New Zealand COVID-19 Briefing Transcript April 14

Ashley Bloomfield: (00:00) [Foreign Language 00:00:29]. Welcome to today's briefing. Today I'm very, very sad to report four additional deaths linked to the COVID-19 infection. One of those was in Wellington and three additional deaths from the Rosewood cluster in Christchurch. This brings the total number of deaths in New Zealand to nine, six of which involved Rosewood residents being cared for at Burwood Hospital. The deaths I'm updating you on today are of a man in his 90s at Burwood hospital, a man in his 80s at Burwood, another man in his 90s at Burwood, and the fourth death was of a man in his seventies in Wellington Hospital and that latter death was associated with overseas travel. Ashley Bloomfield: (01:18) We've previously signaled the underlying vulnerabilities of the Rosewood residence and that this group would continue to be at risk. That does not make today's news any less sad. This is the largest number of deaths we have reported on any day in New Zealand from COVID-19 and it is a sobering reminder of what is at stake here. I do want to acknowledge the families associated with these people who have passed and offer my sympathy and those, I think, of all New Zealanders and our support with their husbands, partners, fathers, grandfathers, brothers, uncles, cousins or friends, wherever they fit in their wider farno, we are thinking of them and of you. Ashley Bloomfield: (02:02) I do ask that the privacy of the families and friends associated with these deaths continues to be respected and what I can say is that of the folk who died in Rosewood yesterday, they all had underlying conditions to some degree and were all confirmed cases of COVID-19. The man in Wellington was admitted to hospital on the 22nd of March and has been quite unwell in ICU for some time. The district health board and staff have been working very closely with the man and his family over the time and will continue, of course, to provide support to the family. Ashley Bloomfield: (02:41) As I've said earlier on previous briefings, the Rosewood group was transferred from a high-level psychogeriatric or dementia unit. The care they have been receiving is very consistent with the high-level of care they were receiving at Rosewood and would have been provided there and that does include end-of-life and palliative care. Ashley Bloomfield: (03:03) Just before I make some more general remarks about what we are doing and how we are working closely with the aged residential care sector, I just wanted to pass on some feedback we've had today from a family of a Rosewood resident at Burwood who could not speak highly enough of the nursing staff. Quoting, "They are just amazing, doing an incredible job. The communication with us was superb. We had lots of calls including FaceTime calls with dad. We are so grateful." From another of the families, "We couldn't speak more highly of the staff and care dad received both at Burwood and at Rosewood. They Skyped with dad and the nurse caring for him arranged for him to see a video the family had put together and there were lots of phone calls." Ashley Bloomfield: (03:47) We know that aged residential care settings and facilities are very vulnerable. The populations there are very vulnerable if we get COVID-19 infection in those facilities. We have been particularly vigilant from early on in the presentation of this infection globally to work closely with aged residential care and act very quickly and preemptively. What I would say is that we've had cases to date or have cases in six aged residential care facilities around the country and this is out of a total of over 650 facilities nationwide. Ashley Bloomfield: (04:33) I mentioned yesterday and in the preceding day that the excellent care and preparation that has in place across that sector and the fact that we have had relatively few of our facilities affected by this virus in quite a stark contrast to many other countries, I think, is testament to the work they have been doing. Again, to emphasize, we've been working with them very closely from early on in this outbreak. We, early on, provided advice around ensuring nobody came to their facilities who had any respiratory symptoms at all. They put in place visitor policies, no visiting policies much sooner than we went into Alert Level 4. Ashley Bloomfield: (05:20) So, I'd just like to outline some of the other measures we are working with them on, just so people understand. Every new arrival into an aged residential care facility goes into isolation for 14 days. There are no shared meals happening in the facilities. As I said earlier on and for some time, no visiting allowed at the moment. I've asked all our DHBs to work with each of the facilities in their region to ensure they have good policies, procedures, that they have access to PPE that they need and good supply lines and to identify what other support those facilities may need to help ensure we keep that high level of care and of preventing COVID-19 getting into those facilities. Ashley Bloomfield: (06:08) There is a low threshold for testing of any residents who might be symptomatic and of any new arrivals. If they have any symptoms