A leading epidemiologist says Aotearoa New Zealand has no idea how many community cases of covid-19 there are in the country because so many people are not recording their rapid antigen test (RAT) results.

University of Auckland Professor Rod Jackson said an upgrade of the testing system and My Covid Record is desperately needed.

His comments follow the leak of a memo from the Northern Region Health Co-ordination Centre (NRHCC) to health providers in the Auckland region on March 26.

The memo states:

“The MoH shared the following with us this week: in the last month we have distributed 50 million RATs into the system and so far less than 1 million results have been reported.”

The memo goes on to mention the increased number of false positives and negatives that occur with RATs (compared to PCRs) and the need to shift towards more PCR testing immediately.

Professor Jackson said the fact that so many people are not recording their covid-19 RAT results means the Ministry of Health’s daily case numbers are meaningless.

“Those numbers clearly demonstrate that expecting people to report the results of self-administered RAT tests was never going to happen on a consistent basis,” he said. “They are only reliable if they are done by trained people and recorded.”

Looking at hospitalisations
Professor Jackson said he did not even even look at the daily case numbers.

“I look at the hospitalisations and, sadly, the number of deaths,” he said.

But Professor Jackson said, in the middle of an omicron outbreak, a switch back to PCR testing might not be feasible due to the sheer number of people who would need to be tested.

“And my concern is people have got so used to easy access to RATs and now they wouldn’t want to wait in line.”

He said RATs are a tool to help slow down the spread of omicron, but their accuracy can be as low as 50 percent.

Auckland University associate professor of public health and Associate Dean Pacific Dr Collin Tukuitonga agrees that poor recording of RAT results highlights the shortcomings of the Ministry of Health’s daily case numbers.

“The reality is we have no idea of the real numbers because people are either not getting tested or, if they are, they aren’t recording their results,” he said.

Real case numbers far higher
“Some people say the real case numbers could be two or even four times higher.”

He said looking at the overall trend shows case numbers are declining in Auckland.

“But in terms of absolute numbers, we have no idea.”

A Ministry of Health spokeswoman said it has continued to monitor and review its approach to testing throughout the outbreak.

She said RATs are the ministry’s preferred testing method as they can be done at home, the results are available quickly and, when people upload their results, they provide an insight into the spread and size of an outbreak.

“We are still undertaking some PCR testing. However, this is mainly focused on priority populations and those individuals who are at higher risk of the effects from covid-19.”

According to the Ministry of Health, from February 22 to April 4 it has distributed 61.6 million RATs nationwide and between December 13 and April 5, a total of 1,614,110 million results have been recorded.

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Bridges is National’s spokesperson for finance and infrastructure.

Kanongataá-Suisuiki said in a Facebook post that she had tested positive on a day 3 test of home isolation, after her daughter had contracted the coronavirus.

In a social media post, she said she had lost her sense of smell and taste, but was “feeling ok”.

Last week, Environment Minister David Parker reported testing positive, and said he had minor symptoms and was “not feeling too bad”.

He had not been in the Beehive since the previous week, so was not with other MPs or staff while infectious, he said.

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Education Minister Chris Hipkins has warned that nearly every New Zealand school and early childhood centre will have contact with covid-19 in the next few weeks.

He told students at Mana College in Porirua today that one in five schools were already managing cases among students or staff but they were well prepared.

“We’re now up to one in five schools [which] have covid-19 cases in them and that’s going to just continue to increase from here,” he said.

“We expect in the next few weeks that just about every school, every early childhood service potentially is going to end up coming into contact with covid-19 as it spreads more rapidly throughout the community. That is now going to happen,” he said.

His comments came as the Ministry of Health reported an almost doubling of new community cases to 12,011, with five further deaths — the highest number in a single day taking the total to 61.

Yesterday’s number was 6137 cases.

In a statement, the Ministry of Health said 8223 of the positive results came from Rapid Antigen Tests (RATs), while 3807 were PCR tests.

There are currently 237 people in hospital with the coronavirus, including three in intensive care.

92% of students vaccinated
Hipkins said 92 percent of secondary students were fully vaccinated, the government had 42 million facemasks on order or in the country for schools, and it was expecting 5000 air purifiers for rooms with poor ventilation.

He also said schools might get easier access to rapid antigen tests after two large orders arrived in the next two weeks.

Currently the tests were a last resort for teachers who were isolating and whose schools could not find enough teachers to safely supervise children who could not be at home, such as the children of essential workers.

“In another week or two we will have a greater supply of rapid antigen tests in the country and at that point we may be able to say actually we can be a bit more generous than that and we can provide tests in a few more circumstances than that including for what we call surveillance which is just to give you reassurance that it’s not out there,” Hipkins said.

Auckland Secondary Principals Association president Steve Hargreaves said that could make a big difference as the pandemic bites.

“That’ll help keep schools open.

“Schools are having to roster year levels home and children are having to learn remotely because so many staff are tied up as close contacts, family members have test positive but they’re still well, they’ve been able to isolate successfully at home and if we can keep those teachers in schools through the use of rapid antigen tests, that’ll be good for our children.”

After-school sport
Hipkins also promised to clarify the rules around unvaccinated children’s participation in after-school sport and cultural activities.

