COVID-19 update 22 September 2021

News article

22 September 2021

COVID-19 Response Minister Chris Hipkins and Director-General of Health Dr Ashley Bloomfield will update the media today at 1pm.

 

>> Kia ora koutou katoa, good afternoon, everyone.

We will start with some good news. A significant milestone for Auckland on a day when our largest city has returned to COVID-19 alert level 3 they have also achieved the significant milestone of hitting 80% of the eligible population now having received their first vaccination. That is very good news.

A very big thank you to Aucklanders who are once again at the forefront of our response to COVID-19. They are setting the pace for the rest of us and have now set a benchmark that we want the rest of the country to see if they can reach as quickly as possible.

I will hand over to Doctor Bloomfield for an update on the case numbers for today and then I have more information on the vaccine program and some news for those who are studying and CIA in Auckland. Doctor Bloomfield.

>>Thank you, minister. Kia ora koutou katoa.

Today there are 23 new community cases to report, all in the Auckland region.

 It takes a total number associated with this outbreak two 1108 and pleasingly 835 of those cases have now recovered.

Additionally, there is one new days from a case from the isolation facility who has returned.

Of today's 23 new cases 22 are considered epidemiologically linked at this point. 11 of those are household contacts including six within one household. Five unknown close contacts and one is likely.

 Investigation continues into the remaining person who is been reported today.

 Yesterday's one unlinked case also remains under investigation today.

Today there are 13 people in hospital with two of those in intensive care.

 Great turnout at testing centres yesterday, with 9780 swabs taken. That is 8441 four hour seven day average.

 It has been great to see strong demand for testing pop-up centres. The pop-up centre yesterday at the sports poll in Clover Park had 553 swabs taken in just one day. Around 1/4 of the residents of Clover Park have been tested since the beginning of the outbreak, so to everybody who turned up yesterday to be tested, thank you very much. W

e are also seeing a good response to testing in other regions. I've through testing centres yesterday saw an extra few hundred swabs, and additionally a further 1700 T processed overnight from the wire Waikato region. -- Wider.

 Based on the testing and the negative results from the other regions areas it is now moved to alert level 3 along with the rest of Auckland and is covered by the relevant COVID-19 public health response level that is in place for them and the Auckland area.

The residence must adhere to be usual level 3 restrictions, and the key one is to stay home as much as possible. Do not expand your bubble at this point. Don't just go out and about. Just do it when you need to.

A reminder also that the section 70 order applies to people who were in the upper Hodaka region from between the 20th and 28th of September and you left the region before 7 PM on the 20th. That includes people living in the area at the time, working there or may be visited the area. Those covered by that notice must remain in isolation by themselves and monitor for symptoms if they become so dramatic of course they should seek a test. -- Symptomatic.

 If anyone has attended a specific location that has been identified and are listed on the ministry for health website, there will be instructions for them to further their isolation requirements. You can leave your place of residence if you are covered by a 70 notice to access health, to get a vaccine or for any other reason necessary to provide a -- to preserve your safety or wellbeing.

The move, as I said for upper Hodaka we has been made possible because of high levels of testing and great committee support for the testing and restrictions and well contained community there.

For example, 93 of 99 contacts at the school in Mangatangi have returned a negative test, which is great.

We are reviewing the situation on a daily basis as well as the other areas covered by a section 70 notice to inform the decision for the next steps. At this stage the requirements to isolate under section 70 remain in place until 1159pm this Friday.

On boundary exemptions, just an update. Personal travel across the level 3 and level 2 boundary is still highly restricted. The threshold for an exemption remains high and you still need to contain the virus within Auckland. However, in addition to the new exemptions announced yesterday there is now also the ability to apply for an exemption for people who want to cross the alert level boundary one way into Auckland to provide a support or care to a person or child care where the parents or guardians are returning to work now that we have moved to alert level 3.

There are strict conditions that apply. No one else is available locally that can carry out that function. That the person crossing the boundaries to travel there and stay until the region moves to level 2 and there must be suitable evidence provided to support the need to travel.

There is a high number of applications presently, so people should apply as soon as possible as there is a very short time frame and they cannot always be accommodated.

Just on the vaccine rollout, the WHO continues to one about the info -- warn about the info demo, which is a lot of info information that is inaccurate. In particular false information can be harmful, mostly because it creates uncertainty and that can then express itself with hesitancy to adopt public health measures or indeed to be vaccinated.

