The COVID-19 outbreak in New Zealand is an evolving situation.

Cases are rising and testing is ramping up.

Currently there are 53 confirmed cases of the virus in this country.

Prior to today’s update at midday, Simon Shepherd began by asking Director-general of health Dr Ashley Bloomfield about the 11 cases announced on Friday.

Simon Shepherd: 11 new cases on Friday, links to travel for most, five tests are still being investigated. That seems a bit ambiguous. Does that mean there’s unconfirmed community transmission?

Ashley Bloomfield: Yes, well, as I said at my stand-up yesterday, some of the results are coming through in the morning before we do the update, usually early afternoon and until we’ve got all the information and there’s been a very detailed interview with each of those cases, it’s difficult for us to confirm whether or not there’s a link to overseas travel. So when I do my update later today, I’ll be able to talk about those cases that came through yesterday morning. Now, one of the good things about the fact that we’re getting those tests through the next day is it’s because there is a big increase in testing happening and so the labs are running a number of batches during the day and some of those into the evening. So we don’t get the results till the following morning.

OK, great. Well, I’d like to talk about the testing in a moment. We are expecting community transmission to be confirmed. So when that happens, what exact changes will that trigger?

Well, if we find there is community transmission, obviously we will continue to do our contact-tracing as part of identifying cases, close contacts, and self-isolation. But we will then think about putting in place other measures to help avoid further transmission in the community and we’ve already seen at the moment people being encouraged to look at their plans for, for example, working from home. We’ve been putting out really strong messages about physical distancing. And I think we’ve seen people respond really well to that. There’s been the advice this week and the strengthening of expectations around large gatherings, so no more than 500 outside or 100 inside. But some of the other things we can do to help increase physical distancing may be, for example, asking some shops to close or asking restaurants and bars to close, could be further down the track.

Yep, all right. What about, we’ve just had the Education Minister on the show and he’s talking about potential plans for geographical lockdown. I mean, what could that look like? Would that mean that domestic travel out of the region would be not allowed?

Well, that could be an option and one of the ways, if we think we’ve got localized community spread, would be to constrain movement in and out of a region and also to ask anyone who had been in that region, but is now elsewhere in the country, to go into self-isolation, so that could be a very effective way of not only stopping transmission in that community, but preventing any further onward transmission elsewhere in the country.

And is that what you’re expecting to happen first – a geographical lockdown – and how close are we to that?

Well, at the moment, we haven’t got any confirmed cases of community transmission. So it’s hard to say how close we are. What we have got is very well-developed thinking and plans about what that might look like and that, indeed, as you say, could mean constraining travel in and out of a region. It could mean thinking about a geographical closure of schools and other educational institutions. It could mean stopping shops and pubs and cafes from opening. So all these options are on the table. The key aim of course here being to stop that wider community transmission.

What do you say to people that seem to be ignoring the advice or even the laws around gathering of more than 100 people? I talk about church services. We’ve had the Destiny Church saying it’s going ahead despite the ban. I mean, what do you say to them?

Well, actually, I think the Destiny Church will be rethinking. That was earlier in the week. I know during the week a number of denominations have called off all church services for the time being. Very responsible, I think. Not just to their parishioners, but also to the wider community. And we also know that the Government does have powers to enforce the 100 maximum on gatherings. So if needs be, those powers will be used.

OK. The Education Minister also on the show just confirmed that children who have been taken out of school by their parents perhaps are posing a greater risk to the community because they’re unsupervised. What should be done by that, because they can’t be contacted and traced if they’re not in school?

Well, I think the important thing, whether children are in school or out of school or, indeed, whether adults are at work or working from home, the key thing here is to maintain that physical distancing and make sure that we can reduce the likelihood of transmission, whether it’s between children in a school setting, whether it’s in the family home, because that’s where we’ve seen, for example, in China, most of the transmission was happening inside family homes, and even in New Zealand we’ve seen a number of related cases inside individual homes. The advantage of children being at school, as you’ve said, is we then know where they were and if we do need to do contact-tracing and self-isolation, we can do that. And we had an example of that during the week at Logan Park High School where we were able to quickly identify 150 close contacts and, not only that, we took the decision to test them and were able to reassure both that school community and the wider community that there weren’t at that point any wider positive cases.

OK, so you mention the ramp-up of testing just a little bit earlier. You say we have the capacity heading towards 1500 tests a day. We have 30,000 test kits in stock, I understand. That’s what you said. So, worst case scenario, that would only last a maximum of 20 days. Is that enough?

So, yes, I didn’t give the number of 30,000, but we’ve been working very hard over the last two or three days to ensure the supply of the test kids, and that includes the swabs and the reagent that the laboratories use to run the test and there’s a lot of work going on. We have different machines in different laboratories. But what I can say is we’re comfortable we’ve secured a really good supply there.

OK, what can you tell us about that? We’ve got more coming? Who’s actually going to sell this stuff to us around the world, because everybody wants it?

