Message from the Director General of Health

Message from the Director General of Health – Ashley Bloomfield

Kia ora koutou It has been 80 days since the last case of COVID-19 was acquired locally from an unknown source. This is a significant achievement and underpins the ability for us all to enjoy life being back to ‘near normal’. The greatest risk of re-introduction of COVID-19 into the community continues to be from people travelling to New Zealand and those working around the border and in managed isolation and quarantine facilities.

It is important New Zealanders do not become complacent about the threat of COVID-19, the pandemic continues to accelerate overseas. As part of this, we need to continue testing at the border and in our community to ensure we are detecting any cases of the virus that might have slipped through the border. Rapid contact tracing will underpin our ability to contain any local transmission and I encourage you all to use the NZ COVID Tracer app to support this.

We know COVID-19 is going to be a priority for at least the next 12-18 months so I'm focused on ensuring the Ministry is set up for a sustained response. This means having the right resources and skills required to support immediate and long-term needs; you'll appreciate a lot of work goes on behind the scenes to deliver the Ministry's COVID-19 work. We have established a dedicated Directorate for COVID-19, now led by Deputy Chief Executive Sue Gordon, to continue this work.

Updated guidance for community testing Last week the Ministry of Health issued updated guidance on testing for COVID-19. The updated advice clarifies which lower-risk symptomatic people should be tested in the community.

Our advice is to test people with respiratory symptoms who are at higher risk of complications if they contract COVID-19, including older people with respiratory symptoms, people with pre-existing conditions, and people in our Mâori and Pasifika communities. We also advise testing of all symptomatic health care workers and aged residential staff.

The updated advice also includes a reminder that throat swabbing is an acceptable option for testing for COVID19 in these groups. We know a nasopharyngeal swab can be unpleasant for some people. A throat swab can be less invasive and may mean people are less likely to refuse to have a test. People should still be offered a nasopharyngeal swab in the first instance, as the throat swab is slightly less sensitive and requires a higher load of the virus to be present to return a positive test.

You can access the guidance on our website.

Testing at the border We continue to prioritise testing for those in managed isolation and quarantine (MIQ) facilities around days 3 and 12 and public-facing border workers who have symptoms of COVID-19.

In addition, we are rolling out regular testing of asymptomatic public-facing border workers (which includes those who work at managed isolation and quarantine facilities) for surveillance purposes. We are focusing on testing staff who don’t have symptoms at managed isolation and quarantine facilities first, as this group have the most sustained contact with returnees who may have COVID-19. This surveillance testing programme is underway in Wellington, Auckland and Canterbury, and we are working with DHBs on a roll-out plan and schedule for other locations.

Contact tracing While we’ve tightened up security at our managed isolation and quarantine facilities, it’s simply not possible to remove all risk of transmission as the number of COVID-19 cases continues to grow overseas. All New Zealanders should get into the habit of scanning the official QR codes with the NZ COVID Tracer app to keep a record of the places they visit.

I was pleased to hear this week that Tairâwhiti DHB has been proactively contacting local businesses to see if they need any help getting their QR codes and remind them of the importance of helping people keep a record of their movements. Thank you Tairâwhiti for showing leadership on this issue. I’ve attached a leaflet that you are welcome to share with businesses and organisations in your community to help them get their QR codes.

The next update to the app, scheduled for release at the end of this month, will make it a more comprehensive contact tracing tool. The main new feature will be the ability to manually add entries to your ‘digital diary’, either at the time or retrospectively. This will allow app users to record visits to locations that don’t have a QR code on display, such as visits to friends and whânau, which means people will be able to keep track of everywhere they go. This does not remove the need for all businesses and organisation to get and display their QR codes. The update will also improve the app’s compatibility, particularly with Android 6 and iOS 11.

Recovery criteria strengthened The clinical criteria for recovery from COVID-19 have now been updated following a review of international practice. Strict criteria have been applied for the last few months before an individual with COVID-19 is regarded as recovered and able to be released from quarantine or isolation, namely that it must be at least 10 days since the onset of symptoms or positive test if the person was asymptomatic, and at least 48 hours without symptoms.

The 48 hours will now increase to 72 hours as an extra precaution.

The new recovery criteria are in line with the approach taken in Australia and fit with guidelines from the World Health Organization.

The review confirmed that the virus can persist for some time in cases who have recovered but are no longer infectious.

This is why testing is not routinely done in New Zealand or Australia to determine recovery, although it may be done if clinically indicated.

COVID-19 vaccine strategy A safe and effective vaccine for COVID-19 is essential to our ability to control the virus in the long term. While no one can predict when a vaccine will be available, a global effort to develop and test a large number of vaccine candidates is well underway, with hundreds of leading researchers taking part from around the world.

In May the Government announced a COVID-19 vaccine strategy for New Zealand to ensure we are contributing to the international research, and to make sure that when a vaccine is developed, we can secure sufficient quantities at the earliest possible time. Supporting other Pacific nations to access the vaccine is also a priority.

The vaccine strategy is a multi-agency initiative led by the Ministry of Business, Innovation and Employment (MBIE), the Ministry of Foreign Affairs and Trade, and the Ministry of Health, with support from PHARMAC and Medsafe.

The Ministry is also developing an immunisation strategy to guide the distribution and delivery of any COVID-19 vaccine once it becomes available. The immunisation strategy aims to make sure we achieve population immunity and to ensure Mâori, Pacific and vulnerable populations and communities are protected.

Measles Immunisation Campaign 2020 There’s never been a better time to strengthen our immunisation and public health system, and planning is well underway to address the measles immunity gap we have among 15-30-year olds. Expect announcements on this later this week. DHBs are developing innovative outreach approaches to deliver free MMR vaccinations to 15-30-year olds where they work, learn, live and play. DHBs will begin rolling out activity for the year-long campaign later this month and during August. These approaches build on the successes of this season’s influenza vaccination initiatives and COVID-19 testing centres which saw people getting health services in popup clinics at marae and other community hubs.

A national promotional campaign later in the year will raise awareness among 15-30-year olds that they may not be protected against measles and motivate them to get immunised or say ‘yes’ when a health professional offers them MMR. We’ll also be targeting whânau and community influencers, educating them that immunisation is the best protection and that it's safe and effective.

Providers will start to see an increase in demand as the campaign progresses, and I ask you to take every opportunity to offer MMR vaccinations to your under-30s.

We must keep our eye on the ball by continuing to prioritise core public health functions like immunisation. I’ll be keeping you updated on progress and ways you can support the campaign.

Thank you for your ongoing support and commitment to the health and wellbeing of New Zealanders. I will cover the Health and Disability System Review as part of my next update.

Ngâ mihi nui Dr Ashley Bloomfield Director-General of Health