The experts on the return of Covid-19 in the NZ community and the move to lockdown

The prime minister has announced Auckland will go into alert level three, and the rest of the country alert level two, after four cases of the coronavirus were detected in a family with no known link to overseas travel or existing cases. Via the Science Media Centre, the experts on what it means.

Shaun Hendy: What you need to do now

Four new cases of Covid-19 have been detected in one family in South Auckland. There are no known links to travel or to managed isolation and quarantine facilities. This means there are almost certainly other active cases of Covid-19 present in Auckland at the moment, so it is important that we behave accordingly. Auckland will move to level three on midday Wednesday, which will immediately reduce transmission if we follow the rules and stick to our bubbles.

Moving to level three also reduces the number of contacts most of us have, which will give our contact tracers a much easier job over the coming days. It would also be worth Aucklanders checking their apps, diaries, and bank accounts to make a list of places they have visited or people they have had contact with over the last 14 days. If you can, you should also wear a mask when going to the supermarket. Remember that not everyone can wear a mask, so wear yours if you can to protect them.

However, there is also a chance the disease will have spread to other parts of the country. Because of this everyone in New Zealand should take the necessary precautions, including wearing masks if you can, especially in close indoor settings, hand-washing, and getting tested if you have any of the symptoms.

Stay safe, and be kind.

Shaun Hendy is currently a professor at the University of Auckland and director of Te Pūnaha Matatini

Amanda Kvalsvig: Lockdowns are effective

This is disappointing news, but it’s not unexpected as we’re dealing with an extremely infectious virus that can exploit any loophole on offer. Moving up to alert level three in Auckland will keep everyone’s bubbles small, and it will also help the contact tracing system because with fewer contacts, it will be easier to identify and quarantine the close contacts of each case.

We know that lockdowns are very effective and this approach worked very well for us the first time around. Adding mass masking (face coverings) to the Covid-19 toolbox will shorten the time it takes to regain control of viral spread. Coughing into a mask seems more likely to reduce infection risk than coughing into your elbow as previously advised. The aim is to return to alert level one and regain elimination status, but that won’t happen overnight: even after we stop seeing new cases it’ll take time and extensive testing to be sure the virus is once more under control.

A key action from government now is to ensure that people who need to go into isolation or quarantine are supported to do so, including financial support and help with practicalities like food shopping. We won’t get on top of outbreaks if people who should be isolating are forced to keep going in to work so they can feed their families.

Dr Amanda Kvalsvig is senior research fellow, Department of Public Health, University of Otago Wellington

Michael Plank: Why swift, decisive action is so crucial

The fact that these new cases have no known link to international travel or people working at the border makes the situation more serious. This means there could be several links in the chain and a larger number of cases that we don’t yet know about. That’s why it’s important to take swift, decisive action and move the whole of Auckland to alert level three as soon as possible. As the prime minister also said, the fact that the four cases have several different workplaces in different suburbs means this needs to apply to the whole super city. Melbourne initially attempted to lockdown specific suburbs and it didn’t work.

The rest of the country in alert level two should also be very cautious. It’s quite possible a case we don’t yet know about has travelled outside of Auckland and it would be easy for the virus to spread. So everyone needs to get back to social distancing, work from home if you can, wear a mask if you need to go out, and get tested if you feel sick.

If we do the right things now, there’s a good chance we will be able to contain this outbreak before it spreads too much further.

Professor Michael Plank is based at Te Pūnaha Matatini and the University of Canterbury

Andrew Chen: A contact tracing wake-up call

The announcement of four new cases in the community is a timely reminder that we all need to be engaged with contact tracing processes. We don’t need to panic, but it reiterates the message that Covid-19 can reappear and we will need to continue to maintain and collect contact tracing records for awhile. This means keeping good records of who we have been in close contact with, and where we don’t know who the people around us are, keeping records of where we have been at what times. When new cases appear in the community, contact tracers will want at least two weeks worth of records to help them identify who else may have been exposed to the virus.

There are a number of tools that you can use to help collect and record this information. The most important is the government’s NZ Covid Tracer app, which can help you keep logs of your movements by allowing you to scan QR codes for businesses. Registering for the app provides the Ministry of Health with up-to-date contact details in case they need to call you, which is already helpful in itself. Importantly, the app can also be used to help notify you if your logs indicate that you have been in the same place at the same time as someone infected with Covid-19 (through an exposure notification mechanism). The app helps contact tracers notify people more quickly, which can help reduce the spread of the disease if people then isolate or get tested more quickly too. This may be especially important in cases where there may be a lot of possible contacts, and the manual approach of calling each person may take too long. The app now also has a manual entry functionality that allows users to enter records for places that do not have QR codes available. Based on the design of the app and the rules governing how the data is handled, the privacy risk is very low and it should be safe to use.

