COVID-19 update 21 October 2021

News article

21 October 2021

Deputy Prime Minister Grant Robertson and Director-General of Health Dr Ashley Bloomfield will update the media today at 1pm.


>> Aotearoa kia ora. 

I will hand over to Dr  Bloomfield to update on case  numbers and other things. Come  back to me for a brief comment  and your questions. Aiming to  enlighten the house and finish  around 20 to.

 Dr Bloomfield. 

>>  Thank you. Kia ora koutou katoa 

we're announcing 102 case in  the community of these 90 in  Auckland and eight in Waikato. 

Our total number of cases in  the south break is 8,260.

Of  today's cases 30 are household  contacts, 40 are yet to be  linked to a current case,  although you can imagine with  this number of cases interviews  on many are just getting under  way or about to happen.

 Now, of  yesterday's cases, the 60, 20  remain unlinked at this point  with investigations on going.  The focus, of course, is on  identifying contacts and  isolating and testing those  contacts.

Today, we've got 46  people in hospital. Our highest  number in the outbreak to date.  45 of those in hospitals across  Tamaki Makaurau and one in  Waikato Hospital.

It's becoming  increasingly clear as has been  the case right through the  outbreak COVID is  internationally a disease  amongst the unvaccinated. That  is certainly the pattern here.  The harms of COVID-19 fall much  more on those who are un  immunised. A BMJ study which  was released just last month  based on UK data shows of  40,000 patients hospitalised in  the techs months to the middle  of this year in the UK 84% of  those people hospitalised had  not been vaccinated and only 3%  of cases are in hospital - in  hospital were fully vaccinated.  Our figures are similar.

We  still three of our 188 people  hospitalised in this outbreak,  6.1% who are fully immunised  that is at least two weeks  since their second vaccination  and fully immunised cases make  up just 4.5% of the total.

So,  further evidence from here and  also from the UK that  vaccination is an excellent way  to protect you, and the  community.

Testing also remains  important. Yesterday 12,759  swabs were taken in Auckland  and 26,669 tests processed  around the country. Every one  of these tests is important for  us, keeping COVID under control.  So, thank you to all those  involved in swabbing and  processing the tests. Testing  available right across Auckland  today, again, and reminder that  anyone with symptoms, even if  they are mild and even if you  have been vaccinated, and in  particular, in New land and the  suburbs of Rosedale Bayswater  where the positivity rates were  mier over the last few days get  tested but anywhere please get  tested and isolate until you  receive your result.

The eight  new cases in Waikato are all  around the Te Awamutu.

Seven  have already been linked to  known cases. Waikato DHB is  continuing testing across the  region. There were over 3,000  swabs taken yesterday.

However,  we would like to see higher  testing numbers in and around  Te Awamutu. Please get tested  if you have symptoms, if you  have a household member who has  symptoms or if in the course of  the last week or so you have  travelled in and out of Te  Awamutu for work or other  essential activities. Whether  you have symptoms or not,  please get a test.

One of  today's cases in Waikato was a  permitted traveller with an  exemption to travel to Napier  last Friday, 15 October. They  were not a confirmed case  during their travel and  subsequently turned positive  when they returned to the  Waikato where they are  isolating at home. Their  infectious period included the  time they travelled to Hawkes  Bay.

There were two close  contacts identified one of who  lives in Wairoa. However both  have returned negative tests.  There is no risk of infection.  They will as close contacts  will be kept in isolation for  the full 14-day period and  retested on day 12.

I would  like to reiterate there are no  positive cases in Hawkes Bay and  thank you to those involved in  this situation for their  excellent support.

The  ministries updated guidance for  allied health professionals  working in settings outside of  district health board and  hospitals clarifying they can  provide services under alert  level three. That would be in  Auckland and the Waikato.

