COVID-19 update 6 September 2021 4pm

>> Kia ora koutou katoa.

Today, I will go to the Cabinet's decision to alert levels for the parts of New Zealand outside of Auckland. But first, I'm going to hand over to the Director-General of Health, Dr Ashley Bloomfield to update us on the latest numbers in case those watching at home have not had a chance to look at the press statement earlier today.

Dr Bloomfield.

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

You may have seen today's numbers already from our 1pm media release. The key figures, there are once again 22 cases of COVID-19. All in Auckland.

 Our total number from this outbreak is now 821.

The total number of community cases this morning as at 9:00 yet to be linked was 33, a small rise on yesterday's numbers. But investigations continue through the day and that number will continue to fall.

Our analysis of yesterday's 20 cases that were announced shows 18 of these, or 90%, were contacts of known cases. And of these, 14 or 70% were household contacts who were already isolating. Five of the cases overall were infectious in the community and one or other place.

All these numbers are moving in the right direction, which is reassuring. I would like to just take the time to once again thank everyone who is a case and who has moved into one of our quarantine facilities as part of the management of this outbreak. It is a sacrifice and a commitment and it is keeping the whole community safe. So I want to thank you.

Of our very close contacts, 99.9% have been followed up by contact tracers and efforts to reach the remaining person are continuing. Around 86% of all contacts have been followed up by our contact tracers and we continue - sorry, have already had a test. Is in our system and our public health units around the country are following up those for whom we don't have the results yesterday.

Yesterday there were 4,750 swabs processed around the country and there were just over 2,000 swabs taken in the metro Auckland region yesterday. This is our lowest testing day since the start of the current community outbreak.

The falling test numbers reflect in large part a big reduction in people with symptoms. This is the impact of the lockdown on stopping all respiratory illnesses from spreading throughout the community and, in addition, that we now have very few locations of interest emerging. However, testing remains central to us being confident that the outbreak is under control.

 Our most important message today is if you have any symptoms you must get tested wherever you are in New Zealand.

 The start of the outbreak, we focussed our testing heavily on those who had contact with cases or who had been in locations of interest. We know there are fewer people, as I said, with symptoms but getting tested if you are symptomatic is still the most important thing. Everything else is supplementary.

Over the next week, our goals are to improve our confidence. There is no undetected community transmission in Auckland and to protect the rest of the country from any possible leak yamg of the virus out of the Auckland region.

And there are three key actions that will help us achieve these two goals.

First, we will, of course, maintain a network of testing sites across Tamaki Makaurau to ensure timely access to testing, including for, of course, our Maori and Pacific communities. The Northern Regional Health Coordination Centre is continuing to look at the best places for our testing centres and they will move in particular to ensure that are reaching interplaces where we have seen cases in the previous few days in south and west Auckland. We will also be working closely with relevant employers to ensure that they support their essential workers in not coming to work if unwell and they are waiting for a COVID-19 test result.

Second, there will be more regular surveillance testing for healthcare workers who worked caring for or onwards are units with COVID-19 patients and our hospitals in Auckland. This will involve both immediate testing and ongoing surveillance testing for the next couple of weeks.

 In addition we are increasing the frequency of testing of staff working in our quarantine facilities in Auckland for the next few weeks given the large number of cases in there and what we know about the Delta vary apt, people are shedding more virus than they did with earlier variants. So in our quarantine facilities we are moving to twice weekly testing for workers there for at least the next two weeks.

And third - and this is new. I did allude to this last Friday. We will be working closely with employers who have workers who are crossing the Auckland boundary to put in place weekly testing of those workers. This is part of our overall efforts to fully control and end this Delta outbreak over the coming weeks. We have started engaging with employers and industries whois wroshgers are affected. Now -- whose workers is affected. Because this is surveillance testing, that is these people don't have symptoms, they will not be required to stand down or stay at home while a resulting their result unless of course they have symptoms. R likewise, just as for other testing, there will be no cost for this testing.

We are still working through the details but the key point is essential workers crossing the Auckland border will be expected to have had a test in the last seven days and be able to show proof of this. We are finalising how we will provide people with this proof and it is likely to be an email or text message that they will be able to show at the boundary. There will be spot checks there to ensure people are getting this weekly testing done. We know there are around 3,000 essential workers who are crossing the alert level boundary each day out of an estimated 220,000 essential workers in Auckland.

 In the first instance this testing will be available, of course. Swabbing at any of the community testing centres in Auckland and at general practices and urgent care centres. However, we are also working with provider in Auckland to enable saliva-based testing to be rolled out and available over the coming weeks, too, to support that effort.

I would like to thank all essential workers for their efforts to keep all of New Zealanders safe. These measures will start from Wednesday, 8 September.

