COVID-19 update 11 October 2021 4pm

News article

11 October 2021

Prime Minister Jacinda Ardern will give a post-cabinet announcement today at 4pm. The Prime Minister will be joined by Director-General of Health Dr Ashley Bloomfield.

>> Tena koutou katoa. Good afternoon.

Today I will update you on Cabinet's review of alert level settings in Auckland, Waikato, Northland, after which Minister Hipkins will share decisions made by Cabinet to strengthen our COVID response through the use of mandatory vaccination for large parts of the education and health workforce in order to protect vulnerable New Zealanders.

At the conclusion of the brief, we will then brief up Dr Ashley Bloomfield, who is, once again, available to everyone to answer questions, based on alert level decisions made by Cabinet today.

It will be clear to never that New Zealand is is a one -- is at one of the trickiest and challenging moments in the COVID-19 pandemic so far. There is a clear path forward over the coming months in which New Zealanders should be able to move to living with fewer restrictions and more freedoms as the result of higher levels of vaccination.

In fact, we have now surpassed the United States, Australia and Germany on first doses and are fast approaching countries considered vaccination leaders. In fact, last week nearly half a million vaccine doses were administered. Including 115,000 first doses and a record number of Maori turned out for vaccinations.

But we are not there yet. And over the next few week, while we lift the levels of vaccination for everyone, we need to maintain restrictions to stop the virus from spreading both in Auckland and in other parts of the country.

This week there are two things we are going to do to drive those vaccination rates up.

The first is Super Saturday where across the country we will put out the stops to increase vaccination rates. It is also an opportunity to get your second vaccine if you're more than three weeks since your first. Getting fully vaccinated as soon as possible means we can be in a stronger position to ease restrictions.

The second thing we are doing to strengthen our response is to make vaccination mandatory for large numbers of our health and our education workforces

. This is a decision that has been made by Cabinet today.

Minister Hipkins will provide more details very shortly.

The reason we are stepping up or our vaccination requirements is because Delta is a more difficult opponent. We have seen that around the world where no-one yet has eliminated a Delta outbreak. It is more transmissible, which makes it much harder to get an I head of. It has thread through communities that are harder for us to reach. This has made getting to zero cases in Auckland very tough.

Regardless, throughout the outbreak we have maintained our approach - test, contact trace, isolate. We're continuing to try and stamp out the virus wherever we find it and we will keep doing that.

But we do need Auckland's help. Because while we vaccinate, restrictions are still so important in terms of our ability to control this outbreak.

In order to support Aucklanders to get through, last week we put forward some safe and minor changes to alert level 3 red carpets to make them more bearable to and to support Aucklanders' wellbeing. Going outside to safely see another household was a change we made because the advice was that it was safe to do so. And I think so far has suggested otherwise -- nothing so far has suggested otherwise.

We need people to follow the rules. That means as a general rule, staying home in your bubble as much as possible, keeping your physical distance, including whej you're at work or meeting up with one other bubble outside, wearing a mask, and remembering basic hygiene measures.

We know this has been an incredibly hard period for those in Auckland, but these measures when followed make all the difference. We want the R value - the reproduction of cases - to stay as close to 1 as possible. It has crept up a little in recent days. This means the number of cases will grow. If it moves up further, cases will grow faster. But if followed, ow alert level restrictions can help control that spread.

So, on that basis, Cabinet has decided that Auckland needs to stay at alert level 3 as it currently stands for another week before we can look again at any further easing of restrictions. Cabinet will review that position when it meets again next Monday.

Onnal zoos in Auckland -- on schools in Auckland, last week, as I toll you, the preliminary advice from the public health team is that schools may be able to open for the beginning of term 4. This was initial advice.

Today the public health team advised us that the current state of the outbreak in Auckland has heightened the need for robust safety measures to be in place before schools reopen. Today Minister Hipkins will set out the measures and our timeline for the implementation of them. Nimes, school also not reopen on the 18th.

Further public health advice will be provided next week. Distance learning will, instead, recommence at the beginning of term 4.

Studentless who are currently able to access education facilities will continue to do so. In the meantime, can I ask students and their parents and care givers of those aged 12 or over to please use this week to be vaccinated.

Now, on to our other re-Johns and their restriction -- ren't Jos and other restrictions N the Waikato, we have a clear gal example of our tried and true method of stamping out the virus working. More than 23,000 tests have been done since the first cases were reported on 3 October. That is 4% of the population. This helps to give us a level of confidence that there isn't any undetected community transmission.

However, our public health team on the ground have asked for more time to reassure themselves that we do not have cases that are more widespread.

As a result, the advice we have received - and agreed with - is that the Waikato should remain in alert level 3 till 11:59pm on Thursday, 14 October. On Wednesday, Minister Hipkins will then confirm the move to level 2, if the health team and Cabinet are satisfied it is safe to do so. We still need people to monitor any symptoms and to get tested if you have any.

This is still a time to be syringe lent against any embers of the virus that by be around. One final pounl - thank you for getting vaccinated. We have seen the largest increases in vaccination of any region in New Zealand last week, jumping 5% for first doses, up to 79%, which is equivalent to nearly 17,000 people getting their first vaccination. Maori are also up 6% in the Waikato, with more than 4,000 people getting their first dose.

