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COVID-19 Testing At The Border - Expert Reaction

The new testing strategy includes regular health checks and asymptomatic testing of all border-facing workers, as well as regularly testing people who are exempt from quarantine, such as New Zealand-based air crews.

The SMC asked experts to comment on these changes.

Associate Professor Lynn McBain, Head of Department of Primary Health and General Practice, University of Otago, Wellington, comments:

“The enhanced testing regime for those at higher risk as listed – border workers, those working in the isolation and quarantine facilities, and international air and maritime crews is a good step forward. The border is clearly the weakest point in the COVID-19 reduction / eradication strategy. This is particularly so now that the number of worldwide cases are continuing to increase at a high rate.

“The statement that: ‘Anyone presenting to primary or secondary care with symptoms consistent with COVID-19 will be offered testing even if they have no history of international travel or contact with travellers’ is not new. This is what is happening currently as primary and secondary services are testing large numbers of people.

“As most New Zealanders return to the new normal of Level 1 – work , school and day care as well as social gatherings, there is an increasing number of low-level respiratory infections (not influenza at this stage). This means that there will be increasing numbers presenting for testing as the current case definition for COVID-19 is very broad. ‘Any acute respiratory infection with at least one of the following symptoms: cough, sore throat, shortness of breath, coryza, anosmia with or without fever.’

“I agree with community testing – however there is a risk that the numbers of tests required to test all of these with any of these listed symptoms will mean that health services are diverting staff and resources to testing and away from usual care.

“A way forward might possibly be looking at alternative modelling for community testing – perhaps sentinel testing, or other ways to have continued confidence in the lack of community spread – but not needing to test everyone with a runny nose or sore throat. There is not a simple solution.”

Conflict of interest statement: Dr McBain owns a general practice in Wellington.

Dr Nikki Freed, Senior Lecturer in the School of Natural and Computational Sciences, Massey University, comments:

“I think the recent cases at the border underscore how vigilant New Zealand will need to be in terms of testing and surveillance to keep COVID-19 case numbers low. The new changes announced today to the COVID-19 testing strategy are a strong move in the right direction.

“There are several important steps in these new changes which will help the Ministry of Health catch cases at the border, and importantly, find any COVID-19 cases that might be circulating in the community. Two of these steps stand out to me. The first is setting a low bar for testing, so that anyone presenting with symptoms is able to get tested, and second is identifying groups who are under tested. Knowing where the ‘holes’ are in community testing is an important step to making sure the surveillance is working.

“Finally, I think the Ministry of Health has done a very good job of adjusting and updating the testing strategy to ensure New Zealander’s remain safe and to keep COVID-19 levels at a global low.”

Dr Freed has been awarded HRC funding to research rapid diagnosis and genome sequencing to follow the coronavirus outbreak.

No conflict of interest.

John Mackay, Technical Director at dnature diagnostics & research Ltd, comments:

“The use of multiple tests is a good strategy to avoid concerns that a recently-infected person will not have enough virus present to return a positive test – thereby greatly reducing the risk of infected people returning a negative test result at a single point in time, i.e., reducing the ‘false negatives’.

“Equitable testing is important – because COVID-19, influenza, and other respiratory diseases are not equitable, affecting Māori and other New Zealand groups to an increased extent.

“Despite flu levels being at low levels (lockdown was not just good for lowering COVID levels!), influenza levels are expected to rise and new tests in development by New Zealand researchers are being designed to detect and discriminate both these illnesses, when symptoms may appear similar. In the meantime, New Zealand continues to have good supplies of the virus testing reagents needed.”

John Mackay has been awarded HRC funding to research rapid 15-minute diagnostics for distinguishing COVID-19 from influenza.

No conflict of interest.

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