NZ moves to the Orange traffic light setting – Expert Reaction

Indoor gathering limits and seating requirements will be removed when the country moves to Orange at 11:59pm tonight.

The Orange setting lifts some masking requirements. They will now be encouraged in schools, for example, but will still be required for certain locations like public transport and retail. The change also means the government is no longer encouraging people, if they can, to work from home.

The SMC asked experts to comment.

Associate Professor Donna Cormack, Te Kupenga Hauora Māori, FMHS, University of Auckland; and member of Te Rōpū Whakakaupapa Urutā (National Māori Pandemic Group), comments:

Kia mataara tonu – critical to remain vigilant and maintain public health measures

“The Government has today announced a move to Orange in the traffic light system, which means removing some of the public health measures that have been in place during the Omicron outbreak.

“COVID-19 is still very present in the community, and especially with inequitable Māori vaccination rates it is important that we remain vigilant and continue with the public health measures that we know help to reduce transmission and keep our whānau and communities safe. This includes:

  • Staying home if unwell or symptoms, and testing as appropriate
  • Wearing a mask, especially indoors or when close to other people who are not in our households
  • Good ventilation and air circulation
  • Handwashing and sanitising
  • Being up to date with vaccinations and boosters, and encouraging 16- and 17-year-olds to get boosters now that they are available
  • Think about ways that we can reduce transmission when holding gatherings, such as tangihanga, especially as winter approaches
  • RAT tests can be useful tools in detecting COVID, but do not protect against transmission, so the other measures remain very important

“Māori communities have been proactive in working to keep communities safe since the first outbreaks in 2020. This is something that we can continue to do, expressing our tino rangatiratanga and mana motuhake, regardless of the Government COVID levels.

“This is particularly important, given that the vaccination programme has failed to achieve equity, and Māori have lower levels of vaccination, as well as a greater proportion of the population that are too young to have access to vaccinations or boosters. COVID will continue to have a disproportionate impact on Māori communities, particularly as other protective measures are relaxed.

“We are interested to know how this vaccination inequity has been taken into account in decision-making about the change to levels. We also want to know how government agencies and employers are being encouraged to support people to stay at home when unwell, including MSD supporting people to have the things that they need to stay home.

“We note new anti-viral medications are available for COVID patients who have, or are at high risk of, severe illness and we intend to monitor the use of these to ensure that they are used equitably.

“As people move around and interact more, and borders open, other viral illnesses may also become more of an issue, such as RSV and flu. This could compound any future resurgence of COVID in coming months. Keeping up with our public health measures helps to protect against these other viral illnesses as well. This will also help with the health system capacity, which is important going into winter.”

Conflict of interest statement: Member of Te Rōpū Whakakaupapa Urutā (National Māori Pandemic Group)

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

“It is encouraging that daily cases numbers (averaged over 7 days) continue to trend down nationally. In all age groups, except perhaps 80-and-above, the daily counts are well off their peaks.

“However, it is important to point out that the decline in daily case numbers is not uniformly true across the motu. In the West Coast, daily case numbers are probably still rising, and in Northland and Southern DHBs, daily case numbers remain stubbornly close to their peaks.

“The Orange traffic light setting poses a significant risk for Southern. Currently, Southern has the second highest per capita daily case numbers in the country but, more tellingly, the total hospitalisation risk is actually inching up. The reason for this is that the daily case numbers in the 60-69, 70-79 and 80+ age groups, while small, have been growing steadily and such cases are more at risk of being admitted to hospital: someone 70-and-above is around 30 times more likely to be hospitalised for Covid than someone 10-19.

“A move to Orange lifts mask restrictions in most indoor settings and so increases the risk of Covid transmission. This risk will be further elevated as people spend more time together indoors during the upcoming winter months.”

No conflict of interest declared.

Dr Jin Russell, Community and Developmental Paediatrician in Auckland; PhD student at the University of Auckland, comments:

“With the shift to the Orange setting, masks are no longer mandatory for staff and students in Year 4 upwards in schools, however wearing masks is still strongly recommended in schools. Masks are an important layer of the multi-layered approach to reducing the spread of Covid-19 in schools.

