COVID-19 update, 19 August

Tena koutou katoa. Good afternoon.

There is quite a bit to cover in today's update.

I want to start with the latest on our work to identify the source of our outbreak. After Dr Bloomfield gives us the latest on our current cases, I will then share some of the work we're doing to accelerate our vaccination program. That includes ensuring that more New Zealanders are vaccinated generally, but especially those who are currently at most risk from the virus. I'll then finish up with an update on Afghanistan.

Let's start with the investigation into how these cases came into our community.

Yesterday, we confirmed we are dealing with the infectious Delta variant and that it came from Australia, via the NSW outbreak. I can now report, from the whole genome sequence analysis, that our current positive cases are a close match to a recent returnee from Sydney, who arrived on a managed red zone flight on August 7th, had a day 1 test on the 8th, returning a positive result on the 9th. They were transferred from the Crown Plaza to the jet park quarantine facility that same day. This person subsequently became unwell, and was moved to Middlemore Hospital on the 16th of August.

What this information tells us is that our cases are most likely to have come from the traveller.

This is a significant development. It means now we can be fairly certain how and when the virus entered the country, and that, based on time lines, there are minimal, possibly only one or maybe two, missing links between this returnee and cases in our current outbreak, and the period in which cases were in the community is relatively short.

There is still a chance that additional information could emerge to change this conclusion. So we do need to remain open to other possibilities. That means you will see our Public Health Unit continue to be very cautious around possible places of interest, and you will have seen that in some of those locations of interest to date.

However, the balance of evidence you now gives us enough confidence to focus our search for that missing link.

Our primary lines of investigation are staff at the Crown Plaza-managed isolation facility, where the returnee was originally based, staff at the jet park quarantine facility, and other MIQ and border staff involved in their arrival and transport from the airport and between managed isolation facilities. Middlemore Hospital is not a line of investigation at this stage.

The individual was only moved there on the 16th, one day before lockdown and delays after symptom onset in a number of our other cases.

So let's break down the possible points where contact with this traveller may have occurred.

On the 9th of August, when the case returned a positive result, our Public Health Unit kicked into gear, contacted Auckland airport and customs, who went through all the footage to determine any con it tact that positive case may have had with staff. This is our usual practice when we have a positive case in a facility.

Three areas of interest were identified. Customs confirmed with me again today that these have all been investigated and staff tested. Nothing has event gated from this line of inquiry to date. Let's then turn to our facilities.

There were 208 staff who worked at the Crown Plaza or the individual in - while the individual in question was there. Of though, as of today, only one of those 208 staff is now overdue for testing, and only by less than 48 hours.

For the jet park, there were 200 staff working across the site from the 9th to the 16th of August. As of today, two are overdue test, but again, by less than 48 hours as of today. All staff across both sites who have not been tested in the last 48 hours are now being retested.

In terms of vaccinations - across both sites, 407 people were compliant with the vaccination order that we have in place. That order requires all existing staff to be fully vaccinated. If a new staff member comes on board, they must have their first dose and complete their second dose within a 35-day window. Only four had one dose and were not yet due to their second. One person had gone longer than 35 days, and that person has been told they cannot enter the facility until they comply with the order. All remaining were fully vaccinated.

As you can see, the compliance generally across these sites has been really high, but we will continue our search in a thorough way across both sites, as you would expect, and we'll look to come back to you with detail on those additional tests we're running across both sights in future updates as those results come through.

The final point - we have learned today that a family adjacent to the case at the Crown Plaza has now tested positive for COVID on their day 12 test.

While we're awaiting genome sequencing, we can assume that means we're dealing with a high level of infectivity in this case. Everyone at the Crown Plaza will stay on while we undertake our usual protocols, but here is where our practice of what we call cohorting is really helpful.

People generally arrive at the same time, and stay for the same period in the facility. It really does reduce down the risks and means that we catch situations exactly like this one. So while today you will see we continue to find cases downstream, there could be relatively few cases upstream, as in people who picked up the virus from the very beginning of the chain. That's simply because it wasn't here for long, we believe, before it was found.

On that note, can I thank again our first positive case that was identified on Tuesday. If it wasn't for you getting tested when you did, this could be a much, much more difficult situation. Having said that, I know we're all prepared for cases to get worse before they get better. That is always the pattern in these outbreaks. But today, we believe we have uncovered the piece of the puzzle we were looking for, and that means our ability to circle the virus, lock it down and stamp it out generally has greatly improved.

I'll now pass to Dr Bloomfield to go over today's case numbers.

Thank you, Prime Minister. Kia ora koutou katoa

So today I can report there are 11 new positive cases of COVID-19 in the community that is since yesterday's 1pm update, taking our total number of community cases all in Auckland to 21.

All of these cases who are in the community are being transferred safely to the Auckland quarantine facility or are already there under the usual strict infection prevention and control procedures. 12 of the 21 cases have already been confirmed as being part of the same Auckland cluster and a further eight are currently being investigated, and are as yet not formally linked.

However, for a number of those, there are strong lead thoz them being linked to existing cases.

One of those previously reported cases of the 21 is confirmed to be unlikely to be linked to the cluster and that is the air crew member you heard me talk about in this morning's media round, so this is essentially a border-related case, probably coincidental, and that case was identified during routine surveillance testing. It's an international crew member.

