COVID-19 Omicron response update – 1 March 2022, 1pm

Kia ora koutou katoa, welcome once again to Manatū Hauora for an update on our response to the Omicron outbreak.

Thanks again for coming.

I want to update you on the shift to phase three today, how that’s going across the health system, including the shift from PCR to RAT testing, and also the current impact on primary care and on hospitals.

First I will give a quick outline of the current situation.

The one o’clock media statement will have a comprehensive summary of today’s cases, vaccination and so-on, so that will be coming out as well.

Today we are reporting nearly 20,000 new cases of COVID-19 with 373 people in hospital, nine of whom are in ICU, and just under 100,000 active cases across the motu.

Now I know that such a high daily case number can be concerning for people to hear and many of us will have whanau members who now have COVID-19 but it’s important to remember that COVID-19 now is a very different foe to what it was at the beginning of the pandemic and with 97% of people over 12 years of age who have now had at least one dose of the Pfizer or another vaccine, for most people COVID-19 will be a mild to moderate illness that can be managed quite safely at home.

The big shift in moving to phase three is the change in our approach to testing, PCR testing has served us incredibly well for just over two years as we have sought to find and respond to every case of COVID-19 at the border and in the community, and that included it playing a major role in the control of our Delta outbreak that started last August and that we had very nearly got right in control of before Omicron appeared.

But with thousands of new cases each day, and nearly 20,000 today, we did reach the point last week where wide use of Rapid Antigen Testing became both useful and appropriate.

It also became clear that PCR testing capacity was not keeping up with demand so pooling of PCR tests, where samples can be combined and all tested at once, has been used throughout the pandemic to help improve the capacity for PCR testing we have.

Typically samples are pooled with about three to five samples during the early stages of an outbreak to increase the processing throughput, for example during the August 2021 peak of the Delta outbreak some labs increased the pooling to eight to ten samples per run and we continued to use pooling in the early part of this outbreak, however it becomes less feasible to pool when test positivity rates rise due to the likelihood that there will be at least one if not more positive tests in each group of pool samples.

For example last Thursday, that’s two Thursday’s ago, prior to the wider roll out of Rapid Antigen Tests, 17 of the 20 DHBs across the country recorded positivity rates of more than five percent.

Now it’s important to point out that prior to the 7th of February, so less than a month ago, none of our labs had ever exceeded that five percent threshold.

The swift increase in positive cases right across the country effectively prevented labs from using pooling in the space of just a couple of days.

At the same time lab capacity was being effected by some other factors.

There was lab staffing capacity as a result of the prolonged workload in responding to the outbreak and people needing to be rested, there are vacancies and some lab workers also tested positive for COVID-19 and couldn’t work.

There were some limits of reagent supplies because of global supply chains.

All of that means it’s now clear that we overestimated a number of tests the lab network could actually process once Omicron began to take off and take off it did quite rapidly.

So the rapidly increasing case numbers across the country and these other factors has led to a delay in the processing of around 32,000 samples.

I’ve been working closely with the minister and explained the situation to her, and our team’s been working very hard over the last few days with the labs around the country, and I want to apologise to people whose test results have been delayed in some instances.

But so saying, our labs are committed to processing all those tests and those people will get a result even though it’s been delayed.

We have sent text messages out to those people whose results have been delayed encouraging them if they still have symptoms or have developed symptoms to go and get a test and of those who received the text around 12,000 had gone and got another PCR, or most of them a Rapid Antigen Test.

So when those results come back for people in some instances the result may be less sensitive than usual due to the delay in processing.

There’s a loss of sensitivity that may affect the negative result, but all positive results will be a confirmation of COVID-19.

If we had recognised this delay a little earlier we may have been able to better redirect and share capacity around the network, but once the samples are in a lab it’s very hard to take them out, because they’re in the system, and move them to another lab.

We’ve also used other things to help reduce this backlog, including sending just over 9,000 to Queensland over the weekend to be processed to help clear the backlog.