Finally, I know we are asking a lot of Aucklanders at the moment and I recognise that these additional testing requirements might be inconvenient and indeed unwelcomed but I do want to reiterate how important they are and that the sole purpose is to ensure we stamp out this Delta outbreak and that Auckland can move down alert levels as quickly and as safely as possible. So thank you to everyone for what you have done to date. It is making a difference and let's see it through.

Back to you Prime Minister.

>> The thank you, Dr Bloomfield.

As you can see, we are making progress but we still have some real challenges aed had. That's why we need everyone's help with those critical things - testing and following the rules of alert levels. I will come to the rules in a moment.

But first, a word on testing. Our case numbers at present are coming down but we continue to see persistent cases attached to the current outbreak. Some of this is to be expected as we see close contacts and family members test positive. But some of these are still what we call unlinked or mystery cases. These matter. Because so long as we don't know where a case has come from, we cannot tell if we have other chains of transmission in the community that we haven't isolated yet. That is a cause for concern appeared it is why testing is so important to us.

And it is why we are asking if you have any cold or flu-like symptoms please get a test. It doesn't matter where you are in the country. We need you to be tested. That's why we ask our contacts to isolate and be tested. And it is why it is so important that anyone working particularly at alert Level 4 stay home if they are sick and get tested.

We also want to increase our testing of people who are crossing the Auckland boundaries to ensure we don't see any spread beyond Auckland. You will have heard Dr Bloomfield talk about this to ensure the safety of those in lower alert levels around the country, we want to step that testing up. That's why it has been said all workers who are permitted to cross the Auckland boundary will be required to have evidence of a test taken within the seven days before crossing.

 And as has been said, this will be a requirement from 11:59pm on Thursday, leaving time for people to go ahead now and get a test.

Because this is surveillance testing, people will not be required to stand down or stay at home while awaiting their result if they are an essential worker. We are also asking those who are permitted to travel for personal reasons to be tested, noting that this travel is often required for urgent reasons and may not always be possible.

Of course, everyone is aware of the exemption process they have to go through for that. These are extra ways we can keep up our surveillance and ensure we can contain the outbreak and stop it spreading to other parts of the country. This also gives us extra confidence as we consider changes to alert level settings outside of Auckland.

As you know, Auckland is set to stay at Level 4 until 11:59pm next Tuesday, September 14. Cabinet met today, though, to assess the latest data and considered the advice of our experts in order to determine alert level settings for the rest of New Zealand.

 Based on all of the information in nt fro of us and on the advice of the Director- General of health, Cabinet has agreed that all of New Zealand beyond the boundaries to the north and south of Auckland will move to Level 2 at 11:59pm tomorrow, Tuesday, 7 September.

Schools and other education providers will be given the next 48 hours to prepare to reopen from Thursday morning. As we have today, Cabinet will review the levels for the whole country including Auckland at a Cabinet meeting next Monday, 13 September and announce any changes that same day.

These changes, meanwhile, have one part of the country at Level 4 and the rest at Level 2. For the most part, that is workable with the hard boundaries we have set up but it does pose challenges particularly for north land, who essentially become cut off from the rest of the country. I want to assure north land that we are working through those issues.

There will be the ability for people to travel through Auckland if someone in Northland, for instance, needs to get to Waikato for their work. People will need to travel directly without stopping while going through Auckland. You will also need to carry evidence for the purpose of travel and the locations you are travelling to. The ability to keep moving down levels across so much of New Zealand is testament to everybody's hard work but it doesn't mean we are out of the woods. To account for Delta, Level 2 will be different to how it has been before.

 As I have said many times, Delta has changed the game so in order to beat it we have had to adapt our game plan too. I want to recap on some of the changes we have made because of the Delta that will mean Level 2 is different than what everyone may recall.

This is Delta Level 2. Face coverings are now mandatory at alert Level 2 whenever you are inside most public venues. So if you are entering a retail shop or an indoor facility like a mall or library, you must wear a mask. However, of course, you can take your mask off in hospitality venues like restaurants, bars and cafes so that of course you can eat and drink. Staff at these venues, though, and at any other public-facing businesses open at Level 2 must wear face coverings as well.

But to keep it really simple, if you are out and about visiting indoor venues please wear a mask. We have learnt the hard way that Delta is at least twice as transmissible as previous strains of the virus and it travels essentially through the air rather than by droplets or contact. That is why wearing masks is so important and our new normal at Level 2.

We also have some new rules on scanning and these have been shared previously but I want to speak to them again. We want people scanning everywhere they go but there are some places this isn't just an ask, it is now a rule. This includes bars, restaurants, cinemas, nightclubs, concerts, churches and close contact businesses like hairdressers. That's where you either have to scan or there has to be record-keeping. Essentially places where there is close contact between people or it is harder to wear a mask and where the virus can easily spread. It also means that if you are at places like private events there must be a record kept of people attending.

But even in places you are not legally required to scan in, my advice is of course do it anyway. What we have learnt is that traditional contact tracing can't keep up with dealt yachlt the virus is too fast.