whatsoever, a precautionary approach is taken. They are tested and they're not allowed into the facility unless they have tested negative and also a low threshold for testing staff. Obviously staff who are sick have to stay home and there's very careful observation of any symptoms of staff. Ashley Bloomfield: (06:37) In addition, we're doing a number of other things and last night I was on a video conference with the head of the Aged Care Association, both the Chair and the Chief Executive to talk about what else we are doing and can be doing with them. There will be an announcement later in the week about funding for aged residential care to help offset some of the additional costs that are incurring to both prepare and look after people who may have or who do have COVID-19 for extra security and so on. Ashley Bloomfield: (07:07) We continue to work with them on making sure we are maximizing the value of testing of both residents, of incoming admissions and of staff. I have also decided to commission a review of the rest home facilities, or the aged residential care facilities, where we have had cases because in some of those instances the cases have been able to be bounded very quickly with no further transmission and others we've seen just how tricky this virus is and that it can spread quite rapidly. Ashley Bloomfield: (07:41) We think it's a very good point in time to to undertake a review of both the facilities where we have had cases to learn about what's worked well and where we could improve, but also to look at some facilities that might be similar where they haven't had cases. My hope is to do this in conjunction with the Aged Care Association so we can use those learnings to inform both what the facilities are doing and also what ourselves as a ministry and the district health boards can continue to do to support them. Ashley Bloomfield: (08:15) I'll just move on now to the cases for the day. Just finding the right piece of paper here. Today, the total number of COVID-19 cases increases by 17. This comprises eight new confirmed cases and nine new probable cases. There are now 628 cases of COVID-19 infection that we can confirm have recovered, an increase of 82 on yesterday's number. Our recovered cases, clearly, now firmly dominate the cases overall. Ashley Bloomfield: (08:57) The new total combined number of confirmed and probable cases, therefore, today is 1,366. Today, there are 15 people in hospital, no change from yesterday. That includes three people in ICU, one each in Middlemore, Dunedin and North Shore hospitals. The person in Dunedin Hospital remains in a critical condition. 48% of cases involve contact with a confirmed case in New Zealand, including those in our clusters, while 39% have a link with overseas travel. Those that can be ascribed to community transmission is still just at 2%. Ashley Bloomfield: (09:37) Yesterday 1,572 tests were processed, which is again a low number. The rolling seven day average is just over 3,000, 3,039 and in total 64,399 tests have been undertaken. Just to comment on that, at this morning's select committee hearing, the CVD Select Committee, the committee heard from Professor Brendan Murphy who's the chief medical officer in Australia. As part of his comments, he also commented on the quite big reduction in testing that has been happening in Australia over the last few days. Like me, he ascribed this to the fact that because they've got quite wide social physical distancing measures and people staying at home, there were just less respiratory viruses circulating in the community of all sorts. It's interesting to see that Australia is seeing a similar pattern to us and a big reduction also in testing there. Ashley Bloomfield: (10:36) So saying, I've sent a message out to all our DHBs today and we now have 70 community-based assessment centers, and I've suggested that they have a low threshold for testing anyone with respiratory symptoms over this coming week so that we can be sure that anyone with respiratory symptoms is not due to COVID-19. Our expectation is the cases will continue to remain low, but we want to be doubly sure, of course, that we are finding any cases that could be out there. Ashley Bloomfield: (11:03) I want to be doubly sure of course that we are finding any cases that could be out there. You may well also have seen the reports that a number of DHBs are now using mobile testing as well to get out to communities who may not have direct access to those [inaudible 00:11:14]. So I think I'll just leave my opening comments there and I'm happy to open it up to questions. Speaker 3: (11:23) [crosstalk 00:11:23] There have been reports that patients at Burwood have been effectively left alone to die. Can you confirm it? Ashley Bloomfield: (11:32) Well that certainly doesn't match with the comments I just shared from families of people who are being cared for, they're I think in stark contrast. So that's certainly not anything that's been reported to me. Speaker 3: (11:41) Can you talk about palliative or end of life care? They're basically just being kept in a comfortable position before they die. Is that right? Ashley Bloomfield: (11:49) So end of life and palliative care is a very important part