A woman who travelled to Northland with a Covid-positive case is also now symptomatic, director-general of health Ashley Bloomfield says.
The woman was finally tracked down by police in West Auckland last night, and has been taken into MIQ under the Health Act.
Bloomfield told TVNZ the woman was showing symptoms of Covid-19, and there was likely to be additional exposure sites across west Auckland. "That may be the case and if there are new locations of interest we will make those available," he said.
He said the fact she was located in Auckland provided some level of comfort.
Authorities were now hoping to get information from the two women about where they travelled in Northland to ensure health officials could locate contacts. However, the first woman - who is also in MIQ - has been so far uncooperative.
"My understanding this person was symptomatic when police found her," said Bloomfield of the second woman found last night. He said she had been tested and the results would be expedited.
Any more information on her health would be released at the 1pm press conference.
Bloomfield said officials had no idea where the pair had been other than accommodation facilities and petrol stations. "We really want to get more details about other specific locations and people they had been in contact with."
Bloomfield said the Section 70 notice enabled police to find and detain the woman who had been evading authorities. It also gave provision for the person to undergo a Covid test. Unfortunately, there was no additional power to force them to speak. This meant they relied on people being cooperative, he said.
"My great hope is that they will provide this information," he said.
He said he didn't know why they were being so uncooperative.
Meanwhile, Bloomfield told The AM Show he didn't believe authorities were stringing people along and had always said they would review alert levels week by week.
Bloomfield said case numbers were going up and the R value was above one. It was important Aucklanders kept to the level 3 rules and minimised contact, he said.
Vaccination rates also needed to rise. Getting everyone double-vaccinated was important to keep case numbers as low as possible.
It would still be about three to four weeks until the majority of Aucklanders received their second jab, he said. He would not be drawn on whether Auckland could move to the next step where retailers could re-open their doors, but said at the moment the case numbers were climbing slowly and the R value was above 1. Health officials wanted to keep the R level as close to 1 as possible.
The hospitals were able to cope with an increase in case numbers, he said, "but we don't want to do that". About 10 per cent of cases would end up requiring hospital care and about 1 to 2 per cent would require ICU or HDU care.
On the latest Middlemore Hospital exposure case, Bloomfield said a large number of contacts reflected the fact the person came into hospital last week and didn't become symptomatic for another 48 hours. This meant a number of staff were on different shifts caring for the sick person.
So far in this outbreak, he said, only one positive patient had spread the virus to staff and that was at the Waitemata dialysis unit late last week, with two staff returning positive tests.
He said this demonstrated good infection prevention controls in hospitals.
Bloomfield said while the focus yesterday was to get those working in health and education vaccinated he did not rule out wider mandatory orders for other workforces on the frontline, including police.
Hosking grills Bloomfield
Bloomfield told Newstalk ZB's Mike Hosking that, despite speculation, he did not recommend Auckland go to level 4 yesterday.
Authorities were focused on getting a high vaccination rate so they didn't have to go to level 4 in the future. That rate needed to be "in excess of 90 per cent", he said.
In a to and fro with Hosking, in which the host outlined the business community's frustrations, Bloomfield said it was still an active outbreak and the key was testing, getting vaccinated and observing the level-3 rules. "I think people get that, Mike."
Bloomfield said case numbers were important but the vaccination rate was key - the R value was just over 1 (between 1.2 and 1.3) which meant cases would grow this week.
The R value or number (reproduction number) is the average number of people infected by someone with the virus. If the R number's bigger than 1, the outbreak grows. If it's less than 1, the number of cases goes down.
Bloomfield said Auckland would be at 90 per cent first or second vaccinations by the end of the week, hopefully.
A single jab provided some protection, and Bloomfield said they'd already dropped the region down to level 3 from 4. "Clearly it's important people get both vaccinations."
Hosking said he was receiving texts from medical professionals about booster jabs and Bloomfield said health officials were 'actively on to that'. The Government was planning to start receiving those when approval was given.
Asked if boosters would be needed, Bloomfield said "almost certainly".
When it was put to him by Hosking that Aucklanders hadn't been adhering to the rules, Bloomfield said he believed the "vast majority" of people were doing so.
What got missed yesterday was the plight of business, Hosking said. Bloomfield said he agreed and that was an issue that was "front of mind for us" and why authorities had moved the region down from level 4 to 3.
Vaccine v virus race; expert's Xmas warning
It is a "race between the virus and the vaccine" as Auckland remains stuck in alert level 3 while the number of unlinked cases continues to rise.
Top epidemiologist Rod Jackson said he would not be making Christmas holiday plans unless the country got to a 95 per cent vaccination rate by early December. So far, just under 82 per cent of eligible Kiwis have had their first dose - that number is more than 86 per cent in Auckland.
"I don't think I'd been making plans to leave home [for Christmas holidays], unless the Government brings in a much wider mandate [to vaccinate workers]," Jackson said. "We need everyone vaccinated before December, and if we got 95% of the population vaccinated by December... yeah, then you can have a holiday."
Prime Minister Jacinda Ardern yesterday extended Auckland's level 3 Covid restrictions for another week and delayed the start of the school term, due to start on Monday, as the region continues to battle against the Delta outbreak.
Last night it emerged that there was a new exposure event at Middlemore Hospital, requiring 21 staff to be stood down.
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A patient had returned a positive Covid-19 test result yesterday after visiting the hospital's emergency department on Friday for a non-Covid-19 related issue where they were assessed and admitted.
The patient was asymptomatic and answered no to all Covid-19 screening questions.