So whilst we don't have the details on the new community cases available at this stage, and interviews are under way, we will release further information as it becomes available through the afternoon. Now, these new community cases are not unexpected, as the Prime Minister said, and we would expect the number of cases to continue to grow, in particular, because of the large number of locations of interest, and the mobility of these cases over the few days before the lockdown started.

There are also eight new cases in recent returnees in our managed isolation facilities. Two of those are historical cases and information about those will be in the ministry's press release.

Two of our community cases were taken no North Shore hospital overnight. One had worsening symptoms and the other is symptomatic and has underlying conditions. One of these people is in their 20s, the other is in their 40s. Both are in a stable condition.

The Prime Minister mentioned the Crown Japan plaza. As a precautionary measure a hold was put on some departures from the Crown Plaza last night hand that was in in response to this bubble of three people in the facility testing positive for COVID-19 at day 12 of their stay. This is something we do where we get an unexpected day 12 positive result to just make sure that there's no pots tension that others may have been infected after they returned a negative day 12 test. So the returnees who are on the same floor who were scheduled to leave overnight are required to stay there while it's investigated further and that is has included already reviewing of CCTV footage and running the whole genome sequencing on these three new cases that is due later with today and that will help us confirm the probable link to the case in the room next door. This was disruptive for those who had planned to leave and they will be provided with full support.

Unless there are specific issues identified that might be cause for concern, it's likely returnees on other floors scheduled to leave today will be able to do so. The overall assessment is that further transmission, based on what we know so far, is there is a low risk but naturally we're not taking any chances.

We thoif now received the results of waste water collected on Monday and Tuesday this week. The sampling collected on Monday returned positive results for waste water from three Auckland sites, Rosedale on Auckland's North Shore, and the western and eastern intersectors. Sampling from Tuesday at St George site in Auckland - and that's a subcatchment of the western interceptor, and that collects waste water from the Waitakari area lsh was also positive this follows negative results from these locations from samples on the 11th of August. I had one of my team just briefly - just quickly map out the locations of the cases and how those sit with respect to those - the drainage areas for those different interceptors and there are cases in all those areas that we know about now. So given we've only got the 21 cases so far, the sensitivity of the test something very high and it does help us with our assessment of the situation.

There will be further results available late today for some other samples taken around the Auckland region, and diszal results are expected tomorrow, including results of samples taken in several locations in Coromandel and Thames.

Other sampling undertaken on Monday and Tuesday at Mount Monganui and several other locations, Hutt Valley, Wellington, Nelson, Christchurch, Queenstown and Invercargill have all come back negative.

On testing, in Auckland, all community testing centres are open again today with extended hours through to 8pm. There are four additional pop-up testing centres open. There is some additional testing going into Avondale College for students to be able to be tested in a safe way. There is increased testing capacity in Waikato with a range of testing sites already in place. Testing sites remain open in Coromandel township and Hamilton. There was an excellent response there yesterday. DHBs right around the motu are ensuring there is good access to testing. We need anyone with symptoms right around the country get tested, to help inform our advice to the government about alert levels. Yesterday, there were close to 16,000 swabs taken across Auckland, the busiest day in in that area since August last year. Around 10,000 of those tests were taken in general practice and urgent care clinics and I want to thank our colleagues working in those settings who have really been very busy over this half the day, their busiest day ever. Nearly 3,000 swabs taken across Waikato and about 600 of those were from the Thames/Coromandel area A massive effort.

I want to thank those for their testing and waiting for testing for their patience. Please be kind to the staff there who are working as fast as they can. We will have more confidence in the advice we can provide the government around alert levels if we have good testing rates. So if you have symptoms, please get tested. There's a lot of contact tracing work happening across Auckland and the Coromandel, and that involves the Auckland regional public Health Service, our national investigation and tracing centre and all of the country's Public Health Units. Isolation by close contacts when in an alert Level 4 requires them to ice hate separate from other household members. So it's not isolating within the household bubble. As of this morning, more than 360 individual contacts had been identified. This does exclude at this stage contacts from large settings like the college and the church of Christ where there is still an assessment under way. Through the day today that number will increase significant lip. Details of additional locations of interest continue to be added to the ministry's website this morning. We are also going to put out regular through the day updates on newly emergent sites of interest, locations of interest through our various social media channels to make sure that it's easy for people to see just which are the new ones. It's very important that people look at the times as well as the place, because it doesn't mean if you had been at those places at any time. Please look at the time there. If people have been at a location of interest, remember the form is to isolate. If you are not already. In other words f you're not an essential worker t does mean you can't go out to the supermarket, pharmacy or anywhere else while you're doing that - while you're isolating, call healthline for advice. Our busiest day for healthline yesterday since April last year, and a record number of people accessing the ministerier of health web site, almost 1.3 million, largely looking for locations of interest.

On that just a reminder, there is a section 70 notice in place which requires everybody who has been at the location of interest to legally follow public health instructions, to ice late and be tested. There is a separate section 70 notice that applies to the household contacts of a person who has been at a location of interest. Under that section 70 notice - and this is a new thing - they are required to isolate as well, and this means they can't go out for any purpose, or if they are an essential worker, they need to isolate, until that person who's been at a location of interest has returned a negative test after Day 5.

