Covid 19 Delta outbreak: D-day for Auckland alert level phase, Cabinet meets after 60 new cases

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The Delta outbreak has seen infected people hospitalised at twice the rate of all the country’s previous Covid-19 cases.

It’s figures like that, along with the 60 new cases announced on Sunday – including 56 in Auckland – signalling the start of “exponential growth”, which experts say make any loosening of restrictions today “not even worth contemplating”.

Cabinet is today deciding on alert level settings for the country, including whether to shift Auckland to the next alert level step and its neighbouring regions out of level 3. It comes a week after the Government introduced a new step system for levels 3 and 2 for Auckland, with the position reviewed weekly.

Since then case numbers have risen steadily by the day, spreading across the border into Northland, Waikato and Bay of Plenty, with hundreds of locations of interest.

The spread is threatening some of the country’s most vulnerable communities, which have also been so far poorly served by the vaccination rollout and still have much lower rates.

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Covid-19 modeller Professor Shaun Hendy said we were not quite at a point where a return to level 4 was required, but we were not far off.

“We should start planning for a circuit-breaker level 4 lockdown in Auckland, if required – we are definitely on a knife edge.”

In the latest Delta outbreak, as of figures from last week, about 10 per cent of 1357 cases have needed hospital care – more than twice the rate for the more than 3000 cases recorded previously, mostly of the initial non-Delta variant.

Given this high rate a “circuit-breaker” could be needed if cases surpassed 100 a day, which could occur even in the next week, Hendy said.

Already it appeared contact tracers were struggling to keep up, with the number of unlinked cases continuing to rise – 19 in Sunday’s figures and 49 over the past fortnight.

At that point contact tracers could start to be overwhelmed, and daily case numbers double within a week. With about 10 per cent of cases needing hospital care, the medical system could start to be “under threat”, Hendy said.

“That 10 per cent, that is higher than we have modelled. We know from Delta overseas it has a higher hospitalisation rate, and we know Māori and Pasifika are at higher risk as well due to being poorly served by the healthcare system, and make up a high proportion of this current cluster.”

What gave Hendy hope was seeing the vaccination rates ramp up across the country.

In the current outbreak those fully vaccinated made up just over three per cent of all cases, and just over one per cent of those hospitalised.

Currently about 56 per cent of the population aged 12 and over are fully vaccinated, and 82 per cent had at least one dose.

“It is still possible we can beat this outbreak at current settings, provided people continue to follow the rules and we really get jabs in arms,” Hendy said.

Immunologist Dr Dianne Sika-Paotonu said her major concern with the current outbreak was how it continued to travel through some of the most marginalised communities, where vaccination rates were still very low.

Māori vaccination rates remained about a third behind the overall rate, and those for Pasifika about a fifth behind.

This was largely due to the rollout implicitly prioritising European/Other and Asian ethnicity, mainly from the age distribution, despite research showing Māori and Pasifika were much more vulnerable to the virus at lower ages.

Despite huge efforts recently to address these inequities, the gap continued to widen.

“The consequences of any premature restriction changes would be dire for our vulnerable communities,” Sika-Paotonu said.

“If we are not careful our health system can easily be overwhelmed.”

Today’s Cabinet meeting comes after a huge week since the Government announced its change in strategy away from elimination and a new step system for alert levels.

Epidemiologist Dr Michael Baker said the new step system was “very confusing”, and dangerously gave an expectation to people in Auckland restrictions would be eased.

“That system should be abandoned – it is not realistic in the short term.”

The comments around moving away from elimination also caught many by surprise, and there was little detail about how and why it should occur, Baker said.

Instead, Baker and colleagues have suggested reworking the current alert-level system, and introducing a regional strategy.

This could see Auckland focus on regional suppression, while the rest of the country continued a regional elimination approach, or zero tolerance for cases.

Baker said the daily case direction in recent days showed the “beginning of exponential growth”, and most concerningly steady growth in unlinked cases.

What was even more concerning was that case numbers typically reflected what was occurring about a week ago, meaning effects of the restriction changes last week would be felt in the coming days.

“You couldn’t even contemplate lightening restrictions with that kind of upward trend.

“I remain very optimistic though that we can come through this in good shape. We just need a clear strategy.”

Prime Minister Jacinda Ardern has also faced criticism for leaving Wellington last week shortly after those announcements, and as the outbreak spread further out of Auckland.

Ardern has spent the past several days touring remote parts of the country to promote vaccination uptake.

National Party leader Judith Collins said it was unacceptable for the Prime Minister nor any senior ministers to be absent from facing questions over the weekend as the outbreak escalated.

“It is easy to stand in front of microphones and cameras when you are being praised and things are going well. It takes a strong leader to front up when things are going wrong and the people of New Zealand have questions.”

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