COVID-19 update 6 October 2021

>> Kia ora koutou katoa.

 I will ask Doctor McElnay to run through the numbers and we will spend time talking about vaccination before questions. 

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

 I will give an update on cases, the latest on the situation in Waikato and some updated advise on the gap between vaccine doses.

 I'm sad to report the death this morning of a patient with COVID-19 at Middlemore Hospital. Further details will be available later today after discussions with their family.

On behalf of all New Zealanders, I would like to recognise this family's loss and offer deep sympathy.  T

urning to today's new cases and Naina in the Waikato. And that brings the total to 18. -- nine.

There are two cases to report in recent returnees in managed isolation facilities and one further case in a border worker which remains under investigation.

The whole genome sequencing is underway to determine if that case is linked to the border or will be classified as part of the community.

After day's 39 cases, only one is yet to be linked to a COVID (inaudible) case. -- of.

 Also an update from yesterday's cases. There are four which remain unlinked from the ones reported yesterday.

 We have 12 active sub clusters where there have been recent cases and they still remain the focus of our public health response.

Looking ahead, we estimate from the number of already notified contacts that there could be an additional 36 cases in coming days among known household contacts.

The hospitalisations, there 32 people in hospital with COVID- 19, seven of which are NIC you or a high dependency ward. -- in ICU. S

wab numbers remain high. In Auckland, there were 13,331 swabs taken across the city. Thanks to everyone who came forward. In Auckland today, there are 22 community testing centres open. Of these, 16 pop-ups including a new centre at Hillsborough Park while the Manukau Sports Bowl pop-up has now closed.

Back to Waikato over the 18 cases in total of which we are reporting nine you today, we know they are all linked to known cases, either as household contact or social. -- new cases. Two of the new cases reside outside the alert level III boundary in place and that is  at (unknown term) and a testing centre is being set up. T

here are five pop-up testing sites operating in Hamilton, Raglin, Huntly and Tokoroa today with all five being open for extended hours to cater to any expected lift in demand. An existing site in Hamilton remains open.

Waikato DHB have also informed us a patient visited its emergency department last Friday night between 10:30 PM and 1:55 AM. That person has now tested positive for COVID-19. The patient was asymptomatic on arrival at ED, was screened by staff following alert level II infection and prevention protocols. Despite adhering to these protocols, out of an abundance of caution, the DHB has temporarily stood down a number of ED staff who are self isolating, undergoing rapid testing with results expected later today. Some of these staff were working in a different part of the ED to the case but are still being tested as a precaution.

 Public health staff at the hospital are continuing to investigate this incident and working directly with every affected staff member. We expect some will be able to resume work following a negative test today.

There does continue to be exposure events at hospitals. This is not unexpected. It is important that people get help when they are sick and it is important we know our hospitals are safe. Our hospitals have strict infection, prevention and detection measures in place including appropriate use of PPE. But for smaller contained exposure events where there is a low risk to the public, going forward, we will not be routinely reporting on these but we kill -- we will continue to report any exposures of significance.

Finally in light of the increased risk from the current Delta outbreak, the Ministry of health is advising using it is to consider a shorter gap between the two doses of the Pfizer vaccine than the current standard of six weeks.

That is because we need to protect ourselves, our phone now and communities. We need as many people as possible to have their first dose to be partially protected. We also need those people to be fully vaccinated with two doses as soon as possible.

In August we extended the standard gap between the first and second doses of Pfizer vaccine from three weeks to 6 weeks to allow us to give one dose to a large number of people faster. But now, by enabling people to have that second dose sooner, but after at least three weeks, more people can be fully vaccinated sooner and hence, increase our community immunity.

Back to you. 

>> Thank you.

 Clearly cases outside of the boundary are a stark reminder of how tricky the virus can be to manage and how dangerous it can also be. We are seeing COVID-19 tracking down unvaccinated people and it is making them sick.

Our goal is to get the vaccine to people before COVID-19 finds them. We are now fully vaccinated half of the eligible New Zealand population and in Auckland, around 85% of people have received at least one dose of the Pfizer vaccine. Yesterday 63,624 people received a dose of the vaccine, the majority being second doses.

Because we are an innately competitive country it is worth noting the North Island and South Island are now neck and neck in the race to be the most vaccinated island. Both islands are sitting at precisely 80% of the eligible population having received a first dose.

