COVID-19 update 14 October 2021

>> Kia ora koutou katoa, greetings everybody.

I first want to acknowledge the absence today of a signing which interpreters, our regular provider has been unable to source a staff today Colmar however a transcript of this media conference will be edited Mac added to the Ministry of Link website just as soon as we possibly can this afternoon.

 I will now head over to Doctor Caroline McElnay the director of public health to update the case numbers for you and make other comments and I will also make a few comments before turning to your questions.  

>> Thank you Deputy Prime Minister and kia ora koutou katoa.

 There are 71 new community cases to report to date. Now being seen seen across many parts of Auckland.

This takes a total cases in this outbreak to 1790 of which 1189 cases have now recovered.

Today's new case numbers are sobering but not unexpected. Because of where we are in the outbreak. As we seek numbers increase it is even more important that people get tested if they feel unwell, and get vaccinated if they are not already.

Testing and vaccinations remain our best tools for fighting the virus. Please also wear masks if you are out and about and wash your hands often.

A reminder that at alert level III travel is restricted and only allowed in your local areas for permitted reasons. These include going to work if you need to, shopping  for food, and getting exercise.

The key thing is for separate families not to be mixing indoors.

Of today's 71 community cases, 32 are yet to be linked to a current case but interviews with these cases are being carried out today. Of these 25 interviews have been delegated to public health units outside the Auckland region to help manage the workload on the Auckland Regional Public Health Service.

Of yesterday's 55 cases, 21 cases remain unlinked at this point. With investigations also ongoing.

There are 33 people in hospital with COVID-19. Five of those are in the ICU or a high dependency ward. All are in hospitals in Auckland with the exception of one case in Palmerston North Hospital.

On testing yesterday there were 13,960 swabs taken in Auckland and 28,646 test processed throughout the country. There are 20 testing centres open in Auckland today including 14 pop-up centres. Please see the Healthpoint website for the locations.

 Just an update on Waikato, there are no new cases to report in Waikato today. The two cases reported yesterday remain unlinked but some potential connections have been identified and investigations continue. Genome sequencing from samples is expected later today and that will also help determine any links. There continues to be a great response from the people of Waikato with 3680 swabs taken yesterday and 6327 vaccinations given. Please keep up the great work.

An update on Northland, there also continues to be a great response in Northland with 2145 swabs taken yesterday. There are no positive cases in Northland. There were 3464 vaccinations given. And we can report that 54% of Maori in Northland have now had the first dose and there have been more than 200,000 vaccinations given throughout the region.

Just an update back to Waikato. There has been a positive  detect in wastewater in Te Awamutu. That was a sample taken on Tuesday. Follow up samples have been taken and we are waiting on results from those. The Waikato District Health Board Public Health staff are investigating whether this is a new case or an old case that might be shedding. We have had these situations before but in the meantime anyone in Te Awamutu who has COVID 19 symptoms or has visited a location of interest should get tested immediately. A pop-up testing site will be available at the Te Awamutu Events Centre car park, from 2pm today until 5pm.

COVID 19 was also detected in a wastewater sample from Raglan on Tuesday. This does follow from positive detections taken from samples last week. Again we have had a number of cases in Raglan, but a reminder that anyone in Raglan with symptoms or who has been at a location of interest at the relevant time to get tested.

I am pleased to report that there has been no COVID 19 detected in Palmerston North, there were some tetections last week but again we had  a known case who was in Palmerston North.

And finally today I would like top make a special mention of the 30,000 Allied Health professionals working in our Hospitals, Primary Care and Community Settings. Its World Allied Health Professions Day and there are more than 43 professions who play crucial parts in New Zealand’s COVID 19 response from lab technicians to Pharmacists, stenographers, physiotherapists, and others. And I’d really like to thank you all for your hard work.

Back to you Deputy Prime Minister.

>> Thanks you very much Dr McElnay

As you can see from today’s case numbers we are continuing to see a growth of cases in Auckland whilst containing cases in Northland and Waikato. We had been expecting and  foreshadowing that case numbers in Auckland would continue to rise. But they are climbing more quickly. We are continuing to act on public health advice.

Every day we discuss the cases and the numbers with  public health teams on the ground and in Auckland and in the Ministry of Health. Their advice has not changed. We can actively control this outbreak at Alert Level 3.

From the analysis done by the public health teams both on the ground and at the Ministry of Health ,  We can see that very few of the cases we see are the result of transmission in workplaces. Where they are coming from is still within households, some inner health settings, and a large number ingathering is taking place inside people's homes. We did see this happening at alert level IV as well. Sadly, it has continued into alert level III. These gatherings inside people's homes are not allowed under alert level III as much as they were not allowed under alert level IV.

My message today is clear. We need people in Auckland to stick to the alert level III rules.