Now, to Northland. Here, unfortunately, we have a situation where we have an uncooperative COVID-positive person who is refusing to divulge their movements and where they have a female travelling companion we have identified but cannot locate. We have pieced together what we can from CCTV footage and other means of police investigation, but we know this is not necessarily telling the us the whole story.

While we haven't had any new cases from the 2,179 tests taken since the case emerged on Friday, without clear information of exact places and locations, the person travelled to, we are relying on high rates of testing across the entire region to give us the confidence we need there isn't any undetected community transmission.

As you can imagine, this is an incredibly frustrating situation, the like of which we have seen rarely in our COVID response before. Given how extraordinary it is, I have asked Health to consider all of the options available to them as they and the police work with the individuals involved. In the meantime, decisions need to be taken.

So far, only 1.1% of the region have had a test over the last 48 hours. Thank you to everyone who's come forward. But this needs to be higher to make sure we have the certainty there aren't undetected cases.

This is an especially important given in Northland we do currently have lower vaccination rates. So, on that basis, Norton will stay at alert -- Northland will stay at alert level 3 until 11:59pm until this Thursday, 14 October. With Cabinet again reviewing settings on Wednesday. Minister Hipkins will advise the public and everyone in Northland of those decisions at the same time as we advise the Waikato.

The two most important things northledders can do in the -- Nortoners can do in the meantime - please, get tested and vaccinated. P of we need the confidence provided by testing to reduce restrictions.

As I said earlier, this is a tricky period in our COVID response. I understand why people will ask and want more certainty than we can provide right now. That's because we are in new territory, but our goal remains the same, even if the approach to achieving it changes. We had a pathway forward. We remain in a very strong position to make the trx from lockdown restrictions to the individual armour of vaccines while maintaining our world-leading position on case numbers, hospitalisations and deaths as well as delivering a strong economy and low unemployment. In the coming week, I will outline the framework for the next steps as vaccination rates lift. Reconnecting New Zealand remains. You will see planning for our self-isolation pilot.

For the next few weeks, we will be careful in our decisions, while getting everyone we can vaccinated. You will see that in the decisions that we have taken today. I will hand over to Minister Hipkins to talk about next steps and increasing our vaccination rates.

>> We ex-Beck to see a busy week of activity across the country as we work to lift our vaccination rates leading up to Super Saturday. That isn't the only approach we're taking.

Workers at our managed isolation facilities and borders are required to be vaccinated. We are seeing that make a big difference.

I can now confirm that we'll be extending this requirement to large parts of our health and education workforces as well. Our education and health and disability workforces have done an incredible job throughout this pandemic, keeping themselves and the people who they care for safe. Vaccination remains our strongest and our most effective tool to protect against infection and disease.

We need as many people as possible to be vaccinated to allow all of our sectors to respond to the pandemic whilst continuing to deliver every day services with as little disruption as possible. Most of the people working in the sectors are now already fully or partially vaccinated. But we can't leave anything to chance. So, that's why we're making it mandatory.

It wasn't an easy decision. We need to have the people who work with vulnerable communities who haven't been vaccinated to now take this extra step.

Vaccinations for children, aged 11 to 5, are not yet approved and the health and disability sector includes a range of high-risk occupations. People have a reasonable expectation that our workforces are taking all reasonable precautions to prevent the spread of disease and the government agencies have been working with them to ensure that they are as protected as possible.

A high rate of ration nation or help to protect staff from getting sick and help to protect them from passing that on. It will also reassure those who are anxious about their children returning to a school or an early learning service. So, to the details.

Cabinet's agreed that high-risk workers and health - in the health and disability sector will need to be fully vaccinated by 1 December. They will need to receive the first dose by 30 October. This includes general practitioners, pharmacists, community health nurses, midwives, paramedics and all healthcare workers at sites where vulnerable patients are treated, including intensive care units. We will be including certain non-regulated healthcare workforces, including aged residential care, home and community support service, kaupapa Maori health providers and non-government organisations that provide health services.

Schools and early learning staff and the support people who work with them who have contact with children and students will need to be fully vaccinated by 1 January 2022 and the target for them to receive their first dose is 15 November.

That includes home-based educators, all those who support people in our schools and early learning services, such as teacher aides, administration and maintenance staff, and contractors. Secondary schools will also be required to keep a COVID-19 vaccination register of their students. Students that don't produce evidence of vaccination will be considered unvaccinated.

All education workforce employees in Auckland and other alert level 3 regions will be required to return a negative COVID-19 test result before they can work onsite at such time as their schools are able to - and early learning services - are able to reopen.

Those who are not fully vaccinated in the period leading up to 1 January will be required to undergo weekly COVID-19 testing until they are fully vaccinated. Work is continuing on what the vaccination requirements, if any, around the tertiary education sector should be and I will provide an update on that in due course. In the meantime, my strong plea to everyone is please get vaccinated.

>> Alright. I will

>> Ask Dr Bloomfield to join us in the vicinity of the second podium. Toby, then Jessica, then Jane.

>> REPORTER: What would the ramifications be for teachers or whose no the workforce who choose not to be vaccinated?

>> Ultimately, in the health workforce, they will not be able to work in those roles. In the education workforce, from next year they won't be able to work in those roles. Recognising that the first dose requirement comes in in the middle of a school term. It will be impractical to be making hard decisions at that point, but by 1 January - one reason we chose 1 January is because it gives schools the month of January to sort their staff arrangements for next year.

