COVID-19 update 10 November 2021

News article

10 November 2021

COVID-19 Response Minister Chris Hipkins and Director-General of Health Dr Ashley Bloomfield updated the media today at 1.00 pm today.

>> Good afternoon everybody.

I hand over to the Director-General and he can do us the numbers and the schooling for next year

>> Today 147 new cases in the community. Of these 131 are in Auckland. 14 in Waikato and two in Northland and we have two in managed isolation. Further details and break down in our 1:00 p.m. Statement from the ministry of health.

Sadly reporting sudden death of a man in his 60s who had COVID-19 overnight and he was isolating at home in Auckland. The cause of death will be looked into by the coroner and whether it was COVID-related.

Any deaths that could be COVID-19-related are fully investigated whether they occur at home or in the hospital setting.

Obviously, our thoughts are very much with this man's family and friends at what will be a stressful time.

In terms of hospitalisations 81 people in hospital with COVID-19. 11 are in ICU or high dependency unit and all in the Auckland region.

 Good to see testing continue really good volume particularly in Auckland. Yesterday just under 28,000 tests processed around the country and 3,420 swabs taken and processed in Auckland alone.

Further on Auckland our team up there has identified six suburbs of concern because there is a higher risk of their being unidentified cases and transmission there. Anyone in the suburbs of Sunnyvale, Kelston, Birkdale and Māngare if you are vaccinated or not get a test and stay home until you receive a negative result.

Down to the Waikato 14 new cases there. Ten and six-in-one household who were known contacts. Three of today cases are from Hamilton and one in Ngāruawāhia. Interviews are underway at the moment. There is testing wildly available through Hamilton and through the Waikato again today.

One location of interest identified yesterday and that is The Base in Hamilton. Please check the ministry website for the time and date and the instructions there.

Up to Northland two cases to report both in the same household in Dargaville and probable links to cases in Auckland identified there. One of those cases is a child under one and it highlights COVID can go effect anyone of any age.

 And all the more reason for us to think seriously about vaccination, because it is one of the best ways to protect our people.

Good testing capacity across Auckland today and good to see vaccinations continue to go well in the Northland area. I encourage anyone who hasn't been vaccinated yet to get along and do so today.

Coming back to COVID-related deaths and clarifying our reporting of these, we will be changing our ways that we will be reporting deaths by COVID-19 to ensure it is reported in a timely way and indicate where there are other causes of death.

The clinical criteria will continue to be guided by the WHO definition which is to report any death where the person had an acute COVID-19 infection regardless of what the cause of death might be. We will be publicly reporting confirmed deaths where the death documents or an investigation has shown that the cause was COVID-19. And we will report other deaths where the cause of deaths not certain but the person had COVID-19. We will report them separately.

The latter group will be classified under investigation while we await further information from the clinicians or indeed a coroner's follow-up investigation.

Just an update on our modelling. Last Monday 1st November I showed some modelling from Dr Gary Jackson one of the team up in Auckland recording forecast case numbers, hospitalisations and ICU numbers and the RU value. That modelling had forecast around 200 cases per day by the end of this month in Auckland. Around 1400 cases a week based on median numbers.

 As I mentioned on Monday they were spot on with what the model it forecast in terms of numbers. Hospitalisations why somewhat higher but ICU somewhat her. Each week around 150 new hospitalisations and around 11 ICU admissions. I do want to put that in context.

There are more 1700 hospital beds across Auckland and over 100 ICU beds. ICU bed capacity does change on a daily basis depending on what the local needs might be and planning and staffing so numbers can increase both in Auckland and around the country. It is important to know the hospitals in Auckland will have and capacity.

Anyone who needs care for any reason do not delay in seeking it. The hospitals are safe. However, we do want to limit the impact of COVID on our hospital system and indeed your wider health system.

Two things people can do there to be vaccinated and second live, to abide by COVID- 19 restrictions.

Most importantly, if you are unwell don't go out.

Two vaccine updates. First around the portfolio as you know we have the four vaccines in our portfolio. Three of which have had provisional approval from MedSafe. To date our program has focused on the rollout of the Pfizer vaccine and success to date. That will be the primary vaccine available in New Zealand.

