortunately, 380,000 COVID-19 deaths reported to the WHO. In just a few short months.

The point here is that we are still very early in the evolution of this pandemic globally. There are still big gaps in our knowledge. And New Zealand is in a position that is the envy of many countries internationally, and that is due to the hard work and, indeed, sacrifice of so many Kiwis.

And just an aside here, I, over the long weekend, took a ferry trip to the South Island. I had a few days down there. And on the way back I was talking with the crew. During the period of lockdown, the crew divided themselves into two teams, and they lived and worked on board the ferries for a full two weeks. And then another team came on and replaced them for that full fortnight period - away from their families, sleeping in all sorts of places on the ferry, including the nursery. So that they could be a work bubble and continue to serve New Zealanders by transporting freight and essential goods between our islands.

So, just one very tangible example of the sort of sacrifices that people made through that lockdown period. And I want to acknowledge that work.

So, because of that hard work and those sacrifices, we have been able to ease our restrictions domestically and open up our economy. If we want to stay in the good position we are in now, we cannot afford to act as if it is all over.

Globally, as I said, it has only really just started. Italy, which quickly became one of Europe's worst-affected countries when coronavirus started to spread across the world, has also started lifting restrictions and allowing travel to and from the country this week. The virus has killed more than 33,000 people in Italy to date, and as restrictions ease they still have around 40,000 active cases, with nearly 3,000 new cases reported in the last week. That is a population of 60 million, but it's still obviously a very high number of cases, both active and new, in which they are easing restrictions.

Across the ditch in New South Wales, rates of new COVID-19 cases are low, very low, as in New Zealand, and they reported no cases yesterday. However, in the week to 30 May, they had 13 confirmed cases, and nine of them were people travelling back from overseas. The total number of cases in New South Wales is 3,095 confirmed cases, around double our total of both confirmed and probable cases - recognising that the population of New South Wales, at 7.5 million, is slightly larger than New Zealand's. But I think it's a good comparison. It's also worth recalling the death rates from COVID in different countries. And an estimated 6.1% of COVID cases reported have reported two have died as a result of their infections, so a 6.1% mortality rate. But there's huge variation between countries.

Our death rate of 1.9% is similar to that of New South Wales, which is 1.6%. And South Korea, at 2.4%. But considerably lower than Italy's, 14.3%, and the UK - similarly at 14%. And Spain, at 12.1%.

Likewise, as I've said yesterday, New Zealand is opening up its economy, and our social - ability to socialise more quickly than other countries and jurisdictions. And in New South Wales this week, only this week, gyms, rec centres and swimming pools and dance studios were reopened for a maximum of 10 people per class.

Outdoor public gatherings in New South Wales remain limited to 10 people, and there is a limit of five visitors to an individual's home at any one time. So, just to put our opening-up measures in context, including with Australia - in this case, New South Wales, which is in a very similar position to us.

Finally, we continue to maintain our strong engagement with other countries internationally, and on Monday evening I joined a WHO regional video call that included reps from Hong Kong, Singapore, China, and South Korea, on the topic of how to reopen borders safely and exchange of knowledge. All participants were, of course, as I was, very interested to learn from each other, and the steps that were being taken both in country and at the borders to combat COVID-19, and how we might safely reopen borders while preventing further outbreaks of disease in our countries.

In New Zealand, we therefore - a point here is we need to remain vigilant to the threat that the virus poses. And even though we are looking at a possible move to Alert Level 1, pending Cabinet decision, this is not life as it was before. We need to make some things a part of our new normal - in particular, staying at home if unwell, obviously hand hygiene, and also sneezing and coughing into an elbow, and keeping a diary of where you have been. Or to make it easier force, using the -- for yourself, using the COVID Tracer app.

Finally, just a reflection on how our health services are increasingly returning to normal under COVID-19 is the announcement today, or the reminder today, that the bowel screening programme is well up and running again. Immediately before lockdown, around 29,000 people who had received letters and kits to participate in the programme were asked to hold off sending in their test kits until the restrictions had been lifted. Those restrictions are now well and truly lifted, and the programme is well up and running again. And around 11,000 of those 29,000 people have returned the kits. I am encouraging those others who still have them at home to do so, to participate in the bowel screening programme. The programme did continue to process tests during the lockdown, and people with positive results are now being followed up promptly with follow-up investigations, which in most case assist a colonoscopy.

So, I guess the point here is to reiterate this is another example of the benefits of our early and timely decision to go into lockdown, that not only protected our healthcare workforce and our services, but has allowed us to reopen our healthcare system quickly to ensure that the full range of health services are available to New Zealanders who need them.

Thank you. And I'm open to questions.

Media: When will it be safe for immuno-compromised children to return to school?

>> Well, that will certainly be something that can happen in Alert Level 1. And I think if we look at the picture at the moment around no new cases for 13 days, then it's increasing - we can be increasingly confident it's safe for immuno-compromised children to return to school, and for immuno-compromised adults to get about their daily lives.

