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COVID-19 (novel coronavirus) update – 19 August, 2020 1pm | Ministry of Health NZ

oh all right good afternoon everybody uh in a moment i'll hand over to the director general to provide today's update i imagine that there'll be quite a few questions uh after the director general and i have been through our introductory remarks uh we will then take questions i will then hand over to dr woods near commodore webb who will be able to answer any questions regarding managed isolation and quarantined facilities so uh director general i'll hand over to you thank you minister kiyokoto katoa so there are 13 new confirmed cases of covert 19 to report in the community today and there are no new cases of people returned from overseas and managed isolation facilities 12 of the 13 new cases are linked to the previous cases in the community cluster and one remains under investigation but is believed to be linked to the same cluster there are 98 people linked to the cluster who have been moved into the auckland quarantine facility that includes 44 people who have tested positive and the balance are household contacts there are six people receiving hospital level care for covered 19. two are in auckland city hospital while four are in middlemore none are requiring intensive care the 13 new confirmed cases today to report bring our total number of confirmed cases of covert 19 to 1293 one previously reported probable case is now reclassified as under investigation the total number of active cases in new zealand is currently 90 of which uh 69 are from the recent community outbreak there is one further community case more on that shortly and there are 20 imported cases in quarantine facility so genomic sequencing genomic sequencing has provided more information about two cases of covert 19 that were under investigation we have been able to genomically link the household of five positive cases of which one that's one of the two and household contacts one of those is a person currently in auckland hospital and they have all now been linked to the existing cluster the that is through the genomic sequencing it still remains for us to identify exactly how the household is epidemiologically linked but we now know that the virus found in the cluster in the cluster is essentially the same one that is found in the members of this household who have tested positive this gives us a high level of reassurance that these people are part of the same community cluster rather than it being a separate cluster now the second case is a man who is a maintenance worker at the ridges hotel which is one of our managed isolation facilities in auckland the man carried out maintenance tasks or carries out mountain maintenance tasks on the rooms there between bookings uh that is followed following full infection prevention and control and disinfection of the rooms and uh while wearing appropriate ppe he tested positive on uh or his positive test returned on the 16th of august and the genome sequencing indicates his case is not linked to the current outbreak in the community but is most closely linked to a positive case that was in the ridges and was identified on the 31st of july this is a returnee from the usa now there is some further genome sequencing and matching been completed on this case today and you will have seen there is further information in a media release that went out recently on contact tracing since the 11th of august 1880 close contacts have been identified and 1691 of those have been contacted and are self-isolating and have either been uh tested or are waiting for testing as appropriate and the pr and other contacts are in the process of being uh contacted as i outlined yesterday a number of locations event can become of interest as we go through our investigations and in most peop in most cases people who are at those locations are considered casual contacts and are at very low risk of any infection anyone who has a close contact will go into our national contact tracing service and to be contacted casual contacts only need to call their gp or health line if they become well or to get advice about getting a test if they are concerned um all these places have just had a visit by someone who it transpires is a case it doesn't mean that there is a need to avoid those places these places are notified and undertake appropriate cleaning uh with guidance from our public health teams we've also been using the covert tracer nz covered tracer app to notify people who may have been in these locations there are two more locations of interest i just want to mention today one is the pack and save supermarket in apirana avenue in glen innes auckland uh the confirmed case visited the supermarket there a number of times between the 31st of july initially at 1009 am and then between the 8th of august at 10 10 am so several times over that period at times the case was up there for an hour doing shopping uh the other location is the mount roscoe primary school on frost road in mount roscoe and the confirmed case was at that location in the 24-hour period between between 1 40 p.m on the 10th of august and 1 40 p.m on the 11th and just to remind anyone who has visited those locations at that those times that does not need to do anything except be aware of symptoms and of course seek advice about getting a test if you become symptomatic on the americold environmental testing a final report is expected to be completed imminently with input from mpi and our esr staff looking into that possible route of transmission through chilled services on materials arriving from overseas the full report will have the detail but it seems clear now that the possibility is being ruled out from that investigation we'll have further details later in the week an update on the exemptions process for people wanting to travel into auckland now the ministry of health has received over 5000 applications so far 700 have been granted 160 declined and there is a team from right across government that is working as quickly as possible through those exemptions they will be granted whether a circumstances like the need to access medical treatment uh provide care for a vulnerable person or to visit a dying relative and there are some business exemptions that are also being in granted where that relates to critical infrastructure or food supply chains and finally on the nz covered tracer app we now now have just shy of 1.5 