COVID-19 media update, 5 April

News article

05 April 2020

The All of Government COVID-19 National Response provided an update at 1.00 pm today.

Speakers:

  • Prime Minister Jacinda Ardern
  • Dr Ashley Bloomfield, Director-General of Health

View a video of the media briefing below.

Update summary

Dr Bloomfield said there are now 48 new confirmed cases of COVID-19 and 41 new probable cases. There are no additional deaths to report.

The combined total of confirmed and probable cases in New Zealand is 1,039. 

There are now 156 reported cases which we can confirm have recovered.

Dr Bloomfield told media there are 15 people in hospital, including 3 in ICU – 1 in Wellington, 2 in Auckland. 2 are in a critical condition. We will not be providing any additional comment on these and do ask that you respect the privacy of these individuals. 

He said we can report a 7 day rolling average of tests at 2,448 per day.  The total of lab tests to date is 36,209 and 3,093 tests were carried out yesterday. 

For the cases we know about, 45 percent have a clear international travel link, 36 percent are contacts of known cases including those in clusters around the country and we have confirmed community transmission of 1%.

He said we now have 12 significant clusters around the country

Contact tracing 

Dr Bloomfield said there's been a significant increase in New Zealand's ability to carry out contact tracing and we have provided a media statement on this today. 

In March, the Government announced a dedicated $500 million fund to help protect New Zealanders and their health around COVID-19. That announcement included a near doubling in resources for Public Health Units specifically to increase capacity for contact tracing.

This included standing up a new contact tracing workforce, the National Close Contact Service based at the Ministry in Wellington and supporting the great work being done by PHUs and DHB. 

As of Saturday, 4909 close contacts had been traced by the NCCS since it was stood up on March 24, with 702 contacts traced in a single day on Thursday.

There are 190 people working shifts in the centre.

Dr Bloomfield says later this week the Ministry will be providing more details on the mental health and wellbeing COVID-19 response and the specific COVID-19 response work for Māori.  

He said these are uncertain times - and we know that people will be going through a range of feelings and emotions. On top of that is the challenges of self-isolation and having to support each other from a distance.  We're critically aware that during this time people need to be looking after their mental health as well as their physical health. 

This week, you can expect to see the release of a range of initiatives from the Ministry of Health to help support people’s mental wellbeing.  The initiatives will range from information and awareness campaigns, online resources and services.  

The initiatives are part of a $15 million package of investment into mental health and wellbeing announced by the Government. 

Dr Bloomfield told media when looking at our rate of testing and capacity, the key things to look for are the number of new cases, especially as testing ramps up. We’ve seen the positivity rate drop at the same time.

Additionally, our surveillance plan has been geared up – some of that testing capacity will be used to inform what’s happening around the country. The other thing is looking into those clusters to find out where they are, the age distribution, geographic spread and what might be happening in the next fortnight.

Dr Bloomfield reiterated the case definition was formally widened on Friday but communicated earlier in week and we’ve seen testing ramp up.

The majority of cases are still linked with overseas travel or confirming close contacts and in particular, family transmission, which is what we’re seeing overseas.

Dr Bloomfield said the numbers of testing has still been good this weekend, more CBACs have opened up and there’s more access to testing that there was last weekend.

He said we’ve increased our contact tracing capacity. Maximum number of new cases is around the 89 mark per day - clearly nowhere near that 1,000 limit that one epidemiologist has talked about. We’ve got a 190 people working on shift in our centre in addition to PHU’s so our capacity is increasing.

If you look at the age and ethnicity breakdown of our cases, it reflects a great many of cases were returning from overseas.

I put our low death rate down to two things – firstly we’re much earlier in an outbreak than other countries are because we put measures in place much sooner, but also we have a much better idea of the total number of cases.

We’re much closer than other countries to finding the total number of COVID-19 cases. 

>> Jacinda Ardern: Good afternoon, everyone. We are in day 11 of our COVID-19 alert level 4 in lockdown. As in the past I've been sharing the platform with Director-General of Health, Dr Ashley Bloomfield. I will ask him to kick off our briefing today. After that, I'll make some comments. Then we will move to questions.

