August 25 2021
There are 62 new Covid-19 cases in the community today. Dr Ashley Bloomfield says the total number of cases in the outbreak has now hit 210. There are 12 people in hospital with Covid-19.
OPINION
The Ministry of Health seems to have either underestimated the challenge of a Delta outbreak or overestimated its own ability.
Either way, the crux question remains: will its shortcomings leave any part of the country in lockdown for longer than necessary?
This is not meant to disparage the incrediblework of testers, contact tracers and public health officials, who have worked tirelessly to encircle the outbreak as quickly as possible.
But the fact the workforce is being urgently bolstered suggests poor preparation; 380 contact tracers were trained on Tuesday alone, as the ministry looks to double the number of contact tracers to 1200 nationwide.
That's despite the ministry's Delta planning showing an existing capacity that should be more than enough to handle the outbreak.
Director general of health Ashley Bloomfield says he has never thought boosting surge capacity for contact-tracing was unnecessary. Photo / Pool
The day before the first case in the outbreak was detected, the ministry told the Herald that the system "can manage call to up to 3000 new contacts per day (associated with up to 180 cases), and this can be scaled to manage 6000 new contacts per day (associated with 1000 cases)".
Eight days into an outbreak, that would equate to 1440 cases and 24,000 contacts - more than enough capacity to handle the current outbreak.
Yesterday there were 210 cases (at 1pm) and 22,000 contacts (by 4pm).
Clearly the number of contacts ebbs and flows day to day, but these numbers don't account for surge capacity - which should never have been needed but has been going full throttle.
Asked if the system looked good on paper but simply found the reality far more challenging, health boss Ashley Bloomfield said: "You never know quite how an outbreak is going to unfold, and one of the things we've done in this outbreak that we haven't done previously is classifying a large number of people as close contacts."
Which just begs the question whether the ministry's Delta plan was adequately preparing for ... Delta.
There have indeed been a large number of indoor locations of interest where thousands of people, in a Delta environment, are all automatically deemed close contacts.
But that's because we've seen how easily Delta can be caught.
A much higher number of close contacts - about 100 per case in this outbreak - could surely have been anticipated for an outbreak that started amid level 1 freedoms, and in Auckland, where most MIQ hotels and quarantine rooms are based.
Knowing where the highest-risk contacts are, how many of them are still being sought, and whether any might have been infectious in the community are all key for estimating how far the outbreak has stretched.
Prime Minister Jacinda Ardern explicitly referenced this on Monday when, in extending the lockdown nationwide, she said she needed more information about the potential spread outside of Auckland.
It's also vital to gather and publish information such as locations of interest - which essential workers might have visited - as quickly as practicable.
By 4pm yesterday, of 22,081 individual contacts, most of them close contacts, 7800 were yet to be contacted.
On Tuesday, only half of the high-risk close contacts - including those who share households and workplaces with existing cases - had been contacted.
By yesterday, this had improved to at least 61 of the 488 close-plus contacts still to be reached. So far 114 of them are outside Auckland - mostly in Wellington - while the location of 72 people was still being looked into.
Then there's the pressure on the quarantine system. There are plenty of rooms, but the number of new cases - 62 yesterday - has revealed the lack of services to safely transport them to the Jet Park.
That has led to some cases stuck at home for more than 24 hours after testing positive, which - regardless of self-isolating abilities - increases the chances of them passing the virus to people they live with.
The Health Ministry says it had capacity to reach and monitor 3000 contacts a day, with surge capacity for 6000 contacts a day. Photo / Greg Bowker
And then there are the test results that have taken several days to come back - even for some positive cases, as well as close contacts - because of overloaded labs and testing stations.
The longer it takes to isolate cases, the more chances they have to pass on the virus.
The use of PCR saliva testing could ease the workload on nasopharyngeal swabbers, but it's taken the ministry several months to overcome its reluctance to use saliva-testing.
It's barely in place to be used for border workers at the moment, and is in no position to be rolled out to help surge testing.
The ministry last year questioned the recommendation from Ayesha Verrall - in her pre-ministerial days as an infectious disease specialist - to build surge capacity to contact-trace 1000 new cases a day.
The ministry thought that surge capacity to contact-trace 1000 cases a day was "obsolete", according to the report.
The report authors agreed with a September report that the ministry's pre-Delta system would "struggle to maintain high system performance of contact-tracing for a prolonged period with 100-200 cases per day".
Asked about these comments, Roche told the Herald his team had nothing to add to what they've already said.
This month, Roche said the ministry had, in fact, started to build surge capacity as well as undertake scenario-planning in preparation for a Delta outbreak.
By the start of the outbreak, the ministry's estimated capacity certainly appeared to be enough to reach all the close contacts in this outbreak in a timely fashion.
But that is not the reality, the price of which could be a longer lockdown.
