Auckland and Waikato stay in Alert Level 3 – Expert Reaction

Northland will drop down to Alert Level 2 tomorrow night following no signs of additional spread of Covid-19 in the region.

However, positive wastewater results continue to show up in the Waikato region, meaning Alert Level 3 restrictions will stay in place and be reviewed again on Friday.

Prime Minister Jacinda Ardern said today that an Alert Level 4 “circuit breaker” in Auckland would be unlikely to lower case numbers any more than the current Alert Level 3 settings, which will stay in place for another two weeks.

The SMC asked experts about today’s announcement.

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:

“An immediate ‘circuit breaker’ response is desperately needed to allow as much time possible for people to get vaccinated, given the risk of exacerbating adverse outcomes for vulnerable groups including Māori and Pacific communities already heavily impacted by the Delta outbreak.

“We’ve seen growing COVID-19 case numbers due to Delta transmitting in the community, an increasing R value for the SARS-CoV-2 virus, border breaches over time, spread of Delta beyond the Auckland boundaries with an escalation in persistent unlinked mystery cases of unknown origin emerging and appearing under high alert level conditions at a time when vaccination levels were still not high enough to keep everyone – particularly our most vulnerable, safe and protected from COVID-19.

“A high degree of risk remains for all at this time – particularly for our most vulnerable communities in Aotearoa New Zealand, with Delta continuing to transmit through our communities and with vaccination levels as they stand currently, with only ~65% of the eligible population fully vaccinated, leaving large numbers still unprotected.

“Given the inequities that have persisted in health for Māori and Pacific peoples already, it was clear 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 – COVID-19 responses are needed that do not make these any worse.

“We desperately need to buy more time to drive vaccination rates up even further as quickly as possible, and to give more time for our hospitals to be ready for what’s coming.”

Comments on vaccination

“Courage in the face of adversity has been visibly demonstrated by our Pacific and Māori communities and respective health workforces, who’ve been working tirelessly, mobilizing and rallying to continue doing the work that’s needed to reach some of the hard to reach in our communities – and protect our most vulnerable from COVID-19.

“The final count from the Super Saturday Vaxathon event exceeded 130,000 first or second dose COVID-19 vaccines in one day – a tremendous effort for Aotearoa New Zealand. The turn-out rates and vaccine uptake for both overall doses and first doses by ethnicity were highest for Pacific and Māori groups – this should also be acknowledged.

“It would be incorrect to assume those who have yet to receive their COVID-19 vaccine are just all against the vaccine – accessibility issues persist for hard-to-reach communities and more vaccination outreach activities and events that are resourced appropriately are needed.

“Continued momentum with accelerated vaccination, testing and COVID-19 prevention efforts must also continue in a way that reduces barriers and builds trust for people – with the appropriate and targeted approaches focused on getting help and assistance out to those who need it most.

“In addition, 24/7 clinics and mobile vaccination clinics, buses, vans, door-to-door efforts are still much needed and would further assist shift workers, those with disabilities and other vulnerable groups and many others who can’t get to vaccination centres running during the daytime.

“Caution and compassion will be needed moving forward, as a high degree of risk remains for all in Aotearoa New Zealand, but especially for our most vulnerable communities.”

No conflict of interest.

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

“Firstly, the whole of the country needs to be congratulated for the success of Super Saturday with the increased Covid-19 vaccination levels achieved. Although it was a lot of work for all the organisers, it was so successful that it might be worth repeating in a few weeks’ time. But we also need more resourcing for community health providers for other local initiatives, including having more vaccination buses that go to small towns and rural areas.

“In terms of today’s announcements, the Government has wisely kept the current Alert Level settings for Auckland and the Waikato. This will help keep the suppression strategy working in Auckland (to prevent the health system being overloaded with sick people) and potentially help achieve elimination again in the Waikato.

“The move down to Alert Level 2 for Northland seems well justified given the community testing and wastewater testing results – so elimination is still working there. But it was a bit concerning that there was no announcement about strengthening internal borders around Auckland and the Waikato to prevent the spread of Covid-19 to other regions. The rest of the country needs more Covid-19-free weeks and months to build up vaccination levels. We need additional border controls such as vaccination requirements and a negative rapid antigen test result for those leaving Auckland and the Waikato. These types of measures would help us to replicate the success of those Australian states and territories which are also continuing with their elimination strategies – even while outbreaks occur in Victoria and New South Wales.”

No conflict of interest.

Dr Bodo Lang, Senior Lecturer, Department of Marketing, University of Auckland, comments:

“How can those who are vaccine hesitant be won over to be double vaccinated as quickly as possible? Answering this question is the key to getting New Zealand back on its feet. Mass communication and advertising have done a tremendous job in getting the vast majority of New Zealanders to vaccinate.

“However, those who are hesitant have not been swayed by the multitude of approaches the government has used. Therefore, those that are hesitant, may require a different strategy: incentives. This is in line with commercial practices: some consumers adopt a behaviour because of internal convictions, others require incentives.

“To maximise the number of double vaccinated New Zealanders in the shortest possible time, the government needs to add an incentive-based approach to its strategy. There are a number of ways to achieve this.

“For example, it could be a financial incentive: every person who is double vaccinated is eligible to go into the draw to win a substantial prize. Imagine being in the draw for ten $100,000 prizes or a shot at one million dollars.

“There are other powerful incentives beyond financial prizes. For example, restrictions in a region could be relaxed for those who are double vaccinated, allowing them to take greater part in public life. This could entail visiting pubs, going to restaurants, entering retail premises, and perhaps even leaving their region. To be safe, consumers who have regained some of these freedoms may still have to comply with a base line of Covid-sensitive behaviors, such as mask wearing, social distancing, tracing locations, and keeping their bubbles to a size health professionals are comfortable with. On the other hand, those who have yet to have two vaccinations would be prohibited from such freedoms and remain in Level 3 lockdown.

“Regardless of what the incentive is, it needs to have a close deadline. The 1st of December 2021, for example. Having a close, specific, and appealing incentive will likely see a marked increase in first and second vaccinations in New Zealand. And that is what New Zealand needs.”

No conflict of interest.