million users and that's around 37 of the population aged 15 and over minister thank you dr bloomfield record levels of testing continue across the country over the uh last five days we have processed more than 100 000 tests 18 421 of those tests were processed yesterday and labs are working well within the 48 hour turnaround timetable that they have been set and in fact i'm told that most test results are still being completed within 24 hours i do want to thank all those involved in the testing process it is an enormous undertaking our lab workers in particular are working incredibly long hours to get these test results processed and i want to thank them for their commitment testing has ramped up at the border both at the airports and at the ports testing of all government agency frontline staff at the auckland border that's customs biosecurity immigration new zealand aviation security and so on will be completed very soon today more than 3 485 workers at ports around new zealand have been tested for covert 19. at the port of auckland more than 5 000 staff working from around 800 different organizations have accessed the port since the 21st of july as at 6 pm last night 2194 of those people had been tested a dedicated testing team is operating extended hours to ensure that workers all have access to covert 19 testing including those who are working the night shift and the twilight shift at the port of tauranga a dedicated swabbing site was established by midday yesterday to begin testing around 6 000 potential workers at that site i've been advised that by 9 30 this morning 95 workers that were considered to be high priority had already been tested alongside others testing's also underway at uh the eight other ports around new zealand as of 6 pm last night auckland airport uh the testing station there had swabbed 2407 of the 4474 potential workers with a testing team working through the night last night to capture night shift workers with regard to testing in miq facilities and again i note that dr woods near commodore webb are here to answer further questions on this later on uh we have had 2806 tests completed uh that's 97 of the workforce um in auckland so that's the of auckland and across the rest of the country 1599 staff uh working in miq have been swabbed happy to take questions well we will be here for for up until about half past and then we will hand over well look i'll get the director general to comment on that but at this point all of the information we have suggests that this is contained that this is just one person obviously that investigation work is now underway the immediate close contacts uh so the household um and the work and work context contacts that have been tested have all come back negative um so that that is a very encouraging sign at this early stage and obviously you know this is this is how the system we want the system to operate which is that where there is an incursion you you identify it quickly and you stamp it out if if that is what happens with every case then further alert level restrictions aren't necessary because that's the way the system is designed to operate i speak to a lack of testing given this person and presumably wasn't tested for four days four or five days three or four days after the onset of symptoms and weren't quarantined for six days after the onset no no i'll ask the director general to comment again but uh this person was tested fairly early on after displaying symptoms uh and there was testing at the there was there was testing at the ridges hotel only a couple of weeks before this uh where so the testing system uh has been as as we've already said ramping up this person was identified at right at the appropriate time but again i'll ask the director thank you so a couple of comments first just to reiterate to your original question that uh none of the household will work close contacts and indeed none of the staff at ridges who were all tested towards the end of last week as part of testing all our miff workers they've all been tested none have returned positive tests other than this person uh his test results suggest recent onset of the infection uh and uh he was tested on the 13th as soon as the test result came back positive he was in self-isolation close contacts identified and so on and there is a number of casual contacts from a church service which is in the um in the media release 56 people all uh have been had contact made except for two who are just waiting for a call back uh and are in self-isolation and uh being tested as well so um this seems very very well contained uh and that's uh we'll keep update you updated on that we'll just see we'll are you sure that all of the staff at those managed self-isolation facilities have adequate protection that their safety is is kind of paramount if you haven't been able to establish the person-to-person links yet was this person given the proper ppe how could this happen look uh minister woods i think uh uh is going to talk a bit more about what happens at the the facility what i would say is that this is someone who's in a a is a maintenance worker who works for the hotel stuff so doesn't have interaction directly within any of the guests so once again a little bit of a mystery here one that we will be investigating fully to find out uh but i can say that when uh when the maintenance workers into any room uh that uh someone positive might have been and they do have appropriate ppe saying that it's a mystery though good enough i mean shouldn't we know where this comes from does it talk to a system failure that things weren't cleaned properly that that that processes weren't in place i think it's we don't know yet yeah and can i just make a comment on that you know ultimately we're dealing with a virus here um i think what you'll hear from very shortly um in about 15 minutes is that there are very extensive um protective measures in place at miq facilities now the investigation so far you know we go through everything cctv footage of all of the people concerned to identify where contact may have happened it does show that this is a highly contagious virus that can that is easy to get um and you know we're doing everything we can to put protective measures in place well what i can say is you know you can put very very stringent protective measures in place there is no such thing as a 100 guarantee um even if you have the very best protective measures in place on testing border workers