So record-keeping and scanning continues to be our best tools to quickly track down any potential spread of COVID and keep us out of lockdown. It is also one of the best means we have of reducing the time we need to spend in lockdown.

So again please scan in. Mask-wearing and scanning are rule changes we have made in advance of this latest outbreak but this will be the first time that they have been put in place.

At the same time though, there are other things we have recently learnt about Delta that had have caused us to take another look at the alert Level 2 settings and ask if there is anything more we need to change.

The biggest issue is this: because Delta is more transmissible, we are much more worried about big groups of people. It is now no longer just whether you have enough space between you and others but rather, if you have too many people in a shared space generally with poor ventilation that really ups the risk.

That's why today I'm sharing two additional changes to Level 2. The first, there is a limit of 50 people for indoor gatherings, hospitality settings and event venues. This, coupled with the rules around customers being seated and tables being separated, reduces down the risk of super-spreader events. If you are an outdoor venue or you have an outdoor space, you can have up to 100 people in that space keeping in mind the rules around seated and separated. This is because ventilation makes a difference to how COVID affects either.

 Call gatherings must record attendee to see help with contact tracing.

The second change relates to imdoor public facilities like gyms, museums and libraries. Previously these venues had no limit on how many people are allowed to be in a space but instead a 1m distance rule is a proxy for how many people could be inside. We are now bringing these venues into allotment with the rules that exist for retail and supermarkets, which is 2m. That again will just mean we have fewer people in a venue with with the number being dependent on the size of that venue. It is a quick alignment that we think in a Delta environment makes good sense.

So a quick summary. Wear a mask. Scan everywhere you go and be mindful that when you visit some places they will have rules around how many people can be inside at any given time. Be patient, be kind and support local.

 These are tough times. Moving to Level 2 is progress and it is positive but it comes with a warning. We have done so well to get this outbreak under control. Level 4 restrictions are working but the job is not done. We are within sight of elimination but we cannot drop the ball. For the full details of the new Level 2 settings, Delta 2, visit COVID-19.govt.nz.

>> How many restrictions will be carried over to alert Level 1 

>> The first thing, when I spoke to our public health officials around alert Level 2, they still absolutely anticipate that if we continue to make progress that we will get back to a 1 environment. But what we will do, the same as we have done with every alert level, look at one, see if there are any improvements we need to make but every day we are applying what we have learnt this this outbreak to any of the changes we are make to go our settings.

>> Nightclubs, churches are actually just too risky and perhaps they shouldn't be opened at all under a Delta Level 2. Did you consider that option? 

>> Well, as you can see, we have changed the settings for those environment. So keeping in mind, of course, for nightclubs we have the environment around seating. That has fundamentally changed the way they operate. Now we have put a total cap on those indoor venues and I know and I have to acknowledge that it will be very difficult for some who are working in hospitality where they may have a larger venue. But what we have learnt from Delta is that actually just merely being inside in shared spaces like hospitality venues does pose risks. So we are putting a total cap on those numbers. We we are also hope to go get back to a Level 1 environment.

>> In relation to the mask mandate, one of the chunks we spoke to today said they wro have trouble enforcing it, when it is not coming from like a security guard at a supermarket. What would your advice be to people who haven't had that requirement on them before?

>> Actually, the most important thing I can say is that we have learnt from experience. You can see from this outbreak that unfortunately it is the social events where people noone another, where they are indoors for long periods of time where they are socialising that we see spread. And you only have to look at some of the examples from this outbreak and that's why it is so important. So I think education is as important as some of those harder forms of enforcement that people ask for, like security.

>> How is Auckland getting on with this 20, 20, 20 over the last three days. How are they tracking to be reassessed on Monday? 

>> Actually, we have based all of our decisions on public health advice so perhaps I will bounce to Dr Bloomfield for that. 

>> Thanks, Prime Minister. Yes, it is a remarkable coincidence it has been 20, 20, 20. The key thing here is the proportion of those cases that are known household contacts and expected cases is increasing. And we will see more of them. So we are expecting more of those to come through. What we are really interested in is whether there are any exposure events amongst those new cases out in the community and also cases that are unlinked. And I should say that even if we look at, say, our essential workers, amongst the group that came through yesterday, there is only one essential worker there. So that is another really good sign. And this is what we will be continuing to have a look for even if the numbers hover around 20 for a little while longer.

>> Does it make you nervous having that 2-4 split at the Auckland border?

>> Not - it doesn't make we nervous if we have a really good regime in place at the border. So we only want - or out that boundary. We only want people moving across the boundary who really need to and we want to make sure - and even before the testing, and we have talked about the testing, anyone with symptoms should not be going out, particularly anyone with symptoms should not be moving across that boundary.