This week a 30 strong team has been set up to support disabled people to access transport and to get vaccinated in a way that suits their needs will stop it is another piece of our plan towards continual improvement to make the vaccine accessible to everyone. To speak with support specialist, people can can call the COVID-19 vaccination Healthline on oh 828 2926. It is free. That is from 8 AM to 8 PM Monday to Friday. If they press two, they will speak to the right team.

 By far the biggest and most powerful weapon we have in our fight against COVID-19 is vaccination.

Vaccines reduce the risk of getting COVID-19, they've reduce the risk of getting really sick if you do and they reduce the risk... Rate of transmission. They are safe, we have plenty of them and everyone over the age of 12 can now get them.

Our strategy to date of keeping COVID-19 out and vigourously pursuing cases that do emerge has served us very well. But we cannot keep doing that forever. New challenges like the emergence of the delta variant has made it harder than it was before.

As the Prime Minister said on Monday, getting back to 0 cases of COVID-19 in the community is now unlikely. We need to prepare for a gradual transition to the next phase of our COVID-19 response. New Zealanders have consistently shown over the last year that they are willing to pigeon as part of the team of 5 million and to help us confront the challenge of COVID-19 head on. -- Petch N. -- pitch in. We can be one of the most highly vaccinated countries in the world but to get there we need a big collective effort. We all have a role to play in getting our vaccination rates.

My message to the 80% of the eligible population across New Zealand who have had their first dose is this your job is not yet done. You still need to make sure you get your second dose, but you also need to help us reach those who have not yet been vaccinated. You need to help us get them comfortable with being vaccinated. We want you to talk to them about the reasons you have chosen to be vaccinated. We wanted help make sure they get reliable, honest information about the vaccine. We want you to help deal with any logistical barriers that may have stopped them getting vaccinated.

The next 1.5 weeks is critical. We want to pull out all stops to increase our vaccination rates. It has never been more urgent. We are asking everyone to contribute to a big nationwide push for vaccination.

This will culminate in a national day of action for vaccination on Saturday the 16th on Saturday, 16 October, Super Saturday.

On that day we will have vaccine clinics open throughout Aotearoa throughout all day and into the evening. Like on election day we will ask civic and political leaders to contribute to a big effort to turn people out.

We currently have 350,000 appointments available on Book I Vaccine over the next 10 days and that does not include vaccinations available through any of our general practice sites where around 20 sent in this 20% of New Zealanders have got their vaccination. -- My.

Tomorrow we will release maps which will show the highest concentration of where people are who have not get -- got vaccinated. This will help mobilise community, whether going door- to-door, waving signs, there we will -- will be a role for everyone to play.

 Political parties have different views on aspects of the COVID-19 response would be united on one thing vaccination. Super Saturday will be an opportunity for all of us to put aside our political differences just for 24 hours and work together for a cause that we all support.

A webpage will go live this afternoon with key information about the day and how people can get involved in it. We are also asking our business community, our media and our community groups to play a role in this as well. Those that want of incentives to the unvaccinated to get them through the door are encouraged to do that. We will ask parents and grandparents to encourage young New Zealanders to take up the opportunity to be vaccinated. We want to leave no stone unturned. No one should be left behind because they have not had the support they need to make an informed choice about vaccination.

Our response as a nation the challenges posed by COVID-19 has been world leading and now we need a world leading uptake of vaccination.

My request to everybody is this let's Petch N and let's get this done. -- pitch in. 

>> How many gang members are in this cluster? 

>> I do not have a precise number. 

>> No, I don't have any precise number. 

>> Quite a large number of gang members in this outbreak? 

>> Yes. 

>> Does that pose a different kind of specialised set of public health risks if you have people (inaudible) operating in the shadows, how do you ensure they are vaccinated, that they are contact tracing?  We have to ensure that we get as much cooperation as possible. Of course, there is no question about it, it poses some bigger challenges, some of the people involved have been more active, considering the alert levels that have been. That poses additional challenges for us was up the focus here is a public-health one. It is about contract tracing, it is about contact testing, and getting vaccinated. 

>> From your understanding, the drug deal has been part of the transmission in this cluster? 

>> I could speculate, but I don't have any specific information. have you seen gang leaders coming to Auckland with  exemptions, how many exemptions have been given? 

>> I haven't personally given the exemptions. But as far as I know, they have only been to given those exemptions, and they are there to help ensure there is cooperation with those during the contact tracing. 

>> How important is it for people like the mob leaders to get out there and talk to these people who may not be listening to the government, there is a lot of criticism of the government for granting the exemption, but considering how many gang members who have courted, is an argument that that is why we need to do that? 