of the care that is provided in aged residential care facilities. Just to put this in context, about a third of our deaths each year annually in New Zealand happen in age residential care facilities, and the staff in those facilities are very well trained in end of life and palliative care, and the residents who've been moved there would have been receiving that sort of care in this situation at Rosewood and they are receiving very good quality care in Burwood. Speaker 4: (12:18) Can you explain why the patients who have been moved to Burwood from Rosewood are so overrepresented in the number of people who have died? Ashley Bloomfield: (12:30) So two comments there. First of all, of course the deaths that are occurring now are a result of infections that happened at least a week, mostly one, two, even three weeks ago. Secondly, it's simply because this is a population that is where the people are older. As I mentioned today, two people in their nineties, one in their eighties, they're already frail. They have very low reserves to be able to fight off these sorts of infections. So that's why we are seeing highly represented in the fatalities. Speaker 4: (13:04) Were they chosen specifically to be moved to Burwood? Was the most vulnerable group out of that group shifted? Ashley Bloomfield: (13:12) It was because the infection was in the group that was in that psychogeriatric care unit that is part of a bigger facility. So there were no people which is effectively closed off from the rest of the facility, and because of the high needs and also because there were infections among staff members, it wasn't possible for them to keep staffing it and provide the level of care and support that was needed for those people who are probable or confirmed cases. So that was the reason for shifting that group to Burwood. Speaker 4: (13:42) [crosstalk 00:13:42] Can I ask about that review as well that you talked about? Is that because you think that things might not have been done properly in some of these situations? Ashley Bloomfield: (13:52) More specifically, it's to look at, again, just to put this in context, we've had a relatively small number of age residential care facilities affected, and that's testament, I think, to the work that has gone on right across the sector to prevent infections getting in in the first place. I think it's just good practice and now's a good time to do it. As we're informing what we need to be doing as we move out of alert level three, sorry, level four down to a level three, and I think there will be things we can learn from what has happened both in the facilities where there have been cases, and also comparing those with some facilities where they haven't just to help strengthen and improve our efforts. Speaker 5: (14:35) Do you personally don't think it's acceptable of the hospital management to be telling nurses that they can't wear a mask at work? Ashley Bloomfield: (14:44) If there's a specific example you can provide me, I'm happy to follow up on that. Speaker 5: (14:48) Yeah, we've heard of multiple examples of that happening. So is that acceptable to you? Ashley Bloomfield: (14:52) Well, I think what is really clear as the advice that district health boards have got and the message that has gone out, and I know that our district health board managers are very aware of what that advice is, and I'm confident that they will be using that advice to inform their conversations with staff. Speaker 5: (15:12) A nurse at Burwood Hospital working on the COVID ward told us that she doesn't have access to foot protection or hair cover. Would you personally be comfortable to go on the COVID ward at Burwood Hospital without full PPE? Ashley Bloomfield: (15:23) So I can't really talk about that specific example, but I'd be happy to look into that. The PPE that's generally required, it doesn't always include hair cover or foot covers, so I'd have to check as to what the situation was that that nurse was working in as to whether those were indicated. What I am confident is that the staff, they will have access to the PPE they need, depending on the role they're playing. Speaker 5: (15:48) But given that this is where a number of our most vulnerable patients are with COVID-19, shouldn't the full equipment be provided to those on the frontline? Ashley Bloomfield: (15:58) Yes, and I'd be confident it would be. And what I can comment on is what the full equipment might be for their particular staff member and the role that he or she may be in it at the time. Speaker 6: (16:11) More than a third of the new cases between Wednesday and Sunday were of healthcare workers. How concerned are you about that jump in numbers and what does that suggest, if anything, about transmission within hospitals or other healthcare facilities? Ashley Bloomfield: (16:27) Yes, thanks for that. Well, I'm concerned about any case in a healthcare worker, particularly where it happens in the workplace. And a couple of comments, one is we've got some information about the cases that are healthcare workers, and what I've asked the team for particular analysis solvers of the cases that have happened in the workplace, how was it that they were infected? So was that through being part