>> In some ways almost the 3-2 boundary was quite difficult. Because in those cases you had more reasons why someone may need to travel between the borders to be able to work in a work applies that was open in a Level 3 environment. Actually, what we have been saying to Auckland is the only reasons we really want to see someone in a 4 environment moving is if they are eligible to work at Level 4. So that really has reduced down the number of reasons that we are seeing people movement, and we are also putting in that requirement around that regular testing the every seven days and that is something that we believe will help with just that level of comfort.

>> Yes, to you.

>> What is the guidance around mask use in schools?

>> I will hand over to Dr Bloomfield for that. I think the most important thing to say here is that we haven't mandated mask use in schools but I will leave it to Dr Bloomfield to give some guidance.

>> So my guidance would be, based on what we know, that we would be recommending the use of masks in schools but not requiring it. I know there is ongoing concern about this. So certainly for students 12 and above and secondary school settings, we would be strongly recommending that there. Then I think as an option for younger children. If parents wish their children to be wearing a mask and they are confident they know how to, and of course that raises issues about access to a mask, but it is not a requirement.

>> Will you mandate it?

>> Well, at this point we don't think, in alert Level 2, first of all where we wouldn't be recommending going down to alert Level 2 unless we were very confident there wasn't a risk or there was an extra risk of the virus or the virus was out of control outside of Auckland. I think it is an area we will keep an eye on and look and see what the evidence shows.

>> I think it is very hard also to compare New Zealand settings in other countries. Because often other country's settings are the settings that they have consistently with COVID in the community, whereas, as we move down through Level 2, there is risk but we currently don't have community transmission. So we take precautionary action so that if a case arises we are in a better position. And there are some differences in the way we treat venues an places where we have consistent attendees. So you consistently know who is at schools, you consistently know who are in workplace said and in some cases we have treated those venues absolutely differently. 

>> Dr Bloomfield, would you give us an insight into the new Level 2 rules. Did Cabinet adopt everything you recommended or are there areas where the government didn't go as far as you would have liked to see?

>> First, just to say it is not my contribution but all of our team inside the ministry and also taking on board the advice and views we are getting from others around other public health commentators and advisor the. So we still have the technical advisory group. My recollection is that everything we advised around what a Delta Level 2 should look like, just as we did around Delta Level 3 and indeed a Delta Level 4, you can see that the extent with which the contact tracing has gone very wide, even under alert Level 4, to consider everybody, virtually everybody as at least a close contact, it is a reflection of that changed approach because of Delta. I think all our advice around a Delta Level 2 has been taken up.

>> There was only one minor difference but it just applied to the distinction - the criteria for personal emergency circumstances over who could travel over a Level 4 boundary. So it was very, very minor and good reason I think.

>> You provided your advice around what should be happening around Level 1 or are you waiting for Cabinet next Monday for that?

>> No, we haven't had any discussion.

>> That will be this week's task. We do it on a week-to- week basis. We will be turning our minds to that and looking at what other countries are doing as well as getting advice from our technical advisory group.

>> You can see we already pre- efrp tively before the outbreak made decisions on masks and skaging. We have used the outbreak to share the rule changes and they are now being implemented for the first time over the course of the next seven days. But what we are also doing is learning in real- time. We are looking at what the public health units have experienced with Delta, what they are seeing around transmission and applying that to the way we implement our rules. That's why some of the lead times are in real-time. Because we are trying to use those experiences and apply them. 

>> On the ward with other patients, I think it is an important question. Sorry.

>> It is. But if you don't mind, I will come to Claire but happy to answer that question because we have been breach briefed on it. 

>> Mine is pretty much the same, about the middle Moore patient, whether or not you have found a link to a location of interest -- middle more. Or another known case. And also how it came to happen and what is happening now.

>> Sure. Go ahead Dr Bloomfield.

>> So on the first of those questions about the link, not yet. But the seem has been interviewing the Auckland Regional Public Health team, they have been interviewing every member of the household. There is a household of 10 people where that case is from. So they will have gleaned more information today. I think they will need to go back quite a way. I'm confident there will be a link there, it is just uncovering that. In terms of what happened with the person who was admitted to Middlemore, from what I have been proofed on, the person presented with symptoms that were not typical COVID symptoms at all. Although, the appropriate screening questions were asked that are asked of everybody who attends an ED under this sort of arrangement. 

>> Dr Bloomfield, there are questions being made if you could face the front while you answer the question.

>> Yes, the person presented to Middlemore Hospital EU without typical symptoms of COVID-19. There is always a screening of questions asked of people attending EDs under alert Level 3 when there is an outbreak on. The person was admitted to hospital to the appropriate place for the symptoms they had. The following morning the attending clinician, on further questioning, did wonder if COVID-19 could be a possibility and so asked for a test to be done. At that point in time the person ideally should have been isolated from others on the ward and that is something that I know that the hospital is going back to have a look at and is reviewing why that didn't happen. Of course, we many be interested as to why that was but as soon as the positive test result was identified, the person was isolated and the appropriate staff and others who may have been exposed were identified and appropriate measures put in place.