 As the director of public health has just said, this outbreak is not in a small number of clusters in a small geographical area. It is affecting people in all parts of Auckland. That makes it everyone's job in Auckland to help prevent its spread. New Zealand alert level III is amongst the toughest set of restrictions applied by any country in the world.

The Oxford strategy index places New Zealand as the country with the highest level of restriction anywhere in the OECD at the moment. Level 3 has worked to contain outbreaks in Auckland before. But with Delta we know we are facing a more tricky and challenging opponent. We also know that the longer restrictions are applied, the more fatigue creeps in and our guard can slip. I cannot urge people enough that now is not the time for complacency. I have two very specific asks for people particularly in Auckland. Firstly, please get vaccinated. The first dose number in Auckland is around 87%, but it has not budged much over that in the last few days. Second doses at 66% are increasing. That we need to see both these numbers over 90% to really make a difference to cases and really ensure that our hospitalisation rates stay low. Secondly, we need people to follow the rules. Stay in your bubble. Wear a mask.  Maintain physical distancing. Do not mingle with family and friends other than in safe outdoor settings. Where we know the virus spread is limited. Level 3 is the highest level of restrictions currently applied anywhere in the OECD. They can work to limit case growth but only if everyone follows the rules. I am conscious that the longer the restrictions go on, the harder it is to maintain our defences. But it has never been more important to follow the basic rules we have applied since the start of last year when COVID first arrived in New Zealand. Treat those around you as if they may have COVID. Limit contact with others and maintain physical distance. Wear a mask whenever you go out of the house. Use the contact tracers app wherever you go. Wash your hands regularly. And get vaccinated. It is the best tools that we have to protect ourselves from the virus and to eventually move down our alert levels. If you are vaccinated, and you know someone who isn't, please reach out to them. Have that conversation about why you got vaccinated and what it would mean to you if they got vaccinated as well. Nearly every country in the world has faced the Delta outbreak. New Zealand continues to outperform others with the lowest hospitalisation and death rates in the OECD. As the Prime Minister said on Monday, we are at a very different phase make difficult phase of dealing with COVID-19 as we transition to keeping New Zealand assay through vaccination and other public health measures. We should not lose sight of the fact that our health response remains world leading and as vaccination rates increase, we will get to the other side of this outbreak without the carnage that other countries have experienced. We just need to stick to the tried and true measures that have worked for us before while we reach those higher levels of vaccination. A couple of other matters. Applications for the fourth wage subsidy will close tonight at 11:59 PM and the fifth round of the scheme open for applications at 9 o'clock tomorrow morning. The revenue test period for this is the 12th until 25 October inclusive. Far in this outbreak so far 717,344 applications for the wage subsidy have been approved with $3.2 billion having been paid out. The Resurgence Support Payment is paying out $960 million to businesses with their fixed costs, for the fixed costs like rent, taking us to a total package of economic support of just over 4.2 billion dollars. Finally on super Saturday there are a fantastic event been planned across the country, one that caught my eye particularly was the Air New Zealand, the turning of their Boeing 737 into a vaccination clinic at Auckland airport. People can board the flight to receive the vaccination and enjoy Air New Zealand's top-class customer service and hospitality. You can get a behind-the-scenes glimpse of an aircraft hangar, tour the Premier, and enjoy free in-flight snacks and get a special boarding pass to commemorate the moment. Meanwhile down in the South Island I want to acknowledge the Canterbury rugby union were are giving away 1000 passes in this weekend's clash against Hawke's Bay for fans looking to get vaccinated. Tickets are also being given to the first 300 people who receive their vaccination each day at the Christchurch Arena drive- through vaccination clinic on Thursday, Friday and Saturday. A reminder you can tune in on the day to the vaccinations on which will be broadcast on multiple platforms including TV3 multi-television from midday to 8 PM. For those of us old enough to remember telephones of the 70s, 80s and 90s, well-known celebrities, influences and health professionals will be live crossing to COVID-19 vaccination sites to capture the atmosphere and experiences of those receiving their first or second vaccine. We do need your help to make Super Saturday a success. Pop along to the events going on near you and help and encourage family and friends and others to do the same for our community. You can find out more information about super Saturday including where to get your vaccination on the unite against COVID super Saturday webpage or by calling the vaccination helpline 800 282926 and just a reminder for those walking -- watching that tomorrow, it will be a one-year media conference rather than the normal media statement from the Ministry of health.

 Happy to take your questions.  

>> However workers will at Auckland?

>> Still being investigated so I don't have the exact information on that stop I want to know the both of them have tested negative in terms of the virus. By and large I think that the boundary around Auckland is working well given the number of people who do need to cross the boundary for legitimate reasons. What we have asked the Ministry of business innovation and employment who have the responsibility largely for the release of exemptions to people, to take another look at the processes to make sure that they are working as well as they can.  

