Covid 19 coronavirus: The brink of elimination? Number of higher risk cases down to two

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New Zealand's march towards eliminating Covid-19 has been given a boost, with the key measure of recent community transmission cases falling to just two yesterday.

Success would be "one of New Zealand's greatest achievements", according to epidemiologist Sir David Skegg, but he warned it would all be jeopardised if New Zealanders started socialising or crowding the beach at alert level 3.

His comments come as groups representing frontline health workers slammed the Health Ministry over access to personal protective equipment (PPE) and the rollout of flu vaccines, while GPs and pharmacists begged the Government for more funding to stay afloat.

Last night Health Minister David Clark ordered a rapid stocktake of the Health Ministry's PPE distribution to ensure it was getting to frontline workers in a timely way.

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With five more days in lockdown, Prime Minister Jacinda Ardern said most Kiwis had been compliant but there had been 4128 breaches and 430 prosecutions.

"While we are looking forward to things we can do under level 3, we must not risk the gains that we have made.

"Each and every one of these people breaching the rules risks undoing the work of others."

The list of fatalities rose to 14 yesterday after the death of a woman in her 80s from the Rosewood Rest Home cluster in Christchurch, from where seven others have died.

"Every person we lose to Covid-19 is a tragedy," said director general of health Dr Ashley Bloomfield.

The total number of confirmed and probable cases is 1451, and with 1036 recovered, there are 401 active cases including 11 people in hospital, two of them in intensive care.

A record 5289 tests were completed and there were only six new cases yesterday, all of them linked to existing cases, or quarantined because they had arrived from overseas.

With a watertight border and containment of known chains of transmission, the key figure in the fight to eliminate the virus is the number of cases from community transmission.

There have been about 60 such cases in all, but most of them have been contained and isolated by the lockdown.

Recent cases still have the potential to trigger a new outbreak, but the number of new cases since the start of April has fallen from six on Sunday to four on Tuesday.

Yesterday there were two - and Bloomfield said neither of them seemed to have become infected in recent days.

"They're not recent onset ones. They're two where we haven't been able to pinpoint exactly where the infection may have come from."

Director General of Health Dr Ashley Bloomfield says there are now only two recent cases of community transmission. Photo / Mark Mitchell

Asked when the number of new cases might drop to zero, he said: "This is the situation we wanted to be in, and the situation we want to stay in."

Appearing before the parliamentary Epidemic Response Committee yesterday, Skegg said New Zealand could become the first western country in the world to eliminate Covid-19.

But rigorous level 3 compliance was needed, including physical distancing, because community transmission may still be occurring.

"If New Zealanders started going overboard with social mixing, exponential spread would start again," Skegg said.

"It's vital that people understand the opportunity we have. Right now we have the chance to claim a historic victory over this virus. If we are successful, this will be one of New Zealand's greatest achievements."

He said even if elimination was achieved, cases would still pop up occasionally.

"They may be introduced by airline crew who are not required even to self-isolate. [The risk] was illustrated dramatically by a wedding in Bluff which has led to a cluster of 98 cases with two deaths so far."

Ardern said there were no plans to quarantine aircrew for 14 days because that would create difficult work arrangements, but anyone with symptoms had to isolate.

Bloomfield added that many of the 30 Air New Zealand staff who had contracted Covid-19 were infected pre-lockdown, but safety measures were being reviewed "to make sure we are not importing any cases through that avenue".

Twenty-five have recovered.

Otago University epidemiologist Sir David Skegg said New Zealand is progressing well towards elimination, which would be one of the country's greatest achievements. Photo / Otago Daily Times

Skegg said there remained a need for rapid tracing and isolation of contacts, adding that if that had already been in place the lockdown could have been lifted today.

He called for more targeted testing in high-risk areas like overcrowded housing, noting the recent wave of infections in Singapore that stemmed from migrant workers crammed into dormitories.

Australia could also eliminate Covid-19, which he said could open the possibility of an Australasian Covid-free bubble, but other western countries were already beyond the point where elimination was possible.

"I fear that much of the world is going to look like a train-wreck in slow motion."

University of Auckland professor Shaun Hendy said the modelling he provided to the Government showed the number of community transmission cases falling to zero around May 4.

That was why he had advocated for lockdown to be extended for two more weeks, but elimination was still possible despite lifting the lockdown earlier.

"It's difficult to anticipate New Zealanders' behaviour at level 3. The concern is we don't quite know how level 3 is going to work. Are people going to rush to the beach?

"I'd advise people to still be cautious. Keep up your physical distance and, as much as possible, stick to your bubble. If you've got any symptoms at all, go get tested."

Skegg said New Zealand's success so far was despite the chronic underfunding of public health units for decades from both Labour and National-led Governments.

He told the committee many of the issues about the health system raised by frontline health workers yesterday would disappear if elimination was achieved.

The committee heard from GPs, pharmacies and dental surgeries begging for more funding, while problems persisted with access to PPE.

The flu vaccine roll-out was called "a debacle" by the NZ Medical Association.

Ardern disagreed, saying the vaccine season had been brought forward.

She said there had been $45 million supporting GPs so far, and asked for any examples about PPE issues.

"Every time they're raised, we follow up."

• Covid19.govt.nz: The Government's official Covid-19 advisory website