Probable Covid-19 case in Northland – Expert Reaction

Health officials are working under the assumption that a Covid case detected in Northland is one of the more transmissable variants.

The case is a 56-year-old woman who was released from managed isolation at the Pullman Hotel in Auckland after testing negative twice during her stay.

The SMC asked experts to comment on this announcement.

Associate Professor Siouxsie Wiles, School of Biological Sciences, University of Auckland, comments:

“I’m sure many people will be alarmed by the announcement of a probable case of COVID-19 in the community in New Zealand. It’s important to remember we’ve had cases like this before and that we have stopped them without needing to move up the Alert Levels. This latest case is someone who has tested positive after recently arriving in New Zealand from Europe. It is highly unlikely they caught the infection in the community. The likely explanation is that they were infected in Europe or while they were in transit to New Zealand. They may also have been infected during their stay in MIQ. Hopefully, the genome sequencing will tell us more. If the person was infected in MIQ, then understanding how that happened will help to determine if any procedures need to be improved.

“We know that people are infectious for a few days before symptoms develop and for the first few days of having symptoms so it is almost certain that the person was infectious while they were out in the community. The contact tracing team will be working hard to identify anyone who is likely to have been exposed and is at risk of having picked up the virus. I am reassured that they will be casting their net wide and treating this as though it is one of the more infectious variants of the virus.

What we have to remember, is that we should be doing everything we can to make the contact tracing team’s job easier. We can do that by making a habit of using the Covid Tracer App and having Bluetooth turned on. Can you remember everywhere you have been over the last ten days, and when?! I know I can’t, which is why I’ve got myself trained to use the app wherever I go.

“So remember: Stop, Look, Scan, Smile. When you enter a building, stop & take a moment to look for a QR code. Open the app and scan. Then think of all the contact tracers cheering you on for doing your bit!

“I’d like to see all businesses helping to make QR code scanning easier by reminding people to scan as they pay for good and services, and putting the QR codes up in lots of different places around their premises, rather than hidden by the entrance. This is a habit we will need for the next year, so let’s develop it now rather than just scanning when we hear of a case outside of MIQ.”

No conflict of interest.

Professor Shaun Hendy, University of Auckland, comments:

“This new case was discovered when a recent returnee, who had been through the MIQ system, developed symptoms and sought a test. The person lives in Northland and has visited a number of places in the region, scanning as she went, but as she was likely infectious, Northlanders should pay attention to these locations when these are released by the Ministry.

“Northlanders should pay attention to any potential symptoms and if they are feeling unwell, should seek a test and avoid going to work – this advice applies to all New Zealanders but is particularly important when we know that there has been a case in the community.

“While this new case is concerning, it is not the same situation that we faced in Auckland in August when the first cases couldn’t be linked to the border. With what we know at the moment – that the person has had only four close contacts – it is unlikely that we will need another lockdown. But we all need to do our bit to avoid this: keep scanning, and get a test but then stay home if you have any of the symptoms or think you might you may have had contact with this case.

“Going forward, it will be important to determine whether the person acquired the case in MIQ, as this might mean there are other returnees who could have been exposed and officials will want to tighten any procedures that could have led to exposure. It is also possible that the person has had a very long incubation period – this is rare, but not unheard of.

“The genomics will also be very helpful, potentially linking the case to other returnees within MIQ or to cases overseas. It will also tell us whether we are looking at one of the new strains. These are becoming more prevalent overseas so it is certainly a possibility.”

No conflict of interest declared.

Dr Dougal Sutherland, Clinical Psychologist, Victoria University of Wellington and Umbrella Health, comments:

“Today’s announcement of a positive COVID case in the community should serve as a slap in the face with a wet fish for New Zealanders. Our rates for scanning of the COVID app have plummeted over recent weeks as we bask in the complacency that we’re “all good here”. This positive test should serve to shake us out of our holiday smugness and remind us that COVID is still rampant and even more virulent than before. We can only hope that the fast and thoughtful actions of the woman who tested positive will protect us all. It only takes one instance for this virus to get out into our community but it can also be the thoughtful actions of one person that saves us from a far greater fate.”

No conflict of interest.

Dr Andrew Chen, Research Fellow, Koi Tū – Centre for Informed Futures, University of Auckland, comments:

“A person with COVID-19 may not show any symptoms for a few days, but they could be contagious in that time. We have a case who may have been in the community for 10 days already. You can’t just wait for the outbreak and then start scanning QR codes, you need to be scanning as a preventative measure in advance of any cases being detected in the community.