The Education Ministry’s website said there were no limits on curriculum-related activities like PE classes, but extra-curricular events like team training at schools must be limited to 25 people if any were unvaccinated and 100 if all were vaccinated.

Hipkins said that was not the government’s intention.

“Some schools are interpreting something like a kapa haka rehearsal after school hours or sports after school hours as being included in the guidance.

“We’d never intended for that to be the case so we’re clarifying that so to make it clear that if you’re participating in a school-organised activity, that includes sports, kapa haka, those other cultural events, the vaccine requirement will not apply,” he said.

The minister’s office and the ministry were unable to confirm details and Hargreaves said that was a shame, because he had unvaccinated students ready to play sport tomorrow.

“It’s really sad because we don’t want to exclude any children from these great extra-curricular opportunities but we’ve been following the guidelines around events, gatherings and those size limits and of course College Sport Auckland has its rule around needing to be vaccinated to comply with those rules and that’s blocked a few kids from playing and the sooner we can get this tidied up the better,” he said.

More detail needed
School Sport New Zealand chief executive Mike Summerell said he wanted to see more detail but allowing more unvaccinated children to play sport would be good.

“We welcome the news. It’s been a divisive and difficult time for sport and for schools in terms of inter-school activity but the announcement this morning means more kids are going to have access to sport where over the last few months they haven’t so that’s a real positive,” he said.

He said the change would not be enough to return big regional sports tournaments to the calendar because they involved more than 100 people.

This article is republished under a community partnership agreement with RNZ.

Covid-19 will be in ‘just about every school’ soon – Hipkins https://t.co/6095x7BEfX

— RNZ News (@rnz_news) February 25, 2022

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Rising covid-19 cases at the border are increasing the risk of the omicron variant spreading in Aotearoa but a leading epidemiologist says the country still has time to prepare for an outbreak.

Today there were 43 covid-19 cases identified at the border, a jump from 23 cases yesterday, and the Ministry of Health believes the majority are omicron.

But New Zealand still has time to keep omicron out and prepare the population before the virus enters the community, says University of Melbourne epidemiologist Professor Tony Blakely, originally from New Zealand.

Looking at New South Wales probably hitting its peak with omicron cases, he told RNZ Morning Report there were lessons for New Zealand to better manage an outbreak.

He said there was a huge “five-fold” undercount of cases because those infected with omicron were more likely to be asymptomatic. There could be up to 180,000 infections a day, he said.

His explanation for nearing the peak was: “It makes sense because of that number of infections per day … the virus exhausts the number of people it can infect because you’re chewing up all the susceptibles.”

He said there was a massive shortage of rapid antigen tests in Australia which was “just appalling”, thereby disrupting employment and the supply chain.

‘Flipping lessons to NZ’
“So flipping this to lessons for New Zealand: Get heaps of rapid antigen tests in before you get omicron and change your surveillance systems, or at least have them ready to go to pivot to being less reliant on PCR when the numbers of omicron go up.

“And follow some of the UK example of getting some free rapid antigen tests out towards citizens who have got some ready for when omicron arrives.”

He said New Zealand could take a few more steps to keeping covid-19 out because it had “the advantage of learning from pretty much every other country”.

“Try and keep the borders really strong which New Zealand has excelled at and wait for better vaccines that have wider coverage and not let omicron in. I think the chances of pulling that off are remote because omicron will get in at some point.

“The second option is, somewhat controversially, to embrace omicron.”

Blakely said omicron was “way less severe” thereby reducing the number of people that died or had to go to hospital.

“Omicron is less dangerous than delta … we’re talking somewhere between 1-5 percent of the mortality risk of a delta infection.”

Good immunity against delta
He said studies showed people who had had omicron then had good immunity against delta.

“So if New Zealand embraces omicron in, the trick is to manage it well.

“But there are other things to do in the next six weeks for New Zealand, which is boost like crazy, try and get at least two-thirds of the over 60 population boosted … before omicron comes in and get the public ready.

“Have a plan in place, mandatory masks when the case numbers get to a certain point.”

University of Canterbury professor Michael Plank said new cases in MIQ was a steep rise from last year, when most days, there were just two or three new cases arriving.

“What that really shows, there is a high risk at the moment of the virus leaking out.”

He said it mirrored international data showing infection rates were higher than ever, in some countries.

No assumptions over MIQ
Professor Plank said New Zealanders could not assume managed isolation and quarantine (MIQ) would keep the variant out.

New testing rules will come into effect for arrivals into the country, with travellers required to return a negative test result within 48 hours of departure, rather than 72 hours.

Professor Plank said it was a helpful step, but he would like to see rapid antigen tests also used, for a final check on the day of departure.

“These tests return a result in about 20 minutes so these can actually be done on the day. They won’t catch every last case but even if they only caught say 50 percent of cases prior to getting on the flight, that would be a help.”

Professor Plank said Aotearoa needed to buy as much time against omicron as possible, to roll out boosters and child vaccinations.

“If you’re eligible for that booster dose, don’t delay, don’t wait for a few weeks, because it could be too late by then.”

This article is republished under a community partnership agreement with RNZ.

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