A key thing I would just like to encourage people to do, particularly those who are in positions of responsibility or influence, is to please point people towards information sources that are reliable and accurate, those include the Uniting against COVID-19, the Ministry of Health website, the ministry for Pacific people websites and your local health providers.

And finally, thank you Aucklanders for your ongoing work. A blood level 3 still requires very tight restrictions -- alert level 3 requires strict restrictions and you can enjoy coffee and other things, please stay at home as much as possible and get tested if you are going out, and wear a mask.

And if you have not, please get vaccinated already.

>>Thank you. To run create a few key numbers, 53 

>>Thank you. To run create a few key numbers, 53,000 doses were administered across the country yesterday. 21,000 of those were in Auckland.

That means that nationwide three quarters of the eligible population aged 12 or over have now received their first dose and 40% have received their second dose and are fully vaccinated.

To or into those numbers a little bit further, 52% of Maori people have had their first dose with 26% getting a second, and Pacific people have slightly better rates, 57 have had their first dose at 36% have had a second. In terms of our over 65 population, 91% have received at least the first dose and 79% have received a second. For those aged between 40 and 64, 80% have had their first dose and 44% have had a second. Those numbers are encouraging but they do show that we will continue to have a challenge that we need to work on. There's a lot more work to do.

 Across Auckland 1,753,000 There's a lot more work to do. Across Auckland 1,753,105 doses have been administered so far. 1,144,713 of them are first doses.

That is what got us to the 80% mark. 608,000 have received both doses, and are fully vaccinated. I now want to talk a little bit about vaccination of our health workforce.

We have been looking closely at what we need to do to ensure that our frontline health workers are kept protected from COVID-19. Because of the nature of their jobs they are at greater risk of being exposed to and affected by the virus and they can transmit the disease to others. Vaccination rates across our frontline health workers are pretty good. DHB healthcare workers were offered early access to the vaccination as part of group to earlier in the year. -- Group 2.

At last count around 80,000 had been fully vaccinated, but the number is higher if we take into account the first doses. Those figures include both the clinical and nonclinical staff working at our DHB. Those numbers are likely to be even higher now, because it is from our last count. Despite that good progress there are some parts of the sector that need to push further to support their workers to be vaccinated. In short, we need vaccination rates to be very high across this particular workforce.

Many other countries have required healthcare workers to be vaccinated. These include Australia, the US, Singapore, Canada, UK, France, Italy, Greece and Fiji. We are considering doing the same here in New Zealand. I have asked the Ministry of Health to consult with key stakeholders on a proposal that would require the majority of healthcare workers to be vaccinated against COVID-19. This would apply to staff working in roles where they are COVID-19 pathway, including emergency departments in primary care settings with vulnerable patients and it would include people working in aged residential care facilities and critical support services, including medical, laboratories and catering facilities and those providing home and community care services it would require them to be vaccinated.

The consultation is happening now. It will include the representatives of those workers, the healthiness, the professional associations, the office for disability and the Commissioner will be represented for aged care employers. That proposal is in line with the current requirements we have in a surround MIQ with our port workers. We do need to ensure that the work is most likely to come into contact with COVID-19 eyes protected as possible and that they in turn are protecting the most vulnerable.

Turning to MIQ I can confirm that the next MIQ room release through the virtual lobby will take place on Tuesday 28 September at 6pm New Zealand time. The lobby will open at five 6pm New Zealand time. The lobby will open at 5pm New Zealand time, one hour before the room release begins.

There is a need to get onto the website any earlier than that as long as you are there between five afternoon -- 5pm and 6pm. This release will be for approximately 3000 rooms across November, October and December. I do want to remind people as I have said previously that we are not running all of the rooms at once.

There will be more releases after this one. The MIQ website will be updated in the next couple of days of information following the feedback we have received from Mondays release.

 Finally now to the people that have been to be a tough in Auckland, particularly our secondary school students. I want to recognise the extended time the students in Auckland have been spending at a low level 2 and a low level 3. They will have had an impact on their studies.

I am increasingly in encourage that people will get a learning recognition credits for the NCE eight that. They will now be able to get one a learning recognition credits for every four credits have they achieved through the assessments in this school year, after a cap of 16 credits for NCI a level 1 and four levels two and three.