This  clarification enables roughly  2,000 allied health  professionals such as  physiotherapists, chiropractors,  osteo paths, in Auckland -  that's just in Auckland alone  to see patients who need to be  seen face-to-face and provide  appropriate treatment of course  they will be screening patients  for COVID symptoms practicing  COVID-19 IPC measures including  distancing where appropriate,  strict protocols around  infection control, PPE use,  scanning and so on.

They will  also keep providing Telehealth  services where that's most  appropriate.

 I want to thank  our allied health professionals  who have had to adapt their  practice through the course of  the outbreak techly in Tamaki  Makaurau over the last few  months.

 Finally it is infection  prevent control this week -  week this week. I would like to  acknowledge the huge effort and  dedication of the IPC  professionals especially the  nurse specialists and others in  the health workforce. That on  going work has been  particularly front of mind  during the pandemic over the  last 20 month and of course has  been a lesson for all of us and  the general public about what  we can do to prevent infection  spreading including and most  importantly not going out to  work or anywhere if you are  unwell. Back to you. 

>> Thank  you very much Dr Bloomfield. 

Just before I take questions, I  do want to say something about  the case numbers. I know for  people who watch the 1:00  briefing it is something that  you follow closely and the ups  and downs can be a bit of an  emotional rollercoaster.

You  will have heard from all of us  who have spoken from here  recently that we can expect to  see case numbers rise. Of the  we do still want to keep them  under control and we're working  hard to do that. We thank  Aucklanders for their  cooperation in doing so and as  we head towards the long  weekend to ask Aucklanders to  continue to stick to those  alert level three rules.

 While  keeping a lid on case numbers  is important to reducing  hospital admissions and  reducing pressure on the health  system case numbers in and of  themselves are not the only  measure we need to use going  forward to assess the severity  of the outbreak. It is  anticipated in the future 95%  of the people who get COVID  could be treated at home with  appropriate community care. And  indeed in this outbreak only a  small percentage of those who  contracted the virus have ended  up in hospital.

The bottom line  here is that the vaccine is the  key to keeping you, your family  and your community safe. We are  facing this outbreak with  higher rates of vaccination  than perhaps others have in  other countries. We are in a  strong position but we do need  to build on that and see more  people be vaccinated.

So, today,  that means that we need to look  at the number of cases and do  all we can to keep them under  control but also keep an eye on  hospitalisations so that we're  measuring the severity of the  outbreak there. The safety and  health of New Zealanders  remains at the forefront of our  mind and it is how we will  continue to focus on managing  the outbreak. 

>> What is in  place for hospital this get  overwhelmed with COVID cases  100 today. What will we see  tomorrow? 

>> I make the point  because we have 100 cases today  doesn't mean 100 people go to  hospital. Far from it. What  we've planning for the whole of  the outbreak making sure the  health system can cope. New  Zealand's health system is  staffed by highly, trained,  dedicated professionals. Dr  Bloomfield who I will turn to  in a moment through the  ministry of health works with  the DHB. We shared workforce  around the country to make sure  people can be given time off to  make sure we get the right  speciality in the right place.  Today, we have six people in  ICU. The number of people in  ICU is keeping reasonably  steady and so ICU capacity is  not an issue for us at this  time. Overall the hospitals  have been planning for this.  That's what they do. Dr  Bloomfield do you want to add  to that? 

>> To add to that one  of the things we've been doing  for the last two months is  supported the Auckland DHB with  staff coming from around the  country. The hospitalisation  numbers the ICU bed use are  consistent with what our  modelling suggested and  consistent with the case  numbers. They're very much in  line. We of course would not  let ourselves get to a position  where our hospitals were  overwhelmed. The key thing is  how we use the resource  available in the hospitals but  in the community through  primary care providers to look  after as many people as  hospital outside -- as possible  outside of hospital. 

>> Are you  confidence of schools opening  next week with the surge in  case numbers today? 

