COVID-19 update, 21 August

Tena koutou katoa.

I want to start today by sharing some good news which is not often the case in the 1:00 updates. Yesterday we had two records, the most vaccinations administered in New Zealand in a single day, 56,843. So far, 72% of New Zealanders aged 40+ are either booked or have been vaccinated with at least one dose. This is great progress.

Over 150,000 vaccination bookings were made yesterday too, which is fantastic. Just a reminder, if you are 40+ or in one of our other priority groups and haven't made your booking yet, visit book my vaccine.NZ today and reserve your spot.

Yesterday we saw the most COVID tests processed in a single day, 41,464. The fact that we have achieved both of these results on the same day is extraordinary. It is exactly what we need to do, both to get on top of this outbreak, but also to prepare us for the future. Despite reaching record numbers, we do need to keep going. We need to test, test, test, to ensure we get an accurate picture of the perimeter of the virus and we should be using this time to increase vaccination rates.

I want to acknowledge everyone who has waited in some cases many hours to get a test, you are playing a key role in controlling this outbreak and helping us back get back to normal faster and you can see as a result we have those record numbers, sometimes 10 times higher than what those areas are usually processing in terms of tests.

But we need to take the pressure off the system. We can do that by standing up additional testing capacity.

Today there are 14 community testing centres open across Auckland, including four new pop-ups stood up overnight, of which one opened at 11:00 and another well open at 1:00 today. In addition for community testing centres for close contacts only are in operation today, these are sites we are using for known contacts to ensure we prioritise their testing.

One of the things we heard coming back with people who needed to be testing were waiting in long lines, we need to move them through. These are not sites we are publicly advertising but those who need them are being given the details to try to get them tested more quickly. In Wellington six community testing stations are open across the region. This includes three pop-ups stood up overnight. Visit Healthpoint.NZ to get details of COVID testing anywhere in the country or call ahead to the GP to see if they have testing available. GPs are protesting a lot of test and await times are often shorter.

Just a reminder of who it is we are focused on testing right now. They are broadly three groups.

Those who are contacts of known cases, if you are called by public health and you need to isolate and get a test. The second update at locations of interest on the dates and times recorded. You too need to isolate and get a test. If you went to a location of interest but not on the date or time set out, you don't need to be tested.

And finally those with cold and flu symptoms, please isolate and get tested. If you are not in one of these groups and if you are well, you don't need a test. It's great to have high numbers of tests across the country, it gives us a greater sense of certainty, but at the moment we need to ensure that those who are at risk of being exposed or who are unwell are getting tested.

Sitting behind all this testing and vaccinations is an outstanding health workforce. This outbreak has particularly impacted on our frontline workers. Even more so than in the past. On behalf of New Zealand I want to acknowledge how tough the last few days have been and also say thank you. If you interact with a health worker in the coming days at a vaccine station or a testing station, please pass on the thanks of 5 million.

I will now hand over to Doctor Caroline McElnay, our Director of Public Health to provide an update on case numbers and outsource investigation.

>> Thank you Prime Minister, kia ora.

Today I can report there are 21 new cases of COVID-19 in the community. That brings out total number of confirmed cases associated with the current Auckland community outbreak 251. All cases have been or are being transferred safely to managed isolation facilities using strict infection prevention and control procedures.

Of the 21 new cases, 18 are in Auckland and three are in Wellington. One of which we reported yesterday. Investigations into the source of these cases continues. 21 cases of the 51 are now confirmed as part of the Auckland cluster with the remaining investigations still underway to confirm the specific linkage but initial assessment shows that in the vast majority of cases there is a link. Public health staff are rapidly interviewing cases to establish how the new cases were infected and to determine further details of their movements. We will continue to release that information as it comes available.

In addition to community cases there are three new cases to report in recent returnees in our managed isolation facilities. On whole genome sequencing, ESI continues to run sequencing from samples taken from the new cases. They have completed sequencing for 29 of those cases, including the three Wellington cases reported yesterday and they are all genome Eckley linked to the Auckland cluster.

All staff are continue to contact Chris with a focus on high-risk locations. That is a team effort involving the ministries, National investigating and tracing centre and all of the country's public health units and they are working tirelessly to investigate the cases. Isolation in alert level IV means isolating away from other household members, so when contact are identified and traced, it is important they get tested and isolate until they receive a negative test result. The number of contacts has increased significantly. This is something we expected as we identify more contacts and test in large numbers.