 >> Ashley Bloomfield: Thank you, Prime Minister. Kia ora katou. There is an increase of 89 cases, 48 are confirmed and 41 are probably cases. There are no additional deaths to report. There are 156 cases who have recovered from COVID-19 infection. So the total combined, confirmed and probable, cases in New Zealand is now 1,039. Today there are 15 people in hospital with COVID-19 infection and that includes three in intensive care units around the country, one in Wellington and two in Auckland. Two are classified as being in a critical condition. I don't have further details or comment to make on those -- on those cases and ask you respect the -- privacy of those folks.

The total number of lab tests completed to date is 36,209 and there were 3,093 tests processed yesterday. As mentioned, we continue to have sufficient capacity, more than sufficient capacity, to do the testing that is needed including under the expanded case definition. For those cases we have information on, 45% have a clear international travel link. A further 36% are contacts of known cases, including those in the clusters we have around the country, and we have confirmed community transmission of 1%, and 18% of our cases are still under investigation. We now have 12 significant clusters around the country with a new cluster in Canterbury, and a further one in Auckland. This was a smaller cluster that has now reached that 10 case threshold. The clusters with the highest number of associated cases remain the same although the case numbers have gone up slightly in each. The wedding in Bluff has 58, the event in Matamata as 58 and the mar College -- Marist College has the largest number with 56. Currently European 74%, Asian 8.3%, Maori, 7.6%, and Pacific, 3.3% - the breakdown of nationalities of cases. More details are on our website.

A quick word on contract tracing. There has been a significant increase in our national capacity to undertake contract tracing both within our public health units that have additional staff but also through our National Close Contact Service. As of Saturday, 4,909 close contacts had been traced by that national Close Contact -- National Close Contact Service stood up on 24 March and 272 close contacts were traced in a single day on Thursday. The team working inside that centre are now making over 2,000 calls per day and there are 190 folk working in shifts there.

Over the next week there are a couple of areas that I'd like to provide more information on and just signalling those ahead, one is on mental health and wellbeing, a range of initiatives that are being implemented to support people in self-isolation and those, of course, the population of New Zealand who are isolating at home in their bubbles. The initiatives are part of a 15 million-dollar investment into mental health and wellbeing announced by the Government. The second area I'll provide more detail on during the week is our Maori response action plan. Back to you, Prime Minister.

 >> Jacinda Ardern: As you will have heard from the Director-General, we now have 1,039 cases in New Zealand with the 89 cases that have been reported today. While I don't want to draw too many conclusions at this stage, you will see that our cases have, in the last few days, been relatively steady. We have not seen the ex -- exponential growth that others have that leads to an overwhelmed health system. That is a good thing. Now what we need to do is see those numbers start to come down. I'm aware that every time we see now cases it may be hard to see success, but we can be sure that what we have done as a country since the very beginning of COVID-19 is making a difference.

Commerce Rodney Jones was interviewed this morning and talked about some of the modelling has has been done using the expertise of his team including a biostatician and using key learnings and expertise since theout break of SARS. This is modelling I have seen over the last few weeks and monitored closely especially since at close points it has been accurate in predicting New Zealand numbers. On the eve of lockdown it had modelled that we would have 4,000 cases at this weekend. We instead have just over 1,000. It means we have 3,000 fewer people sick with COVID-19, who are passing it on to others and then to others, and then to others. We can and must continue to break the chain of transmission. As Rodney said we need to get to half-time and beyond that to see the full gains of the lockdown. We have made a good start and the decisions we've made to date have made a difference.

I've also seen reporting and statistics from Google that give us some insight into our reduction and movement as a nation that reflects impressively high levels of compliance by New Zealanders with the requirements of being at level 4 and reducing contacts with others. There's been an overall reduction in movement in places of retail and recreation of 91%. Even visits to the supermarket and farm say, which remain -- pharmacy, which remain essential services and open, have dropped by half. Going to parks is down by nearly 80%.

And while we are doing well at alert level 4, we also went earlier, before that point, in order to ensure the virus wouldn't have a stranglehold here. That was the case for many of our measures. New analysis by the Ministry of Foreign Affairs and Trade shows we closed our borders 25 days after our first case. Germany took 49 days, Spain 52, Australia 55, Singapore 61. Our first economic package was in place 18 days after the first case. Most countries took more than 40 days. Ours was 6% of GDP - bigger at the time than the UK, France, Germany, Italy, Spain, China, Korea and Japan, and on par with Canada. Our case rate and death toll is well below other comparable countries. Yes, we had the benefit of time because our distance and because our early border and mass gathering measures also have made a difference there. But we had the benefit of a window of opportunity where the benefit of witnessing a terrible trajectory overseas. You can see now just how small that window of opportunity is to try and stop community transmission. Going hard and going early appears though to be paying off for us.

