COVID-19 update - Omicron response update 24 February 2022

Ministry of Health COVID-19 Media Briefing transcript

Speakers:

• Chris Hipkins, COVID Response Minister
• Dr Ashley Bloomfield, Director General of Health

>> Kia ora koutou katoa. Thank you for joining us.

Our regular providers have not been able to provide sign language interpreters for today's event, so closed captioning is available on the Ministry of Health's live web feed but we will also make a transcript of today's press conference available on the Ministry of Health website as soon as possible after the event is finished.

At 1 o'clock today Ministry of Health will release its regular update, its regular daily statement outlining New Zealand's key COVID-19 statistics on the last 24- hour's. Ahead of that statement being released I can confirm today's community case total is currently around 5000 cases.

That is a mix of PCR tests and rapid antigen tests. There are over 1000 rapid antigen test results in that, so I thank the people who have been uploading those results. They will be in the 1 o'clock statement, the specific numbers. They are being finalised at the moment.

Following on from 3297 cases yesterday and 2846 cases on Tuesday, this continued rise and the number of hospitalisations we have which today is 205 means that we are now confirming our shift to phase 3 of our planned Omicron response. That will happen as of 11:59pm tonight.

We have continued to monitor the outbreak carefully and consider the public health advice that we have been receiving before we come to that decision.

With the numbers rising sharply over the last week, as we expected they would, I don't think the shift is going to come as a surprise to many. Most people have been gearing up for this moment. Details of the changes and what they mean for you are being provided on the Unite against COVID-19 and Ministry of Health websites. That will be available this afternoon.

I do want to provide reassurance that phase 3 won't mean any sudden lurch in terms of personal restrictions or movements. That's because our traffic light system has been specifically designed to smooth out these kinds of processes. We want to move through the phases seamlessly and relatively smoothly which is what we have been doing.

We aim to keep people safe with as little disruption to their day-to-day lives as possible. Our priorities now shift to isolating those with COVID-19 and their household contacts to reduce the spread. At the same time, supporting supply chains and essential business and services to continue to operate. In order to do this, there will be a number of changes you will see when we move to phase 3 from midnight tonight.

Only confirmed cases and their household contacts will be required to isolate. I will run through that again.

It will only be confirmed cases and their household contacts, the people they live with, who will be required to isolate.

All other contacts will be asked to monitor for symptoms, but they do not have to isolate.

Rapid antigen tests will become the primary means of testing for COVID-19.

They will be available through thousands of sites around the country including pharmacies and GPs. And we have got millions more arriving in the coming days.

Major shipments are due today and over the weekend. We expect businesses to be able to make rapid antigen tests available to the public for purchase through retail outlets from March. We will have more details in the next day or two on that.

We're also now moving to the start of greater self- management when it comes to COVID-19, including the use of new self investigation tools which will support positive cases to self notify their contacts.

Because only household contacts are required to isolate, this tool will help us keep track of exposure events and locations and the overall spread of the virus.

Contact tracing teams, our teams, will focus on identifying and tracing those who visit at high risk locations such as hospitals or aged care facilities. And there will continue to be support for those members of our community who aren't digitally set up to engage that way. Hospitalisations now become a major focus and daily case numbers will become a less important metric from this point onwards.

This is critically important, practical changes to ease some of the pressure on our health system over the next 3-6 weeks have been driving the changes we have been announcing today. That ensures we can keep critical services and supply chains operational and keep our economy moving as well. There is no doubt the next few weeks are going to be pretty challenging.

But New Zealand is better positioned than most countries respond to Omicron. We will get through this. We have seen and learned from what is happening overseas.

We just need to stick to the plan we set out as we manage a higher number of cases in the coming weeks before we reach a peak as other countries have. Because so many New Zealanders are now vaccinated, and because Omicron has a less severe reaction, or triggers a less severe reaction amongst many people, we can have that more devolved response placing much greater emphasis on self- management and allowing our teams to focus more on the vulnerable, the most vulnerable. Preparation and supporting will be a key for many people.

We have been asking people to prepare for the last few weeks both mentally and by putting their plans in place.

Making an isolation plan, having their stay-at-home kit ready, talking to friends and whanau about how they will manage if they and their household need to isolate. High vaccination rates should also help to get us through the next stage.