>> It's  always a ball between the  potential risk of infection  spreading but also the other  health social and educational  needs of the students. Our  assessment for a while has been  that it is safe to open those  schools. I think a number of  measures have been put in place,  including reducing the number  of students by confining to  years 11 to 13, the use of  infection - strict infection  prevention control, mandatory  use of masks and we also note  especially in Tamakimakoto we  have good vaccination rates in  the 12 to 18-year-olds. That's  encourage ing. It will require  as any student who is not - or  staff member shouldn't go to  school. We will keep a close  eye on that until through Labor  weekend and advise if there's  any change in that. The 

>> To  add onto that we wouldn't have  made the decision if it wasn't  on the basis of good advice and  good safety measures. As the  Director General just said  we're making sure infection  prevention measures are front  of mind for all schools. We  have teachers being vaccinated.  We want students to be  vaccinated. Some schools are  now deciding they want to pick  that up themselves as well. All  of that is positive. We're  talking about a cohort of  students between years 11 and  13 who are coming up to some  really important parts of their  schooling journey. We wanted to  make sure we could facilitate  that in a safe way. We don't  have year nine and 10 student  and we don't have Primary  School students returning at  this time. We always look at  risks and the balance of making  that right. 

>> How concerned  are you about the growing  number of unlinked cases and  are any of today's unlinked  cases in Waikato? 

>> There was  the one that hadn't been linked  yesterday in Waikato. I suspect  as interviews take place that  will change. The other seven  were all contacts. 

>> How  concerning is the growing  number of unlinked cases? Are  you reaching the point where  contact tracers are starting to  feel immense pressure? 

>> Can I  comment on that? It's to be  expected. It's by virtue of the  nature of the outbreak and also  the numbers. Again at this  point in the outbreak in  Auckland the focus is not so  much on trying to link the  cases. The most important  information is to try to find  out who the contacts might be  of those cases and get those  people tested and isolated.  That's been the focus for the  last week or two of our contact  tracing effort. The contact  tracing is just as intensive  and as timely as it has been  right through. 

>> Can I add one  thing to that answer too,  throughout this outbreak we've  been making sure we share the  burden under public health  units around New Zealand and so  particular clusters of cases  have been managed by public  health units outside of  Auckland throughout the  outbreak. We're conscious of  the fact the contact tracing  team in Auckland are doing a  great job for us. Woo are  spreading that load around. As  Dr Bloomfield said what we're  focussed on is getting to  contacts. The linking and so on  is no longer the most important  job that they have got. The 

>>  The converse argument from  epidemiologist s if you don't  know where it's come from you  don't know if there's an  undetected chain of  transmission. Isn't that just  as important as finding on  going transmission from one  doll low says? 

>> At this point  in the outbreak the key  response here is high rates of  testing to continue and finding  cases. Right from the start of  the outbreak every case of  course is another one to add to  the numbers. But we want to  find the cases. Likewise the  modelling that we get updated  from Auckland everyday does  look and see if there are  likely to be large numbers of  undetected cases in the  community and the latest model  elg show no it's a pretty good  match. Our sense at the moment  is we are finding most of the  cases out there. 

>> Do you have  the sense of - in the sense of  how many more cases there could  be based on the contact in  Waikato and Auckland which you  have reported before? 

>> In  Auckland we're too far into the  outbreak and the numbers are  too large for us to be able to  keep a track of that. In  Waikato we know there are all  the close contacts have been  identified. Well, all the once  - the -- all the ones the  family close contacts have been  identified. For some of the  close could contacts we don't  have a good indication of all  of those. We are using the  cases to spread the word around  their networks to ask people to  get tested and in a way it's  good to see the testing numbers  coming through. We are  identifying the cases so that  approach is working well. 

>>  With the Waikato cluster,  effectively, it is much more  one that we can see, that we  can identify. We have to work  through with people to make  sure we're getting all that  information, but I think - I  distinguish the two quite  significantly from here. 

>> Do  you have an estimate of how  many more cases there could be  in Waikato? 

>> I don't have  that in front of me. There will  be more cases in week bike  because -- Waikato because we  have people in households and  that's the way it spreads. The  by having the measures we have  in place in Waikato we continue  to try to stamp out the  outbreak. We're taking the  approach we're taking because  we believe we can do that. 