>> Of the number one priority is to stop COVID 19 in its tracks, which means doing what we needed to do in getting in front of the virus with contact tracing and testing, and where we have been able to enlist gang leaders to help with that, we have done that. I have no time for the gangs, I have no sympathy for them, but the number one priority he has to stop overnighting. 

>> What about people who say you are giving them a special treatment? 

>> If there was not a community organisation, or some other entity where we had to get somebody in to make sure that we were reaching the necessary places, that is exactly what we would do. 

>> Is everybody with COVID accounted for at the moment? 

>> In terms of not knowing where people are? It is possible there are contacts at  the that we are not aware of, but our contact stresses are doing their best to find them. My understanding is that everybody who has been identified as a positive case has been accounted for. I think we had an issue yesterday, which was resolved quite quickly, but as of right now, I'm not aware of anybody who is out there at large was 19. 

>> Can I clarify some of the rules, because there is still some confusion about the phase 1. Maybe because the government put out a friend set of rules for these things, can playgrounds open? 

>> Yes. 

>> Can stadiums open under a light level II with more than 400 people? 

>> I'll have to check that. 

>> Can you go to the toilet if you go to your friends house for a barbecue? 

>> No, in the cities outdoors. 

>> Why is there a different set of rules for people who are socialising, you can have two bubbles, but if I go to a workout class, there is more. 

>> They will be socially distanced in those group activities, there are additional requirements for things like a group workout where people have to be certain distances apart. 

>> So if friends want to catch up and take a yoga mat along, that is fine? 

>> If it was part of a structured class and they were following the Reverend guidelines. 

>> It seems incongruous to have only two bubbles, but 10 bubbles, what is the difference? 

>> Of the difference is that people are participating in a structured activity, where it is supervised, there is a structured distancing involved. 

>> . 

>> The middle more hospital and the Auckland District Health Boards will be putting those supports in place. They have obviously been looking after the person for some time, but there will be a wraparound service offered to the family. 

>> Isn't listed on the COVID 19 website is a parenting arrangement. Why is that? The cultural practice of raising other (unknown term) members and that. The passage to the Auckland border, she says it is because her parenting arrangement was (unknown term), do you think satisfactory maker 

>> It is very difficult to comment on individual cases without specific information. Do you think the cultural practice should be a reason to allow people through the body? 

>> Potentially, but it is something that I would like to have a look at. 

>> On the vaccination pitch, what is the hold-up for mandating vaccination for teachers? 

>> I have been consulting, I foreshadowed this week or two ago, we have been consulting with more of the health workforce, we have also had more consultation in recent days, with our education workforce, and representatives of the education workforce. The cabinet will need to make final decisions about a mandate requirement, which I fully intend to take to cabinet at the next cabinet meeting, we will be able to announce after that. 

>> Should they prepare for a mandate in schools? 

>> If I was a teacher I would certainly ensure that I had my first dose of the vaccine at this point. 

>> Can have more details about the deceased? It can you tell us how old they were, how long they were in hospital, if they had any underlying conditions? 

>> I don't have those details, but as I said, we can share details later on, once we have consulted with the family.  

>> It is a pretty big piece of information. 

>> I don't have the details. 

>> There should be something. 

>> There is conversations happening with the family, we have to respect their wishes, they are obviously grieving, so when they are able to release information, we will, I personally don't have the information, certain staff do, and we will release information on families comfortable. 

>> Are you going to expand the ? 

>> We haven't made an immediate decision to do that, but we will keep that under review. We are looking very closely at that. It is quite a content community, from what I gather, from the people who have been up there doing the work. And there is a good degree of cooperation and compliance, but it is possible that we would extend the boundary. One of the questions will be exactly where the boundary goes to, because if you take these two locations, that extends the boundary quite a big way. We will work through that, we just haven't made an immediate decisions. 

>> Is there a chance that the original cases, isn't there a big chance that there are cases outside of those boundaries that we don't know about? 

>> We know bit about the movement of the people concerned within those areas. That is helping to isolate the risk. And we are seeing some really proactive activity amongst that particular group at the moment. I will ask Doctor Michele. 

>> I spoke to the medical officer of health over in the Waikato today, they are confident that the cases are all linked, there is a strong linkage with those cases. The further and more widespread testing, that is a very critical point, wastewater surveillance is still negative, in the Waikato area, so we are awaiting their specific advice about whether or not we need to do anything particular for the tuna cases outside of the boundary. 

>> Did you hold off meeting at Pfizer executives last year as it was claimed? 