I do want to emphasise that the delays are not the fault of our labs or the staff there, they have been working incredibly hard right through the pandemic and have done phenomenal work over these last few weeks.

But we’re addressing the situation and just again to emphasise to anyone who had a PCR test on the 23rd of February or earlier and who is still waiting for your result, if you have symptoms still or have developed symptoms, then please go and collect a Rapid Antigen Test from your local testing centre or you can contact Healthline for advice.

We are sending a text message today to all those who are affected, and again most of these people have already had an earlier text message.

The shift to phase three and to the use of Rapid Antigen Tests has made an immediate impact on relieving the pressure on our labs and a big drop in the use of nasopharyngeal swabs and samples arriving at our lab so it has got down to a much more manageable level over the last 24 or 48 hours.

We’re seeing strong uptake of Rapid Antigen Tests by people with symptoms or who are close or household contacts by organisations who provide critical services, and indeed right across the health system to test both staff and people coming into hospitals and into other places liked aged residential care to help supporting the safe delivery of care.

General practices and urgent care clinics across the country and particularly leading out in Tāmaki Makaurau are rolling out supervised Rapid Antigen Tests and they will now have unsupervised tests to hand out to people, and if people do need to pick up Rapid Antigen Tests the Healthpoint website has an increasing number of sites on there, or places on there where you can go to collect them.

Already more than 40,000 people have self-reported a positive Rapid Antigen Test result, and in fact of the nearly 20,000 cases today only a couple of thousand of those were PCR confirmed results, the rest were people self-reporting Rapid Antigen Test results.

This is incredibly important for us understanding the extent of spread and I want to thank those who have and encourage everybody who returns a positive Rapid Antigen Test to please upload that result online through My Covid Record.

We now have plenty of Rapid Antigen Tests in the country.

We distributed over five million around the system in the last seven days.

We have 12 million in our central stores and we’re expecting over 16 million to arrive this week, so we are well supplied, the challenge is distribution with some of the logistics network’s staff being affected by the outbreak but we are getting tests out as quickly as possible around the community.

Just for those people who are going to pick up a Rapid Antigen Test, what can you expect.

Well if you’re unwell with symptoms you will be offered testing kits for yourself and your household and whanau who may also be contacts.

You will be given enough for three tests per person and provided guidance on how to undertake the test at home and how to record this in My Covid Record.

That’s if you go to a GP, if you go to a community testing centre you will be given three tests per eligible person, whereas if for example you’re a critical worker and you go to a community pickup centre they can be pre-ordered online, and you again will be given three tests for everyone in your household.

So we’re not just giving them to the person who is the case, they can take them home for their households to use.

In phase three our health system has been preparing and our hospitals are keeping up with the demand that is there, again 373 people in hospital today.

What was seen in the Auckland region over the last few weeks is that the average length of stay for people in hospital is quite short, 2.2 days.

This is around half of what it was during the Delta outbreak, so people are going in requiring some care mostly on the ward.

The vast majority of people are not requiring any respiratory support either on the ward or in the ICU.

We have good capacity, our hospitals are ready for this, and they can look after other illnesses, so please if you are unwell and require care ring Healthline, see your GP or if it’s an emergency please do go to the hospital.

At the moment our hospitals across the country are about 80% occupancy which is actually a bit lower than it has been and our intensive care units about 57% occupancy, so we have the capacity there.

But only a small proportion of people with COVID end up in hospital, most look after themselves and their family at home and there are many others who are getting care from their GP or another community provider, and sometimes social supports as well.

It’s been great to see good uptake of self-service tools.

Around 54% of people notified by text that they are a case in the last week have then followed up with a case investigation form online and that helps us to target support to those who are at high risk.

At the moment we’ve got about 90,000 being managed through our nationwide clinical database which is called The COVID Clinical Care Module and that just makes sure that people are getting the care they need.

Finally, New Zealand like just about every other country in the world has not escaped Omicron to date but where we can be an exception is how well we minimise the spread and the impact of the virus and protect people as much as possible from it.