>> So one of the questions that we were discussing at the briefing this morning is just ensuring and checking again for our own satisfaction that when people are presenting at ED that they are being asked those questions. Were they a close contact? Have they been tested for COVID? Are they displaying any symptoms that are usually attached to COVID-19? In this case the person presented with abdominal pains. The issue we are asking ourselves should there be a widening of the health checks.

>> Were staff wearing N59 masks. Can you respond for the families of the patients who were also on the ward who have called this neglect glent?

>> Yes, I'm aware that families of others on the ward will be concerned and I have seen those concerns expressed and I fully understand them. That's why the hospital has undertaken to have a look to see what happened in this case and I'm sure the first people they will be providing an explanation to will be those other patients who were on the war at the same time. I don't have any information about what PPE staff were wearing on that ward so I would have to come back to you on that.

>> Prime Minister, how confident are you now with the drop in case numbers that New Zealand will return to zero cases daily. Is there modelling? 

>> Look, I would rather get there and then declare that that's what we have achieved than get too far ahead of ourselves because there is work to be done. One of the difficult things every time we discover a case, and automatically there are going to be more attached to that. You have seen today we have got one case that we have identified. They are in a house, in a large household, which bheens almost inevitably you will see extra cases come through from that. For us it is day by day but day by day we are making very good progress. What I don't want to do is to make the mistake of moving too quickly and then seeing a are you search evens because that has happened with Delta before -- seeing a resurgence. The on Delta 2 or whatever you are calling it.

>> Delta 2.

>> The new restrictions are 1m by 1m with caps of 50. For lots of people that will be the difference between opening or not. Will there be ongoing support for those businesses? Snool remembering 2m is what we are applying for spaces like museums, public libraries and the like, gyms, swimming pools. Those are often larger venues. But we are asking to use 2m as a general guide to reduce down the number of people overall who will be in those venues. What I acknowledge, whereas we haven't changed the distancing that is already in hospitality, what we have done is put in a total cap. I acknowledge that will be tough. The best thing we can do for those individuals is yes, keep up the support they are able to access an we will keep sharing any changes there as we go through the alert levels but also try to get back to as much normality as quickly as possible. That is certainly our goal. There will be some out there who may have been questioning is it that we are going to stay in a Delta 2 for prolonged periods of time? That is not what we are anticipating. We want to keep moving but it will depend on how successful we are.

>> Workplaces that are not customer-facing, say an office (INAUDIBLE), are they basically going backs to normal?

>> Yes. So if you are not customer-facing at all, then many of the rules there remain the same. But we are asking people to be Delta aware. So if they are able to just be aware of what we have learnt from this, reducing down contact with one another, just being really mindful of what they will have seen reported over a number of weeks.

>> (INAUDIBLE) have you got the police involved in that yet? Are they helping you?

>> Yes. So even before then, where we have cases that we can't or contacts we can't get hold of through the emails or we can't get a response through the emails and contact details we have, what use what we call our Finder services that includes any information other agencies may have including the police. What e- would are also doing is where we have got people with outstanding tests, the local public health units, if they can't get hold of people, are actually doing visits to their address that we think people are isolating at. Snooment unlinked cases, there is a (INAUDIBLE) every day that will get sorted out for the next 48 hours. (INAUDIBLE). (INAUDIBLE) 

>> We have asked for that information. I got a graph which I am sorry, I didn't have a chance to have a look at. But what I would say is that it is not just the epidemiological link in. In the past we have used this as well because we can often link people through our whole genome sequencing. Usually when we are talking about not having an epidemiological link, we might have a very strong idea about where it happened but we can't directly identify the person to person transmission that might have happened, but our whole genome sequencing will often fill in the gap. Into this is something I have noticed a change in the way the public health teams are briefing us. In the past if you had two COVID positive cases that happened to be at the previous venue, that previously wasn't enough for the public health people. They wanted to find how they had person to person contact in order to identify it had been that place where transmission occurred. Now there is an assumption that if you are in the same venue at the same time it is entirely possible for it to simply that have been the transmission event in a Delta environment. But as Dr Bloomfield said, what we have asked for is basically a to date stamp. Those mystery cases, because if they were very, very early on, then look, we accept that there were a large number of exposure events early on. But if you are getting them later on an an infection on set later on then they are more risky to us. Hopefully I might be in a better position to share more about that tomorrow?

>> (INAUDIBLE). If there is going to be border rules, that is about two hours driving.

>> Sorry, for people when they are transiting through? Yes. We have been in this position before and really, I think the request that e- would have from those in the north is just to allow access to other Level 2 environment. Because in Level 2 you are allowed regional travel. So someone from Hamilton is allowed to move to Rotorua. That's why we ask them to bring evidence of where they are going and why and just move straight through. That will be key. Do not stop in Auckland. It is a Level 4 environment. Unless you want to end up being told to isolate. So keep moving through. Thomas, then I will come back to the back.