>> Not at all. My understanding is that Pfizer had a letter in June which was sent to a number of countries, discussions with Pfizer commenced not long after that, the negotiations typically involved the signing of a confidential disclosure agreement, my understanding is that that was supplied by Pfizer to New Zealand's representatives towards the end of July, it was assigned quickly thereafter.  Conversations were ongoing throughout the period, so I don't think we were slow there. It is also worth remembering that, at that time, there were 200 different vaccines on offer, and everybody was trying to sell them to us. At that point we had to make judgements about who we thought the most likely wants to be successful work, and if you look at the four that we ended up purchasing, I think we ended up making quite good decisions about which ones to go with. Pfizer was one of the ones that we decided we would buy, which proved to be a very good decision. 

>> Did the supply issues occur because of the speed of other countries compared to New Zealand and the timeframe? 

>> No, if you look at what we initially purchased, we initially purchased 750,000  courses of the Pfizer vaccine, and we got access to those in accordance with the agreement that we entered into them. It is difficult to crystal ball engaged back in time, and say, if we had asked for 5 million courses of the vaccine, would we have been able to get them earlier, I don't know the answer to that, and we never will. We made the decision early this year to order the additional doses, then they were delivered, they are keeping with the schedule that we were given at the time. 

>> As we continue to look at boosters, and other medical treatments, in terms of the speed and how six weeks can become a very long time and an outbreak like this. 

>> It is a rapidly involving space, and if we rewound back to just over a year ago, it is more than that now, to when the conversations about vaccines first started, even the most optimistic people I don't think were predicting that we would be this far through vaccination as we are now. The vaccines got to market quickly, and we should all be pleased about that. It potentially means a global pandemic will come under control faster than it may have otherwise, than it otherwise would have done. But back then there was still a lot of that we didn't know, and it is easy to look back now with what we do know and say, " we could have done things differently", undoubtedly yes, but we had to make decisions with what we knew at the time. 

>> We have seen a rising number of cases, the spread from Waikato down to Cambridge, and a large number of these cases infectious in the community, are we losing control of the outbreak? 

>> As I have said, my understanding and the feedback we have had from contact tracing teams, they feel that these cases are reasonably well contained, in the sense that they know who their contacts are, they are all linked to one another, they know what the chain of transmission was. If we start to see more cases popping up, then that changes the dynamic mock, but at this point, the feedback we have had from the contact traces is that we don't need to make it a boundary decision immediately, that we will keep it under review, and if we feel that we need to in the next 24-48 hours, then we will do that. And we can do it quickly. 

>> Vaccine certificates, in terms of mandating them for large-scale events, do you anticipate sporting events being part of that to make rugby matches and what have you. 

>> We haven't made it decisions about where exactly we will draw the line, and what is in and out in terms of the vaccine certificate, and where you will need to produce it, but it is likely that big events, sports games, concerts, hospitality venues, those of the venues that we expect to be included. 

>> What do you make of public criticism from a public health doctor within the public health unit who said yesterday, " we couldn't get back to 0 cases because COVID took hold in communities where mainstream society figure. Our current situation instead of poverty, housing, and colonisation". 

>> I think it is true that COVID has taken hold in some of the most disadvantaged part of the community. And around the world, when we look at it is happening around the world as vaccination rates increase, that is increasingly part the pattern. In other countries, as  well. COVID 19 finds the most vulnerable people in the community, and it finds people who haven't been vaccinated. And often those two groups are one and the same. And that is absolutely our experience of this outbreak here in New Zealand. 

>> Have you failed to sufficiently engage and protect with these vulnerable communities in response to contact tracing? 

>> There has been an awful lot of effort put into increasing our vaccination rates in those vulnerable communities, including working with our Pacific health providers, primary care, pharmacies, putting pop-up vaccination clinics in, sending the buses out, it is a difficult community to reach, they are people, in many cases, and I don't want to generalise everybody, because I don't think that is fair, but we are seeing within those communities a disproportionate number of people who don't trust government generally, and that distrust is built up over generations, so that means we have to do different things to reach those communities. 

>> Vaccination rates, what are they in Cambridge, caviar, and At the moment, and harsh concerned should those communities be? 

>> The only one that I have of  those three is (unknown term). The database shows 362 people within the population who are illegible, 248 at the first dose, and 149 second dose. In percentage that is 61% first dose, 41% second dose. (Inaudible)

>> Have they been able to use the test (inaudible)? 

