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Auckland jumps down to Alert Level 2 – Expert Reaction

Prime Minister Jacinda Ardern has announced that New Zealand will move to less restrictive Covid-19 Alert Levels at midnight tonight.

The Auckland region will go to Alert Level 2, apart from members of the Papatoetoe High School community, who are being asked to stay at home until Monday. The rest of New Zealand will return to Alert Level 1. These Alert Levels will be reviewed again on Monday.

The Prime Minister also announced that mask-wearing on public transport will remain compulsory nationwide for now, including at Alert Level 1, pending a further decision from Cabinet.

The SMC asked experts to comment on this announcement. 

Dr Amanda Kvalsvig, Epidemiologist, Department of Public Health, University of Otago, Wellington, comments:

“We have a small group of cases that are strongly linked in terms of being known contacts. That’s very positive news. But it is a concern that although onward transmission is being effectively managed, the source is still unknown. Despite some reassuring results, stepping down Alert Levels does introduce risk because there’s less protection against unknown transmission from potential earlier missed cases.

“There are many positives to note. As demonstrated with the Auckland August cases, an outbreak can still be controlled even if the original case is never found. NZ now has a superb testing and contact tracing system, with people working around the clock and great uptake from the school community. We also have a Prime Minister whose understanding of the principles of outbreak control is extremely impressive and on today’s evidence, well up to postgraduate level. This ability to ground decisions in evidence and transparency in communicating how decisions are made is a key element of New Zealand’s elimination strategy.

“When removing Alert Level 3 protections in a slightly uncertain situation, retaining layers of protection is sensible and it’s good to see the Prime Minister noting that the whole country will continue to use masks on public transport. It would also be good to see much more emphasis on safe indoor ventilation, and exercising and socialising outdoors.

“As this country moves towards more regular mask use, it’s essential to put in place better practical support for people who need to see faces to communicate optimally. The Government needs to work with stakeholder groups including Deaf communities and those with hearing difficulties to ensure that equitable solutions are in place.”

No conflict of interest.

Professor Nick Wilson, Department of Public Health, University of Otago, comments:

“This shift in Alert Levels is not cautious enough from my public health perspective, and also from an economic perspective given that regaining successful elimination is also best for the economy. We still don’t have any clear idea how the pandemic virus got through the border and many test results are outstanding. It would have been more prudent to have shifted Auckland to Alert Level 2.5 where:

  • There was also mandated mask use in indoor public places and indoor workplaces. The Government should be making far better use of mandating masks – given that they are effective, involve minimal inconvenience and could speed up the end of all lockdown measures. Mask use on public transport is very high when it is mandated – but usage drops off when it is just a “recommendation”.
  • There is much greater tightness with the borders around Auckland. The value of a targeted approach is greatly reduced if so much movement is allowed around a targeted zone. It really should be closer to zero movement – potentially with only the exceptions of life threatening emergencies.

“Ultimately NZ is having far too many preventable border failures – now up to 11 such failures since August 2021 as we have detailed. Australia is also having a notable border failure rate – despite superior processes in hotel-based quarantine when compared to NZ (eg. travellers don’t ever leave their rooms in Australian hotel quarantine).

“The high border failure rate for NZ highlights the particular need to turn down the tap by restricting arrivals from “red zone” countries. This could be only allowing in humanitarian cases after appropriate both pre-flight testing and pre-flight quarantine.

“Vaccination of border workers will almost certainly help a lot – but much more needs to be done including getting MIQ facilities out of Auckland, tightening processes in MIQ facilities, and mandating use of QR codes located at potential super-spreading settings such as bars, nightclubs, gyms and churches. Enabling the Bluetooth function on the app should also be mandated for all border workers. Without improvements in all these areas it seems likely there will continue to be border failures every few weeks, while we wait to get widespread vaccination of the NZ public.”

No conflict of interest

Dr Hiran Thabrew, Child Psychiatrist and Paediatrician, University of Auckland and Auckland District Health Board, comments:

“We live in an uncertain and ever-changing world. However, at times such as this, when faced with the prospect of lockdown, the uncertainty of our existence becomes more apparent.

“Going back into lockdown can affect us in a number of ways. Many people will experience feelings of numbness, worry, anger and sadness may recur – basically a grief reaction. Some will experience re-triggering of unpleasant memories, emotions and thoughts from previous lockdowns. For a few, there may be relief at not having to go to stressful school or workplaces. Coming out of lockdown will also lead to variable reactions, including relief, excitement and increased fear of illness and anxiety about returning to regular routines.

“Resilience is a set of skills that we use to navigate difficult experiences. These skills are learnt from early childhood by watching how others (especially our parents) behave and by individual practice. Each of us will use a slightly different set of resilience skills, but regardless, if healthy and effective, they should help us get through these times and even grow emotionally. Skills that previously worked to get us through hard times, such as previous lockdowns, are worth using again. Those that were harmful to ourselves or to others are best avoided. Children usually depend on their parents to build and practice these skills, so parents should remember that what they say and do matters.