>> They have received an exemption?  

>> I don't have that information.  

>> You don't know how they were able to get across the border?

>> No, it suggests we are still investigating that and I have no at -- doubt we will find out quickly just as we did with the cases in Northland but I want to reiterate the boundary is by and large working well. There will be situations like this and that is why we have asked the Ministry of business to take another look at the way exemptions are granted to make sure that these sporadic cases don't grow.  

>> How is that going on with sex workers as well? Is the boundary working well if you are a sex worker? We have had a few examples now.  

>> You are telling me that, these two people have been identified in the media and I will not speculate on the occupations of others. Suffice to say that where there are cases of people and their role where that this happens, -- rare, we need to look at the systems.  

>> Is concerned about the plan for home recovery of positive COVID cases given case numbers are rising and so is the number of lawbreakers?  

>> I think we need to put that in context. As a piece of work we've been looking at in large part because it will be in the future something that we would be using. Where we have asymptomatic people who are vaccinated in the vaccinated environment, we always intended that people would be recovering at home. We are now working through the process of what that looks like and how to manage them. We have a home isolation pilot for people returning from overseas and we are working our way through those processes to make it as safe and secure as it can be but I do want to reiterate it was always part of the plan as we move further down the track to be able to ensure that those who need care within a health system and hospital system get it, but in a vaccinated environment, many people will be... Very few symptoms at all and will be able to live at home quite easily.  

>> Increasing in rule breaking, can you tell us whether they are parties or what sort of events they are and are you considering covering the rules on lawbreakers if it continues to happen?  

>> Yeah,, look, the information given today from public televisions on the ground is that they categorise them as gatherings -- public gatherings. In a sense it doesn't matter because gatherings inside houses where you are mixing bubbles are not allowed. Sadly we saw this at alert level IV as well and it has continued to bit at level III. In a way it doesn't matter if it's a party or any other kind of gathering it isn't allowed and we need people to stick to the rules.  

>> Will you make it happen?

>> You did ask that, sorry. Obviously we continue to look at all the rules to make sure they are fit for purpose and we work with the public health professionals on how it can be tweaked if it needs to be tweaked. We have not had the advice yet but it's quite clear this is a problem so we will be internally discussing.  

>> You said at the beginning but 25 were given to officials to help with the caseload? A confirmed contract racing has become too overwhelming for those on the ground in Auckland?  

>> We are not concerned. It is part of our model that we have been using right from the beginning where we... It is a network of public health units across the whole country and that has been happening since the very beginning of this outbreak. As the case numbers increase, the resources on the ground in Auckland gets more stretched and that does not mean to say they are overwhelmed, it's just part of the processes we have where we can allocate those cases out to other parts of the country.

>> Are you concerned about some of the comments about those refusing to get the anti-vax of -- refusing to get the vaccine to connect  

>> We encourage everyone in New Zealand to get vaccinated. It is vitally important for all of our future that we have as high a rate as possible and I think it is particularly important for community leaders to show leadership and get vaccinated. And so, I don't want to personalise this to that particular mare but she is in the media, it is clear that she has espousing views that are not going to help us get vaccinated. There are small numbers of people and you've heard it on the podium here in recent days you will not be able to use the Pfizer vaccine but it is a very small number of people. It is a safe vaccine, it is a vaccine that has been used all around the world, and I would encourage that particular mare and every other mare in New Zealand to promote vaccination. I would like everyone to be vaccinated.

>> A quick one on that.  

>> Will go over here.  

>> OK.  

>> Thank you, one of the reason she doesn't want to be vaccinated if she is waiting for Nova backs. She will not be the only one who has that position. What you say to Kiwis who were waiting?  

>> Maybe I will let the doctor add onto this but Pfizer vaccine is a safe vaccine. It is a vaccine with one of the highest efficacy is of anything out there at the moment. All around the world millions of people have received it and it is safe for them. It is the vaccine we have and it is the vaccine we are asking New Zealanders to use unless there is a medical reason otherwise.

>> I totally support that. We are aware that there are some people who have... Some individual concerns about Pfizer vaccine and that is why the government has other vaccines as part of the portfolio and we will be looking to get those vaccines in so that we can add to the portfolio but Pfizer vaccine is a very safe vaccine and has been used throughout the world very effectively. And we've seen that here.  

>> And Novo vaccine? It hasn't had the same trials?  

>> It is certainly not as widely used and it is not to say anything against the Novo vaccine but it is to say that we have Pfizer vaccine here in New Zealand. It is widely used, it is safe and we are asking all New Zealanders to get on board with that.  

>> Look, pointing to household breaking the rules and having gatherings, why are we not seen

>> Prosecutions?