>> Will be you requiring parents to be vaccinated as well? Or require only vaccinated parents to use vaccine passport to access school grounds or fig like that.

>> If parents are volunteering, spending more time in school than just doing pick-up and drop-offs, then, yes, they would need to be vaccinated to continue those volunteer roles.

>> Epidemiologist Rod Jackson wants more vaccine mandates. Could we see more sectors like the police, the public service, bus drivers - could they be mandated?

>> You can see we're making clear decisions on where individuals are interacting with vulnerable New Zealanders. Our young children, school settings, and also healthcare. I think for New Zealanders, that will make good sense. In other high-risk settings, like, for instance, large-scale events, or potentially hospitality, that's where we're looking to use things like vaccine certificates as a way to ensure that only vaccinated people are engaging with one another. That's a big piece of work we're doing at the moment. I will let you finish...

>> Public servants who are immunocomprised.

>> Public servants?

>> Who might be immunocomprised, don't they have a right to go to work and feel safe knowing the people...

>> Keeping in mind individual work places will also be undertaking their own health and safety assessment of the role of vaccines in those work places. What we are doing is looking at the areas where we have a direct responsibility for those workforces. Health and education is a very clear area where those are individuals dealing with vulnerable New Zealanders and we believe we owe a duty of care to those vulnerable New Zealanders.

>> Jessica.

>> When you announced the phase 1 last week with the ECE, we did have a number of cases leading tume that as well.

>> Yes.

>> Why is it different? Why not go to phase 2, even though we have the high cases this time?

>> Keeping if mind this is - wear always said we would review weekly, but we would be very careful and methodical. We would look at what was happening with the outbreak and we would also look at our vaccination rates. Now, we are seeing good progress on vaccines. But still we do need those fully vaccinated numbers to continue to lift. So, my message to Aucklanders - is you can help us in two ways F you are due a second dose, please get it. It makes all the difference for your safety and the safety of those around you. The second thing is please do continue to uphold level 3. I know it's tough. But those restrictions are designed for your safety and your family's safety.

>> Around the decision to change the opening of the school date, it was going to be 18 October, have things got worse than you thought they were?

>> Well, of course, the time actually when public health made the decision and said to us about the phasing, they thought we would be in the first phase for two weeks. We said let's just keep coming back and review weekly and get a regular cycle of review. That was act hill the position at the time. On schooling, though, their view was indicatively the 18th but they wanted to come back, reserved the right to come back. They've done that. Their view is safety set in addition schools are important. We have set out today expectations on vaccines. There is more detail for schools again around things like not having assemblies, use of masks, safety precautions that we need to be able to implement and take the time to implement before schools resume.

>> (INAUDIBLE) worse than you thought they'd be?

>> Oh, look... We have seen the R value tick up slightly. Again, our restrictions in Auckland are still designed to be able to control this outbreak. We need everyone's help. Not just around vaccination. But, yes, still making sure that they are following the rules of level 3. They are really important. Jane and then Jason.

>> To the situation in Northland, it's a difficult situation, one we haven't seen before. Are you looking at doing anything extra for the people in Northland who are really uncertain about what's happen? There aren't a great deal of locations of interests? People would assume these two people have travelled a lot. You know, is anything extra needed? I think - you know, there's a lot of anger and upset up there about the situation.

>> Yeah. So I might see whether or not Dr Bloomfield or Minister Hipkins may choose to speak to this as well. What I would say is Health are working closely with the New Zealand Police. Of course, we do need to allow New Zealand Police to undertake their own investigations. Some of which you can imagine we wouldn't necessarily go into great detail around some of the - some of the tools that they are using. But we are engaging them, because of the extraordinary nature of this situation.

>> The other two things that are happening that are very important, of course, is making testing widely available, right across Northland and whilst we have seen an uptick in testing, we need more. There will be people in Northland who know the people who travelled there, may have had some interaction with them. It's very important for you to get tested. Of course, the other thing is - we have seen a great response to this - is making vaccination more widely available. That's the - a thing that regardless of where these people haveful thatted, it's very important that all Northlanders take up the opportunity.

>> You want people to get test who had aren't symptomatic? Just anyone to get tested?

>> Symptomatic testing. People who have been in the locations or areas of interest, whether they are symptomatic or not, and anyone who may have had interaction with these two people who have been up there, they will know who they are. Whether they are symptomatic or not, go and get a test.

>> Jay some? Derek, Jo.

>> Go ahead.

>> You talk about optioned available to health authorities. Can you explain - are you talking about health orders or stepping up in terms of going and finding people? (INAUDIBLE).

>> Yeah. Essentially, just considering... This is an extraordinary set of circumstances. We have an individual who we know who they are. We can't locate them. So, really it is between - between health and the police to make decisions over what methods they will use to then find that person.

>> Is it taking too long, though? We have had several days and the risk must be getting greater the longer this person is out there and the longer those locations of interest toot aren't being identified.

>> Yeah. On the public health risk it would be for Dr Bloomfield to comment. My question has been - look, I feel the exact same frustration that everyone else does. This is an extraordinary set of circumstances where we have someone who may or may not be COVID-positive who has travelled with an individual who we have identified but cannot locate and they are refusing to cooperate. I mean, it is beyond irresponsible. It's dangerous. We are using every tool and means we can to try and locate the individual and, again, I have just encouraged all views and options to be on the table. Health and police are really pulling out all the stops to try and get that certainty. Dr Bloomfield.

