Unlinked cases under the spotlight – Expert Reaction

Twenty new community cases were reported on Sunday, including eight cases yet to be linked.

In total, 34 unlinked cases remain in this delta outbreak – including the eight from Sunday. Three sub-clusters remain where officials have concerns about possible undetected spread beyond households and close contacts. The PM also announced an extra 500,000 doses of the Pfizer vaccine have been secured from Denmark.

The SMC asked experts to comment on this update – and ahead of Monday’s alert level decisions.

Dr Dianne Sika-Paotonu, Immunologist, Associate Dean (Pacific), Head of University of Otago Wellington Pacific Office, and Senior Lecturer, Pathology & Molecular Medicine, University of Otago Wellington, comments:

“The detection of mystery cases unlinked to the current outbreak is concerning, and likely to affect the potential for a shift in Alert Levels for the Auckland region.

“Community transmission appears to continue, and it will be important to identify and break new transmission paths for the virus quickly. The unlinked cases highlight the need for everyone to remain vigilant as the Delta variant of the SARS-CoV-2 virus cannot be allowed to run rampant within our communities – we’ve seen other countries punished for their delayed actions.

“It is critical that those who need to have a COVID-19 test still come forward to have this done, and should not be afraid to do so. Additionally, for those who are unwell and require emergency care and attention at this time, it is important to seek medical help as needed.

Vaccination comments: The COVID-19 pandemic has further highlighted the inequities in health for Māori and Pacific peoples that have persisted over decades and generations. It was known from the outset of the COVID-19 pandemic that Pacific peoples and Māori communities were vulnerable to being disproportionately affected by COVID-19 and would require prioritisation, especially for the vaccination roll-out.

“In response to repeated calls for improved support for Pacific-focused and tailored efforts around prevention, testing, and vaccination for COVID-19 it has been encouraging to have vaccination efforts and activity become galvanised across the country, and it is hoped that this momentum will continue moving forward.

“The additional funding recently announced to support this effort for Pacific communities in Aotearoa New Zealand is welcome news and recognition by our Government of the importance of supporting Pacific solutions for Pacific peoples and communities.

“Multiple Pacific-led vaccination events have since been organised and held around the country in an effort to improve COVID-19 vaccination accessibility and rates for Pacific communities, and these have proved highly successful.

“That our Government has also secured additional doses of the Pfizer vaccine is a relief – and much welcome news.”

No conflict of interest. 

Dr Rawiri McKree Jansen (Ngati Raukawa, Ngati Hinerangi), Clinical Director, National Hauora Coalition, comments:

“Covid’s Delta variant will exploit weaknesses in our society – the huge inequities and unequal access to the determinants of health. The virus is now travelling in younger adults, adolescents and children, it is travelling in communities with more housing overcrowding, it is reaching communities where traditional public health messaging and traditional contact tracing approaches are less acceptable.

“We are seeing more families who have more complex social needs being Covid-positive. This is very, very different to the early outbreaks, and requires some very dedicated and well-resourced responses.  This is a significant challenge for communities that have been made vulnerable because of lower income, lower employment, and poorer quality housing.  We must collectively double down on supporting communities that are most affected.”

No conflict of interest. 

Dr Clive Aspin, Senior Lecturer, School of Health, Te Herenga Waka – Victoria University of Wellington, comments:

“I would like journalists to ask decision makers about their response to the high number of infections among sectors of our community who are already disadvantaged:

“How are they responding to the modeling predictions that disadvantaged groups (e.g. Māori and Pasifika communities) are going to be disproportionately affected by COVID-19?

“What measures are in place to resource these communities to deal with the high rates of COVID-19?

“What are they doing to support the uptake of vaccinations among disadvantaged groups?

“What are they doing to counteract the false information about vaccinations that is being spread within these communities?”

No conflict of interest declared.

Dr Matthew Parry, Senior Lecturer, Dept of Mathematics & Statistics, and Associate Dean International (Sciences), University of Otago, and New Zealand Statistical Association President, comments:

“A promising sign is that the ‘test positivity rate’ in Auckland is trending downwards. The test positivity rate is the ratio of the number of positive tests to the number of tests that were performed on a given day. When we combine this information with the number of new cases, which is also trending downwards, this gives us some confidence that the testing levels in Auckland are high enough to support our elimination strategy.”

No conflict of interest. 

Professor Graham Le Gros, Immunologist, Director Malaghan Institute of Medical Research; and Programme Director Vaccine Alliance Aotearoa New Zealand – Ohu Kaupare Huaketo, comments:

“We need to prepare for the time that elimination does not catch up with the delta virus, and New Zealand will have to swing into action to keep the vaccinations up – e.g. Ministry of Health vaccinators linking with Māori and Pacific providers, and reinforcing the nursing capability of ICUs and infrastructure for dealing with potentially sick people. Even if we catch up with this outbreak, it is highly likely there will be others.

“It’s not that NZ is not trying hard enough, it’s just that the delta variant does not play by the rules – it’s a virus constantly able to change infection strategy and change the degree to which it induces symptoms. Also, in future we will have to trust that the vaccinated immune system of a healthy human is the only thing able to protect against the worst effects of the virus.

“The border controls required to keep a coronavirus out of New Zealand (or contained, in the case of Auckland) are not sustainable in the long term. Elimination is not the long-term strategy for a country the size of NZ, and with its level of interdependence on travel and shipping with the rest of the world. But in the short-term, the elimination approach is appropriate and will help us to vaccinate as many New Zealanders as possible.

“Also, we need to keep an eye on the horizon for how vaccines are now being trialled in the over 5-year-olds, so in the foreseeable future we will be able to consider full vaccination of the population.”

Conflict of interest statement: Professor Le Gros is Programme Director of the Government-funded Vaccine Alliance Aotearoa New Zealand – Ohu Kaupare Huaketo, a partnership between the Malaghan Institute, the University of Otago and Victoria University of Wellington.