As of 10:00 this morning, 5065 individual contacts had been identified. This number will increase throughout the day as records are fully processed and we expect to have another 5000 contacts by the end of today. The majority of those contacts are located in the Auckland and Waikato regions with a small proportion located in other areas throughout the rest of the North and South Islands. As of 10:00 today, 1982 contacts were located in the Auckland and Waikato regions and 266 contacts located throughout the rest of New Zealand.

On locations of interest, we are working around the clock to get further details of the movements of cases. We have been hearing concerns about the time it takes to get some locations of interest published.

This is a very fast moving situation and we need to make sure not only do we get information quickly, but it is correct and accurate, and that can take time to confirm. Also our contact tracers are dealing with people who have just been advised they are a case and they are often very stressed and so it can take time for people to recall exactly where they have been, when under pressure.

While it takes time to gather that information, we are working as fast as we can to get that information out and put the list of locations up on the ministry's website as soon as it becomes available.

Also, use of the COVID App allows push notifications to goes -- goes straight to people of interest so we can quickly identify those contacts. I want to reiterate if you were at a location of interest at the specified times, please self isolate and call helpline on oh 803 58 self isolate and call helpline on oh 800 3585453 for advice on testing. By calling Healthline for advice, people who have been at those locations of interest at relevant times are logged into our contact tracing system. That means your swab can be tracked and processed faster by the Laboratories, so please call Healthline.

I want to talk about wastewater. We have had a detection of COVID-19 in a wastewater sample collected from Warkworth on Tuesday of this week and so our message is anyone who has been in at a location of interest at a relevant time or is symptomatic and is in the Warkworth area to get tested. A pop-up testing centre has been set up at 77 Lawson drive and this will be open until 5:00. People are asked to call ahead on 09 to call ahead on 09425 to call ahead on 0942585 to call ahead on 094258585.

The wastewater catchment area at walk with is 3500 people and extra wastewater testing will be taken from the Warkworth and Snell speech today and tomorrow.

On the general comment about wastewater testing we have 41 sites are ground the country covering 3.7 million New Zealanders. -- around. -- beach. There are further sites being edited.

There continues to be COVID-19 detected in wastewater in the Auckland region. Those samples were taken on Thursday, including the North Shore and eastern Auckland. ESR expects to receive further samples later today from Auckland, Wellington and Coromandel. There have been no unexpected detections to report from a wastewater sample taken from other areas around the country.

And just a bit about metro Auckland hospitals, you would be aware the North Shore Hospital emergency department had been closed. It continues to be closed until further notice with ambulances being diverted to other Auckland emergency departments. However, the hospital is open to direct primary care medical and surgical admissions with referral from a GP. On-site staff testing is now in place at North Shore Hospital are both symptomatic and asymptomatic staff. As at 6:30 AM, 829 DHP staff had been tested. All return results that were negative and we still have 208 results pending. -- return.

All had contact with the patient at North Shore Hospital and 84 have returned a negative result. Of the patients in affected areas at the same time as the positive patient, 20 are still in hospital. All have been swabbed and the test results are all negative. Public health officials are closely monitoring the situation and additional support is available for hospitals across metro Auckland if needed. Back to you, Prime Minister.

>> Thank you very much, Caroline McElnay.

Our cases have grown again but given the large number of locations of interest and what we know about Delta, this isn't surprising. We have always said cases will rise before they fall, and based on the experience of overseas countries, we expect cases to continue to rise through to next week before they start coming away and it is always good to share what those expectations might be before we start reporting cases in the coming days, so we expect them to increase. But there are actions you can take to make sure we don't create new cases or spread the virus in lockdown. One thing we have learned from New South Wales is the virus can keep spreading during lockdown from people going to work or people breaking the rules of a lockdown and meeting with other people and then passing on the virus.

This is one of the key reasons the case keep going up and the lockdown continues to be extended and a devastating 825 cases have been reported in New South Wales this morning. No one wants an extended lockdown and no one wants to see that rate of transmission, so the number one thing everyone can do now is reduce down your contacts and ensure you stick to your bubble.

I especially ask that anyone who is a worker in an essential service make sure you do not go to work until you get a negative result and employers have advised you of this as well if you are in those groups of people we asked to get tested. This morning I asked our public health team how compliance was looking and it was heartening to hear that the people they are contact tracing are at home.

That is exactly what we need. We just need to keep going because that means eventually our locations of interest will eventually start to decline as we contract -- contact tracer people at home during that period of infectiousness. -- contact tracer.