why are there still exemptions for airline crew coming into the country look there are different arrangements for airline crew coming into the country um there are very strict arrangements around um what they do when they're on the plane what they do when they're off the plane if they're stopping in another country um to ensure that they're not coming into contact with covert 19 if they're having a layover uh in another country they are then they have a 48-hour stand down when they return to new zealand they are tested at the end of that 48-hour period so there are different arrangements in place for aircrew um there of course are a lot of protective measures taken for aircrew that's interesting that you mentioned that's just in place for people coming from high-risk countries right so can you give us some examples of what's high risk medium risk and low risk now all air crew who are coming from overseas should be tested at the end of their 48 hour stand down period now one of the things that i'm going to be doing in the next few days to eliminate doubt because we continue to get questions about this by the end of the week i will also i will issue another uh order that specifies all of this so that there is absolute clarity around it but the rules are very clear to those who are following them at the moment but to avoid any public confusion about that um i will issue another order that makes that very um crew clear on transfer flights um taking people between managed isolation facilities or from auckland to managed isolation facilities why are they still not required to be tested or isolated look i'll have to come back to you on that one um i'll come to you on there can you can you clarify was the man um was he tested on august 13th is that what he said yes he was tested on august 13th was he tested because he was symptomatic or because there was an outbreak and there was mandatory testing in the broader facility everybody at that facility was tested on the 13th so that was that was part of that's part of the routine testing regime that we have been putting in place which is he was he was picked up as part of the routine surveillance testing two days before perhaps i could just talk to that knowing the clinical picture so he had some mild symptoms two days before that he attributed to a pre-existing condition they then went away and so that's why he was back where he didn't actually have any symptoms when he was back at work a senior uh quarantine officer has told us the staff at the border had asked for a regular testing program weeks ago this was defined unions also say their members didn't have an issue with tests so why are you trying to shift glam and say that the water workers didn't want tests look i think we've we've been through this um over the last few days what you'll see from the numbers is that the the rate of testing has been steadily increasing over the last three weeks or so i've been very clear we would have liked to have seen those numbers increasing faster what we also know though is that not everyone was being tested at work so those who got tested through a community-based assessment center a seaback or who got tested at their gps we up until now have not necessarily been recording them in the right column to be able to say that they were you know to categorise the nature of their been a work among staff to be tested so why did you say that when the border officials are saying that's absolutely not the case look there has been some reluctance among staff that's certainly the advice that we have had there certainly isn't now which i think i said three or four days ago as well which is a good sign but is that fair though because it paints the picture that the workforce weren't keen when the reality is that it wasn't being offered to them look it was a variety of factors i've never said that that's the only factor there are a variety of factors hesitancy to be tested um has been something that we've been grappling with a lot across the country up until now including four staff who are in that category it's not been the only one we've as i've said uh one of the the line of sight issue around you know people who are being tested and making sure that that was recorded in the right way um has been a challenge as well that has now been addressed so there has been more testing taking place than people might necessarily think but it hasn't necessarily been recorded and reported in the way that uh we're now we're now doing to give that point are you also aware that another one of the factors is that people have been volunteering themselves for tests and they've been declined those tests they should not have been declined tests that was happening i'm going to say are you aware that that was happening because that's what we're hearing anxiously yeah look beyond anecdotes um so i get anecdotal reports all the time and i can tell you every one of those anecdotal reports and i'm sure dr bloomfield can tell you every one of those anecdotal reports i've been following up with the ministry um and obviously you know we've been working very hard to get testing uh happening in higher volumes and more frequently bloomfield just on the maintenance worker you say it's a mystery how they contracted at the virus what are the different theories you're investigating and just to be clear this worker never entered the room of the returning so i think it's best in that regard to minister woods we'll talk to that second uh shortly uh i think there are um there are a couple of possibilities human to human transmission directly and it may well be and that's part of the reason why all the guests and the staff are being retested as whether there was someone who was an intermediary between the guest uh who tested positive on the 31st and then this man who has tested positive so that's one possibility and the other is through environmental contamination because we know this virus can survive on surfaces not for that long but it can survive and infect people minister on the exemptions on the ministry of health website this is on return for aircrew coming back from low and medium risk countries they just complete a health assessment and then can return home and operate as usual i'll just get the director general to answer that i don't have the technical detail on that but we can come back to you on that we will could you just further detail the health act order that you're going to bring in around testing later