>> I  will come back to you on that.  It was something we were doing  earlier on with the smaller  number of cases in Auckland. We  will separate out the Waikato  cases and see how much  potential household and other  contacts there are and  conversion rates. 

>> Following  on from that can you tell us  how many unlinked cases there  are in Waikato and where they  are spread and if there are any  active cases I think outside of  Raglan, and Te Awamutu. 

>> The  eight cases were around the Te  Awamutu area. Seven in Te  Awamutu one in Kihikihi. Seven  have been - are already known  to be linked. The other one is  being interviewed but there's a  strons sense there will be a  link there. The only cases that  I understand that have been  unlinked were the two in  Hamilton from about a week ago.  They're still - they have been  linked through the whole genome  sequencing it's unclear -- it's  clear but the epidemiological  hasn't been made yet. 

>> What  was your other question too? 

>>  How often is the wastewater  testing being done around the  country. Obviously there are  more cases in Auckland chances  of it leaking out, should be  there be more focus on that.  Can you tell us how often the  wastewater has been testing  around the country? 

>> It  varies. My understanding there  is a dashboard on the website.  It's the same dashboard I get  that shows wastewater testing  results on a daily basis from  around the country. Most places  weekly some twice weekly. I  guess we're in a point in the  outbreak in Auckland where  probably the wastewaterest  testing of less use because we  know it will keep returning  positive across the city. So,  we will be increasing the  frequency across Waikato over  the coming week or two to  identify whether there may be  detections in some of the  smaller towns around Waikato.  

>> In recent days, recent in  the last week within the  Waikato area there's been an  increase in wastewater testing  just as there was in Auckland  as well. So, there's regular  testing around the country and  then we hone in on areas where  we believe we need to do even  more regular testing. 

>> Could  it be more frequent around the  country than once a week? 

>>  It's something we can look at.  I wouldn't rule out trying to  increase it. We take advice  from the Ministry. We use  wastewater testing the way I  described throughout the  pandemic. We will continue as  we're asked to. There's no  resource restraint around that.  

>> The likelihood of it  spreading around the country  and we obviously want to find  it, if it does, as soon as  possible. 

>> There is regular  wastewater testing around the  country. Not that there's none.  I take your point you're  suggesting should we up it  everywhere? The advice we  continue to get from the  Ministry and others is we  should do regular testing and  focus in on hotspots. 

>> We're  looking at it again as part of  a future testing in a highly  vaccinated population including  which test - the sort of  surveillance testing, the  population but also the  wastewater testing. That may  well see us doing the latter  more frequently as part of the  disease detection really, early  detection after about a month  from when we move into a highly  vaccinated population. 

>>  Director General we have  information to suggest that  somebody at one of the MiQ  facilities in Albany had left  the facility and then came back  later in the day or later after  a period of being out in the  community. Have you got any  information? 

>> I haven't. 

>>  We can follow that one up for  you. 

>> Just as a punt, the  initial case that launched  Delta into New Zealand where  are we with that? Have you  found anything to suggest where  that came from? I know it's  been a while or has is that  trial completely cold? 

>> The  trail went cold. We obviously  focussed our re-sources on  managing the outbreak. We did  look very hard there but  weren't - we have a really good  idea of we know which hotel it  came from, which person and  pretty much which day but how  it jumped across the border  there as it were has not been  able... 

>> That's not common in  these sorts of things. We have  a lot of information about it  but in the end the absolute  100% confirmed link wasn't able  to be made. Jo. 

>> Just on the  allied health announcement  today there's been calls for a  long time, particularly for  people who get regular physio  treatment, why has it taken so  long to decide... 