>> Dr Bloomfield, what was the advice you gave to Minister Hipkins around (INAUDIBLE) test for people who have been in NSW regarding the flights that come back to MiQ in 14 days.

>> Gosh, if you don't mind, I would have to go back and just have a look. I haven't got that at the front of my mind at the moment. 

>> Sorry, would you mind repeating that again.

>> The advice that Dr Bloomfield gave to Minister Hipkins about whether pre- departure test should be required for people leaving New Zealand. 

>> I remember that. The advice at that time was that there was - remember, this was very early on in the outbreak when the numbers were much lower.

>> 500 a day.

>> I feel like it may have been a bit earlier than that. It was at the decision we decided to have red flights. Nonetheless the view at that time was two- fold. There was probably as much risk in having someone go and attend because if they had a high positivity rate at that point, there was as much risk for people going to receive a pre-departure teltsdz test. Given they were going no quarantine, the advice was to test them on rifl.

>> I given your comments to me.... 

>> It is as I relay ed. There was definitely no recommendation from the Department of Health to have pre-departure testing.

>> I'm asking Dr Bloomfield for that. 

>> Sure, but I just gave it early.

>> Your comments to you, how it was an important part in terms of limiting the number of positive cases that come into MiQ and, therefore, potentially leak out into the community. How does that marry with not getting people from NSW to do that when it was Delta-driven. I'm sorry, but NSW Health system was not that stuffed that people couldn't get a COVID test.

>> It is not the only place that we don't have a pre- departure environment. Other places comes straight in as well.

>> Look, I'm very happy to come back to you on that as in all these matters, I take the advice of my public health team and the circumstances at the time.

>> (INAUDIBLE) that decision don't seem to make much sense.

>> It is in the context though. One of the thing to keep in mind the Red flights, the proximity of their availability to bring people back, the processing time in Australia. There are a range of factors as I recall. Let's get the advice out and we can share it with you but that's not absolute recollection of what was shared with. Everything is eventually released anyway. I have spoken to it so I have no problem to release it.

>> I have got a few colleagues. I spoke to cancer patients who have had surgeried cancelled due to the outbreak. Dr Bloomfield, why were they cancelled and what is being done to clear the backlog?

>> The surgeries would have been cancelled with full clinical oversight. If there was a sense that the surgery didn't need to be done urgently and it would have been to ensure that any surgery that was being done was able to be done safely as well in the context of an outbreak. As you can imagine, not just in other parts of the country but in Auckland, any surgery that needs to be done because there is an urgency about it will be being prioritised and cancer- related surgery is right at the top of that list. So clinicians will be working very carefully to prioritise people who have had surgery that are missed, cancer an non-connoisseur- related.

>> More published vaccine priority access codes for Maori. Do you think he was race- baiting and sav at that staging the roll-out for Maori. Can you many people why it is important that marry are prioritised?

>> The most important thing for New Zealand is that everyone who can be vaccinated is vaccinated. That means our health providers locally will use tools to reach out to their local patients in order to encourage them to be vaccinated. I have seen there has been a very swipt reaction on tlien what seem has done and I think that is with good reason.

>> Are there are going to be further restrictions for large gatherings for the remainder of the year. So looking forward to Christmas, fess calendar season, sports and musical events.

>> This stage is very much focussed on the next stage of moving down into the Delta 2 environment and the restrictions we need there. With you you can see what we are taking into consideration, the way outdoor venues work verse indoor venues. The next stage for us is to look at what Level 1 looks like but our goal is, as always, to be as normal and as safe as we can be. The last one and then I will come to you an then I will finish.

>> Are you confident that Glen Eide mosque is the appropriate place for the terrorist to be serving... 

>> I'm confident people did everything in their power to keep the community safe. Leaders in our company have been helpful to work alongside agency to see ensure the community is safe.

>> Just going on from that, could you give us any information about why the terrorist didn't get recommended rehabilitation and deral calendarise programs while on remand. Is there any update to the timeline of the Counter Terrorism Bill.

>> On that letter point, Cabinet had a discussion today around the Counter Terrorism Bill which is sdu to be reported back to the house from the Select Committee and the timeline. I expect to be able to give you an update over the next week or so. We are still working to have the legislation passed before the end of the month. The really helpful thing is that it had already gone through the substantial public consultation so people have already had that their say. We haven't had to rush the proceed. Now we will go through the process in Parliament a little more quickly. On the question of rehabilitation - look, we have put out in the public domain a large amount of information but I do still think there is a role for those other reviews that we have, the Coroner's process, the PCA to give us those extra insights into what happened in this case. Thomas, I think I had one for you. 

>> Could you provide more information about what programs and offers of support...

>> Yes, I do think that that is part of the work we need to do as we put out all of the agency's responses. You may have seen that they have responded to some of the questions around, for instance, the mental health sum port and assessments, and, for instance the fact that those wrl rejected and some of the challenges that existed there. But I think actually, overall our goal here is to just to provide all the information and be willing to critique ourselves.

