Auckland moves to Level 3 – Expert Reaction

Auckland will move to Alert Level 3 on Wednesday, while the rest of the country remains at Level 2.

Part of northern Waikato, which has seen new Covid cases, will also move to a “bespoke” set of temporary restrictions, designed to create a “Level 4 environment”.

The SMC asked experts to comment. 

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

“Moving Auckland to Level 3 on Tuesday night is a calculated risk. Although the majority of the cluster has been controlled and most new cases are household members or known contacts, we are still seeing some stubborn spread between households that is proving difficult to stamp out. There is a danger that the increased number of people out in the community and the workplace at Level 3 will add fuel to a smouldering fire and lead to an increase in cases.

“Contact tracers are finding that most new cases are not being infected in essential workplaces or services, but via extended family or friends. This means that some increase in the number of workplaces and services operating at Level 3 may a relatively low-risk way to relax the lockdown, provided they carefully follow the appropriate procedures. But, it also means it’s absolutely crucial that people continue to stick to their bubble and don’t take Level 3 as a signal that it’s OK to meet up with family and friends.

“If people do this, there is still a good chance this outbreak could be eliminated under Level 3. But we will need to keep a close eye on cases and for signs that the virus is spreading between households. If the outbreak starts to gather steam, it may yet be necessary to tighten restrictions again. An uncontrolled outbreak still has the potential to rapidly overwhelm our health system. Once vaccination rates are higher this threat will start to recede, but we are still months away from getting everyone fully vaccinated. In the meantime, please enjoy the additional freedoms of Level 3 responsibly and most importantly stick to your bubble.”

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

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 decision to move the Auckland Region out of Alert Level 4 at this time, comes with a degree of risk for Māori and Pacific communities in Aotearoa New Zealand. Māori and Pacific peoples remain highly vulnerable to being disproportionately affected by COVID-19.

“It will be critical for anyone who is currently unvaccinated to get the COVID-19 vaccine as quickly as possible. The Delta variant spread into our communities at a time when vaccinations rates were way too low. It will also be imperative also to support our young people get vaccinated, and ensure any questions and concerns they have are addressed, and that they’re also included and involved in leading youth-targeted efforts to help others get vaccinated.

“Continued vigilance and concentrated testing, mask wearing, vaccination and monitoring efforts will critical for keeping the Delta variant under control and for dealing effectively with further mystery cases that arise.

“We’ve all seen how quickly Delta can move and how a single case can quickly turn into many more. It is critical that those who need to have a COVID-19 test still come forward to have this done and that for those who need to be vaccinated, to get the COVID-19 vaccine as soon as possible.

“For those whose lives are split across the Auckland Regional boundary, the potential risk of COVID-19 spreading across this border and into other regions remains. The recent turn of events unfolding late last week and over weekend illustrate the reality of how easily and effectively Delta can spread across a boundary. A “bespoke” boundary and temporary restrictions have now been set out for the northern Waikato area at the centre of three positive Covid-19 cases.”

No conflict of interest declared.

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

“The NZ Government is making a relatively brave move lowering the Alert Levels for Auckland – given that the outbreak is clearly not fully under control as seen with the recent spread into the north Waikato and also persisting mystery cases. Hopefully the Government will also shortly move to intensify a range of control measures that will increase the chances of eliminating this outbreak. These include mandatory universal use of masks indoors – including in schools in Alert Levels 2 and 3.

“A range of other improvements include accelerating vaccination efforts in Auckland, enhancing surveillance, and increasing the economic support package for people in Auckland as some of us have recently argued for. It is important that all these measures are considered as the price of failure is very high as can be seen with the situation in Victoria and New South Wales in Australia.”

Conflict of interest statement: Nick Wilson has no competing interests and receives no external funding for any of his research on Covid-19.

Professor Kurt Krause, Infectious Diseases Physician; Professor of Biochemistry, University of Otago, comments:

“The new cases in the Waikato are of concern and require careful attention. Given that they are almost certainly the Delta variant they will have the capability to rapidly spread within the community. It would be interesting to know if the original case had been tested before moving into the community or not.

“Cases such as this would potentially benefit from the use of monoclonal antibodies against SARS-CoV-2 such as that produced by a number of pharmaceutical companies. The Regeneron Pharmaceuticals product has the advantage of strong evidence of effectiveness following subcutaneous administration which is advantageous over intravenous administration routes. These antibodies have the potential to greatly decrease infection post SARS-CoV-2 exposure and to lessen symptoms following any infections that do occur. They must be given early in the course, preferably within 96 hours of the index case having a positive test.

“This treatment (REGEN-COV) is not currently approved in New Zealand. However an application was lodged with Medsafe on 3 Sept by Roche Products which are handling the Regeneron product in NZ. It is undergoing priority review.”

No conflict of interest.

Professor Marc Wilson, School of Psychology, Acting Dean, Faculty of Science, Victoria University of Wellington, comments:

“I think the alert level change is a good thing, or at least the best thing to do right now. That’s to say, we’re hearing a little about Level 4 ‘fatigue’, and about now is when I think it might be a good idea to drop to Level 3 – which is closer to Level 4, than 2 – to provide people with a breather.

“This may NOT be the right thing to contain the virus, however. By that I mean that the right thing to do is probably to continue to keep to Level 4 from Waikato upwards, but I think that without some reinforcement, Aucklanders (and those north and just south) need to get the sense that their efforts are recognised, or they may look to the recent cases of folks breaking the rules as role models, rather than the people they don’t see – because they’re at home, sticking to Level 4!”

No conflict of interest declared.

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

“As we move down the alert levels, it is critical that everyone continues to keep up their habits around contact tracing records. Contact tracing enables public health officials to identify people who may have been infected quickly, and reduce the time that people may have been infectious in the community.

“Keeping your records using the NZ COVID Tracer app is the recommended mechanism to have your data in one place. This means scanning QR codes, adding manual entries where there is no QR code (e.g. at home), and turning Bluetooth Tracing on. We have seen a significant increase in the number of people participating over the last couple of weeks with much of NZ at Level 2.
There are now over 2.1 million devices participating in Bluetooth Tracing every day, which is over half of the adult population. We are seeing the most QR code scans per day at the moment (around 2.5-2.6 million per day), and expect this to increase further over the coming weeks as movement increases. The app has been developed in a privacy-conscious way and its functionality has been verified through the open source code, and in my opinion it is safe to use.

“If you cannot use NZ COVID Tracer, or choose not to use it, then it is recommended that you both keep your own diary as well as provide your information on pen and paper at the venues you visit. It is mandatory for most venues to provide a mechanism for you to provide a record. This way, if you get COVID-19 you can provide records of your movements to contact tracers from your diary, and then contact tracers can use the paper records at venues to find other people who need to isolate. I encourage businesses setting up their processes as Auckland moves down alert levels to use a ballot box approach for pen and paper records to reduce the risk of privacy breaches from people seeing details on open registers. Even where it is not mandatory, it is good practice to provide your details just in case.

“However, digital contact tracing using information from the NZ COVID Tracer app significantly speeds processes up in comparison to pen and paper approaches. It is one tool in our response to COVID-19, alongside other tools like vaccination, physical distancing, and wearing face masks. They all work together to reduce the risk, and so even though it may be inconvenient to keep contact tracing records, it does help with our response.”

Conflict of interest statement: I have had interactions with the Ministry of Health around digital contact tracing in an academic capacity, but am not employed or paid by them.