“The case did the right thing – they scanned their QR codes and they had Bluetooth Tracing on. This means that MOH can identify locations of interest quickly, and potentially alert other people who have been exposed quickly too. But for all of us to benefit from the use of this technology, we need as many people participating as possible. You can’t be alerted via digital means if you aren’t participating, and while manual contact tracing is still good and will probably get to you, it may be slower. Speed is of the essence in combatting this disease. All the modelling suggests that time-to-isolation is the strongest factor in keeping an outbreak under control.

“But we should also remember that the app is only one layer of defence in our response to COVID-19. If you are showing symptoms, get a test and don’t go to work. If you have no symptoms, wash your hands, wear a mask when you can, and keep records of where you have been and who you have been near, preferably with NZ COVID Tracer and Bluetooth Tracing.”

No conflict of interest declared.

Dr Amanda Kvalsvig, Senior Research Fellow, Department of Public Health, University of Otago, Wellington, comments:

“The Government urgently needs to respond proportionately to the now extremely high risk of an outbreak and uncontrolled spread. The only proportionate response to that level of risk is to throw everything we have at keeping New Zealanders safe. If it looks to many people like an overreaction, then it’s probably about right. It would be a terrible tragedy to have more outbreaks and deaths just weeks before the vaccines get to New Zealand.

“The new variants are much more transmissible and appear to cause more severe disease as well. In response, the Government must turn down the tap to reduce the number of infectious cases on long haul flights and in MIQ facilities.

“The Government has a duty of care to protect travellers, MIQ workers, and guests, as well as the general population. A five-day pre-flight hotel quarantine with at least two tests would greatly reduce the risk. Reducing the number of MIQ spaces unfortunately looks increasingly necessary until the protective effect of vaccines has properly kicked in.”

No conflict of interest declared.

Professor Michael Plank, Te Pūnaha Matatini and University of Canterbury, comments:

“The new community case of COVID-19 is a woman who recently arrived in New Zealand and completed her stay managed isolation on 13th January. She was tested and went into self-isolation on 21st January meaning there were 8 days when she could potentially have passed the virus onto others in the community. Our contact tracers are already tracking down the woman’s contacts over this period, using the QR and Bluetooth data from her phone. People who have visited the same locations at the same time will get a notification through the app to stay at home and call Healthline. Ministry of Health will also publish a list of locations and times on their website which people can check.

“New Zealand is well prepared for border incursions like this with testing and contact tracing capacity. The case has a clear link to the border and has not had a huge number of close contacts in the community. This means there is a relatively low risk that a large number of people have been infected. Once we have the results from testing close and casual contacts in the next few days, we will have a clearer picture of whether any change in Alert Level is needed. Dr Bloomfield has said that they are assuming the case is one of the new variants of COVID-19. This may be confirmed by the results of genome sequencing in next day or so. Given that these variants are more transmissible, it makes sense to cast a wide net with contact tracing and testing as many people who may have crossed paths with the case as possible.

No conflict of interest declared.

Dr Sarb Johal, psychologist, comments:

“The investigations of a probable case in Northland are likely to cause concern for many people. It’s worth remembering people tend to have a blind spot for dangers that have a long lead-in time. The fact that the coronavirus can be present in the community for days before people start testing positive is important. This means it is absolutely critical that people are using the app to check in as this contributes to understanding how and where the virus may have been transmitted in the days preceding detection.

“The argument that, ‘we don’t need to use the app because we don’t have Covid-19 here’ is a false one, because the virus may well be present – it just hasn’t been detected yet. By using the app, you are making a valuable personal and community contribution to being able to tackle any outbreak swiftly, should one occur. Make sure QR codes are available, visible (in colour, as it is a memorable reminder of the Covid-19 campaign), easy to access and ideally displayed in multiple places in premises.

“Use the QR codes, no matter where you are in New Zealand – our response may depend on it.”

No conflict of interest declared.

Lesley Gray, Senior Lecturer, Department of Primary Health Care & General Practice, University of Otago, comments:

“This is a timely reminder that we need to be vigilant – just because we cannot ‘see it’ does not mean Covid-19 is not there. Remember to scan, Bluetooth, handwash, hand hygiene, keep socially distanced from people not in your close family bubble and wear a mask on public transport – even if it is not mandated to do so. We will hear more details of this person’s movements in the next 24 hours, meanwhile if you feel unwell and have any symptoms that could be Covid-19 – self-isolate and get a test.”

No conflict of interest declared.