>> (INAUDIBLE)

>> We know engagement occur you had but I do think that there is room for us still to look in a little more detail across all of those areas. But keep in mind that that would have been - there is a range of different agencies who have had a role all the way through to the police to Correction. So I think it will be helpful for us to use those processes to draw that out.

>> Why couldn't he be rorpted under national security (INAUDIBLE) 

>> I will give you the short version. That if an individual - of course he was going through a tribunal process, first of all, and had appealed the cancellation of his refugee status. One of the issues that would be considered by the tribunal, however, is whether or not the individual was a protected person. So if someone is a protected person then that makes deportation very, very difficult.

>> Did you basically - government lawyers decided he would likely be deemed that right. 

>> They weren't the ones determining ifly would be deported that. Was relevant as to whether or not Immigration New Zealand had grounds to detain him pending his tribunal process.

>> Given he is a protected person, you said you would like to see if you could find an avenue for someone like him to be deported in the future. How could you do that without foregoing im obligations. Into that is top of mind for us. We have to keep in mind we have international obligations here. So the question I asked specifically, when someone fraudulently obtained that status, what ability do we have. That then poses a national security threat. There is a bit of work to be done through there. Again as you said it is complex... 

>> (INAUDIBLE) if he is a protected person.

>> No, there are a few things we can explore still. I'm just going to give us a bit of time to work through some of those options. It won't be quick but I think it does warrant us exploring. Because most New Zealanders will say, "Well, if you wanted fraudulently in gaining that status and you are a threat to national security, surely there are some mechanisms that we can use there" so that is what we are exploring.

>> Michael, in the front today?

>> I guess realistically, how long do you think that the rest of country south of Auckland will need to spend at Level 2 before we go on to Level 1. Can you see a situation where we will stay at Level 4 and the rest of the country Level 1?

>> We take every decision based on the data that e- would have in front of us. So we don't attend to get into those hypotheticals other than to plan and prepare so that we have all of the options available to us. I think the only thing I would say is all the options are available to us. It will literally come down to the public health advice we see and the confidence we have.

>> I would agree. I guess the big focus over this coming week is on Auckland to make sure we are doing everything we can to support the efforts to get confidence that the outbreak is well-controlled there and that we haven't got ongoing transmission.

>> How damaging are comments like that? And what would be your message to frontline staff specifically who might feel quite deflect ed now.

>> To the team, keep up doing what you are going. Our goal, the country has to be getting the highest level of vaccination rates that we can across all New Zealand, across every region. Keep it up. Don't try and stop the good work being done. The only other thing I would say, every day our health providers will send out messages directly to their clients, to their patients and we undertake targeted messaging for patients all of the time. It is not unusual in a health program to do that. So to try and undermine that for no reason, in fact for all the wrong reasons, it is hugely.

>> 

>> Just in terms of mask use in schools, would you not consider schools to be more high risk than, say, 50 people in a nightclub 

>> Not necessarily actually and for good reason. One of the points that the Prime Minister made is that in schools they are actually very controlled settings and you know exactly which children and which classroom generally. Whl they are interacting most is when they are outside usually during breaks. So no, I wouldn't consider it a high risk setting than a nightclub. In fact, all the evidence, even without Delta, is that the highest risk settings are the ones where there is that, amongst adults, close contact and crowded and in confined spaces.

>> In terms of testing, would an increase inned intoing tests there are some health leaders calling out saliva setting. (INAUDIBLE). Could that be brought forward?

>> The thing we focussed on, because that is the area we have got really good testing - capability capacity, is around nasal pharangeal swabbing. That is widely available across Tamaki Makaurau. The saliva testing we will be introducing, is already in a number of our border areas including ports now around the country and we will be adding it as an option for essential workers who may need to be on testing over these coming weeks.

>> The New Zealand Muslim Association says Corrections engaged them last year and ahead of a person's release in terms of managing his rehabilitation back into the community. They then pushed back and said, "We would like to help but can you resource us, can you put a time frame" and that sort of thing. They said the communications dropped off. Are you aware of this? And why would Corrections not take up the offer to help and effectively dump him at Islamic centre which is under-resourced to deal with it?

>> Yes. That's why I have said look, whilst there is information that e- would have around the timelines of what happened and when and engagement in the system, it won't necessarily be every engagement with, for instance, community organisations or complunt leaders. That's why I do think that there is room for us to have a look at every element of this. Some of those standard reviews that will take place in a case like that help with us. What we are going to do is just to have a look and see are there any gaps in that, that means we won't dig into some of those issues we need to but we need to be willing to lesh. Again my one message around the Muslim community is that no-one's eyes should be turning in that direction at all. At all. As we look at this case. Of course, we as government and as agencies, we have to reflect on ourselves but that is not the direction I would encourage anyone to turn their minds to. There was nothing but good faith there.