What has helped us so far to do so well with this pandemic is doing the basics well, so please continue to do so.

Wear a mask to protect others and yourself, physically distance, practice good hand hygiene and most importantly stay home, don’t go out if you’re unwell.

Please be particularly considerate of those who may be the most vulnerable to the virus, older people, people with disabilities or with pre-existing conditions.

There’s no doubt the next few weeks are going to be tough.

The health system can’t do it alone so thanks in advance to all New Zealanders for continuing to support our efforts to live with the virus on our terms.

I’m now open for questions.

Dr Bloomfield, in terms of people currently in hospital, what’s the breakdown between those who have Omicron and Delta.

We don’t know exactly of those in hospital and with that short stay in hospital of around 2.

2 days it takes a wee while, there’s a bit of a lag in us doing the whole genome sequencing on the PCR tests of those hospitalised.

I don’t have the exact breakdown.

In fact we’ve just got some up to date data on that so I might circulate that afterwards.

Do you think it’s useful to have that knowledge available to the public given the significant differences.

Yes it does and that’s why we’re systematically wanting to make sure the samples for our people hospitalised get to ESR and go through the whole genome sequencing.

It’s not urgent in terms of the clinical management of those people but it is helpful for us to know just what the proportion of people who have got Delta or Omicron is.

And based on the information you have been receiving so far, what kind of symptoms are people who are not boosted having if they are sick, particularly with Omicron.

I mean do you know that.

Well what I would say is whether or not people are boosted I think the symptoms are similar, and we’re seeing the most common symptoms are cough, sore and scratchy throat, runny nose and not feeling that great actually, that sort of fluey feeling, the whole body aches.

But what we do know is that people who are not boosted are more likely to be symptomatic and more likely to experience more severe symptoms.

On symptoms, are you aware of any new symptoms.

We’ve heard that children and adults have been presenting tummy bug like symptoms and then testing positive, but are you aware of those kinds of symptoms.

I’ve seen some reports of sort of gastro, tummy symptoms, particularly in children.

We have seen that throughout the pandemic, some people have what we call these atypical symptoms.

So the symptom pattern has shifted.

Early on the thing that was really indicative of COVID-19 was this loss of sense of smell and taste, that doesn’t seem to be a thing with Omicron, it’s more those upper respiratory tract symptoms, and that can include, I think some people are reporting earache as well.

Quite a lot of earache which is typical of an upper respiratory tract infection.

On the trusting issue, Newsroom’s been asking for a week now about the backlog and delays in getting PCR results.

When did the Ministry of Health learn that this was a problem, that this problem was brewing.

And how did you so badly overestimate your capacity there.

Thanks, and we have replied an initial response and there’s a follow up response I’m going to work on with the team after this.

I think there are two things I would say, first, the pool capacity is something that we’ve been able to use to date and we’ve seen in the Delta outbreak we were able to surge up to around 40,000 tests a day and we had been increasing the capacity across the labs such that the surge capacity was up around 70,000 which can be sustained for a few short days but that’s very much pooled.

Our unpooled capacity as it transpired we were aiming to get to around 39,000 tests a day by the end of March and in one of my earlier statements I may have given the wrong figure, I’m going to check with the team, but at the moment it’s around 30,000.

But even to date we’ve not really seen the volumes get that high, up to that 30,000 level so we’ve been working with the labs to understand what was the gap.

And I’ve asked also for an external review just to see what happened through that.

And it’s a combination of things, it was staffing vacancies and staff being off, some of them are the new machines that were due to come in were delayed and also there was some delays around reagents.

In terms of your question about how long we’ve known, really it’s emerged over the last week but became particularly obvious and acute late last week and we’ve been working on it right through the weekend to see just what the opportunities were to move samples around to address the backlog.

Do you expect to see a sort of short term bump in case numbers as those PCR tests are processed, which they’re not really.

Look I don’t think it’s going to make a huge difference because most of our positive results now are coming from Rapid Antigen Tests.