I am also further adjusting the threshold for accreditation to a 44 credit points rather than 46 threshold that will apply to students in other parts of the country. These changes basically bring the support available to Auckland students in line with his what they received in 2020. That was following the second lockdown.

 I hope this will provide a reassurance to those students that their qualifications and the rewards that go with them remain within the average despite the disturbance they have experienced this year. I want to end by thanking our schools, our teachers and our whanau in Auckland for the work that they have done to continue that support of students right through the lockdowns and run through a very disrupted year. I know that a lot of effort has gone in and I want to acknowledge them.

Thank you for that. I will open up the question.

>>Are those extra credits enough to actually help students improve through the high school year? They have been through a lot.

>>They have been through a lot. The level of disruption this year is similar to what we saw last year, if you combine the lockdown. This he had last year. We are bringing the support available to them in line with what we did last year. I also want to note that this is not the last opportunity that they will have to gain support. Last year we offered summer school support for those students had felt a little bit short of being able to complete their qualifications. This awkward uptake of that last year and we will be making sure that that is available again this year. I know that schools are working really hard for example by providing extra support during the school holidays, the forthcoming school holidays, for those completing assessment. I know there is a lot of work going on to do what the students who have those critical assessments. We have heard about Maori rates lagging behind. If we want to get 90 lagging behind. If we want to get 94% and above, what rate you think you would feel comfortable with before you would look at easing restrictions? 

>> 90% and above. It is very important we have an across-the-board high vaccination rate and it is clear therefore that we need to put more focus, even more focus on and even more resource and generate even more demand among our Maori population. As the Minister pointed out, and that over 65 group with the overall rate is already over 90% we are seeing similar rates for Maori Pacific and Maori non-specific and that is a position we want to be. It is no good for anybody if there are communities or groups that have low vaccination rates and so our aim is to have the same high vaccination rate for all groups. 

>> Across-the-board 90% of vaccination rates before you are comfortable relaxing things? 

>> I don't do the relaxing.  There is not much relaxation in this role at the moment. The first part of the statement is correct. We are not looking for any lower rate amongst any group. We are intent on getting vaccination rates at 90 and above all groups and I might point out we have done this before with childhood immunisation rates, they have dropped a bit in the last few years. We have been above 90% and it is also important we get high coverage across geographical regions. 

>> When we are talking about 90% that would give us one of the highest vaccination rates against COVID-19 in the world and looking at the numbers we have seen in the high uptake we have seen in recent months, that is absolutely achievable for New Zealand and so it is an invitation to every New Zealander come forward and be part of that effort. It will position us very strongly in terms of the response to the global pandemic and will be one of the best responses in the world and we will all be proud of but when we talk about 90% that is not and it addition to 10% of New Zealanders to sit back. We need everybody vaccinated unless they have a reason not to and that group is a very small group. The people who have a medical reason not to be vaccinated. We are not talking lots of people so our message to everyone is play your part, come forward and be vaccinated. 

>> The Prime Minister's challenge yesterday at least 90% of Aucklanders get vaccinated before the next alert level decision will you guarantee a move down? 

>> It will depend on a range of factors. We are encouraged by high vaccination uptake, just in Auckland but across the country, the greater the possibilities. I saw that in an advert. It gives us greater possibilities, does mean we can manage things without the need for as many restrictions as we have had in the past as we look to the future. But in terms of decisions we make, we make those on a variety of criteria vaccination rates 01, the number of cases, and in cases we are seeing, the potential exposure events there may have been, there's also things we consider. 

>> Is it right we may never get that down to 0 cases after this outbreak? Also, minister, could you reduce the time between the first and second doses going from six weeks back to the original three weeks between jab one and two? 

>> The first thing I would say is we are not giving up on getting back down to 0. That is why Auckland is still at alert level III. We have a very good shot at getting back down to 0, what we are striving for, what everyone in Auckland is making sacrifice for us to achieve, what are public health teams are working so hard to contact trace to be able to achieve. It is still within reach. Moving to alert level III, does not in any way mean we are not still pursuing getting back down to 0. It is worth remembering that we have got to 0 before from alert level III before without having to go to alert level for at all, so we are well positioned going into alert level 3 to continue the road back down to 0. 

