Otago University epidemiologists say New Zealand should consider suspending all international flights to free up MIQ spaces as officials deal with the Delta outbreak.
In a new commentary, Professors Michael Baker and Nick Wilson, and Drs Jennifer Summers and Leah Grout, have called for four other major immediate steps the country could take - including splitting New Zealand into four zones - to help bring the flare-up under control.
"It's also important that upgrading our response to this outbreak builds our capacity to respond to further outbreaks, which will be critical to sustaining our elimination status in the medium to longer term," they said.
Pause international flights
The outbreak has made domestic air travel around the country extremely limited - those currently permitted to fly are people carrying out level 4 services or moving freight - while the Cook Islands has suspended arrivals from New Zealand.
International flights to the country are continuing to operate, with 14-day quarantine and testing requirements still in place.
The experts said the action would free up spaces in MIQ facilities in case they were needed if the community outbreak grew larger.
"This was the rationale for when Victoria in Australia suspended all incoming international travellers for four months in 2020," they said.
"Such a suspension (or minimisation) would also reduce the risk of another outbreak from a border failure event associated with additional infected cases coming into the country."
They noted there'd been already been 10 reported quarantine system failures linked with international travellers into New Zealand.
"Having two separate but simultaneous outbreaks could impose extreme stress on the country's contact tracing system."
Split up NZ
The experts suggested New Zealand could be split into geographic zones, with regional alert levels.
"Doing this requires the ability to use regional zones with complete travel restrictions between them to allow for different control responses and speed of moving down alert levels," they said.
"For example, the Government could now divide the country into four separate zones between which travel would be completely prohibited, at least until there is a clearer understanding of the extent of the current outbreak."
They pointed to Australia's internal state borders, which had allowed the country to have states and territories with no sustained community transmission, while one dealt with an outbreak.
"But in contrast to Australian state boundaries, New Zealand will typically have much shorter borders to control."
Given that QR code scanning rates had been woeful before the outbreak - daily scans were totalling only around 500,000, out of nearly three million app users - the experts said a mandate should be in order under level 4.
"Levels of QR code scanning have been inadequate in New Zealand, which makes contact tracing more difficult, slower, and less complete for health authorities," they said.
"Therefore, QR code scanning should be made mandatory during level 4 for both essential workers and people using essential services.
"QR code scanning could also be mandated at lower alert levels for high-risk venues in terms of super-spreading events, [such as] bars, night clubs, gyms and churches."
The experts backed the Government's move to expand mask requirements under level 4 to everyone older than 11, and in places like supermarkets, bus terminals and taxis.
"But this policy does not go far enough and it should ideally include mask use at level 4 for all essential workers who are in shared indoor spaces [such as] in factories that are operating under level 4 to produce essential products such as food, but also for the export market," they said.
"In some of these settings workers on production lines can be quite close together and ventilation might not be ideal."
Vaccinate more essential workers
Prime Minister Jacinda Ardern has already made clear the Government now has a greater focus on vaccinating essential workers, who are allowed to keep operating under level 4.
But the experts were concerned this planned focus wasn't strong enough - and that there needed to be a "complete prioritisation" of this group in Auckland to help accelerate outbreak control.
"Indeed, spread of infection by essential workers has been a problem with the current Sydney outbreak and this group is now being prioritised for vaccination in Sydney," they said.
"It is also very concerning for example that only 40 per cent of the New Zealand police force has been vaccinated.
"If demand for vaccinating such essential workers is very high in Auckland – then it would probably make sense to delay the roll-out for other people in Groups 3 and 4, until the demand from essential workers is substantially dealt with."