Media: We've seen some businesses still not contact tracing at all. What would you say to some of those businesses?

Dr Ashley Bloomfield: Well, I've said it once before in recent months - get with the programme. This is something that will be helpful for all New Zealanders. It's not a lengthy or troublesome operation to register for an NZ business number, to download the QR code and display it for people. And we are looking at this very point in time at a requirement on businesses to do so as we move into Alert Level 1, as it will form a very important part of our ability for people to keep track of where they have been, and therefore to contact-trace quickly if we need to.

Media: Over the past couple of months, New Zealand has had the advantage, benefit, of being able to see what's happened internationally and being able to make decisions based on what best practice has been internationally. But now we're ahead of the majority of the pack, at least, and sort of making decisions based on, I guess, what are we making decisions based on? And how difficult is it to not have that benefit of looking internationally to what other countries are doing, or did do?

Dr Ashley Bloomfield: Well, I think there are still lessons to be learnt. And I talked about that group of countries that I was on the call with earlier this week, countries and territories - so, China, Hong Kong, Singapore and South Korea. All of those countries in our own, sort of, Western Pacific region, have lessons that we can draw on. They're all countries that we might look to early to increase - or open up the possibility of travel to and from, if we're all confident in our border measures and in outbreaks being well under control. Secondly, we can also continue to learn from other countries as they reopen restrictions, or open up their economies and their societies from a different position. In other words, I talked about Italy, but also the UK and others, just to see what the impact is. And, for example, if they get a second wave of infection, how quickly that happens. And what measures they can take to contain any second wave. And we're also interested, of course, to see if there is an emerging seasonal pattern. So, as European countries go into summer, whether actually there is a lower, sort of, rate of spread of the infection. So, yes, continuing to look internationally, and also just at our closest neighbours - we still continue to work very closely with Australia and things like the trans-Tasman bubble are a key priority there.

Media: And from, I guess, almost a personal perspective, what is it like - obviously you spend a lot of time reading what's going on overseas, reading research and so on. What is it like reading that in the context of other countries who are still very clearly suffering from a pandemic, and looking outside to New Zealand, which is not as if nothing's happened, but, you know, the restrictions here are much lighter than there?

Dr Ashley Bloomfield: Yes, well, what's it like? Well, it's satisfying for us to be in the position we are in. And I've talked before about possibly being in a better position than we might have anticipated because of how closely people abided by the restrictions and expectations under the lockdown. So, saying, it's also incredibly a reminder that we cannot afford to take our eye off the ball here. And hence I talked yesterday about the sort of range of things we're looking at, at the border, to make sure we're belt and braces there, so that we don't get new chains of transmission onshore. If we do, that means we may have to sort of put restrictions in place that would then restrict the economy, and if we can maintain very open movement of people and goods and services, then that is really the best thing we can do for our economy. So, hence our really strong focused effort on the border.

Media: If we go into Level 1 and something happens and it all breaks out, there are cases everywhere, this morning you said there was no Plan B to remove them with your elimination strategy. Can you just clarify, do you have a backup plan if something happens, of where do we go?

Dr Ashley Bloomfield: Well, the elimination strategy includes the plan as to how you respond to infections and outbreaks onshore. So, hence our testing capacity, our contact tracing capacity, and our measures to help support people who have to isolate then. So, that is the plan. And, you know, one of the things perhaps referring back to the earlier question, I haven't seen a better plan in other countries. And if you look at, for example, those countries that have done well, all those pillars, including the border measures, are the mainstays of their approach and why they have been successful. So, I don't see any need for us to change the plan. What we've done is geared up each aspect of that, so that we are able to both prevent and also then identify and rapidly contain any outbreaks that might occur.

>> So, I may just go back a level? Is that what you would do f a Level 1, something happens, will we come back to Level 2?

Dr Ashley Bloomfield: It may be necessary, but the aim would be to contain things and remain within Level 1. So, that rapid - you know, if people are getting a test quickly, we're able to get the test results rapidly, and then rapidly identify contacts. That's what we're gearing the system up to do, so that we don't have to put in place restrictions again.

Media: When do you start stress-testing the systems that you talked about yesterday, the contact tracing, all those sorts of things, so ensure that we're ready for that?

Dr Ashley Bloomfield: Over the next few weeks we'll be doing that. We're still just rolling out the information system to the final District Health Board, building up the capacity and capability in our public health units, and so then we'll do some exercises to test the system to make sure we are ready.

Media: There's been some talks of trans-Tasman test flights from Wellington to Canberra - will you be involved in this process at all? And what safety measures will be in place?

Dr Ashley Bloomfield: I don't know about the test flights, but I guess that once a decision has been made by both governments to open up a trans-Tasman bubble, we would, indeed, test the process very thoroughly from, you know, the airports on both sides of the Tasman, right through - walk it right through the flights, make sure all the measures of are the types that both countries are satisfied everything is in place. I can imagine that is very much a part of the planning that has happened. And I know that a full range of players, both public and private sector, have been involved in getting the plans down to a level of detail that would allow that to happen.

