COVID-19 update 1 December 2021

>> Kia ora koutou katoa,

 today I will run through an update on vaccines especially with reference to the 5 to 11-year- olds. I have more information on the traffic light framework and a few words on the Omicron variant but 1st to the Director-General for the update.

>> Thank you, kia ora koutou katoa.

Our statement today from the Ministry contains a comprehensive summary of today's cases and other key measures so just a brief overview now.

We are reporting 146 new cases today in the community, 124 of which are across Tamaki Makaurau, 14 in Waikato, four in Bay of Plenty and one new case in Nelson Tasman region.

The new one in Nelson Tasman is in addition to the three we reported yesterday but they are officially being added to the telly today.

There are also three new cases in managed isolation and recent returnees from abroad.

In terms of hospitalisations, there are 83 people in hospital today. Two in Waikato, and the rest are across Tamaki Makaurau. Of those, in Auckland, five of them are in ED or an assessment unit. 78 are actually on inpatient wards.

 Nine of our total patients in hospital are in the ICU or high dependency ward.

 I have got a couple of slides today to show how we are tracking compared with some of the modelling earlier in the month, and how things are tracking today, particularly with respect to hospitalisations and the ICU. Thank you to the interpreter.

One month ago the modelling I showed was based on the predicted trends from early November. You can see the blue line at the top and the orange line at the bottom. The dotted line being hospitalisations predicted based on the data in early November, and then the use of ICU beds, the orange one, down the bottom.

Those data have been reset and the modelling updated. This is just from this morning, actually, from Dr Garry Jackson, who is one of our very good public health ABD Miotti Justs in Auckland. You can see he has reset -- epidemiologists in Auckland. Hospitalisations have levelled off across Tamaki Makaurau as has the usage of beds in the ICU.

Likewise we see in the table on the side and we will happily provide these slides to all of you, whilst our hospitalisation rate throughout the full outbreak has remained at between 11% and 12% and it has been for the last four weeks, the proportion of people who are cases requiring ICU care has dropped from 5.7% across the full period of the outbreak down to 3% in the last month or so. This reflects two things.

First, the impact of vaccination. We know it prevents hospitalisations and serious illness. But it also reflects the very good work of our clinicians in Auckland who are looking at the international evidence and using the latest treatment protocols, so early use of oxygen, dexamethasone and antivirals to prevent people becoming seriously unwell and requiring care in the ICU.

So a demonstration of the impact here that vaccination is having in Auckland on hospitalisations and bed use in the ICU, which all reinforces the benefits of vaccination.

So that remains the very best thing people can do. If you have not been vaccinated, please do that. It's also one of the best ways we can continue to protect people who cannot be vaccinated including our tamariki.

A reminder also that if you have any symptoms of COVID-19, including a sore throat, dry cough, a loss of smell or taste, it might be a runny nose, fever, please get tested straight away.

Some of our more recent cases, people have waited 7-10 days before they have been tested. So it's a reminder, please get tested straight away and remain isolated until you have your test results.

 Just in terms of scanning and use of the NZ tracer app, this continues to be very important as we go into the new traffic light system

. As Auckland moves into red on Friday, we expect the number of locations published will increase. We are no longer publishing locations of interest where exposure was just casual. Our experience through the outbreak is that we just don't see cases in supermarkets and these sorts of settings. But from Friday, places like the gym, and the pub, and hospitality venues will be open.

 It is very important therefore that you keep using the NZ COVID tracer app. Then we will start identifying places of interest because people are more likely to be in crowded spaces in high risk settings. So a reminder of the three things to do when you go out, your mask, your vaccine pass and your scan as well. And while our job is by no means done here, it is great to see good progress in our high vaccination rates. I know the Minister will talk more about that, and the high levels of testing.

Our seven-day average number of tests across the country is around 28,000 and that is excellent. That's what we need to keep doing if we're going to enjoy the summer ahead while living with COVID-19 on our own terms so thank you to all of our health workforce for the work you have done and to all New Zealanders been vaccinated and tested.

>> Thank you, and a big shout out to all New Zealanders who have now received both doses of the vaccine and now have maximum protection against COVID-19.

93% of eligible New Zealanders have received at least one dose. We are on track to exceed a 90% overall nationwide vaccination rate within the next couple of weeks if demand continues at current levels.