“I recommend that schools keep a strong mask wearing culture at school while in Orange. This could be reassessed after winter. This is sensible as Aotearoa New Zealand may be heading into a particularly difficult winter with influenza coming back over the border, and other seasonal viruses, and while Covid-19 continues to circulate in the community. Winter is typically a time when viruses thrive, and healthcare services are stretched. Masks can play a role in making indoor settings safer for people who are medically at risk, including children with pre-existing conditions.

“Masks are effective in reducing transmission of Covid-19 and other viruses in indoor settings. Where multiple prevention measures are in place, the risk of onward transmission of Covid-19 in schools can be limited and spread can be kept lower than in other settings in an open society.

“There is an educational, social, and developmental cost to wearing masks. However, this needs to be weighed against the costs of lots of viral illnesses circulating, particularly this winter which could cause students to miss a lot of in-person school time. Children will have lots of other opportunities for mask-free time when outdoors and outside of schools.”

No conflict of interest.

Associate Professor Siouxsie Wiles, microbiologist, University of Auckland, comments:

“At the orange setting of the COVID Protection Framework, masks are still required in numerous settings, including in retail venues and healthcare settings, and on domestic flights and public transport. I’m grateful we’re keeping this as there are plenty of examples from overseas of all public health measures being lifted to ‘bring back some kind of normal’ only to have to be reinstated weeks later when cases start to rise again.

“It was a bit of a shock to hear some of the journalists struggling to understand the logic behind keeping some requirements for masks when at orange people can also ‘pash on a dance floor’. There is still COVID-19 circulating in the community in New Zealand and many people will be doing their best to avoid catching the virus to protect themselves or their vulnerable friends and family members. They won’t be going to nightclubs, but still need to be able to go to the supermarket.

“I’m disappointed mask-wearing is not being kept mandatory for schools and tertiary education. Again, these are settings in which we really want good protective measures kept so that vulnerable members of our community can attend. I think it’s a mistake to leave it to individual schools to decide what’s appropriate as it will mean some families feel they have no choice but to take their children out of school for their or their household members’ safety.

“Rather than fighting to return to a normal that no longer exists, we should be adapting to a world with another highly infectious airborne virus, one which has likely killed millions of people and is able to cause serious short and long-term illness and disability. That means normalising the wearing of masks and bringing in guidance and standards for ventilation to make indoor venues safer.”

No conflict of interest.

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

“It’s a good time to be relaxing the traffic light settings when cases and hospitalisations are declining in almost all parts of the country. We have successfully flattened the curve of this Omicron wave – although hospitalisations and staff absences have put intense strain on our healthcare system, things would have been even worse without our efforts to slow the spread.

“This point marks the end of the Omicron sprint and the start of the marathon. Covid-19 isn’t going to go away and we are very likely to have further waves of infection as immunity wanes, people’s behaviour gets back to normal, and new variants arrive.

“Our high vaccination rates are massively blunting the health impacts of Covid-19. But because it’s so much more transmissible than other respiratory viruses like seasonal influenza, it will continue to be a significant public health issue. As we move away from restrictions and mandates, we need to work on a long-term, sustainable set of mitigations. This should include vaccines, high-quality surveillance systems, a focus on clean air indoors, and financial support for people to isolate when sick.”

Conflict of interest statement: Michael Plank is partly funded by the Department of Prime Minister and Cabinet for research on mathematical modelling of COVID-19.

Arindam Basu, Associate Professor of Epidemiology and Environmental Health, University of Canterbury, comments:

“Today’s announcement indicates that the focus is now on keeping life in ‘business as usual’ mode, accepting the risks of infection and community transmission. It is uncertain how emergent variants will play out. With cold weather setting in, and we are heading into winter, more people are likely to spend time indoors. Now that there will be ‘no capacity limits of indoor gathering’ and a significant number of people are still at high risk of infection, and as we know that Covid-19 is airborne, as bars and cafes are expected to fill again, it’d be important to have more clarity around policy on ventilation in gathering spaces, schools, and other venues from the Ministry of Health. Masks will continue to remain very important protective devices for source control, and new variants remain a cause of concern.

“It is also time we expect policy statements around long Covid management from a public health and public policy perspective.”

No conflict of interest.

