COVID-19 update 15 September 2021

>> Tena koutou katoa,

I will hand to Dr Bloomfield for the case investigations and I will speak about the vaccination program and user and managed isolation and bookings.

To you, Dr Bloomfield. 

>> Te Reo Māori (Speaks Te Reo Maori) we are in the third day of Maori language weight and I hope you are improving your Te Reo during the week.

 There are 14 new cases of COVID-19 in the community, all in Auckland and it takes the total number of cases in the outbreak to 983.

There are also three cases of COVID-19 in our managed isolation facilities.

Again today, early on it is clear that our current new cases are linked to existing cases. An analysis of yesterday's 16 cases showed that three were infectious in the community, creating 10 exposure events, however these were largely essential businesses such as petrol stations and dairies, the visits we would expect people to be doing and prior to when people were notified they were a contact.

On testing, huge thanks for people in the suburbs of Mount Eden, Massey and others who have been out and got tested. We saw an increase in testing across Tamaki Makaurau yesterday with 341 people taking the opportunity.

A huge thank you to everyone across the Motu, 15,105 tests processed yesterday. In terms of the Auckland boundary, later this week police will begin checking that people who are permitted to cross the boundary have proof they have had a test in the last seven days. Anyone who needs a test can go to any community testing centre, GPs or urgent care clinics providing that anyway in the country. Or they can book in with their GP.

Saliva testing is now an option and we've seen good uptake of saliva testing with 176 employers covering more than 1800 employees signing up to use that modality.

And in addition, over 350 individuals have also signed up.

On contact tracing we now have 996 active contacts being managed by our team and public health units across the country and of those 93% have had direct contact and 91% have returned at least one test. Continuing follow-up happens with these people to make sure they get there later tests as well.

 As has been reported already, a worker at the Auckland hotel managed isolation facility has tested positive for COVID-19 as part of routine surveillance testing. There is a potential link with the community case so at this case it is not being considered a result in consider -- transmission and we are running the genome sequencing which should confirm that case is linked to the existing outbreak. We know the worker was fully vaccinated and is also now in quarantine.

 I want to emphasise the vast majority of doctors and other health professionals support our vaccination program. More recently this has sparked a deliberate grassroots initiative of doctors who want to help answer questions that people may have about the vaccine. This is called Doctors Stand up for Vaccination, within less than 40 hours of this being promulgated on social media there were more than 200 signatures of support from doctors, and in a week more than 4500, there is huge support including doctors from our vaccination program and a small number who don't agree with the program.

 There have been claims on social media that people's natural immunity or vitamin C are sufficient to fight COVID-19 so there is no need to get tested or vaccinated. This is not the case. This is an infectious virus that can cause serious and ongoing health problems. Not just the acute infectious illness but as you No, long COVID symptoms.

And an update about treatments for COVID-19 in New Zealand. Yesterday I noted my warning about potential misuse of Iva than which hasn't been shown to be safe or effective for the treatment of COVID-19. Even though there have been a relatively few cases in New Zealand, we are up-to-date in terms of our knowledge and use of appropriate treatments, good processes in place to assess emerging new treatments in a fast and proven approval process when we decide on which ones we want to use here.

Just a note on how the main medications and treatments for COVID-19 work. COVID-19 infections caused two major issues and people, first of all the viral attack on the body and the harm that causes in and of itself and the second is that in some cases the virus can trigger an immune reaction which can cause further problems. New treatments are now being investigated and indeed used to cover both these areas and they concentrate on three domains.

First of all, antiviral drugs that limit the ability of the virus to replicate and thrive in the body. An example is rendered severe that has been used quite awhile internationally and is being used in New Zealand.

Secondly there are medicines that calm the immune system overreaction that is prompted in some cases, particularly those who would end up very well and in ICU, an example is dexamethasone, a widely used steroid which has been part of our treatment protocol for some time for people who are very unwell in ICU.

 And third their antibody treatments that help the body fight the virus. Studies have shown that one of these a monoclonal antibody may help hospitalised patients by reducing the severity of their infection and the length of time they requiring hospital.

