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Auckland Jumps Down To Alert Level 2 – Expert Reaction

Prime Minister Jacinda Ardern has announced that New Zealand will move to less restrictive Covid-19 Alert Levels at midnight tonight.

The Auckland region will go to Alert Level 2, apart from members of the Papatoetoe High School community, who are being asked to stay at home until Monday. The rest of New Zealand will return to Alert Level 1. These Alert Levels will be reviewed again on Monday.

The Prime Minister also announced that mask-wearing on public transport will remain compulsory nationwide for now, including at Alert Level 1, pending a further decision from Cabinet.

The SMC asked experts to comment on this announcement.

 

Dr Amanda Kvalsvig, Epidemiologist, Department of Public Health, University of Otago, Wellington, comments:

“We have a small group of cases that are strongly linked in terms of being known contacts. That’s very positive news. But it is a concern that although onward transmission is being effectively managed, the source is still unknown. Despite some reassuring results, stepping down Alert Levels does introduce risk because there’s less protection against unknown transmission from potential earlier missed cases.

“There are many positives to note. As demonstrated with the Auckland August cases, an outbreak can still be controlled even if the original case is never found. NZ now has a superb testing and contact tracing system, with people working around the clock and great uptake from the school community. We also have a Prime Minister whose understanding of the principles of outbreak control is extremely impressive and on today’s evidence, well up to postgraduate level. This ability to ground decisions in evidence and transparency in communicating how decisions are made is a key element of New Zealand’s elimination strategy.

“When removing Alert Level 3 protections in a slightly uncertain situation, retaining layers of protection is sensible and it’s good to see the Prime Minister noting that the whole country will continue to use masks on public transport. It would also be good to see much more emphasis on safe indoor ventilation, and exercising and socialising outdoors.

“As this country moves towards more regular mask use, it’s essential to put in place better practical support for people who need to see faces to communicate optimally. The Government needs to work with stakeholder groups including Deaf communities and those with hearing difficulties to ensure that equitable solutions are in place.”

No conflict of interest.

 

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

“This shift in Alert Levels is not cautious enough from my public health perspective, and also from an economic perspective given that regaining successful elimination is also best for the economy. We still don’t have any clear idea how the pandemic virus got through the border and many test results are outstanding. It would have been more prudent to have shifted Auckland to Alert Level 2.5 where:

  • There was also mandated mask use in indoor public places and indoor workplaces. The Government should be making far better use of mandating masks – given that they are effective, involve minimal inconvenience and could speed up the end of all lockdown measures. Mask use on public transport is very high when it is mandated – but usage drops off when it is just a “recommendation”.
  • There is much greater tightness with the borders around Auckland. The value of a targeted approach is greatly reduced if so much movement is allowed around a targeted zone. It really should be closer to zero movement – potentially with only the exceptions of life threatening emergencies.

“Ultimately NZ is having far too many preventable border failures – now up to 11 such failures since August 2021 as we have detailed. Australia is also having a notable border failure rate – despite superior processes in hotel-based quarantine when compared to NZ (eg. travellers don’t ever leave their rooms in Australian hotel quarantine).

“The high border failure rate for NZ highlights the particular need to turn down the tap by restricting arrivals from “red zone” countries. This could be only allowing in humanitarian cases after appropriate both pre-flight testing and pre-flight quarantine.

“Vaccination of border workers will almost certainly help a lot – but much more needs to be done including getting MIQ facilities out of Auckland, tightening processes in MIQ facilities, and mandating use of QR codes located at potential super-spreading settings such as bars, nightclubs, gyms and churches. Enabling the Bluetooth function on the app should also be mandated for all border workers. Without improvements in all these areas it seems likely there will continue to be border failures every few weeks, while we wait to get widespread vaccination of the NZ public.”

No conflict of interest

 

Dr Hiran Thabrew, Child Psychiatrist and Paediatrician, University of Auckland and Auckland District Health Board, comments:

“We live in an uncertain and ever-changing world. However, at times such as this, when faced with the prospect of lockdown, the uncertainty of our existence becomes more apparent.

“Going back into lockdown can affect us in a number of ways. Many people will experience feelings of numbness, worry, anger and sadness may recur – basically a grief reaction. Some will experience re-triggering of unpleasant memories, emotions and thoughts from previous lockdowns. For a few, there may be relief at not having to go to stressful school or workplaces. Coming out of lockdown will also lead to variable reactions, including relief, excitement and increased fear of illness and anxiety about returning to regular routines.

“Resilience is a set of skills that we use to navigate difficult experiences. These skills are learnt from early childhood by watching how others (especially our parents) behave and by individual practice. Each of us will use a slightly different set of resilience skills, but regardless, if healthy and effective, they should help us get through these times and even grow emotionally. Skills that previously worked to get us through hard times, such as previous lockdowns, are worth using again. Those that were harmful to ourselves or to others are best avoided. Children usually depend on their parents to build and practice these skills, so parents should remember that what they say and do matters.

“Parents can help children build resilience skills by:

1. Providing them with age-appropriate and factual explanations of what is going. This includes acknowledging the ongoing uncertainty of our current situation and reassuring them that parents will do their best to keep them safe.

2. Offering them opportunities to express their feelings and validating these experiences.

3. Developing a flexible new plan for the coming week that includes study and relaxation time, and adapting this as needed depending on the state of lockdown.

4. Encouraging them to continue to ‘do their bit’ to get through this by focusing on the things they can change (e.g. hand washing, keeping up with schoolwork, phoning elderly relatives to check on them).

5. Modelling healthy emotional expression and self-care.”

No conflict of interest

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