We still strongly encourage people to get their booster doses if they haven't already done so. We are currently around 70% of people who are eligible for a booster have either taken a double booked in. So there is still room for us to get ourselves even more protected in the coming days by people taking up their booster. You are far less likely to end up in hospital if you get COVID, if you have your booster.

The Director-General can speak more to that.

Care and support will be available in the community to those who need it most as it always has been. And our community providers are being resourced to provide care in the community and wraparound health and welfare services alongside clinical care for those who have higher needs.

Whatever phase 3 might mean for you, as people, business, organisations or communities, I want to reinforce we have carefully planned for this and New Zealand is in much better shape going into the potential peak of Omicron cases than many other countries. So keep supporting one another and we will get through this.

Jessica?

>> We go into phase 3 in a few hours time, why don't we have enough stock that can kick in and a few hours time?

>> We been making sure we are getting test results out, sorry, test kits out there distributed around the network. I will get the Director-General to comment more on that in a moment. In fact I realise I didn't hand over to you. I am a bit discombobulated being in a different environment. I'll answer your question and then I will get the Director- General to say a few words before we do Q&A. I apologise, everybody. We have distributed rapid antigen tests throughout the network. We have more arriving daily. We are preparing to make them available through retail sales or to remove the impediments for people to make them available for retail. We might come back to that in a moment, but in the meantime I will let the Director-General...

>> Is a good enough to say to people, don't worry... Going into phase 3 in a few hours time?

>> They are available for those who need them now to test. Available through the testing network.

>> Following that, we heard this morning there is a testing centre in North code in New -- Northcote in Auckland turning people away.

>> The Director-General can provide an update on that case, my understanding is more tests have been supplied to them. We are seeing a surge in demand for testing so making sure we get the tests in the right places, the last thing we want is people sitting on stockpiles when there is demand elsewhere. In them into the right place is always a logistical challenge but where centres are running out we are getting more to them as quickly as we can.