>> Prosecutions are up to the police and sometimes they will be called to these gatherings. What we know is that the rules are very clear and people know they can't do this. But let me finish. The important thing here is that throughout COVID we have to rely on people to do the right thing. The police cannot be everywhere so even if they do find one and they do pursue a prosecution which they may well do, that is not going to be the solution to the problem. The solution to the problem is people doing the right thing and obeying the rules. They were going to summer, summer festivals, vaccination certification, it seems to be enough uncertainty that... That festivals are being? Is there any assistance or anything to shore this up so there is more certainty over summer? Or will we see more of this?  

>> We've been consulting closely with the event industry about vaccine certificates so they are very well aware of the direction of travel we are going on. You have heard described here that those large-scale gatherings will need that so people know that that is going to be part of the future so there should not be any uncertainty whatsoever about that. In terms of the second part of your question I do know that ministers Stuart Nash and David Clark have been discussing with the event sector what kind of support could give assurance about being able to carry on with events. I'm sure if you ask those offices you can get an update on that work. Coming down.  

>> What is your list for the 30 case numbers or the number of active cases and contingencies for Auckland when things need to be rolled out?  

>> Well, a lot depends on what happens over the next few days. We have been working really closely with our colleagues in Auckland to make sure that they are prepared for any increase in hospitalisations or ICU admissions. Based on the numbers that we been seen over the last few year my days, we will expect a doubling of cases over the next 14 days. That is assuming that the trend continues. And we don't know if that is likely to be the case because again reiterating with the Deborah minister has said, by people following the rules in alert level III, we expect that we are able to get a lid on the situation in Auckland but certainly we've been working with the Auckland district health boards to make sure they are prepared. The do you have a best estimate on those contingency ICU plans?  

>> We are already doing the planning. There is a lot of work. I mean, it's not just about the current beds they've got all the current ICU beds. There is a lot of planning around how we can start to change our approach and that is where the... Management of the community and in the community.

>> The important point here Derek, yes, the planning has to happen, because that's the responsible thing to do, but bear in mind where we are today with five in ICU. Our level of hospitalisation, hospitalisation rates, remains relatively low and so ICU capacity is fine at the moment. But people of course need to prepare for the prospect that it might grow. No, but I think the way you are describing question makes it sound like it's an imminent problem but it's not. But it is a problem that is being worked on.  

>> So as of Monday, three in hospital and if we get a doubling of cases, it could be in 12 or 14 days, I'm just trying to get an idea...

>> The bottom line is we don't have the exact information here but again be clear, the number of cases, hospitalisation rates, number of people going into ICU, the number of cases at the moment isn't giving us the high levels of hospitalisation or the high levels of ICU that are directly related.  

>> Asking you about contact tracing, does the Ministry of health have an idea of what the saturation is for the contract raising capacity in a delta sense in Auckland? Obviously with the outbreak, maybe a month or so ago, getting a few cases a day that the Minister of Health said we could have a thousand new cases a day and capacity was stretched and it was nowhere near a thousand.  

>> Yeah, the capacity is very much dependent on the amount of detailed investigation you do with each case and that is where we can certainly cope with a large number of cases but it does mean that the detail, the detailed investigation into those cases, would decrease. We would still be putting in place the management because the real focus is on the contacts and making sure that those contacts are identified quickly and that they are quarantined so they are not passing on the infection. Because we work as a national system I've been assured that we have the capacity to deal with the numbers we are dealing with. We are not seeing any pressure across the system with the...

>> I'm asking particularly about more data coming on.  

>> The latest I heard yesterday was about 170 or 180 cases a day would start to really put pressure on the system as a whole. And then, you know, what we are also doing to support that is how we can use technology better to allow you to then deal with more cases. Again, some of the interviews that we do, the details we going to, we are looking at ways on how we can prepare.    Not cover the Ministry of health so that they can do 6000 contacts per day. But how is six contacts for a case seems quite long. What would happen if you sort of exceeded six contacts?  

>> That was raised to modelling that was done last year and what was seen certainly with this outbreak was that we tend to see a lot more contacts with the cases because we have large households. We are already factoring that into how we manage those contacts. That is already there in our planning.  

>> On the vaccine hesitancy, the data that has been collected, what about people being worried are any extra efforts being made?  

>> Collecting data on what?  

>> Pregnant women.  

>> Not aware that that has been recorded as part of the vaccination event. We may have other ways of obtaining that information or at least getting an estimate of how many of the pregnant women are being vaccinated. We can look into that and get back to you with how we might do that but it is not generally recorded when you are vaccinated.  

>> Let's be very clear. The vaccine is safe for pregnant women. There is no evidence anywhere in the world to indicate otherwise.  

>> The border controls. We have seen that whole region essentially shut down because of a breach. How urgent is that work that you are getting done to look at those rules? And is that something you have seen happening?  

>> Applications?  

>> To go across the border. Is that simply want to crack down on?  