>> The only thing I would say is police have got a reasonable level of confidence the person is not travelling around in Northland. That reduces further public health risk. Obviously we...

>> The second person.

>> What we are keen to do is have that person tested. That would be very important.

>> Health options - are you looking at health orders stepping up authority that might be needed to coerce...

>> The health order right now would...

>> Yep.

>>..require the person to - if Dr Bloomfield - that already exists.

>> It is already in place. Is the police are looking at all options available to them to actually do what they need to do to locate the person.

>> The step-up options - are the options that have been on the table, but haven't been used until now, that could be triggered a stand-off is reached, for example, and... You know, if it gets to that point? Has everything been done?

>> I think there are still other options vaj. You will forgive me for not going into the tools available to the police. Because that is for them and their investigation. Because this obviously extends beyond just contact tracing now.

>> Has the woman broken the border rules on a previous occasion?

>> I cannot answer that, unfortunately. No. I don't believe... No. No.

>> Why not name her?

>> Again, that's - I see that as a matter for health and police. It is one option I have asked them to consider, as they work through the issue.

>> There's... Sorry. I have said I would go to Jason and then Derek.

>> There is a good chance that the other person who has not been located is potentially watching this press conference right now. What is your direct message to this person?

>> The absolutely easiest option for you right now is to come forward, allow a test to be undertaken, so that we can ensure we are protecting those who have been around you, and that may include your family and friends. That is by far the simplest path forward from here.

>> You said the R value crept up. Are you able to tell us the nature - or number?

>> It's tending between 1.2 and 1.3 currently.

>> Finally, how do you know that this person's not travelling around when you...

>> We're not going to get necessarily into all the police investigation at this point. But I think what Dr Bloomfield - shares information which is relate haven't for those in Northland.

>> (INAUDIBLE).

>> I don't know that. The police will have an understanding of that. The information they have passed to us is they have a reasonable level of confidence that he is no longer moving around.

>> Keeping in mind we want to allow them the ability to undertake their investigation and to locate the individual, the more information we give away on how we are doing that may make that harder.

>> (INAUDIBLE) report Northland level 3 until the person is located?

>> Not necessarily. We do not yet know as to whether or not that person is positive. What we do know is that the more testing we have, the more confidence that we can have. Of course, in the meantime, we're doing everything we can to locate the individual?

>> It is possible that there - two people who want to Northland interacted with communities who aren't really going to be tested, like (INAUDIBLE) existed in South Auckland despite public health's Beth -- best efforts...

>> Health are working through a number of different community providers, community groups and community leaders. It's not that they are just relying on finding these two individuals and using the police. They have extensive options available to them to continue to dot their work and make sure that they are testing as we should.

>> Yeah, Derek.

>> (INAUDIBLE) unlinked cases in the Waikato?

>> No. No. All cases for the last few days have been linked. All the cases amongst the 31 we are reporting in Waikato stem from the same original case and they have been both epidemic logically and whole genome sequence linked.

>> (INAUDIBLE) vaccination numbers have come out. Does that present a lower public health risk than the unknowns in Northland (SPEAKS INDISTINCTLY)

>> Yes. The testing rate, which the Prime Minister mentioned, 4% of the population over the last week or two, the vaccination rate going up and just the fact that all those cases are linked and are a known family or other contact is - is comfortable. However, we will look - take it day by day and look at what else is emerging over coming days before giving our final advice.

>> What we have is uncertainty. The best thing we can do to allow uncertainty is to get more information. Failing that, also testing. Coupling that together with testing is what gives us greater certainty. Sorry. I will go to Joe, Henry, Mark then Luke.

>> You made a comment earlier about mask in school assemblies. What is the nature of mask- wearing for schools, given the mandatory vaccination? What was the public heath advice on that too? How does it marry with the decisions that have been made?

>> There quite a lot in there, Jo! Secondary schools mask use is required. Secondly schools when they are reopening and that is in fact around the country, not just in those other areas. We haven't finalised decisions about any additional public health measures that might be put in place when schools reopen to larger numbers in alert level 3 areas. At this point we've not made that essential the. We'll keep that under review. Health continue to provide us with guidance on that. Their view is everything that we can do to turn down the risk in those school environments we should be exploring. We h is what we're doing -- there is what we're doing.

>> It includes - the early advice is that includes the avoidance of assemblies, anything else that might increase risk indoors.

>> A couple of things that haven't be ruled out you haven't necessarily decided...

>> These are general guidance that's been used before.

>> OK. (INAUDIBLE). In terms of some small regional isolated schools where there is few teachers, there might be quite a large number of parent whose come to do voluntary aide work because of the isolated communities. Do you have concerns about how onboard - as much as I hate that phrase - they might be...

>> Aligned.

>>..going along with vaccination if they are against it.

>> The Ministry of Education will be working closely with those schools. I want to reiterate an important public health message which I reiterated when I was standing here last week. That is that unfortunately we do have a number of more isolated communities in New Zealand who this that COVID-19 is a big city problem. Actually, it isn't. Those in those isolated and rural areas are just as at risk. So, we need to see high rates of vaccination. There is a message we will be pushing through our education system and the Ministry of Education will work with those schools where there is some resistance to make sure that we can continue to provide education for children.

>> What is the check? How does the Ministry of Health in a city know what is happening...

>> Ministry of Education.