Let’s say there’s around 30,000 samples to be processed with a positivity rate of say five percent and spread over several days, I don’t think it’s going to make a huge difference in our case numbers each day, and what is pleasing to see again is we’re seeing widespread use of Rapid Antigen Tests now we’ve got high prevalence in the community and that people are actually reporting those results.

I think that backlog, you said it was around 32,000 for that.

What’s it at now.

That’s where it’s landed at, it’s up 32,000.

So that’s the backlog of samples that are at five days or more that are now being worked through by labs right across the country.

What was it at its peak when it was. Around 50,000, but again the teams have been working over the weekend on this and that included sending some samples to Queensland, making an arrangement for some to be processed there as well.

How did the staff have central isolating across the health sector.

Can you be sure that the sector will be able to cope with widening cases.

Yes I am confident.

We’ve prepared for this and of course one of the things we really want to do is reduce the amount of other care that COVID displaces in primary care, general practice as well as in our hospitals.

And the first thing of course that gets delayed or deferred is our planned care elective surgery and we’re seeing that particularly in the Auckland region and that will happen across the country as they deal with an increased number of cases.

So our hospital capacity is there, our ICU capacity will be sufficient, but again the number of cases, the number of people that end up in hospital will be directly related to the number of cases we have, and we still want to try and keep that peak as low as possible, so people avoiding spreading the virus is important for our health system to be able to cope Do you have an idea of what that figure is, the clinical workforce that is out for COVID related reasons and also I guess that limitation of surgeries and stuff.

Like what the percentage of that’s also been impacted.

I did hear a figure today.

I think, Middlemore reporting around 15 or 20% of their staff who were not at work today because they were cases, or they were household contacts or looking after others.

So what the hospitals do, and this is something they experience every winter because staff or staff family members go down with winter illnesses, so they’ve got the plans in place to move staff around and to reduce planned care right down.

So you’re comfortable with about 20% loss of staff.

I think that what I would say is that the DHBs have planned for and have plans in place to manage that, and what we do know is it will be particularly acute at this point in the outbreak and over this next week or two.

And again, so the wind back of planned care will be temporary while they need to focus the beds and the staff on looking after people who are acutely unwell and also to cope with the staff who are off work.

What if any use will there be for a two-dose Vaccine Pass in the traffic light system after Omicron peaks.

Well that’s something we’re looking at.

There are three things that are really closely related, one is the COVID Protection Framework, and we go with that once Omicron has peaked, and in particular because it’s very much predicated on the Vaccine Pass.

So the second issue then is what does being up to date with one’s vaccination mean now with Omicron it seems really clear that that includes a booster, so it’s looking at that.

But third is just what will the role of Vaccine Pass’s and indeed vaccine mandates be because they’re closely related, once we get through this Omicron peak and as the PM signalled, these are all matters that she’s sought advice on including from Professor Sir David Skegg’s group, but also we are looking at those to provide that public health overview as well.

How much does the protest activity influence your advice on that matter.

Not much.

Dr Bloomfield, it’s taking critical workers in Wellington more than two hours to access Rapid Antigen Tests and GPs are also reporting that they’re facing delivery delays, when will that access get easier.

Yes, so I noticed there was a story in Wellington today, and I saw a photo in one of the publications of people queuing, so I talked to the team and the issue again is not so much supply it is the distribution out and we are working every day with our District Health Boards to make sure there are plenty of Rapid Antigen Tests out where they are needed.

So we are addressing those sort of delays as they arise.

Does there need to be another site though if it’s taking hours for people to access the tests.

Yes.

It may require another site or more staff at the sites, and what we’ve seen with PCR testing is the DHBs are very good at surging staff in if they need to so I’m confident they will respond to the queues and also we are able to respond with getting more Rapid Antigen Tests delivered out.

I’ll just sweep across this way.

What’s the latest advice on the BA.

2 variant and is that becoming widespread in the community, do you know.