FAR recently completed consultation for treatment of moderate to severe COVID-19 in New Zealand and they will make a decision soon about its ongoing funding but in the meantime it has been used and funded by FAR and more than 30 patients. There are several other monoclonal antibodies approved overseas under emergency authorisation and FAR is discussing those with the manufacturers and suppliers, two new treatments are showing the most promise.

The first is Rona praise coming showing promise in helping cases from developing. It compliments rather than replaces vaccination as all these treatments do. An application has been made to made safe in the last couple of weeks and the UK counterpart of med safe has approved the treatment of the UK. We are looking at the evidence to see if this is a medication we want to use in New Zealand and then we will move on the funding of it.

A second promising monoclonal antibody treatment, another one similar which compliments rather than replaces vaccination. Some good data coming through from evidence in trials and made safe has not received an application but the ministry is engaging to explore potential supply options and encourage an application for approval through, in the meantime any of these medications can be prescribed by a doctor if they are indicated and if available here, even if there is not an approval, they can be prescribed off label. We have a technical advisory group of clinicians who meet weekly since August and it is providing updated advice to us all the time on emerging treatments.

 Finally a shout out for our midwives and in particular those working in Tamaki Makaurau during alert level IV.

As you would imagine much of their work is face-to- face and with the usual protections and use of PPE to ensure pregnant women get the care and services they need.

Happily, babies don't know it is locked down and they continue arriving. It's timely to arrive anyone in the country who is expecting a baby about the importance of getting vaccinated. We have seen some unvaccinated pregnant women arriving in hospital with COVID-19, quite unwell, as a result of the virus.

It is very clear from experience globally and our expense here with a large number of pregnant people now vaccinated, there are no additional safety concerns with getting the COVID-19 Pfizer vaccine, it is safe at any stage in pregnancy. And vaccinating during pregnancy also helps protect your baby as there is evidence that infants can get antibodies of the virus through cord blood and then through breast milk.

Most importantly, the vaccine will keep pregnant women out of hospital and if they are very unwell, out of ICU. Both as a time to celebrate, not a time to worry about the effect of COVID-19.

(Speaks Te Reo Maori). 

>> Some good news out of Auckland International Airport, the first batch of doses we purchase from Denmark touched down a little over an hour ago. These 250,000 doses, along with the 275,000 doses purchased from Spain last week means there is nothing holding back our COVID-19 vaccination campaign.

62,000 doses were administered across the country yesterday, 26,793 of those were in Auckland. That meant nationwide of our eligible population, those aged 12+, more than 70% have received at least one dose of the vaccine, 36% have received their second dose and are therefore fully vaccinated.

However underneath those numbers sets some  challenges that we still need to highlight. 48% of Maori have had their first dose, 23%, their second, 62% of Pasifika peoples and 32% of at their second..   

We are particularly focused on Auckland this week of course. The Auckland DHBs have so far vaccinated over 1 million people with over 500,000 people receiving both doses.

By the end of this week we want everyone across metropolitan Auckland to have had the opportunity to have had their first dose. We are making every effort to make sure that happens. The northern response vaccination centres are allowing walk-ins out all of their community vaccination sites.

 The number of pharmacies joining the vaccine rollout continues to rise. There are currently 51 pharmacies across metropolitan Auckland carrying out vaccines and so far they have delivered over 170,000 vaccinations. A further 81 pharmacies will be joining the program very soon. At GP clinics 118 sites are live and a further 109 are being brought on board.

As the Prime Minister revealed previously, we are launching our first vaccination buses tomorrow. Details are being finalised but they will be acting as pop-up vaccination centres to deliver outside of the bus to ensure that appropriate social distancing can be observed. We will be taking the vaccination buses to areas where vaccination numbers are low or where we know communities might find it more difficult to access the existing vaccination services we are providing. We are looking to extend this program to 12 buses so we can reach communities across the wider Auckland area over the coming weeks.

We want to make it as easy as possible for everyone to get vaccinated and particularly so if you are in Auckland. It is our best protection as we plan to move down alert levels. I want to managed isolation in quarantine.