>> The Education Review Office and the ministry have good monitoring systems if place.

>> We need to ensure that parents have that level of confidence that whether it is a teacher aide or teacher that we are doing everything we can, particularly for those children that cannot be vax nated, to keep them safe and well.

>> I had Henry and then... Of course, Mark. Henry?

>> On the vaccine mandate, there are small towns in New Zealand (INAUDIBLE) where there is one small GP our health outlet. (INAUDIBLE) is there no GP in that town? Is that the cradle for... Based on availability of services?

>> I can speak to schooling and then I might be Dr Bloomfield to speak to the health system. In terms of schooling, we are used to - the Ministry of Education is used to supporting school whose have sudden short- term staffing needs, for whatever reason. They will continue to be able to do that. One of the reasons, as I indicated, we set 1 January is the deadline for those working in schools to be vaccinated is that it does give us the rest of the summer holidays then to work with schools who are potentially affected. If is what transpires. I would ask Dr Bloomfield to comment on the health.

>> First, there will be some health workers and, indeed, education workers who won't be able to be vaccinated for one reason or another. So there will need to be an exemption basis. But there will also be a requirement to look at the nature of the work those people are doing. In the situation you're talking about, we would take those on a case by case basis. Actually, if we look at vaccination a rates - for example, in our Auckland - across our Auckland District Health Boards, they are already in the mid-90s. I have got actually a high level of confidence that heath staff will be vaccinated. I think particularly those who are working in isolated place us, I would imagine even more likely. If there are situations that arise then we will address those on a case by case basis.

>> (INAUDIBLE) purely health- based, you know, immunocompromised people, or will there be room for people who have exemptions for some other reason which is not based on their own health?

>> We haven't thought about an exemption process for the latter. I would like at them on a case by case basis. There is an exemption for health reasons. I expect the number to be small. On the other case, we are not anticipating putting in an exemption process.

>> On that...

>> I will stick with my order, if I may? Have you finished your line of questioning there, thanks Henry? Mark. Then I had Luke and then Mikey.

>> Did Cabinet today consider raising restrictions in Auckland if not though level 4 then layering something else, giving the upward trend in case numbers?

>> One of the things that... We have broad his just discussed settings every time. And that has been just generally as we look at what is happening in Auckland and we consider not only the restrictions but one of our criteria has always been compliance and adherence and the ability to continue to comply. So one of the things that we factored in, for instance, is what you saw in Australia was they had the same restrictions constantly and yet they saw at a certain point their cases tick up, without having made any changes. So, one of the things in our thinking has been over time adhering to really strict restrictions is the hard. And you can expect that human behaviour might change. So, last week what we sought to do was provide additional things people can do safely to try and prevent people perhaps doing things that might be pun safe. Meeting inside, if you want to do something that's not necessarily within the rule, you probably try and do it behind closed doors. That might include meeting another family inside. That poses risk. Instead we provided an option that is safer. But we have to make sure people are aware that they are able to do it so that people don't ask questions when they see people outside in a park or having a picnic. This is the kind of thinking. We have asked Auckland to stay in restrictions longer than ever before. We have tried to take into account the impact on their mental health and wellbeing and their ability to continue to comply.

>> How do you balance the aspect of people following restrictions while making sure the restrictions are doing enough...

>> Yeah.

>> On current trends, with the R numbers...

>> There is nothing to suggest that what well ear seeing in our cases is because, for instance, of people being able to meet another household outside. We have seen some transmission in work places. We discussed today some of the work places or cases in work places, might be a better way to express it. We have seen at the moment that that tends - we have seen a small pattern, but I'd call it small. I don't think it's a large number of cases, Dr Bloomfield, in the area of construction, food delivery and taxi services. Again, not a large scale. Small pockets. And here this is where we're going in and trying to undertake surveillance testing to see if that is a widespread issue. But in those areas there is guidance on how to prevent issues. Social distancing. So you're at work, it doesn't mean go and drinks after work with your workmates. Asking people to comply with all the public safety measures and each workplace. One final thing I would say - if you're stepping into a taxi or any other vehicle with another person, masks are required and evidence suggests that window at the front and back being down improves ventilation vastly and can prevent onward transmission. I want to impart that piece of advise too.

>> Dr Bloomfield, on the locations of interest page, a large number of locations that have being added now, the instructions for people who have been there is no longer to stay home and get a test, but now just to monitor your symptoms that, you can go to work and that sort of thing and if you develop symptoms get a test. Why that change?

>> Two things on locations of interest. First, the person who lived near Katikati, who spoke about this, who subsequently returned a negative test and now a second negative test, we have stopped considering that person - that case as being infectious. Those locations that related to that person will now - are being removed from the website. I want to thank the person and their whanau for an amazing job and for the public health unit there in treating it as if it was a case and for others responding by being tested. On the other locations of interest, what we have found in looking back and reviewing the outbreak over the last two months is we have had, I think, one case out of tens of thousands of people who were classified as - our terminology - casual-plus. So, that very casual exposure rather than in close contact, only one case has arisen there. And, therefore, the - we've adopted the response. The advice now is based on what we have learnt and the very, very low risk that there is transmission - that people who have been in locations of interest, where this exxo sure is very low risk, they are not required to isolate and be tested as they have previously, but watch for symptoms. That is what is behind the change.

>> I will come to Luke.

>> Probably one for Minister Hipkins.

>> Yeah.