>> Thank you, Minister. Welcome to the Ministry of Health, welcome back to all of you to the Ministry, kia ora koutou katoa. I will make my opening comments and then I can respond to some of your anticipated and keen questions about rapid antigen tests. To start with one of the reasons we advised the move to phase 3, and as the minister has suggested, around 5000 cases at least are a combination of PCR and rapid antigen test confirmed cases today. There is increased demand for testing. The planned move to phase 3 and the move from PCR testing which has happened over the last couple of days around the country especially as demand and case numbers have grown, at community testing centres, and rolling out widely over coming days to general practices and a range of other places will help ease the pressure on our labs so our PCR testing will be used for people who are unwell or more susceptible, for example, those in hospital, people who are immunocompromised, pregnant people, and others for whom it is very important in terms of clinical management to have a specific diagnosis. To speed up the testing process, both symptomatic people and asymptomatic close contacts whose rapid antigen test is positive will be considered a case without the need for a confirmatory PCR test. And to reiterate the comment from the Minister, thank you to those who have already started uploading their positive rapid antigen test results onto My COVID Record and we will incorporate those in our daily numbers from here that we report. People should also advise their employer of a positive result so appropriate measures can be taken to identify potential contacts in the workplace who may need to consider their own movements and so on. Rapid antigen tests will continue to be used for critical workers who are household close contacts. That will help support them to return to work if they need to if they are critical workers. Recalling that at the moment both cases and household contacts need to isolate for 10 days. But household contacts who are critical workers who are asymptomatic will be able to still use that exemption scheme and use rapid antigen test to go back to work. We will also follow up any rapid antigen test positives we get from people coming across the border, with a PCR test. This is so we can do hold you -- hole G gnome sequencing and it helps with border surveillance. Businesses have been able to import rapid antigen tests since the beginning of December. And we know businesses like ourselves have had challenges procuring supplies because of global constraints. Those are easing and as the minister said we have large supplies now arriving over coming days. There may not be rapid antigen tests on shelves immediately but they will be available soon in retail outlets. Likewise, in Tamaki Makaurau GPs and clinics will begin to roll out supervised rapid antigen tests from today. The important point here is to find out whether or not your general practice has the tests and is it doing this, check on the Healthpoint website. That will have an up-to-date list of all the places you can get a rapid antigen test. We do have enough in the country to help us through a widespread Omicron outbreak in coming months. We were down to a million, we had 6.3 million unused tests yesterday, a million arrived last night and there is another 4 million arriving today and further shipments this coming week with another 10 million at least arriving over the next week. We are getting them out to places, but as you know from demand on certain supermarket products at times there can be a mismatch between demand and supply. In the case of the centre in Birkenhead, Auckland, yes there was a shortage and more stocks have been supplied there. One of the things we are trying to anticipate is also the impact of people in cases and contacts on supply chains and logistics like courier companies. So we have got rapid antigen tests as distributed as possible through the system. Just on isolation and why we are moving to just household contacts, we know with Omicron as with other prior variants of the virus, household contacts are the most likely by far to become infected as secondary cases. That's why in this phase we are focusing now just on household contacts isolating. As the minister said, from tomorrow only, cases and their household contacts will be required to isolate. While other contacts will not be required under the Section 70 Notice to Isolate, clearly it's important that people know if they have been in contact and that is why we are asking cases to self register and let their contacts no because they may need to take appropriate precautions. They may need to let their employer no if they are a critical worker, for example. Likewise they may need to modify what they do, not visit older relatives or people who may be susceptible if there is a risk they were a contact. And for everybody, for all of us, this is a time to be really mindful about who you visit over these coming weeks. It is not the time to go and visit older relatives in aged residential care if you have been a contact. As we did earlier in the pandemic, act as if you have COVID and look to protect the others around you remembering that over one third of people who are infected with Omicron, if they are vaccinated, will not have symptoms. So it's important we all do our bit there. Boosters, the minister has mentioned. What I want to focus on with my brief comments on this today is our modelling of the low transmission scenario such as the one Dr Garry Jackson at Counties Manukau talked about yesterday assumes high rates of booster uptake. At the moment nearly 70% of eligible people have done so. We need to increase that. And recently published evidence, just in the last week from studies by the CDC in the US, show yet another reason why this is important. There has been some question about whether the vaccine, even people who have had three doses, protects from either being infected or from transmitting to others. There are two new studies from the American Center for Disease Control and prevention that now confirm the vaccine protects you from getting infected in the first place and it is hard to pass the virus on if you are not infected in the first place. Just as we know they protect against severe illness. This is quite profound. One of the studies published in the Journal of the American medical Association shows it compared with being unvaccinated the odds of contracting Omicron after receiving three doses dropped by 67%. Two thirds. And for Delta the risk declined by a stunning 93%. So yes, three doses of the vaccine doesn't just protect from hospitalisation and death, it protects people from being infected by Omicron in the first place. So a highly boosted population here will serve us all well. Finally, just to let you know our health sector has been working hard over the last few months to get prepared for Omicron. There has been a lot of work undertaken by District Health Boards, by our primary health care providers and community providers. All DHBs have plans in place. You will have seen the hospitalisation number at the moment is over 200. That is a significant impact but hospitalisation rates across the country on average 85%, that's about usual. Occupancy in the ICU is about 62% so we have capacity in our hospital system but we want to try to keep the hospitalisations as low as possible. Even now with over 25,000 active cases, the hospitalisation rate is less than 1% so it is much lower. But the number of active cases will drive that hospitalisation number up. If you are unwell for any reason, you should and can safely seek care throughout the whole system and that includes inside our hospitals. Back to you, minister, for the hard questions.

>> We will have another go, sorry.

>> (INAUDIBLE) what happened, why is it now only household contacts?

>> We are trying to make it as simple as possible. We don't want confusion about who needs to isolate. We have worked hard over the last few weeks to make sure it is as clear as possible so people understand whether they need to isolate or not.

>> If you are sitting in a small old office, that's likely you will pass it on or catch it as someone living in your house.

>> It's important to note, this is who is required by law to isolate. That doesn't mean people who feel they have been exposed shouldn't isolate if they are in a position to do that. This is who is required to isolate.

>> In Pasifika households especially where we see families isolate to an excessive extent when you don't have medication, is it appropriate to be sending a message that you can judge how far you want to isolate and how?