As I indicated here a couple of weeks ago we had to make a difficult decision to pause the further release of vouchers or managed isolation in light of the growing number of community cases we were needing to accommodate at our MiQ facilities and I want to acknowledge again now as I did then that the challenge that poses significance challenges for Kiwis looking to return home and for others who have a good reason for wanting to come to New Zealand.

 Today I have some further good news, I can confirm that ports will be lifted from Monday, 20 September. The local pressure on our MiQ system has started to ease and we have rooms available between now and Christmas. The first 3000 or so of those rooms will be released from Monday. 4000 rooms per fortnight will be released in stages over these months as is our usual practice. As I signalled previously, the way people apply for these rooms will change.

 Some critical times. From 8 AM on Monday New Zealand time, the lobby will be open. And the room releases will start from 9 AM. The whole system is designed to improve the experience for those using the managed isolation system and to level the playing field but I want to stress again, it isn't a silver bullet and we are fully expecting there will be more demand for the rooms than there are rooms available.

While we make it easier for people who are fully vaccinated to come into New Zealand, while we are looking at options to do that from next year, we expect that pressure at our managed isolation facilities will continue at least until the end of the year.

More than 170,000 people have come back into New Zealand through that system. That is a much larger portion than other comparable countries have accommodated through their managed isolation, but there of course our unavoidable constraints.

The lobby system is a big change. All the detail on how it will work will be on the MiQ website shortly but I want to make a couple of quick points. It's not a first in first served model. If you join anytime between 8 AM and 9 AM New Zealand time, that will secure the ability to participate.

Anyone who enters the lobby during that time will have an equal chance of getting an invitation to book. People will be held in the lobby until the room release begins and then people will be automatically are randomly moved into a queue. When they get to the front of the queue they will be gradually allowed through the website to secure a room.

There is no need to refresh the website regularly anymore, there is no limit on the number of people that can enter the lobby, thus registering they are trying to secure a room. Once all the rooms have been taken, the lobby will be closed, anyone who is left in the lobby will be informed that the bookings have been completed for the day. That is until the next tranche of rooms is ready and we will signal when those rooms have been released so people can take part in the process. It is important that people know their preferred flight route and select the correct date for revival -- arrival.

We don't want people to grab any date if they are at our flights available to get them there at that date, we could waste rooms when we have demand that such high levels, we don't want to see that happen. People need to check the flight checker on the website before the lobby opens and select a appropriate date. For people who are wanting to travel from Australia, Mondays release will not include flights from Australia, they cannot participate on Monday. However we are releasing a another voucher release in September that people in Australia can access. We can confirm that when a decision on the trans-Tasman bubble which were expected to make in the next week, we will signal availability of red flights for people coming from Australia. I want to work out, remind people overseas or Australia or anywhere else, where there is a need for urgent travel you don't have to chance your luck. There are criteria for urgent travel and we have rooms ring fenced for that. If you meet those criteria, if you need an emergency allocation, check the website to see if you meet those criteria and put in an application if you are successful going through that process, you won't have to go through the booking system.

Happy to open up the questions. 

>> The system is based on luck rather than need on the length of time you've been waiting, why is that better? 

>> Those with an urgent need to come home can come home and if there is time sensitivity, we work hard to accommodate that within the emergency allocation system. This new process we put in place means the luck is equally shared, rather than whether your web browser is faster and you are reflecting faster or whether you happen to be online at the time the rooms are released. We are trying to give everyone an equal opportunity.

>> People are suggesting a points system, if your need is greater and you've been waiting for longer. Is something -- is that something you have considered? 

>> There is a lot of complexity for a points-based system and for a two-week stay in isolation, standing up a booking system based on what would effectively be an detail needs assessment, evidence that could be verified, the burden associated with that would be significant. We think about the nearest comparable examples it's people applying for visas, you work your way through the points system, it takes months to process that. There is an army of people who verify that documentation. Therefore you are going to do that with managed isolation room for a two-week booking it would be a huge system and it would potentially take longer for people to access vouchers. 

>> Any idea roughly how many people, the demand? 