>> If we are talking about vaccination we have had good tools, the tools are getting better. One bit of feedback we have had  around vaccination is there is better data and we are working with them to get better data and we are getting better data in terms of granular and behind a data. In terms of testing a PCR test is still the best way of identifying risk. One thing about rapid antigen tests is they have international evidence, good at detecting people already infectious. PCR tests need to pick up people earlier than a rapid antigen test. At this point in this outbreak PCR tests are still the best option. In terms of rapid antigen tests, Doctor (unknown term) is leading this. I expect in the near future we will see rapid antigen tests more widely used in New Zealand and a wider range of settings and on a much more frequent basis. 

>> (Inaudible) those people might not have wanted to (inaudible) testing if they (inaudible)? 

>> A saliva test is a PCR test. It is a different sampling method. The overall methodology is the same, either drawn from saliva or from the nose, but the processing is soon -- still the same. It has to be sent to a laboratory. With a rapid antigen test it can be done almost instantly on the spot, about 15 minutes to process. When we can use those more widely, we will do that. They are being tested at the moment. We are already... Being used in this outbreak at the moment. We are getting good information from that. I expect we will see more rapid antigen tests fairly soon. I will come back over to the site. 

>> Are you aware that 25 large (inaudible) asking for emergency use of rapid antigen testing (inaudible) within the next seven days? (Inaudible)

>> I understand the underlying motivation I think it is a good motivation they want to provide more tools for the people they are working with to be more frequently tested and to identify risk. I'm aware of other countries around the world where rapid antigen tests are widely used as part of risk mitigation. One reason we have been (inaudible) in New Zealand is they are good at detecting acute infection but detecting early onset infection, not so good and one concern is particularly when dealing with this... Still in this phase when we are trying to stamp out every case we get, they potentially get -- give people false comfort. 

>> (Inaudible)

>> Not in the next week I would have thought but I do see that more rapid testing will become a bigger part of our response fairly soon. 

>> (Inaudible) anticipate the commandeering of private (inaudible) and what is the government planning? 

>> Nothing at this point. That is to ensure if we need to in the future we have the ability to surge up testing if we need to. There is nothing immediate on the books at the moment. 

>> Did Pfizer offer in June or close to then early access to vaccines in 2020, earlier than the end of the first quarter? 

>> Not to my knowledge, no. I will come up to (inaudible) and you can figure out who asks the question. 

>> The case in the Waikato, did they catch COVID, go to Auckland and catch COVID or did someone come from Auckland and give them COVID in Hamilton? 

>> I do not actually have the details there of the direction of transmission. There is still a little uncertainty between the two initial cases that were reported. Which one is the index case, we are still working on the premise it was the Hamilton case, is the index case but I don't have precise details but I am informed by the public health teams there that they have a strong connection with a case in Auckland. 

>> No one seems to be able to answer that question for us and made it points to the fact if there was some nefarious activity going on, are you (inaudible)? 

>> Yes, the teams have reported that cases are being very willing to share information. At the beginning of an investigation like this were the case appears in the community you are always a bit on the back foot because you are rapidly trying to find out what happened but there is no indication from the public health teams they are not getting information from the people concerned. But also they are speaking to... Using all resources at a community level to work with those individuals and to work with the social contacts to make sure we get that information because the more information we can get, the more testing we can do and manage any cases as they appear. 

>> We will let you two have more and then we will come over to the site. 

>> Why are you setting up a testing station in Tokoroa? 

>> From the conversation this morning I know there is proper testing happening around the broader region as part of the surveillance to see if anything has leaked out and to see if there is anything we have not picked up. 

>> It is part of our surveillance approach where we are specifically looking at places of interest were case finding and we also want an assurance there has not been any further spread, so a general approach that we step up testing station so people can get tested. 

>> Are you disappointed the website was change so many times (inaudible)? 

>> I don't update the website so not sure what the updates were last night. Obviously, we try to get information out that is clear and consistent, so if there was switching...

>> (Inaudible) clear and consistent information out there? 

>> Some days are better than others but if you rated since the pandemic over the last 18 months I think we have done pretty well. 

>> (Inaudible) every Kiwi to get vaccinated, how would you start those conversations? If you were in their shoes, how would you open up that conversation with someone who is hesitant? 

>> I think understanding the motivation for being vaccinated for those who have been vaccinated actually helps with the unvaccinated. There are some things that put people off. Generally avoid talking about needles, that is pretty clear, comes through in all research that needles are a thing that puts people off, so don't talk about that part of it talk about the underlying reasons for getting vaccinated, what is the vaccine do, particularly around the mRNA nature of the vaccine, make sure you refer them to someone who can speak knowledgeably is probably your best bet. There is good information from health practitioners with health practitioners speaking and refer them to that information. 