I’ll start with your second question, is it widespread.

We know that right from the start of our Omicron outbreak we had both of those subvariants here, a BA.

1 and a BA.

2 sort of line of transmission so I would expect we’ve got, we don’t have any recent whole genome sequencing, but I would expect we have possibly a reasonably even distribution out there.

I think in terms of what’s the latest on it, one of the things that we’ve seen from Denmark is, first of all the vaccine seems to be just as effective which is good, regardless of the subvariant, and also that if people have been infected with the BA.

1 subvariant that provides a high level of protection from being infected, cross protection from being infected again with the other subvariant.

Actually, just on that do you still need to isolate if you’ve already had COVID.

So just say your flatmate has it and you don’t get it but then four weeks later you do, does that flatmate who was originally COVID positive have to isolate again.

No they don’t need to for a period of some months.

I’ll just say some months ‘cause this is new to us, but they would have a high level of immunity, and of course be at a very low risk of being infected and therefore at a low risk of infecting others.

So this is a question that’s been asked of me, so the advice is if someone’s recently had an infection within the last two or three months then they don’t need to isolate again if a household family member, and while we’re on the topic we are looking today again at the period of isolation for both cases and household contacts, currently ten days, to see if that might be able to be reduced.

Our team is looking at the evidence again.

What we are seeing from our outbreak in terms of the risk, and we’ll be providing advice to ministers in the next day or two on that as well.

Will that possibly be going down to seven days.

Would you be comfortable with that.

Yes it could be, and again whatever the period of isolation you’re just taking a slightly increased risk that someone might still be infective at the end of their infection period, but of course with the situation we’ve got with so many cases and also we’re seeing quite a big impact on critical services, that trade off is there to be made so I’ve asked the team to again look at just where the balance of risks and benefits is at the moment.

Staff at hospitals who have been infected, do you have a sense of whether that’s from transmission in COVID wards and staff who are treating COVID-19 patents getting infected by them.

I don’t have any information on that.

I’m really confident that staff over the last two years, particularly in those Auckland hospitals, have got really good at the use of PPE to protect themselves, and of course their infection prevent control procedures so I would say that the vast majority of these people are likely to be being infected in the community because that’s where we are seeing the infections happening.

The outbreak has sort of been described as multi-speed with Auckland having a lot more in front of it now, do you expect that elsewhere, other regions in the country will see a similar proportion of their population infected as well and it will just, kind of a week or two from now.

Yes I think that’s what will happen and there are two things about that, first of all that’s what we see with flu every year when it’s here.

It sort of moves its way, usually from North to South through the country, and second it also gives us the opportunity for the rest of the country to learn from the Auckland experience, so we’re arranging seminars and webinars so the Auckland clinicians can update their colleagues around the country in different specialties around just what they’ve learnt and how they can prepare and also manage when they do get that wave.

Could that academic curve sort of look like a two humped, one man, with sort of a hump and a peak and slowing down and then the rest of the country coming up and pushing it up again.

It’s possible.

Let’s see.

And I mean one of the things that is interesting looking at overseas places, like I mean places in different states in Australia and even Denmark and the UK, they come down and then remain at a sort of a, what is almost a baseline level of infection, so it will be very interesting to see where we settle there, but we’re planning to expect a baseline level of infection and plan for that going into winter because that may then be compounded by flu and other things that are coming across the border.

The COVID-19 website the how to get a RAT section had said that, “RAT home testing kits would have been available from the 1st of March,” but yesterday that was updated to say, “Early March,” instead.

What’s happened there.

Do we not have enough to send to people at home.

Do you know.

It might be minister.

If we’re talking about testing kits that people can self-administer, they’ve been available from last week through the community testing centres, they’re the ones that are being given out.

General practices up until the last couple of days basically had the supervised Rapid Antigen Tests.

Sorry, this is the home test you can order.

That you can purchase.

So the site said, yesterday it said, “From the 1st of March you’ll be able to order RAT kits for home testing,” but now it says, “From early March.

