Mystery COVID-19 Case In Auckland – Expert Reaction

The Ministry of Health has provided more details on Auckland’s new community case of COVID-19.

The student in her 20s was one of three cases announced at the afternoon media briefing today. Three close contacts have been identified so far, all of whom are currently well. Her job at A-Z Collections involves customer interaction, and although she received advice to isolate, she went to work and wore a mask after speaking with her manager.

Her apartment building is close to the Grand Millennium managed isolation facility, which had a fire alarm evacuation on Monday night. But the Ministry of Health said that is not likely to be the source of the infection because the woman became symptomatic earlier that day.

The source of the infection remains unknown. Her swab is currently undergoing genome sequencing at ESR, and results are expected tomorrow.

The SMC asked experts to comment on this update.

Lesley Gray, Senior Lecturer, Department of Primary Health Care & General Practice, University of Otago, comments:

“Reports indicate this latest community case first felt unwell on 9 November, was tested on 10 November, but went to work despite advice to isolate by the Public Health Service to isolate pending test results. I would urge anyone with symptoms/waiting for test results or thinking they might have been in the same locations to self-isolate – do not go to work while waiting.

“There are a number of locations visited by this new community case reported today, and so anyone who visited these locations must arrange to get tested and must isolate at home pending results. Now is not the time for complacency. All Downtown Auckland workers have been asked to work from home if possible tomorrow.

“Notwithstanding the source for the current Auckland community case, there are important questions to be addressed in terms of disaster preparation for the MIQ facilities. Given where we live, there is likelihood of concurrence of two or more hazards, which introduces complexity and amplifies uncertainty.

“Reports of mingling between residents of an MIQ facility and members of the public following a fire alarm on Monday evening raises several questions. Why did the MIQ facility not have adequate disaster risk reduction plans in place for e.g. fire, flood, earthquake, volcano risk? And why were there insufficient barrier measures to contain the MIQ residents, far enough away from the ‘risk’ but also away from interaction with Auckland residents? This does bring into question the suitability of current facilities for multiple hazards management.”

Conflict of interest statement: Lesley Gray recently completed HRC/MoH Rapid Response grant (HRC 20/990).

The Ministry of Health has announced two new community cases of COVID-19: one in Auckland, and one in Wellington.

The Wellington case is connected to the November quarantine cluster. The case in Auckland is under investigation, with no known link to the border or any managed isolation facility. This person went to work at the A to Z Collection store on High Street while waiting for the results of their test, which returned positive today.

The SMC asked experts to comment. Earlier comments on the November quarantine cluster are available here.

Associate Professor Siouxsie Wiles, School of Biological Sciences, University of Auckland, comments:

“The latest announcement of a community case of unknown origin in Auckland just highlights the importance of every one of us doing our bit to ensure that any virus that does get through our border controls doesn’t turn into a large cluster.

“While at Alert Level 1, we should all be using the app, wearing a mask on public transport, and getting tested and self-isolating if we experience any symptoms that could be COVID-19. The pandemic is growing exponentially overseas so we will likely see more and more people arriving in New Zealand incubating the virus. Quickly identifying any community cases means we should be able to stop any outbreaks using testing, contact tracing, and isolation rather than having to move up the Alert Levels.”

No conflict of interest.

Lesley Gray, Senior Lecturer, Department of Primary Health Care & General Practice, University of Otago, comments:

“From what information we have available about the Auckland community case it seems a little troubling that there is no obvious links to earlier cases.

“I was travelling (between Wellington and Christchurch) earlier this week and it was very interesting to note minimal use of the hand sanitisers placed in many public areas, little apparent scans or check ins with the Covid-tracer app at the airport, and I only saw one person mask wearing in Wellington domestic terminal and 3-4 people wearing masks in Christchurch. Both airports were busy, lots of people around and flights pretty full both ways.

“People need to think about their movements going back as far as last Friday. While we may recall ‘key points’ of our movements, can you list out every place you were? Every bannister you touched, every door you opened with your hand, every customer in a coffee shop? We will learn more about these community case contacts movements in the coming day.

“We are fortunate to live in a country with such low case numbers, and very few cases in the community. However, to spell it out – we all have to be prepared for the possibility of a community case who perhaps may be asymptomatic and therefore will be going about their day to day routines, just like you and I.

“For now, I would urge government to make mask wearing mandatory on public transport (buses, trains, flights etc.) and to remind everyone that the main protections we have for ourselves currently have not changed: hand hygiene, physical distances when out and about, mask wearing and knowing where you have been using the tracer app. Manual entries are fine, but the tracer app helps notify others in the same locations quickest, should there be a case in your area. None of us want Alert Level rises, and many will have great plans for summer outdoors.”

Conflict of interest statement: Lesley Gray recently completed HRC/MoH Rapid Response grant (HRC 20/990).

Professor Shaun Hendy, Director of Te Pūnaha Matatini, comments:

“The new community case in the Auckland CBD is quite concerning. At this stage, the case has no clear links to the border, so we are in a similar situation to that we faced in August. The individual concerned sought a test after developing symptoms, but continued to go to work at the A-Z Collections store this week. Anyone in Auckland, particularly anyone who has been in the Auckland CBD in the last two weeks, should seek a test if they have any of the symptoms associated with COVID-19. Anyone who has visited A-Z Collections this week should self-isolate and seek a test.

“As public health officials have yet to identify any link to the border or to an MIQ facility, there is the possibility that we will face a rise in Alert Levels as we did in August. Hopefully we will learn more at the press conference later this afternoon. Contact tracing and/or genomics may yet link this to one of the recent cases that have arisen in MIQ workers and this would mean we are facing a much more contained situation than we were in August. But if a link can’t be established then we may be looking at a larger outbreak and this might require raising the Alert Level in Auckland.

“Both our testing rates and use of the app are higher than they were in early August, so I think we are likely in a better position now than we were then. Nonetheless, it is important that we all remain vigilant, especially those in the Auckland region.”

Conflict of interest statement: Te Pūnaha Matatini is funded by the TEC, but is also currently working under an MBIE contract to supply COVID-19 modelling to government.

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