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Jacinda Ardern and Ashley Bloomfield have been lauded for the elimination approach. (Photo by Hagen Hopkins/Getty Images)
Jacinda Ardern and Ashley Bloomfield have been lauded for the elimination approach. (Photo by Hagen Hopkins/Getty Images)

OPINIONSocietyAugust 24, 2020

Decision day: The key factors Ardern and cabinet will consider in making a call on alert levels

Jacinda Ardern and Ashley Bloomfield have been lauded for the elimination approach. (Photo by Hagen Hopkins/Getty Images)
Jacinda Ardern and Ashley Bloomfield have been lauded for the elimination approach. (Photo by Hagen Hopkins/Getty Images)

What are the criteria and the scenarios, and when will the alert level decision be announced?

On day 13 of Auckland’s alert level three lockdown and the rest of New Zealand’s level two restrictions, Jacinda Ardern and her cabinet meet today to make important decisions about when those statuses will change – and to what.

Cabinet is expected to meet in the early afternoon, with the director general of health, Ashley Bloomfield, presenting his advice on changes. Cabinet will then make its decision, with the prime minister addressing a media briefing at around 3pm to deliver the news.

There are two categories of decision making, both for Auckland and the rest of the country. First, do we move out of the existing settings, as planned, at 11.59pm on Wednesday? Second, to what?

At her media conference on Friday, Ardern laid out “eight factors that we have in place to make alert level decisions”. The first four are “key health measures”, and the second four are “broader measures”.

Let’s walk through those factors – before considering what might play out.

1. Trends in the transmission of the virus, including the director general’s confidence in the data

The day’s case numbers, typically revealed at 1pm, relate to information compiled up to 9am that morning. Bloomfield and co will have the most up to date data as they go into cabinet, but if it is consistent with recent trends then things are looking promising.

Yesterday, just one case was detected in the community, linked to the known cluster. (There were two detected in MIQ, or managed isolation and quarantine facilities; they’re not an issue as far as this consideration is concerned.)

Ardern and Bloomfield have both stated that the new case count does not need to have hit zero to move out of the current levels. That said, however, puzzles remain around a couple of transmissions in Auckland, and the source of the outbreak itself remains a mystery.

They will also look at genomic sequence information – which offers an indication about the links of transmission, and statistical modelling, such as that led by Shaun Hendy of Te Pūnaha Matatini.

Hendy told RNZ last night: “We don’t want to see these numbers rising but we just do need to put it in context that this is quite a large, sprawling cluster that’s really touched lots of different parts of Auckland so it’ll be a while before we get confidence and certainty that we’ve found the edges of this cluster and there’s no more undetected transmission taking place.”

He added: “They will be looking at a more complete data set than I have access to. Having said that, I would prefer them to be cautious – there’s still a reasonable chance of undetected transmission out there, even though we have had very, very high testing rates over the last week and that will give them confidence.”

2. The capacity and capability of our testing and contact tracing system

There has been a marked improvement in both these categories since the original outbreak. Since the new cluster formed the total number of tests conducted is closing in on an extraordinary 200,000. The previously elusive “gold star” contact tracing system – which requires 80% of close contacts to be reached and isolated within 48 hours of notification – is now in place. Last week the figure hit was 84%.

The more visible app-based part of contact tracing is a complement to this core Public Health Unit system, but it, too, has picked up, after being essentially dormant while the country bathed in level one. More than 1,712,000 users are now registered with the Covid Tracer app and more than 300,000 QR code posters have been generated.

3. The effectiveness of isolation, quarantine and border measures

Issues around testing, protocols for air crew and maritime workers, and staffing of hotel facilities have all been raised in recent weeks. While serious shortcomings have been identified, the system for the most part operates well. That has been bolstered – thanks to the scrutiny – with more army personnel being brought in, a tighter testing regime introduced and power-pair Heather Simpson and Brian Roche enlisted as troubleshooters. Anyone who tests positive and their households will now, in almost all cases, be admitted to the quarantine facility, Jet Park hotel.

4. Capacity in the health system more generally

There is currently no exceptional pressure on the health system.

5. Effects on local economies

The Auckland Business Chamber is pushing hard for a move to alert level two for the region at the end of play on Wednesday. Reports yesterday that 89% of Auckland businesses are drawing on the wage subsidy underscore the pressures on what is easily New Zealand’s biggest city.

6. Effect on at-risk populations

There is high confidence that the virus is not at large. There remain risks in Auckland, however, particularly as non-close-contact transmissions appear to have taken place, such as via an elevator and a bus.

7. How people have been following the rules

Google data – and anecdata – indicates that people in Auckland are a little more complacent than last time around. Mask wearing remains inconsistent.

8. The ability to operationalise a new alert level

This shouldn’t present any great challenge when moving down a rung, but there remains the real prospect of redesigned, or intermediary, levels. That will take a bit of time to install and communicate.

Levels 2.5 and 1.5?

There has been much talk in recent days about recalibration of the alert levels – or halfway points that might be assigned. This is less than ideal in terms of the communications effort: the beauty of the alert system lies in its familiarity and clarity. And yet in practice there have been tweaks all the way through – the scaffold of the alert level system can bear changes.

Central to the idea of a 2.5 is releasing Auckland from lockdown but keeping a short-term backstop of the regional border. Ardern has said she believes the virus is “encircled” in Auckland. If restrictions are to be reduced substantially in the rest of the country, keeping accursed Aucklanders out would be a temporary safety net. And remember, last time the country went from level three to two, it came with temporary restrictions on bars and gathering sizes.

As for 1.5? Bloomfield has himself raised the possibility of some additional measures, including reduced gathering sizes, distancing requirements, and mask wearing obligations. Just imagine if the recent outbreak had seeped its way into a packed Spark Arena or Eden Park. The version of alert level one we enjoyed in recent months is unlikely to be seen again for some time.

How might it play out?

Without laying eyes on the latest data and modelling it is difficult to predict, but it’s a reasonable punt that a measured and cautious approach will again prevail: extend the current settings for four days, pushing level three in Auckland and level two in the rest of the country till the end of the weekend, with the shape of revised levels two and one to be outlined later this week in advance of the switch. That would offer the confidence that any remaining embers could be snuffed out, while extending the lockdown by two business days.

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