We are also making gains on the number of people who have received 1/3 or a booster dose, and as of this morning, 13,224 people have received a third dose because of a medical reason. 51,127 people so far have received boosters and we have only been doing these boosters for a couple of days now.

We expect around 450,000 people to get booster doses between now and Christmas and we are well on track to deliver that. T

he uptake of AstraZeneca has been pretty low so far, which is what we expected. It is in the low hundreds of people. About 650 doses so far delivered. But it is a choice that is available to those who need it.

Today I wanted to set out a bit more information about the vaccination of 5 to 11-year- olds.

There is still detailed to be worked through and a Medsafe process to go through. We are now well advanced in our planning for the rollout of vaccines to 5 to 11-year-olds. This under 12 age group have a lower risk of direct health impacts from COVID-19 compared to older age groups but COVID- 19 can still have serious health consequences for them, particularly for children who are immunocompromised or have significant rest retreat conditions. The paediatric -- respiratory conditions.

 The paediatric version of the vaccine is about one third of the adult dose, it has been thoroughly tested and trial. Using this paediatric version of the Pfizer vaccine is conditional on approval from Medsafe and they are making excellent progress with the work they are doing to ensure the expert advisory committee will be receiving the advice by mid December.

Once Medsafe makes its decision, the ministry polls technical advisory -- ministry's technical advisory group makes recommendations on the rollout of the vaccine and planning is well underway for that to start.

We are expecting to start rolling out the vaccine before the end of January. And we have in our conversations with Pfizer been able to secure supplies, deliveries, of the paediatric dose in order for us to start rolling that out pending Medsafe approval.

Health officials will continue to work with iwi, DHBs, local providers and communities including the Ministry of Education, schools and early childhood centres to identify any additional locations we may want to bring online for the administration of paediatric doses which of course will also be available through our existing vaccine network.

We will be taking a whanau- based approach there, and we recognise this is an opportunity to reach members of extended whanau who may not have come forward as adults to receive their vaccinations. It's also possible other childhood immunisations may be brought up-to-date at the same time.

 In terms of the COVID-19 protection framework, in two days New Zealand will shift from the Alert Level system to the new framework or the traffic light system as it has become widely known. It is a big shift after 20 months living in one of four alert level's with some sub- steps that have been very successful helping us to minimise the impact the virus has on our lives.

We are now moving to a framework designed to keep us all safe as we have strove to do all along. And provide business and vaccinated people more confidence to operate and move around a lot more freely than they have been for much of the recent months. It is a recognition that New Zealand has now officially moved into a new phase of our pandemic response. Where vaccination and good health behaviours will be the key thing that keeps us protected, rather than across the board restrictions.

The framework is pretty simple and it will feel normal once people get used to it. The main message is that at every colour setting, vaccinated people will be able to operate a lot more normally whilst taking a few key public health precautions. Getting vaccinated and having a My Vaccine Pass is the key to making the framework work for you.

So far we have issued 2.8 million My Vaccine Pass which is about 90% of the people who have applied for it have received it. We are working really hard to get those other people -- 95%, to get those other people there passes in time. We have an X to 400 people working in the processing team -- extra 400.

The fastest way to get the My Vaccine Pass is through the online portal but you can also get the pass at one of the 400 vaccinating pharmacies throughout the country.

 If technology is not your thing, you can go to 1 of those 400 pharmacies and have them print it for you. At the orange level, people with the My Vaccine Pass will have an experience almost identical to life at Alert Level 1.

Red will be a bit more restricted, vaccinated people with a My Vaccine Pass who are currently at Alert Level 3 will enjoy much more freedom than they do now. We have been working really hard to get that balance right. We know it will take time for people to get used to the new rules and the various guidelines, and there will be a few teething issues along the way.

What I know once the new framework settles in, it will mean more freedom to go about our daily lives especially if you are vaccinated and at the same time having built-in protections for communities and the wider health system.

As the Director-General has just stated, if everybody gets into the routine of masks, scan and pass, we will be doing well so take your mask with you when you leave the house, where your mask when required, scan and use the tracer app - that will continue to be a really important part of our response - and download your My Vaccine Pass and have it ready to be scanned.

For those who are not ready yet, and you want to keep your family and yourselves safe, please go and get vaccinated.