The patient then developed a cough on Sunday and was tested.
Health officials said there are 40 patients have been identified as contacts as a result of the exposure event. Of these, 15 are inpatients while the remaining 25 are being followed-up by the Auckland Regional Public Health Service.
Thirty-four staff have also been identified as contacts. Of these, 21 staff have been stood down with testing plans.
Waikato, Northland eye level 2 move
The outlook is however slightly brighter for Waikato and Northland, with tentative plans to bring the regions out of level 3 - to level 2 - from 11.59pm on Thursday.
The moves come after 35 cases were announced - all in Auckland, and the number of unlinked cases in the past fortnight increased by nine to 58.
This number was down to seven when Auckland moved out of level 4 nearly three weeks ago.
The number of people in hospital also increased by four to 33 yesterday, including a child at Starship Hospital. Seven people are in ICU.
The R value, the average number of people an infected person passes the virus on to, is now between 1.2 and 1.3, meaning case numbers are expected to keep increasing.
Based on these factors, Covid-19 modeller Professor Michael Plank said there was little option but to keep Auckland's current restrictions in place.
"It's clear cases are trending upwards and it looks as though the shift from level 4 to level 3 has contributed to pushing the R number above 1.
"Moving to step 2 of the reopening roadmap at this stage could easily cause cases to spiral out of control.
"At current vaccination rates, this could lead to large numbers of people needing to go to hospital."
As more people were fully vaccinated the R number should reduce, as well as reducing the risk of hospitalisation, Plank said.
"This will eventually allow easing of restrictions and the faster people get vaccinated, the sooner we'll be in a position to do this.
"We are now in a race between the virus and the vaccine."
Plank said the option of a strict "circuit-breaker lockdown" could still be needed if cases started to rise more steeply. He also urged stronger measures to stop inter-regional spread, including testing at the boundaries.
Immunologist Dr Dianne Sika-Paotonu said the case numbers were worrying given the overall population was only about 50 per cent fully vaccinated (about 56 per cent of those eligible and aged over 12 are fully vaccinated).
"High vaccination rates of at least 90 per cent and beyond, coupled with the appropriate public health steps against Delta, will help avoid future higher alert level lockdown measures – paramount to keeping everyone safe from Covid-19."
Te Pāti Māori called for Tāmaki Makaurau, Auckland, to be put back into level 4, and level 3 for the rest of the North Island, until eligible Māori were 95 per cent vaccinated.
"Failure to do so is committing our people to death by Covid," co-leader Rawiri Waititi said. "The reality is that the Government has failed to deliver to Māori."
Ardern rejected that assertion, and said level 3 remained tough restrictions and was not "opening up".
Ardern said part of the Government criteria had always been compliance when considering alert level changes - over time adhering to really strict restrictions was hard.
Ardern also signalled boosting vaccination rates was Auckland's ticket to lessen restrictions, though she declined to put a figure on it. Currently about 87 per cent of the region's eligible population have had at least one dose, and 62 per cent both doses.
Ardern also said any moves would have to be equity-based, with still lower rates in parts of society more poorly served by the health system.
Mandatory vaccinations were also announced on Monday for many health and education workers, as part of this drive.
While there was positive reaction to the announcement from many employers, Auckland University epidemiologist Rod Jackson said vaccination announcements were "nowhere near brave enough".
"Look, it's a good start but ... we need to go a lot further," he told TVNZ. "Education and health are the obvious ones, but the police are also pretty obvious. I think supermarkets, I don't want to go into a supermarket, and I'm worried about whether they've vaccinated. Actually hairdressers ... that's about as close a contact you're going to get. And so I think hairdressers should be mandatory as well."
He said the Government should have given businesses the mandate to demand mandatory vaccinations for staff. "I think the biggest gap by far was not giving businesses, the mandate to introduce 'no job, no job, no entry' policies without being scared of being prosecuted."
He said a 90 per cent vaccination rate was not good enough. "That leaves over 400,000 New Zealanders, who are eligible, unvaccinated. And the scariest thing is that 10 per cent of people are probably our highest-risk population. We've seen it overseas in the UK, 10 per cent of people were responsible for passing on 80 per cent of the infections."
Northland is set to move to level 2 from Friday, and a female travelling companion of a Covid-positive woman who visited the region was finally located in west Auckland last night. They have been taken into MIQ.
"They are refusing to co-operate, it is beyond irresponsible, it is dangerous," Ardern said earlier.
On Waikato, Ardern said a potential move to level 2 was based on a boost in vaccination rates and no unlinked cases.
GPs accept mandatory vaccines
Royal NZ College of GPs president Samantha Murton told Mike Hosking on Newstalk ZB that mandated vaccines were going to come eventually anyway and it was better to introduce them as soon as they could.
Vaccines were available to all healthcare workers anyway but now it was the factor that staff "must" have it. She expected a little push back "but it won't be massive".
As for vaccine-adverse people, Murton said people had different opinions. People still got sick even if they had a good diet and treatment needed to be available.
Murton said there would be people who would give up their job.
PPTA Auckland regional chair Paul Stevens said he thought all members who were eligible to get the vaccine should.
"They have time to do that and we think it's really important and our responsibility as teachers to make sure all our students are safe and that anyone who comes into a school is safe."
While it was a compromise in terms of personal choice, the imperative needed to be the health and safety of their students, he said.
About one in five of its members did not agree with the mandate. However it was a "really small percentage" of teachers who would be reluctant to get the jab. The PPTA believed it shouldn't be protecting someone's job if they weren't prepared to protect students.