in the week uh yes so we will um there will be two orders uh that i will um be issuing that i'm endeavoring to issue by the end of the week one is an order that clarifies exactly well there may be one in the same order but two distinct issues one will be around formalizing the regime for air crew because while there is a regime in place there's a lot of questions about it so formalizing that in an order will make it much more transparent to people and the second will be uh the routine formalizing the routine testing that will go forward from here the order that i have put in place this week or the two orders that i put in place this week are around um this surge of testing um and then of course the next order will make sure that we're maintaining our testing our surveillance testing and it will specify exactly what what's expected there what will you specify weekly testing that is exactly what we're working through at the moment so it'll be based on a risk based framework so those at the higher risk will be the most frequently tested the order that was forthcoming on the contact tracing requirements for businesses at level two apparently there's some uh redundancy in the existing order that your office was seeking to handle when can we expect to see that yeah that will be updated this week as well so as you'll be aware the latest order puts in place a mandatory requirement for qr codes to be displayed there is still a bit of an ambiguity about whether or not people need to be making people sign a manual register and scan and using a qr code so we'll make it absolutely clear that it's an either or that you need to make sure that there's a system for recording everybody that's entering but it does not have to be both and so we'll clarify that uh in the next order that we're putting dr out how many of the 70 cases in the community have had their genome sequenced or will happen is the plan to sequence all of them yes so all new cases we are getting the genome sequenced and any case in managed isolation now will be sequenced a number of earlier cases have been sequenced but by doing them at the time we know there will be is more likely to be a successful genome sequencing done because there will be rna material in the sample so yes all the new cases are being sequenced and furthermore that will help us sort of um outline the essay will outline the sort of the the relationship between the cases so it gives us a clue about the who was infected first and and who they then infected because each time the virus is passed on most times there's a should i say there is a very small change in the in the genetic makeup of the virus and so they can map through what the chain of infection is at this point i can say that it seems so far that the uh the case that was the first is the one uh is the person from the americold facility whose symptom onset was the 31st of july so the genomic testing to date suggests that he that person that he was the first to be infected in this cluster okay can i just check in on the on the numbers of the of the auckland cluster another 13 today it doesn't appear to be dissipating is it on track to becoming the biggest cluster through the pandemic and should aucklanders start that mental prep preparedness that they might be spending more time in lockdown i think in the last part of your question it's all very premature at this point you know in terms of speculating about what may happen we've always been very clear that we keep a constant watch on these things we're constantly reviewing uh the alert levels and i'm not going to preempt any decisions about that i think that's still far too early um in terms of the the number as to whether it ends up being the biggest i'll hand over to the director general uh look i think you're right it is on track to being the biggest one of the things that um is different now compared with the clusters uh when we had the outbreak earlier and when alert level four and three is uh we are um conf we are increasingly confident we are tracing and identifying all of the cases and because we've got all those close contacts in isolation and are testing them we will have a better a better idea of and this is what we want to have of all the cases associated with the cluster whereas it would have been in our earlier clusters earlier in the year there would have been other cases that were not identified but because of the lockdown arrangements there was no further community onward transmission comment on that though because of the lockdown that we have the level three lockdown we have at the moment as we identify new contacts they are effectively already in isolation because of the level three requirements and so that has helped to contain the virus while we've been going through the contact tracing process the person who started the conspiracy theory that you referred to over the weekend yesterday have been found what is the appropriate action to take against them look that's a matter for the appropriate authorities i'm i don't have all of those details i i've seen that there's a transcript of a conversation with that person being released i haven't had a chance to look at that or or to read that um obviously there's some remorse on their part um that's so that's an encouraging sign so research out today shows a lot of new zealanders drink heavily at home how worried are you about that worsening during lockdown and will the government look at policy to tackle the issue of takeaway alcohol um look i'd encourage all new zealanders to drink responsibly when they're at home an update on the exemptions when you label go into auckland some people are given those exemptions uh why are they taking so long to come through and why can't people who had exemptions in the previous lockdown just have those carried over and use those obviously it's a different situation in this lockdown in the sense that different geographical areas of the country are being treated differently and so movement from a level three to a level two area um if you had free movement during that time during the previous lockdown it doesn't necessarily mean you should have free movement during this one because uh that previous exemption you had assumed that the place you were going was under the same protective measures as the place that you had been and that is certainly not the case at the moment so it is a different process i acknowledge that you know that they will add a little bit of time we're