of caring for someone or involved in the care of someone with COVID-19, or was it because they are part of a cluster where they may be a close contact of another staff member? I think that's the important thing. And then by understanding that, we can get a better understanding of what else we may need to do to help ensure that our staff are protected in whatever setting. Speaker 6: (17:15) We've gone from the high eighties of new cases down to the high teens. Is it your perspective that New Zealand's past the peak of new cases? Ashley Bloomfield: (17:22) I think it's clear that we are past the peak under this alert level. The key information we're looking for now is for each of those new cases, we want to know very quickly where have they come from? And if we can't immediately link them to an extent, case or cluster, then we need to do a pretty forensic analysis and find out very quickly where they've come from, and have a very quick and close look at all the possible contacts there, and put a ring fence around it. So yes, we've passed the peak. That seems to be clear now. We will be more confident once we know about each of those new cases that has been appearing really from the last week and as we go into this week. And also if we continue to get reasonable testing rates of people with any symptoms, and we're still not finding additional cases, that will provide us with even greater level of assurance. Speaker 6: (18:13) Looking forward, when do you think, or based on the modeling that you've seen, when we're going to get to down to a level of maybe just nine or 10, or maybe one or two, three or four? Ashley Bloomfield: (18:23) Well, as soon as possible obviously is what I would be looking for. And once we get down to not just the low number of cases, but confident that through our testing, we're not identifying further cases that seem to be popping up out of nowhere, rather than being linked to existing cases. That's what we're really looking for. Speaker 7: (18:44) This morning on the select committee, you spoke about testing in regions. What can you tell us more about that and when it started or has it started and where to? Ashley Bloomfield: (18:52) Yes. So the testing analysis we published last week, I've asked the team to get another extract today so we can update that. As last week it was about 49,000 tests that they had analyzed. Actually it showed quite good spread across the regions with some lower testing rates in some regions, particularly Whanganui District Health Board and Tairawhiti District Health Board. So we are looking to get the numbers of testing up there, and really, there's good access to [inaudible 00:19:18] and I know that both DHBs have been making sure that testing is widely available. Ashley Bloomfield: (19:24) What I've said to them and to all DHBs is just have a really low threshold. So anyone with respiratory symptoms, with upper respiratory symptoms, which could just be a sore throat, or a runny nose, test those people anyway. They don't necessarily have to have lower respiratory tract symptoms, or cough, or phlegm, or fever. Speaker 8: (19:47) [crosstalk 00:19:47] The man who passed away in Wellington Hospital, was he related to the Ruby Princess incident at all? Ashley Bloomfield: (19:55) No, he wasn't. Speaker 8: (19:57) And the Ruby Princess cluster grew by two on Monday to 18. The two new cases are not in the Hawke's Bay, I understand. So are those new cases people who were passengers on the ship or are they believed to have been evicted by the ship passengers or crew? Ashley Bloomfield: (20:10) The information I have, and this was from yesterday, was that it was actually, I think a tour guide, and a household contact of that tour guide, and is from Wellington. Speaker 9: (20:23) [inaudible 00:20:23] says Cabinet could be playing Russian roulette with Kiwi lives and making a decision on the COVID-19 lockdown if we don't ensure rapid contact tracing and complete surveillance testing. How confident are you that we won't be in a risky sort of unclear position come Monday? Ashley Bloomfield: (20:39) Well, we will make sure that we can provide really robust advice to Cabinet, and we that we are confident in the extent of, and the pace of our contact tracing, and we've got some analysis coming through about what the current speed is with which people are who our contacts, are identified and tested, and we've seen that time decline. I'm just waiting for the final information on that. And likewise, I think Professor Sir David talked about the surveillance testing and making sure that we've been very deliberate about getting wide testing across a range of population groups, and that's why we're increasing the testing this week to compliment the over 60,000 that we've already tested. So it's about 1.1% of New Zealanders have been tested already, and we're going to try and increase that through there just to get a really good picture. Speaker 10: (21:35) [crosstalk 00:21:35] Can you confirm that the private function cluster in Auckland was a stag party? Ashley Bloomfield: (21:41) That's my understanding. Speaker 10: (21:43) Can I ask about contact tracing? Way back in the day when we had a small number of cases, you were able to