>> If you are a household contact, you have someone in your house that has COVID-19, you are required to isolate. If you have a friend who has COVID-19, you can make a judgement about whether you think you would be at risk based on the nature of the contact you had, or a workmate, based on the nature of the contact you had. We are moving to a position now where there will be a much greater number of cases in the community, and we are asking New Zealanders to accept a much greater degree of personal responsibility for what they do with that.

>> The nurses Association said they were told if a nurse tests positive, as long as they are asymptomatic they can still go to work, is that right?

>> I will get the Director- General to comment on workforce guidance.

>> We have a specific scheme in place for healthcare workforce if they are a critical worker and it is essential that they are able to work to keep a service going. They cannot go back to work for the first seven days. But if they return a negative rapid antigen test on days five and six and they are asymptomatic, yes they can return to work three days earlier than the full 10-day isolation period.

>> Around schools, what is the guidance for parents around sending kids to school?

>> You mean if those children are contacts?

>> At the moment it's household contacts. If it's a child in a classroom, can you give parents some idea of what they should be doing?

>> I think the Minister of education is very well-placed to respond to that question.

>> Again, it is household contacts. People who live with someone who has COVID-19, we need to isolate. I acknowledge schools will also want to know what they need to do about this. Detailed guidance will be sent out by the Ministry of Education as to how schools work through this process but the fundamental premise remains the same - if you have got someone in your household who has COVID-19, you are required to isolate. If you are simply a broader contact of someone who might have COVID-19, you are not required to isolate. But parents I am sure will make judgements about that. I know schools will make pragmatic decisions about, for example, how they coded student absences where this is the driver behind that absence. Schools are prepared to work their way through it.

>> If you have got parents who can afford to take time off work and keep kids at home, that is such an advantage compare to other kids whose parents may be in a job where they cannot take time off and the kid has to go to school and there is no requirement for them to stay home.

>> As a parent I can tell you that has always been the way whether COVID-19 or any other illness when it comes to trial illnesses. Or children having to stay home for whatever reason make child illnesses. Early childhood services and schools are taking a low tolerance approach. Kids with symptoms are being asked to stay home. And that is good practice even if we weren't dealing with a potential peak in COVID-19 cases. I acknowledge that puts pressure on families and some families are in a better position to do that than others. It's one of the features of being a parent that when your kids get sick or they have to stay home you have to find ways of dealing with it.

>> I have two questions for the Director-General, if I may. A lot more people are getting COVID-19, can you explain if I contracted COVID-19 how I would be told, triaged, cared for, how you discern people who will be fine at home and those who will need hospital level care?

>> Yes. Under phase 3 this is similar to what it was under phase 2. We did a briefing on this last Wednesday. It has already started under phase 2, many people will be self managing. To date, most of the testing has been PCR testing so people have been notified by text and then with a link for them to fill out a form and provide their information. On the basis of the information provided, there is follow-up to determine what clinical or social support they might need if it is indicated. For the vast majority of people that's not the case. That continues into phase 3. For people who don't respond to that text, then there is a mechanism to follow those people up with a phone call and other ways to try to contact them to determine whether or not they require any clinical or other support. For people who are uploading their tests onto My COVID Record because it is a rapid antigen test, likewise that test goes into the system and there is a process whereby they will be able to identify whether they need clinical or social support to isolate.

>> Delta is still circulating in the community to a smaller extent. Can you advise whether it is appropriate for Kiwis to act like they might get Delta rather than Omicron, what the likelihood is?

>> To be honest, I go back to my comment that everyone should act as we did earlier in the pandemic. You will remember the specific call, act as if you might have COVID and behave accordingly to protect others, including using masks et cetera. It doesn't really matter whether it is Delta or Ron. -- Omicron although we know there is a higher risk of Delta causing hospitalisations. We are still doing genome sequencing of our hospitalisations and we will have an indication of what the balance of hospitalisations is between Delta and Omicron soon and that will give us a picture of what the circulation of Delta is in the community still. Mark?

>> We have been asking for several weeks now for people particularly in Auckland not to get tested if they don't have symptoms, or they are not close contacts, is that message getting through? Is that reflected in the testing numbers? Or are people still turning up and testing centres using resources that could be better used elsewhere?