We are also receiving a large number of complaints about enforcement, particularly about people holding gatherings and these are all being referred to police to follow up. Finally, it is a time of uncertainty, and so, quite normal for people to be anxious. Please, do keep an eye on each other. Last year, we crushed the curve by looking out for each other. Don't forget the smallest and largest question you can ask someone is "Are you OK?" Back to you, Prime Minister.

Thank you, Dr Bloomfield. As you can see from that update, Level 4 is where New Zealand needs to be at the moment. But as we talked about yesterday, we want to ensure we don't waste any time in vaccinating Kiwis. I want to start by thanking New Zealanders for continuing to take up the invitation to book are in - their vaccinations and remind everyone over the age of 40 you don't need to wait for an invit tags. You can go to the website or ring the 0800 number now to book yourself in. Yesterday was a record day for bookmyvaccine.nz with 195,537 bookings made in a single day, which is fantastic. During yesterday's stand-up, the 1pm update, more than 7,500 people per minute were using the site, and it performed exceptionally well. As signalled yesterday, a phased approach to reopening vaccination sites with the Level 4 protocols in place has now begun.

This enables everyone to stay safe while we vaccinate. So, please, if you have a booking, and you've not had any other communication from your provider, please, still go, because we're expecting you. Primary cares facilities have also resumed carrying out COVID-19 vaxxes today and with some less urgent appointments being cancelled as a result of Level 4, many now have extra capacity. The plan is to use that extra capacity to continue with those who are already booked in but to also bring through essential workers. Our plans to vaccinate these workers started with those who are customer facing, who interact with the public as part of their essential work. For example, supermarket workers who may not have been eligible because of their age bands to date. We're working with employers of these essential work forces to identify the individuals and workers, you can expect to hear from your employer with extra details. We're also working with the COVID vaccination healthline on a process for smaller businesses and people who are self-employed to enable them to book if they too fit that criteria. On that note I also want to pay sure New Zealanders that our vaccine supply chain continues to operate well with the deliveries continuing to go out daily. But again, please do book.

It just means that we can ensure good physical distancing when you attend your vaccination appointment. As you know, it's imperative that we get as many people as possible vaccinated. When we make a decision on who is eligible, though, our No. 1 priority is the medical advice of our experts. You will remember that in June, our regulator, Meldsafe, granted provisional approval for the iz Pfizer vaccine to be given to 12 to 15-year-olds in New Zealand. Similar decisions have been made by other regulators in Europe, the US, Canada and Japan. The advice was then considered by an additional group of experts, who also supported an extension of eligibility to young people. On that basis, Cabinet has agreed to make the Pfizer vaccine available for 12 to 15-year- olds. This is not a decision we have taken lightly.

Many of us are parents ourselves and take this duty of making decisions about other people's children extremely seriously, but it is safe, and it's the right thing to do. So 12 to 15-year-olds can become eligible and book, along with everyone else that we are opening up to from the 1st of September. We know, though, that a number of these children's parents will already be eligible to book their vaccines.

We want to be practical about this. So from tomorrow morning, parents and care giveers are eligible for their vaccines will also be able to book their 12 to 15- year-olds at the same time. But if you've already booked, then just bring them along. Please just make sure that while you do that, you work hard to keep physical distancing up from others. There are an estimated 265,000 people in the 12 to 15- year-old age bracket, so this is an important next step. Please be assured again, we have more than enough Pfizer vaccines for everyone, including the 12 to 15-year-old age group. As COVID takes centre stage in New Zealand, international events and obligations remain. None more so than our responsibility to New Zealanders and those who helped New Zealand in Afghanistan. Earlier today, we deployed a C-130 Hercules and supporting personnel to assist with international efforts to evacuate New Zealander, Afghani nationals an other foreign nationals from Afghanistan. The New Zealand Defence Force is preparing to deploy for up to a month and due to the developing situation in Afghanistan, sought approval from Cabinet to deploy up to 80 personnel to support the international response.

The contingent will include air crew and maintenance staff, a medical team to support our personnel and evacuees, operational support staff, logistics personnel and others. All personnel are vaccinate and will be carrying out COVID-19 prevention wrote comes. They will complete 14 days' managed isolation on their return to New Zealand. We would continue to work along side partners, especially Australia, as we respond to this rapidly evolving humanitarian situation. This means that we may see some individuals bound for New Zealand returned on partners assets and vice versa as our international partners look to cooperate wherever they can to safely expedite the evacuation of those most in need.

When we met this morning with officials, we were advised, though, that the situation on the ground is incredibly difficult. People are struggling to get to Kabul airport. We need to be prepared for how hard this mission will be, and how difficult it will be to evacuate those who we are seeking to help. Our thoughts are with our Defence Force team as they enter on this deployment. I know that you will do what you can. Before I conclude, some final public service announcements, back related to our Level 4 settings. First, we're being asked to remind businesses who are wanting advice or to know what support might be available to them that they can call the EMA's business help line on 0800 000 362.

Of course, MB also provides support through business Connect. Second, ministers have made a decision to extend the period for air travel from Queenstown and the Cook strait ferry through to 2359 on Friday, 20 August. This applies only to people need be to return home, and is in response to the large amount of demand that we have on those facilities. Lastly, I note everyone outside Auckland and the Coromandel in particular is anxiously awaiting news on how long their Level 4 conditions will remain in place. Ministers will meet tomorrow morning and we'll share a decision taken at tomorrow's update.