>> The  ministry has been working  closely with the professional  bodies and in many senses, it  was a clarification of what the  - what is permitted under alert  level three and early on in an  outbreak when certainly in  Auckland we're trying to  effectively stamp it out and  get back to zero, the controls  under alert level four and  first part of alert level three  were designed to minimise  contact between health  professionals and people as  much as possible. It's now  reached a point and certainly  talking with our DHB colleagues  up there that enabling access  to some of the allied health  services in the community will  help with any - with conditions  progressing to a point where  they might need hospital care  and we've also worked out with  those professionals how they  can ensure they and the people  they are treating can remain  safe. 

>> Minister, lastly, Sam  asked you about will you give  any consideration to expediting  the proactive release of this  type of health advice. Have you  had any conversations with the  Prime Minister or cabinet  colleagues about that? 

>> I did  after we spoke have a  conversation upstairs. I will  have to follow up on what  happened with that because it  wasn't resolved. 

>> Dr McElnay  said last week that about 170  to 180 cases was that point  where our health system would  get a bit of pressure put on it.  Do you have any indication  where - if New Zealand may  start to look at getting those  kind of numbers each day? Is  there any modelling to suggest  that. 

>> I will give Dr  Bloomfield a chance to respond  to that. I was standing here  when that was said. I think the  context is important. In terms  of the earlier question there's  a difference between how we  manage pressure in the system  and whether or not it's  manageable. We believe it is  manageable. Obviously as we get  to a greater number of cases,  particularly greater number of  hospitalisations then hospitals  have to start managing their  resources. And that is the  process that they have been  planning for, for some time.  This is being - this is common  in other situations we face in  New Zealand when you get a very  large outbreak of the flu or  you have other reasons why  hospitals have systems to allow  themselves to be able to move  resources around. I think  that's what Dr McElnay was  referring to once you got up to  hospitalisations around a  higher level that will be  driven by a higher case load  then hospitals will begin to  start moving their resources  around. 

>> Two comments here. I  wasn't on the podium of course.  But I think it was particularly  talking about the pressure on  the contact tracing system. But  it's effort to the healthcare  system. At the moment our value  is 1.2 to 1.3 which is doubling  about over day which means  we're likely to reach those  case numbers in two to three  weeks' time. What is most  important what proportion of  those cases have been  vaccinated. That will be  material in terms how many  require hospital care. There  are two things Aucklanders to  do to take pressure off the  staff and hospitals to continue  to get vaccinated and abide by  the alert level three  requirements. 

>> On Monday  showed about 77% of people  weren't vaccinated, including a  fair chunk of them were  children. About 50% didn't -  weren't vaccinated. Are you  anticipating to see those case  numbers have a higher  vaccination rate just to try to  reduce those hospitalisation  levels? 

>> Yes, so actually we  just saw some modelling from  our colleagues in Auckland  today showing that over the  course of the outbreak in  Auckland the proportion of  cases who are vaccinated is  increasing. It's still by far  the minority. So, next week  will give a little bit of a -  do a little bit of a show and  tell on how this happens, of  course, as you get a highly  vaccinated population the  greater the proportion of your  cases will be vaccinated. But  it does absolutely keep down  the hospitalisations because  they're much less likely to be  hospitalised. As I said only  1.7% of those hospitalised in  this outbreak have been fully  vaccinated. 

>> It's simply a  function of maths in any way  the more people we see  vaccinated the more likely as  an outbreak growth you will see  people in the outbreak who are  vaccinated. To reiterate Dr  Bloomfield's point both at a  personal level being vaccinated  means you are less likely to  get the virus, less likely to  be sick with it and far less  likely as we statistically know  to be hospitalised. As I said  in thy introductory comments  we're looking at all those  measures in terms of how we  measure this particular  outbreak. I will come up the  front. 

>> Question for Dr  Bloomfield. I think it was  yesterday 86 cases that are  isolated at home. Can we get an  updated number of that and how  Delta in the outbreak whether  there's any concerns isolating  people at home considering the  virus spread through  unvaccinated households so  far... 