However, we know that there is a small number in New Zealand who cannot have the Pfizer vaccine we think it is appropriate to have an option available for them. Those people who cannot have Pfizer for medical reasons and that is likely to be just a few hundred people. There are other people who may have a different reason for wanting another option. That includes people who are required under an order, to be vaccinated to be able to continue in their work. And we requiring them to be vaccinated to protect themselves and the people that they work with, which might be patients in a hospital setting and of course children in school settings.

On the basis of advice from our technical advisory group and work from our vaccine team we are in a position to be able to make AstraZeneca, COVID-19 vaccine available as a second option for people aged 18 and over. And like the Pfizer vaccine it will be a two-dose course. We will have more details about this next week. Including the timing, the availability is likely to be in late November.

But there is quite a lot of work to ensure that the workforce is trained to administered a second vaccine, that clinics are available to do so, obviously cold storage and logistics are in place for that. Some work to do that. I am just signalling that is an option that will be available. Not for everybody. Again those two groups those who cannot have a Pfizer vaccine and those required to be vaccinated but are not prepared to have an mRNA vaccine but maybe willing to have the AstraZeneca vaccine. It won't be available as wildly as the Pfizer vaccine.

 I want to reiterate that Pfizer remains for good reason based on scientific advice our main vaccination program.

Continuing with Pfizer, as you know on Monday MedSafe approved a third booster dose of Pfizer for people 18 and over who have already had the full two-dose course and recommended it be for a minimum of six months since their second dose.

I have now received advice from the COVID vaccination technical advisory group with some recommendations with priority for boosters and we will be providing advice to vaccine administers on Friday. Again we are getting closer to be able to roll out the booster program starting with those vaccinated first and those at the higher risk that is our healthcare staff and those vaccinated early. Further deals next week. We are anticipating late November as the timing when that program will get underway.

Just to reiterate it is second from the third primary dose for people with severe immunocompromised and already rolled out successfully.

>> We are in a face where we are look to go ease restrictions and open to the rest of the world. We think it is absolutely vital that we do that carefully and safely. Looking forward to the end of this year and into next year, we want to ensure that we are providing as much certainty as possible to teachers and students and the community. Nobody wants to be in a situation heading into the summer break or ahead of term one next year, we are still unsure how children and young people can return to school and early learning safely.

Today I am outlining a plan to return to face-to-face learning this year. It will look slightly different to what we are used to. We all need to become comfortable with the idea and get used to public health measures that will can now in place.

For years 9 and 10 they will return to school joining those students already year 11 and to 13 students back preparing for their exams. It can happen from 17th November.

Children and young people in years 1-8, students will also be able to return from that date part-time. That can include half days through year levels or through groupings. Full-time learning will continue onsite for the student who have a need for it.

For example had they are going to work. Those students are already back full-time now. Each school will get a bit of flexibility to decide what works best for their learners and their community. They will have full support from the Ministry of Education regional doctors. They will be in touch with schools directly how they will structure returning to school.

Public health advice supports a return to onsite learning.

Some further measures do need to put in place and they will be. That includes mask wearing for years 4 and up. Ventilating classrooms which will become a lot easier over the summer break. Limiting the number of students onsite and making sure that groups of children distance from each other.

The health advice also tells us that in other countries out of school activities actually create a greater risks of transmission than what happens in a place of learning. So what is clear, the risks of reopening schools are outweighed by the benefits of kids re-engaging in their learning in a face-to-face context. The balance of risk is shifting as we continue to see vaccination rates throughout the community increasing. Auckland is already at 90% first doses and that does provide a good layer of protection.

When schools go back next week, all teachers onsite will have had one dose of the vaccine and that further helps to reduce the risks of transmission. The ongoing restrictions have been incredibly hard on young children and of course their family. Returning to school and interacting with their friends and teachers and getting back to face-to-face learning will have a positive impact on their well-being and learning. We also know that COVID-19 has been pretty tough on the staff working in our schools and our early learning services. We know that they will need a bit of time to build back from that dis disruption and focus on their professional development and their children's to get the best chance of success.

To ensure that they have got time and space to manage the return to school following the disruptions caused by COVID-19. So that means re-setting the time lines for the curriculum, the introduction of New Zealand history and the NCA change program.

