Covid-19 Omicron: New XE variant could require tougher Covid rules if strain arrives in NZ - Ashley Bloomfield

New Zealand could be forced to impose stricter Covid rules if a new highly transmissible variant of the virus arrives here, Dr Ashley Bloomfield says.

The World Health Organisation has issued a warning about XE - a new strain of the Covid-19 Omicron variant which appears to be 10 per cent more transmissible than BA.2 Omicron, the current strain circulating in New Zealand.

The new variant is a mutation of the BA.1 and BA.2 Omicron strains and regarded as a "recombinant", being formed from at least two other viral sources.

XE was first detected in Britain in January.

Bloomfield said today if XE arrived in this country health chiefs would need to look at its characteristics and whether they needed to impose stricter rules such as limiting indoor gatherings to keep the numbers down to a manageable level.

When asked if science and politics have been too intertwined, he said the reason New Zealand had done incredibly well throughout the pandemic was because politicians had listened to the science and had been willing to take the advice.

Ultimately it was politicians who made the decisions, but he thought New Zealand had struck the right balance, he told AM.

Bloomfield said his job was to give the best advice he could and he said he was pleased the advice they had given had influenced the response to the pandemic which he though had served them well.

Bloomfield said he had received advice from the vaccination technical advisory group around the need for a fourth vaccine jab and they would be giving that to Government ministers later this week to consider.

There was a lot of interest in this area, but not a lot of evidence around the globe, he said.

From today, the new Pfizer Paxlovid Covid-19 pill could be prescribed for a very small group of high risk people. The criteria was narrow because it was only a select group who would benefit from it because it was aimed at preventing high risk people ending up in hospital. Bloomfield said it was an excellent development to have this now available.

NZ to remain in red traffic light setting

Experts have backed the "cautious" call to stay in the red Covid setting at least until Easter as, while cases are declining, Auckland still leads the country in hospitalisations per capita.

Meanwhile, hospitality representatives say they are "gutted" and question why there has been no movement given low transmission rates at venues.

But with the health system near bursting point, experts warn everything possible needs to be done to avoid another "wave" of Omicron, as seen in other countries, with winter arriving and the border reopening likely to reintroduce a range of infectious diseases.

From today controversial vaccine passes will no longer be required, and Government-enforced vaccine mandates will be limited to the health and disability, aged-care, Corrections and border workforce sectors.

Ahead of Monday's traffic light decision had been hints of a further loosening of restrictions in a move to orange and removing indoor gathering limits, and at least for Auckland where cases were well past the peak.

Bloomfield said today that the decision so remain in red was based on the high Covid numbers as well as those with the virus in hospital.

Bloomfield told Newstalk ZB's Mike Hosking the main difference between the red and orange setting was the 200-person limit in gatherings inside.

Put to him that that was still affecting businesses and sectors waiting to put on concerts and recitals, for example, Bloomfield said: "Go and talk to staff who are working in those hospitals."

There are over 700 people with Covid in our hospitals, so experts are wanting to see those numbers drop.

Asked about a fourth Covid vaccine dose, Bloomfield said: "The advice will be going up to ministers this week and they'll make an announcement once they've made a decision."

Countries that are recommending a fourth dose are doing so particularly for older people and those who are immunocompromised - such as people having cancer treatment.
Bloomfield said the peak of the number of people in hospital had gone on longer than experts had expected.

People out and about in Takapuna. Staying in the red setting means gathering numbers remain limited. Photo / Alex Burton

There has been a steady decline in daily Omicron cases - down 36 per cent from two weeks ago - hospitalisations beginning to slow and high vaccination coverage coupled with natural immunity gained from infection.

But while case numbers in Auckland had slowed each of its three DHBs remained with the three highest hospitalisation rates per capita in the country, with Counties Manukau at the top with 134 patients.

Auckland made up close to half of the 734 current hospitalisations - a large drop from about 600 a few weeks ago, but still at the high end of pre-outbreak models.

"The trends are all in the right direction but with the hospitals still under pressure it makes sense to be cautious," Covid-19 modeller Michael Plank said.

"A move to orange might not cause a second wave in itself, but it could increase it a little or prolong that decline."

It comes as doctors and nurses have been raising concerns in recent weeks about the pressures on the stretched health system, with the added issue of staff contracting the virus themselves.

Plank said greater caution was also needed with the border reopening to more Kiwis from overseas, along with international visitors progressively from April 12, with potential for other infectious diseases.

A major tool remained the vaccine, he said, with still about a million eligible people yet to get their booster shot, which was highly effective at reducing severe illness from Omicron and pressure on the health system.

Public health expert Dr Collin Tukuitonga said that given international evidence of multiple waves of Omicron it made sense to stay at red a little longer.

"It is about how we can protect best the health system. Those hospital numbers are not as acute but even so, that is still a lot.

"The system is under stress, and hospitalisations are just one indicator. There are many cases treated by GPs, nurses in the community and through Māori and Pasifika providers."

Tukuitonga said the border reopening would likely see the reintroduction of "bugs from the past", such as influenza, adding extra pressure.

"The big problem would be if we got another wave coinciding with flu in the winter."

Meanwhile, many hospitality sector representatives have expressed disappointment at the ongoing gathering limits.

Hospitality NZ chief executive Julie White said she was at a loss as to how that decision had been made, given the Government had already admitted that hospitality venues were not considered vectors of the virus.

"The Prime Minister said two weeks ago that they now have the data that shows our venues aren't the vectors that are spreading it. It's down to around 6 per cent [of all transmission].

"We're at a loss as to why we're not moving."

Prime Minister Jacinda Ardern said Auckland's hospitalisations remained above highest modelled scenarios. Photo / Mark Mitchell

The decision comes after nine more Covid-related deaths were reported, along with 10,205 new community cases.

The deaths reported took the total number of publicly-reported deaths with Covid-19 to 405 since the pandemic began.

Prime Minister Jacinda Ardern said that while the country was "doing well" many areas were still facing a surge in Covid-19 cases.

She said daily cases were still numbering about 13,000 and even though the pandemic appeared to be running out of steam in Auckland, it was still too soon to open up the country.

Asked why Auckland couldn't move to orange before the rest of the country, Ardern said there was still significant pressure on the health system. Hospitalisations in the Northern region remained above the highest modelled scenarios, she said.

Asked about Auckland potentially moving to an orange setting, director-general of health Dr Ashley Bloomfield said the country's biggest city still had a significant pandemic.

"In Auckland, yes, the case numbers are coming down, but there are still several thousand case numbers a day."

Bloomfield said daily admissions had declined in Auckland but there were still about "20 to 30" new admissions among those DHBs alone.

A move to orange was not about a number but the trend, he said.

It was important to protect Auckland's healthcare system, partly because the city had some of the country's most specialised health services.

Bloomfield said there was still a "long tail" of hospitalisations and "Auckland is part of a national hospital network".

"It's less about the case numbers and more about the hospitalisations."

He said it was important to note only about one per cent of cases ended up in hospital, and many others were being cared for at other health providers such as clinics and GPs.

The Green Party called for further action to protect vulnerable people, including a greater focus on child, Māori and Pasifika vaccination rates.

Covid-19 response spokesman Teanau Tuiono said work should begin on ventilation standards and high-quality masks distributed free.

Act Party leader David Seymour said gathering limits should be dropped right now in line with other countries removing restrictions.

"We desperately need tourists to want to come to here – why would they choose New Zealand if they face restrictions when they arrive?"

Cabinet will review the traffic light settings in 10 days, ahead of the Easter long weekend.