getting reports that it's sort of up to seven days is that appropriate given the circumstances we're operating at the moment have you had reports that it's been too slow um look um everyone's working as quickly as they can um to to make sure that this is dealt with in as timely a manner as possible you were talking about that 48-hour turnaround type of testing but we've talked to someone who managed isolation who have been waiting four days for their final test uh as what's the reasoning behind that and is there anything that's been done to accelerate it that's news to me um we'll have a look at that but we'll have a look um uh there are um the managed isolation tests particularly those ones that are where people uh have to return a negative test before they go we try to prioritize those of course the auckland labs have been processing high volumes but we'll work with the managed isolation facilities to make sure those tests do get prioritised close contact is anything being done for second tests are they necessary and are they being uh encouraged to go for those can i just comment on that so um people are tested but close contacts also remain in self-isolation for the full 14 days as well no not not routinely unless of course because they're on symptom watch also for that period if they develop symptoms then they are tested again well i'm just aware that we've only got a little bit of time before question time and i do want to allow dr woods any comment or web uh the opportunity to take the podium so we'll take a couple more questions um and we will be back tomorrow so there'll be plenty more time to ask questions minister has any further thoughts being given to setting up an inquiry or review into new zealand's response to pandemic look i think it's inevitable that we will get to the point where that is sensible but at the moment all of our focus is on the response and i don't want to take people off the response to to to do too much reflective uh thinking when actually we need it all eyes focused forward on making sure that we're dealing with what's in front of us right now leaving the international airport without tests to work in other areas of the country is that a problem sorry can you run that password we understand border workers have been leaving the international airport in auckland without tests to work in other parts of the country is that a problem look again i can look into that but i can tell you that um everybody uh in in the borders um is currently going through a testing cycle and that will be uh routine follow on that um do you think it's smart or safe to have international air crews to have layovers at hotels in auckland used by the general public uh the protocols that have been put in place with those hotels keep those air crew well separate from any members of the public very last question dr bloomfield kind of following up on ben's question of the last couple of days there's been these dozens of new cases and has there been any clarity from speaking to these people when they were infected and i guess what i'm asking is has anyone been infected since auckland went into level three yes within households and the diagram we are updating daily on our website includes for each case the date of their positive test and also where pertinent if they are symptomatic the date of their symptom onset so that creates a picture of how all these things fit together and secondly of course as i talked about the genomic sequencing helps us develop a picture of how the infection progressed through the community but as i've said and we found earlier in the year most of those infections will occur within households even when they go into quarantine because they may well have been infected before that happened all right a quick introduction question if i can um very last question to toby that's a bit cheeky but go on i think thank you for recalling how soon this week could we see 12 a year 12 and 13 return to school and are you confident schools to manage this safely so it's not automatic that year 12 to 13 students can go back to school this is a process that they will have to apply for they will have to demonstrate that they can meet all of the restrictions that are implied that are in place for people who are at work uh under alert level three so they'll be treated the same as every other workplace providing they can demonstrate that and they have to demonstrate that before their students would be allowed to return uh they can demonstrate that to the secretary for education then they would be allowed to do that i would envisage that the schools that will be using that they'll be using that sparingly for those students who need to be on site so there are some applied subjects which you can't easily do from home and so that's the group of students that we're wanting to make provision for bearing in mind uh that for those who are in potentially their last year of schooling they've effectively lost a term out of a four-term year so we're trying to be as accommodating as we can whilst not doing anything that treats young students and schools differently to any other workplace and so that's the key criteria there now we dr dr bloomfield and i will be back tomorrow so we'll now hand over to dr webb at dr woods any of commodore web thank you thank you well as you've just heard from the health minister and the director general of health um there is a case of a worker at a managed isolation facility contracting covert 19. just want to give you a quick rundown and update and obviously take any questions around that as soon as we had notice of the positive result a number of planned procedures were activated the case of the maintenance worker is not linked to any incident system breakdown or indeed any wider outbreak at the facility in fact the facility is one which has had no serious incidents reported or indeed happen at them as described by the director-general there is a genomic link between the maintenance workers case in a positive case of a us returnee who was in the hotel between the 28th of july and the 31st of july the room the us returnee was in has not been occupied since her transfer to the jet park quarantine facility on the 31st of july and it is still empty the room underwent hospital grade cleaning with hydrogen peroxide vapor sanitizer using a bioquail machine on the 14th of august to date there is no obvious evidence of person-to-person contact between the worker and the returnee