That’s right, they do want it. But we do have good supply chains and there is reagent on its way to New Zealand when we have been able to also secure additional kits out of Singapore, which is great. So, it is important we can do the testing of everyone who needs testing and that’s one of the ways we can find cases early and then contain. And also, it gives us a view, for example, the last couple of days there have been around 1,000 tests both days, we know the number of positive tests from yesterday – we added the 11 in – so if we think about that, about 1% of tests are positive at the moment. For the ones we had information on, there’s that link to overseas travel. So it’s giving us a really good picture of knowing when – and early - we might have community transmission occurring, so that’s encouraging.

OK, you’ve just ramped the testing up to 1000 a day, but earlier this week a total was 530 that had been done – I think Monday or Tuesday. So do you think that we haven’t been aggressive enough in the testing that the criteria has been too restrictive and that we don’t really have the full picture of COVID-19 in our community?

Well, what we were doing was getting good technical advice on the case definition and that changed very regularly as more information became available from overseas and also as we had an idea of what the risk was in New Zealand. I think the increase in testing in the last few days and the increase in cases, all reflecting people who have travelled back – many of them aiming to get back to New Zealand – and of course coming from a wider range of areas that have got outbreaks – particularly Europe and the USA – whereas prior to that there wasn’t those outbreaks in those other countries.

OK, talk about the restriction on who can come now. So it’s just citizens and residents. Do you believe that we’re a little bit behind on this? Did we go too late, because we’ve got these incidents of tourists travelling round the South Island not self-isolating? Have we missed an opportunity there?

Well, New Zealand’s actually one of the countries that’s led the world on travel restrictions. Right from early on there was the restriction in place from China. Iran was added very quickly, before, I think, every other country. We’ve then strengthened those restrictions and then further strengthening later this week to exclude even visitors, so I think we’ve been proactive in ensuring we’re sealing the border. These are big decisions. This is the first time ever this decision’s been taken at the border. So they’re not small decisions. I think we’ve been very alert and we’ve responded at the right time.

I appreciate that these are very big decisions and have massive impacts on communities and the economy, but still, since the travel restrictions were announced and then came into effect on Monday, arrivals at Auckland Airport were still in the thousands per day. They don’t know the exact numbers, but they were down 44% on normal level. That’s still about 7,000 a day. Is 7,000 a day a missed opportunity to keep COVID-19 under control?

Two things there. First of all, the arrivals have dropped precipitously during the week, so they’re much, much lower now. The second thing is that people coming through the airport – it’s really clear what the expectation is around them to declare any symptoms that they might have. A couple of days ago there were over 100 people assessed at Auckland Airport who either had symptoms or it wasn’t clear that they might have symptoms. They were assessed by nursing staff. But everyone coming through is not just clear about what is expected of them, but they know they have to go into self-isolation for 14 days. Where they seem to have an objection, then there is a conversation there and then and they have to show evidence that they intend to self-isolate and again we’ve seen some people who haven’t done that have been visited by the police and arrangements made.

All right, let’s just talk about equipment again. You mention that you’re sourcing some stuff from Singapore. Can you tell us exactly how many tests we are going to have for the community? I don’t know where the 30,000 figure came from, but that is a miniscule amount of the population.

The important thing here is that we test the right people. Because not only is it the test kits, of course, our laboratory staff need to make sure that we are not wearing them out either. And so we need to make sure that we’re doing the tests on the right people. We have seen an increase in testing. I’m confident in the supply of the test kits. But we also need to make sure that we continue to test the right people and we are finding the cases and not just testing people, for example, who don’t have symptoms.

What about personal protective equipment for medical staff? Various news stories come in. Somebody told me a DHB – they only had two weeks. You said yesterday that some masks had actually perished whilst they had been in storage. How many masks did you lose? Are you confident that we have enough of personal protective equipment for the health staff?

That’s an area I am confident in and I can say that because since 2009, when we had the Swine Flu pandemic, we have maintained and rotated out of our national store, a very large supply of personal protective equipment, including the 18 million masks. And not only that, we do have mask production on shore and that can produce around 200,000 masks a day. So that’s an area I think we’re well covered. Yes, some DHBs did find that their stores they had set aside had expired, and we’ve been able to replace those.

Was that a lot of equipment that expired?

I don’t know the exact details, but the important thing is we were able to replace that and so all DHBs either have or have access to all the PPE that they will need.

All right, just finally, a lot of the response to COVID-19 has changed recently because of the paper that was done by London’s Imperial College. So, we were flattening a curve. Now we’re talking about a wave of curves we have to deal with. But they say that this could go to 12 to 18 months, until a vaccine is available. Is that the picture that you’re seeing for New Zealand?

It is the picture and we need to be ready to be in this for a long haul. If we want to avoid that really large peak that would lead to a high number of cases and potentially create real problems for our healthcare system, we’ve got time to ensure that we can follow that longer course. We need to go early and make sure that we keep that peak below the health system capacity and that’s the course of action that we’re taking.

Dr Ashley Bloomfield, we appreciate the work you’re doing and your time this morning. Thank you very much.