do this to 100% accuracy or the people with contacts. Do you have a rough figure for how many contacts are being traced now, as we've got so many more cases? Ashley Bloomfield: (21:58) That we've got so many more cases, did you say. Speaker 10: (22:00) Well, we've already got like 1400 cases or something like that. Ashley Bloomfield: (22:02) Right. Speaker 10: (22:02) I'm talking about when we had 50- Reporter: (22:03) Well, we've got like 1400 cases or something like that. Ashley Bloomfield: (22:03) Right. Reporter: (22:03) I'm talking about when we had 50 cases, you were able to trace all the contacts with 100% accuracy. Do you have a rough figure, ballpark figure on how many contacts you're able to trace now? Ashley Bloomfield: (22:11) That we were able to trace now, so we we're able to trace, well, we've got 220 staff available to trace, so we would have the capacity to trace around between 50 and a hundred new cases per day. I would say the capacity now is around a hundred. What I can say is that of course, our number of cases per day is now much smaller and also the number of close contacts is on average around four to five rather than what was a much higher number before the alert level four restrictions came in. Ashley Bloomfield: (22:38) So far, that closest contacts center has traced several thousand people, but that's over the two to three weeks since they were, since it was stood up. [crosstalk 00:22:49] Oh, sorry, follow-up question. Reporter: (22:50) Just regarding the app, the idea that we're going to develop this app and it's going to test, do, do a lot of that contact tracing for you through Bluetooth. How many percent of people will need to take that up that app in your view for that to be effective? Ashley Bloomfield: (23:02) Yep. Just to pick up the point about trace a lot of the people. Actually, it will be very much supplementary. The fundamental way to identify and trace close contacts will still be the routine process we have, which will be better because we'll have that electronic and be able to link it to NHI. The Bluetooth and other apps will be supplementary to that. Ashley Bloomfield: (23:25) Professor Murphy talked about this because Australia is looking at this and their view is they would need to have over 80% of people using that technology. Now, that doesn't mean necessarily they need to be using a single app, but they need to be using an app which can use that Bluetooth type technology and exchange of information so that when a case is identified, you can pull out the data from the person's phone to find out what other phones they may have been close to during the infectious period. Reporter: (23:58) [crosstalk 00:01:58]. Tell me the man who died last night at Burwood. Want to know why they couldn't put on PPE gear and be with him in his final moments? Ashley Bloomfield: (24:06) Yeah, so I think this goes to the issue of the current approach under level four, which is not to allow visitors to people in hospital. And you know, this is clearly a very distressing time for family members. And this is something I've asked my team to look at very specifically is about the visiting policy for people who, not just dying, but others in hospital and what, in another example raised with me this morning in select committee of course, is new mothers, as well. And so, I think we are having another look at that and to see, what are the things we could put in place to ensure that we could maintain the safety of both the person in hospital, as well as the visitors and the staff there? That's being actively looked at. Reporter: (24:53) [crosstalk 00:02:55]. Also, just a follow-up on that. Does the- Reporter: (24:53) [crosstalk 00:02:56]. Distribution models are supposed to be rolled out, so has that gone according to plan? And can you give us a little bit more detail how that will exactly work? Ashley Bloomfield: (25:03) I can't give you a lot of detail. I'm sorry. What I can say is that there are two elements to that national distribution. There's the national... The distribution from a single point out to the district health boards in the health sector. From there, they distribute on to the providers in their area. And then, separately there's a single distribution network for non-health care essential worker organizations and that is happening in parallel to ensure that essential workforces who need PPE for their work are able to get it and it's distributed out through that mechanism. Reporter: (25:40) The follow-up on that today is planned, is that now being rolled out? Ashley Bloomfield: (25:44) That's my understanding. But I will check that and make, we'll make sure we include that in our media release that goes out subsequently. Reporter: (25:51) Any updates that are just on the charter flights that were supposed to be bringing stocks in? Do you have any numbers on how many flights have come in and what they've been bringing in? Ashley Bloomfield: (26:00) Oh, PPA? Reporter: (26:00) Yeah, of PPA. Ashley Bloomfield: (26:03) What I can say is that there was the order of the, I think the 40 million masks and they have started to come in this week. So yes, they're on the way. We'll get some more detail about the exact flights and when they