Wednesday, February 28, 2024

“Stamp it Out”- PM announces Covid re-emergence plan

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Prime Minister Jacinda Ardern has just delivered a speech setting out a Covid-19 re-emergence plan, potentially in the community as we are seeing in Australia and in other jurisdictions around the world that, like us, were successful in getting the virus under control. Ardern said the most important thing is that the Government would look to localise its response in the first instance rather than moving to nationwide lockdown. The Government would seek to keep as much of the economy open and running as possible, so it would use the alert level system in a localised fashion and with scaled-up and rapid localised health responses to ring-fence any cases. Here’s her speech:

Kia ora tatou

Today I am setting out our plan in the event we have a new case of community transmission of Covid-19 in New Zealand.

I will take a bit of time to do that, and then I’ll be happy to take questions at the end.

Since we moved to level one, we have continued work to ensure we have an ongoing level of preparedness for resurgence in New Zealand.

The framework I will be speaking to today has been through a Cabinet process, and is more important than ever.

It is designed to give the public, and our business community as much certainty as we can around what to expect if new cases inside our borders are found. And that is something we all must prepare for.

We have been 75 days without community transmission here in New Zealand, but Covid is now exploding outside our borders and every country we have sought to replicate or have drawn from in the fight against Covid has now experienced further community outbreaks.

We only need to look to Victoria, New South Wales, Hong Kong, Singapore and Korea to see examples of other places that like us had the virus under control at a point in time only to see it emerge again.

This does not mean anyone has failed- it means perfection in the response to a virus, and a pandemic, is just not possible. That is certainly the case as we see this pandemic continue to grow.

The World Health Organisation this week reported the global infection rate is nearing 13 million cases, with over 215,000 cases reported globally on Tuesday.

To put that into perspective when we closed our borders on the 19th of March there were 240,000 cases in the world in total. It’s fifty times worse than that now.

We see this growth in cases around the world reflected in the steady stream of New Zealanders returning from overseas, some of whom are bringing the virus back with them, which we continue to contain at our borders.

In the main the pattern of returnees carrying the virus reflects the state of Covid in the world, with our cases coming from places like India, the US and the UK.

New modelling by Rodney Jones indicates there will be over 100,000 new cases a day in the US by the end of the month, nearly 70,000 cases a day in India and nearly 10,000 cases a day across Europe by early August.

We will continue to welcome home New Zealanders from these places as citizens, as they have a right to come home to their legal place of residence. But with that right comes risk, and the need to continue ongoing stringent measures to keep them, and everyone around them, safe.

Victoria in particular is a cautionary tale for New Zealand that we must learn from.

It appears their current outbreak is linked to a managed isolation facility similar to the ones we run here and that the entire outbreak was seeded by just two cases.

That goes to show how quickly the virus can spread and it can move from being under control to out of control, and that even the best plans still carry risk in a pandemic.

It’s important to remember that our border facilities have served us well so far.

Our testing regime is picking up cases amongst new arrivals who are in quarantine and nearly 30,000 people have been through a facility without a case of Covid transferring to the community. But there is limited room for error.

Just as many of our frontline health workers like nurses who were in contact with Covid patients got the virus from those patients during level 4 lockdown, our frontline border and airline staff and staff in our managed isolation facilities are in daily contact with returnees carrying the virus. Even our most experienced and trained support workers have picked up Covid.

Experts tell us that even with the best precautions possible, the chances of the virus passing from a surface, or contact with someone who is a carrier are high.

We must prepare now for that eventuality and have a plan at the ready in the event that it does.

The first thing we need to do is continue to ensure our border and our managed isolation facilities stay as tight as they can be.

We have ensured our frontline workers at the border are safe by wearing appropriate PPE, getting regularly tested and that our systems for managing returnees are robust and limit the risk of spread. As I say the system has done the job it was set up to do to date.

The work done by Minister Woods and Air Commodore Webb in recent weeks have made significant additional improvements in this space, and we will continue to improve the system. Australia is currently conducting an audit of its quarantine system and I’ve asked Prime Minister Morrison to share any insights so we can continually learn and improve on what we do here.

But again, no system is 100% foolproof and around the world we are seeing even the most rigorous measures being tested by the virus.

And so today I am setting out the next stage in our Covid plan in the event we have new cases in the community.

The first thing to note is that the Government’s strategy for responding to the Covid-19 pandemic remains elimination. That has not and will not change.

Allowing our hospitals to be overrun, further deaths and the economy to close down again for an indefinite period of time is not a strategy.