in fact this case highlights how tricky and insidious this virus can be i'll just now hand over tea commodore webb to outline some of some more details and then we'll take your questions thanks minister as the minister has outlined we took immediate action to limit the risk presented by this situation a person testing positive for covert in a managed isolation facility is something we're prepared for and practice at responding to we have strong protocols in place obviously this is slightly different and that was the first time that a staff member connected to a facility has tested positive as dr bloomfield mentioned it is worth emphasizing at this point that this particular case involves a religious hotel maintenance worker who does not routinely interact with any of those returnees as soon as the positive test was established a series of actions were undertaken immediately at ridges the hotel was put into immediate lockdown on sunday morning as soon as the positive test was returned thorough cleaning of shared areas of the hotel were carried out as the master has outlined close contacts of the staff member identified and they were put into self-isolation until tested close analysis of movements were undertaken and this includes a review of cctv we've also reviewed room entry data to look for connection to cases uh with other guests genomic sequencing has been sought through esr health advice is sought on subsequent actions and further testing of all returnees and other cases and staff were undertaken confirmation that infection prevention control measures were correct has also been followed once we had confidence and health advice that it was appropriate to do so normal procedures within that facility were then resumed minister thank you we'll take your questions talk about strong protocols but how can you say that when obviously there was an error if they were able to have that person-to-person contact and infect each other well i'll just i'll just start off and then i'll ask you commodore webb to comment more broadly on that um there is at this date no evidence that it is per person to person contact we're obviously still investigating how that may have occurred and that will also include looking whether there's a possibility of surface contamination it's something that we can't rule out and something we will investigate in terms of our confidence level in terms of the procedures that were required by the the staff at this facility it was an incredibly well-run facility um there have been no incidents at this facility and in terms of the reports that we've been receiving back on a daily basis from the nzdf team that have been the operational leads at their all the reports that we have been receiving is that this is a very well-run facility but i'll ask you a commodore web just to give a bit more up from another point so the fact that it is surf it could be surface to surface contact doesn't that point to it being a system value even more that it obviously wasn't cleaned it wasn't protected so that people were able to contaminate each other what we do know is that the maintenance worker was not in the room of the us returnee after it was vacated on the 31st of july in fact no one in the hotel entered the room until the 14th of july when it when it was entered to be claimed we have verified that by using the room entry data the card swipe access to the room in question it's something that we've interrogated quite closely so in terms of that being a problem we have ruled that out through the through those processes we have also we've also um obviously there's been interviews as a commodore website with the maintenance worker in interviews with the returnee trying to establish if there is any link if they were in any common area um we are not seeing um any glaringly obvious points of connection this does not mean that we don't continue to keep investigating but in terms of procedures around use of ppe by the maintenance worker and coupled with the knowledge of when he was in that particular room um is something that we're satisfied with what we have also done through looking through swipe card access is seen the times in which the us returnee was out of the room um she was a a particularly um a brutuni who stayed in her room a lot for the three days that she was in the facility i think two or three occasions when she left so we are looking at cctv footage at the periods of time when we know that she was out of her room to establish or not there was any contact but really want to emphasize that a maintenance worker is not someone who has routine contact with returnees they enter unoccupied rooms minister what is yours do you accept that you have failed in your duty to actually test the miq facilities it was supposed to be happening from june 23rd look um i think you hear quite a deal of discussion about testing obviously with the minister of health and with the director general and it's something that we've been working with health over a period of time particularly around surveillance testing and testing of non-symptomatic stuff that asymptomatic testing is something that we've been feeding through and something that is being rolled out we're seeing now that we do have that mandatory regime in place and you would have been getting daily numbers of the tests coming out of those facilities wouldn't you return these the day the daily reporting daily reporting we were getting were around returnees i want you to bear in mind until friday there was not a mandatory testing regime for staff which meant it was incredibly difficult to monitor and collect that data as the advice we were getting from health because they weren't all happening on site some people were electing to go to a community a community testing station or to go to a or to go to a um see back reassured that those workers were being tested and then you didn't follow up and ask questions as to whether surveillance testing had started in terms of the the non-the asymptomatic staff that had started it was in the under the voluntary regime um towards the end of july and actually they were on site at this particular facility um where this case has been has been um earlier in july i think around 30 percent of the start of 30 or 40 percent 40 of staff at this um this hotel did have surveillance testing carried out prior to this outbreak but i would like to point out that that surveillance testing was not on site when this individual has returned