 My final word today on Omicron, understandably there is a bit of anxiety about this. I want to be clear, it is a cause for concern but not a cause for panic and we will be keeping things under constant review.

Our readiness and response planning in the event of a new variant of COVID-19 entering New Zealand remains the same as it has been four previous variants in that we are ready and we have plans in place.

 Knowledge continues to emerge about the variant which is still in its infancy and we are watching closely and monitoring international evidence. More information is likely to become available in the next few weeks.

 In the meantime we remain in a good position to minimise the impact any new variants have on our border settings because we have the ability to still do 14 days of isolation for those people coming into the country from those higher risk locations.

And the management of their cases and contacts, as we have been doing for some time now, continues to be really important. PCR samples, test samples, many cases identified at the border are being prioritised so that we will know as soon as we can, they have been prioritised for holding sequencing, and we will complete genomics sequencing.

The WHO keeps reminding us that to defeat this pandemic globally we need a comprehensive approach which includes vaccination in combination with proven public health and social measures. And we know these already work.

 It remains important everyone around the country continues to play their part and be vigilant. Vaccine producing companies have started assessing how effective their vaccines are against this new variant and we are following that closely.

Our advice to the public remains that vaccines are still the number one protection against COVID-19, and that includes against the Delta variant which is responsible for our current outbreak. There is no change to the advice on booster vaccines which is for people over the age of 18 to get there booster dose at least six months after their second dose.

As I have indicated, the rollout of that is proceeding at pace.

>> It at your perspective it is a matter of time before Omicron arrives?

>> We are not stepping away from those and in the meantime we have got the ability to capture that.

>> But the government look into extending the border restrictions especially if the prevalence continues?

>> We are still planning for the January and February courts and the removal of restrictions for those courts and we keep it under constant review.

>> And that could be extended?

>> I would not say it is a likelihood but the possibility and we are continuing to head towards those January and February days.

>> 20% of those under 10 is a significant number. Are you comfortable with the end of January start date?

>> I am very aware that around the world one of the big trigger points of the points is heading back into winter and so if you ask me where I want to be for New Zealand heads back into winter and the risk increases, and the northern hemisphere experience has highlighted that, we want to have as high rates of vaccination as we can and I would like to think we all have paediatric vaccination rolled out and young people will be vaccinated and that will put us in a very strong position heading into the New Zealand winter. It is folly to think about that now when we are just heading into summer but we have to think that far ahead and I think we will be well protected and then one of the best positions we could be heading into winter. In terms of children, of course we are seeing more cases in children because at the moment they cannot be vaccinated and that is something we keep in mind and that is one of the reasons we are moving to a protection framework and not removing all restrictions because that helps to provide extra layers of protection.

>> The restaurant Association in Auckland is upset because they have been close no four months and they have got nothing from the revitalisation package for Auckland. Why?

>> In 36 is also, they will be able to reopen and serve customers and will be checking people's My Vaccine Pass. There are a lot of people in Auckland who cannot wait to get out and be able to dine out and enjoy those freedoms again and I'm expecting the hospitality sector will see a big increase in demand in the next few weeks.

>> But they have been unfairly disadvantaged when other people have been given virtuous but they will not be valid for restaurants as they were in Britain.

>> Approaches are designed to give people the confidence to go out and re-engage again. So we are telling people thank you for their hard work and thank you for staying home for a prolonged period of time and now they must go out and enjoy what Auckland has to offer and of course the hospitality sector will benefit from that because people will be enjoying hospitality and those things they are getting passes for.

>> What is the incentive? I could speak to get them out of the house and we are certainly providing that.

>> And what about people who are nervous about sending their children back to school and waiting until their child is fully immunised?

>> We want skills to move to the new framework by the New Year and we have seen that the ad in the middle of exams and some kids have just gone back to school and we are giving them extra time to adjust relative to everyone else but from the New Year we will put in place the protection framework and we have to get those kids back to school and that potentially helps us with the vaccination efforts as well. The is going to be the potential to do more vaccination in school settings although I'm not saying that will absolutely be the case in every instance because there may not be. We are giving up.

>> And they will have to keep children at home until they are fully immunised? I could speak unless there is a medical reason and so those families with medical reasons, of course.

>> There was a point made about 20% being under 12 and the vast majority of those cases are from household transmission and not from transmission in school settings and saw the risk to children around getting infected is inside households in the best way to protect them is for parents and those who are eligible in the facials to be vaccinated.

