PM Jacinda Ardern has confirmed New Zealand could move to alert level 1 next week, buoyed by 11 straight days of no new Covid cases.
The Government could remove the last remaining restrictions around gatherings and movement next week – but public health experts still have some big worries about the looser world of alert level 1.
While tough measures at the border continue, there are no distancing rules for level 1 – nor arethere for personal movement, or for gatherings, currently limited to 100.
"Level 1 potentially means we keep our border restrictions, but life feels very, very normal otherwise," said Prime Minister Jacinda Ardern, who planned to consider dropping down at a Cabinet meeting next Monday, provided there was no evidence of Covid-19 spreading in the community.
However, scientists have pointed to some issues they'd like addressed to ensure the virus doesn't flare up again.
"We are rapidly moving into a post-elimination situation, which is very good news – but we are still an island in a global sea of Covid-19," Otago University epidemiologist Michael Baker said.
"And there hasn't been much discussion about what scenarios we might see over the next 18 months, or even six months – and right now would be a sensible time to be planning right through to the end of next year."
Indoor events and 'mass masking'
Baker saw large indoor events as an obvious risk if New Zealand began widening its bubble to include other countries – and questioned whether banning them could be a trade-off for relaxed borders.
"We are talking of bringing essential workers and overseas students back into the country, which is good for the economy – but it also means we are going to be in an ongoing risk management situation," he said.
"Even well-managed quarantine systems at the border can have failures, and we are also coming into winter, where the virus does seem more transmissible.
"What's more, is almost everything we know about this virus says that significant outbreaks come from indoor events – there's very little problem with outdoor events – and it comes down to being close to one another, talking, coughing and laughing.
"At the moment, the control measures we are proposing are ineffective for stopping that situation."
Additionally, Baker saw merit in "mass-masking" in close-quarter environments, such as trains and buses, as a back-stop for curbing spread.
Otago University epidemiologist Professor Michael Baker has questioned whether New Zealand goes without large indoor events in exchange for a widened bubble. Photo / Jason Dorday
"I occasionally use the bus in Wellington and see people wearing their hats and headphones – to have a face mask as well would not be hard for people to accept."
Baker said New Zealand was now among a minority of countries not to have policies encouraging the wearing of masks.
The Ministry of Health, however, remained of the view that there was not enough evidence one way or the other to advocate mask-wearing, which came with benefits but also risks.
While non-medical masks could provide extra protection in preventing an infected person spreading Covid-19 to others, they were not proven to effectively protect wearers from catching the virus, the ministry stated.
In a commentary, Prime Minister's chief science advisor Professor Juliet Gerrard also noted there was a chance that rigid border controls could see a case slip through.
"Detecting these cases rapidly is vital to containing the spread of any new cases and maintaining elimination of the virus, and we must do this without the tools for widespread surveillance which have been deployed in places where there are fewer concerns about individual privacy," Gerrard said.
That called for ongoing widespread surveillance testing of the population, including broad testing of people displaying any of the wide-ranging symptoms associated with Covid-19.
A recent Otago University study modelled how long it might take to detect an outbreak if a case were imported and how many cases we would have by that time.
It found we could detect 95 per cent of outbreaks up to 33 days after introduction - by which time there would be between one and 68 infected cases in the community.
All Blacks and Hurricanes halfback Aaron Smith uses the Covid NZ tracing app before attending training in Dunedin. Photo / Supplied
To pick this up, officials would need to be carrying about 5600 tests a day, mostly focused on people who present to their GP or hospital with symptoms.
Those estimates assumed level 2 measures and more tests would likely be required, with well-designed surveillance and geographical spread, once New Zealand was at level 1.
In another new paper, researchers from Auckland University of Technology and the University of Queensland found exceptional speed and high take-up rates would be crucial for digital tracing solutions for Covid-19.
Baker said it appeared New Zealand's official tracing app wasn't providing much support so far.
"A Bluetooth-enabled smart-card looks a lot more appealing, in terms of feasibility," he said, adding his colleagues were busy working on such a tool.
A new agency?
Baker also saw the need for an urgent review of New Zealand's handling of the crisis – and the creation of a dedicated state agency.
"We do really need to rapidly review our institutions for managing the next phase of the pandemic," he said.
"We've scraped through the first battle, but I think we do need a new style of agency. It would help depoliticise risk management issues – and in a way that's consistent across the whole country."
Otago University epidemiologist Professor Michael Baker. Photo / Mark Mitchell
Baker proposed a New Zealand equivalent of the US Centers of Disease Control and Prevention (CDC), adding that Asian nations which had similarly tackled the pandemic well had such agencies.
New Zealand's response had been overseen by the Ministry of Health, which set up a national co-ordination centre on January 28, and regional public health units that had directed local testing and tracing.
"We need to get our systems working at a very high level - because the cost of failure is so high now."