>> Doctor, with your experience you must have had these conversations before. How do you go about starting that? 

>> I endorse everything the Minister said.  Anti- vaccination perspectives are not unique to COVID and something we have experience with other childhood immunisations and it is about being clear, understanding what the concern is because people have a number of concerns and sometimes they are as straightforward as not liking needles. Or often they have heard something and they assume that fact that they heard is actually true, so it is understanding what is the concern that people have and being able to step through those concerns. A conversation with trusted people, people you trust and health professionals, are in that category of highly trusted individuals, a wide range of health professionals, so that is what I encourage people who have concerns talk to a trusted professional to get the real facts. 

>> Thing we are picking up informally and through feedback is that the number of people who are staunchly anti- vaccination is not a particularly large number. We are seeing a lot of people saying, "I will probably get one, just not right now. " They probably do not see it as urgent. They think they will get to it eventually. The message we want to convey and what the rest of the community conveying is now is important. There is an urgent need to do this and please do it now. 

>> On the Waikato hospital case that came in on Friday, any more details? We understand the staff were stood down, was at this morning? (Inaudible) within a five day period, how long was the person in hospital? Do we expect they had COVID in hospital? 

>> I only have limited information on the particular case but my understanding is they did not present with COVID-like symptoms but they have tested positive since and as part of the routine backward look, that we do to see where people have been whilst infectious, the ED department has then come up as come up similar to a location of interest where the person was while infectious, and hence, the follow-up of the staff there. 

>> (Inaudible) capacity throughout Auckland and Waikato, with staff being stood down is there extra capacity being brought in? Are hospitals struggling with these staff members being stood down? 

>> I have not heard concerns from Waikato today. As I say, they were getting rapid testing done, so results back quite quickly. We would expect a number of staff who have been stood down to resume work. I would also expect a high number of those staff to be vaccinated already. I haven't heard any comments from Waikato that there is a particular pressure at the moment and certainly that is a question we have put to all of our District Health Boards have they got any concerns about the staffing and appreciating the pressure that Auckland has been under for some time. The rest of the country, we have confidence in the staffing. 

>> The back row. 

>> Can I follow-up? 

>> There have been exposure events in Auckland and what considerations were made with respect to those when you decided to ease level III restrictions? 

>> (Inaudible) we have modified level III restrictions to give people a little more freedom. We are still at level III in organ. There is still risk in Auckland and that is why we have stayed at level III and have not moved further so we consider all of that.  

>> I have not seen evidence to suggest that. Even the shift from level IV I have not seen evidence to suggest that. Even the shift from level 4 to level III (inaudible) the current outbreak we are dealing with. 

>> There has been lots of discussion on greatness. How much longer will the South Island be at level II and is there a roadmap for the South Island and what would that look like? 

>> As the Prime Minister set out and we will talk more about this in coming weeks, it is likely we will start a transition to a different way of managing the risks around COVID-19 and that will happen gradually, it will not be a sudden big bang, but it means that level I as we knew it previously will probably look a little different in the context of a highly vaccinated population and our response to individual cases or individual clusters of cases will probably be different as well. We are working our way through that. I haven't got any announcements on that today. There will be more coming in coming weeks on it. 

>> (Inaudible) transition away (inaudible) the Prime Minister said on Monday that was only possible because we have achieved much higher vaccination rates (inaudible) and can you get the sense on where the line was when that became possible? (Inaudible) 1/3 of the population fully vaccinated or (inaudible) having one does (inaudible)? 

>> Getting up to 80% of the eligible population in the vaccination program having at least one dose, good number and very helpful. We obviously want to keep pushing so our forward bookings suggest we will get to 82% based on the people in the booking system but as I outlined, we can do better than that. When I look around the world and at other countries who have done really well, Portugal have about 98% of the eligible population vaccinated. That is one of the highest vaccination rates in the world. If they can do that, we can do that as well. My message really is every vaccination helps. Every vaccination puts us in a stronger position. 

>> (Inaudible) rest of the country (inaudible) Maori have (inaudible)? 

