Covid 19 Delta outbreak: Expert says 'very resistant' tail puts level 2 in Auckland next week in doubt

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Daily case numbers dropped to single digits yesterday, but Aucklanders are being warned not to expect level 2 next week because the last embers of the outbreak could still flare up.

Epidemiologist Professor Michael Baker said Auckland remained on a "knife edge" because the virus was still stubbornly circulating in marginalised communities where people were less likely to get tested.

"The tail has been very resistant to whatever we're doing. The difficulty now is whether you can even think of moving out of alert level 3 until we're getting no more of these unexplained cases."

He called for a more targeted "neighbourhood" approach to detect and stamp out the remaining cases, which continue to pop up despite alert level restrictions.

"The numbers have stayed in this range, hovering at around 20 per day with a slight downward trend for four weeks. That means despite the trend looking slightly positive, we're not going to get there on the current pattern."

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Active cases:

There were eight cases yesterday, the first time daily case numbers dropped to single digits since Friday last week, and all but one were linked.

The unlinked case was a person who presented to the ED in Waitakere Hospital on Monday evening - one of seven unlinked cases in the past fortnight.

Prime Minister Jacinda Ardern says the number of daily cases continues to be volatile. Photo / Mark Mitchell

Prime Minister Jacinda Ardern said the lower number of cases was pleasing, but there was "a bit of volatility at the moment".

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'90% for Auckland is not enough'

Epidemiologist Rod Jackson said today that a 90 per cent vaccination level in Auckland was "not enough".

He told Newstalk ZB's Mike Hosking that unlinked cases was still the key consideration for moving the city to level 2.

The Government had moved Auckland to level 3 because residents could no longer cope with level 4 lockdown.

"We have to stamp them out or else it's a Melbourne or Sydney."

Jackson said the country needed to pull out all the stops in getting people vaccinated.

"This is war," he said.

Jackson said it was vital that any people moving across the Auckland boundaries were double-vaccinated and no one should be coming into the country without full vaccination.

Jackson said even with high levels of vaccination there were still half a million children who were currently ineligible to be vaccinated potentially at risk of the virus.

"The only thing that influences whether we go to level two or not is whether we've still got unlinked cases - that's it."

Jackson said Ireland, which was similar in size to New Zealand, now had 90 per cent of its population double-jabbed but had got there a different route than New Zealand.

They had experienced 5000 deaths and were therefore freaked out. Also, the vaccination campaign had also been led by doctors.

NZ 'muddling through' border policy

Massey University sociologist Paul Spoonley told Hosking on Newstalk ZB that New Zealand was "muddling through" its border policy.

In the European Union and its Covid passport there were some using it and some not. In the UK, you needed to have vaccines done in certain countries and rules around it "were all over the place" in regards to travel.

Spoonley said it wasn't clear which country was going to take the lead on it. "We need clarity about what's going to happen in New Zealand and also what's going to happen internationally."

Airlines also wanted procedures about what happens when people enter and board the planes to ensure those going in won't spread Covid.

Associate Health Minister Ayesha Verrall said the long-tail of Delta had proved quite challenging and they were taking it day-by-day and would look at the most up to date data to make sure they were making the best decision around whether Auckland would move alert levels.

Verrall said re-sampling of wastewater had been recollected in Tauranga but it did take some time for the results to get through.

Parts of New Zealand didn't enjoy good contact with the health system and that was the group they were trying to access now with more bespoke approaches.

She said modelling won't answer the question about whether someone unvaccinated was going to take up the offer and get vaccinated.

"It would be based on assumptions that may or may not proved to be right," Verrall told The AM Show.

The best case scenario was that New Zealand could reach the 90 per cent target within a few weeks if people were willing to get vaccinated.

Meanwhile economist Shamubeel Eaqub says there is "no hope" for the world in the battle against Covid-19.

"I think the big thing is that globally, it is now an endemic because we have globally failed to roll out vaccination to poor countries," he told TVNZ's Breakfast.

"There is really no hope that we'll be able to eradicate this virus from the world.

"So when we open the borders, it will come into New Zealand."

While vaccination rates have increased in New Zealand, there remains large pockets of the population - including children - who remain unvaccinated.