 For early learning services it means delaying the consultation on gazetting of the early childhood education. Changes are still critical and still very important parts of the Governments work in the education space. But they do require considerable effort and we acknowledge that between now and the end of the year we need our schools and our teachers and early learning services focused on support to return to learning. Focusing on well- being and teaching and learning, will serve our communities best over the next few months and that is what they should be focused on.

>> Why did you decide to make it part-time for primary school kids to go back? With only a month left of the school year?

>> Looking at public health advice. You will note, yes, it will be part-time for most students and schools will manage that in different ways. We haven't set a hard and fast number. Because of course it will depend on the school, how much space do they have? How much of their learning can they do outdoors? They will be following public health guidance around managing that transition back to school in a way that works for their community. While providing that layer of reassurance to parents. I am very aware that there are some parents out there who will be really nervous spending their kids back to school. We want to support them through that process so the confidence to do that.

>> On the flip side parents at home weeping that it will be part-time.

>> I spent several months at home with my own children with the COVID-19 response. It is pretty tough going and it is a fraction of what the parents in Auckland have had to do in the last few months. I absolutely acknowledge that.

>> Years 9- 10s to go back to school and high school environment.

>> Ultimately remember this is a cohort who can be vaccinated. We have seen good vaccination rates. So we are looking at 8- plus per cent first dose for that cohort already. That gives us an extra layer of confidence to go back in greater numbers than primary school where vaccination is not a problem.

>> The man who died at home, did he have a (INAUDIBLE) when was the last time (INAUDIBLE)

>> I don't have any of that information just at the moment but that is a information, the death was only notified this morning and we will be looking an seeing what contact he had and what support.

>> That should be something you would have pretty access to?

>> It is the team on the ground and they go back to the interactions through the health line and the providers that might be been providing face-to-face support and the teams as well.

>> The Wellington Mayor has notified there has been a positive waste water test in Wellington, do you have any information about that.

>> I think that we reported it yesterday and positive cases in the managed isolation facility.

>> Just on the schools can they choose to have the students back full- time in the younger age group.

>> They will need to adhere to public health guidance. They will be sent out come come prehence I have health guidance. Bare in mind some schools have a lot of empty space for example and the ability to spread students out more and other schools are jammed in. It won't be 100% even across the schools. We have set out what they need to achieve and some flexibility to do that.

>> Can I get clarification on that please. Could a school choose to have students back full-time if they can meet the public health require mgts.

>> If they can meet the public health requirements while they are doing that.

>> How many schools will be full-time and how many part-time and how many (INAUDIBLE)

>> I can't give you that guidance. I don't know at this point. Schools will be working with their local community. We will certainly know before it happens. But at this point we need to allow schools their time to work their way through that.

>> (INAUDIBLE) super-spreader between school children (INAUDIBLE).

>> I will let Dr Bloomfield comment on the public health advice that we have received which is that schools are a relatively safe environment, if all of the public health measures that we are putting in place are put in place. That's the advice that I have had from my team. And also in discussion with counterparts in NSW. Got quite a lot of experience over the last month or two with that, that they are not seeing that spread within primary school and even unvaccinated children. As the minister said earlier on the spread is more likely to spread outside of school settings than inside.

>> If a completely unvaccinated teacher turns up to school next Tuesday and refuses to leave what happens to them?

>> The schools will be working with the Ministry of Education to manage. The Ministry of Education has been in close contact with schools to ensure that they are preparing and know where they sit with their staff and they have been getting regular feedback with that. There are a handful of schools saying that they have got some concerns and the ministry is working very closely with them.

>> (INAUDIBLE)

>> Ultimately I don't make decisions who is to be arrested that is matters for the police but the schools will work closely with the Ministry of Education.

>> In terms of schools who have reported staff who don't want to get vaccinated, will they not open next Tuesday?

>> Ministry of Education will be working very closely with them. The first thing that we do when we experience a pocket of the workforce that don't want to be vaccinated, to make sure that we are taking an educated and informed approach first before we do anything else. We found with our port workers a lot of concern when we introduced the requirement amongst the port workers that would result in a lot of port workers walking off the job. They didn't. That is because we took an educated and informed approach. Many had been targeted by those who were spreading misinformation. When we got good reliable information in front of them they have those chose to be vaccinated. I am aware that the people out there who are sewing disinformation are targeting these work forces in particular for that disinformation at the moment.

>> Why not wait until years 11-13 go on study leave so you have fewer students at school?