The lockdown is the best way to stop the virus and it is also the best thing for our economy. By making the pain as short as possible. So I say to New Zealanders, be proud of your efforts that you have all made, the sacrifices that you have made. It is making a difference. Now is the time, though, to remain focused, to not let up and to keep our eyes on the mission that we all jointly share. This is why we have strengthened efforts to go after those who aren't sharing that mission and who appear to be breaking the rules.

As Dr Bloomfield and the police announced yesterday, a new Health Act notice has been issued to firm up the guidance around the rules in place during alert level 4 and ensure the success of the lockdown and help move the country out of it as soon as possible. And the police are enforcing these guidelines. Over Friday and Saturday, police completed 795 prevention controls in communities across the country and undertook 990 reassurance checks at essential services such as supermarkets, petrol stations and pharmacies. While compliance has been generally strong, there are still some who I would charitably describe as "idiots". A 38-year-old Christchurch man arrested at man after being seen on a video coughing on people in a supermarket I include in that description. He has been charged with endangering life by criminal nuisance and obstruction of an officer of health and will be appearing in court tomorrow.

Before I conclude, I want to dwell briefly on some of the discussion I have seen emerge over the past few days over what kind of public health response is best for the economy. I've said it many times before and I'll say it again - no matter what it is you favour, the solution is the same. Fight the virus.

A strategy that sacrifices people in favour of supposedly a better economic outcome is a false dichotomy and has been shown to produce the worst of both worlds - loss of life and prolonged economic pain. We need only look to history here as a guide. There is research available that looks at, for instance, the 1918 Spanish Flu. Times may have changed but the lesson overall is that those who worked rousely to stem the spread -- zealously -- fended better. However, I know there is real and genuine struggle in New Zealand right now and I don't carry that lightly. That is why the $5 billion paid out for wage subsidies in a couple of weeks has been so important to cushion the blow of going hard and going early as we have in New Zealand. But, nevertheless, we are likely to feel the long-term effects from a global downturn. As the Minister for Finance said on Friday, our message to business is to hold on to your people, give them the wage subsidy if you need to. And have a plan for coming out the other side. In particular, plan how your business will operate in different levels of the alert framework.

The Government's focus this week remains doing all we can to stop the spread of the virus so we can move out of lockdown as soon as possible. Our efforts remain focused on good levels of testing across all regions and getting a better picture on community transmission, continuing to scale-up our contact tracing efforts, as the Director-General has outlined, and ensuring New Zealanders' businesses are receiving the financial support they need. I also expect this week to receive further advice from the Ministry of Health and my Chief Science advisory and others on the evidence-base needed to have confidence we do have the virus under control and therefore can move with certainty out of level 4, and the measures that will need to be in place at level 3 to ensure we prevent the risk of further outbreaks.

Finally, a public service announcement, daylight savings ended overnight. This is when we usually ask people to check their smoke alarms. As we are at home, do not led that slide.

 >> Prime Minister, would you charitably describe David Clark as an idiot

 >> Jacinda Ardern: I've discussed privately and publicly his activities. He has been asked to restrict any activity that could be considered to put him at risk in the same way we're asking every New Zealander to do that. We don't want a situation where people are engaging in risky exercise, for instance, causes there to be call-outs or unnecessary call on our front-line services. None of that want that. He fully understands my expectations of him. He needs to be a role model.

 >> Do you recognise if he is unable to do his job right now because he appears to be hiding from the media...

 >> Jacinda Ardern: I wouldn't classify him that way at all. I would expect him to continue to do his job obviously.

 >> He put out a press release on Friday about repurposing ICUs, we couldn't speak to him about that.

 >> Jacinda Ardern: Again, I wouldn't interpret it that at all.

 >> Where is he?

 >> Jacinda Ardern: You know exactly where he is, he is in lockdown, and that the Dunedin. He continues to do his job and many other New Zealanders continue to do their jobs from the place that they are in lockdown.