” Right.

If it relates to people being able to order them to be delivered from the system I’m not sure, I’d have to come back to you on that.

What I can say is that Rapid Antigen Tests are now available retail, and some retailers are making those available, and for many of those, I think the Chemist Warehouse you can order them online and have them delivered.

For a pack of five that’s $45.

Would there be at any point those packs to at least be subsidised to people that simply can’t afford a five pack for $45.

Anyone who needs Rapid Antigen Tests, as I’ve said, there are many, many millions in the country and our supply, anyone who needs them because they’re a case or a household contact or as part of that critical worker exemption scheme is able to access them for free through a range of places.

What do you make of one of the protest groups, which is calling on people to refuse to scan and wear masks, basically encouraging people just not to comply with any current health advice or restrictions around COVID-19.

Well it’s irresponsible and it’s really important, as I finished with my opening comments today, that we keep doing the things that have served us incredibly well to date and have meant that our death rate’s one of the lowest in the world, and that is people getting vaccinated, thank you everybody, fantastic effort, and our boosters are going up every day.

Do keep scanning, masks are incredibly important, please keep using them to protect yourself and others and physical distancing.

So that’s the message from me.

Realistically, sorry I’m just following that up.

Realistically, are you concerned that there’s a percentage of the population, maybe it’s five percent, maybe more maybe less, that are just living in this parallel reality where nothing you say seems to be getting through the alternative ideas of the world are so deeply embedded.

I mean how much does that worry you.

Does it worry you.

Doesn’t worry me because I’m hugely encouraged that 97% of New Zealanders who have actually had at least one dose of the vaccine are aware of what it takes to protect them and others and are taking that opportunity, so it’s an incredibly small minority.

So I think that that’s fantastic.

It’s world class.

Do you think those people who are in what you say is the 97%, do you think it’s their civic duty to engage with those persons who believe COVID doesn’t exist or believe in those theories.

Is there anything that can be done.

Well I think if I can just encourage them to keep doing what they’ve done and keep doing what they’re doing, that’s what will get us through here and again, appreciate the efforts they’ve taken.

On Novavax, I saw something saying that kiwis will be able to get that in March.

Indeed, yes.

So announcement today that ministers have confirmed the decision to use Novavax.

It’s approved.

Our teams are now setting up the operational requirements to be able to deliver that through our system and we’re expecting deliveries in the next couple of weeks.

So anticipating from mid-March Novavax will be available as a primary course.

It’s a two-dose course, not yet as a booster but that would be further down the track anyway.

I know there are a number of people who have been waiting for the Novavax vaccine, so I’m very pleased we’ve reached this point and we’re now able to make that available for those people who have been not willing to take one of the two vaccines that we already have available.

Does the ministry know how many people roughly that you know, will take Novavax and hasn’t taken Pfizer.

I understand over 200,000 people who haven’t yet had any vaccine, so that’s the potential pool.

What we saw with AstraZeneca was that actually the uptake was quite low.

I think less than 10,000 people have taken up AstraZeneca as an alternative to Pfizer, and let’s just see with Novavax whether the many people who have said they have been waiting for it to come actually come forward and have it.

I encourage them to do so.

It’s a good vaccine, it’s an effective vaccine and it's a relatively safe vaccine so once we have it available please, if you haven’t already had a vaccine come and avail yourself with that opportunity.

Is there any advice from the government, like is the ministry procuring people to get Pfizer rather than Novavax.

We’ve taken the decision and ministers confirmed that, ministers have taken the decision based on our advice that we will continue to have a Pfizer-based, so an MRNA based vaccine programme.

There is good evidence that it is an incredibly effective vaccine, including against Omicron with a booster, its safety profile is excellent, and it has served us well and our advice is, and ministers have agreed to continue to have a largely Pfizer-based programme.

We’re not planning a switch to a Novavax, or programme based on another vaccine.

I’m just going to come over this side again, down the back.