“Parents can help children build resilience skills by:​

1. Providing them with age-appropriate and factual explanations of what is going. This includes acknowledging the ongoing uncertainty of our current situation and reassuring them that parents will do their best to keep them safe.

2. Offering them opportunities to express their feelings and validating these experiences.

3. Developing a flexible new plan for the coming week that includes study and relaxation time, and adapting this as needed depending on the state of lockdown.

4. Encouraging them to continue to ‘do their bit’ to get through this by focusing on the things they can change (e.g. hand washing, keeping up with schoolwork, phoning elderly relatives to check on them).

5. Modelling healthy emotional expression and self-care.”

No conflict of interest

Professor Michael Baker, Professor of Public Health, University of Otago, Wellington, comments:

“I would feel much more comfortable with this Alert Level change if we used this opportunity to introduce a more sophisticated approach to managing Covid-19 containment.

“We currently have only one level (Level 2) between the circuit breaker levels (Alert Levels 3 and 4, which largely require people to stay at home) and minimal controls (Alert Level 1, which is largely about managing borders).

“The Alert Level system needs to be updated to reflect new knowledge about how easily Covid-19 is transmitted in indoor environments and how the Alert Level system is now being used in a more nuanced and geographically targeted way.

“We need additional Alert Levels (e.g., 2.5 and 1.5) to make mask use requirements clear, better describe limits on indoor gatherings, and manage movements outside of geographic areas where there is higher risk of Covid-19 transmission, notably Auckland at present.

“Using this updated approach, Auckland could then shift to Alert Level 2.5 and the rest of New Zealand to Alert Level 1.5. Doing this would help to avoid the high level of complacency that sets in when we move down the Alert Levels.”

No conflict of interest

Associate Professor Siouxsie Wiles, School of Medical Sciences, Faculty of Medical and Health Sciences, University of Auckland, comments:

“It’s no secret that I would have preferred for Auckland to stay at Alert Level 3 for a couple more days until all the test results had come back. But, the decision by the Government to move Auckland to Alert Level 2 and the rest of the country back to Alert Level 1 suggests they are confident the outbreak is under control and any further transmission can be limited using the test-trace-isolate strategy. No doubt, the rapid move down the Alert Levels will also signal to New Zealanders that they will only use the more restrictive Alert Levels when needed and for as short a time as possible.

“With this news, it’s very important that New Zealanders continue to be vigilant for any symptoms of COVID-19 and get tested as soon as possible to ensure that any cases of the virus in the community are identified as soon as possible. This has always been important, but is even more so with these newer more infectious variants of the virus. I really hope that the small size of this outbreak doesn’t lull anyone into a false sense of security regarding these new variants.”

No conflict of interest

Dr Sarb Johal, psychologist, comments:

Note: These are comments are from Dr Johal’s blog post on his personal website, which you can read here.

“The New Zealand Government has this afternoon taken the decision to lower the Alert Level of the Auckland Region to Level 2, and down to Level 1 in the rest of the country from later tonight. Auckland’s Level 2 will be reviewed further on Monday.

“Many people will be relieved. The fact that most children will be able to go back to school, and people can head back to as much of their routines as will work under Level 2 will be welcomed.

“However, for some there will be lingering worries. Is this really the right move? What if the tests that we are waiting for indicate that there are more positive cases?

“The Government has judged that the conditions are controlled enough for them to be confident that, even if new cases emerge, there is a high chance that they will be linked to known cases, and that control measures already in place will be enough to manage this outbreak. Given this judgement on health advice, they have used the flexibility in the Alert Level system to enable as much of a return to normal life as possible.

“This flexibility is crucial. The danger is when we are faced with threat that we become rigid and react based on emotions, rather than a dispassionate assessment of the facts. And, though the conditions surrounding this decision can be interpreted differently, and that these may be contested, the decision has been made.

“For those who are fearful, this Alert Level move will be challenging. It will require all in Auckland to truly act in accordance to the guidance of Level 2 behaviours, and not skip back to Level 1. Level 2 means Level 2. Resist the urge to act as if this is all over.

“The threat is judged to have lessened but not vanished.

“If you are unwell:

  • If you’re sick, stay home. Do not go to work or school. Do not socialise.
  • If you have cold, flu or COVID-19 symptoms, call your doctor or Healthline and get advice about being tested.
  • If you have been told to self-isolate you legally must do so immediately.

“It’s important that you use basic hygiene measures, including washing your hands, coughing or sneezing into your elbow and cleaning surfaces.

“Use the QR code scanning app.

“You should keep track of where you’ve been and who you’ve seen. This helps with rapid contact tracing if it’s required.

“Keep your distance when outside your home. You should keep a distance of at least 2 metres in public and in retail stores, like supermarkets and clothes shops, and 1 metre in most other places like workplaces, cafes, restaurants and gyms.

“At Alert Level 2, the risk of COVID-19 being present in the community is higher.

“You legally must wear a face covering on public transport and on domestic flights and are encouraged to wear face coverings in situations where physical distancing is not possible, like in shops.

“Go well out there and stay safe.”

No conflict of interest. Dr Johal is the author of ‘Steady: Keeping Calm in a World Gone Viral’.