 >> Do you expect him to be fronting for interviews as regular responses I think including Q+A this morning was a no-show.

 >> Jacinda Ardern: Keep in mind Q&A has had myself and the Minister for Finance. There is no lack of members making themselves available to answer questions you and the public have.

 >> As key minister, would you expect him to be fronting on stories like that as a matter of course?

 >> Jacinda Ardern: Yes, and he will cooperate to do so but you also have a range of other ministers including myself to answer your questions.

 >> I know it is early discussions but given your summary today, what kind of things would you be looking for and are there timeframes being discussed?

 >> Jacinda Ardern: Those are plain to see. You'll be getting that information in real-time essentially only a few hours after I do. Things like case numbers gives us a sense of the rate of transmission and whether or not we've been able to slow that down. Then we're looking at what's happening with community transmission, and also the success of contract tracing for or clusters. All of that information will tell us whether or not we have control back of COVID-19 in New Zealand and whether we're in a position to move to different alert levels. I want to dig deeper. That's why I've asked the Ministry of Health alongside our experts and those in the science field to help dig deeper into theita we need -- the criteria we need to use as a country.

 >>. ..Rapid testing that's happened

 >> Jacinda Ardern: Already you can see, relative your positive rate, relative to the number of tests you're undertaking. I'll ask the Director-General to touch on this as well. In some countries, for instance, 50% of their tests are positive. That gives you a sense that their ability to test broadly in the community is constrained by how big the outbreak is. We have a high rate of testing. What we want to make sure is we have enough regional spread in that testing. If there's areas where we're not seeing enough data, that we're spreading out that testing so that it can give us the intelligence we need. That's work that the Ministry of Health is doing as we speak. Director-General, do you want to touch on that point though?

 >> Ashley Bloomfield: Yes, a further comment on that. I think the key things we'll be looking for are, of course, the number of new cases and especially as that testing has ramped up and we've seen the positivity rate drop at the same time, we haven't been finding more cases. If you think yesterday we had around 50 new cases with around 3,000 tests done, now that's a positivity rate of just over 1%. Whereas when our test rates were lower it was around 3%, which is the level, say, of South Korea. That's one thing. We also have our surveillance plan geared up. Some of that testing we'll be able to use as well to inform what's happening on the surveillance. The other thing is just also that looking into those clusters and into those cases still under investigation to find out if we, for example, assume they were all community transmission, where are they, what's the geographical pattern, what's the age distribution and what are they telling us so they might give us an indication of what might be happening over the next two weeks.

 >> Jacinda Ardern: Jane?

 >> I wanted on the flipside, is cabinet considering a level 5? Do you have a contingency for tighter restrictions...

 >> Jacinda Ardern: This is as tight it gets. This is as tight as it gets. You will see that relative to other countries that have used lockdowns, this is equivalent to what you've seen in Italy and the likes Spain. New Zealanders, relative to those countries, have applied the rules by and large. The goal of this level is to reduce down the contract as much as possible but continue to look after the health and welfare of New Zealanders. That's the level we're at. We need to get down from this level.

 >> To clarify that point, we won't see anything like curfews or anything like a 24-hour stay at home ban?

 >> Jacinda Ardern: No-one wants to see that kind of level of extension. That seems to have been used in countries where the original rules haven't been applied. And haven't been followed. I know New Zealanders, the reason that they are reporting where they see non-compliance is because they want to maintain the access that they currently have to the outdoors. We do too. As long as people stick to the rules we should be able to maintain that.

 >> The case definition has been widened on Friday. Is there any indication that community transmission has increased, is it way tot soon to tell. If that's the case...

 >> Ashley Bloomfield: The case definition was formally widened on Friday but testing started to ramp up from the middle of the week. Again, the positivity rate has dropped even with that wider testing, which is good. And we have still seen the majority of cases are associated with international travel or confirming close contacts and, in particular, famly transmission within households, which is exactly what's happened overseas. That's where most of the transmission is happening. So we haven't seen a big jump in community transmission but we will be looking closely at those as-yet - those cases still being investigated to see what they are telling us.

 >> The numbers have been more or less the same, so that doesn't seem to have gone up?

 >> Ashley Bloomfield: It is a proportion. The time has gone up slightly but that's the time it takes to rule out international travel or close contact as at the cause and then they're classified as community transmission.

