…actually: let’s do this.
“Case A” in the latest outbreak was a 58 year-old Devonport man who developed symptoms, presented for testing on August 16th and tested positive.
It was thought that the man had been infectious since August 12, and during that time had travelled between Auckland and the Coromandel. Because of the length of time the person had been infectious in the community the decision was made to bring the entire country to Level 4 on the same day the case was identified.
Level 4 is the highest alert level in our system, and had only been used once before, back in April/May 2020 at the start of the pandemic. Level 4 is used when there is suspected wide community spread with no clear epidemiological links. We had a single covid case in the community. But we don’t know how he got it. At Alert Level 4 people are required to “stay in their bubbles.” You can shop for groceries, get medical care, get a Covid test or vaccination, exercise in your local area, or go to work if you are an essential worker. Face coverings were mandated for public transport, inside retail businesses and public venues. People were given 48 hours to return home.
The initial Level 4 lockdown was set for 3 days, to give people a chance to get home, and to be able to get an inital assessment on the extent of the outbreak. On Day Two four new community cases were announced. One was a workmate of Case A, the other three were contacts of the workmate. One of those contacts worked at Auckland Hospital. Another was a teacher at the local college. Over the next few days the cases rise. But because we are at Level 4 the majority of initial cases got Covid before we went into lockdown. Wastewater testing show traces of Covid in Auckland, in Warkworth, and Wellington. On August 20th three cases were identified in Wellington. (Where I live.)
The decision is made to extend Level 4 for at least another two weeks. That decision automatically triggered the Wage Subsidy scheme. I’m a self-employed photographer, and I had all of my work cancel for the next month, so I qualified for the subsidy. I applied for the subsidy at 3PM Friday afternoon (I had to answer 5 questions online and sign a statutory declaration, and one of those questions was “what is your bank account number”) it was approved 3 hours later and deposited into my bank that night.
Genomic Sequencing is a tool we use extensively here to be able to figure out how an outbreak develops and evolves. And through genomic sequencing we were able to find a genomic (but not an epidemiological) link to a person at the border. The returnee from Sydney arrived on August the 7th, returned a positive test on the 9th, was transferred to the Jet Park Hotel (where positive cases are monitored), then got sick and transferred to an Auckland hospital on August 16. Despite a huge amount of effort (including checking CCTV, extensive contact tracing) they haven’t found an epidemiological link between the returnee and Case A. But all subsequent genomic sequencing show that all the cases are related.
Because this is Delta the definition of the types of contacts was changed. We have three types of contacts:
Close Contact: a person at a higher risk of infection, typically household contacts, or a workmate.
Casual Plus Contacts: people that have been at the same Location of Interest at the same time as someone who was infectious.
Casual Contacts: anyone who was in the same place at the same time as someone infectious but not near the infectious person.
Because of the expanded definitions the number of people that had to be contact traced was significantly higher this time around. And what the data has since shown is that those getting infected are almost exclusively close contacts. Delta is ripping through families. A lot of young people, even toddlers, got Covid during this outbreak. But Casual Plus and Casual contacts were significantly less likely to get Covid.
People who get Covid are moved into Managed Isolation Facilities (MIQ), along with their close contacts, because we know that the close contacts are likely to be infectious. This allows the people to be closely monitored in case they get sick, it means that they don’t have to worry about going shopping or cooking food, it removes the infectious people from the community and provides less exposure events. We even have specialist teams that go out into the community to safely transport people into MIQ.
People in MIQ get tested on Day 1, Day 3 and Day 12. Which means that someone could go into MIQ today and test negative, they might test negative on Day 3, but they might test positive on Day 12 in a couple of weeks time. So this outbreak will have a long “tail”, but that doesn’t mean there is uncontrolled community spread. It just means it takes a lot of time for Covid to do its thing.
Most of New Zealand dropped to Alert Level 2+ last week, and Auckland (fingers crossed) moves to Alert Level 3 next week. We learnt a lot of new things during this outbreak, and as we drop back down the alert levels we will do things just a little differently, as we always have.
Is our system expensive? Sure.
But the alternative? We just have to look overseas to see what is happening, both in terms of the incalculable human and financial cost, and its a great big NOPE from us. Our Covid modellers estimate that if we hadn’t locked down when we did our ICU’s would have been overrun last week. And even if we had double the capacity (to match hospital capacity overseas) it would only have given us an extra couple of weeks, if that.
Just to be absolutely crystal clear here: lockdowns, masking up, contact tracing, isolation, all of these things? All of them work. But they won’t work on their own. They work in concert with each other. They work when used with strategic purpose. Vaccinations are part of that strategy. But it’s a mistake to make vaccination the entirety of the strategy, because when you hit roadblocks you run out of options real quick.