Summary
On 17 August 2021, after over 100 days of no community transmission of COVID-19, New Zealand detected its first community case of the Delta variant of COVID-19. Delta, compared to the previous Alpha variant, was much more transmissible, harder to contain, and caused more serious clinical illness.
At the time, only around 18 percent of the NZ population was fully vaccinated and the government was pursuing an elimination strategy and operating under the Alert Level settings. The government’s response to the first Delta case was rapid, with an immediate national lockdown imposed - the first in over a year. The Ministry mobilised its response, with testing, contact tracing and border settings kicking into gear.
While in the first month the outbreak was largely contained, it began to spread in hard-to-reach populations, and by mid-September community cases had reached over 1,000.
Systems and services to support contact tracing and case investigation were scaled at pace and new public health measures were implemented to suppress transmission. Cases continued to rise into October and Public Health Units (PHUs) were straining to meet the needs of people who became infected with Delta, and Managed Isolation and Quarantine availability (where community cases had almost exclusively been managed) was nearing capacity. It quickly became apparent that we needed a new model for managing Delta.
In October 2021, the Director-General commissioned an independent review into the Ministry’s response to the August 2021 Delta outbreak. The purpose of the review was to capture feedback and reflections from the health sector on the response, to inform the Ministry’s future emergency response preparedness and management. The review was undertaken by Dovetail Consulting Limited who assembled a team of senior researchers and evaluators with backgrounds in health policy and planning, Kaupapa Māori and social research. To inform the review, the researchers conducted a series of interviews with senior staff within the Ministry who were directly involved in the Delta response, as well as senior stakeholders from across the health sector including DHBs, PHUs, and the NRHCC.
The review draws on feedback from 39 respondents, from across the Ministry of Health and the wider health sector. The review also draws on Ministry of Health data on COVID responses and international data on COVID trends up to December 2021.The Dovetail review took place in a rapidly unfolding environment where decisions were being made at pace to manage the impacts of Delta. Subsequently, some observations and reflections made during the review have been superseded by events and decision making. Despite this, the Dovetail’ rapid review has endeavoured to capture learnings that remain relevant to future responses - it was not intended to provide in-depth analysis or a comprehensive evaluation of the response.
Dovetail submitted the draft review to the Ministry in December 2021. The Ministry provided significant feedback, including requesting for the provision of actionable recommendations that could assist the Ministry to improve its COVID-19 response. The Ministry provided further feedback on subsequent drafts before a final version of the report was confirmed on 23 March 2022.