>> I would not want to speak. If we look at some countries transitioning slowly and progressively down through restrictions, they have generally managed... They have often started with the lower vaccination rate than we have at the moment and have taken small steps as we are taking small steps. The countries that have taken that approach have tended to go back less where is the countries that have taken big steps towards removing restrictions have then had to lurch backwards and forwards, so I am looking at other countries Ireland, Denmark they have been more slow and steady in the way they have stepped down and that is the approach we are taking her. We will come over here.      Why have GPs only in the last few days called ? Should not have happened a while ago? 

>> GP practices and primary care practices are funded on a per dose delivery basis. That model served us quite well up until now. As we get to the tail end of this, to the people that they are seeking to reach, some often require a bit more of an intensive approach, and of course then we do look at the way that we find that, but up until the last week or so, the issue has been that we had lots of demand coming in, and we are making sure that we are vaccinating as fast as we can. As the demand for first doses drops away, and you can see that we have to go out and push more to find people, to encourage them to come forward, that will be more intensive, and yes, we look at doing things differently. 

>> A 63-year-old man was arrested, charged, in connection to a protest which happened in the domain, we could make a connection as to who that was. A glad to see the police taking this action? 

>> And that is ultimately a matter for the police, it would be unwise for me to comment on that. 

>> Talking of the transition, has your appetite/tolerance for community transmission changed since we have seen the spread of COVID outside of the boundary and into communities which aren't highly vaccinated? 

>> Not at this point. We are still at a low level III in Auckland, still at a low level III for a region in the Waikato. If there is any suggestion that the group that we are dealing with is not contained, there is potential that that will change. 

>> A concern how the virus may spread? 

>> The moves we are making in Auckland are very moderate. They have been designed with the fact that COVID 19 could still be in the community, have designed those with that in mind. 

>> Victoria C 1005 Victoria C 1500 cases of a day, what is your tolerance for putting more restrictions on and bringing it back up ? 

>> I will never put hard and fast numbers on it, because to some extent it depends on the nature of the cases. In this outbreak we have had quite a number of young people in this particular outbreak who have recovered reasonably quickly. On the other hand, if we were to see a large scale outbreak amongst pockets of older people, that would be more concerning, because we know that the rate of hospitalisation could then be higher. It will be the nature of the cases which were Pele as big as a role. 

>> Would be longer now than six months ago? 

>> We are very slowly beginning a transition here. It doesn't mean that we are going to suddenly learn she into something. Like I said before, looking internationally, the countries which have been slow and steady in the changes have tended to be able to sustain it. 

>> Could Auckland is expect these restrictions to remain until Christmas? 

>> I won't cast that far ahead at this point. 

>> There is a suggestion now that , Do you have any specific modelling done to predict what  would happen despite late changes? 

>> It is very difficult to model those things, because they are quite small changes in terms of the modelling. But you would have all seen the modelling that is being put out around this particular cluster. And we are still within that modelling. It may shift which of the lines on the model we are likely to head towards. 

>> The health advice is that zero cases no longer possible. 

>> I have been on a call every morning, with the exception of maybe one or two days since the outbreak began, every single morning, including the weekends, at 80 minutes past 11 every day. I have been well aware of the nature of the outbreak we are dealing with sick, and the increasing reality that getting back to 0 gets harder and harder as every day goes past. I guess I have had longer to adjust my mind 's state than those who were hearing that for the first time this week, but I think it has been heading in that direction for a while. 

>> Public health experts say publicly that it is getting increasingly difficult, but they thought it was possible, did you have advice saying it was no longer possible? 

>> The advice of the director- general on Monday was that getting back to 0 cases was pretty unlikely. I think we have been trending in that direction. Should I would also like to say that we need to make sure that we are keeping people with us. Alert level restrictions only work if people voluntarily comply. We can't have a police officer on every corner making sure that people do what they need to do. It has been a strain, so the changes we made this week relieve a little bit of pressure. If that increases the likelihood of people complying with the rest of the restrictions in place, it does potentially help us. 

>> And a social worker returning a weak positive? 

>> Do you have any further details of a week positive case from an essential worker? 

>> There is a case under investigation, the test result is not clear as to whether or not it is definitely a case. There's somebody based in Auckland, but was in fungus I when they had their test. That is the only information I have at this point. It is not yet a confirmed case at this point, it is a test result which sits outside of comment terms of the CT value, it's is outside of the range which allows us to determine it is definitely a case. So I'm sure that person will be retested. So I don't have anything further or not. 

