Dr Ashley Bloomfield: The fight against COVID-19 will continue for many months to come

coronavirus 29/04/2020

The fight against COVID-19 will continue for many months to come, but New Zealand's ability to combat the respiratory illness has come a long way, the Director-General of Health says.

Although Aotearoa transitioned out of full-scale lockdown on Monday night, and has seen dwindling case numbers and no widespread community transmission, the Prime Minister and Director-General of Health Dr Ashley Bloomfield continue to emphasise that we are not out of the woods yet. One case left unchecked could lead to a large outbreak.

The World Health Organization's Western Pacific region response manager Dr Abdi Mahamud told RNZ on Wednesday that New Zealand's response "had been one of the strongest in the world" with clear Government leadership, a whole of society approach and decisions based on science. 

But he also warned people not to become complacent, saying it will be a "long, long battle" until a vaccine is developed and social distancing, like what is being practised in New Zealand, will be required until that happens. 

Dr Bloomfield echoed those points on The AM Show on Wednesday, saying Kiwis need to recognise there is still a long road ahead even though we are seeing some reassuring results.

"We are not there yet. You would have heard me talk yesterday about the fact this is a sustained effort over many, many months," he said.

"It is impossible to say that there is [no community transmission],  but we are very confident that it is unlikely. We are finding that every case we are seeing each day is linked to an existing case and... despite testing a lot of people, we are not finding cases out there unexpectedly, which is very reassuring."

New Zealand has recorded 1472 cases of the virus and seen 19 deaths. On Tuesday, there were just three cases reported, with two able to be quickly linked to existing cases or clusters. There are also 1214 recovered cases, far more than active.

Dr Bloomfield says New Zealand has made good progress in a number of areas key to combatting the virus' spread and limiting the chance of another outbreak.

Modelling provided to the Ministry of Health and the Government in March prior to the lockdown predicted that if no significant action was taken to limit the spread of the SARS-CoV-2 virus, tens of thousands of people would need to be hospitalised.

Due to the lockdown and compliance of New Zealanders, that hasn't eventuated, with only nine people currently in hospital with the virus and one in an intensive care unit (ICU).

Before the lockdown, New Zealand had about 200 ICU beds, Dr Bloomfield said, but that was able to be increased in case of the worse. 

"At its peak, we had four or five people in intensive care. We never needed to use all of our ICU beds or even much of a proportion of them. You always have to prepare for the worst, which we did, but then we acted to head that off," Dr Bloomfield told The AM Show.

Contact tracing is a similar story. A report by Dr Ayesha Verrall earlier this month found that the country's ability to contact trace - a crucial part of the war on COVID-19 - wasn't up to standard. This was largely due to limits on public health units (PHU), which have since been expanded with investment from the Government. A national close contact service has also been developed to support the PHUs.

Dr Bloomfield explained that means New Zealand's capacity grew from having the ability to trace the contacts of about 50 cases to 185. With further investment, it could grow to 300. Between April 13 and 17, 80 percent of close contacts were contacted within 48 hours, better than the benchmark of 72 hours. 

"[A] really huge improvement in performance there and that is where we want to be. We are continuing to build capacity, both out in our public health units around the country, all 12 of them, but also here at the Ministry to make sure we can support them with our national contact tracing service."

Work also remains underway on developing a phone application which could help with contact tracing. Other countries, such as Australia, have already rolled these out.

Sustaining these efforts will also be crucial in case there is a large spike in cases under alert level 3. If we continue to follow the rules and respect the need for physical distancing, Dr Bloomfield is confident though that we could see greater freedoms relatively soon.

"We are on track for alert level 2, which will open things up even further. The key ingredient for us to get to alert level 2 as soon as possible… is how people behave under alert level 3, because we will need to maintain that going into alert level 2, especially the physical distancing, that is going to be fundamental to us staying on top of this," he said.

There have been concerns though about the distribution of personal protective equipment to medical professionals. Dr Bloomfield has previously said New Zealand has plenty of equipment and DHBs are following guidelines when providing access to it. The Auditor-General has launched an investigation into the management of stock, something the Director-General has welcomed.

Dr Bloomfield has pushed back on Wednesday against any suggestion New Zealand went too far with the lockdown, causing significant damage to the economy.

"I don't think we went too hard. If you look at countries overseas, you can see what the alternative is. When we made the decision, or the Government made the decision and the advice was pretty clear from us, you looked at all the countries where it got out of hand, they had to go into lockdown anyway, and what's more, they are staying in lockdown longer than we have," he told The AM Show.

Australia is regularly pointed to as having similar COVID-19 cases and deaths per capita to New Zealand without the need for a full lockdown as Aotearoa imposed. However, the hospitalisation rate in Australia is much higher and its restrictions - similar to what New Zealand is now under - are expected to last for several months.