If you cannot or do not want to use the NZ Covid Tracer app, there are other digital tools that can be helpful, such as turning on Google Maps Timeline on Android smartphones, using other QR code or location tracking apps like Rippl, or taking photos of the buildings that you enter (which will automatically have a timestamp associated with it). A pen and paper diary method is also fine for keeping your own records. These are still valuable in the event that you are diagnosed with COVID-19 and need to provide information on your close contacts to a contact tracer. However, it is important to note that these methods will not allow the Ministry of Health to automatically inform you about exposure risks relevant to you.

This is also a timely reminder that businesses should display the NZ Covid Tracer QR code, so that their customers and visitors can easily add to their records. This is an important part of protecting both your customers as well as your employees, so that they can be identified and notified quickly in the event that there is an exposure risk.

Dr Andrew Chen is research fellow, Koi Tū: The Centre for Informed Futures, The University of Auckland

Jacqui Maguire: Dealing with anxiety

Tonight’s announcement of community transmission without a located source is likely to raise a number of emotions, especially for those in Auckland. Anxiety, fear, anger and disappointment are likely.

It is important to remember that emotions evolved to provide us with information that could help us make sense of our experiences and guide our behaviour. For example, anxiety alerts us that we are facing a threat and need to act in a way that ensures survival. What does this mean right now – wash your hands, cough into your elbow and if you are in Auckland stick to your bubble. Disappointment signals we have lost something meaningful to us – in this instance our liberty. Take that disappointment and use it as motivation to stick to the rules. Turning away from or suppressing your emotional reactions will only intensify them.

New Zealand will need time to emotionally and cognitively adjust to this announcement. Hold compassion and kindness for yourself and others as you adjust, reach out and offer support to those around you. Take one day at a time, practice your wellbeing strategies and hold the hope that we will get through this together.

Jacqui Maguire is a registered clinical psychologist

David Welch: Genetic surveillance is essential

In order to find the source of these latest cases, or any future community transmission, an important tool we have is genetic surveillance. This means that all positive swabs should immediately be sent for genetic sequencing, whether they are found at the border or in the community. The community cases can then be compared to all other cases to find a close match, which would suggest a likely chain of transmission, and aid contact tracing.

Genetic surveillance has been occurring but not all positive samples are being sent for sequencing, and sometimes the delay in sending in samples is considerable. Several sequencing labs are available and ready to sequence any samples at short notice with a rapid turnaround.

Dr David Welch is based at the School of Computer Science and Centre for Computational Evolution, University of Auckland

Dougal Sutherland: Planning gives us back control

Many New Zealanders will be responding to the announcement of returning to lockdown levels two or three with fear, anxiety, or even anger. This is normal. We experience these emotions when we are under threat. And we are under threat again.

Left unchecked fear and anxiety will drive our behaviour. We may act without thinking clearly and panic or lash out. But we don’t have to be ruled by our fear.

The first thing people should do is stop and take a deep breath. Pause and notice how we’re feeling. Once we’re calm, remember that we’ve done this before. We can remind ourselves of what levels two and three were like and what we did to get through them. Then make some plans. Planning gives us back a sense of control. Cancel those non-urgent appointments and buy yourself some time.

Get into the habit of regularly checking in on yourself. How are your anxiety or anger levels now? Do I need to do something to help soothe myself again?

We’ve done it before and we can do it again – even though it’s really, really annoying to have to do it again!

Dr Dougal Sutherland is a clinical psychologist at Victoria University of Wellington and Umbrella Wellbeing

Lesley Gray: Essential measures for all of us

It is vital that people review their own non-pharmaceutical intervention strategies (hand hygiene, physical distancing, contact tracing methods and now, please add in a cloth/fabric mask to your strategies – if in Auckland please wear a mask if you need to access essential services during this time. This is a strategy to minimise possible aerosol spread. The Covid-19 virus is tiny, but it is carried on saliva and it is the saliva that is trapped in layers of fabric, thus reducing the aerosol droplet spread.

If people believe these strategies can be effective they are more likely to use them. In lockdown level four, there was a high belief in the effectiveness of masks (which is great). For contact tracing apps in level three there was low indication of uptake and this is borne out by the figures released by government earlier this week. If less than 700,000 have installed the app – how many of those have never used it, if the app has only been activated some 2 million times in total?

Lesley Gray is senior lecturer, Department of Primary Health Care & General Practice, University of Otago

 




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