What I'd like to leave you with today, though, is some optimism, but also, a strong serving of caution, as you would expect. News that we believe we've identified how this Delta variant entered New Zealand should not be underestimated. It means that alongside the what, we now believe we have a good handle on the how and where.

That said, it is well known globally that Delta is tougher than previous variants of COVID. So while we have further information to inform our response, we also know it is going to be a tough fight, that we all need to play our part in. So, please, stay at home, wear a mask if you do need to go out, practise good hygiene, stick to our bubble, and be kind to those around you. While the high numbers of people getting tested has seen some people waiting in queues I want you to know that you are doing the right thing for yourself, your family, your community and New Zealand. High compliance alongside reports of low vehicle traffic tells me that New Zealanders are following the rules that will work and our public health units are reporting that when they are making calls to contacts, there is high compliance with Level 4 requirements. So thank you. Sticking together beats the virus and together, that's exactly what we are going to do. Happy to take questions.

How close are we to determine those one or two missing links and do you have a theory as to whether it was at jet park or the Crown plaza?

Everyone at the moment is focusing in on the Crown Plaza, just as as a result of timing. There's no other reason, really, more than that, than the timing of the onset and then some of the other cases that we're seeing. At this point in time, though, no, I don't have a working theory, but as you can see, we are chasing down every possible point at which this individual had contact with others, and just seeing if we can analyse every single element of that to see if we can find where this occurred.

(Inaudible) identifying the source precisely, how much of a bearing does that on whether we stay in lockdown longer

We're always worried about how far is the reach going and the spread downstream, but what we're really focused on is how long was it out there before we knew about it? So this information today gives us a good strong sense that it may not have been long. And that's really helpful information for us in making these decisions. But what about you, Dr Bloomfield?

One of the key reasons behind or key influences behind our advice to the government about the alert level change was how many undetected chains of transmission could be out here so what seems to be a short time period between when this virus arrived on our shores or this particular person arrived hand then the time frame between when the first person presented and then if we go back, when they became symptomatic is reassuring but the focus still remains very much on controlling further spread of the outbreak so it's a very important piece of information.

People should be preparing to lock down longer, though, shouldn't they?

We've already given the indication to Auckland and the Coromandel around what we believe our intention will be there for Level 4 over the seven-day period. So we already gave thaind case from the beginning. You can see with the fact that inevitably we always see cases go up before they come back down. But what we always try and do and what our Public Health Unit were talking to us about on our briefing this morning is just again putting that ring around the outbreak. The sooner we're able to do that, the higher confidence we can have but I'll really look to give people a steer tomorrow once we've had a bit more advice and evidence.

Isn't it too late to start prioritising potential services? Shouldn't that have been done right back at the start in because in two weeks they will be part of the general vaccine rollout and is this including taxi drivers, police, supermarkets?

Yes, it is. Thank you for the question that actually would be wrong to imply that they weren't already in that cohorting. So we already have roughly 4,000 members of our New Zealand police force who had been vaccinated. When we had limited supply, though, we started with those who were working around our managed isolation facilities, as you can understand. Supermarkets, we had several weeks ago, started working with providers, employers around identifying and vaccinating that work force. That, if I recall correctly s over 50,000 people, so it's not a small work force, because it's not just check-out staff, it's all those in the supply chain, but we had already started that work before this outbreak. Likewise, those who work for our foreign emergency services were also part of our priority groups and those who work in our ambulance services, those most likely to be interacting in some of those services that still continue, we had been working through. Now we're just trying to up the pace a bit.

Is it disappointing to have so many complaints, Dr Bloomfield, of non-compliance, given the severity or potential risk of this outbreak?

Have we provided you with some of those numbers?

I gave an indication. I haven't got the numbers. But I do recall this time last year, when we were in alert Level 4 last time, there was a high level of vigilance by people on potential breaches of the protocols. So it's not unsurprising, and of course, it's helpful as well, because the police can't be everywhere, and so it does rely on everybody to keep an eye on each other. But counter to that is also being helpful to each other too.

Is it your assessment that there is high levels of non-compliance this time?

No sense of that.

Yeah.

As the Prime Minister said, our public health teams are very clear that they are getting a high degree of compliance from their sense and certainly, Commissioner Coster was saying this morning that the police are finding that people are being very compliant so far.

Roughly 684 online breach notifications. When we've been verbally briefed by our public officials, people are generally quite positive. We do expect, because sometimes people will be reporting, that's when an employer is operating when they shouldn't be. We have the breakdown by region, organisation, individual or employer, for instance.

Just on the question of police, do you find it acceptable that just 40% of all cops have been given the vaccine before this lockdown?

Again, as I explained, of course, as we were moving through - remember in the beginning of our roll-out, we were having to match what supply we had with the demand we had, and we had two competing things we needed to do. Vaccinate those at risk who worked on the front line, so more likely to be in an could tact with COVID and for our police, that represented those working across facilities, so 40% still with that definition have been vaccinated. At the same time, we needed to vaccinate those at the highest risk which were our older people and our vulnerable people. Then we broaden out. We are looking to now expedite them. The large number of people who are at some point possibly coming into contact with others during Level 4. So 40% of the police, we'll work on the rest. 55,000 potentially people who work across supply chains for our supermarket network

Give us a brief overview of what it is that Cabinet will be assessing when it meets tomorrow when it's looking at either keeping the lockdown in place or expand ing it.