 >> Up to 18% might be community transmission?

 >> Ashley Bloomfield: I would expect that a good proportion may well be community transmission. The important thing is where that is happening, whether it is in one or two locations or whether it is more widespread.

 >> Jacinda Ardern: Joe?

 >> With testing dropping off last weekend, are we seeing that this weekend as well?

 >> Ashley Bloomfield: The numbers have still been good this weekend. Still a lot of testing happening. What we've seen is more of those community based assessment centres opening up. There is more access to testing this weekend than last weekend.

 >> Jacinda Ardern: I think we have to factor in human behaviour as well. We can only test people who are coming forward for testing at those comment -- community testing stations. Some people believe a weekend is different to any other day. Community-based testing, of course, we're making available testing seven days a week. But some people are still accessing GP clinics first. (Inaudible question)

 >> Sorry, it allows it when one of the people lives alone. Has there been a change, why the change to effectively criminalise so many relationship?

 >> Jacinda Ardern: My understanding is there was consistency between shared care arrangements guide that had gone out and -- guidance that had gone out and two different households coming together. My understanding was that was consistent.

 >> There is no announcement of that in the health...

 >> Jacinda Ardern: From the version that I saw, there was allowances for shared bubbles but I'm happy to go back and look. My understanding is that that is utterly consistent with what we had. I'm happy to check again though for you you, Ben.

 >> Do you seek to publish the criteria so businesses can see very clearly... ?

 >> Jacinda Ardern: Look, I do expect to be quite transparent around that because people need to know what it is we're looking for. As we have been transparent with the alert levels as that stand and so, yes, that is guidance that I am likely to share but what I want to make sure is that we've really got a framework that is agreed upon that can then be shared. Most of it is obviously information that we'd already have - what's happening with case numbers and community transmission as we've said.

 >> Will you be able to tell people whether or not... ?

 >> Jacinda Ardern: Yes, I'm happy to be very clear on. This firstly, I've heard a lot of rumours that there might be, for example, be extensions already. No decisions have been made, the point at which we'll be exiting level 4. Because we have to rely on the most up-to-date data that we have. We're not at a point yet where we can see the full impacts of alert level 4 yet alone make that determination. What I can say is the more people comply, the more likely it is that we'll be able to come out at the time that we've said. I've also said there may be circumstances where certain regions, depending on what's happening with cases and clusters, may still in longer than other regions. Again, it depends on our ability to risk control back of COVID-19.

 >> You don't know whether those will be lifted or extended prior too 48 hours?

 >> Jacinda Ardern: If you see, for instance, an exponential growth in cases then obviously that will send a signal to New Zealanders. We haven't seen that. But there are other signs we need to look for to make sure we have wrested control back of COVID-19. You'll see that other countries, I understand the likes of Singapore, are looking to move into a phase like us. They've called it their "circuit-breaker". That's exactly what we are doing. We are getting control back so we can then make sure that we continue to stamp out COVID-19.

 >> What about criticisms we're not going enough contract tracing. One epidemiologist thinks we need to increase it to a thousand cases a day using apps. What do you make of that?

 >> Ashley Bloomfield: We've certainly increased our contract tracing. But our maximum number of new cases we've had each day, today is probably the highest number, 89, so we're clearly nowhere near that thousand limit. We continue to increase it. We have 190 people now in addition to those in public health units, so plenty of capacity to contract trace based on the numbers. We also have the ability because we've moving it on to a digital platform to expand that should we need to.

 >> What's the breakdown? Balafoutis a couple of comment --

 >> Ashley Bloomfield: A couple of comments. If you look at the eth breakdown and -- ethnicity breakdown and age breakdown, it reflects a great many people were returning from overseas in the last few weeks in particular. I expect we will see the Maori and Pacific cases continue to grow as we see more close contacts confirmed and/or community transmission.

 >> Ourdate --

 >> Our death rate is very lowed compared to other countries. What do you put that down to?

 >> Ashley Bloomfield: First of all we are in an earlier part of the outbreak because we put in measures much earlier. Where you see a disproportionately high number of deaths compared with the overall case numbers, it is very clear they're not finding all the cases. We are, I think, much closer to finding the majority or all of the cases than other countries.

 >> Prime Minister, what advice do you have for people who...

 >> Jacinda Ardern: That it's not funny and you will be arrested.