>> We do want to these students back at school. As I said we have 80-plus per cent vaccination amongst the school population. Auckland is doing very well in that able cohort. As a result the risk is lower because of the higher race of vaccination.

>> 90% is your target for everything else. Why is 80% good enough for now.

>> Not for workplaces and workplace are open with large people in them. It brings secondary schools in line with large workplaces, effectively.

>> Can I ask Dr Bloomfield on the three deaths in home isolation, looking back at the previous two days is the health system failing these people? Should they have been in hospital? Not quite up to investigations for the third person yet, whack you -- what can you say broadly how home isolation is working.

>> The first thing that I can say it is working well. At the moment in Auckland there is 1,671 people isolating at home. We are continuing to strengthen and improve the system. The clinical assessment and advice of anyone isolating at home, still 344 people in isolation in quarantine facilities too. So there are people who, for reasons for health reasons or because they can't isolate safely, are in quarantine. And there is space to have them there as well. It is not as if there is a shortage of space. We are looking back at each of these deaths to see what was the level of interaction. Exactly what happened in those cases? Was there any problem with the clinical assessment and also clinical handover? There is nothing to suggest so yet. The third one which came in overnight we don't have detail on that. We are look very carefully at any opportunity to improve both the initially assessment and allocation of someone and how the system is working. We are using pulls sim ters. Some people can deteriorate quite quickly even if they have a history of being well and well at a time.

>> They don't die here in hospital, do they?

>> Yes, people do die. In fact until recently all our deaths had been in hospital.

>> They are much less likely to die if there is a ventilator handy.

>> Obviously we have... Right through the south most of our people have been in the community, either in quarantine facility, now at home. Relatively small proportion of people who have ended up in hospital. Yes, then if they do deteriorate and their admission to hospital is based on a clinical assessment. If they do deteriorate oxygen is available. Likewise in the community if they become unwell they are transferred to hospital.

>> (INAUDIBLE) considering the outbreak in the multiple community, is a response to opening up schools at any stage at the moment?

>> There has been good consultation across the education sector and that includes our... So the Ministry of Education has been working with the whole sector to prepare for schools reopening. There is a degree of nervousness out there and degree of enthusiasm out there as well. A lot of mixed emotions amongst the education sector. I think that is why we want to step through this carefully. We need to rebuild that trust and confidence amongst the parent community so that they are confident in sending their kids to school. That is what we will be doing in the next few weeks.

>> The two people isolating, there is no places have interest, why is that?

>> Whilst there might be exposure event they are ones where sthe know all the people at those events. Woo we only will notify places of interest at a public place and where there is a possibility that members of the public who may not have known, why exposed.

>> A little bit of stress in the area, people are a little bit scared, a tiny little community. Do you think by not having that clear information out there like that is leaving gaps for people think that COVID is a hoax.

>> It shouldn't be. Just to reiterate, the locations of interest we put up very promptly if we establish that there maybe risk or exposure to wider members of the public. Most of the exposure events that we get for most cases are in settings where we can identify and track down all the people there. So there is no need to identify a location of interest.

>> Just on vaccine certificates, we have seen Auckland up its retail stores and lot of places are only to admit vaccinated customers. You spoke about it yesterday. Is there an update today on vaccine certificates?

>> We will have a comprehensive update for you next week. The system is in the final phase of trailing to ensure that the system is robust and work to plan. We are confident that we will have the system available to people and provide a bit more of a time line on that next week. Jessica.

>> Northland coming up, has anything changed for you and your thinking around that, is that still set to happen?

>> It is still on track to happen. At this point we haven't had any reason to think otherwise.

>> The second vaccine, if you are unvaccinated at the moment can you just choose which vaccine you have? Is that an option available to people?

>> To reiterate our program is for good reason a Pfizer-based program and there was a deliberate decision. One of the things to look back in retrospect it has turned out to be one of the most effective and safest vaccines. So including against Delta. AstraZeneca is there as an option for people who can't have the Pfizer or people who are required to be vaccinated because they are captured under an order. Not willing to have an mRNA vaccine like the Pfizer ones and it gives them an alternate vaccine and there will be a process around that. 

>> At many places as they have been able to get Pfizer?

>> No, it will be available in a limited number of place.