>> Dr Bloomfield, is there a chance we may not get back down to 0 cases two

>> It is a possibility but at the moment we are doing everything to achieve getting back to 0 cases. And on the vaccination interval, our advice remains the same at the moment. Our advice is a standard interval of six weeks, gets a really good balance between maximum immunity and also allows us to make sure we get as many people getting those first doses. 

>> Is it a supply issue, though? Wasn't the rationale for extending it in the first place, wanted to get maximum coverage but now we want maximum double doses. (Inaudible)

>> There were a number of factors we took into account in advising the extension of that interval. It is not a supply issue now. It is our considered view and based on the advice from our technical advise re-group that six weeks is a good amount of time between vaccines to get the best immunological response. -- advisory. And reduce the likelihood of side effects, so that is our advice. 

>> As long as there is COVID-19 in Auckland will you maintain a police boundary? 

>> We haven't typically had a police boundary if an area has been at alert level II and another area has been at alert level I and so it is a very hypothetical question at this point but we would continue to follow hard boundaries if you like when we are at alert level III or four but we typically had a softer boundary if we have had a different electoral boundary like an alert level I, two boundary, for example. We make those decisions at the time, but typically when we have had an alert level I, two boundary or everybody at alert level II, we haven't had it enforced, the boundary. 

>> Dr Bloomfield, moving down to 0, what does that future look like? (Inaudible) case numbers every day and some level of level II, level III restrictions? 

>> That is the million dollar question and doing work on and very active discussions. One of the reasons we are able to have the current low case numbers we have got and they are liver Delta and if you think about the fact that even today one household, six people, because Delta does tend to have high transmission rates and sound households, one of the reasons we are keeping it down is because we are in this position now having had a big outbreak (inaudible) but we have 80% of Aucklanders having had at least one dose of the vaccine. There is no doubt in my mind the vaccine is already playing a role and the future is the one we are thinking about which is when we have got that high rate of vaccination across the population. 

>> A large percent, for example, you would still see some households getting it but that that would be consistent with what your future looks like. That is a tolerable, OK picture?  

>> It is consistent with the approach we are taking now. We would actively testify in cases and respond with cracked -- contact trace in isolation. -- Wood there need for the entertainment industry to (inaudible) would that be consistent with that strategy? 

>> We are aiming to move back to a situation where we are joy the freedoms of end alert level I. -- enjoy. At the least possible restrictions including mass gatherings and vaccination is by far the most important part of that future. 

>> On vaccinations, where are the wall-to-wall advertising campaigns, is ports people, community leaders encouraging people to get vaccinated? There is a bunch of people not listening to the 1 PM information that you could be capturing in the same way you lead a very good ad campaign strategy last year. -- sports. 

>> There is an advertising campaign you would have heard people's reasons for being vaccinated, the stronger our vaccination, the stronger our possibilities. We are shifting that up. That is reach a lot of people we have needed to reach but there are groups we have not reached as effectively with that particular campaign. We are shifting the campaign up a bit. It is skewed younger because that is the demographic we need to reach more heavily into. Therefore it is using the media that will reach younger people. It is skewed more towards Maori and Pacific communities again because we need to reach deep into those communities. The fact that some people will not see the ad campaign as much is a sign that spending is being more targeted to the groups that you need to see it. 

>> What went wrong with the first roundabout that it hasn't worked in terms of attracting younger people, particularly Maori and Pasifika? Why was that not the target in the first place? You were aware those communities were being affected by this and were being targeted. 

>> I do not necessarily accept  the overall conclusion you have reached. We are seeing vaccination round is around 30,000+ a day which is what we aim to get to early in the year. We had a good spike as a result of the letter before with the goal is or has been to be vaccinating at that rate of 30,000 a day which we are still doing. Younger people have had access to the vaccine, have been eligible for the vaccine for the least amount of time, so the rates are lower. There is catching up to do. We are still seeing them come through but we need to see them continuing to come through at an even bigger number than they have been which is why... That is where our campaign is being directed. Earlier on it was targeted at everyone. Now we understand a bit more about where we have good rates and where we need to target more, that is what we are doing. 

>> (Inaudible) campaign and people have access to it. Young people have had access for sometime. 

>> They have been subject of a broad advertising campaign. We can switch that up and be more targeted. 