>> How concerning is that if there is a positive case that? Over the last year and 1/2, these cases that are investigation pop up from time to time. And as often as not, they turn out to not be cases. Or it could be a historic infection where somebody has been tested through part of regular testing, and it has thrown up a very weak result. The reason that we don't announce cases under investigation, unless there is a good reason to do so, is because they quite often turn out not to be cases. If there is a case, there will be contact tracing, and if there is exposures, or a location is of interest, then we will release that come up but like I said to maximum it it is a potential case under investigation, you don't have a confirmed case yet. That is pretty much all of the information I have on that.  

>> On misinformation, some countries are looking to put algorithms up which push up anti-vaccination material into newsfeeds, what are you going to do with Facebook and Google on super Saturday to reduce this information? 

>> I think that Facebook and Google from what I have seen have already been quite productive in removing some of the biggest sources of misinformation. 

>> Streams which go up beyond these live streams? Promoted by the operatives. The 

>> I have seen that, I would ask social media companies to continue to be proactive helping to manage that. I've usually, we want to tackle the source of that discontent, and a lot of that is just people that don't have the right facts. 

>> When you made the change from a three-week gap to a six week gap between vaccinations, the argument was that the international insured it was best practice, now you are saying three weeks, which makes it seem like that was a political decision because you were running out of accents. Do you admit that? 

>> It wasn't because we were running out of vaccine, although it did allow us to vaccine a more people weekly, but that was not the only consideration there. It was a consideration, amongst many, and I think we were quite open about that and many of the times that we were definitely considering that. That we make this decision is based on the advice we get from the technical advisory group. Their advice at that time was to move to 6 weeks, now the advice is three. 

>> Two days ago the administrative health was telling that the time was still six weeks, how does it change so quickly,...? 

>> We have sought further advice from the technical group on this issue, because a number of health officials have said to us, that at this moment in time, when we want as many people as possible fully vaccinated, can people be vaccinated before the six weeks, and of the technical advisory group has come back and said that there never was any safety concerns, so yes, because there was no concerns with fascinating access three-week. So from a pragmatic/practical  is perspective at this time, if you have had your first dose, and the only thing stopping you from your second dose is waiting for the six week marker, the advice is actually that it can be done sooner. 

>> What was the main reason for changing from three weeks to 6 weeks? 

>> That was a comment from a technical advisory group, it was a combination of looking at the schedules which have been used in other parts of the world. In New Zealand we were  quite unique in having the three-week gap right at the beginning, which we stuck with, a number of different countries had different schedules, so we looked at the optimal schedule. The advice from the technical advisory group, when you put everything together, 6-8 week gap was recommended. 

>> So now what you are recommending is a suboptimal? 

>> Now we are saying, it is still within the realms of being optimal. It is arranged. If these are not pivot points where, on one day, because you get a vaccine one day had, it is suboptimal, doesn't work that way, it is arranged. The technical advisory group has advised us that, yes, people can get the vaccine, as many others have come so long as you have the three-week gap, and that is the bit that is sticks fixed, it is the three-week gap between the two doses. 

>> A couple of last questions. 

>> The vaccine was deemed marginally more effective if you had a six week gap, are we going back to the three-week gap now because delta is here? 

>> We want people to have maximum protection, and we get that from double doses. 

>> Do you have advice on compliance? That decision on Monday, in terms of ratcheting our instructions? 

>> No, that we have had feedback centimetres frame. 

>> . 

>> In the mood on the street, the media coverage, there is clearly Isis. 

>> The zero cases issue, do you regret trying to level III, and do things that made it more difficult to get to 0 cases? 

>> No, and as I said, I haven't seen any evidence, or the views from any contact tracing team, that the level shift didn't have a material effect in terms of the cases we are dealing with at the moment. 

>> Did you release the health advice which underpinned the transition which have been strategic since the pandemic began to make 

>> We aren't moving away from elimination, our overall approach is to have zero tolerance to have 19 cases, but the way we do that is going to change. And that is going to change progressively over a period of time. It isn't a shuddering shift, it is just that as we get to a higher vaccinated population, the way that we express our zero tolerance towards covert changes. 

>> You are saying that we can't get to 0, so you aren't eliminating it. Seven like you are confusing elimination and eradication. 

>> A one-word question. Now that we are making a transition in the COVID strategy, in one word, can you describe your feeling about it? 

>> I'm optimistic about the future. One word, optimistic. 

>> Medical professionals have raised concerns that roadside drug testing is unreliable, would you fold on pushing this through parliament? 

>> Roadside drug testing doesn't really fit in my domain, so it is best to director to the relevant ministers. 

>> It if it is unreliable, would you want to set ? 

>> It is outside of my domain. Thank you everybody.