All the same criteria you would usually expect. The get free to which we believe we have the ring around the outbrairchth now, remember, what we're always looking for is whether or not the positive cases that you've got coming through are from those that you're deliberately identifying as contacts and then testing, as opposed to people we have not yet identified so that's one of the things that we look for. Whether or not you've had a time period - because at the moment the cases that we're tracing have an infectious period across the weekend pre- lockdown. Now, the period of time you spend in lockdown reduces that and of course that puts new a much better position. Then the spread. We want to see a high number of testing across other parts of the country, so if your' symptomatic and you live outside of Auckland and Coromandel, we particularly want to you go and get tested thatly.s our confidence that we haven't got spread, waste water testing helps as well. Those are all factors.

They are the main factors, Prime Minister.

Dr Bloomfield, could you clarify how many people do you know about that you're considering close and personal contacts?

I gave the number earlier on. I have to have a look here. 362 individuals had been already categorised and were being followed up. But by the end of today, there will be well over 1,000 who will have been contacted.

(Inaudible) are they essentially people who have reported having cold-like symptoms around that period, but probably looking at the (inaudible), it probably wasn't COVID?

Correct. So the CT values of all the cases have been diagnosed are very indicative that these are very acute infections and they're sort of more acute symptom onset is very clear. What the public health team, probably unrelated, but they're taking a very cautious approach so there are a couple of earlier places, one the earliest about the 3rd of August that is included just to be precautionary but we're confident that all the cases so far, all 20 in the community cluster, are very acute infections.

It has been requested that the travel be pushed back to get people back to Queenstown.

I accept it was a lengthy report, but right in the last two paragraphs of the report, I referred to the fact we would be extending for the interislander and for Air New Zealand out of Queenstown for an additional 24 hours. We will check in with them again because we have heard that there is high demand there. The issue as you will know for Queenstown is because of the particular runway and airport situation there, there are certain pilots that have the ability to come in and out of that airport. And that does limit the number of flights they are able to bring in but I know Air New Zealand are working very hard to lift their capacity

.

What is your confidence at the moment about the outbreak being contained to Auckland?

Again, the higher the number of test, the greater confidence we can have. So we'll look at those testing results and what they represent as a proportion of the population. We'll also look at whether or not we have close contacts through other parts of the country. All of that will give us a sense of whether or not we have a risk of their being spread outside those main hotspots.

Is there any data yet on whether or not any of the close contacts are from other parts of New Zealand?

Not that I know of, but we will follow that up. The other point I just want to make is all of the people tested at Auckland Hospital, and the tests prioritise where the close contacts of the person who worked there, all of those tests to date have come back negative which is an encouraging sign as well.

My recollection is we might've had some casual contacts in some of those larger hospitality sites but we'll go and check for you .

Do you know how many people were at the locations of interest even based on QR things that went out?

No their entirety for a location of interest? I mean, for instance, a very precautionary approach, you will see that one of our locations of interest, if I recall correctly, is from the time someone reported having symptoms, but isn't necessarily within the time frame that we believe our cases were out in the community. That's a mall, and so for that location of interest, you can have a large number of people that actually may not have come within cooee of that person, and so that you can see that actually quantitifying the numbers there, often very difficult. We posted it out of an abundance of caution nonetheless, but we asked people to look at the times. We don't want every single person across the day. Look at the times of interest and then just monitor the health advice.

(Inaudible)

We haven't - obviously it's not a decision for me, that's a public health decision but you can see from our description that, again, it's a cautious approach.

Yes. As we gather more information, often we will refine the times and some of the places - locations of interest and they may be removed. You know, if you look at the number and the types of places, it will be many, many thousands of people but the priority of course is the ones - the people who've been at those locations who are essential workers, who will still be out and about in the community. That's why it's very important for our essential workers and their employers to keep a really close eye on those locations of interest, if they have been at any of them, they need to isolate.

Tomorrow when you start to look at people, is there a particular threshold for how much testing you would hike to see in areas outside of Auckland, particularly the South Island, to give you some confidence as to whether you could match particular areas out of certain levels?

Alongside testing numbers, contact - the contacts that we're looking at, waste water results. For the proportion in order to give high confidence, I do often hear our experts talking about the proportions they'd like. That's not a calculation I make, though. We leave that to our public health experts to make those calculations.

So often we like to try to get at least 1%. The population tested that gives quite good coverage. But the important thing is we'd like to have as many people as possible who are symptomatic. So it's really getting - if you look at through winter, we were probably getting somewhere between 5 and 10% of symptomatic people routinely being tested. We want to get that much closer to 100%. So that's the really critical thing.

If you're symptomatic, definite my go.

In terms of the South Island, obviously they get quite critical when there are cases down there. Is your message to get tested and get those numbers up so that you can potentially drop them down if possible?

It's important in addition to the waste water testing we have good community testing. I saw reports from Christchurch yesterday with that there is a high level of testing happening. It would be helpful to that across country

I heard some smaller communities asking for waste water testing. I heard Dr Verrall is that it's even more important that symptomatic team get tested. Waste water is helpful but our primary source of information is often those testing results.