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

“The change to Orange under the COVID traffic-light system brings with it an end to the government encouraging people to work from home. Many businesses will welcome this move as it will bring with it the hope that workers will return to city offices and CBDs. However, there may be psychological consequences for workplaces encouraging their people to return in person. It seems likely many people will continue working from home, at least some of the time. This presents a challenge to organisations about how they create psychologically safe teams in a dispersed environment. There is also the challenge of how to support people with different levels of anxiety associated with increased human contact.

“Flexibility and agility will be key for adjusting to this new normal. Research shows that allowing people to work from home a few days a week is associated with better wellbeing and productivity, so allowing workers to continue a hybrid office/home set-up should be encouraged. Many people leaders will have already trialled new ways of maintaining social connections amongst dispersed teams and continued creativity in this space will be needed to help build a sense of workplace whānau. It’s much easier to become isolated and detached from work when you’re not around others so remotely monitoring worker’s mental wellbeing will become a much more intentional task for leaders over the coming months. Taking steps to proactively protect and maintain people’s psychological wellbeing will ease the transition from Red to Orange and pave the way for a mentally healthy transition to Green.”

No conflict of interest.

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:

“A shift from the red to orange traffic light system setting of the COVID-19 Protection Framework for all of Aotearoa New Zealand has been announced, coming into effect 11:59pm 13th April 2022.

“This setting change will include the removal of indoor/outdoor gathering limits and seating requirements, and less restrictive mask requirements, among others. Although masks will be required for some activities, they are being dropped at schools – although still encouraged.

“High COVID-19 case numbers are continuing to place added strain and pressure on our health and other support systems in Aotearoa New Zealand – with the actual COVID-19 community case figures likely higher than those being reported currently.

“Shifting from red to the orange traffic light system setting is also happening at a time where immunity gaps currently exist in Aotearoa New Zealand. During the COVD-19 pandemic, there has been limited exposure to other viruses such as the influenza virus here in Aotearoa New Zealand, meaning there is potential risk of influenza outbreaks.

“Children, tamariki and tamaiki aged 5-11 years also still need to be vaccinated, people are still in the process of getting booster doses, with boosters for the COVID-19 vaccine now readily available for 16–17-year-olds in Aotearoa New Zealand.

“Of those affected by the current outbreak in Aotearoa New Zealand, a total of 246,861, 31 per cent (nearly 1/3) were children, tamariki and tamaiki and rangatahi aged 19 years and under, comprising 13 per cent of all hospitalisations.

“Of those children aged 5-11 years, 54.1 per cent of the general population have received their first COVID-19 vaccine dose (20.8 per cent second dose), and for Māori and Pacific tamariki and tamaiki, vaccination levels for first doses are at 35.1 per cent (9.8 per cent second dose) and 47.3 per cent (11.1 per cent second dose) respectively.

“Regular childhood vaccine schedules (non-COVID-19) for children tamariki and tamaiki in Aotearoa New Zealand have also been affected by the Covid-19 pandemic. As a result, there is potential risk of outbreaks for whooping cough, measles and other illnesses. A resurgence of influenza and the respiratory syncytial virus (RSV) could also possibly occur.

“Of those in the eligible population who have received a COVID-19 booster dose, 72.7 per cent of the general population have received theirs, and for Māori and Pacific peoples boosters levels are at 57.2 per cent and 59.3 per cent respectively. Inequities that remain evident with respect to vaccination and booster levels need to be addressed with equity approaches that build trust and reduce barriers for people.

“It will be more difficult to manage potential future outbreaks caused by new variants of the SARS-CoV-2 virus once in the community setting and especially if resistant to current COVID-19 vaccines. Monitoring for new variants of the SARS-CoV-2 virus will be necessary as virus variants will continue to develop and spread while unequal global COVID-19 vaccine coverage, availability, accessibility and distribution issues persist, and remain unaddressed.

“Border restrictions are also being eased with vaccinated visitors from Australia now able to enter Aotearoa New Zealand, and vaccinated visitors from around the world able to come through on 1st May 2022.

“Being fully vaccinated against COVID-19 should now include a booster injection, given that those who remain unvaccinated and without a booster, still have a higher risk of becoming sick from COVID-19, passing on the SARS-CoV-2 virus to others and also becoming hospitalised.

“Even with the large number of recent changes with the COVID-19 response, there is still work to be done to look after not just ourselves, but importantly, protect those around us who are vulnerable.”

No conflicts of interest declared.