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Covid is like a "human flame thrower" and we shouldn't allow Kiwis who haven't been vaccinated into events of more than 100 people, an epidemiologist says.
Covid's appearance in the small, vulnerable and relatively low-vaccinated communities of Kawhia and Cambridge further challenged the Government's commitment to eliminating the virus.
"We've got to try and contain it because there's still a lot of people out there that aren't vaccinated and we're still likely to overwhelm our health services," Waipa mayor Jim Mylchreest said.
His concerns were supported by health experts, who have called for a tightening of restrictions to prevent further spread and more resources and support to be poured into vulnerable communities at the heart of the outbreak.
Also today a shop in Hamilton and another in Raglan have been named as locations of interest after being linked to people with Covid-19.
The Four Square Heaphy Terrace, in Hamilton, was visited by a person who has tested positive for the virus on Monday (October 4).
The affected time is between 6.50pm and 7.25pm.
The Four Square on Bankart St, in Raglan, is linked to a positive case who was there on Saturday, October 2, between 9.45am and 10.45am.
39 cases yesterday
Covid-19 Response Minister Chris Hipkins said despite 39 cases reported yesterday, and many of the previous day's cases being infectious in the community, they were almost entirely linked to each other.
Thirty were in Auckland but nine were in Waikato, the northern area of which was recently put into level 3, including cases in Kawhia and Karapiro.
Deputy Prime Minister Grant Robertson told NZME's managing editor Shayne Currie during a live Q+A on the Herald's Mood of the Boardroom that officials can connect all of the 17 Covid-19 cases in the Waikato at the moment including Kawhia and Karapiro.
Asked about extending the boundary given it appeared the virus was slowly moving around the district, Robertson said creating a boundary around North Waikato was hard but said they would look at including Kawhia and if they did need to move the boundary they would.
He believed businesses would automatically move to a level 3 style operation - he was already aware of one Kawhia business which would - which was good. He also encouraged people to get tested if they were feeling unwell.
Asked about a timeline of 8 weeks in level 3, Robertson said Covid didn't operate on a timeline and the Government wanted to keep moving forward.
The good news was that the rates of vaccinations in Auckland had increased in the past few days. Modelling showed it would take four to eight weeks to get to 90 per cent and they would make an announcement in the next couple of weeks. Robertson wouldn't confirm if 90 per cent was the magic number and said there had to be further analysis of who the 90 per cent were.
Regardless of which number you pick, New Zealand had to get to a high number of vaccinations to reduce hospitalisations and death rates.
He said they wanted at least "90 per cent plus".
Asked if he was taking on any more business consultation and feedback, Robertson it had rumbled along and the Government wouldn't always agree but they were always working with the business community, especially former Air New Zealand chief executive Rob Fyfe, and they were regularly having conversations about businesses operating with Covid.
When they announced the vaccine certificate yesterday, officials had been liaising with those to be affected prior to that announcement. Robertson said he was talking to banks and other businesses and they wouldn't always agree.
Things Sir Ian Taylor has been talking about Covid and self-isolation are things the Government is talking about and need to be included in their overall response to encourage people to travel, he said.
About people wanting to travel, Robertson agreed, and said it wasn't too far removed from what the Government was doing, Robertson said.
As for the trial, there were 400 applications and about 150 spots, Robertson said that response didn't surprise him and self-isolation was now a critical part of the next phase.
As to identifying the 150, the Government "wanted a mix" and to include Auckland and Christchurch and which businesses they could learn the most from.
If they got down to it and couldn't identify 150, they would organise some balloting.
On mandating staff to get vaccinated, especially as people return to the office soon in Auckland, Robertson said it won't come as a surprise that this was a "tricky and new area of employment law" and organisations were looking at that now.
It could be written into contracts but not added to existing contracts.
It was the same issue with rapid testing and they needed to work to make sure people were healthy when returning to work.
The Government had to make sure people continued to get vaccinated.
Asked about the six-week delay to contact Pfizer last year, Robertson said the Government was working its way through a number of companies at that stage. It didn't delay the arrival of the vaccines in New Zealand, he said.
There were always discussions taking place and the offers weren't firm and neither was the development of the vaccine.
He said people had to know that it was safe, get it approved. Somebody writing a letter is not the same thing, he said.
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The Ministry of Health yesterday reorted the second death of the outbreak, a man in his 50s who had been in the intensive care unit for 40 days.
The ministry released Countdown Dinsdale and the emergency department at Waikato Hospital on Friday late morning as Waikato locations of interest.
Just one of the new cases was not yet linked, along with four from the previous day.
"These additional cases are reasonably well contained," Hipkins said.
"They are all linked to one another, they know what the chain of transmission is. But if we start to see more cases popping up the dynamic changes quickly."
Covid a 'flame thrower'
Auckland University epidemiologist Rod Jackson told Newstalk ZB's Mike Yardley we had "maybe" lost control of Covid-19 in Waikato.
"We're into fire season and Delta is like a human flame-thrower in a forest.
"And if you're vaccinated, you're like a pine tree - green, clean green pine tree. And if you're unvaccinated, you're like an Aussie gum tree.
"There's a flame-thrower out there and if you don't use that the right way, we're going to have a lot of fires around."
He said the only thing we can be certain about is if you are not vaccinated, you will get Covid-19.
Jackson said that analogy was a good one because in terms of catching Covid - if you're a gum tree, you will get burned. But if you are the pine tree, you will get singed.
Delta's biggest threat was the speed of the spread.
"We have to damp it down - that's all we can do now. There are only two ways to damp down Delta and that's with vaccination and restrictions.
"There's no other way."
He said the Government knows people remain hesitant about getting the vaccine. Government officials were still treating those people "softly, softly". But they needed to take a harder approach.