>> (Inaudible) can you tell me why you ask it now. Live captioning by Ai-Media Simpson had it on his Facebook page last night. 

>> I will hand out to the director-general. 

>> Confirming now to make it easy for people to understand what is happening. That region under the order to alert level III last night and I was letting them know that that is the current situation and also importantly it is under daily review and we can make a decision about if it continues on Friday. 

>> Can I just ask one on this leaked document that Chris Bishop has come across that says there are supposed to be 650,000 doses per week from July to September and he says this shows this is a government failure and you have slowing down the vaccine for a while. 

>> This is a claim Chris Bishop has been made repeated times despite the fact he's been told it is not true. A poor reflection of him. The document he purports to have a one of a number of models the Ministry of health put together when vaccine supply in terms of exact delivery dates was uncertain so they have models seeing us get all vaccines by the end of September, models that saw the vaccine supply running it through until late in the year. Those are prudent thing to do to plan for the different scenarios that you have. I think it is absolutely dishonest for him to be continuing to say we have in any way delayed vaccine deliveries. Our entire focus from the beginning of this year has been getting vaccines into the country as fast as we can. 

>> Following on from Joe post my question about young people and vaccinations, this outbreak has really disproportionally affected young people. It is the ad campaign enough to try to get these rates up as fast as we need them? 

>> We will see more than just advertising, we will have targeted initiatives to reach young people and you are already seeing a cross-country in areas where vaccination rates need to come up there are in a different things taking place. A shout out to (unknown term)  which promised a bacon item. We have seen a good uptake as a result. We will see more of that as we get to that group that we really need to target to get them to come forward. 

>> (Multiple speakers) (Inaudible) incentives to get vaccinated. Is that what we need? 

>> Employees have been doing their bit by the -- by encouraged employees to get vaccinated, I'm aware of the Warehouse to be vaccinated and I welcome that. I think they are being a very good, responsible corporate citizen in the work they are doing to help protect their staff and I would encourage others to do so. In terms of if we are offering incentives you will see examples like the Taranaki DHB like I mentioned and we will continue to look at where there of further opportunities. 

>> Do you feel like you did a good job communicating what was happening given the boundary moved down and where they were in the alert levels, could you have done that better? 

>> Undoubtedly, yes, and I think timing there was a challenge but yes, undoubtedly, we probably could have communicated it more clearly when that shift was going to happen. 

>> Dr Bloomfield, how concerned are you at how much busier Auckland is... Motorways are (inaudible) social distancing in the lines. How concerning is that? 

>> I will reiterate what alert level III means and so saying, I imagine most Aucklanders are doing what alert level III requires so again encouraging people, the only reason to leave home is to go to work if you need to and if you are going out and about and collecting coffee or other takeaways, followed those rules and the advice and includes using a mask, scanning and maintaining physical distancing. 

>>Are we still seeing those contracts becoming close contacts?

>>Well, they may have been from where someone might have been an essential worker, so it could have been in a workplace or it could be that there is a legitimate reason that someone has a non- household close contact. Example, a number of our location that we are working with with the public health team in Auckland is working with, our hostiles, so they could be non-household are not related close contacts but apart of a hospital.

>>We will come over the far side.

>> Has been a commitment to the position to move towards (inaudible) Yi

>>We continue to pursue elimination, which is zero cases when they pop up. 

>>What is the update on the proposed MIQ situation? Are you happy with the consultation that was had?

>>I personally had a conversation last week and I have had the strong opposition to MIQ being established at Rotorua. I  understand that there is discontent there. We are looking to increase our capacity around MIQ but we are listening to communities as well. Ultimately to operate MIQ you need to have a workforce willing to support it, you need to have people willing to supply the hotel, a variety of different factors come into play.

>> (Inaudible).

>> I imagine that we will have more to sail out in coming days.

>> Can you please give us information about the high school student that travelled from Auckland? And also anything about the Clover Park testing and the level of compliance and what sort of level would you like to see there are testing? Could you tell us a bit about the location and what you would be comfortable with.