>> On that particular point I haven't seen any particular evidence but indicated in Auckland I think there were some difficulties getting older people but I do not think that was necessarily because of the contact details they provided were fake they just were not necessarily at the place they had provided at the time when they returned Auckland. In terms of the overall answer to your question. I just want to reiterate. The boundary is by and large working well. Given the numbers of people coming across it many of whom have very legitimate reasons to do so, we have to be careful about that management and so guess it is an important piece of work to see if there are process changes or there are ways we can make sure the small number of people who are misusing the system are caught up with and that is the best work underway.  

>> On testing delays, the time it is taken between getting a swab and notifying a case, how many positive tests took longer than 24 hours to return?  

>> I personally do not have that information. That is a question you have already asked and the Ministry of health will follow-up on.  

>> Good days and days so masking, how many positive cases the return, taking longer than 24 hours back to return?  

>> I do not have that metric for specifically what you are asking but what I was informed about earlier today was that the median turnaround time for tests in Auckland is 24-26 hours comment that is the median and certainly our expectation has always been that the test will be turned around within 24-48 hours.  

>> That is not happening so I want I want to know. What I want to know is how many positive cases are taking longer than 24 hours to return?  

>> I don't have that information with me. We have metrics on the time that it takes and we have published those metrics in the past and we can certainly get those metrics put on the website.  

>> 80% within 24 hours, of all test. That was before Delta. And were not even hitting that Mark.  

>> I'm going to drop you because you have asked that question and Doctor McElnay has said she doesn't have the specific metric. If it is OK. We have given you the number of the meeting of 26 hours. There will be from time to time situations we do not meet that. That is unfortunate for those people and it can cause real distress and I apologise for the distress that causes those people. But it is a rarity. If it was not a rarity, we would be hearing a lot more about it. Guess, it has happened in those cases. But it is not commonplace. Was the longest it is taken to return a positive test result to a positive case?  

>> I would have to get that information. I have not got that information but I want to reiterate that it is our expectation that the turnaround time is 24-48 hours and on the whole that is what we are seeing with our labs. We certainly have been assured of that earlier today that our labs are processing results. If there has been a specific situation that I'm not aware of the details of it but if there is a specific situation we are very happy for any individual to let us know and we can investigate to see what happened. Because sometimes there are specific situations, things that have happened, but that is not our expectation at the Ministry of health, that you have that delay.  

>> What I'm trying to understand is why no one at the Ministry of health and only you, Doctor Bloomfield and anyone else stands at a podium can tell us how many of those test results are not coming in within the gold standard. There was a gold standard pre- Delta and no one seems to be monitoring or tracking that data of those delays.  

>> That data is tracked by our labs and labs pass that information through to us at the Ministry.  

>> I believe the response has been entered.  

>> You have both characterised the case and was today is not unexpected. Yesterday you said that the growth was significant. I think this is quite a scary prospect for TVs. To state that it is not unexpected must be you have an expectation, can you share with us what you expect the parameters of cases to be? And will it tick up to that limit that was talked about before of 170, 180 per day?  

>> We have been clear that the reproduction rate is somewhere between 1.2 and 1.3. That means if you follow the maths that we will seek those cases continue to rise. What we know is that absolute 33, is working well and we should be able to keep it down around 1.2 and even take it below that. What I want to reassure New Zealanders today is that there are going to be more cases. That is going to happen. What we are really looking out for now is what happens with those cases. Do they end up in hospital? Are we concerned about what that means for our health system? And for people cosmic help? The good news as I have said before is that our current rates of hospital as Asian state relatively low. That is good. One thing that can help is getting back stated because we know that even if you get it you will not get as unwell. On the trajectory we are on at the moment we will see cases getting towards the triple digit mark but we can manage that if New Zealanders and if people from Auckland in particular for the rules.  

>> The circuit breaker and that was ruled that yesterday. It seems to me that hospitalisations is the key measure for you, will grow in numbers of hospitalisation levels put that back on the table?  

>> Important to note that we talked every day with our public health officials on the ground and here in Belgium and so we listen to their advice. Their advice has not changed. Of course, we continue to look at the circumstances that are in front of us. Alert level III provides us the ability to be able to manage this outbreak. That advice has not changed. If the facts and circumstances change, of course we consider the advice given to us.  

>> You are giving a wishy-washy answer. You could have given the response at any time during the pandemic. What is the thing that you are looking for to put their back on the table? Maybe you should ask Doctor McElnay.  

>> The edge of your question is the circumstances as we stand now, that advice has not been given to us so there is not a number. The directives of your question is that there is not a number. Of course, however, as we look at the circumstances, if the facts change in the nature of the outbreak changes, we will listen to the advice we are given but I want to reiterate that is not the advice we have been given and the advice we have been given is absolute level III, it is working properly, it can manage this outbreak.  