So far, New Zealand had managed to save more lives than many other countries fighting the virus.

As a result, the country's economy has also been better than many OECD countries.

National to unveil MIQ policy today

National leader Judith Collins said today that her party had a plan for people overseas trying to get back into the country which it would make possible for Kiwis who have been double-jabbed to get home by Christmas.

"We are so excited about this."

Collins suggested the Government adopt the policy in its entirety and Kiwis would be able to be home and "you will be able to travel".

National's policy will be unveiled at 10am today.

National is being careful about revealing who peer-reviewed it as they didn't want them to be attacked by the Government.

When asked if people could die from National's proposed policy, Collins told The AM Show that New Zealand could not stay in this situation forever and "living in a hermit kingdom" (a phrase former Prime Minister Sir John Key has used to criticise the Government).

She said people died in car accidents, but that didn't stop them driving. There were also other consequences of lockdown such as medical treatments being delayed, mental health concerns and businesses collapsing, she said.

Three active subclusters

Director-general of health Ashley Bloomfield said there were only three active subclusters, "largely" in south Auckland, where cases were still emerging among people who weren't contacts.

Two of them were households linked by genomic sequencing, while the third centred on transitional housing - a boarding house.

He said there had been some targeted testing in Clover Park, one of eight Auckland suburbs of concern.

Health staff had knocked on about 100 houses on four streets, but only nine households had agreed to be tested. Half of those who declined a test had already been tested.

Public health teams were also looking at testing people in other transitional housing, he said.

Professor Michael Baker says the tail of the virus remains despite alert level restrictions, and a more targeted approach is needed to finish it off. Photo / Supplied

But Baker called for mass testing in relevant neighbourhoods, following appropriate dialogue with community leaders and health providers.

"We've got this brief window of opportunity to extinguish these remaining lines of transmission."

Of the 203 active cases in the cluster yesterday, about 80 per cent of them were Māori or Pasifika.

Top Māori GP Dr Rawiri Jansen said the virus was still present in communities that were less responsive to traditional public health messages and contact tracing approaches.

"Low income, housing stress, over-policed, over-incarcerated - these communities require a specialist approach."

It was important to use appropriate health services who don't come across as "police knocking on your door to interrogate you as to whether you have any symptoms".

"We do want to do more testing in particular suburbs and particular communities. Some of it's happening, using providers that are culturally concordant and taking a respectful relationship-building approach.

"It might be that we need to see more of it to really get it under control."

Baker said the impact of moving to level 3 would continue to be seen in daily case numbers until the end of next week - and it was "hard to imagine" case numbers not tracking up.

"There are still hundreds of thousands of unvaccinated people in Auckland. These marginalised groups are connected with other people through a whole lot of channels.

"If their kids start going back to school from these households, we'll start to see more transmission of the virus out of those communities."

Baker said he was less concerned about the extra freedoms for more travel out of Auckland, because there was no widespread transmission.

From today, people relocating out of Auckland permanently are allowed to leave the city, as long as they have had a negative test in the previous 72 hours and had proof of the reason for their travel.

Legit reasons included moving to a new home, starting a new job, caregiving obligations such as childcare, or tertiary study outside Auckland.

Dr Rawiri Jansen says the south Auckland communities where the virus remains prevalent are less responsive to traditional public health messages and contact tracing approaches. Photo / Dean Purcell

Ardern said about 77 per cent of the eligible population had had one vaccine dose, but upping that to 90 per cent would be "really tough".

"Even at 90 per cent [of the eligible population vaccinated], you end up somewhere around 75 per cent of your population vaccinated," she said.

"That's why it's not enough just to say, 'We'll give everyone a chance to be vaccinated, if I'm vaccinated, I'll be fine.' When 25 per cent of your population isn't vaccinated, that does require management to ensure that outbreaks don't impact your health system, and don't impact people like children."

Of the 1185 cases in the outbreak so far, 260 of them are children under 12 who aren't eligible to be vaccinated.

Bloomfield said there had been positive wastewater results in Tauranga from a September 23 sample. More tests were being done to see whether it might have been from a recovered case.

He asked people in the greater Tauranga area to get tested if they had any symptoms or had been at a location of interest.