>> The first opening of the lobby will give us an indication of that. But I want to reiterate the importance of people having their flight details sorted so they are not jumping online and booking anything available because that would potentially mean that we wouldn't get the best use out of the rooms available. There are a lot of Kiwis out there, how many are planning to come home we don't have an accurate gauge at. 

>> Can you guarantee that the system cannot be gamed? 

>> The lobby system is designed so that digital bots and algorithms cannot game the system. There is no way to lockdown people getting other people to book on their behalf. Sometimes there could be legitimate reasons for that. It's not something we encourage but there could be legitimate reasons, it's a very difficult thing to stop. 

>> The system was designed so that bots cannot game it and Kiwis have a fair chance? 

>> That's correct. 

>> Is it fair that superannuated so having their pensions cut because they cannot get spots in MiQ? 

>> My colleague Ministry of Social Development has been working on that issue, that sits in her portfolio area. I haven't had a chance to talk to her about that in the last few days but she's been working on that. 

>> There is this issue of Kiwis stuck overseas and they can't get home in 26 weeks... 

>> I know she is aware of it    

>> How far in advance of the first flights, and how far in advance will the lobby keeper been opened up four flights in the future ?$$NEWLINE

>> This deals with bookings between now  and December and typically we release the closer bookings in larger numbers and hold back some of the further advance dates but we release some of the further advance dates so we won't release a lot in December but we will release some. We will receive a lot of October capacity available. We will release that next week. There are some bookings that are quite short a notice bookings, space available so some start in September and some of that will be released next week. There is not a lot but it will be released next week, some in October and some in November and then in the forward months. 

>> Is it acceptable to be To people during a pandemic 

>> Different country selective incisions on that. 

>> What about Fiji who are having a rough time at the moment 

>> I am not involved in that decision, other ministers have jurisdiction there so direct your questions there. $$TRANSMIT$$NEWLINE

>>  Considering there is difficult to deal with the pandemic and knowing what is happening in Fiji at the moment. $$TRANSMIT

>> We have people on the ground in Fiji helping supply vaccines to Fiji, as a global community we are in this together, and the issues of deportation is not what I am in a position to comment on. 

>> This is one thing the lobby is designed to achieve, a risk we have had previously is and  we foreshadow rooms for bookings and everybody jumped on at the same time and try to book them at the same time and the whole thing would fall down. This is a way to allow people to get on the website and register their interest in booking a room and do it in large numbers. The system manages the through demand as they go through the process to make sure the site can cope. If there are tens of thousands of people access rooms at the same time that will create problems. This will avoid the problems. 

>> With the vaccination rates why are some DHBs lagging behind or getting ahead with vaccination rates and why are some lagging behind and what has been done to work with those DHBs. 

>> Each DHB has put up a plan for how they are going about vaccinating going to start with groups 1 to 3 and I am not bothered about them getting ahead. It is always relative in some DHBs that are below the average. They all are delivering ahead of what the original plans were and there is no problem with capacity in the system to deliver, and the opportunity is there for people to be vaccinated. 

>> Some DHBs are making it easier, why is this.  

>> Differences in how they bring on general practice and pharmacies with different approaches. If you look at some of our DHBs with more rural populations they need specific initiatives to get to those populations. I am confident that every DHB has the capacity and different approaches in place to ensure that all of the population can be vaccinated by the end of year. 

>> What about letting people out of MiQ when they are cases, how can you be certain that an asymptomatic case is no longer infectious without testing them. 

>> We do a clinical assessment to make sure they have not had symptoms for at least a 10 day period. And that it is least 10 days since a symptom onset and because of Delta and one of the things we have had advice on is we have increased that to a 14 day period before people are judged to be recovered. 

>> So be judged at 14 days. $$TRANSMIT

>> It has to be a minimum of 14 days +72 days with no symptoms. 

>> Minister there remains concerned that outbreak response was not focused on people of Marie mac and Pacifica people, could you have done better. 