Asked about what he thinks about future larger events, Jackson said: "I wouldn't let anyone into a rugby game unless they're vaccinated."
He said any future event with more than 100 people attending should require everyone to be vaccinated.
Rapid tests required
Otago University Associate Professor James Ussher said rapid antigen tests now had a place given we were shifting to living with Covid, but warned there was a need for follow up tests as they were regarded as less reliable when it came to detecting infections.
"To date we've been pursuing an elimination strategy and that has required the most sensitive tests so we don't miss cases - we've had zero tolerance for that - and as such rapid antigen testing hasn't formed part of our response
"There are hundreds of these tests out there and they have variable performance with the best being up to 80 per cent sensitive compared with PCR but many performed a lot worse.
"Clearly with a move to transition and then to living with Covid there's going to be an important role for [these to play] rapid antigen testing," said Ussher.
But the clinical microbiologist said it was important to get good quality tests and that they were deployed in the right fashion.
"I can understand the desire of businesses to ensure continuity through regular screening of employees, however we need to ensure we've got appropriate tests and processes in place before using these."
Ussher said a positive test would need to be followed up as it would be more likely that it had yielded a false positive.
There was also a risk of missing infections.
Ussher said it was critical a positive rapid antigen test was followed up with a PCR test to confirm the infection.
Processes would need to be put in place before this was rolled out, including how public health would be notified.
'It might take five conversations'
Associate Minister of Health Peeni Henare said a lot of work had to be done to raise low Māori vaccination rates.
"It's going to take one-on-one conversations. In fact, it might take five conversations."
He said he had been seeing fantastic initiatives within the community and health providers - specifically Māori health providers - working to help Māori.
Part of the work these groups are doing is working to build trust among Māori who remain distrustful of the vaccine and anything connected to the Government or Crown.
Henare said one of the things they were hearing was that better co-ordination is needed in the regions.
But he said the Government was not going to release data about Māori vaccination rates - which some Māori health groups have been asking for.
He suggested that those groups wanting such data should speak to their own circle of whānau and friends to get an idea of where people stand.
Henare did not believe many Māori would want their private information - particularly medical information - released publicly.
Hipkins did not rule out putting wider regions into level 3 and extending the boundary, but said at this stage it still appeared to be under control.
Ōtorohanga District mayor Max Baxter told the Herald he was unsure how to contain a case in Kawhia given there was only one road in and limited stores for locals to get supplies.
The Ōtorohanga District is at the bottom of the Herald's Top Towns table for percentage of people fully vaccinated - at just 32.9 per cent of the eligible population.
The spread was linked to a "large gang presence", Hipkins said - an admission after days of speculation the outbreak had been moving through the underworld.
Hipkins noted that some people in the outbreak had been more "active" than permissible under alert levels.
Hipkins also addressed questions about how the Government was interacting with the gang community, including granting exemptions for two leaders to enter Auckland to assist with promoting vaccinations and testing.
"I have no time for the gangs, I don't have any sympathy for them," Hipkins said.
"But the number one priority here has to be to stop Covid-19."
National Party leader Judith Collins said there was a real concern about the growing number of cases in Waikato, especially the lack of locations of interest being listed.
"It's pretty clear at least some of them will be gang-related and people do need to know where it is.
"The relevance is other people generally comply with the law. If you're living as a gang member outside of the law, basically you're in the criminal underworld.
"Your chances of actually complying with orders seem to be pretty remote, particularly when there's the temptation of taking a load of methamphetamine from Auckland to Waikato and coming back with a bootload of KFC."
Hipkins said the nature of the outbreak was following similar patterns to overseas, and had taken hold in vulnerable and marginalised communities.
His comments followed tweets from a senior Auckland health official who said the "current situation is entirely due to poverty, housing and colonisation".
"We couldn't get back to zero because Covid took hold in the communities that 'mainstream' society forgot.
"Same reasons our vaccine rollout is too inequitable to pull us out of lockdown."
Asked if the Government had failed to prepare for this situation, Hipkins said "an awful lot of work" had gone into increasing vaccination rates in vulnerable communities and testing efforts.
Dr Dianne Sika-Paotonu, an immunologist at the University of Otago, said the treatment of the most vulnerable communities in the country was providing a "mirror on our society and reflecting who we really are as a country".
The spread was "not surprising", she said, given still-low vaccination rates in those new areas and restrictions being eased.
"A further extension of the alert level 3 border will be likely needed to keep the new Waikato cases contained and limit further spread.
"These latest developments are sadly unsurprising, with Covid-19 case numbers continuing to increase, and with unlinked mystery cases of unknown origin also persisting.
"As we have seen demonstrated already, the ongoing potential impact and consequences for our most vulnerable communities remains serious."
Meanwhile, Hipkins yesterday announced a "National Action Day" next Saturday, October 16, to boost vaccination rates.
Hipkins said with more than half the eligible population now fully vaccinated and more than 80 per cent with at least one dose, everyone had to do their bit to reach the remaining 20 per cent.
"We've got a plan and to make it work we're asking everyone to contribute to a big nationwide push for vaccination."
National leader Judith Collins, who had even sent her deputy Dr Shane Reti back up to Northland to give vaccinations in the region, said they supported the plan.
On vaccine hesitancy Collins said she would share her own experience, and tell people she trusted the science.
"Even though I do not understand all of the science, and the mRNA work that has gone on, but I am aware that I don't have to understand everything to trust it.
"One of the things I say to people is that a lot of people like KFC. I don't, by the way, but a lot of people do and who knows what is in those secret herbs and spices? And yet people still eat it."
- additional reporting Belinda Feek, Thomas Coughlan, Claire Trevett