On locations of interest, I have an update in addition to what was shared by Caroline McElnay. You recall we talked about gene sequencing, narrowing the nightly source of COVID to an individual who arrived in New Zealand on 7 August.

He said at that time we were continuing to keep some of our options open. That was because we didn't have a complete sequence but it was enough to give us roughly 90% confidence in our theory. That sequence was then re-run and we received the results yesterday stop the results give us even greater confidence in the match. On that basis, a decision has been made to remove locations of interest that predate 7 August.

We ask that everyone from those locations still comply with level IV restrictions, so you still need to stay home but you no longer need to report for additional testing. Of course the decision has been made only recently so it will still need to be updated on the locations of interest website.

This is an example of how the science can help us narrow the public health measures needed in an outbreak. It was absolutely right, though, in a Delta environment for our public health team to be cautious in their approach until we had evidence to the contrary. A couple of quick pieces of information before we wrap today. We know isolation can impact on abilities... The ability of people to access food.

If you are sick or cannot leave home to buy food, you can ask family, friends or neighbours to make a contact list drop-off of groceries to you. If you are delivering supplies to someone remember to stay 2 m apart and were replaced covering.

Ideally, though, drop things on people's doorstep and leave. You can also use your click and collect service and ask a friend, family member or neighbour to drop off groceries. Compliance and reducing contact is critical to stopping the virus spreading.

Overall, Compliance has been outstanding. We are seeing a similar level of reduction in traffic and movement as the last time we were in level IV. Since level IV came into place, 17 people have been charged with a total of 20 offences nationwide. Of the 20 charges filed, 11 after failing to comply with the COVID-19 order, seven for failing to comply with direction prohibition and restriction and two for health (inaudible) breaches and in the same period, we have had 53 formal warnings. Police have issued 70 infringements nationwide including 61 two people who fail to remain at home and five the persons who fail to wear face covering and you do need to wear face coverings when entering an essential service like a supermarket. Overall, those numbers are really low, so thank you to everyone.

King to the plan we know works. Even if we know we have a plan that works, the uncertainty of these periods of time in lockdown are really tough. -- sticking. It does have a mental health impact. Reach out to friends, family and a video chat and message already helps. Local GPs are still working at a level IV and can provide advice on how to get help to support your mental well-being during this alert level including phone and video consultations. You can also call 1737 17374 free to talk services with a trained counsellor. That is 1737. There is more information about accessing the range of mental health services on the COVID- 19.

GO VT got NZ website. some online services are fantastic. Don't hesitate to look and I encourage you to share that with others.

>> Are you satisfied with the amount of time taken to get those locations of interest on the official website? A lot of people there is a lot riding on Windows pop-up.

>> Of course, considering we are on level IV, so there should be at home when receiving that information, it may give people additional information if they fall into category of needing to be tested and all prioritising those areas where we may have essential workers affected because we need them to stay at home but there is always managed to be struck on the one hand, if it has the wrong date or time, you can have a raft of people enter into the testing system that we don't need, so we are constantly trying to get that balance right that we have enough information we believe we can verify before putting it into the public domain.

The second thing to remember is that we are still reaching out to those contacts we identify, sometimes before they are even on a website. Our website is not the only way we communicate with contacts which is a very important thing to remember.

>> How satisfied are you with the work in terms of testing that people are lining up and going to testing centres. Are you satisfied there is enough social distancing. There were issues portaloos that are there the people waiting for hours but whether they were being properly sat as -- sanitise.

How satisfied are you a testing centre doesn't become a spreading centre.

>> When it comes to testing and testing capacity, the number we have had processed since our last report, over 40,000 is extraordinary. We had a record the day prior with less than 30, so you can see why we have seen people having to wait the length of time, in some cases 10 times our normal demand will stop on the one hand it is fantastic, helps us find those cases and will help us get out of lot but we don't want people waiting long periods of time or having contacts turned back because of the time they have waited. Extra testing sites, we are telling them where to go so we can rush them through.

To everyone who has waited it out, a huge thank you, we didn't want you to experience cues, we've been working hard on solutions to stop that happening again. Doctor McElnay?

>> We have every confidence in the district health boards and the setting up of testing sites that they have taken that into account and the spacing of people waiting, the use of PPE, that is a local requirement but I have every confidence in their protocols.

>> Has the alert been raised with you, has it been taken into account, about the use of portaloos?