>> I just want to clarify, when you say we are likely to see Dublin of cases in the next 14 days or so do you mean a doubling of the number of daily cases or total cases?  

>> That is only what the model assuming nothing else changes, that is what the 1.2, 1.3 says, if nothing else changes. That is daily.  

>> In that case can vehicle to move to home isolation at that point right?  

>> As we said yesterday there are a number of options to us in that regard. That includes those coming across the border into New Zealand and it also includes the potential to move towards home isolation as well.  

>> At what point do you just get out of it because it is not worth it anymore.  

>> I do not think there is a point, there will always be a need when we have positive cases who need that kind of support and management. As I said in an earlier answer, as we move through a more vaccinated population, you are likely to see more asymptomatic people who can look after themselves will atone. That was always in the plan because once we get to those levels of vaccination via comfortable with, we will still get cases and therefore people will be managing.  

>> For New Zealanders overseas at the moment, you getting one case at the border every day but we are getting 60, 70 in acuity, is it that we are still not letting TVs come home during outbreak?  

>> We will be looking at the relative public health risks as we move through what minister has described. Those are the kinds of judgements we need to be looking at, but we are not without cases coming across the border as well. We have to work your way through that. Obviously we look at relative risks and as we moved to a position that we want to make sure we get those who did that support, need to be in an isolation or quarantine facility that the right people are there.  

>> Pretty bleak scenario over the next couple of days. You're likely to seek cases keep going up. Is there any hope that the Monday cabinet needs and says that Auckland is ready to relax any restrictions?  

>> We will take that advice would be get it. As I have reiterated a few times today, alert level III as it stands now remains a way that we can manage this virus. We will take the advice and listen to it but I will not pre-empted today.  

>> I have been told by a well- placed source that over half of the cases they are mild and can you confirm that and how concerned are you about that?  

>> I don't have that specific piece of information in front of me but obviously in an outbreak like this one we have seen different ethnic groups be at the forefront of the outbreak at different times and obviously the outbreak began as an outbreak among the Pasifika community and it is different to parts of the population. What I would say is that in the end what goes are interesting, what is most important is that everybody in Auckland takes responsibility for adhering to the alert level III restrictions. This is not an issue for any particular ethnic group. This is an issue for everybody in Auckland and indeed for everybody New Zealand.  

>> I asked because obviously they are more at risk not putting the blame on any particular group. With the contract to get answers about which independent experts advise this move away from elimination and the stages and let 33, can you tell us which independent experts advise this move in any of the experts?  

>> Be advised that we get comes from the public health unit and the Ministry of health and I am aware that the intern talked to people across the community including those on the ground but Doctor McElhinney can characterise the way you make the decision on that advice.  

>> Yes. The question is what you mean by independent, we have a process where we review the outbreak, we review the situation, we have public health experts who are employed by the ministry but also we have public health experts working at Auckland Regional Public Health Service and in the District Health Board is in Auckland and meet with them. We discuss with them the situation. And we provide our combined advice which goes through to the director-general and from the director-general through to the ministers.  

>> Some of the most prominent commentators on this pandemic they say that they were not consulted about this pretty strategic shift, so why can't the government named the independent experts?  

>> What you heard from Doctor Caroline McElnay is that they have a process of working through with people who are public health experts and people of that advice. It comes to us through many different sources, because we hit it through public discourse and through directly sometimes from those public health experts so we are very well aware of the views they are espousing. We have a process that is tried and true. We have run it throughout this process, throughout the pandemic. It has guided our decisions. We are still being guided by public health advice.  

>> It has been a week since the morbid woman was located. You have any confidence that these women are going to cooperate and if not what is Plan B if they continue to refuse? 

>> I don't have particular entitlement.  

>> The advice we got yesterday is that we do have as much information as we were going to get from those individuals and that is what Northland have used to guide where they have got their testing stations and any locations of interest that are there. The strategy if you like in Auckland has been to encourage testing throughout Northland and to really encourage vaccinations.  

>> In Northland for the women to be identified, the communities do their own contact tracing, is the women's right to privacy in Northland... The writers?  

>> No, we are safety -- focused on Northland safety and health and we have been working closely with the public health officials and working very closely with those who are contact who have been identified to be able to maximise and reach into the areas where we think they may have been. There is, I believe, a location of interest where they went to a hairdresser and that will be identified and people will be able to see that. That information has come from the work that is going on on the ground. We simply have to deal with the situation that is in front of us now. Matters around what might happen to the two women remained in the police as hands and I think I might have read that their options are in that regard... Sorry, Charlie?  

>> Just a question on Auckland health services, why is it that dentists can operate at level III and argue looking at reconsidering that?

>> We have been having discussions around what we call allied health support because there is obviously a concern that some of those services are very important people in need to be used and there have been some discussions about that and we would awaiting some advice. Up the back you?  