>> With the benefit of high site you could have found things done better, but we go through a process of  identifying those so we -- where the response can be sharpened up we look at that. Some of this happens in real time, we identify improvements that can be made and we make them as fast as we can but of course we will look back when there has been something like this and say if confronted with this again other things that we would change. 

>> The approach to COVID 19 in New Zealand has served our community as well and we know that some communities can have adverse outcomes if COVID-19 was allowed to spread within our community. All New Zealanders have been playing a part in driving COVID-19 out of our community, which protects everybody. I absolutely stand by the decisions we have taken in that regard. Will there be things in the margins where we do things better, we always look of things. 

>> On people coming to Australia, an announcement on the trans-Tasman bubble coming next week, do you think we should resume lights with some states. 

>> We don't want to get at the head of the decision there as there are issues around flight scheduling and other things that need to be worked through before we give certainty to people in Australia. My clear message to people in Australia is I would not be banking on the trans-Tasman bubble reopening anytime soon. 

>> So if they use the MiQ system the bubble is out. 

>> I will not put a timetable  on this, if we are suspending the suspension, and if this is likely we will have to make a decision about how long we will do that. There are decisions that flow from that around flight scheduling and those sorts of things. We will have answers to that within the next week. 

>> On the vaccine rollout, obviously updated numbers have calmed down from a couple of weeks ago. Does it look like at this point  we have actually seen a peak of days and we would expect given the population that is vaccinated that that would continue to come back. $$TRANSMIT

>> I know the Minister has aspirations here and so do I.  I know we have days where we hid the peaks, and there will be a range of media channels that will support us, and it is important we get our vaccination rate up as high as possible and that means everybody eligible getting out there and being vaccinated because there is capacity in the system that we exceed our highpoints. 

>> So those under the age of 40, if we see them coming forward and looking in and there vaccination levels start to match those of older age cohorts, then we will continue to see a high level of vaccine delivery in New Zealand. There is no risk around supply as we have plenty of vaccine available. We have plenty of capacity and now it comes down to people booking in and coming forward to get the vaccine. 

>> On school holidays you say you are receiving advice from the Ministry to pull them forward, what is the thinking behind that, and are you leaning one way or another particularly in Auckland. Holidays. 

>> It is a complex decision, not just cut and dried and I want to acknowledge the parents, they have been at home for a long period of time with their children and this creates challenges. I will certainly look at what is best educationally for the children and I acknowledge strong feedback from the teaching community about the prospect of shifting school holidays this late in the year, given all of the other pressures going on towards the end of the year. I also acknowledge that the last time we did that was the beginning of the process. Teachers had not been teaching from home for that period of time, they have been teaching at home over the last month. There is a lot to work through and we have not made a final decision on it yet. There are arguments both ways, and we will make a decision ultimately based on what will be best educationally for the kids. $$TRANSMIT

>> Are you concerned particularly in Auckland that they are exacerbating the system.  

>> The divide existed before COVID-19, we have done a lot of work to close the digital divide to get connections to households that do not have them, getting digital devices to children who do not have access to them. We have not nailed the problem yet. So the distance learning capacity in schools does vary and some children are using  packaged material to learn at home and others are using digital. Many different models are being used and this creates unevenness and challenges. The best place for kids is in school, we want to have them in school as soon as possible. We don't have a specific timetable yet. 

>> Have you seen any increase in bookings since you have made the plea. 

>> Will ask Dr Bloomfield. 

>> There has been an increase in bookings and people going to the drive-through ones, but there is plenty of capacity. Please roll on up. The bookings are solid for the next 2 to 3 weeks. We want to complement that with people turning up and as the Minister said, all the vaccine centres will take walk up appointments, for people to just turn up. 

>> Should we go to Level 3 in Auckland next week, should they extend it to a full 14 day cycle. 

>> When we confirm these decisions we will foreshadow early thinking on timeframes and timetables. There was a lot of water to flow under the bridge, and as we know with the COVID-19 response there are no certainties and we must review everything every day based on new information. There are and courage in science. Dr Ling has already talked about case investigations today, there are fewer unlinked cases, while there will still be bumps and case numbers, particularly large groups of case context, it does not cause additional alarm. If people are expecting to be positive, it does not mean there is something to be worried about. If we saw a surge of unlinked cases that might be something to be more worried about. Generally speaking trends are in the right direction. Never say never. Things can change and change quickly. 