>> There is not really an alternative, but I would hope people would follow the guidance of making sure they sanitise their hands as they move through any area in which they may have contact with others.

>> I'm not aware of that specific situation but we can get the details and follow that up.

>> On what you are saying about the numbers rising before they fall, have you got any modelling to suggest what the peak number per day will be?

>> I'm always told to be cautious with modelling and outbreaks, early on or with relatively small numbers. They change daily. I thought it would be useful, however, that instead of giving numbers because they are so variable for these projections, you've heard Dr Bloomfield talk broadly about the totality of the outbreak, to give a sense that we haven't piqued yet, that is our view. I think that's important to share with people, so they know what is likely to occur and it doesn't mean the strategy of our lockdown is somehow unsuccessful. That is to be expected. We are still contact tracing people pre-the lockdown who may have been moving about. Soon that will start to fall away and that's where you see the success of the level IV restrictions.

>> With the areas of significance, 10,000 by the end of today, is that causing you concern?

>> >> It is a very large number, we are often being very broad when they post them, we are happy with the speed and often we are making the decision to be very broad when they are posted. Sometimes they will be narrow in order to get the information out there in case there are essential workers in there. I am not concerned by that roared reach because A, we are in level IV so by large people should be at home and B, with delta it's better to be safe than sorry. Previously with locations of interest we were interested if you had physically contact with people and in a delta environment we are being more cautious. That is why you will see more contacts.

It is deliberately larger, it's all about adapting the way we are working with delta. If anyone is looking at those contacts and thinking it seems more than we used to have, that's because we have changed the way we are doing things because of delta.

>> Back on the Wellington locations, why did it take so long for that flight from Wellington to Auckland to be identified? And why did people have to wait for that flight to be uploaded to find out they were at a location of interest instead of being contacted behind-the-scenes?

>> Sometimes they do both. I can't tell you the sequence. In some cases it may have been it was advertised publicly before, it depends on the sequencing. With flight data we have your details so you are able to be contacted, it might be posted online beforehand.

>> The posting online is an extra to get it out to the public at large what the location is. The public health team are already following up those contacts and in a situation where we have a flight and details of who was on the flight, those people would have already been contacted, not waiting for it to go on a website before they take action.

>> Just on that, it is quite a cautious approach capturing that flight as well. Because the exposure event we are worried about, we believe happened the same day so the likelihood of that person being infectious on that plane, but we are taking a cautious approach with this outbreaks to get out of it sooner.

>> Is one of the hindrances to getting locations of interest up quickly that people are having to go back through their memories and their bank records to do that? What is slowing it down?

>> I'm not aware there is particularly underuse of the app, it takes time when you are doing the interview to go through those details and we use every sorts of information that we can have. But just to confirm, if people haven't been using the app, that's when it takes time to go through each and every location of interest in order to be accurate.

>> And we do use someone's banking transactions as a way of prompting their memory. They will be interviewed often multiple times in order to extract additional information or clarify bits of information. Again, with getting those locations of interest out, it can be iterative and we are balancing putting sometimes what might not be quite accurate information out there quickly.

>> You say we are not at the peak yet.

>> I don't believe so, I don't have a crystal ball. My instinct, and I'm not an expert, my instinct from more than 12 months of experience would be, no, I wouldn't have thought so.

>> Post Tuesday, it seems unlikely that Auckland will leave level IV on Tuesday. People are planning for the end of September.

>> That is really asking me to cast into the future. We want to base our decisions on the evidence. You would have heard yesterday when we asked all New Zealanders to stay at level IV until the end of Tuesday with amounts months on -- announcements on Monday. Auckland can see they are sitting at the centre of this outbreaks so it's likely we will have to take measures that continue to be cautious. Having said that, I don't want to protect what happens for the rest of New Zealand either.

>> With these supermarkets in Auckland being locations of interest, all the staff will have to self isolate, are there plans around how to ensure that goes nga mihi nui quite a large number of supermarkets.

>> Doctor David Clark who holds ministerial responsibility for this area has been in talks with our supermarket chains around what can be done to ensure they are using practices and measures that enable ongoing supply chain and operations. There have been a couple that have been off-line for long periods. Sometimes you find that shut down immediately and when they work through shift details and likely contacts I get themselves back up and running.

He is talking with them about the kind of contingency they have in place. One thing to add, there is a drive-through vaccination station being set up in the Auckland DHP specifically around some of the essential workforce in the first instance. There will be more throughput for people in the supply change. Not just checkout operators but thousands of people to keep food moving throughout the country.