We have seen overseas the toll that that takes on lives and economies.

We have said from the start that the best approach for the economy is a strong health response, and the evidence has supported that approach throughout.

We can already see that with New Zealand’s economy more open than nearly anywhere in the world because of the steps we took to break the chain of transmission under lockdown.

Our plan moving forward seeks to protect that position and minimise any economic impact of future cases.

So in the event of new community cases, we would move immediately to implement our “Stamp it Out” approach again.

There are two key things to remember.

Firstly, the simple approach of limiting the ability for the virus to move from human to human to break the chain of transmission remains the foundation of our response no matter what.

That’s why our key public health measures remain important for protecting ourselves and each other from the spread of disease. They are:

–  wash your hands regularly and thoroughly

– cough or sneeze into your elbow

– don’t go to work, socialise, or be out in public if you are sick

– Keep a digital diary of your whereabouts by downloading and using the Covid Tracer app.

These principles are key to the second ongoing tool in our response.

Rapid contact tracing, testing, and use of isolation and quarantine for those exposed to Covid. That is why the Covid tracer app, and whatever other means of recording where you have been remains vital. Every time you step into the world I want you to ask this question “if I come into contact with COVID today, how will I know, and how will others know”.

If you are in or near a situation of community transmission this will be an exceptionally important tool for contact tracing, and for finding you.

In this area we are constantly looking at how we can use new technology to strengthen our response, the same goes for testing.

But these are the principles we are all familiar with. Now I want to touch on what would be different.

The alert level system and framework remains in place. But in the event of cases, rather than apply the framework nationally, we would look to apply our Alert Level system at a localised or regional level in the first instance.

Our priority will be to control any cases with the least intrusive measures, and over the smallest area we can.

In practical terms that means doing absolutely everything possible to avoid the entire country returning to Alert Levels 3 or 4 as a measure of last resort.

“Our ‘Stamp it Out’ approach is scenario specific meaning that our actions will depend on the severity of the situation.

And of course when we see the first Covid-19 case beyond the border, you can expect us to move very quickly and very firmly to contain it while we gather information on the situation we are facing.

However there are three broad starting scenarios we can plan around.

1. A case or a number of cases in a community.

2. A larger number of cases or cluster in a region

3. Multiple clusters that have spread nationally

Let me run through what each scenario might look like.

First a contained case or cases within a community.

We would be looking at applying strong restrictions but only applied locally in a neighbourhood, town or city to contain the virus and stopping it spread.

We would likely remain at Alert Level 1 nationally.

The local measures to contain the case would involve rapid contact tracing and isolation of cases and their contacts, scaled up and targeted testing of people connected to the case, such as workmates, those they live with or those in their neighbourhood.

The point with this scenario is we would look at act hard and fast, but local in an attempt to ring fence the virus.

The second scenario is a large cluster within a region.

Here, a significant increase in testing would be the priority. We would look to undertake much wider community testing, on top of testing any contacts or potential contact of those with the virus. This could look like it did in Victoria where health staff went door to door to test people in affected areas.

We would also take steps to stop the spread to other parts of the country so a regional shift in Alert Level would likely be applied that restricted travel. This would mean travel in or out of the city, town or region could be stopped, people in that place asked to work from home, and local restrictions on gatherings implemented.

The aim here is to contain the spread away from other areas to avoid the whole country having to put in place restrictions so we can remain at Alert Level 1 nationally, depending on the evidence of risk of spread outside the region.

The final scenario is if multiple clusters, spread nationally.

In this scenario we would most likely apply a nationwide increase in Alert Level to stop transmission.

There is an assumption in all of these scenarios that we know whether we have a contained outbreak or not. Where we don’t have full information, we will take a precautionary approach, and scale back as needed, rather than run the risk of doing too little too late.

Ultimately though, as with the original application of the Alert Levels we will be guided by science and what we know works. Internationally the evidence remains that going hard and early is the best way to stop the virus and ultimately delivers the best results for human health and the economy over half measures that aren’t as effective at getting on top of the virus and sees us in lockdown for longer.

We have learnt much from the first wave at stopping the chain of transmission and eliminating community transmission.

We learnt if we act fast we can stop the virus spreading.

We learnt that if we restrict contact we can stop the virus spreading and we learnt that everyone being vigilant and following the rules worked.

No one wants to go backwards but the reality is our fight against the virus is not over and we must have a plan at the ready to protect our current position if it comes back.

And I believe we can do that. Because the facts show when New Zealand’s team of 5 million goes about implementing a plan it works, no matter what comes our way.

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