As infections, hospitalisations and deaths slowly tick up once again, let’s review where we stand.

New Zealand is experiencing a fifth wave of Covid-19 infections, with case numbers rising once again as we head towards the summer holidays. But those under 30 are still not eligible for a second booster and most people under 65 aren’t easily able to access preventative antiviral medication.

With very limited mandatory protections in place, and without regular updates (or a new government to answer questions), here’s the situation as the country gears up for infection-friendly Christmas shopping, extended family gatherings and summer music festivals.

What the numbers tell us

While most of us have stopped paying attention to regular Covid case updates, Te Whatu Ora hasn’t. The health agency’s latest update showed an increase in the average number of cases and deaths being reported week-on-week, while hospitalisations had also surged. 

The seven-day rolling average of new infections was 849, with the total number of new cases at 5,947. That’s up from 5,872 the week before. (These numbers are likely to be under-reported. Did you log your infection the last time you got Covid?)

There were 284 people in hospital with Covid-19 as of midnight Sunday, compared to 212 at the same time one week earlier.

The rolling average number of deaths was five, with the overall Covid death toll rising by 27.

Professor Michael Baker, one of the country’s leading Covid communicators, told RNZ this week that these were the highest hospitalisation figures in six months and that wastewater testing had resulted in the highest detection rate for Covid since January. “The wastewater testing…doesn’t depend on human behaviour, and this is showing a really big uptick in detections of the virus across the country at the moment,” he said.

“So we’re very much having this fifth wave of infection at the moment.”

What may have caused the wave?

Baker put it down in part to the removal of mandatory self-isolation requirements back in August. This change meant that while it remained recommended to isolate if sick with Covid-19, there was no legal requirement to do so. In effect, Covid-19 would be treated in the same manner as any other illness – if you really want to risk making other people sick, it’s up to you and not the government. August also marked the end of mandatory face masks in healthcare facilities.

At the time, prime minister Chris Hipkins acknowledged the “significant milestone” and said the restrictions had been moved due to a decreased public health risk.

Another potential explanation for the increase in cases could be that people may be due another Covid-19 booster. 

Speaking of, what’s the latest with vaccinations?

There may be a new wave of Covid infections, but little has changed in recent months when it comes to booster accessibility. Practically everyone remains eligible for an initial course of the Covid-19 vaccine – everyone over the age of five, and those younger in select circumstances. Those over the age of 16 can get a booster, and teens above the age of 12 can also get one if they are at increased risk of severe illness.

Aren’t more boosters key?

Now that we are several years into the pandemic it’s all about renewing the vaccine’s protections via repeated booster shots. Think about how you might get another flu vaccination every year. 

Except not everyone is eligible for more than one booster shot and there’s no suggestion these rules will be loosened anytime soon. As it stands, if you are 30 years of age and over, you can have a booster regardless of the number of boosters you have already had, though official advice is that you should wait at least six months between shots.

If you are under 30, you can only get a second booster in select circumstances such as if you are pregnant or at risk of illness. 

Shouldn’t we be changing the eligibility now we’re heading into another wave?

It may not be necessary, at least according to Pharmac. The drug agency’s pharmaceuticals director Geraldine MacGibbon told The Spinoff that the current vaccine eligibility criteria had been recommended back in February and remained valid. But, she said, it could be altered again in the near future. “Pharmac recently received clinical advice on the current and future Covid-19 vaccine eligibility from our Immunisation Advisory Committee. These records are still in draft, and we will share the record of this meeting on our website when it becomes available,” she said.

“We would consult publicly if any changes were proposed in the future that would affect people’s access to Covid-19 vaccines.”

According to MacGibbon, and as noted by the Covid-19 technical advisory group at the start of this year, the benefits of a second dose for healthy people under the age of 30 years was “less certain”. 

That being said, in Australia for example, all adults over 18 can get another booster so long as it has been at least six months since their last. In fact, earlier this year it was recommended that all adults, albeit particularly those with risk factors, consider getting another vaccine dose.

How is uptake tracking?

There’s still a slow but steady trickle of first and second dose vaccinations, most likely as a result of people becoming eligible. Over 90% of the eligible 12-plus age group have completed their primary course and 72.8% of those over 18 have received a first booster.

However, just over half – 55% – of those over the age of 50 have received a second booster. For those between the age of 50 and 64, just 38.4% have received a second booster, while those over the age of 65 have been more proactive at getting the dose – 71% have received a second booster, according to Te Whatu Ora.

But what about other treatments?

Vaccination isn’t the only treatment – a range of preventative antiviral treatments are now available. In New Zealand the currently available medications are Paxlovid and Lagevrio (previously some patients were able to access Molnupiravir, but this is no longer offered).

Despite their wide availability around the world, in New Zealand these antivirals are still only available to select demographic groups. These include those over 65 (or over 50 if you are Māori or Pasifika) or if you have certain health conditions such as sickle cell disease.

“The access criteria for Covid-19 antiviral treatments have been designed to target New Zealanders most at risk of severe illness and death as a result of Covid-19 infection,” MacGibbon told The Spinoff.

“The access criteria are informed by clinical advice from our Covid-19 Treatments Advisory Group and available evidence regarding the effectiveness of the treatments and information on risk factors for severe disease.”

This criteria was regularly reviewed and updated, she said, most recently at the start of October this year when access was extended to disabled people and people with one or more health conditions that have resulted in severe frailty.

Are we alone in our new wave?

No, other countries are also reporting an increase in Covid-19 infections. In Australia, for example, they have judged a renewed surge in part by an increase in prescriptions for antivirals like Paxlovid. 

The UK experienced a new wave about a month ago, reported the BBC, with hospitalisations tripling in the three months to September. There were also reports of a fresh wave in Singapore and, slightly earlier in the year, the United States. 

Cool. 

Yeah. Just remember, even though it’s not mandatory any more, stay home if you are unwell and take a test. Rapid antigen tests are free until the end of February at least.