>> When you are talking about the new mandated vaccines for health workers who deal with vulnerable New Zealanders. What's a "vulnerable New Zealanders"? What's the definition.

>> Those who can't be vaccinated, those who are unwell and, therefore - seeking health care.

>> What about - I mean...

>> And our older New Zealanders, home care workers come in.

>> Anybody over 65?

>> Yes. That's one of the reasons why we included the home-based care sector. Both ends of the spectrum - those caring for elderly in their homes and for very young children in their home.

>> If you're in the healthcare system, you have an illness, perhaps a disability, you know, something that may potentially make you more at greater risk, if you happen to contract COVID-19.

>> This - is there an expectation that this will be standard to other workers like physios? Osteoss others...

>> We haven't considered that. One thing we will be looking at in due course, of course, is that for personal services, for those who are providing services where they are coming into close contact with people, there is going to be consumer demand for the people providing those services to be vaccinated.

>> So there is no consideration being given - active consideration being give tone that...

>> Not right at at this point.

>> OK. Sorry, if I may... I am going to come to Mikey. And then Ben.

>> In terms of the vaccination register that was mentioned in the press release for schools...

>> For education, yep.

>> That's to do with students, is that because there's a requirement for anyone over - between 12 and 16 who's at school to be mandatory vax vaccinated.

>> There are no requirements on the learners to be vaccinated. That is important. We're not going to exclude people for - you know, from being able to participate in education, either because they can't be vaccinate ed the or because they have chosen or their parents have chosen not to vaccinate them. Bear in mind, one of the reasons that we are particularly conscious of education is that a very significant number of the children in schools can't be vaccinated at this point.

>> How difficult was that balance, making that decision, given the height of expectation around students, around staff, sorry, and volunteering parents? Was that a tough decision? What do you say to parents who may want to see those student whose are eligible to be vaccinated?

>> I would encourage all those young people who are eligible to come forward and be vaccinated. We are seeing a good uptick in the last couple of weeks of the number of young people coming for ward to be vaccinated. Particularly as we offer vaccination in more education settings. Many schools are working with their local health providers get vaccination available in schools. I'd encourage them to take that up. But this Government and previous Governments for a long period of time have taken the view that people who hasn't haven't vaccinated shouldn't be excluded from education. In fact, often those are the very people who need a good education.

>> (INAUDIBLE) unvaccinated students?

>> Depends on age. Dr Bloomfield, you want to get doing that? There is a differentiation in research based on age.

>> Yes. Certainly schools haven't previously been a setting where you have seen a lot of transmission. All they have they have found in the UK with widespread transmission, which they still have there, despite high vaccination rates in their over 16s they are see high levels of infection in school-aged children. I should point out schools are required to record vax nate status of students. This is extending an requirement, which will be helpful if there is a case in a school to identify which children or students who may have been at high risk.

>> (INAUDIBLE) on behalf of a colleague. In terms of health, why did you release the directive without providing more specific detail as to who this applies to, ie do hospital cleaners come under this?

>> Ultimately we are looking at those who interface regularly with patients. So, that's broad terms the definition. Dr Bloomfield can speak to that.

>> (INAUDIBLE). Maintenance staff has been covered off under education.

>> Mmm.

>> Contractors. So, how is that different in a hospital setting with cleaners?

>> Mmm.

>> My understanding is it's the vast majority of staff working in healthcare facilities who may have interaction with either patients or residents of residential care facilities. But there will be a lot of spec - a lot of specifics made available. It will be very clear who will and will not be required to be vaccinated.

>> It is something we have been consulting on for a little while as well. Iming go to Gena and then come back do Ben.

>> The ministry said it's not unexpected there will be Auckland DHB star members who acquire COVID-19 within the community. Are you accepting, then, that there may be clusters around hospitals?

>> No. The comment there - we have seen there from the start of the outbreak and brave outbreaks - because our DHBs are probably three of the largest employers, these people are being infected in their lives outside of work. And - when they are identified, of course, then there is follow-up to ensure there is no further spread within their work places, given the fact they are healthcare settings.

>> Actually, in healthcare settings, the transmission within healthcare settings has been well controlled.

>> Yes. The only ones we have had in the entire outbreak are the ones in the last day or two that - around the dialysis unit at North short # shore. -- shore. Otherwise no on ward transmission.

>> With the voluntary surveillance settings of hospital staff and all corrections staff?

>> I can't speak to the latter. What I can say is in the Auckland region, hospital staff have been amongst the most regularly tested and have got some of the highest testing rates. There's been widespread ongoing surveillance testing of the healthcare staff.

>> On Corrections, keep in mind Corrections actually are maintaining a COVID-free environment for existing inmates. Those who are coming into custody are being tested in order to determine whether they are potentially a risk to that COVID-free environment. And staff do have high rates of vaccination and Corrections are working to continue to ensure that's the case. Those who have - in the past been in contact with positive cases have been vaccinated, staff are in PPE.

>> Because of the risk of and outbreak...

>> Sure.

>> And officers that may catch it d.

>> And it's fair. I wouldn't... I don't think we would rule that out in the future. For instance, we are looking at ongoing surveillance testing in high-risk work places going forward. And wed are, of course, trialling the use of antigen testing for healthcare staff and people coming into ED. Looking broadly, what are the high risk settings where an outbreak is problematic? Tilde include corrections -- I would include corrections. We will keep that under advisement. I will come back to Jane, Ben. Michael.