are arriving. Reporter: (26:15) A follow-up on the earlier question, if you change the criteria around PPA for family members who are, have a loved one with COVID in a critical condition, do you recognize how devastating that will be for the families who weren't able to be there with their loved ones who have died today? Ashley Bloomfield: (26:33) Well, I think regardless of whether the policy has changed, it clearly has a big impact on families and I can absolutely understand that. That's one of the reasons why we want to look at it very specifically. The key priority here- Reporter: (26:47) But shouldn't that have been done much sooner, then? Ashley Bloomfield: (26:51) We have all been doing things under alert level four that we felt were necessary to break the chain of transmission and stop for the whole country. The sort of situation we've seen in other countries that haven't acted quickly and gone quite hard as we have because you end up with a much bigger problem and it's not just access to loved ones. It's the fact that we end up with many, many more cases and many, many more deaths. Ashley Bloomfield: (27:20) I really, you know I genuinely, for someone who has had two parents, both parents pass away. I absolutely understand how people must be feeling and that is why we are looking specifically at that policy. Reporter: (27:33) [crosstalk 00:27:34]. Dr. Bloomfield, you mentioned the Whanganui DHB and Tairawhiti DHB is two DHBs with low testing. You said yesterday that the Tairawhiti was one of the areas with low total cases of COVID-19, is it possible that those low cases could actually be higher but it's not identified because of the low testing in that area? Ashley Bloomfield: (27:56) It's possible. The testing rate is, the testing numbers and rate are lower and the positivity rate is lower. And I know that DHB is putting in place a number of, is going to some lengths to go out and ensure that there is testing available to try and increase the number of tests. That's exactly what we want to rule out. We want to be sure that we're not missing cases. Reporter: (28:20) And so, what the Tairawhiti DHB, what would you put down to in the [inaudible 00:28:26] why would their testing be lower than other DHBs? Ashley Bloomfield: (28:31) I think the main reason for this as they simply have a lower number of cases, and that is because most of, well, arguably, well, actually all of our cases have been associated with either people coming in from overseas and/or spread from those people. All of our cases, the ultimately, the index case was an import from overseas. I think it's just there has been less traveled to those regions, particularly early on when we saw cases popping up in other places like in Auckland, like in Queenstown or associated with events like the wedding in Bluff, where the link was to overseas travel, as well. Ashley Bloomfield: (29:09) I think that's the reason, but we want to be assured that that is that there are not cases out there that we're missing and that's why we're doing the testing. Reporter: (29:17) For a number of days now, you've been saying that this event in Auckland couldn't be named because of privacy reasons. However, today that you've outlined that it was a stag party. What changed to make you be able to tell us what exactly it was? Ashley Bloomfield: (29:28) Well, that doesn't change what it was. It was a private event. I was specifically asked the question and I replied, because I knew the information. Reporter: (29:35) [crosstalk 00:07:37]. Will you name the latest rest home in Auckland that has a cluster? Ashley Bloomfield: (29:41) No, I can't and I don't have the name of that rest home. What I can say though, is that that cluster includes, half the cases are involved in a rest home and half are in the community. And what's not clear is just yet quite the relationship between that and whether it originated in the rest home or just happens to involve a rest home. As soon as we think it's appropriate, we will name the rest home for facility. Reporter: (30:05) You mean you'll tell us the number of cases and the condition of patients at the rest home? Ashley Bloomfield: (30:12) I don't have that information. Sorry. Reporter: (30:13) [crosstalk 00:08:13]. Just a follow-up question. Will you be providing rest homes with testing kits? Ashley Bloomfield: (30:19) Not testing kits, per se. As I said, we've, we're having a very active discussion about appropriate use of testing, very low threshold for testing and they wouldn't need to have the testing kits, per se. They may do the swabbing there or they may need someone to come in and do the swabbing. The testing would be done at one of our laboratories and low threshold for testing any symptomatic resident, low threshold for testing any admission who may have symptoms and also staff who may have any symptoms suggestive of COVID-19. Reporter: (30:51) [crosstalk 00:30:51] swabbing and rest homes. Ashley Bloomfield: (30:52) Sorry, would it make? Reporter: (30:53) Would it make sense to do widespread swabbing in rest homes? Ashley Bloomfield: (30:56) It does if you've got an outbreak, but clearly we've got the vast majority of our have our age-residential care facilities have not had