Longer lockdown for all NZ – Expert Reaction

Level 4 lockdown is to continue across the whole country until at least midnight on Friday. Meanwhile, Auckland will remain in lockdown for at least another full week.

The next steps for areas outside of Auckland will be reviewed on Friday, while Aucklanders will be updated on Monday. The move comes after 35 new Covid-19 cases were confirmed nationwide today – 33 in Auckland and two in Wellington, bringing the community outbreak to 107 cases.

The SMC asked experts to comment. 

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

“From this announcement, it is clear to me that the government are trying to stamp out the current delta outbreak while keeping the country at the lowest Alert Level necessary. That is why they have said they will review the levels for Auckland in one week and for the rest of the country before that.

“All this suggests to me that they are looking to move parts of New Zealand down to a lower alert level as soon as they can be assured it is safe to do so. Given close contacts have travelled all around the country, and we are still within the incubation period of the virus, it is safest for the South Island to remain at Alert Level 4 for now.

“Wastewater testing and PCR testing of contacts and anyone with symptoms are both really important tools for identifying where in the country the virus is and who is infected. Importantly, testing the wastewater is a new tool that we didn’t have the first time we were in Alert Level 4.

“We can see by how quickly this outbreak has grown, that the increased infectiousness of delta in combination with super-spreader events can quickly overwhelm the ability to use contact tracing to identify cases and stop chains of transmission. That is why the Alert Level 4 restrictions are so important for New Zealand to minimise the chance of chains of transmission continuing so that we are able to stamp out this current outbreak.”

No conflict of interest.

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

“Keeping the whole of New Zealand at Alert Level 4 until the weekend is the right decision. New Zealand is in the midst of a dangerous outbreak of the Delta variant of COVID-19 and the true extent of the outbreak is still uncertain. Although confirmed cases are so far restricted to Auckland and Wellington, close contacts have been identified all around the country including in the South Island. There may well be other contacts that haven’t been identified and some of these could still be in their incubation period. By Friday we will know more and a drop to Alert Level 3 is a realistic possibility for regions with no active cases.

“For Auckland, the week-long extension is clearly necessary given the sheer number of cases and locations of interest in the city. At the moment, cases being reported were very likely infected prior to the lockdown, so we are still building a picture of how widely the virus spread before the outbreak was first detected. By the end of this week we will start to see the impact of the lockdown on case numbers. At this stage we can begin to estimate the reproduction number (the average number of people an infected person passes the virus on to) during Alert Level 4. This will allow us to gauge how likely it is we’ll be able to eliminate the outbreak with current settings and how long that could take.”

Conflict of interest statement: I am partly funded by MBIE for research on mathematical modelling of COVID-19.

Professor Shaun Hendy, University of Auckland, comments:

“It is becoming clear that we are dealing with a cluster that was towards the upper limit of expectations when it was detected in Auckland. This does mean we will likely see Alert Level 4 held in place for at least several weeks more in the Auckland region. For the rest of the country we will have to wait until later in the week to see if they remain clear, in which case, an Alert Level shift could be considered on Friday. In Wellington, where there are active cases, officials will need to rule out spread within the community to see consider an Alert Level shift.”

Conflict of interest statement: “Shaun Hendy leads Te Pūnaha Matatini’s COVID-19 modelling programme, which receives funding from MBIE’s Covid Innovation Fund and the Tertiary Education Commission.”

Dr Jennifer Summers, Senior Research Fellow, Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE), Department of Public Health, University of Otago:

“Extending Alert Level 4 nationwide was the right decision given the highly transmissible nature of the Delta variant, and also because of the spread of known contacts across New Zealand. It is not surprising that Auckland is currently set to remain at Alert Level 4 longer than the rest of the nation.

“However, the Government needs to monitor the occurrence of COVID-19 cases outside of Auckland and wastewater testing results, which will provide necessary information to help determine whether alert levels can change across different regions in New Zealand. In particular, caution should be used when considering moving Wellington down alert levels given that there are cases in the community (albeit known cases are now reported to be in MIQ facilities).”

No conflict of interest.

Jacqui Maguire, Registered Clinical Psychologist:

“Whilst a significant proportion of New Zealanders seem to accept the need for level 4 lockdown, todays announcement is unlikely to bring relief to New Zealanders who are experiencing covid-fatigue and frustration at lockdown length ambiguity.

“Whilst I think it is fair to acknowledge that anxiety levels do not appear as high as the 2020 lockdown (as we now have a mental blueprint to activate), any sense of novelty has well worn off. It is also important to note that uncertainty and inability to plan for the future can increase distress. Community residents across the country have reported the mood of their neighbours as a mix between acceptance and negative frustration and hostility.