>> I can understand that people have been cooperating with contact traces?

>> I've heard nothing to the contrary.

>> Prior to this outbreak Maori and Pasifika and doctors were warning that an outbreak could be devastating for Maori. 80% of children are Pasifika, and areas highly populated with Maori Pasifika communities, are you concerned that what they have devastated -- predicted to be devastating for Maori Pasifika happened?

>> Every bit of the strategy is around Aotearoa New Zealand cos population. Even before delta if we had a COVID outbreak it would be devastating particularly for our Maori Pasifika populations. And this is down to some health inequality we have a New Zealand. It's part of the reason we have a elimination strategy is to prevent devastation in those communities. It's why we are in level IV, to prevent that devastation.

>> I'll come back to you, I'll take questions from others.

>> Can you give details of the 21 new cases today, with heard some of them right schools in New Zealand -- schools and university.

>> Case investigation, those interviews are still ongoing for some of them. But even from the first cut of information coming through on our update today, we are informed that broadly speaking there is a view that they are predominantly likely to be linked to our cluster based on the first lush of information. You will forgive me for not getting into the specifics because those interviews are underway. Our public health units are interviewing and locations of interest go up. One quick point on locations of interest, we are looking to sequence the timing of when they go up and in a more predictable way. Certain times of the day, so people know when to go back and look.

That is one of the things we think we can do to make it easier for everyone.

>> On the Auckland University student who is now in Wellington, did they get tested before they travel to Wellington?

>> I have not had it indicated to me that they did anything inappropriate. I wouldn't want to leave any suggestion there. They travelled in the 48-hour window back to their home which was within the guidelines. I couldn't comment on the sequencing of the testing.

>> I'm only aware they were tested in Wellington.

>> (Inaudible)

>> When we have the flight details it's more straightforward for us to contact race. -- Contact race.

>> (Inaudible)

>> I couldn't contact on specific details for public health units or locations of interest but what I would say on that flight, that one is very much on the cautious side. The public health unit may have made a decision because of the way everyone is in close proximity on a plane, versus walking through an airport. I wouldn't want to hazard a guess.

>> On the flight, the exposure event was the same day. Much lower level of risk.

>> A cautious approach being taken there by putting that as a location of interest. Very cautious.

>> Back to the person who spent vaccinated, (inaudible) we are diverting vaccination testing centres...

>> We are obviously managing to do both, I am not suggesting that the extraordinary work from our health workforce but the fact we had record vaccination on the same day we have record testing demonstrates that at the moment we are doing both at full capacity without the loss of service. As I quickly mentioned, the northern region health coordination centre is launching a vaccination centre on Sunday that will be able to vaccinate a large number of individuals, up to 2000 per day, starting a little lower than that but ramping up. There is a specific focus on essential workers for that vaccination centre.

That will be by appointment only so they can bring through that essential workforce and that drive- through environment.

>> Does that mean vaccination is are all now open now?

>> Not all of them are operating but with our ramp up we were onboarding primary practice, GPs clinics. That has continued. If there are centres that are not operating it presents for a number of reasons around level IV, we have brought new sites and that is why we have managed to continue to scale up.

>> When you say they are all linked to the cluster, >> At this stage the view is they are.

>> Do you know how many got it because they are personal contacts of other cases versus simply by virtue of being at location of interest? Are there any locations where there is a particular issue?

>> Good question.

>> Are many of the positive cases so far vaccinated?

>> Public health units have been collecting that data and I can't speak to that at the moment. You know about the one that was fully vaccinated. There might be others but I can't say for sure at this point. Obviously we are treating everyone in the same way, it's interesting information but not necessarily changing our approach. One thing they have is identifying the connection, working through those events where it appears that there may have been more infections among those who may not necessarily have identified themselves as being close contacts but were at the same event.

That will enable us to really hone in on if we have particular events that would fall into the category of being super spreader and therefore once we should continue to pay extra attention to. That is all part of the process of interviewing and identifying where people came into contact with COVID.

>> Identified or early flagging?

>> Before, I think we would want the public health unit to finish the interview so maybe if we come back to you tomorrow and give you a suggestion of some of those locations we think look like they were more problematic than others.

>> I think that is right. We still have some analysis to do and then we can break that down into where people were at a location of interest versus being a contact of a case. We should have that.