>> On the modelling, how many cases are you predicting we could have in New Zealand by the end of February?

>> Be modelling, as Dr Bloomfield has shown, is a very successful response in Auckland and was modelled were looking at earlier have proven to be well outside the range of what we have actually been dealing with.

>> The important thing here as we continue to update the modelling as we get more experience and even if we think about Waikato, we have not seen a big increase in TCC and this is a reflection of the high vaccination rates there and places outside Auckland we have confined to small clusters. The important thing is to keep doing what we are doing but certainly some of the worst case scenarios that were modelled 1-2 months back are not what we are expecting because we are clearly seen the impact of vaccination.

>> How many cases are we expecting in terms of the daily case numbers?

>> We cannot predict the future and we used the modelling to assist with planning and we plan for what we think might happen of we might get surgeries at the important thing is the vaccination rates continue to increase and they are now climbing above 90% for first doors. -- First doors.

>> And do we have to offer the families an apology?

>> Any death from COVID-19 is when we take seriously and we have to look closely at anything like that to see if there are lessons to learn and things we can improve about the system and we will continue to do that but it is a global pandemic and so in terms of do I accept responsibility for the consequences of the global pandemic - I will accept responsibility for doing everything we can to keep people from and safe within the limits of what we can reasonably do.

>> The chief executive at the Cos talked about the report and offered an apology to those families and I endorse that apology and we always strive to make sure the system does its best for whanau and individuals and there were things that did not go as well as they should in the system and deaths that we are preventable and it is appropriate to apologise for that and to put efforts into ensuring that we make sure that this not happen again.

>> Is it appropriate for the government to apologise?

>> I am sorry for anyone who loses their life to COVID-19. That is why we are doing this and that is why we have been doing this for nearly 2 years. I don't want to see any families in that position if there is anything we can do about it.

>> Are you going to apologise to the families of the people who died under the watch of the government because you put the system in place.

>> There is a process to go through there in terms of an apology and I'm not in a position to be able to offer that but I am sorry for anyone who loses a loved one due to COVID-19.

>> One of the things the health of the day says that businesses have to verify a reasonable number of vaccine passes. What is a reasonable number? 1% or 50%?

>> It depends on the context and so if you are a bar or a restaurant or you have a bouncer on the door and you are controlling entry anyway and people are waiting in the queue, it might be feasible to be checking more but if you were doing a larger event and there are a lot of people coming in in a short space of time then it will be different. We deliberately did not put hard and fast numbers and that because we don't want to create a system that is unworkable.

>> What kind of changes could you make if you saw evidence that unvaccinated people are getting in as a result?

>> We keep that under review and I think the vast majority of people from New Zealand and the vast majority of businesses you want to do the right thing. We are seeing good compliance with measures over the last two years and in some cases it has not been voluntary but we have been asking for goodwill because we have not had that ability to enforce every QR code scan and every action that people have taken and people have been wanting to do the right thing and I think the success as a country has been because people have been wanting to do the right thing.

>> Are you able to see how many of the vaccine passes have been issued?

>> Several thousand and they think it was over 5000 but I don't have the exact numbers.

>> Many people have had issues getting that. People are doing the right things but still facing restrictions on their life.

>> We asked people previously and they said it could take 10- 14 days to process those and we are doing that and people are supplying information at the last minute and so they are cutting it fine and I know that the team are working hard to process as many of those as fast as they can but ultimately, particularly for overseas vaccine records where there has to be a degree of integrity in the way. Being processed, and I'm confident that there is and there are 400 people working in those teams and we can ask Dr Bloomfield if he wants to add to that.

>> An update for those who have registered your details because they were vaccinated overseas, from tomorrow, they will be able to download My Vaccine Pass onto the phone or device and print it off. The functionality is going live at midnight tonight and so from tomorrow it will be like. For those people who have not registered, there might be a weight and the functionality will be at an impasse and in the meantime there are people who might have a problem because it is overseas vaccination or an issue around names and we have around 80,000 queries relating to that. They will be issued with a temporary pass they can use in the meantime and we will be working to get through the backlog and a large number of people are working on this.

>> So there are people around the country who don't want to be vaccinated and this will affect their jobs and they might have to leave.