On waste water, given that all of those three sites have been tested in Auckland now, is there an argument to start daily testing or carry on daily testing in Auckland and further across the country because we may just pick it up?

Dr Bloomfield will comment on that.

In fact, as soon as the outbreak was identified, ASR moved to daily testing across the Auckland region so that's already in place. In other part of the country, it was already on twice weekly. So we're just making sure they continue the twice weekly sampling around the rest of the country.

When would you love it up to daily across the country?

I take advice from my ESR colleagues on that. The role of the waste water test something particularly helpful just as a supplement, really, to the community nasopharangeal swabbing. That's the most important thing.

Can you explain to the public why Auckland Hospital isn't listed on the list of locations for, interest with a staff member positive there and do you know whether case B was infected - whether the case there was infected before or after the weekend?

You go for the Auckland Hospital. I will dig through the case information on case B.

Auckland Hospital, we published right at the start. So it's not so much that it's alongside other locations of interest. It's a very specific setting in which there's a set of actions and protocols being put in place to reduce the risk of further infection if there is any there and of course to identify if any of the patients or staff are infected. So it's not equivalent to our usual locations of interest.

Case B, if I recall, was the workmate of the original case. Your question was do you believe they were infectious...

Before or after the weekend..

My recollection is that they reported symptom onset that was prior to the weekend. I believe our infectiousness period was covering the weekend, from my memory. Please let me clarify that.

Dr Bloomfield, have you seen any (inaudible) that takes into account this possible link to MIQ (inaudible).

Actually, I talked about some of the early modelling from Shaun Hendy yesterday. I got some updated numbers overnight from another set of modelling that was actually based on that earliest date, that 3 August date, and the median number it came up was somewhere around 50. More at the lower end of the number I gave yesterday. So that's encouraging especially because our sense is that the 3 August date was probably well before the virus was here in the community and our first person was infected in the community .

We offend get a lot of disclaimers on modelling in the early stages of outbreaks of just how hard it is. Probably our modelers would want us to put that disclaimer in at this point as well.

Those test results that came out yesterday, when do you expect those results to be available?

They will be available tomorrow.

Obviously you were talking at the beginning that there has been a lot of testing throughout the country. Is there any plans at this stage for more surge testing public stations? We've been hearing reports of a lot of people that have been turned away, specifically in Hamilton, at testing centres, some people have been told had they can't come or it's not open.

I hadn't heard that at Hamilton. I do know at the point of closing last night some individuals may have been told a centre was closing.

There is additional - all the testing that's usually open is available, and they've put an extra work force and there are additional pop-up centres in Hamilton and of course out in the Coromandel as well.

Is that all able to handle the influx of people that are wanting to be tested? These stories are coming in thick and fast.

We've had a particular conversation about some of those areas where we have large locations of interest, so, for instance, west Auckland. That's a particular focus for the team today, what we can do to ease some of the waits that people are experiencing in west Auckland because of those big sites of interest, particularly the high school.

Are you able to give us any information at all about the positive cases, you talked about the ones yesterday, including are they part of - do they have any connection to the casino, the school?

I do know that five of them are a family group, and that at first glance, there is a connection to Avondale College. That's the only one I know about, but that's all I do know, and as soon as we've got more information, because the interviews are ongoing, we will share that.

The teacher and then potentially another five?

A family.

A family and they are in the group of the new cases?

That's right and there was already one of our additional cases reported yesterday was already an Avondale College linked person as well.

Are they not the family?

They're separate from the family. We had two.

In terms of the potential spread in that school, given the nature of a school, it's a big institution, what's happening there?

Obviously there's some experience there and always devastating for our school communities to go through this, but right back to the beginning of our outbreak, we have had several schools that have had this experience and so it is not unusual for us to see cases within a school community, only recently in Papatote we had cases pop up through community. Level 4 is a good mace to be given the size of the school. Now what we want to really do is make it as easy as possible for the school community to go and get tested and their family, just want to say to them, they are working through making that easier for you. I know some of them have been in lines as of yesterday.

Why don't you have drive-through vaccination centres set up by now? Australia has had them in operation since April and you've received earlier this month.

I was just reading some reporting from our vaccination team talking about plans that in some cases were already in existence around drive-through vaccination centres. In some cases our DHBs identify that in terms of efficiency, there are some cases sites that are large enough to get really good through-put safely and alternate methods. Keeping in mind, yes it's a great way to keep people socially distanced but you need to keep up your observation periods for a large number of people over a period of time. So we let our DHBs do that assessment. What's going to deliver safely as many vaccines as possible? Some are looking at using drive-through vaccinations but actually some have decided alternate methods will work better in this circumstance.

(Inaudible) another amnesty period against the travel.

Keep in mind that after that period we do still have an exemptions process for exceptional circumstances. So that would kick back into gear to enable people who need to move.

(Inaudible)

Yeah, look, my view is that last time of course we had a prolonged period in Level 4. We managed to get people by and large moved within that 48 hours, a bit of flexibility around the edges, where we know there's travel constraints, but really we have asked people to move as quickly as we can and we really did it mean it but we always do have that exemption scheme.

(Inaudible) we're hearing reports that people turned up to pharmacy having booked in and the pharmacies doesn't have a record of them.