COVID-19 cases. They've got excellent policies and procedures in place and we'll keep working with them to make sure we keep that the situation. Reporter: (31:12) You worked for the World Health Organization previously, to what extent do you think it's post-SARS guidance around border closures, specifically, that they weren't effective in dealing with the spread of that virus influenced any nations sort of delaying border closures in response to COVID-19? And with the benefit of hindsight, do you think it was a mistake for countries or WHO to lean on that post-SARS advice? Ashley Bloomfield: (31:40) That's quite a big question. What I will say is that early on in this outbreak, even before it was declared as a pandemic, WHO was asking countries to be thoughtful about the role of border closures, but still saying, "It's also up to you." Ashley Bloomfield: (32:01) And we saw many countries, in fact, implemented border closures. New Zealand was one of those, as was Australia and a number of other countries. What also became apparent, and one of the reasons our advice to the government and the government moved quite quickly around the use of border restrictions and then closures is because it was quite, it became clear that this virus was quite different to the SARS virus in terms of its infectivity. Ashley Bloomfield: (32:27) And what we've seen both here and overseas is that it can spread so rapidly and it's quite tricky as a virus. And so, I think what is clear is that border closures have been a really important part of countries, including our own, being able to maintain a very strong, keep it out, stamp it out approach. I'm sure WHO will continue to review its own advice on this and also inform its future advice around this managing these sorts of situations globally. Reporter: (32:56) [crosstalk 00:32:56] That patient that you mentioned in the North Shore in ICU, do you know the age of that person? Ashley Bloomfield: (33:02) No, I don't have any more detail- Ashley Bloomfield: (33:03) No, I don't have any more details on any of the people in ICU. I'm sorry. Speaker 13: (33:07) Can anything be done, and should anything be done, about the unused capacity that's opening up as the number of tests that's being done declines? Ashley Bloomfield: (33:17) What I can say is it's very good we've got the capacity we need because testing will continue to be a really important part of our ability to stay confidently in lower levels of alert, so three or even two, if we are able to test rapidly and identify early any cases of COVID-19. That would be, again, moving to having a low threshold for testing anyone who's got respiratory symptoms, we've now got capacity to do over 6,000 tests, should they be needed. Speaker 13: (33:51) So I suppose if we can do 6,000, we're doing 1,000. You're not thinking about every day putting that 5,000 window to use somewhere, or opening up the program? Ashley Bloomfield: (34:02) Not for testing asymptomatic people. What we now have is a situation where we've got capacity to test pretty much anyone who has got symptoms of a respiratory illness, so a low threshold for testing, and that is the most important. And also, to have capacity to do quite wide testing where we get cases where we're not sure what's going on, and particularly in settings like a healthcare setting. Speaker 12: (34:26) [crosstalk 00:34:29]. Ashley Bloomfield: (34:31) Sorry. Speaker 12: (34:32) Would you encourage people with very minor symptoms then to go and get tested? Ashley Bloomfield: (34:37) Well, if anyone's got symptoms that they think may be suggestive, then there's always a clinical assessment, but I think a low threshold. I think the clinician will always apply some judgment in these situations. If it's very clear there's actually no risk of COVID-19 and the symptoms are not in the slightest bit suggestive. But at the moment, we would rather over-test than under-test, quite clearly. Speaker 14: (35:01) That's why the two people from Burwood weren't sent to ICU in Christchurch? Ashley Bloomfield: (35:07) Weren't sent to ICU? Because they and their families, in discussion with clinicians and in fact probably with the facility they were already in, would have already made a decision about whether they wanted active intervention including ICU type care if they got into the situation. And as I say, a third of people every year in New Zealand die in age residential care facilities and the care they receive is appropriate for where they are and the decisions they've made about what sort of care they would like to receive. Ashley Bloomfield: (35:37) There's a question in the back? Speaker 15: (35:37) Does the frailty of the residents at Burwood Hospital the risk time residents who were taken there, does it really limit the medical interventions that can be made? Ashley Bloomfield: (35:48) Those [crosstalk 00:35:50] people would receive all the medical interventions and care that was appropriate for them to both relieve symptoms and, if appropriate, to treat their illness. However, they will have already had an agreement in place, and I should say also just a reminder, that the medical care for those residents, while they are been looked after at Burwood, is still being