>> It is not for them to determine if that is appropriate, actually.

>> To be no the size of the group of people who have been issued with My Vaccine Pass what?

>> About 800,000 people haven't got a pass, although they are fully vaccinated. As I said people can get them from the 400 or so pharmacies that do vaccinations. They can also contact the 1800 number and have one posted out.

>> Northern DHBs have got behind iwi saying only double vaccinated people should be able to travel to the region, is the government weighing in on that?

>> We are not. If you look at the fact that Northland is going into red, it highlights the fact we acknowledge there is a more vulnerable community there with lower vaccination rates. We want to see those vaccination rates getting up. I would say to all those expressing concern, nervousness or anxiety, in Northland, the best thing they can do is go out there and find those people that have not been vaccinated and have conversations with them about the importance of vaccination. It is their choice whether or not they are vaccinated, but unfortunately many of those people are making the decision not to be vaccinated based on misinformation. Everybody who is in that anxious and concerned category can do something about that.

>> The Waitangi National trust announced this afternoon they are going to again cancel commemorations up there in February. Do you think that is a sign that yes they are going into red but there is no optimism that they will be at a much higher vaccination rate come the start of February, given that decision by the Trust was made with the modelling and advice of the Northland DHBs as well.

>> My ministerial colleagues who engage regularly with iwi leaders up there indicate there is a degree of realism amongst iwi leaders about the scale of the challenge they have two get those vaccination rates up. There is more misinformation up there by far. The highest concentrations of misinformation in the country, if I could be so bold as to make that claim. That means we have a real challenge on our hands.

>> Was advice sought personally from you, did you provide any detail to the Northland DHB?

>> I was not asked for advice.

>> There has been a long list of locations of interest for the last 12 days, how likely was at these cases were infectious in the community? (INAUDIBLE)

>> On the first question, the first case identified in Nelson Marlborough a few days ago was someone who had symptoms for a while and so therefore the exposure time, the possible time they were infectious in the community, was a reasonably long period. That's why those locations of interest go back a way. There is whole genome sequencing we are following up and that will give us an idea of the link back to where the first person may have been infected. We have one other case in Nelson Marlborough that is not associated with the first person. There are three in a household, close contacts. That's in the first group. And then there is one person who was identified yesterday who is not linked, and that is another one we are following up to see where that person may have been infected. That person has a number of close contacts both in the household and the workplace who are isolating and being tested. We may see further cases there but once we have an update on what the whole genome sequencing is showing, we will update you.

>> Omicron was in the Netherlands at least five days before South Africa reported it, so why is the government singling out those nine African countries and putting them on the high risk countries category list?

>> It is based on a public health risk assessment. We want to try to minimise the chances of that particular strain of the virus making its way into New Zealand, or at least delay it as much as we can.

>> Given the news it was in Europe earlier than expected, what will it take to put some of those European countries on that list?

>> We keep it under review all the time.

>> Given how much more prevalent that strain of the virus is becoming, is there advice to warn anybody looking to go overseas in January against doing that?

>> No.

>> Back to Northland, like you indicated, there is a lot of misinformation up there. There is also a lot of access issues. So it is the misinformation and lack of access to the vaccines, those things have gone hand in hand and resulted in the position Northland is in now?

>> I don't think lack of access to the vaccine has been a problem in recent months. In fact vaccine has been widely available there. But misinformation has certainly been a challenge. And it continues to be. We have all got a role to play in combating misinformation.

>> There were access issues. Waipareira had to leave Auckland in lockdown to go up and assist Northland's vaccination efforts. So there have been access issues. What was the government doing on that to fill in the gaps where misinformation has obviously been a problem?

>> If you look at what we're doing to combat misinformation, we are doing what we can reasonably do. Unfortunately misinformation tends to spread through networks the government does not have access to. So that is one of the things that makes it really challenging. These are not people who are plugged into the 6 o'clock news or night or reading the newspaper. They are getting their information from sources we don't have any ability to influence. That's one of the things that makes it challenging.

>> Twitter, the Prime Minister goes live on Twitter a lot. Why does this not exist in the spaces where misinformation exists and access was an issue. People in Hokianga had three hours every two weeks to get a vaccine, so it was an issue. So where was the government when those conversations were being had in the villages around Northland?