>> We are seeing that message getting through. We also saw yesterday the impact of rolling out rapid antigen tests in Auckland. About 40% lower number of swabs taken yesterday for PCR tests across Tamaki Makaurau. And I think around 14,000 rapid antigen tests handed out. What I would say is for all of us, the message has been for the last two years, and it has served us very well, if you have any symptoms or you may have been a contact, go and get tested. So everybody is having to make that shift. That shift is now happening. And of course the use of rapid antigen tests will really support us to make sure we can maintain our PCR and lab capacity.

>> Moving to the traffic light system, red, orange, red, phase 1, phase 2, phase 3, in rapid succession do you think people might be getting fatigue with the rules and not being able to keep up about who has to isolate, what test you have to get et cetera?

>> Well, a comment from me is the reason we keep doing our regular briefings and putting out our releases is to try and be as clear as possible, and also the material on our website. I agree, especially with this outbreak, it has been a rapid rise over the last two weeks. So we are seeing these transitions happen possibly quicker than we may have anticipated but we have tried to be really clear including by laying right up at the start what the three phases were and making sure people are aware of the requirements clearly from the start.

>> People who are existing close contacts, right now, do those close contacts left Mac at midnight?

>> Yes they do. Just as when we shifted from Phase 1 to phase 2, the new rules came into play, that will be the same tomorrow for people who are currently isolating as non-household close contacts under the phase 2 regulations as it were. But so saying of course we are encouraging everybody whether they are required to or not to just be thoughtful about the risk they may pose to others and take appropriate cautions.

>> The protest at Parliament, everyone there was deemed a close contact 20 minutes ago, 30 minutes ago. So in 11.5 hours that close contact status disappears, what you expect those people to do?

>> I would expect them to do what we expect of all New Zealanders, and that is to essentially do the right thing to protect other people. That's the reason we have done well to date is because New Zealanders have done that actually. Regardless of what the rules are, it has still relied on a high level of trust and confidence that people will do the right thing and they have. Of course we ask the same of anyone who is at any location of interest.

>> Why don't we just get any more questions for the Director-General and then I will come back.

>> Down the road you got a big group of people yelling, singing, no masks, all gather, how would you feel?

>> I would be as concerned as anyone else because we know exactly the sorts of things that are likely to spread this virus, and so it puts the people there at risk. In some of those people, especially because we know there are lower vaccination rates, will get unwell and especially unwell. That to me puts them at risk and I am concerned about that.

>> Do you know of any more cases today?

>> I don't know of any confirmed, but if we get an update from the local public of unit we will provide that update.

>> Someone connected to the protest turned up at Wellington Hospital yesterday who was sick, where you made aware of that?

>> We have seen reports that there have been people at the protest to have sought care at the hospital through the emergency department, most likely because they are away from the usual place of residence. So there have been people who have been at the protest and have turned up at the hospital, and because everyone going through the ED at the moment is being tested, they have tested positive for COVID-19. I am not sure is whether they sought care because of COVID-19 -related symptoms or for another reason.

>> How many people at the protest have turned up at the hospital and how many are sick? Speaker Mackay don't have the exact number.

>> What work is being done to establish the containment rate?

>> We are now looking at this point in phase 3 where we start to use a combination of data sources to see what our case ascertainment rate is like and that includes how many people in hospital, which I talked about, and at the moment our hospitalisation rate is similar to what other countries have seen with Omicron. Obviously our PCR and RATS tests are combined. It's not so much to quantify case numbers but to see where the different areas are. The wastewater testing will show us whether case numbers are increasing or declining in those areas. We won't have the full picture of the total number of cases, you are right. There will be cases out there that don't make it into the official numbers. But all these things will help us estimate the total burden.

>> We have heard experts talking about the need to determine that rate. Pollux in Australia had to do that work during their peak -- colleagues, and experts are saying we need to get that rate to understand exactly what we're dealing with. Do we have any idea about when we're going to understand exactly how many cases or infections we're going to have across the board?

>> Two comments. One, we have our modelling and that has shown us what we might expect based on a number of assumptions. Secondly, as the Minister mentioned, what is important is our hospitalisation numbers and the impact across not just hospitals, remembering the vast majority of people who need clinical care will be looked after by their GP or other clinical providers.

>> If we have that rate we can predict what populations and areas are going to be hit harder and then we can look at resource in those areas.