“What will be important :

  • If there is chance to provide part of the country with more certainty (even if the lockdown length is longer) this would help calm people. Knowledge is power.
  • To make mask use mandatory. By providing ’soft advice’ to mask up when leaving the house, without policy to back this up, this will inevitably cause various behavioural choices across communities. This in turn can lead to divides, and individuals personally taking up the role as ‘community vigilante’.
  • Lockdowns do have significant impact on mental health. We therefore have to minimise opportunity for divide, and enable people to concentrate their energy on caring for their wellbeing.
  • It is helpful for people to use a model, like Te Whare Tapa Wha, to personally address their level of wellbeing. This can enable people to visually identify what they are already proactively doing, and any areas of need.
  • If experiencing covid – fatigue, research identifies that we are more likely to continue acting in accordance with the rules when we use others as motivation. “I am wearing my mask to keep my elderly neighbour safe”. “I am staying home for all the small business owners who can’t currently operate” etc.”

No conflict of interest.

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

“The number of cases reported today is not surprising and even gives some reassurance that there have not been large super-spreading events in the days before Alert Level 4 was introduced. Due to the fast response, NZ is looking like it will probably replicate the success with control of a Delta variant outbreak – as seen in Queensland and South Australia (rather than the looming failures in Victoria and New South Wales).

“Nevertheless, the continuation of the Alert Level 4 setting for the whole country to at least Friday night seems wise as there is still a lot of uncertainty. Also more work is needed on allowing for a strong regional approach with tight internal border controls. This will allow for regions such as the South Island that might soon be declared Covid-19 free (after more testing in the community and of wastewater) to move down through the Alert Levels faster than regions that still have cases.

“The Government has wisely strengthened a number of control measures such as wider contact tracing, mandatory mask use, QR code scanning, and encouraging the faster vaccination of essential workers. Nevertheless, a neglected area it should now address is providing advice on improving ventilation. This advice around opening windows etc needs to go to: (i) contacts who are isolating at home (who also need to wear masks); (ii) settings that are still operating under Alert Level 4 eg, supermarkets, healthcare settings, factories etc. International research often shows that ventilation in many workplaces is only at half the ideal level (which is 4 to 6 air changes per hour) and there are multiple health and productivity benefits from improved ventilation.”

No conflict of interest.

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

“The NZ Government is clearly taking a strong precautionary approach to the Delta variant of COvid-19.  I am sure many in for example the South Island had hoped to go down a level or two in today’s Prime Minister’s briefing.

“Clearly there are so many possible routes of transmission it is still too early to say for sure that South Island (and other regions of NZ) have not been touched by people with cases of the Delta variant.  As we have seen already, this is a highly transmittable variant and if the reproduction of 6 more people being infected from every one positive case (as the PM comments) that is a very high and very quick transmission route.

“By Friday of this week we should be able to see clearly, and in conjunction with the wastewater testing results, the actual extent of covid-19 transmission throughout NZ in this current outbreak.”

Note: Lesley has received a Health Research Council grant for this research: “Improving effectiveness and equity in the operation of COVID-19 ‘self-isolation’”

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

“With no end in lockdown seeming likely for many New Zealanders, we are going to have to dig into our mental reserves to get through. If you haven’t done so already now is the time to get into some good habits around emotional wellbeing. Spend some time reflecting on how the last lockdown went for you, what you need to repeat again and what you need to change.

“Start each day planning for the day ahead and making sure you’re scheduling wellbeing into your day. Practice exercising, socialising (within your bubble limits), mentalising, and spiritualising on a daily basis. If you’re fortunate enough not to have to go out to work, catch-up on some sleep – it’s the elixir of life! Don’t settle for just getting through this by the skin of your teeth, focus on how you can flourish in spite of the circumstances.”

No conflict of interest declared.

Dr Sarb Johal, registered clinical psychologist, comments: 

Note: This is an extract from a Twitter post from Dr Johal.

“Anticipatory grief is that feeling we get when the future feels uncertain. It can be about things we hope for over the longer term, our imagined futures. This kind of grief can feel very confusing. Our primal mind senses that something bad is ‘out there’, but we can’t see it. This breaks our sense of safety & makes us feel like worse is yet to come. So what can you do when you feel those waves of dread, loss or grief approaching?

“A useful starting point is to understand the five stages of grief: denial, anger, bargaining, depression, and acceptance. Although not everyone goes through all stages in a simple process, it’s interesting to observe how these stages have played out in our responses to Covid19.

“In the early days of lockdown again, we can see denial: “This virus won’t affect me/us. We just have to live with it” There’s anger: “You’re making me stay home and taking away my activities.” There’s bargaining: “Okay, if I stay home, physically distance for four weeks everything will be better, right?” There’s sadness: “I don’t know when this will all end.” And, finally, there’s acceptance: “This is happening; We have to figure out how to proceed.”

“Though we may find ourselves experiencing different stages of grief at different times, this final stage of acceptance is perhaps where the power resides, because that is where we can find things that we can control – I can wash my hands. I can keep a safe distance. I can wear a mask. I can learn how to work virtually. I can get vaccinated to stop the worst health problems.”

No conflict of interest declared.