>> What are some of the options on the table considering it is unlikely we will reopen next week, what are some of the options and is it possible that we could say no Australians. 

>> Certainly possible. I don't want to pre-empt a cabinet decision, are we going to be reopening the transit Tasman bubble in the next week, I think people can see what is happening in Australia and what we are grappling with in New Zealand and know it is an unlikely prospect. As for how long the suspension of the bubble could go on for, we will look at this next week. $$TRANSMIT

>> When you make this decision will you give a date. 

>> It will be a rolling series of decisions because we'd don't know much around the bubble at this point. $$TRANSMIT

>> How many people can fit in the lobby at one time. 

>> I understanding is that is unlimited, people can continue to sign up getting there. $$TRANSMIT

>> If people can go on and cancel what happens, are they wasted. 

>> They are reallocated. We regularly release rooms that have been cancelled. 

>> So you will have a lobby system, and that will take place with the big bulk and any cancellations people have to check in daily if they miss out. $$TRANSMIT

>> We will look at the overall cancellation rate, as much as we can we would like to group rooms into the foreshadowed release of rooms. We have not made a decision on whether there will be out of cycle, rereleases of short gnosis vouchers for example. No decision has been taken. 

>> Dr Bloomfield following up on what you are saying earlier about more people to get that vaccine, at the beginning of the week 22% of eligible people have not signed up yet. 

>> I don't have that figure in front of me I will come back to you. $$TRANSMIT

>> Yesterday you commented on either nectar and -- you are speaking about the depth of a teenager how hard is this information and disinformation getting to the final point. 

>> Information around the vaccine has been out for some  time and I guess I don't think it is so much information, whether it is the right information or miss or disinformation the important thing is that we make sure everybody knows how they can get the vaccine and why it is important for them to do so. We have seen from this outbreak in Auckland, and it has given many people a reality check  that the virus is not just real but it can be harmful. We have had people in hospital and in intensive care, affected hundreds of people in Auckland. The vaccine is highly protective against symptomatic infection and getting unwell and dying from this infection. We have seen this in Auckland and people need to understand that and take up the opportunity. We have a good and safe vaccine. I don't want to emphasise misinformation out there because the vast majority of New Zealanders understand that getting vaccinated is the right thing, and we will make sure that they can. 

>> Some people are not anti- that's nation but they do have questions and this is legitimate. Make sure you ask the questions of the right people not those who are potentially spreading misinformation. Talk to your GP, or a nurse as they are very active in the vaccination program. Listen to the scientific community who are answering questions around the vaccine every day and get good reliable fact-based information for an informed decision. It is perfectly a K to have questions. We one should have questions comes to the sorts of things, but done not -- don't get sucked in, use reliable sources. We have consistently seen that the level of vaccine hesitance declining in New Zealand.  From the beginning of the year where it was a significant number to a much smaller number now, and it shows as the vaccines are being rolled out and people can see it is safe and confidence grows we can be increasingly confident that we can get up to high levels of vaccination in New Zealand. We can do this quickly. We have the capacity to do it.   

>> The difference between the vaccinated and unvaccinated overseas has become divisive and emotional. Is there anything the New Zealand government has done that will make New Zealand different? 

>> What we are seeing overseas as COVID-19 is morphing into a pandemic of the unvaccinated. Unvaccinated people are affected worse in places like the US where they have high vaccination rates in some areas and low rates in others. Of course we look internationally at that. What we are saying now, we stayed close to research on that around New Zealand s 's attitudes, we are not seeing people being sucked into misinformation in New Zealand at the same rate they are in the rest of the world. I am proud of New Zealanders for that. I would say to anybody who has those questions, ask a trusted source. 

>> Some modelling data shows towards the end of August Maori made up 10% of new cases in the community but in the last five days that has jumped to about 40%. Would you be looking at doing something different to help contain that? 