>> Te Paati Maori says not to put Auckland back into level 4 and the rest of the country into level 3 is a modern form of genocide, given the vulnerability of Maori. What is your response.

>> I disagree.

>> Is there enough being done to protect the vulnerable communities? We know the vaccination drive. Is it too early to open Sydney Cup.

>> I couldn't consider level 3 opening up. We are still in very heavy restrictions in Tamati may -- Maukoto. Vaccinate rates need to left. We have positive indications. For Maori over 65 the lowest rate across the country is for a first dose is 89%. In fact, many of the areas are above 90%. We again see high rates for our over 50s. But we need to continue to see the rates pick up across every single DHB and we're putting a huge amount of effort into that, as our our Maori provide else as we speak.

>> (INAUDIBLE) for Maori to get vax knitted in this context -- vaccinated in this context.

>> In my view, the urgency is across the board. Yes, there is greater urgency for Maori because we have seen - we have seen lower rates. But let's celebrate the high rates, particularly for our over 65s, they are impressive, the rates that have been reached, which shows us what is possible with that ongoing evident.

>> Prime Minister...

>> I did say I was going to come to Ben, didn't I? Yes.

>> Cases are going up in Auckland at a time when you are increasing freedoms. Are you tracking how many cases are coming from those reduced - increased freedoms? The work places under level 3 that were allowed - under level 4? Have we had cases at picnics that have been taking place?

>> To answer your second question, no. The health advice is no, we haven't seen any cases that emerge from those changes. And if those rules are complied with and followed, nor would you expect to. Social distancing and being outside, if done properly, is considered to be a safe activity. I would again ask everyone don't treat it casually. The guidance we give is for reasons. It's based on evidence. It's based on what we know of Delta. So, if you follow them it will be a way to keep yourself safe. But, again, the level 3 rrkss is, they are still tight. We ask people to follow them.

>>..an acknowledgement that transmission is at the level 3 businesses.

>> We have seen work places where we have seen cases. So, you have heard me talk about construction, food delivery and taxis. So, those are some - some of those are work places that become open and available at 3. I don't think it's fair to say that we would have had, say, zero cases or no increases in cases where it not for that move. I don't think necessarily that would be the case.

>> Can I ask to reflect on the 4-day trip you made to (INAUDIBLE) and other places. Did you see it was worthwhile...

>> Yes.

>> It looked enjoyable. Would you suggest it would be possible for other high-profile popular people in their regions to go and try salute the (INAUDIBLE)?

>> I'm not sure I would describe myself in that way. I'm not sure if that is what you were doing. I consider it worthwhile. I make sure I am contactable at all times. More of a struggle in some parts of the country and others.

>>. I tested that. Staying in close contact with - in particular, Minister Hipkins, as we had some decisions that needed to be taken. But next to that, the most important thing for us right now is lifting those vaccine rates. My message was not just one of thanks to those working on the ground, but a message that has Minister Hipkins said, this is not a city problem. We have to make sure that nowhere in New Zealand considers that Delta and this outbreak is only age issue for Auckland. We will be in a disastrous situation Federal Parliament we don't see vaccination rates high across if country and already you hear those from Ragland commenting they didn't think it wonderful reach them. Delta finds unvaccinated people, no matter where they live. So, we have a duty to make sure that we find them first with our vaccine programme.

>> (INAUDIBLE) or other people...

>> Yes. Absolutely. And I know that our programmes - our providers, are looking for those local heroes and influencers, but actually everyone is an influencer within their own family and the number of times that I heard someone say to me, "I wasn't going to do this, but my niece encouraged me", or my aunty is a nurse and told me I needed to come or I came because I was worried about my baby sister. Those people are as influential as anyone else.

>> Quick one tore the director against...

>> Sneaky.!

>> Given the increase in (INAUDIBLE) cases and R value increasing, coupled with the high (INAUDIBLE) rate, what gives you confidence that Tour Down Under the current settings it's working and (INAUDIBLE) well the health system.

>> Current hospitallationations are 33. Steady on ICU at 7. One additional cases we have is in Starship Hospital. That's again an individual who cannot be vaccinated. That is again why it is so important that the rest of us are. As you will have heard me say, when followed carefully and when those restrictions and the rules around them are followed, they can be done safely. So, it's our job to continue to reiterate - you know, why it is we need Auckland to continue to be cautious. But also keeping in mind this is the longest we have ever had these hear, restrictions. We do -- harsh restrictions. We need to make it easier for Auckland to continue to maintain them as well. We will keep monitoring that R value, keep monitoring cases and we will keep monitoring vaccine rates, because we believe they will also make a difference in the long run.

>> (INAUDIBLE) if cases get up to 100. That will start to overwhelm contact tracers, hospitalisation rate, higher level (INAUDIBLE) overwhelming the health system and there would need to be a sir set breaker level 4.

>> 100 cases does not necessarily mean it would overwhelm the health system.

>> Two things. First, we would always give advice based on what we are seeing in front of us. And we and and and won't resile from giving what we think is the best public health advice. The second is, you know, we're in a position where our vaccination rate in Auckland and across the - in Auckland 87% of people have had the first dose. It continues to increase. And that - so, 100 cases amongst people who - some of them will be vaccinated and - in what is an increasing highly vaccinated population is different from 100 cases in an unvaccinated population. And, therefore - we have shown in this outbreak, as has happened in other countries, that vaccination is - makes a significant difference on hospitalisation rates and death rates.