>> As of yesterday I  think by the end of the day -  by the middle of the day it was  101 people from 55 households  who were isolating at home.  There's public health and clin  cal risk assessment done before  people -- clinical risk  assessment done before people  are put in that low-risk of  being able to isolate safely at  home. In particular if people  in households where it's  difficult for them to be  separate from other household  members then almost they go  into a category where they  would be supported to go into a  quarantine facility to avoid  that - what we've other seen as  quite a high rate of infection  of family members. 

>> I have a  question on behalf of Shaun.  They want some of the family  members stuck in Auckland to be  able to travel down and support  the rest of the family as they  grieve. Why is that not allowed  and why are there such  prescriptive rules around what  constitutes an immediate family  member? 

>> As you know this has  been one of the hardest things  throughout COVID-19. I have  stood here and answered  questions here about it before.  It is a truly difficult area  for both those who give us  advice how exemptions are  granted and the governments in  terms of the rules. Throughout  this period of people there  have been people who tragically  missed out on attending  funerals and it is very hard.  The advice we take however is  around how we minimise risk and  the thing about funerals,  weddings, those sorts of events  is they are one where people  find it extremely difficult to  socially or physically distance.  So it is a very, very difficult  area. I know the ministry works  throughout to find way to  facilitate people. It is  challenged by the con at the  present time of tungihunga  because it implicitly involves  a wider group of people. That  makes it more challenging. We  do know that this is a risk  area for us. We try to manage  it sensitively you many, many  people have unfortunately had  to do that. Do you have  anything to add? 

>> Just that I  know our team looks at every  application on its merit and in  fact we've extended the  criteria for that sort of  family relationship that does  allow people to travel out - to  include not just first degree  relatives but where there's  other relationships as well. If  people do ask for a review of  it. I think there was a request  yesterday of that then I ask  the team to go back and look at  it. 

>> In this case it's an  aunty. Have we put too much of  a lens on what constitutes  immediate family. Have we not  taken... 

>> I believe the  Ministry does take into account  cultural factors but in the end  there will always be a limit to  numbers. That the issue that we  are dealing with. 

>> Also just  aside from tungihunga. Should  there not be I guess some  sympathy given and leniency  given where whanau need the  support of the wide family. 

>>  Again my heard goes out to this  whanau and all the others who  have been through this. It is  without doubt one of the most  difficult areas of managing  COVID-19. We try to do it  sensitively. We try to do it  safely and I'm sure the  Ministry and others would have  been assessing any application  that way. Ben? 

>> Do you agree  with quite morbid suggestion  from Mike Smith who said it  will take Maori deaths to up  the vaccination rate. We did  see that lightly after the AOG  cluster. 

>> I don't want to  look at it that way. We've seen  really good progress in multi-- - Maori vaccination in the last  few weeks. We've come through  with significant increases. We  are working every single day  with every provider we can to  make sure we increase Maori  vaccination rates. I don't want  to look at it that way. I want  to look at it as a lot of Maori  on the basis how they can  support their whanau and wider  community to be able to stay  safe. I appreciate there will  be people with different views.  

>> May I also ask does the  increase case count, does it  expose of having the folly of  one of these freedom days as  has been by the opposition on  December 1.. 

>> Putting  yourself in a position where  you need to say there needs to  be a certain percentage.  There's also a so-called  freedom day seems to be a  somewhat contradictory position.  What we need here is to get  vaccination rates as high as we  possibly can across as many  parts of our community as we  possibly can and you know I -  everybody would love it if you  could set a date with COVID  that everything would be over  but that simply isn't how the  virus works. I understand the  frustration that sits behind  that. Actually the strong  advice we've had is it's about  vaccination rates. I will come  to Jason. Before I do. I can  say I got a message saying  there's no truth to that rumour  and there are no facilities in  Albany. 

>> Is the decision for  cabinet tomorrow still around  Waikato? Is that still on the  Agenda. 