overseen by the general practitioner who looks after them when they would look after them if they were still at Rosewood. [crosstalk 00:36:21] Sorry. Just come here. Speaker 16: (36:21) Just a follow up to Craig's question with the large [inaudible 00:36:26] testing. What's your message to the public? If you have a runny nose or a tickly throat, you should go and get tested? Ashley Bloomfield: (36:31) Well, the advice to the public is if you have any symptoms you are concerned about, ring Healthline, ring your GP or you can go to the Seabeck. The locations of those are made available. That doesn't mean you will automatically be tested, but as I said, the message out to those running the [inaudible 00:36:51] have a low threshold for testing. Anyone with upper respiratory tract symptoms or lower respiratory tract symptoms. Speaker 17: (36:57) Do you know roughly how many people were at that stage then? Ashley Bloomfield: (36:58) I don't. Sorry. Speaker 18: (37:02) Do you know how many in New Zealand staff have tested positive for COVID-19? Ashley Bloomfield: (37:07) No, I don't have that number. Would you like us to get that number? Yes, we can. We can find it. Speaker 18: (37:11) Do you have wide concerns about airline staff is potential [inaudible 00:37:15]? Ashley Bloomfield: (37:15) I don't have concerns. What I have asked my team to look at is specifically, now we have the very strong border restrictions in place with every person who travels and other than airline staff, going into 14 days quarantine effectively to make sure that our position around how airline staff... What precautions they have to take are still appropriate. Having looked at the advice for airline staff, which is very thorough, I think the precautions are appropriate to reduce the risk of them being infected and or introducing infection into the country. Perhaps the last couple of questions? Speaker 14: (37:52) You spoke this morning about ethnicity testing. Can you tell us a bit more about that and a bit about how Sentinel testing planning for that is going? Ashley Bloomfield: (38:01) Okay. On ethnicity. What we've seen from the testing to date is it's quite good coverage across the different ethnic groups. It's not exactly in proportion to the population, but it's quite close. We will be looking over this next week for a good spread of testing by both region and by ethnicity, to make sure that we are not under testing in certain populations. And the issue of Sentinel testing is an interesting one and I'm intending to follow up with Professor Murphy from Australia about what approach they are planning to take to Sentinel testing. At the moment the wide testing we are doing and especially if we essentially are testing most people who have respiratory symptoms, you could argue as, in a way, almost population Sentinel testing. The question is still about whether there is a need to test people without symptoms and none of the advice we've received from all of the experts is that we should be doing that at this point. So it's really having a low threshold for testing anybody with even low level symptoms. Speaker 19: (39:07) Are you totally ruling out in the future testing asymptomatic people? Ashley Bloomfield: (39:11) Not at all. No. That may well play a place in the future and maybe in two ways. It could be with the diagnostic testing. That in particular, once we get antibody testing, that could play a role in looking to test people who we think... Or to see what level of past infection there has been in the population or to find out whether someone has been infected and therefore is over an infection. Speaker 20: (39:39) You said you have no concerns about airline stuff. Have you seen that report that an airline staffer might be the index case in the Bluff cluster and if that's the case, shouldn't that person have simply stayed at home if they had symptoms? Ashley Bloomfield: (39:39) Yeah, I don't think I said I have no concerns about airline staff. I think what we need to do is make sure that airlines staff... The measures that they are taking are protecting both them and ensuring we're not introducing cases into the country. That's going to be very important. In the case of the Bluff cluster, what I can say is I know that the infection there originated from overseas, but I don't have enough information as to say whether it was one or another person or what the occupation of the person was. Speaker 20: (40:28) [crosstalk 00:40:28] comment on, this morning Australia says that they are able to contact trace cases within two to three days. Ashley Bloomfield: (40:33) Mm-hmm (affirmative). Speaker 20: (40:35) Do you have an idea of when New Zealand will be at that capacity and do we need to be at their capacity before lockdown is lifted? Ashley Bloomfield: (40:41) Yes, we are. We're at that capacity now and we're at their capacity with the current number of cases or even more. What we want to make sure is that we have that capacity to do that even if we have a much larger number of cases and that's why we've trained the extra people and also why we are looking at the digital solutions as well. Ashley Bloomfield: (41:01) Look, thank you very much. I appreciate your ongoing trust and support.