September 12 2021
There are 20 new community Covid cases today, all are in Auckland. No staff or patients have returned a positive case after being in potential contact with the cases in Middlemore Hospital.
There are 20 new community Covid cases today, all of them in Auckland, but Prime Minister Jacinda Ardern has given no hint whether the news will impact on the city's level 4 lockdown.
Ardern said she didn't want to speculate on a decision about lowering alert levels for the country's biggest city.
"We're making it based on the best information possible," she said.
"It will be tomorrow. We haven't made any decisions at this stage."
Cabinet meets tomorrow to review alert levels for the whole country.
Director general of health Dr Ashley Bloomfield said there was "no widespread community transmission in Auckland" but assumed there could be more cases out there.
That's why there had been targeted testing of people, including those who were asymptomatic, he said.
Bloomfield said no staff or patients have returned a positive case after being in potential contact with cases in Middlemore Hospital.
Bloomfield and Ardern revealed today's case numbers just after 1pm.
Ardern said although there were 34 unlinked cases, there were only a handful they were honing in on.
"Within the group, it is a handful that we're quite fixated on."
They were still seeing household contacts coming through and did still expect a proportion of day 12 tests to come back positive.
Ardern said it was known where the vast majority of cases came from.
Unlinked cases will "very often" be linked back to the outbreak, often through genomic sequencing that takes a bit longer.
Ardern said it was hard when numbers jumped around, but it wasn't a sign that level 4 wasn't working, more that the tail of Delta can be long.
"We feel all of that anxiety with you as well."
Asked about unlinked cases and how low that number needed to go for Auckland to move out of level 3, Ardern said key considerations included where they fit in the bigger picture, whether they were an essential worker or if they were wearing PPE for instance.
All of those questions were involved in each case, she said.
This will allow the supply in the country to be able to meet the surge in demand of the last few weeks until the larger shipments arrive in October.
Ardern has a close relationship with Denmark PM Mette Frederiksen, and met with her in 2019 while they were in New York for UN leaders' week.
Earlier this week about 250,000 doses arrived from Spain, enabling the rollout to continue to meet the current surge in demand - though vaccination numbers have dropped off in the last week.
Denmark has high coverage of the population that is fully vaccinated, and has lifted all Covid-19 restrictions.
Half a million Aucklanders are now fully vaccinated. Drive-through sites in Auckland have capacity to do 10,000 vaccine doses a day, she said.
"Thank you Auckland, and keep it up," Ardern said.
Ardern said she and Bloomfield had both been advised separately that a death being widely speculated about online was unrelated to the Covid vaccine.
The subclusters
There are 379 cases in the Mangere church subcluster, another group with 164 cases, and 76 in the Birkdale social network. There are 16 subclusters or groups of interest, seven of which are considered to be contained.
There remains concern about three groups where there is possible spread beyond households.
There are 350 very close contacts still in their 14-day isolation period. So far about 16 per cent of very close contacts have tested positive.
Of yesterday's 23 cases, 11 are contacts of other cases, seven are household members of a case, and 10 were potentially infectious in the community. Three of them are unlinked.
The case from Middlemore who tested positive last weekend has now been linked to the wider outbreak, Bloomfield said.
New locations of interest continue to be identified, and Bloomfield asked people to keep checking these on the ministry's website.
Ardern said they were still reporting what initially were unlinked cases and they might be people all in one household.
The bigger issue tended to be people who have popped out to a supermarket and not known they were a case, she said.
Because it was Delta, any exposure events gave officials cause to be concerned.
Bloomfield said they didn't seem to have seen transmission from people who were judged to be casual or casual-plus, so that hadn't been a feature.
There had been high transmission rates in households and some transmission to other close or very close contacts but not the "casual or fleeting transmission".
There are 18 people in hospital, including four in ICU.
One person presented to Middlemore Hospital in the last 24 hours and is in ICU. Bloomfield said it was important to seek care immediately.
"Our hospitals are safe. There are very strict protocols in place. Please do not delay or hesitate in seeking care."
Ardern asked people with symptoms to get the care they needed. The best place for them to be was in hospital if they were sick.