>> How many COVID cases...  

>> At the end.  

>>  

>> How many do we expect the isolated home in the next month or so?  

>> I don't have a specific...

>> Oh, it's hard to generalise over the next period of a month, but well, in the short term, because what we're doing with the home isolation for cases is using a risk-based approach and our regional public health are looking at the cases that they got so that will be a smaller number in the first instance but with the ability once we've got system set up to have a much bigger proportion so it might start off at about 10 or 20% and then could increase to 50 to 60% but the important thing is that regional public health have to do a risk assessment and that does depend on what they see as the risks and then we need to have the systems in place to be able to support those people to isolate safely at home. And have their welfare needs met.  

>> Sorry, to clarify, when does the first instance kick in?  

>> Throughout the outbreak there has always been individuals who have been enabled to stay at home for a variety of reasons. Our medical officers have had that ability. Just at the beginning of a process of confirming a process with Auckland district health boards to have more people staying at home so it's just right at the very beginning.  

>> Bear in mind the facility still have beds, we have rooms, we are going through the process now. As we've seen people have done this for medical reasons, they may have some equipment they need to be near, sometimes for specific personal reasons we have manage that process. Now we are beginning to look at contingency planning but it might be needed relatively needed to be able to move to that. We will go back there.  

>> On the number of unlinked cases obviously it has risen dramatically in the last fortnight. What was behind the massive rise in the system being overwhelmed? Is it also the nature of the cases and things on the tracer end?  

>> I think, I mean, you make a good point about the nature of the cases and we were just talking before about the evolution of people who particularly perhaps have come via the gatherings and so on but I've mentioned which are not necessarily easily identifiable. The second thing is it does take time to work through the cases and we do knock some of and then obviously you get larger cases throughout the day. It adds more into the system to be dealt with.  

>> With the 83 cases in the day, the number of unlinked were much... Far lower than that?

>> Manager of the Opera, at the beginning, we were dealing very much with a set of household clusters -- management of the outbreak. As we've seen the outbreak move on we seen a wide away in ways people are getting it. I mentioned in my opening comments examples of people going into health settings and another example is the private gatherings.

>> You've spoken a lot today and been asked a lot today about the license. Have you given any consideration to that advice to the public? It is a good enough? There is immense public interest right now in seeing that information and it is very timely. Why not move it out sooner?

>> It is not something that as you can imagine I'm presently dealing with and so I'm happy to take that back and talk to the Prime Minister's office and others about it being expedited. The I'm really confused about the timeline of things here. The home isolation might start pretty soon but you are taking some decisions about MIG and how people who are vaccinated might come but there are different accounts from ministers on how quickly it could occur. Could it be as soon as next week that you make decisions about changing the setting of the order?  

>> So we at the moment have enough MIG space to deal with the cases coming through but if they continue to come through in higher volumes we will need to start moving to a different process. Decisions on the process are being worked out now so they can then be deployed as soon as they are needed. Part of the decision- making process is the risk assessment process as I said earlier on, to look at the risks of people coming across the border versus the risks of people in the community. Secondly, part of the picture would then be making sure that we have those who can look after themselves at home and look after themselves at home. The fact that the work is going on now is a useful thing to do. We will keep an eye on the case numbers. Our first and best preference remains putting people into M IQ.

>> If someone is in the UK and they are checking furiously on the M IQ system right now, they are trying to get a spot, should they understand that things might actually look really different as soon as like a fortnight comes along?  

>> You imagine with great respect to those people, and I know it's a very difficult situation to them, that is not how we are looking at it. We are looking at it from the point of view of how we manage cases and using the advice that we give about risk and how we do that. I can appreciate them by doing that it looks like their experience could be different but we have to do it the other way around about the way in which we continue to protect the health and well- being of New Zealanders and the way we manage those cases.  

>> The risks of changing. How to -- could be in a couple of weeks?  

>> If the cases keep rising on a curve that they are wrong and you look at the number in the M IQ places we got we will need to move in the coming weeks but we are doing that by working out our way through what is effectively a risk-based process, looking at the border, looking at where we have cases in the community, and looking at what self isolation looks like. Barry myself isolation is always part of the plan. We are now trying to bring some of that work forward but it is most definitely a part of the plan.

>> Back on Sandra Goudie, is a mandate for community leaders or public officials on the cards at all? Is that something?  

>> It's not something we discussed. Don't you ruling it out completely?  