>> Jason?

>> For the Director-General - are all COVID patients in hospitals being treated within Auckland? Or are there some in other parts in country?

>> There is one in hospital in Waikato. And one in Palmerston North who what the driver who was admitted a few days ago, but is improving.

>> No new admissions to either of those hospitals. Sorry, I will come to Derek. Sorry, and then Bernard. Sorry.

>> I wanted to ask if you know how many contacts there are Waikato and Northland.

>> I will... Document if I let Dr Bloomfield flick through his notes to see whether...

>> Haven't got it broke undone by region. But we can provide that.

>> Yep.

>> Is there another vaccine available in New Zealand (INAUDIBLE)? We have agreements with other...

>> A good question.

>> Might be teachers and healthcare workers who have medical reasons not to take Pfizer and (INAUDIBLE) unfair to have a...

>> We have been thinking about that for our other mandated workforces.

>> There isn't one at the moment. We have got both Yanson and AstraZeneca approved. We have are working with both to ensure we can get supply or t'other.

>> (INAUDIBLE) outlined today by Minister Hipkins shouldn't... When do you think they will be available for those?

>> We have been working... We have been working on that for a while. It had been straightforward from the suppliers' end.

>> We will update as soon as we can about the availability of a second. We would see that as exceptional. One thing is that the Pfizer vaccine has shown its very highly effective and also has a very good safety profile. That's why we have based our programme on that one.

>> Bernard?

>> Prime Minister, do you think you can easy restrictions in Auckland or anywhere else before Maori and Pasifika, particularly young ones, have a first dose vaccination rate that is above 90? Can you...

>> Let's get high rates and then you won't have to ask me that question. It is one of the reasons that we have been very cautious about being too simplistic and just saying when we reach X rate, then Y whether happen. It does matter whether or not you have good spread across rage range and across different ethnicities and communities. It was clear from the modellers, keeping in mind that they do model differently and do have different outcomes in different numbers, but they would all agree if you have large unvaccinated groups who are more likely to socialise with one another, such as young people, you are more likely to get outbreaks, even if you had a 90% rate. That is why even spread is important.

>> What is the threshold that you're looking at then before restrictions can be...

>> Two things? We want higher vaccination rates. We have said that - as a general rule of thumb, while we haven't attached movement based on this, we are aspiring to 90-plus. But at the same time, that is - it is movement is not contingent solely on that. It matters what is happening in the outbreak and the impact on our hospital system. Ultimately, our - we are not going to simply say that a hospitalisation rate is all that matters. We don't want people broadly affected by COVID if we can prevent it.

>> Last one, Bernard. Thempb I will come to Jenay.

>> Does that mean you could ease rrkss before those most vulnerable young Maori communities...

>> Safety - that would depend on what's lapping with the outbreak. If it is widespread, uncontrolled and is more likely to reach them, then that would be of concern. Our values here on COVID have remained the same. We do everything we can to prevent people having contact with the virus. As much as we can. Which is why what we are doing now is the exactly the same as we did on day 1. That is we are continuing to be very aggressive with COVID. Much more so than you see if other countries. That's for that very reason. We want to prevent people's contact with this disease.

>> Prime Minister, last week you suggested there could be more financial support on the way for struggling households.

>> Yes. I...

>> Do you have an update?

>> I will get Minister Sepuloni to do that. She does have announcements to make. I will leave that to her. I imagine that will be likely - I believe - over the course of the week most likely.

>> Can you give us any hints as to what it might look like? Dpluf described it. We are mindful of the impacts of COVID restrictions on low-income families.

>> Jo to you. And then I will finish with Henry.

>> On the Maori vaccination rates. Minister Henare said that the group that has been worked with, getting across the line, you are looking at conversations they are having with whanau leaders, support people, and that the next group that needs to get across the line is going to be more on n the category of 10 to 15 conversations. Are you concerned at I guess the time it might take to do that and what effect that will have, if it pushes out into next year? If you want that rate high as well, those conversations and that, I guess, comfort level could push out for quite a bit?

>> Not necessarily. I will give you an example. For instance, over the past four days, I've seen examples of where actually two to three conversations over the course of an hour was sufficient. But actually just the first ask want enough. The first conversation. And also the ability for an individual to ask some questions and then talk to a health professional on the spot really made a difference too. The second thing I observed is that even, for instance, through our drive-throughs, I saw some young people who had come along that day to observe what was happening, to ask questions, to think, and you could - you got a sense, because some were describing what it would take for them and that they were very close to being vaccinated that the next opportunity very likely that they would be. But we are at that harder end where it's not so much just having a vaccine station on the corner of a street is enough. We need to be proactive. Henry. And then we will finish. He's just left.

>> On education and other (INAUDIBLE).

>> One way to deal with a press conference! (LAUGHTER)

>> Have you used this time at all to install ventilation systems in any other schools or give money to board of trustees...

>> Yeah.

>> Given the science has moved so much on ventilation.

>> Yeah. I have had conversations with Minister Hipkins about this. I would rather he speak to it than me try to summarise some of those conversations. Some thought has been given to those issues and what the science tells us, but also what's going to be possible in some of those schooling environments. I will let him speak to that. OK. Thank you very much, everyone. See you tomorrow.

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