>> Right through the pandemic, I think we have used our testing rates and our analysis of what the epidemiology is in different areas and we now have an epi curve for each DHB so we can see what is happening there. Yes this will be important but I would like to say, it doesn't require us to have the exact picture of the number of cases out there. We will look at a range of metrics to manage our way through the next few weeks.

>> Can you clarify, why would someone buy a RAT versus getting one from the pharmacy? And are you putting on measures to stop massive price rises? Should people who have money then be able to avail themselves of the test versus those who can't? Second those who need to be tested will have the test freely available. Those who want to test for other reasons, we will be looking to remove the barriers to them purchasing their own tests. And we will look to do that very quickly.

>> Will you have any controls on the price? And the numbers that you can buy?

>> It is fair to say we will keep a close watch on what is happening there. Retailers in New Zealand, over the course of the pandemic, I think have in the main been very responsible about not price gouging when they have had the opportunity to do so. Certainly when a variety of things have been in short supply. But we will monitor it closely.

>> Can you clarify why on earth you are stopping people at the border right now? There are eight cases at the border as of yesterday, compared to 3000 cases in New Zealand. Is there any point given Omicron is here, is there any real moral justification. A New Zealander is coming home?

>> We are days away from the border reopening. For Australia, and then shortly thereafter followed by the rest of the world. We are reviewing the self- isolation requirements for people coming into the country. I have no announcement on that at the moment, we are still being advised about whether people should still need to self-isolate on arrival in New Zealand. We expect to get that advice in the next week or two. And we will consider that and make further decisions based on that.

>> It sounds like self- isolation could be completely gone within the next month.

>> In the next month we will certainly make a decision on that.

>> Dr Bloomfield, how many DHBs have significant deferrals of planned care because of the Omicron outbreak?

>> At the moment, the only one I know that has made significant deferrals is Auckland DHB. Even in the Auckland region, which has clearly been the hardest hit, the other two District Health Boards are still doing about 70% of their volumes. At the moment I am not aware of other DHBs. If you look at hospitalisation rates, they are relatively small compared to capacity in the DHBs. The key thing that tends to drive them needing to either defer planned care will be the staff, if there are staff off because of cases or be in contact.

>> Have you been made aware of any staff disruptions?

>> Not at this stage. They are all having staff disruptions. To say they are interested in and supporting not just disruptions because of staff challenges inside their DHBs but also in the community, particularly aged residential care so they are working closely with aged residential care to make sure that area is supported if needed.

>> Given the number of cases we are seeing in schools, does the gap between the first and the -- the second and the third doses for 5 to 11-year-olds need to be shortened?

>> The advisory group provided advice we need to maintain that eight-week gap. There's a good reason for that. That's why most countries who are vaccinating 5 to 11-year- olds are maintaining that eight-week gap. Because children have much more attuned immune systems, they have a much bigger response to the first dose. And also a bigger gap is better for long-term immunity and for reducing the likelihood of some of those rare side effects.

>> Do you think we will get to phase 4 of the Omicron response, and if you think we will, when will that be?

>> I don't think so because I don't that we have elaborated phase 4 yet. Just three, I hope.

>> Do you still need to scan if it's only your household contacts? Speak at this stage it is still helpful to scan. People can still notify their non-household contacts. Again that's an important point. The difference is that those people are not required to isolate. But I think it is really helpful for people to know if they have been exposed because then they can act accordingly to protect others.

>> Where are we at in terms of approval?

>> We have had advice, I had advice from the scientific advisory group. I passed that advice to the Ministers and they are close to making a decision on that.

>> Days?

>> Can I note, at this point Novavax has only been approved as a primary cause. We have 96, heading towards 97% of eligible New Zealanders have already completed their primary Corso it's a very small number we are talking about. -- course, so it's a small number we are talking about. The Cabinet process is not far off, the other part is to curing supply. One of the issues is we want to get enough -- securing supply. We want to make sure we get enough but we don't want to get too much so we can't use it because that's not great. We're talking about only 3% of people who can use it. It's not approved as a booster at this point. So balancing all those things... We are not far away. But we're not quite there yet.

>> Do we have numbers on how many people are isolating at home?

>> Yes... We have got a bit of a picture through our contact tracing teams who are following up I think at least 15,000 people who are identified as self- isolating. But we will make sure we get the numbers out around who is on our system. There will be others who are self-isolating that are not necessarily in our contact tracing system.