>> We are working closely with Maori and Pasifika health providers, vaccination rates are not as tight as they are for the rest of the population. We've younger age cohort in our Maori and Pasifika populations and the younger age cohort is more difficult to reach than the older cohort. We will be pushing out to make sure we do everything we can to make vaccines as widely available as possible. It's about encouragement but also about going to where the people are, making sure that the people who are going to where the people are, are able to provide them with reassurance, answer their questions, give them good in partial fact-based information so they can make an informed decision. 

>> There is another day at that shows that Maori are more likely to die from COVID, are these numbers not concerning enough to try to change the way that services other than vaccines are delivered to Maori communities? 

>> The Director-General would like to comment on this too but I would take my hat off to our Maori and Pasifika health providers who have been working hard to reach into those communities, to make sure they have good information and access to the vaccine. I would condemn those who are trying to undermine those efforts. 

>> Can I make a quick comment? One of the things that has impressed me about the vaccination program this year and the response to the outbreak over the last 4-5 weeks in Tamaki Makaurau, the way Maori and Pasifika have been involved in the testing and also the provision of support to those whanau that need that. In terms of the vaccination program we've had those providers involved from the start and you saw through the first 2-3 months the rates for over 65 where highest amongst Maori and Pasifika and that is because those providers were leading efforts and getting out into communities. I think we will see continued strengthening of those relationships and providers with further investment off the back of both vaccination program and the outbreak response. 

>> There is a report this morning of the person who breached the Auckland lockdown and travelled and is facing prosecution. Do you have any details about that situation, how they got out of Auckland and whether they are vaccinated or tested? 

>> Those are issues for the Auckland police, the New Zealand police who enforce the lockdowns and those who are permitted to move around, that is an issue for the Health Department. Particularly not if there is a prosecution looming or some kind of enforcement looming, those are matters for those agencies. I would simply say again, the vast majority of people in Auckland are doing it tough for the rest of the country and we thank them for that. And the actions if there are a handful of people who are not doing that, they are undermining the collective team effort and they should not. 

>> There is another report this morning about a small outbreak, do you have any details about that, specific supports that have been offered? 

>> All I would say again as we share information we collect from people where there is a public health rationale to do so. We don't typically disclose the background information on positive COVID-19 cases or their contacts unless there's a good reason to do that. I don't intend to start doing that now. What I can do is provide reassurance to everybody that we are seeing a great amount of cooperation and willingness to engage from the communities, all of those we are seeing testing positive in the current outbreak. 

>> Can you clarify how often the MiQ rooms will be released? 

>> We foreshadow they will be regular, weekly or fortnightly and we will say when we are releasing them again. 

>> For Kiwis in Australia, is it fair that they cannot be included in Mondays release alongside everybody else alongside other countries around the world? 

>> For people in NSW we worked very hard because they were the people who are ultimately captured by the sudden closure of the trans-Tasman travel bubble and they didn't have an opportunity to return home, in every other part of Australia there was an opportunity for people to come to New Zealand before the suspension kicked in. For those in NSW we have worked hard through a prioritise process to make sure those who needed to come back were able to. I appreciate with the passage of time, people who were able to sit it out for a period of time may not be able to do that indefinitely and that's why one of the reasons why next week when we make that decision we will set out more specific information for people. I know there are Kiwis there who want to get home and they are front of mind. I don't want them to feel they have been forgotten, they have not. 

>> Is it urgent enough to make this is day by day stuff and you are pushing it off another week. 

>> I acknowledge COVID-19 has caused huge disruption for a lot of people. We currently have Auckland at a high alert level which is restricting people from going what they would normally do. It is difficult and I acknowledge that and we will provide certainty as soon as we can. 

>> You are cutting off their pensions while they are overseas in a foreign country. 

>> That is a question for the Ministry of Social Development, she has been working on that. 

>> Do you note how many people have been using Ivermectin and is it becoming an issue here like overseas. 

>> I don't have data on how many people have been using it, I know people have been requesting it from a GP and you would have seen Doctor Brian Betty a couple of weeks ago from the College of GPs addressing this and reminding people it is not a safe treatment and they shouldn't ask for it for this purpose. There have been people who tried to import it but I don't have any numbers on that. 