>> (INAUDIBLE) very much driven by health providers. What would the DHB specifically doing in Northland and the Lakes area. Are they driving some of this work or (INAUDIBLE)

>> It is very much a joint effort and we have seen, I think really good results and in Tairāwhiti in the last week or two. Of course, those health providers who are delivering the services out on the ground and they are doing a fantastic job. Very much with the support including funding support but other support from the district health board and it is very much a joint effort.

>> (INAUDIBLE) mobile vaccination clinics. Has more thought gone into that given the (INAUDIBLE)

>> They have and some was the additional funding, additional $60 million providing for Mati health providers and focus on 7 areas to start with. Some of that funding was to support the use of mobile vaccination clinics.

>> (INAUDIBLE) up for review at the end of this month. Are you giving serious consideration to that or leaving it (INAUDIBLE)

>> Look, we haven't actually made decisions on that at this point. Of course, we keep it under constant review as we said we would do. We are entering a new phase in terms of our international boarder management but that is of course intricately linked with the work around our domestic boundary and our overall work here. We want to see as high a rate of vaccination as possible before we see the presentation of more COVID-19 cases in the communities. All of those things are considered all of the time. We are getting to a point where things will look very different in the next three to four months in terms of the international border and Trans-Tasman travel and travel within New Zealand. It all inter connects and there is a relationship in all of it.

>> People (INAUDIBLE) Queensland, for example, (INAUDIBLE) three or four months times things will have changed. Have you not giving serious considerations awed (INAUDIBLE).

>> We looked at those lower risk Australian states. One of challenges there they are 2349 in the progress of removing their own risk restriction. Of course, we keep it under review.

>> Unvaccinated travel which we are proposing to do (INAUDIBLE)

>> They haven't done it yet. Like I said we keep it under review. I am not ruling things out at this point. Mark.

>> On ventilation in schools, you are saying you are giving them a good chance to sort that out. What did you mean by that

>> By far the best ventilation is to have the doors and windows open. You look at the most design of our schools that is the most source of ventilation for classrooms. They don't have built in air-conditioning systems it is the doors and windows. Summer makes that a lot easier. That is very effective when they have all their doors and windows open. It is actually, creates a good flow-through of air.

>> Next year there will be COVID in the community, hopefully not high numbers but it will be there. And we get to winter, what is the strategy for schools then?

>> Look, our goal here is to move forward and to keep moving forward. So not to move to something that we then have to flip-flop backwards and forwards from. So the response framework, the protection framework that the Prime Minister set out just recently, the traffic light framework, whatever you want to call it is really designed to ensure 245 that we don't have to keep going backwards. We can turn the dial on the risk down without having to impose a whole lot of unnecessary restrictions.

>> As the teachers return next week, and say yes, I will get the AstraZeneca vaccine at some point. Will they lose their job or is that a holding pattern that they can put themselves in

>> It is something to work through. We do have an exemption programs in place. You have to be clear on the grounds on exemption between now and the end of the year. If you have people saying "I will never be vaccinated" there is no point of giving them an ex ex efrps. If there is a problem around timing that might be given a consideration.

>> (INAUDIBLE)

>> It is not a good enough reason for me. We also want to make sure that we don't lose good people. The best thing for them to have a conversation with people who know that they are talking about. As indicated before, some of their his hesitancy around the Pfizer vaccine disappears and they are willing to be vaccinated with Pfizer. I can't overstate this really, the extent that people have been subject ed to information about mRNA vaccines that is just not true. People have been.

>> Worried about today making this announcement, were you worried about giving credence to that view, allowing (INAUDIBLE) mRNA vaccines are unsafe and (INAUDIBLE)

>> I will let the Director-General comment on that. Before he does that I want to be clear the process around that will be about confirmed consents. People will need to know what they are signing up for and not signing up for if they are going to make that decision.

>> Just to add to that, all vaccines have advantages and disadvantages benefits and risks. We know that the effectiveness and safety profile of the Pfizer is very good. AstraZeneca is not as effective against the Delta variant and we know it has specific rare side effects that have been well published. We want to ensure anyone who decides to have the AstraZeneca vaccine has the access to information just as we have provided it for the Pfizer vaccine.

>> One more because we are going to run out of time soon.