>> I will let you finish your question.

>> Just on that though, the President feels really upset because he feels the situation on Friday could have been prevented if the Corrections had continued through with their initial engagement which is the country 's foremost Muslim people.

>> The only pattern you can see is a reluctance to engage. I think that was one of the difficult things throughout this period as well. But I can't e- speak to the engagement directly outside of government agencies, I just know that was a pattern we were seeing. 

>> On surveillance testing, you said the workers crossing the borders will have until 11:at on Thursday to get it done. But Dr Bloomfield said it would be Wednesday 8. Could you provide clarity around this. Is it midnight on Wednesday. What is the date?

>> Basically we want a seven day window tore people to get a test. We are asking them to do it before they cross the border. We will be working with different organisations who particularly cross the border frequently to make sure that is workable but at the moment I have 11:59 on Thursday.

>> The truckies will be properly kept in the leap on that. This morning they were saying they were blind-sided.

>> Dr Bloomfield spoke about this several case ago. This is not the first time we talked about it. It is the first time we put a date on it. People understand we are move moving the rest of the country on much lower alert level. People want to have confidence that those who are moving through the country are doing so in a way that is safe for them. This is one way that we can move the rest of the country whilst still having that border. Very few places around the world have been able to maintain those different levels of restrictions and this is one way that we can do that.

>> What sort of improvements would you like to see in the number of cases or the types of cases - to see either Auckland go down from Level 4 or the rest of the country go down from level Delta 2?

>> Obviously you have seen that we have been willing to move down with the rest of the country regardless of what is happening in Auckland and in part that is one of the reasons why the board is really important to us. I think in the past, of course, people in New Zealand we move around a lot. We have a lot of trans-see interest movement and freight moving. The border has been critical to news making this decision. There is not so much movement appeared we are putting in surveillance testing. For Auckland we have already set out what we want to see there. We want to see a good sense of containment and that's what we can't to look for. Mystery cases are particularly important to us.

>> Could you move down a level if there was still 10, 20, 30 mystery cases sn?

>> Look, mystery cases, we do want to get a sense if we have had them. So over the course of several hundred cases, if you have had them right at the beginning of your outbreak it is very different than if you got yesterday. So we assess that as well.

>> I think two things on the face of it. One is less cases, two is effectively none are mystery cases. That all our cases we can very quickly link back to existing cases. And that won't come as a surprise to anyone.

>> E- wool start wrapping up in a moment.

>> Just to both of you on the Elliott Street vaccination centre which is closing tomorrow. Into really?

>> Put ago side the fact that they are oefgly going to other street centre where there will be more people. Northern regional health said they had also taken into consideration eliminating people's concerns using the vaccine centre next the Crowne Plaza. Given the comments of both of you over the last few weeks about not being concerned about the proximity, does that surprise you that that wouldn't affect it.

>> No, not at all. Because we raised it with the team. We worked through all the issues on the Crowne Plaza to give ourselves comfort that we had done what we needed to do to assess its safety. We also acknowledge some people might have residual concern. Rather than people being worried and not turning up, we found a venue that had a larger space. It hasn't moved because there was an ongoing public health concern but we were worried people might be hesitant to go there. This is a win-win, bigger, and we don't have to worry about that concern.

>> The Delta perspective review you have been doing, has anything come to light before it needs to change before the next cohort goes in there.

>> No, they have checked with the ventilation from the common spaces, the swab spaces that it vents appropriately. They have changed delivery protocols. They have increased the separation now so it is up to the wall. There has been a number of changes but there has also been a review around it as well. Our technical team have reviewed that. Dr Bloomfield, do you want to comment on that?

>> Just to reiterate there has been a number of things done to reduce any potential for residual risk. The technical advisory group that includes public health expertise and also a couple of our key scientists in the Ministry have had a look at the report and are satisfied that any residual risk has been minimised to the greatest degree possible.

>> We will finish. Down the back. 

>> Will there be tertiary guidelines for Delta level 2 because understandably, it is not (INAUDIBLE) in schools. A lot of lecture theatres, they have classes that are massive so they aren’t able to have just 50 people there. Students are encouraged to come. Into they do.

>>The universities have already - they already have developed up a Level 2 operating protocols as I recall.

>> All the students still arrived and (INAUDIBLE) others had to sit elsewhere and go online. Obviously you would want to prevent that now, would you want?

>> What I might ask the Minister of Education to go back and do is what you have raised is not so much there are not protocols but the way they are working in practice. Happy to ask the Ministry of Education, whether that is causing congestion with people mingling in a way that is not appropriate. I will have him go and have a look at that with universities. Thank you everyone. Sorry, Sam, I didn't see you.

>> Mask use at university said, is that mandatory?

>> Not mandatory but I would strongly encourage it and it would be a really good place for people to be using masks and scanning in.