We saw yesterday almost 650 cases reported in Victoria University Halls, how high risk are halls of residence and what advice do you give to universities regarding this.

Well I can speak from personal experience that university halls of residence are high risk at the moment.

We have a nationwide super spreader event that is the start of the university year so we’re seeing this right across the motu, and it’s very clear that universities have done very good planning for this and have got in place the supports that students need to be able to safely isolate and to protect the students that might not yet be infected from getting infected.

I’m very encouraged by, and indeed right across the education sector from early childhood education right through I think they’ve done a great job of planning for what we’re now seeing.

How many cases have come out of parliament’s occupation today and would you urge Wellingtonians to stay away from the protest where they can as there are active cases among the protesters.

Yes.

I think we’re reporting at the end of yesterday the total of 17 cases.

There are undoubtedly more because there will be people who haven’t been tested there.

So I would encourage, as the police have been, for safety reasons, Wellingtonians to stay away from the protest and another reason to do so is to protect themselves from potentially being infected with COVID.

Travellers from this week are going to be saying, the majority of travellers are going to be saying goodbye to MIQ, can you tell me from Thursday what we’re going to see MIQ hotels used for.

That’s with my colleagues in MB and they’re in the process of providing advice to ministers on what will happen to MIQs from here.

What I would say is we will still have some residual MIQ capacity because not everybody coming across the border will be eligible to go straight into the community.

There will be unvaccinated people, there will be non-New Zealanders and others who will be coming across the border, but that’s an active discussion, I expect the government will be thinking about that over the next week.

And what about the people who need it to isolate.

Yes we’re still retaining some capacity to support people from the community who may not be able to isolate safely at home.

That will still be available for that.

Hospitalisations.

What’s the rate of hospitalisations for people, you know they’re COVID hospitalisations, but they actually presented with something else first.

Two things I’d say there is, our hospitalisation rate’s very low in this current outbreak.

We’ve got around 100,000 active cases, 373 people in hospital.

So if you use the approach of the number of hospitalisations over the number of active cases it’s well under one percent, but our team is looking to see how other countries have calculated their hospitalisation rates so we can compare, particularly with Australia.

In terms of whether people are there because of COVID or just happen to incidentally have COVID it’s hard for us to estimate that, but the one estimate we do have from Middlemore from last week was it was about between 70 and 80% of people had presented with symptoms and they were there being treated because of their COVID symptoms and the others were there for other reasons and happen to incidentally have COVID infection, and that’s consistent with what we saw in overseas because they’ve had no.

One thing with hospitals, are we gonna have to see clinical staff shift around the country to support possible gaps in different DHBs.

Like people who have to go to Auckland to support them.

Possibly, but unlikely because I think we will see all DHBs will have challenges.

As we can see there are quite large and increasing numbers of cases in all DHB regions and so there will be less ability for them to move staff around between DHBs and also DHBs are thinking about what they need to do to support community providers, particularly aged residential care in their own region, so that will be the priority for them.

In terms of people who present to hospital with non-COVID symptoms, like a breath that 15 to 20% you said, do they show up in that 373 figure or would they be excluded from that.

At the moment they’re all included in that figure, and we have looked at and are trying to find ways whereby we could find that out and work out what that is in real time but it’s actually very difficult, but we’re just aiming to try and get a weekly estimate of what that proportion is.

Is there any final questions.

I’ve just got one at the front here.

Do you know how many police have caught COVID from the Wellington protest.

And is there any thought of supplying RATs to, I don’t know, to the protesters because one of the major difficulties has been that many reject testing so it’s hard to understand how far the spread is going.

I can’t give you an answer to that first question about the number of police and police would have to answer that.

The local public health unit, Regional Public Health, is responsible for that outbreak there.

I’m sure that they would make Rapid Antigen Tests available for people if they wanted to be tested, but there are also places nearby that they can collect Rapid Antigen Tests if they need to.

Final question.

A parent asks about learning of children’s positive test results from rapid tests.

They say, “Why is it you can’t do it over the internet, and you need to phone through to a jampacked Healthline.