>> Is that concerning, that it isn't recorded? Should the numbers be recorded? 

>> I don't think it needs to be recorded and one of the things I have emphasised it is not a proven safe treatment is because it is of concern if people believe misinformation if that is the case. It is not a safe proven treatment but what people can do if they want to be safe from COVID-19, they can be vaccinated, that is safe and effective. 

>> On the couple who went from Auckland to Hamilton, do we have information on what exemption they used to get across the border? We understand they took a commercial flight back to Auckland, is that appropriate given the potential risk you make 

>> I don't have any further detail on that. 

>> Judith Collins former press secretary had a go at Judith Collins saying the attack on Susie Wiles was unacceptable for the leader of the National Party. You agree? 

>> I notice Judith Collins on radio New Zealand said this morning that thought leaders should lead by example stop I agree with that. I can only take from that she does not regard herself as a thought leader. 

>> They have been suggestions around businesses offering cash incentives or prizes to get people vaccinated. What responsibility to businesses have for encouraging their staff to get vaccinated? 

>> I think businesses should encourage their staff to be vaccinated, the best thing they can do is make sure they have the time to be vaccinated and support them in that decision. We are seeing really good support from employers for people to do that. I don't have anything further to say around incentives at this point. Ultimately the biggest incentive should be that people don't want to get COVID-19 and want to protect themselves and protect their families and community. That has to be the number one incentive here. Everyone should be focused on that. Vaccination keep yourself and the people you love and care about say. 

>> Monoclonal antibody drugs, why did we not proactively request clinical trial data from the manufacturer and instead wait for them to apply Accure 

>> Med safe requires the applicator and -- the manufacturer to put in an application. That doesn't stop those medications from being used. There is a section under the medicines act that allows clinicians to use those medications even prior to an application and approval and in this case, they can also be publicly funded. 

>> Should (inaudible) discharged herself before the results, should she have been able to go while there was a test pending given Auckland was in lockdown? 

>> That is not unusual, there is no obligation on anyone to stay. As soon as the positive result was received, the important thing is the person was followed up and found quickly and that triggered a range of follow-up contact tracing. 

>> Considering the number of people at that residence where she returned to come is there any broader risk because of the number of people involved? 

>> The reason she returned to, her whanau, her partner and a young child, and what I can say is both she and others who have been contacts have been well engaged and cooperative with the follow-up contact tracing and that is what we are after, we need to find cases and stop any further spread and in that case there's nothing I'm concerned about. 

>> The vaccine data released today shows that only about one third of a group has been vaccinated but that is 60% of group 3. Do you have any concerns about that? 

>> There is potentially data issues there. Some of the estimates of the size of group 3, some of those people could have been vaccinated as part of group 4, I'm happy to crunch let down, I don't know if the Director-General wants to add to that. All the earlier groups are subsets of group 4, some would have been vaccinated through group for that could have counted in groups one, two or three. 

>> I would add that if you think about group 3, we should be looking across and combined groups three and four what the coverages. Groups one and two are different because they are higher risk occupations and we are particularly interested in getting them fully vaccinated as soon as possible. 

>> Over the last couple of weeks each day there has been at least a few cases that were infectious in the community, not usually a nudge -- a large number. How load is that number need to go before you feel confident with the likelihood they might be a couple of cases each day that are infectious? 

>> I've never put hard and fast numbers on anything. Ultimately you look at a range of factors. Are we seeing unlinked cases, people active in the community, what is the nature of their activity in the community and the level of risk that comes from that? How many people do we have isolating in the sense of known contacts that are waiting for test results, how many do we have test results for what does that tell us? These are all things we look at. There are not hard and fast rules here, you have to digest quite a range of different information in making decisions around alert levels and future courses of action. 

>> (Inaudible) 

>> Like I said, we should all lead by example of course. We should be kind and we should sometimes reserve our judgement on others, thanks, everyone. 

>> The Prime Minister might update tomorrow on that.