>> On MiQ, (INAUDIBLE)?

>> We have always left open the possibility. In terms of the dates of the next three weeks or so, what we know from previous experience working with airports and airlines, they need a reasonable notice period. That we are going to shift dates it will likely be later dates rather than earlier dates simply for logistical reasons as much as anything else. With the stepping out of the changes already announced and being planned for, you'll see quite a lot of change in the next few weeks including some of the people who have been squandered from other jobs into MiQ -- seconded, will be returning to their other roles. Police, Defence, they'll be returning to their regular roles as MiQ reduces steeply over the next few weeks in terms of the number of people in it. So we are now in that process. The next couple of weeks are pretty well mapped out. But we have already always been open about the fact that some of those further afield dates may change.

>> Many New Zealanders are going to be feeling and chess -- anxious about the fact that COVID is around the corner, what is your message to them?

>> Keep calm and carry on. Follow the advice. If you have COVID-19, stay home. Get your household contacts, those you live with, to stay home and follow the guidance you are given. If you think you might have been exposed to COVID-19, then we are now asking you to take personal responsibility for what you do in response to that. Look for the guidance that is out there. And follow that guidance.

>> As Education Minister, with the vaccine mandates for schools, when those restrictions going to be lifted?

>> We are working our way through exactly how to provide radio clarity here. And exactly -- greater clarity here. And exactly where the line gets drawn because no matter what you do you have to have a line somewhere. We're still working through those details. I absolutely acknowledge there are some inconsistencies that are quite stark. You can be playing sports at lunchtime, but the exact same game with the same people in the same place couldn't take place at 3:05. So we want to work through that so we ensure all kids can fully participate in school life. There are still issues to work through around the interaction with things like club sport, for example, so we want to work our way through that and we want to provide clarity. I envisage that would be in the next couple of days that we can provide that.

>> Did you get it wrong with these restrictions?

>> No I think they have been interpreted in a way that something's got captured in a way we didn't expect them to be captured.

>> In addition to allowing private sales of RATS, a system like the UK where you can get seven packets every three days, everyone does it for free. In Scotland, they are advised to take 2 RATS every week and before they go socialising whether they have symptoms. It does a better job to capture the numbers.

>> At this point I'm really comfortable with the testing arrangements we're putting in place. I wouldn't rule out in the future making tests more widely available for other purposes including more surveillance but not at this point.

>> Will there be a testing requirement for household contacts?

>> Yes.

>> Can you explain how the self release after 10 days happens? Do they need a test to confirm they are OK, or do they just, 10 days later, walk out?

>> So a case can release after 10 days, so they don't need to have any test to release. They can self release. Likewise, household contacts will be required to have a rapid antigen test on day three and a 10 and return a negative test and be released. If either of those are positive, or if they are symptomatic and return a positive test, then they isolate for 10 days from that point.

>> On RATS, do you mean much the first?

>> I haven't put a specific date on it. As I indicated, I expect the process to move quite quickly from here so I am expecting to get some paperwork on that in the next day. It may even be in my office already. It may have arrived in the last few hours. I think things will move quickly. Of course that is on our side, in terms of the regulatory side. How long it takes for retailers to get supplies is not something we can control.

>> Will be self-isolation requirement be enforced and how? Does that affect cops on duty on the weekend, do hundreds of them have to go and self- isolate?

>> Remember in phase 3 we are looking at people who live with someone who has COVID-19 are required to isolate.

>> This is one day before we move to that.

>> It is as of midnight tonight.

>> What is meant for the cops who were on duty? Isolating in a hotel room for the rest of the day?

>> They will follow the guidance they are given.

>> On the RATS, can you pledge RATS will be available to buy for the peak of this outbreak?

>> We don't know when this peak will be.

>> Or is it because you haven't got organised and there are no RATS to buy?

>> I don't think that is fair or true at all. We have got rapid antigen tests available for those who need them. They are available now, as of today. Making them more broadly available is going to ultimately depend on private sector suppliers being able to source them and make them available.

>> What about people coming from Australia? (INAUDIBLE)

>> Obviously I encourage people if they are bringing rapid antigen tests with them to make sure they are bringing those that are approved for use in New Zealand. We are not going to search every bag for RATS.