 >> Ashley Bloomfield: I concur completely. It is completely out of order.

 >> Do you understand the Australian Immigration Minister statement on temporary visas, do you understand that affecting New Zealanders and it affects previously casually-employed workers to leave Australia?

 >> Jacinda Ardern: It struck me that applied to any New Zealander who may be affected may not qualify for their JobKeeper employment. I think they'd do well to remember if they wish Australia to be in a position to gear up in the aftermath of the outbreak then they'll need a workforce to do that. New Zealanders on average earn more and pay more taxes and others. They are a key part of the Australian economy. I would have thought they wouldn't want to be so quick to lose them. The second point I would make is that New Zealanders also make up the health workforce. And that there are some, for instance, who won't be being kept on because they may have been involved in contractual arrangements in the health workforce and in elective services. And that, I would have thought again, would be a workforce that they would wish to keep. I'll be happy to take them back though. I'll come to you.

 >> On midwives, midwives are telling us that they have more work at the moment because they're having to do more home births and even things like shopping for expectant mums. They haven't got any extra Government funding though and are really crying out for that. What do you say to them?

 >> Ashley Bloomfield: What I can say is we're looking at all our workforces including primary care workforces like our midwives to see what is happening in terms of the funding they are getting and also what additional support might be needed. If some of the activities they are doing are ones they wouldn't normally do like the shopping, we'll make sure that there are other options for them to ensure that the women they are looking after are getting all the care and support they need.

 >> I understand there are some concerns for our preschools not getting access to online learning

 >> Jacinda Ardern: That's an area we were mindful of. Next week I will get the Minister for Education to give an update on the work being done to overcome the digital divide. We never wanted an education system learning relying solely on devices. I might let him come and share that with you. Jane, I will continue then Henry in the front.

 >> People arriving at the border, there's still conflicting advice between Healthline, Ministry of Health, the COVID site and even Grant Robertson on Friday, people being told different things about whether they can leave their home during the first 14 days. Some said they can, some said they can't. Is this inconsistency helpful especially for such a high-risk group, knowing what they can do and also for compliance?

 >> Jacinda Ardern: That is because there are different guidelines depending on whether you're symptomatic and quarantined versus those in self-isolation.

 >> These are people not symptomatic sent home with a plan and there are self-isolation rules. Some say that can stay home, they have to stay home for the first 14 days. Some advice is they can go for a walk?

 >> Ashley Bloomfield: If there is inconsistency we can clear that up. I can be very clear, these people are treated as if they are close contacts. They should be self-isolating even from their other household members and maintaining that physical distancing and other infection control approaches. Yes, they can go out for physical activity, a walk around the block, by themselves. They should be avoiding all close contact or physical contact with anybody else including their own family members. They certainly shouldn't be going out to access essential services also, of course, they need to access healthcare, in which case the first point of call is to do that over the phone.

 >> Jacinda Ardern: That was actually the advice that we had for people who came into self-isolation from the time that we put our first border controls in, in February. What might be getting confused is that people who are symptomatic are in quarantine are being treated obviously as you'd expect with much stricter guidelines. Sorry, I did say I was coming to you, Henry.

 >> On local cases, mayors are telling us that they've been asked by ministry not to spread - tell people the number of cases and that numbers are being kept at DHB level. Why is that...

 >> Jacinda Ardern: It's on a public website though.

 >> It is just that the public website will not add town by town.

 >> Jacinda Ardern: Clusters are clear though. That's publicly available. You can see where those are. We speak about them regularly.

 >> Is it a privacy matter?

 >> Ashley Bloomfield: We do provide quite detailed breakdown for DHB region. For some small DHBs there is a close alignment between the major town and DHB. In Southern regions, a good example, it may be harder to find exactly which towns but there are privacy issues here. If you have two or three cases in a relatively small town I think it important that people's privacy is respected.

 >> Jacinda Ardern: If this information is being sought so that people can have more or less concern about the way they behave or the way they apply the rules, we need everyone to act as if they have COVID-19 let alone someone in their town. So, actually, having that information shouldn't change the way people behave. We need everyone to act cautiously.

 >> What do you have to say to Kiwis who might think about relaxing the isolation once the...