>> It's just not something we discussed. Just a few more. Jokingly  

>> When you were talking about how you were going to develop M IQ are you talking about just taking cases that are turning in when it comes to the COVID cases and putting them into self isolation or will you look at everyone being treated on a risk basis in terms of self isolation which would be obviously very much for your 4M IQ allowing you to bring more people from overseas back and is said yesterday, the five to seven day potential, bringing it down to a smaller number for double vaxxed people, it was shift significantly the number of people coming from overseas. Can you clarify what steps you are talking about taking a  

>> On that exact point it is a risk-based assessment, and assessment underway right now and we were open about the fact that that's what we are considering. That is the policy work being done right now and yes, as I've already said, it would result if we went to seven days for people from overseas from everywhere, from some places, that would change the configuration of it. That is the work that is underway right now.  

>> It is it... Is it based on the domestic cases all self isolating and opening up in IQ space or is it based on just the ones that can't currently under the numbers...  

>> It is based on risk and not every person and in New Zealand will be able to be in a position to solve isolated home. That is what is been brought through.  

>> Minister...  

>> They told you that half the cases or today's cases were Marie Mack. Is that an interesting fact? Can I expect you to reflect on that language? Do you have another way to describe it?

>> There is nothing pejorative about that. It is a fact, there is nothing pejorative about it if it's true and I don't have that information in front of me. The point I was making was that I don't want this to become a situation where we are ascribing a particular part of the pandemic to a particular community. The point I was making was that this is the responsibility of all Auckland is to be able to deal with it.

>> The point on stigmatising and we know that Maori people are more likely to die from COVID-19 the data is important so why do you say?  

>> I really don't have that piece of information in front of me right now. I can easily go and get it and confirm it. We are acutely aware of the importance of making sure that we vaccinate all our population including Maori. We have huge campaigns underway to do that. We are well affair of the fact they regrouped in our community who are more vulnerable to COVID and so we constantly think about that and there is nothing I believe that I set my answer that would undermine that at all. Just a couple more.

>> Going ahead today with the COVID-19 technical advisory or and other experts and public health officials for today, can you tell me what will be discussed in the meeting and as it was brought forward because of the concern of the lack of consultation from experts?  

>> I don't believe it was brought forward for that reason. I believe given the nature of the outbreak where we are today, that we wanted to get advice from the group in a range of different issues as far as I'm aware.  

>> What will be discussed?  

>> That will emerge over time but it was the breakout as a whole, where we are at, going full, you will be well aware of the prime minister has had a couple of times lately that we are looking to make some announcements next week around the next stage of how we manage the outbreak in terms of the frameworks. There is questions there that we want the group to reflect on as well as the outbreak as it currently stands.

>> That will be fresh? Will Auckland be scrapped?

>> There has been a lot of calls but we will get your advice in Cabinet on Monday. Just a couple more.  

>> On booster shots is it something that the government is getting advice on this week? Is that right? Going forward is it something you want to see?  

>> I know there is work underway on booster shots. Just to clarify again, we have enough doses in New Zealand for us to be using the current Pfizer vaccine to be able to begin booster shots. There is a lot of work to be done to work out the best way of doing that but that work is ongoing.

>> That's right. I'm not aware of the advice or if it's gone up that has been a very active piece of work.  

>> Term.

>> Just in case numbers you mentioned before around spread with indoor gatherings and health settings but you have a breakdown of roughly how many are happening in workplaces like building sides and supermarkets? And also the start of the pandemic which suburbs in particular have cases? Do you have that separately now?  

>> Very few of the cases are coming through under worksite. Very, very few. That is not where this outbreak is going at this stage. In terms of suburbs I did make that point in my opening remarks. This is no longer an outbreak about a couple of clusters and a couple of suburbs. This is an outbreak that is now affecting all of Auckland and therefore we need all of Auckland to play their part. Last one?  

>> Thanks, a couple of the nuts and bolts. The South Island businesses are incredibly frustrated that there is no plan for their pathway forward. Is there a plan for the South Island in level II and if there isn't will the pathway be announced?  

>> As I just said the Prime Minister has foreshadowed a couple of times that she intends to talk about the next steps in terms of the next framework and how that will work and they will obviously include the South Island which will happen this week.  

>> On the vaccine mandates, the guidance has not yet been issued to health and education employers. Given their 16 days level healthcare workers to get their first vaccine where will the guidance be announced?

>> I'm not aware of the particular status of. I know there was consultation as the guidance mandate was developed and I can't speak particularly about health and I don't know if the doctor has anything

>> We will follow that up.

>> Obviously we are aware that people need to know and that the broader mandate was announced and was very clever people.  

>> The government lost control of the COVID response?  

>> Absolutely not. Where we are today is one of the triggers with the COVID-19 but we still have in place some of the strictest alert level restrictions in the world. We are still able to stand up here each day and tell you how many cases there are, that the cases are being followed up. One of the lowest hospitalisation rates in the world, one of the lowest mortality rates in the world, we are at a very difficult pointing COVID as we translate and we can move forward from there. During this period we need people in Auckland to obey the alert level III restrictions and that is what will make sure we keep the outbreak under control. Thanks.