The comprehensive All-of-Government response keeping New Zealand safe from a Covid-infected man who escaped managed isolation was missing a crucial element.
The Countdown supermarket where the man spent 20 minutes on Tuesday night didn't receive any advice from the Ministry of Health.
This seems absurd in the face of the global health crisis and the constant message of the need for ongoing caution and vigilance.
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Let's walk through this.
The 32-year-old man sneaked out of the smoking area of the Stamford Plaza at 6.51pm. He had already been tested for Covid-19 and was expecting a result the following morning.
He walked indirectly to Countdown where he arrived at 7.02pm, left the supermarket after 20 minutes and then took a phone call for 22 minutes. The call ended at 7.42pm, and he returned indirectly to the hotel, arriving at 7.58pm, where he was interviewed by police.
Some 90 minutes later, police in personal protective equipment visited the Countdown. They reviewed CCTV footage with staff and surfaces were wiped down, including the self-service check-out he had used.
The store remained open during all of this until its normal closing time of 10pm, and opened the next morning at its normal opening time of 7am.
Countdown contacted the Ministry of Health at 7.22am off its own bat to inform them of what had happened overnight, and again half an hour later to say it was shutting the doors at 8.15am "for a deep clean" and would remain closed for the rest of the day.
Unfortunately the store was "accidentally" opened for three minutes later that morning and 11 customers were served, but this was after the deep clean had finished.
Countdown wasn't informed of the man's positive test result until 9.56am - but that detail matters little.
Prime Minister Jacinda Ardern has said repeatedly that the people in managed isolation facilities are treated as if they have Covid-19.
That is how it should be. It's how we all behaved during lockdown. It's the best way to minimise risk.
It happened for the two sisters who drove from Auckland to Wellington, who were only granted early leave on the condition that they kept their distance from others, stayed away from public facilities, and were tested in Wellington - which subsequently returned positive.
Why wasn't the Countdown closed - forcibly, if necessary - as soon as the man's visit there came to light? If someone has Covid-19 at a school, it is cleaned and closed for 72 hours.
Why wasn't a health expert watching the CCTV footage with police and Countdown staff to advise them on where and how to clean?
Why weren't Countdown workers given advice and told to self-isolate immediately?
There are 18 workers self-isolating, but they took that decision themselves. Why is a business being left to make these decisions without expert health advice, given that our Covid-free haven is at stake?
Countdown wasn't even told that the man had been tested and was awaiting a test result.
Let's keep in mind that the risk remains low but is not nil, as the man doesn't seem to have had close contact with anyone, and the chances of catching Covid-19 from surfaces are slim.
But serious questions remain, and Cabinet Minister Megan Woods and Air Commodore Darryn Webb seemed surprised by them yesterday.
The crack team parachuted in to take quarantine and managed isolation by the scruff of the neck didn't provide any satisfactory answers.
Instead of saying Ministry of Health advice should be an essential part of any response to someone absconding and hanging out in a particular location - in this instance in busy central Auckland - they basically said it was something that needed to be considered.
Woods said the man's close contacts, if any, and his movements were the priority, but the man moved through the Countdown and potentially came into contact with people there.
Last night the ministry sidestepped questions including whether they responded - in any way - to the two emails from Countdown on Wednesday morning.
Astonishingly, the essence of the response - and the advice, if any had been offered - was this: "The ministry would not have required this Countdown supermarket to close as a result of the man's limited time there."
It is right to say, as the Government has, that policing 6000-odd people in 28 facilities in five cities is challenging, and people are and should be angry that the man absconded in the first place.
Woods and Webb should be applauded for quickly bringing in a 24/7 police presence to each facility.
But that shouldn't detract from the need for good processes to minimise risk.
Woods said there needed to be a standard process to "bring together all of the key players within minutes".
In this case, the critical health element of that equation was completely absent.