 >> Jacinda Ardern: They would be making huge assumptions about where New Zealand is currently. None of us have been rushing to make judgement, and neither should the public. The evidence tells us this is how long we have to stick tightly to alert level 4 for us to get control back and for us to heighten the chances of coming out of this really restrictive period of time.

 >> Given the goodwill evidence, how impressed are you with New Zealand's compliance?

 >> Jacinda Ardern: I, from day 1, have thought that the effort New Zealanders have put into this has been incredible. The fact that that they moved so quickly. The fact that everyone understood why this is so important. Now we need to just stick to it. You've seen other countries like, for instance, the UK, the sun comes out, people wish to go outside. It's important that no matter what the environment is like, we need to stick to the requirements of alert level 4 because it improves our chances of getting out of this alert level.

 >> Just in regards to the mental health services that you're going to be rolling out, obviously people who use those sorts of services know exactly where to go and who the right people are. There might be people partway through this lockdown now who have never had any interaction with those sorts of services. How are you going to target people who don't have any understanding of how mental health support works.

 >> Jacinda Ardern: I'll actually hand over to Dr Bloomfield to talk on that a little bit more, but one of the points that I would make is so many of these services are accessible in a lockdown situation. And so for mental health services, 1737 is still the place to go. It is so important that that's actually now a telehealth service. If you feel more comfortable with your local GP, many of them have put in place consultations to do that digitally, over a service that is designed have face-to-face contact so they can see you, see how you're doing. You can still use familiar services but they just might be provided in another way.

 >> Ashley Bloomfield: To add to that, we'll be sure to have both a range of channels whereby people can access those services and also really good information about how to do that not just the 1737 but there is already a range of online resources and we're looking to push out some additional ones as well this week. We'll give detail on that in the next day or two.

 >> Jacinda Ardern: The last couple of questions.

 >> On behalf of, Dr Bloomfield, how confident are you that our testing is reliable?

 >> Ashley Bloomfield: I'm very confident in our testing. We have a really good range of testing around the country. Just to point out testing doesn't start in a laboratory unless the laboratory is accredited, certified and that their testing process has gone through the appropriate regulatory assessment. I'm very confident. We have our ESR Laboratory has our reference laboratory for all other labs across the country.

 >> Can you tell us about the 5.5km bike ride during the lockdown?

 >> Jacinda Ardern: Again I have taken walks and I expect other New Zealanders would have taken a bit of time to go outside and get fresh air. We ask New Zealanders to keep it local and do it safe.

 >> Can you tell us anything else about the Canterbury-Christchurch cluster?

 >> Ashley Bloomfield: I'm sorry, I don't.

 >> What does day 1 of moving from down from alert level 4?

 >> Jacinda Ardern: Intensive planning. We need to make sure first we have all the criteria question need and all the different thresholds really interrogated. That's the work we're doing at the moment. I've always shared the obvious ones but we need to look at more. That's the decision-making point. Them you've seen the framework for what alert level 3 looks like. We need to make sure therefore we have all the guidance that sits around that.
 
 What I would the though is that - it is not government alone that has a role to play in that. We've already asked some parts of the education sector to do some planning for what different alert levels will look like for them and how they can help us with, for instance, the intensive contract tracing we'll need to be able to do no matter what level we're at over the next period. I ask all businesses, have a look at the alert level framework, think about how your business could success my operate within each, keeping in mind we will need to, for many months to come, be able to contract trace all New Zealanders who come in contact with one another and workplaces have a role to play in that. OK. Thanks, everyone.

 >> I have a question on behalf of others.

 >> Jacinda Ardern: You need to put them up-front. One.

 >> Fiji announced yesterday that a 20-year-old woman who returned to there from Auckland on 22 March went into immediate isolation. She could have only contracted the virus in Auckland. Has contract tracing been done for this woman? Are you confident COVID-19 has been... Aerodynamic I couldn't give you --

 >> Jacinda Ardern: I couldn't give you a specific answer on this without prior warning. For those travelling into the Pacific, we had those additional screening, no-one should be travelling symptomatic. That's a prerequisite for all flight scar across -- carriers across the globe. I'm sure the Director-General can follow up.

 >> Ashley Bloomfield: Each country has its own health focal point. Whenever there is a situation like this where someone has travelled to another country from another, there is a formal notification made to kick off contract tracing from any country where there person has been or has come from.

 >> Jacinda Ardern: Thank you. 

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