>>Right, if I can remember all of that. I cannot tell you anything about the student that travelled. That was beyond our purview. They took a flight down and I do not have any information about the reasons for the flight or what checks were done at the border. On Clover Park, there was fantastic testing yesterday. 573 swabs since the first On Clover Park, there was fantastic testing yesterday. 573 swabs since 1 September, Clover Park has had the highest number of swabs and the highest proportion of any suburban south Auckland. In fact across Auckland. What I would encourage people in Clover Park to do today is if you have not had a swab within the last couple of weeks, whether you have symptoms or not, go along and have a swab. We are trying to get as many people tested in  a suburb as possible.

>> There is a class in a small shopping centre. Do you have any details on that?

>>I do not have any details on that. Are you talking about the small shopping centre in that region?

>>Clover Park.

>>There are a number of locations of interest that would be places that people that are now cases visited as part of their accessing of a essential service doing a low level 4. We cover those as a location of interest. I think a lot of those are in Clover Park.

>>We will go through people that have not had questions. Ben.

>> You have given the vaccinated number four Auckland, do you have a vaccination number for all of them?

>>I will find that one for you. Do you want just four Auckland?

>> (Inaudible).

>>We will get there for you.

>>Assure that the shop had in the vaccinated about 400 people in a week. That sounds pathetic. As I tried? Is that what you want to be them to be doing?

>>My understanding is yes a vaccinated number of hundreds of people. I think it is hard to say it is pathetic. That is one of the options for people. There are more buses coming along. The important thing is where they are vaccinating. They are going out to those populations and into those areas which we know have got low coverage. We are using a very targeted approach. You might see those buses appearing in spots where Aucklanders may be frequenting over the next few days because they have just come out of a light level 4. 

>>Do you have advised?

>>Yes. 

>>You said before that you are looking for at least 90% of vaccination in Auckland. Given the known inequities in our system and the high vulnerabilities, to that rate to be even higher ?

>>Absolutely. Ideally. As high as possible in all of our groups, which is why it is pleasing to see one of the group that we know as most vulnerable for poor outcomes of COVID-19, people over 65, to see that vaccination rate already over 90% and still going up. That is very encouraging. It is even more important for those groups that you have poorer health status overall to have high vaccination.

>>We will come to you over here.

>> Can we see the opening up of the construction industry? We would want to see (inaudible).

>>, I think I will disentangle the two things because the vaccination rate is one important thing and our device -- advice and decision about reflections.

>> So there have been (inaudible). How at risk of people at risk of contracting the virus and spreading it on given this and what can be done about the mistrust of authorities?

>> The reports I have had, and we try not to comment on individual cases, but the feedback I have had from those that are doing the contact tracing work is that they are finding very high levels of cooperation from all of the communities that they are looking at. It is very encouraging. In terms of the risk of spread I would say that where ever there are bigger groups of people, whether it is big families or other people living in a more communal environment, of course that increases the overall risk of someone contracting a COVID-19 if it gets into that kind of setting. So whenever anyone is living in a high density environment with more people around, then that increases the risk.

>>Are you worried about a risk of spreading that community?

>>I have had feedback that we have had good communication and cooperation from those under investigation.

>> Can you trust that that is what is actually happening?

>>I work on the feedback from the people that are doing those investigations. 

>>Just to endorse what the minister said, the Auckland regional health team is working with a range of people that are helping with engagement with the groups. One thing that will help protect those groups is vaccination. That is part of the conversation that has been had with those whanau that have been infected, getting them into the vaccination pathway as well. It is great as a high level of interest there.

>>You talk about individual cases, but it is not identifying in terms of saying that there were three gangs identified as (inaudible). Vaccination would help. This is a group that you simply cannot get to in terms of the goal of reaching zero cases?

>>Like I said, I think we are seeing a good degree of cooperation. And as a result... We are talking about larger groups of people, people that live in more communal environments.

>>You have also talked about other breaches, right? There are these environments where the bubble reaches are occurring.

>>I do not think they are confined to any particular part of society. In my experience. Again just to reiterate what the minister said, there has been excellent engagement and good relationship that has actually identified a new potential contacts and that is exactly what we are after. We want to find contacts and we want to find cases.

>>It is not about circling at this group it is about whether you can forget their get the job done. Are you convinced that he can?

>>I am. It has been great to see the work that has gone on to put us in this position.

>> Minister, you said that you would need to see zero a very few unlinked cases in order to move down to level 2. What is the plan if cases continue to stubbornly pop up one or two a day for the coming weeks? Where we stay at level 3 or four until we get those high vaccination levels?