Bloomfield said there was planning in place for staffing at Middlemore. They did now have a process in place and if needed additional staff could be made available from elsewhere in Auckland or the country.
There were 10,958 tests processed, including just under 5000 in Auckland.
He said there had been good testing in areas of interest around Auckland.
More than 13,000 essential workers have been tested so far, with no positive tests to date, Bloomfield said.
That included 5500 DHB workers, and 3450 further healthcare workers.
Of just over 38,000 contacts, 92 per cent have returned a test result.
Bloomfield said a very cautious approach has been taken for granting travel exemptions outside Auckland for personal reasons. He wanted to pass on his sympathy to those who had applied but been turned down. This was due to the public health risks, he added.
Asked about rule-breakers, Ardern said she believed New Zealanders knew why there were restrictions - so people could get their freedom again.
Generally people were very good and she appreciated the load Aucklanders were carrying on behalf of the whole country.
If alert levels changed, Ardern said that wouldn't mean there would be any additional reasons for Aucklanders to move out of the city - it would be essential workers only.
There was a personal exemption process.
Borders were there to do a job but "aren't ironclad so that is a consideration at any time".
There were a number of people in utility services and businesses who could apply for exemptions. There were those in primary production and quite large-scale employers. Freight and logistics staff were also regularly crossing the borders.
Health advice
Ardern said they were yet to receive the final health advice for both Auckland and NZ.
There had been a lot of work for the border and boundary policy, but no policy was going to be foolproof.
Queensland was now dealing with cases out of NSW: "When you have a country battling cases within its own borders it is tough."
So long as there was an outbreak, there was a risk that Delta could spread.
There were checks to reduce the risk but around the world no boundary was iron-clad.
As for keeping Northland and Waikato in a higher alert level, Ardern said they would consider everything but were yet to get any official advice.
NZ was a place where there was a large amount of movement, including through freight and essential workers. She said one thing she would consider was the relative risk to the rest of the country when there was an outbreak in Auckland.
Ardern said there hadn't been cases in the South Island for a long time but that was because people had followed guidelines.
As for 5000 contacts who hadn't been reached, Ardern said officials were still well within the targeted metric. Some of the 38,000 would be from larger events.
Asked about the reaction to headlines over the past few days involving Siouxie Wiles, Ardern said as a general rule of thumb she saw politicians in a particular category. But for the most part, other people in different roles were doing their best. "I don't believe what's happened in this case warrants the response that was received."
Yesterday's cases
Yesterday there were 23 cases, all in Auckland, a jump from 11 the day before and 13 the day before that, though the ministry said the numbers will bounce around as day five and day 12 test results come through.
The number of cases that were potentially infectious in the community have been eight on Friday, one on Thursday, and six on Wednesday, and five on Tuesday.
Yesterday the number of unlinked cases in total was 36.
The three cases announced last night included a 5-month-old baby and their parent, who arrived at Middlemore's children ED department on Friday afternoon. The parent said they did not have any symptoms, nor had they been to a location of interest, but staff said the baby had symptoms and they were both tested.
Five contacts so far have been identified.
A woman who attended an antenatal class at Middlemore on Wednesday developed symptoms the following day, and then tested positive.
Contacts were being identified last night, including whether she had contact with any staff.
Epidemiologist Michael Baker says the new cases highlight the difficult dilemma facing Cabinet as it decides tomorrow whether Auckland can come out of level 4 lockdown and down to level 3 from 11.59pm on Tuesday.
"These unexpected cases, all of them really do need to be resolved, and we need to have several days with no cases like this."
Covid-19 modeller Rodney Jones said the likelihood of Auckland moving out of level 4 next week was looking "very low".
Middlemore has been the focus of other cases and contacts in the last week.
A man was admitted last weekend and shared a ward with other patients. He later tested positive and 149 patients and staff had to be tested.
And a woman, now in managed isolation, tested positive on Thursday after she went to the emergency department and adult short stay ward before going home.
She'd earlier told staff she'd not been exposed to the virus, had no symptoms, and hadn't been at any locations of interest.
Seven police officers, 36 patients and some visitors are considered to have been potentially exposed.