>> I think if you look over the course of the rollout, we have been working really closely with our local DHBs, our iwi, our primary health care providers, hauora Ovide is to spread that vaccination net as widely as we can -- providers. That has included a significant amount of funding specifically for the Maori vaccination campaign right from when the vaccination rollout first began.

>> What about putting a Maori minister on the program?

>> Minister Peeni Henare has been up here on many occasions he continues to be an important part of our COVID-19 team, and I'm aware he has been making himself available to the Maori media on a weekly if not daily basis as well.

>> The narrative seems to have changed recently around access and it not being an issue, not just from yourself but from the Prime Minister and others. When you talk about access no longer being an issue, are you talking specifically about vaccination clinics that are available? Because when I have asked questions about it it has been pointed to the comments of the the likes of Shane Reti and others, so you can explain your definition of access no longer being a problem?

>> The former, not the latter. I understand and acknowledge for other people there will still be barriers. Time off work, the cost of petrol to put in the car to go to the places where the vaccine is available. I acknowledge those things can be a challenge but there are lots of people working hard to help people overcome those challenges.

>> I guess you can see how that can be a bit misconstrued. Saying access is no longer an issue makes it sound like there is a mobile vaccination clinic in every town and village around the country. That actually there is not, we know that. Isn't it the point that you should be upfront about the fact that access is actually about people getting to where the clinics are? And if that is a problem, you do have an access issue.

>> If I took that to the extreme, there are towns in New Zealand where you cannot buy food. There are no food outlets but people still eat in those places so people find ways to get to the places where they can buy food. The reality is we have got buses, we have got mobile clinics, moving around the country to try and provide as broad coverage as we possibly can.

>> Just a follow-up, has there been any consideration for giving (INAUDIBLE) days?

>> That question is best addressed to the PM or others.

>> So he doesn't have his own day?

>> I know he is out there working really hard on the vaccination program for we speak to each other frequently and he is trying to make of self as accessible to Maori communities as possible. He is also I think aware that this is not necessarily the best way for him to do that. There are other ways including direct engagement with Maori media and getting out and about which helps him to do that.

>> Is there any risk Nelson goes into red because of these cases on Friday?

>> Let me be clear on this. The fact that cases will pop up in different places around the country and we may be dealing with localised outbreaks that are reasonably controlled, that doesn't mean we automatically consider a shift from orange to red every time that happens because more of that will happen. It doesn't mean we are suddenly going to be flicking places into red all over the show all the time.

>> A few days ago, British scientists came out saying (INAUDIBLE) testing was a reliable way for stopping the spread, the NHS rolled out antigen testing ages ago, why is it taking New Zealand so long?

>> Lateral flow is on our radar. I just want to make a comment about testing. We have rightly had PCR-based testing, largely nasopharyngeal but also saliva based as the mainstay of our response to date. That has served us incredibly well. We have one of the highest testing rates and the lowest positivity rate of any country in the world and that is why we have been able to control our outbreaks here so well including the current Delta outbreak in Auckland. From today there is a range of businesses in Auckland that were part of the pilot who are now able to order and use rapid antigen tests, as will some healthcare settings like age residential care. Likewise we are looking at, as Minister Verral announced last week, the role of rapid antigen testing and their availability and pharmacies to be able to help people will be available for people who are unvaccinated and who need to travel outside of Auckland from the 15th. So yes, we are using rapid antigen testing. But to be really clear, it's only more recently it has become a form of testing that is appropriate to use in New Zealand because we have had such a low rate of COVID cases.

>> In terms of it coming more available now, what measures are in place to ensure rapid antigen testing is carried out properly in the workplace?

>> In the workplace? It was the purpose of the pilot, to make sure first of all that employers had people who knew how to supervise the use of the tests, but also that we could collect information on what the results of the testing showed in terms of picking up any positive cases that were true positives and/or any false negatives and any false positives. In terms of wider use in the population, that's why we are proposing to use pharmacies as the distribution network because you will recognise and pharmacies the technician or the pharmacist can explain the use of the test to a person who is going to use it or they can supervise the use of the test so we are confident that the test is being used appropriately.

>> Amelia, lucky last question.

>> Just on the road blocks, is the government going to condone or condemn the iwi roadblocks?

>> The only ones putting roadblocks in place should be the New Zealand police. So no, there should not be any iwi roadblocks set up.