>> Particularly what we are looking at. Our there certain sites more worrisome than others? You never want to take your foot of the break. That might lead people not to be tested at certain locations of interest and we wouldn't want that.

>> It has been reported a New Zealand citizen accused of having ties with Isis has arrived in New Zealand. Can you confirm?

>> No, I cannot public comment -- publicly for a range of reasons.

>> The person who question here (inaudible) what is the isolation arrangement for the said person. Would it be a general cohort?

>> The most important point is we are undertaking all of the usual COVID-19 related protocols for someone who has come in from a country that has COVID in circulation which is essentially anywhere in the world at present so we will follow those same protocols.

>> In terms of guarantees, what can you give to the public they will keep safe?

>> I would give the same reassurance I have all the way through. While we have obligations given this individual we are talking about is a New Zealand citizen, and the status of their children, we have, however, still undertaken all of the usual steps you would expect us to take to keep New Zealanders safe. That has been a priority. While there is some constraint on my ability to talk about the details, we have used every labour we have to ensure people's safety. -- lever.

>> Are you asking New Zealanders to trust you without giving detailed? Share not me but our systems.

>> In terms of that how are you balancing the public's interest and safety and right to know with the fact that you need to keep people safe? Will you release more details on the public interest side later down the track?

>> The key test for me is my job is to keep people safe and we are using all of the levers we have to make sure that we have done everything we can to keep people safe while at the same time fulfilling those obligations we have because this is a New Zealand citizen. There is not really an option. The alternative would have been to say to Turkey we don't take responsibility and they could have then deported that person without warning and without our preparation. That would have been wrong, would not have ensure the safety of New Zealanders, so we have planned for it, are ready for it, and we are keeping our mind that in mind that there are children and we have an obligation.

>> I love how you take ownership for the colleague's questions. You have had a couple already. Go ahead.

>> Would you consider reassessing the North Island and South Island (inaudible) virus, why hasn't the De La Salle school, high school location as the location of interest given they have already informed staff and students? Thirdly, (inaudible) are begging to be open for click and collect. Why are they unable to do that?

>> I will start with the last one. At level III we have the ability for them to operate but it is much more invented at level IV. That is always been our approach reduce as much contact as possible so you do not end up in a situation like New South Wales. On the second question around locations of interest and in a way you answered it yourself. Yes, we work to get these on a public website but you acknowledged staff and students, the most important group we want to contact our already be in contact and prioritised and that is key. They are the ones we want staying home and a priority. Our north and south, we consider all options depending on where we have concern so if there are places in the country we are worried about we look at how we can practically implement borders around them if we need to have different alert levels so we keep all options on the table including whether a boundary exists around the city or a whole island. Anything further on the location?

>> No.

>> Home suburbs have been named of the first three in Wellington. (Inaudible) should people be expecting locations of interest? Shiver and keep an eye on. I know additional -- locations were uploaded this morning. Check for the locations. It is not a matter of because someone lives in a suburb that whole suburb somehow is problematic. It depends. It is all about where someone has been.

>> That is right. There is variability between individuals in terms of what they do and I have been informed by the medical officer of health these cases have not been out and about particularly so we would not expect to see locations of interest.

>> Young people, however, move around a lot.

>> (Inaudible) that is about 1% of the population, a pretty high rate. On that number, you would finished early December if you kept that rate up. Are you expecting that at the top of the curb (inaudible)?

>> We will see what is possible. I don't want to put definitive numbers on that yet. -- curve. And to create and generate those numbers is fantastic and we have a way to go yet. We haven't open to the entire population yet so I wouldn't want to speculate that we have worked hard to put ourselves in the position where we can complete as much as possible this rollout this year. That has been our goal.

>> (Inaudible) on first dosing, you get to 80% of the entire adult population at first doses around October 20 (inaudible) 80% of the entire population has had a dose, (inaudible) of this happening again?

>> Not based on every country around the world unfortunately. Even those with some of the highest rates in the world have dealt outbreaks and the thing I would say is that does not mean that there is an issue with the effectiveness of vaccine. -- Delta. We are seeing a significant reduction in hospitalisation and severe illness so the vaccinations are doing what they are meant to do that our strategy has always involved vaccination plus good public health measures. We want really good reach and full vaccination, not just one, full vaccination, reduce the need to be at this extreme end of public health measures which is lockdowns using things more like those infection controls, making sure we are protecting ourselves at the border and contact tracing when we have cases.