How concerned are you that you might be missing thousands of cases and missing thousands of kids who are under five or not vaccinated and do not or cannot have a.

Can I look into that particular issue, ‘cause of course that would be of concern if these tests weren’t being loaded up.

As you say, there is that alternative for people to ring and register the result through Healthline.

Of course there’s high demand there at the moment so there may be a bit of a wait, but I’ll come back, we’ll check with the team and come back on what plans are in place to help facilitate parents uploading results for children.

Technically it may be a challenge but I’m sure the team will be thinking it through.

Somewhat similar to that then, how much larger do you think the infection is in the community rather than confirmed cases.

I guess you know we have the protest, we’ve got events where we know people are getting tested.

How much do you think we actually have in the community.

I don’t have an estimate beyond the case numbers we’ve got.

What I would say is I think we’re getting a good picture of the overall burden of cases and the spread across the country, and if I look at Denmark, which does a lot of testing and has had high rates of testing right through up to 180,000 tests PCR capacity every day, I think they’ve settled at around 40,000 infections a day.

That’s having got a peak and come off the other side.

So I think we’re detecting a very good proportion of our infections in the community, but we will be supplementing that with some modelling as well and our wastewater results.

And I’ll just need to, we’ll find out and update this week on when we are likely to be able to find our sort of estimate of what proportion of cases we think we’re getting through our testing.

So you’re kind of divulging really that it’s not like there’s double that are getting missed or something.

Well it could be.

I mean we could only be finding a third or a half of these cases.

We simply don’t know, but I think if you look at the rapid rise and the fact that we are capturing 20,000 cases in a day here in New Zealand and we’ve got 100,000 people we know are active cases, and from probably your own understanding of what’s happening in the communities that you are part of, I think we’re getting a pretty good picture of what the burden of infection is out there.

Just two more questions from down the back.

Just first of all, your answer to my last question, you said you were aware of the risk of halls based on personal experience, what do you mean by that.

I’ve got a family member who’s in a hall of residence, so the picture is the same right around the country in all the university halls of residence.

And I guess the point I was trying to make is, it’s really clear to me that the halls had made good preparations for and are dealing with the situation really well.

A quick question about the testing, the 32,000, who are these people.

Is that all over the country that they haven’t received their results, and how sure are you that it won’t happen again.

It’s largely Auckland based with also some in the Bay of Plenty.

The particular issue, the issue where the backlog happened quite quickly and was quite extensive was in Auckland, but those Auckland samples are being shifted around the country and being analysed around the country, so it’s mostly been an Auckland issue.

And in so saying, Auckland was where we rolled out the Rapid Antigen Tests starting over a week ago, even before the shift to phase three.

We’re very confident it won’t happen again because of our Rapid Antigen Test supply and that being the main form of testing, and also we do continue to build our lab capacity.

So it was due to the delay in the Rapid Antigen Testing.

No.

It wasn’t so much that, it was more that I would say we were a day or two late in recognising how quickly things were going up, and the point is once the samples are in the lab it’s hard to take them out and redistribute them, so we still had capacity across the network but we didn’t have the opportunity to redistribute them and probably if we’d started to do that a day or two earlier then we may still have had a backlog but perhaps not such a big one.

But as I say, the labs are now processing that backlog, people are being messaged, and many of them taken the opportunity to go and be retested, the majority with a Rapid Antigen Test.

Would a prevalence survey be useful in establishing that rate that you were talking about, of how many more infections there are for each

Yes.

And I think there will be a point quite soon where we will want to do a prevalence survey.

My view is that that would be most helpful after we’re coming off the outbreak.

I think we can combine the number of cases with what we’re seeing in the hospital and healthcare system impact as well.

But I think a prevalence survey will tell us, give us a good indication of what proportion of the population were infected and retrospectively will give us an idea of the number of cases we might have had and the level of residual protection we’ve got in the population.

Thanks very much for coming up.

I appreciate your time.