the symptomatic test he was picked up under the new mandatory system where all staff are and where that was on-site we were told that mandatory testing wasn't necessary because the voluntary testing was there it was being done so why was that not happening where is the miscommunication occurred why did you not know that they weren't being tested what we've seen consistently and you would have heard us stand on this platform many times and say that we've been continuing to work with health to ensure that it's not just symptomatic staff that can be tested um to roll out the system that we now have rolled out and has been rolled out that we are having routine testing for all staff whether or not they are symptomatic or non-symptomatic and is what and is broader than surveillance testing that is something that we've continued to work with health on and something we will continue to help work with health with because as i have stood on this platform and said it is something that we have heard from staff when we've visited facilities um about access to testing and it is a reason why it is something that we have been working with health on we seem to be universally outraged by this i mean what should they make by this total accountability goal should we say between the ministry of health between your ministry between the prime minister um there well first of all i reject the premise of your question um in terms of the accountability what we had was a voluntary regime so there was testing for all symptomatic staff i think that's something that needs to that needs to to be um well understood the question was around the testing for asymptomatic staff because the clinical advice from health was that you did not need to be routinely testing one of the pieces of information that we've fed through that in health have maintained and rightly maintained that the most important proactive way in which we maintain our facilities to be covert free is through the use of ppe through good and infection prevention controls that are inside the facilities and making sure we have those procedures right that testing is only ever a reactive mechanism it is one tool in our toolbox um but in terms of the fact that we now have that in place as a mandatory system what we can report to you um now is um the fact that at the facility where this has taken place there is 100 of all staff have been tested and across the network in auckland i think it's 97 of all staff within miq have been tested ministers are you saying that their fault here is that is that the ministry of health was essentially withholding tests that you know staff didn't have access to them they weren't able to they weren't able to get the tests and that's what the hold up was no um what what i'm saying is we were working with them and what we saw was the system being rolled out from from mid mid july i think it was 21st of july the first one on site at this particular facility we did have the rollout of surveillance testing which wasn't just for symptomatic staff obviously before that there was the issuing of vouchers for people to be able to go to other facilities to have tests so this was a system that was being rolled out isn't there a difference between surveillance testing and routine testing and routine testing was said to be to have begun to occur from june 23. so surveillance testing um in routine routine testing yes there is a difference but in order to have routine testing what we found out is that it needed to be mandatory and that is the order that was put in place on fridays in terms of timing the hotel was locked down on sunday why the public only finding out about it today so of course the case was reported at the time that any other case was we had to do some some health wanted to do some further investigations in terms of the links of the case so the case was reported yesterday as it would have been at any other as with any other case in terms of going into the details of the case we were waiting on the genomic sequencing to be able to be able to link it to the cluster or not that only arrived with us this morning and so that's why we're giving the further detail but the case was reported in the same way but from our perspective from from a facility's point of view any commodore we can speak to this everything that needed to happen happened from sunday morning onwards yeah that's right so as soon as we understood that the positive tests had been received um the hotel reacted immediately and uh all returnees were isolated in their rooms normal follow-up measures were taken which included um making close contacts aware and then also isolating the close contacts immediately starting the testing follow-up work and then uh and then the contact tracing that follows with that why why the delay though why not let the public know yesterday that this process was happening uh rather than than just did you want to wait and see so that you know why wait well i think what we've seen is actually getting the detail is actually quite important in the in the process of follow-up so the genomic testing um to link whether it's a cluster that we're already aware of is a really key part of the analysis and so uh the normal 1pm reporting yesterday was consistent with the information that we had and then uh and then that follow-up genomic testing is taken uh through to as the minister said through to this morning that the public know though were things like the church gatherings and things like that shouldn't people doesn't that help people come forward and stop this spread people would have been looking at it yesterday saying oh no one's reporting that no one's talking about that so just to be absolutely clear that all the contact tracing has been taking place nothing has changed because we haven't given the the the in-depth details of this case the the contacts from the church group have already been contacted testing is underway so there has been no delay in any of the processes that needed to take place because of that and as i said um the ministry of health wanted to wait for the for the details of the genomic testing so we could establish or disestablish the link with the known cluster that came through this morning and that's why we're in the position to be able to give you these details today but in terms of the processes and procedures that we needed to put in place at the facility they were activated as soon as the information came through you know just back