>> (Inaudible) November, going well but (inaudible) and another case like this happens (inaudible)?

>> Highly speculative. Our goal and this is my singular simple message, get vaccinated. It reduces the risk of being in this situation and reduces the need to use these more extraordinary measures and it saves lives.

>> On this outbreak we are far behind to vaccinate our way out of it stop the strategy now is level IV.

>> I want us to get back to levels of freedom. People, even countries with high vaccination rates, bringing in restrictions alongside high vaccination because they have dealt outbreaks so my goal, our goal at the moment is let's deal with this outbreak, get us back to those freedoms and I absolutely believe we can do that. We are on track. Everyone needs to stick with that. I will take the last couple of questions if I may.

>> (Inaudible) facility and what happens when it gets full?

>> A good question. We had that conversation this morning. It is not at capacity, we have space, are prepared if we have additional cases. We have extra capacity, can prioritise having cases at the (unknown term) Park and using other facilities, we have family household members are not having to isolate them together but if they are at risk, isolate them in another facility so we have already done that work and confident we can manage.

>> I will let you finish.

>> (Inaudible) working with massive queues at testing centres and hospitals not having a substantial increased ICU capacity in the past, I guess has the government done enough to prepare?

>> We have considerably more ICU capacity, can stand up before the capacity outbreaks so the message we have had from Dr Bloomfield. Our goal is not to use ICU capacity. -- lose.

>> Has the government in enough to prepare for a public health outbreak? -- done.

>> We are one of the last countries in the world that has had Delta in the community so with even the best measures you still have to be prepared for the scenario and still have to have a plan for the scenario and we do and that is what we are activating now. In terms of Murray households and intergenerational, have there been struggles to isolate families in one house? If there has been, what has been done to do that? Caroline McElnay?

>> I don't have specific details but we are aware of that and a conversation we had this morning with the Auckland District health Board around how to enable and support families to be able to do that. Obviously for cases, we have the ability, the jet Park facility where cases go but also looking at a facility we can then accommodate close contacts who cannot isolate easily from the rest of the household so look at different ways we can support families.

>> Overcrowding in homes, how big a risk is that to the way people can isolate?

>> It is a challenge and we know with the delta variant in particular that household transmission is a very real... Likelihood and so it is important to, particularly when we know we have a case, that is why we have a different accommodation option for people who identified as cases but it is something when people are identified as being at a location of interest to separate as much as they can from the rest of the household but also it is about the importance of getting tested because until we have the test , the test is negative, so we are taking a cautious approach.

>> It is a reason we can expect numbers to go up because with Delta, previously would see some household infection not necessarily the entire household. On these occasions in overseas experience it is telling us you can almost certainly see very high rates of infections among households so that is another reason we expect those numbers to go up. I felt like I was a bit dismissive of (inaudible) and not ask another question. If you don't persist... I will give it to you in front and then I will finish.

>> (Inaudible) have been asked to travel to (inaudible) evacuation (inaudible) and are getting turned away because of the crowds. What is your understanding on the ground as it stands and is the evacuation (inaudible) mission?

>> It is being hampered, no question and that is something we were advised of by officials at the point that we deployed our asset into the region to try to assist the evacuation. Our role, though, is to support the evacuation generally and all partners work together, will not just be bringing out their own people but often are supporting others and will be a part of those efforts but I am concerned that because of the situation on the ground we need to start working on what the next stage will be because it does not look like we will get everyone out that we want to get out.

>> (Inaudible)

>> Too early to say but there is a window that everyone is using to try and use the secure space that is available at the airport but it is an entirely separate issue of people's ability to safely connect with the airport and as Not all the people we are trying to reach our even in that province. No-one has been able to connect them to cobble. We are part of an international effort that doesn't just involve us uplifting our people. We are working together so that we are in a position to bring out whoever needs to come out on our assets and our partners are doing the same for us. It's not an environment where anyone is picking and choosing, we are doing our best.

>> (Inaudible)

>> We are working closely together and as I described, we will all be picking up one another's citizens and Afghan nationals. I will let you finish this line and then we will wrap.

>> (Inaudible) have made offers of 20,000 refugees over the coming years, would you be making a similar offer?

>> You will know in previous decisions we've made already, have been around broadly increasing refugee numbers. Too early to say what the make-up of Afghan nationals will be amongst that but you can see this is going to be an area with a large number of refugees in the future and that is something we will work through. Thank you, everyone.