>> The advice - the  public health risk assessment  we will get from the Ministry  of health is likely to come  through late this afternoon.  Ministers will attempt to  assess it as quickly as we can  so we can give certainty to the  people of Waikato as we can.  We're likely to try to announce  it possibly this afternoon.  That won't mean another press  conference just to reassure you  of that. It will likely be done  by media release as soon as we  get the information. There's a  timing issue. Dr Bloomfield and  his team provide their advice  and it works its way through to  us as ministers. We are  conscious people in the Waikato  will want certainty in which  case we will try to do it this  evening. 

>> Is there going to  be a cabinet meeting? 

>>  There's a group of cabinet  mince who have been given power  to act on this. We can meet in  a number of forms, virtually  and in person. We will be able  to manage that. We will go to  Henry. He hasn't had a question.  

>> Minister, have you seen the  news on the warehouse to  require vaccination for all  staff. Are you happy about that  and do you think that basically  every retail store could  possible lick -- possibly -  retail chain make the same. 

>>  It's clear that a number of  businesses have been working  their way through this and  working their legal obligations  and assessing the health and  safety of their workforce and  suss kers -- customers. If you  go on the WorkSafe website you  will find a risk assessment  tool you can use as an employer  as to whether or not you should  be vaccinating or your staff  should be vaccinating. A big  part is public facing and if  you're in that position it  would justify from health and  safety perspective you decided  you wanted all your staff to be  vaccinated. In terms of the  broader issue work has been  going on between government  ministers, business groups and  unions to discuss how we will  moving forward from here to  provide the maximum amount of  certainty we can. I think  everyone will appreciate it's a  relatively new area for  employment law. People are  treading carefully. That work  is progressing. In the meantime  as I say there is a risk  assessment tool. I'm not going  to comment specifically on the  warehouse, but certainly where  you have a lot of public facing  staff you can look at that tool  and see that from health and  safety perspective you are  likely to want to have  vaccinated staff. 

>> That will  drive the vaccine up. After  Super Saturday we have seen...  The last since August looks  like things are dropping off.  

>> We know as we get to higher  rates of vaccination we get to  people who are perhaps more  hesitant or harder for us to  reach. It's not a huge surprise  in the absence of a major  effort like Super Saturday. We  are now applying all the  resources we can to reaching  those people. To answer the  first part of your question, I  welcome anything that lifts  vaccination rates. I think more  people talking about the  importance of it not just from  the health and safety of you  individually but the people you  work with, the community you  around is a good thing. 

>> Do  you see... They don't want to  be in court. Currently as a  first assessment tool that can  be challenging. 

>> Whenever you  get into matters of employment  law anything becomes  challengeable. I have no doubt  at some point there will be  legal cases in this area around  the world you can see them  happening. The work ministers  are doing is give as much  clarity as we can. We are aware  of those employers who are  telling us, please mandate this.  We also have ones who don't  want it as well. We have to  make sure we have a legal  framework that is robust.  Discussions about that are  happening. I'm sure we will  have more to say about it soon.  

>> Legislation will be too far,  if Legislation was necessary to  give that certainty to  businesses then that's what  they would do. Do you not think  it's necessary or do you want  to put it under the statute  books and have it in that kind  of form? 

>> As I said in my  answer to Henry this is  evolving and evolving quickly.  You look around the world at  examples that have gone either  way. What I think the most  important thing is certainty.  If certainty can be delivered  by Legislation that's one thing.  If there are other ways of  doing it we should look at it  as well. We need both employers  and employees to be able to  come along with this. If - I  know we're in the middle of  this now. If we all took a step  backwards and for a moment  considered that's the kind of  employment law change we will  be considering it's a big step.  We're in the middle of a  pandemic. Big steps are things  we've had to do. We have to  make sure we work through so we  don't put ourselves in the  position Henry mentioned of  being in court. 

>> I mean the  government's potentially... 

>>  Correct. 

>> Is there anything  on the horizon that could be  the test case for it? 

