Immediate and dramatic measures including border closures must be taken in New Zealand if this country is to avoid the Covid-19 devastation overseas, says a Wellington doctor.
"I am extremely concerned about the potential for the situation to develop in New Zealand as it has done around the world, particularly in Europe," said Dr Kelvin Ward, an urgent care physician.
"We need to act now before the situation is out of control."
Ward stressed that he was not an infectious diseases expert. But his firsthand experience at his medical practice, and evidence of what was happening overseas, had convinced him that New Zealand needed to act faster.
New Zealand's borders are closed to foreign nationals who have been in or through mainland China and Iran, and all travellers from other countries must self-isolate for two weeks after arrival.
Ward said the restrictions should go further, and borders should be closed to all but returning New Zealanders and people in roles which were needed to combat the virus.
There should also be "extreme social distancing" and widespread closures, including closure of institutions like schools, universities and restaurants, he said.
"It seems to me those are common sense and quite obvious responses given what happened in Europe and America.
The Government has already banned public gatherings of people with more than 500 people, and further restrictions are expected to be announced this afternoon.
Some countries where the outbreak is more advanced have taken more drastic measures. Australia has banned gatherings of more than 100 people in indoor spaces. London faces a lockdown and all UK schools have been ordered to close in coming days. The US-Canada border has been closed to all non-essential travel.
Ward's concern was partly driven by what he had observed at his own Wellington clinic, he said.
It was now getting 10 to 12 coronavirus-related referrals a day from Healthline, though none had tested positive.
"We are becoming overwhelmed," he said, saying that the clinic was not set up to test people in large volumes.
Of greatest concern was that two patients who had been tested in the last week had shown no intention of self-isolating. Both were tourists.
"This is extremely worrying - the self-isolation system is not watertight."
The testing for coronavirus was complex and time-consuming, Ward said, taking between 30 mins and an hour for each patient. That was on top of the usual busy workload for an urgent walk-in clinic.
"There's the donning and doffing of protective equipment, and each consultation takes a significant amount of time. This is adding to an already stretched primary care workforce."
Community testing centres are now being set up around the country to allow testing for Covid-19 to be scaled up significantly.
There are 20 confirmed cases of Covid-19 in New Zealand and that number is expected to rise. There was no evidence of community transmission, which would lead to the confirmed cases rising exponentially.