September 08, 2020
Dr Rawiri Taonui Covid-Maori | Risk at Border greater than in Auckland Cluster | 8 September 2020
Dr Rawiri Taonui Covid-Maori | Risk at Border greater than in Auckland Cluster | 8 September 2020
There is a greater risk to New Zealand from the high number of arrivals and active cases entering at the border than there is from the Auckland OutBreak. If we do not address numbers crossing our border, there is a risk of a third wave arriving in October/November.
Officially there are 165 cases of Covid-19 in the Auckland OutBreak. This summary notifies 169 being the total announced since 11 Aug. Māori and Pacific peoples are being differentially impacted. We comprise 84% of cases. There have been two deaths, one Māori, one Pacific.
The Origin of the Auckland Outbreak
The likely origin of the Auckland Outbreak is that someone, such as aircrew or maritime crew, entered the border, was not tested and passed Covid-19 to someone at the border or in MIQ and from there the infection made its way to AmeriCold. Alternatively, there was a breach in MIQ similar to that in the Rydges case where a person entering from the USA tested positive on their third day and was transferred to quarantine but not before infecting a maintenance worker.
It is unlikely that we will identify the source case/s that initiated the Auckland OutBreak. The earliest case a worker in AmeriCold became sick on 31 July meaning they were infected by a ‘source case’ sometime around 25/26 July. The probability is that this source case was themselves infected around 19/20 July. They would have recovered well before the Auckland OutBreak was detected on 11 August. 99% of Covid-19 cases that have recovered will test negative two weeks after having recovered. Therefore, although we have conducted well over 300,000 swab tests in search of the source case the chances of identifying it were always negligible.
The Auckland Outbreak -Daily Cases
The Auckland OutBreak continues to build toward 200 cases. Numbers reported peaked between 12 and 18 Aug. While there is a long tail, there is an overall incremental decline in numbers. All new cases since 29 Aug have come from people already in self-isolation because of previous identification through contact tracing. This indicates containment.
The Auckland Outbreak -Active Cases
The number of active cases in the Auckland cluster (red columns) has also declined from a peak of 117 active cases on 29 & 30 Aug to 77 yesterday and 80 today. Again, this indicates a level of containment.
We should be concerned that the number of active cases in MIQ facilities (blue columns above) both numerically and as a proportion of overall active cases has been steadily rising.
Risk at the Border
The rising trend of active cases in MIQ replicates the pattern of numbers and cases crossing our border before 11 August. During the middle of July, there was a decline in the number of people entering New Zealand to about 1480 per week, as border protocols were reassessed, and new MIQ facilities brought online to boost capacity.
Once in place, from 27 July onwards there was an upward surge of numbers entering at the border to about 3500 per week. Border entries declined after the Auckland OutBreak was detected. Over the last week and a half, these have surged again to around 3,150 per week.
In both instances, an increase in active cases in MIQ followed. From a low of 3 active cases at the end of the first wave in June, there was a sustained run of active cases between 20 and 27 in the period immediately before the detection of the Auckland OutBreak. And after the latest surge in border entries, there has been a sharp upswell to 43 active cases in MIQ.
This is a concern because every active case in MIQ increases the number of potential points of transmission to staff at the border, in isolation hotels and in quarantine, transport between facilities and via mediums as small as a button in a lift.
A Long Slow Wave
In many ways, New Zealand is experiencing a long slow wave. There have been 272 positive cases since the first wave was defeated on 7 June (the date the last active case recovered). 169 of those are in the Auckland OutBreak and 109 at the border in MIQ. During the first wave, just 33 cases came across the border and into MIQ.
Managing the Border
The government has moved to mitigate risks at the border by announcing a new regime of testing. Workers at managed quarantine facilities, community testing centres and workers who transport those to quarantine will be required to undergo testing once a week. From September 7, workers at isolation facilities, airside government officials, airside district health board workers, airport staff, pilots, stevedores, and ship crew will all be required to undergo fortnightly testing.
Australia
The new measures will assist but do not address the fundamental risk presenting by the numbers crossing our border. Recently the Australia federal and state governments moved to limit the number of entries into Australia to mitigate the kind of risk now presenting at our borders.
Queensland provides the best comparable example to New Zealand. At 5.0 million the population is the same size as New Zealand. Queensland also has a lower rate of 260 Covid-19 cases per million of population than New Zealand at 340 per million. Queensland has a limit of 500 arrivals per week. Queensland manages arrivals through one airport. New Zealand is allowing six times as many people across the border. We process arrivals through three airports. Western (525) and Southern Australia (500) place similar limits on arrivals. Both states also have lower cases per million than New Zealand.
The highest rate of entry into Australia is in Sydney at 2,450 per week. New South Wales as a population of 7.3 million (50% larger than New Zealand). A comparable rate of entry in New Zealand would mean reducing our current flow of about 3,150 per week to 1600 returnees per week.
Summary
New Zealand needs to lower the rate of arrivals into New Zealand not to exclude New Zealanders wishing to return home but to protect New Zealanders already living at home. The latest outbreak is related to a surge in numbers and positive cases crossing our border. Māori and Pacific communities are paying the highest price for that. If we do not address numbers crossing our border, there is a risk of a third wave arriving in October/November.
Noho haumaru stay safe and self-sovereign
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