>> What is the price we are looking at for those RATS? We were told the price was being worked on in November, and we still don't know.

>> Ultimately it will be a market, so the market will determine the price. We are looking closely at whether it will be a reasonable price or not. I don't know if you had anything to add to that.

>> Just to confirm when rapid antigen tests become available through retail outlets, that will be through private suppliers and those private suppliers will determine the price. We have a pretty good idea of what we think is a reasonable price.

>> What will that be?

>> Somewhere between eight dollars and $10 per test.

>> You say about 70% eligible have been boosted at the moment and you are referencing the desired level, what is that? Apart from 100% as the ultimate, what is the desired level you would want now and when we get to mid to late March?

>> To be clear we have done well to get to 70% now. Likewise just approaching 50% of our 5 to 11 year old children in a month have had their first vaccine so as good as just about any other country. The more people that have boosters, the better for them and the better for us getting ahead and on top of this Omicron outbreak. So we have plenty of capacity. Anyone who is eligible should get boosted.

>> What is the desired level?

>> As high as possible.

>> For the Minister, we heard you reference the resourcing that is going to providers providing help for people self- isolating at home. We have heard from a number of Auckland providers, it is understood the welfare side is going well. MST are resource and quickly but for the health side, especially Maori providers, haven't been paid for work they have been doing since December. It is understood, they are characterising the hold-up as a tennis match between the ministry and DHB in terms of getting contracts out. It has been months they have been doing crucial work they haven't been paid for, why is that? Is work being done to rectify that?

>> I am not in a position to comment. I don't have the detail and it has not been brought to my attention. It is something I am happy to look at. Jessica?

>> Have any MPs tested positive for COVID-19, and is that extraordinary (INAUDIBLE)?

>> Not that I'm aware of. I know that MPs are taking a lot of extra precautions in terms of what they are doing. You will see MPs right across Parliament being pretty conscientious with mask use and public health measures. A lot of our activities now are being done in different ways. My own constituent work I am doing via zoom rather than in person so my electorate officers are not having people coming in at the moment. A number of MPs are doing similar things. Events we are being more selective about the sorts we attend at the moment while we are in this peak. Think that is fair to say of all MPs right across the spectrum. But it is only a matter of time. We are bound to see cases. MPs are travelling all the time, they are out and about, it's only a matter of time.

>> 5000 cases today, public health experts and the testing positivity rate suggest that is an undercount. Do you believe there is much more COVID in the community than 5000 and if so, what roughly in terms of numbers?

>> We know. Even in earlier outbreaks we have known there were more cases than testing might show. I don't want to give a rough estimate necessarily but the positivity rate today is about 11%. Still well below what we have seen it go up to in other countries. I think Australia or NSW is still at about 30%. So it is a reasonable estimate. Again as we get those rapid antigen tests out there with the higher incidence and we will see those being more accurate, that will give us a pretty good picture of the number of cases. Something we can expect that there will be a significant number of cases we will never find because many people don't have symptoms. So they won't seek testing in the first place.

>> Do you fear we will run out of RATS?

>> No, I'm confident in our supply.

>> Would you expect people to upload their RATS? NSW has $1000 fine if you don't upload. Are we looking at that?

>> I wouldn't rule anything in or out. If you look at the numbers today, a good number of people are already doing this. You Zealand is throughout the pandemic have shown in the main -- New Zealanders in the main have shown they want to do the right thing and I expect that overall approach will continue.

>> Some people may not want to pay the eight dollars or more, they will still get them for free if they are symptomatic, so what stops them from going into the clinics?

>> We are trusting more people in phase 3 to do the right thing.

>> If more than one person in a family gets sick, does that reset their self-isolating period 20? -- self-isolating period back to 0?

>> 10 days starts from the first case being diagnosed or the symptoms start. If the household contacts don't return a positive test, they are released after 10 days even if another household member subsequently tests positive.

>> Have you given any thought to regional eyes in the phases? People have asked why the South Island needs to go into phase 3?

>> We haven't thought of doing it by regions. One of the things we have seen is that all areas of the country will move very rapidly in the direction. We saw southern within the space of a couple of days ago from a very low number of cases to 1 of our highest positivity rates and one of our highest case rates in the country.

>> Thank you everybody.