>> Realise that COVID will be in our community at some point -

>> There are pockets of the New Zealand community who have formed the view that COVID is not going to affect them. They are wrong. COVID-19 won't be just in Auckland. We are reaching the point where COVID-19 will spread and it will find unvaccinated people. That has been the international experience of that. But no, we are not going to keep Auckland locked down. As the Prime Minister has indicated, we actually want Aucklanders to travel for their summer holidays. So that does just reiterate the urgency people around the rest of the country get can vaccinated because COVID is coming.

>> Just for Dr Bloomfield I appreciate you might not be able to talk about the latest (INAUDIBLE). The previous two, are you able to say they were managed by a GP or nurse or whether they accessed their medical reports?

>> I don't have that specific information. What I would say is that the most of the daily contact, once a person has had that initial assessment of isolating at home, is from health line. That contact includes access to a clinician at any point in time who can join the call to delve further and provide clinical advice. As we shift the moulds it is likely that general practices in some areas, some general practices are not set up with, they don't have capacity or capable to support. In some area practice nurses might be involved in that assessment and ongoing follow-up as well.

>> Instead of calling them have they got clinical backgrounds?

>> They either have a clinical background or able to access a nurse or a doctor to be involved in the consultation. This is just like Healthline which is operated here for more than a decade. People call with a set of symptoms and they arrange a very good range of clear protocols to ensure whether that person needs further clinical advice.

>> Why have you only got 344 cases in quarantine when there is 880 rooms available for them. 1600 people isolating at home. You have people isolating in cars and garages.

>> Can I just note, in some case people indicate this they prefer to isolate in the community and reluctant to isolate in an MIQ facility. Some people are making that choice for themselves. We are well past the point now where we can't put all our case in MIQ. Isolating in the community is the default unless there is a good reason to put in the MIQ.

>> People prefer to isolate at home and one of the key questions "Are you comfortable and happy to isolate at home?" If not there is the choice to go into quarantine.

>> The contact tracing number 1,142 contacted by those numbers haven't had a single phone call from contact tracers how is that good enough?

>> I have to look at the numbers.

>> You are managing 4,500 cases in the community.

>> Yep. The main reason for that would be that the cases have only just been notified and they are still... Only recently identified their contact. Those people are in the process of being followed up and that initial conversation had with them.

>> (INAUDIBLE)

>> Very confident in our contact tracing system and it served us well through the pandemic.

>> Dr Bloomfield how is the work going with (INAUDIBLE) has this been any progress.

>> I know that there was a meeting yesterday and my sense is that progress is being made to make the data available to really help focus efforts to identify Mati who haven't been vaccinated or late for their second vaccination. But we can provide an update after this exactly on what has happened.

>> Mati has made up the represented highest case numbers for the last 35 days. What has done down to target Mati communities? It just probably isn't enough?

>> Significant effort going into both testing and vaccination and very often we are, for example, there might be a number of cases from a residential facility, either a transitional housing or other facility. Then the teams are going back regularly with testing and vaccination offer. Often people are moving in and out of these facilities. So that is one of the things that is happening. Of course, as you know, our Mati providers have additional resources to help ensure that they have got everything that they need to support higher rates of Mati vaccination.

>> We will have to wrap up short but a couple more questions.

>> A break down of people catching COVID, contact to people who might be rulebreakers. Dr Bloomfield on (INAUDIBLE) is that a relief for you. That is your long-term plan for that.

>> I will have to come back to you on the break downs around the settings where cases it seems cases are most likely to have been infected. In particular, the breakdown the household and non-household exposures. I'm very, very pleased to see this decision around fluoridation and looking forward to working with my team to developed a process how the team assessed and provided advice to me and I sign off on fluoridation on child health. It won't be a whole country wide approach but it requires consideration of local and community factors.

>> Last question.

>> Just on (INAUDIBLE). People in Auckland and Waikato have been told wearing masks for children under 12 is not appropriate will do more harm than good less likely the child will wear it correctly. Why has that changed now (INAUDIBLE)

>> One of the things I would say about masks as people would know our advice has changed just not on masks but a wide range of topics. We are seeing much wider use of masks and wider acceptability of masks, even with children, I am seeing children wearing masks. Our view was it was a useful additional measure that will help reduce the risk on top of other measures. It is worthwhile doing.

>> Thanks everybody. We will wrap up there.

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