>> We're  certainly not looking to take  the case. Look, again, the only  reason I mention is that is  because if you look around the  world that's what's happened.  So, I would not be at all  surprised but we are working  through that process. I do  welcome as many people as  possible beings vaccinated and  obviously as I say right now  people could take a look at  that risk assessment tool and  make a good judgment. 

>>  Challenges of government... 

>>  I'm not aware of anything right  now. 

>> I want to clarify there  might be a decision of Waikato  alert sefl setting today? 

>>  Potentially. The only reason I  say it we want to give people  in Waikato as much notice as  possible. 

>> The Prime Minister  said on Monday it was going to  come on Friday. 

>> That's right.  It's because the public health  advice gets delivered today and  we don't want to delay. We  sometimes get criticised in  this room if we sit on a  decision for a short length of  time. So, ministers when we  were briefly discussing matters  earlier this morning concluded  if the Director General  provided his advice to us today  and we can make a decision  today we should do that. 

>> Ask  the worker who went to Hawks  Bay who later tested positive,  dune their -- do you know their  vaccination status? 

>> I don't  and it was a person who was  related to childcare  arrangements. I don't know  about their vaccination status.  They returned back to Waikato  before they were a confirmed  case. I know one of the two  contacts in Hawks Bay was fully  vaccinated. As I said both  those people returned negative  day six tests. 

>> Do you have  any more mandatory vaccination  for people leaving the brown  bring? 

>> Not -- boundary. 

>>  Not lately. Conscious of the  time. I will take a couple of  more. 

>> You are talking about  the on going need for the  difficult ones to get  vaccinated. Does it bother in  places for example there has  been a plea from people who run  services for a caravan-type  style - for a number of month  now and they finally got  granted it yesterday because  Maori vaccination became such a  talking point and the minister  called out the DHB for being  slack. Why does it take that  sort of comment to prompt DHB  to deliver the services that  multi-service providers who  know what they are doing on the  ground actually need? 

>> I  can't specifically on the DHB  in this instance. What I know  we have good examples where we  have good things between DHB  and other providers. We know  others that don't. Our job is  to make sure we work with every  provider who can and help us  lift the vaccination rates. I  absolutely respect that there  are more multi-health providers  around New Zealand who know  chair community well and they  know their community in many  ways a lot better than perhaps  some of the people in the DHB  do. We have to listen to them.  This won't work unless we're  collaborating. The DHBs are  vital O cogs in this. They're  under a lot of pressure,  working, very hard. We can  share the burden of that. I'm  pleased they have responding to  the minister's call. 

>> Have  you been involved in that at  all? The Mish u has been raised  with you here, most of the time.  Have you talked to the DHB?  That h that prompted them to  thifr this? 

>> -- deliver this  service 

>> I don't talk to the  DHB. My team does. They meet  with all the senior offices  from the DHB. I spoke yesterday  with the CE of Tanawaki to ask  what he else they needed and I  was reassured by what I was  told around what had improved  in terms of working within the  relationships. I know it is  important. I know he had a  conversation with the Chief  Executive yesterday. 

>> Dr  Bloomfield when will the border  be updated to recognise other  vaccines for border workers  such as Air New Zealand pilots?  

>> I don't know. I will come  back to you on that it is close  to being completed. 

>> The  ministry of health delayed  court proceedings, why did you  offer a proposal that was not  the data set that was asked  for? 

>> I'm not going to  comment on that. It's a process  that will be - may still be  before the court. 

>> We will  leave that. We will take the  final one. 

>> On travel  documents. Has anything been  done to tighten up the process  after those two travelled out -  to Northland. Has anything been  done? 

>> I believe I might have  said on the podium. We went  back and worked with NBN how  those travel permits are  granted. They are in a thorough  process of checking categories.  There was an element of human  error in what happened there.  So processes and systems get  constantly checked. I think I  said a number of times before  with the numbers of people who  are moving it is very tough but  each day I know that there is a  group of people working really,  really hard to make sure that  they help keep New Zealanders  safe by working through the  permitting system. Every now  and then there will be a  mistake. As soon as it happens 

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