on testing you said that there was a um that symptomatic testing was still occurring but there was no real clarity around asymptomatic testing is that right is that is that where the miscommunication is so in terms of the the ability to have um a hundred percent across everybody that that the systems weren't in place for that that one of the things that we know and we've identified to health and we're looking at and we've looked at ways to to bridge um the the kind of the the system that to ensure that it can happen is that of course our staff who are miq's can't simply leave to go to community testing stations because we're asking them to do a job in the facilities um often at the time those stations are open so we've been working with health to identify some of the barriers to higher uptake that being one another issue is but at the time of day that you do the testing because obviously we run 24 7 operations at our miq facilities it's not a nine to five operation so that we've been trying to time getting um testing teams into the facilities to coincide with shift change so that you can get both sides of a shift a little bit confused as to why it's taken two months to do that when we were told on the 23rd of june that regular health check and asymptomatic testing of all border facing workers would be happening as part of the government's testing strategy yeah and look i think the the minister of health and the director general have canvassed the issues around testing why it hasn't happened no in terms of the the the rolling out of the testing regime that is a matter for for health um and i think that the director general and the minister answered a lot of questions on it when they stood here today with them had you raised those concerns of them that your staff had been telling you that they weren't getting tested enough and they didn't respond who didn't respond look we have been working with the ministry of health that's the reason why we we had rolled out surveillance testing we had seen a shift that from july we did see surveillance testing which was new coming into our facility so there could be greater access to testing sir you said that this man had been tested on thursday the maintenance worker as part of new mandatory testing does that mean that you wouldn't have been tested uh had that cluster not occurred on tuesday not have been found on tuesday that's a hypothetical um i don't have the detail around what what they what what the existing that got overridden plans for getting more surveillance testing into that facility were whenever we talk about testing though dr bloomfield always says that before someone goes to work in the morning their temperature is taking their ass about symptoms this man had symptoms two days earlier which if i'm doing the math right would have been the tuesday when the cluster was found what happened to him on that tuesday morning so he had his health checks on both days um and that he he passed those health checks in terms of the temperature bit um in terms of the the and talk to bloomfield outlined this that he did have a cough but that was put down to a pre-existing medical condition that he has so that he wasn't picked up through that but what we have checked and can confirm is that the health checks um occurred on each day that they should have for this individual does that be more rigorous though so if it was put to a we now know that the man had coveted 19 and it wasn't a pre-existing condition so if someone goes into a health check and has a symptom should they not go to work in one of the countries few m.i.q so did you say we know it wasn't a pre-existing condition now it was covered 19. no no but when he reported his symptoms he attributed it to a pre-existing condition i think the important thing is the temperature checks and some of the others i mean what we do know is this is an incredibly tricky virus that we do have people all around the world who do test positive who display a range of different symptoms it shows why it is that we have to ensure that we're putting many many measures in layered measures of security now i can hear the bowel starting to rain so we'll take a couple more over here when you're talking about the 30 to 40 percent of people who are covered by this voluntary regime the ceo of the new zealand health group which contracts those health check workers the workers who are conducting these health checks she said and they have workers in all 18 managed isolation facilities she said that zero of her employees had been tested so would that 30 to 40 percent cover the people who are contracted to the facilities or just the full-time staff i am assuming that it covers the contracted workers from the data we've seen because there's a number of contracted staff across a range of professions but we're happy to follow up and verify that for you follow up on justin's question he shows up to work on a tuesday and he has cough it's the day that a community cluster has broken out and it's been confirmed surely you've been on the side of caution look he he passed his health check we have a new cluster surely common sense here is you should go home and you should be tested straight away as we can say he he passed his health check um in terms of the temperature which is one of the important parts of that um he had his test on thursday that's all we can tell you at this point in time do the health checks need to be stricter than if someone can go into a facility with a coffee even if they have pre-existing conditions look i mean we've always said that managed isolation has to be a part of a process of continuous improvement we do need to look at what further measures need to be put in place to pick pick up people who are displaying symptoms even if they may be going through the routine health check and deemed okay we do need to look at ways in which we can strengthen that and we certainly will be doing that as a result of this so was there ever asymptomatic testing at miq there was surveillance testing of asymptomatic workers yes that started occurring in july we can get that for you but my understanding is this that will be both symptomatic and surveillance testing so we'll need to get that number to you and see if we can break that down we went a month without it after you promised it so i can get you the dates around when that surveillance testing started but there but they are questions to put to the ministry of health okay thank you you