Media: How many businesses so far have applied for the QR code?

Dr Ashley Bloomfield: Yes. I'm sorry I can't provide that figure, because we were just waiting for it before I came down. But we'll make sure we put that up on the website in the release.

Media: Do you expect - do you have an expected number of businesses to apply for the QR code?

Dr Ashley Bloomfield: I would expect all businesses to do it. Again, it's useful for their customers, and so it's not a big ask of businesses. It's going to be very helpful for people who have got the app, and I'm hoping that as many New Zealanders as possible do have it, for them to easily keep a track of what their movements are.

Media: What kind of consequences could you see if businesses didn't contact-trace?

Dr Ashley Bloomfield: Well, I would hope that, as they have, and as New Zealanders have today, they would continue to support the effort. The consequence may well be that it takes us longer to contact-trace people when we need to, and that may require then restrictions to be put in place. I think we're all - have a common interest in avoiding that.

Media: What's your understanding of asymptomatic transmission? Because the research on this has been mixed. Can a truly asymptomatic person, so not just pre-symptomatic, but asymptomatic, actually transmit the virus?

Dr Ashley Bloomfield: You're right that the research is mixed. And I think two comments here. Yes, there are people who do seem to have either no symptoms, or very low level of symptoms, but who may be shedding, and therefore transmitting quite large quantities of the virus. If not directly to people, they're leaving it in the environment, where we know it can remain for some time and infect other people. The second is there is a group of people who may be asymptomatic at the tail end of an infection, so some weeks even beyond when they were originally symptomatic and may test positive. The evidence there, from studies in Singapore and South Korea, suggest that those people are not infectious, they're not actually shedding viable virus, there may just be viral particles that still show up as a positive test. I think they're two different groups, and it's the ones who are truly infectious and appear to have no symptoms that are the ones that make it tricky. And hence our efforts to wait a good long period before we are confident and say we are confident there is no hidden infection out in our community. Any final questions?

Media: Is it good enough that some of the government QR codes aren't working?

Dr Ashley Bloomfield: If you've got examples of where they're not working, very happy to check those out. I've found all the ones that I have been scanning have worked just fine.

Media: One of my colleagues just asked me to ask you about the findings around how transmission has occurred in New Zealand, and the Ministry's knowledge of cases so far. So, for example, is there any evidence of outdoor transmission, or has it always been just within high schools, for example?

Dr Ashley Bloomfield: I can't speak very specifically to whether any of our 1,154 cases have been a result of indoor or outdoor transmission. But the pattern we've seen here is that transmission is quite common inside the family home, and it is common inside indoor settings, workplaces, and where people have a lot of interaction with each other. Less we do know from experience around the world that it's less likely to transmit outdoors, because it tends to be more space between people, and, of course, just because of the weather conditions, the virus doesn't tend to stay hanging around in the air quite so long.

Media: Is there anything else you can tell us about the one active case? Do we know their symptoms? Is it unusual for them to have had it for this long? And are any of these symptoms end up being permanent for people, and in that case what would happen?

Dr Ashley Bloomfield: I don't have any details on the specific case. But what we're waiting for is for that person to be, I guess, officially declared as recovered. It would be at least a 10-day period since the onset of symptoms, and a 48-hour period of being symptom-free. So, it may well be the person is at the tail end of that 10 days. The issue of residual symptoms is quite interesting. There are I guess, case reports being published now, where people particularly have residual loss of smell and taste. Of course, this has been quite an interesting and unique symptom that there's been more evidence around for, and for some people this is the only symptom they have. Or it's an early symptom, and there does seem to be some residual loss of smell and taste. Now, the loss of taste is linked to the loss of smell, because actually it's our sense of smell that gives us most of our taste. So, it seems that probably the virus is doing some sort of temporary damage to the nerve that creates the sense of smell, and nerves can take some months to recover. It will be interesting to see if these people do fully recover their sense of smell.

Media: We've heard of some people with, like, pneumonia, they can't taste anything for the rest of their lives. So, would you be testing people in that sort of situation, to see if the disease is gone but they've got the leftovers, if you like?

Dr Ashley Bloomfield: I think we're quite confident now, referring back to those studies in South Korea and Singapore, even these people who have positive tests don't tend to be infectious. And I guess one way to determine that would be to test for any antibodies, if they've got any antibodies, through a blood test. You'll be aware that Otago University and the Southern Community Laboratory in Dunedin are doing a study, to calibrate what seems to be one of the better antibody tests. That will be an additional useful tool we will have to look at people who may have recovered and perhaps help us in determining our response for the future. Any final questions? If not, thank you very much. And no further stand-ups for the rest of this week. So, have a good weekend.