Happy to follow up on those reports. Yesterday we had 7,500 people accessing the site at the same time and it did function. I hear the odd report of people having to try one or two times. Look of course we want this to be as easy as possible. We don't want anyone to be put off but please f that does happen to you, just pop back on again later. You can see we had record numbers able to successfully book in. So we don't think they're systemic issues but I'm happy to take away your examples

You're extending the vaccination rollout to 15-year-olds. Who do young people talk to?

We've been thinking hard about how we make sure we're not just talking to parents about the importance of vaccinations but we are are talking to our young people as well so the Ministry of Health and our vaccination teams have been working on answers those questions, in a really accessible way and we'll keep working on some of those materials. But my message to parents who will need to of course provide consent for their children is that I would not have been a part of a process in approving this unless I believed it was safe. Because around that table, we have - we are parents too, all affected by these decisions so we take them very seriously. Anything you wanted to add on that?

Auckland has a huge homeless community. Is there a vaccination roll-out plan specific for the homeless community and if there is, has it been taken up by anyone?

So obviously, you're talking just solely for vaccination as opposed to some of our Level 4 readiness as well? Look, that's probably a question I best throw to Dr Bloomfield, but at every stage, we have talked about making shoo you that our roll-out is equitable. That we are targeting everyone within an age bracket, regardless of whether or not they have a fixed abode or not. My recollection is that there was good outreach going on with our Social Services into those groups, but rather than me going on recall, I will ask Dr Bloomfield

I would have to come back to you with the detail. A number of the DHBs had specific initiatives to reach to homeless people.

Auckland City Mission, for instance, do run outreach clinics. I do know the doctor from Auckland City Mission, for instance, was amongst the cohort being vaccinated and I believe we were utilising them in some way but I will come back to you.

Do you have any concerns around the homeless community in Auckland right now, and the virus is there?

So at Level 4, you will remember that in Level 4, our Social Services do continue to still ensure that they are providing those basic necessities for the likes of our homeless community and last time, our hacks - absolute folk cause was on housing everyone. Again that focus comes on straightaway in these situations. From our lockdown a year ago, a good proportion of those we housed then remain housed. So that's good news.

(Inaudible) can you clarify the rules around masks and whether people exercising need to wear one?

So we have not mandated mask use for exercise outdoors in Level 4. Our general advice is when you go out, wear a mask but we also want to be practical about someone who may be, for instance, engaging in a very strenuous run. I couldn't speak to personal experience, but where a mask might become difficult. In those circumstances, please, good decent social distancing. We know with Delta, walking past someone is a risk. But, again, be courteous. General rule when you leave the house, wear a mask but we will be practical there.

Dr Bloomfield, could you just explain how fleeting a contact needs to be to catch Delta?

Well, actually, not even just Delta, even earlier variants of the virus. So we saw from the transmission event that happened in the jet park recently that even doors being opened within a short period of time by people on opposite sides of the corridor and the virus being in the air was enough to cause infection. So it can be a very transient exposure

.

Around someone for like 15 minutes?

Not necessarily. We've tended in the past to use 15 minutes as the benchmark, but no longer. We look at anything that might be even a transient exposure.

Given the increasing number of cases in Auckland, how likely is it that the lockdown settings will be extended tomorrow and for the rest of the country, what kind of things are you looking at in terms of extending or...

We are always careful about getting too far ahead of decisions that we need to still be provided advice with, and that Cabinet still needs to consider. But we were really deliberate right at the beginning, given we had a case, that the time we weren't clear on where it had originated that the likelihood for Auckland needing to stay in seven days in Coromandel was high, which is why we gave that seven-day outlook. You will see from the stage that we're at, obviously that seven-day indication was the right one to give for Aucklanded a are and the Coromandel, but we will confirm all decisions for all parts of the country tomorrow.

(Inaudible) looking to in terms of the rest of the country?

Same things as I 've already indicated and the same things we consider on all occasions, just again whether we've seen spread from those locations into other part of the country and really good levels of testing to give comfort as well amongst other things but also it does matter whether or not we feel like we know enough about the outbreak and the place is started too. For the South Island, I know it's really frustrating when you're in the situation you're in and the outbreak can feel so far away, but I would much, much rather you be included now than us be in a situation where we miss something or someone and you end up in a lockdown that could've been prevented. I just don't want that.

The new cases at the Crown Plaza, what's the theory as to how that transmission happened? Was there person-to-person contact?

So you are not able to leave your room until you deliver a negative result when you first arrive. So the case from which we believe all of these cases originated would not have been cleared to leave their room because they hadn't returned a negative result, in fact, they returned a positive. So that means that narrows down the possibilities, but we do use camera footage where it's available and room-key movements to identify what may potentially have happened. So that's a process that our MB staff are going through now

Could it be a ventilation issue?

Ventilation units on the Crown Plaza had already undergone some work quite recently but again, I don't want to speculate or rule anything in or out, but ventilation was an area where some work had already been done, as it had across a number of facilities.

On the south island, have you considered asking ESR to test the waste water at Queenstown and (inaudible). A lot of Aucklanders will be travelling between those two locations.

We do have waste water testing in Queenstown already. So that's part of our regular testing.