>>Why observation there is that everybody wants hard and fast rules uncertainty. They cannot be in this time of environment. We need to weigh up the different pieces of evidence and data and advise that you have when you make the alert level decisions. We have never set hard and fast rules. We have an alert level framework that provides guidance and that is what guides our decision-making. But you never say never and you never say absolutely. You just have to consider every decision based on its merits and based on what you know at the time. 

>> Could be sustained level for for longer? Would have made a difference? -- Level 4.

>>Alert level 4 was designed to give us the best possible start and position us as strongly as possible to get back to zero again. You may recall that in previous outbreaks we have gone to alert level 3. With delta we decided to go to a lower level 3 to really maximise our chances here. And that is what it has done. As we step back down to alert level 3 we do so knowing that the time that Auckland has spent at level 3 - - alert level for and other areas of the country have really put us in a strong position to stamp out COVID-19. Jessica.

>> There are people that are not weighing masks being denied access to service. What is your response to that?

>>If people have an exemption they should be served. 

>> Is it is that I really struggling through the Christchurch area are finding it hard to operate through level 3. Could you offer that certainty to them? What clarity could you give them about that?

>>I know that people want more certainty. I think everyone wants more certainty across the board. I think we have been doing this for 1.5 years. There has been constant disruption every time they feel like someone has a footing they have their business back on track, something happens. In terms of travel people were relieved with the trans-Tasman bubble in the manner closed. Right the way through we have been living with this for the last 18 months. I guess that people are tired, they are feeling worn down by that. We are still doing this. We are pursuing the elimination strategy and it is in writing for New Zealand. We are looking to the future. It won't always be this way. My request of people is to just hold your nerve and hold on because the future is going to be better. But I acknowledge that it has been a pretty tough .5 years. 

>>In terms of implementing a no jab policy?

>>We will have more to say on that in good due course. Ultimately I'm very supportive of people, encouraging people, to be vaccinated. There are some legal issues to work through around the No Jab, No Pay service approach can work and be implemented or enforced. And my advice to them is that you are getting good legal advice before making those decisions.

>> You talk about vaccination rates. Are you primarily looking at fully vaccinated, double dosed rates? Or does the first dose come into your calculations? We have got first doses and double doses.

>>The double dose absolutely. We want people to be fully vaccinated. If you look at the high rates of first doses, we are not talking a long gap. It is a six-week gap we now in the first dose. We are not seeing any tailing off of people coming forward to get that second dose when they are eligible for the second dose. I am very encouraged by the first dose rate. I think the first dose rate gives us an idea of where we will get to in terms of people being fully vaccinated, and that is ultimately the number that we should be interested in. We are talking about first doses at the moment because many people that is the best indicator that we will have because I won't be out eligible for the second dose.

>>When it comes to those alert level decisions you're looking at vaccination rates are double dosed things, right? 

>> In terms of alert levels not necessarily. But in terms of future decision-making than yesterday double dose could be the factor.

>>How and why are you looking at first doses when it comes to alert levels when there are people that are not as protected, are they chemo

>>It is a sign that people are committed to being vaccinated. They are in the system and are committed to getting their second doses. They are just awaiting the time.

>>It will not stop the spread if you only have 90% of Aucklanders with one dose.

>>One dose does provide a significant level of protection. That is a message to be vaccinated. You have never left it too late. Even with one dose you have a much greater degree of protection than with no dose. I will invite the director- general to discuss that.

>>The first-rate affords a good level of protection that means that somebody has 30% and then there is 95 to 99% against being hospitalised are dying. It is as good as any vaccine.

>>The very last question.

>>Just someone this morning said that the self isolation at home decision would be trialed. If this goes well, would it be possible that from the start of 2022 we could see normal people returning from being overseas? 

>> I don't think it will be a big bank. We can look at the variety of approaches through the trial period and next year, we will have a high rate of vaccination across the country, will have good, high rates of vaccination of people coming in and that will set us up well but I don't want to pre-commit to what that might look like until we have gone through the trial process. That is what it is designed to do. The very last one. 

>> Is there a chance that we could... For MIQ, we could prioritise vaccinated attorneys? -- people who return? Shiver and watch this space. 

>> Something you are looking at? 

>> There are international developments around the requirement for vaccines to charitable and this travel and we are involved in those discussions. Thanks.  

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