Yes, and on Monday the 16th there was nothing detected in Queenstown and we had a returned result on the 17th, Invercargill is all clear as well.

(Inaudible)

So remember, the pre-departure requirements, we set for every other traveller, but because in Sydney, they were (a) all required to have stay-at-home orders, (b) it was considered by Health at that time a relative risk to send people into testing facilities to be tested when actually they were coming into quarantine anyway. So that was the health advice we have and that we adhered to. Everyone else needed to deliver those tests. For NSW, you came red flights, straight into quarantine and you did also need to sign a declaration confirming you had not been at locations of interest or come into contact with cases.

(Inaudible) was it likely that they became more infectious...

I don't believe I have seen the CT nor that case, but by the fact that we believe - we believe - we have someone in an adjacent room and we still need to genome sequence it, that would indicate that this individual had a - I'm told infectivity is the best turn of phrase there.

(Inaudible)

So that's where that cohorting is really important. Of course, all of those people on the flight, it was a red flight, so that means everyone's treated as if they have COVID and they all go into facility. So if they did indeed become infected, we would then see that through our testing, and we do contact-trace. Even when we have someone on a red flight, we do contact-trace around those people as well.

Given (inaudible), have you got the flight from that plane...

They're a all on regular testing. I've had no reports that is an issue of concern. Every single element is being looked at as part of this.

On locations of interest, is there any way to set up like a hierarchy? For instance some of the locations like you said are really big, so I know Auckland University of Technology has been identified as one of these locations. (Inaudible) a lecture theatre or something like that, so where there is a hierarchy of testing. Is anything being done about accessibility of testing sites for people who don't have cars, so pedestrian access?

So on the first question, yes, our contact-tracing teams and the Public Health Unit does a triaging of the sites and also the people who they really want to get tested first. Of own they'll put the information up first. They know it's AUT then refine it down to a specific place where it was higher risk. I will have to come back to you for the follow-up around students. It's a very important question, so I'll just make sure we get information about how students who might be in hostels might get testing.

(Inaudible)

I guess the key thing I will check and come back on is whether student health is still open and doing testing, because as you saw from what I said earlier on, most of the testing, the majority of the testing across Auckland is still being done in general practices and urgent care clinics and so on.

I will take a last couple

What concerns do you have capacity in facilities that are intensive wards and Emergency Departments?

Dr Bloomfield brings down those numbers lately waiting for that very question.

I will have to find them but I would say we don't have any concerns at the moment. But since the outbreak last year, our ICUs have had readiness plans. We have imported and distributed an additional number of ventilators. Most of those are out in the district Health Boards but we also have a national supply but most importantly they have trained and maintained the training of staff who can look after a ventilated person, not necessarily in an ICU bed, but in another bed in the hospital, should that be needed as part of our surge capacity.

We've heard Repco supercheap auto are operating at Level 4 with click and collect. Hard Vo Norman staff say they're interacting with delivery drivers and feel unsafe. What's your message to employers?

We're very clear to employers, they should only be operating (a) if they can operate safely within Level 4 protocols and (b) if they are part of that supply chain for essential goods and services. And that is very narrow. Look, without wanting to get into some of those individual scenarios, I will have MB look into those specific examples. I can't see many reasons why those individuals would be claiming to be a part of those essential services. And again, for employers: it is not, for instance, sufficient to say, well, I'm operating in order to provide essential services, so I'll bring in staff to restock shelves and do stocktaking.

It has to solely be for the purposes of the provision of essential services. And I would say to any employer: you do not want to be in a situation where we stand on this podium and read out your place of work during a Level 4 lockdown because you unnecessarily put people at risk in a workplace that should not have been open

.

Vaccinations will resume, many are still shut today, it's causing problems and frustration. When will they reopen and do you have enough staff to service bothth increased demand for testing as well as vaccination centres?

We have said that not all of our sites will be back up and running in the same way as prior, because some sites may not necessarily be able to open in a way that is considered safe in a Level 4 environment. Some will be coming back onstream over time. So won't be quite up to full capacity today, but we do expect to get closer to full capacity over the coming days.

The level of confidence in the genome sequencing matched to the days from Australia. You've said most likely, probably. What is that threshold being exactly sure and is it enough to - I know you said options are still open, but is it enough to carry on on that path?

This is something we've asked our scientists and those who interpret our genome sequencing for us to present their views on that. The way it was described to me is that the genome sequencing for our cases and the individual traveller, they've said indistinguishable, so that means a really close match. There's just one element they say, one snip away, so very, very close and they've put it to me that they would say roughly 90%. So that's the number I've been provided with.

Yes. So it's a very close match. There's just one base difference. I've seen the sequencing. But the comment that was also made to me is because there are a large number of cases in NSW, there are lots of genomes that are essentially very similar. And so the genome sequencing from cases B through G that came through late last night, all of those genome sequences are identical, and it's not possible to tell what the direction of transmission might've been. So sometimes, you see it's absolutely identical, sometimes you see this one or maximum two base difference. This is what is a one snip or one base difference, so it's about as close as you can get.

So enough confidence as we say to only give small caveats but we will of course just use all the evidence that comes before us, but at the moment you can see there's enough for to us really chase down that person who arrived, keeping in mind there was no other way to get in from NSW at that time other than on those flights. OK. Thank you very much, everyone.