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COVID-19 (novel coronavirus) update – 24 August, 2020 1pm | Ministry of Health NZ

what's up now uh everybody good afternoon today we'll go directly to the director general for the latest update on cases and then i'll update you on a range of actions that we're taking to further tighten the screws on this elusive virus dr bloomfield thank you minister kiyora kotukatoa so today there are seven new confirmed cases of covet 19 to report and all are related to the community cluster in auckland and are in auckland there are no new imported cases of the seven community cases two are linked to a church in auckland and two are household contacts this brings our total number of confirmed cases to 1339 and we will report that through to the who one previously reported case is now considered recovered so we the total number of active cases in new zealand is 129 of which 19 are imported cases in quarantine in the auckland facility by this morning our contact tracing team had identified 2446 close contacts associated with the community outbreak and 2 390 of these had been contacted are self-isolating and of course being tested at the right time and we have a process in place to track down the rest of them please if you are called by our contact racing team please do take or return the call as quickly as possible there are now 160 people linked to the cluster that have moved into the auckland quarantine facility and that includes 89 people who have returned positive tests as well as household and household contacts we have eight people receiving hospital level care for covert 19 all are part of the auckland community cluster two patients are in auckland city hospital both are stable and in isolation on award one patient has been discharged from hospital to the jet park quarantine facility in the last 24 hours there are two people in north shore hospital one is stable in isolation on award and that is community connected to community cluster one is critical in icu and that is a community case that is still under investigation by auckland regional public health there are four patients with covert 19 in middlemore hospital two are stable and in isolation on the ward while two are in icu and in critical condition these are the same four patients that is those in middlemore who have previously been reported all are indeed part of the community cluster our hospitals continue to manage the covert 19 patients with full infection prevention and control so they remain safe places for others to go and receive care there is an additional person who remains in waikato hospital but not as a direct result of covert 19. on to testing laboratories completed 4434 tests yesterday bringing our total test to date to 701 504 and we often see in fact almost invariably see this volume on both sunday and monday lower right around the country because of the drop in testing over weekends just on the nz covert tracer app we now have over 1.8 million people who have registered for the app nearly 45 of the population 15 and over it's great to see this high level of uptake uh and the awareness that is there of the value of the app both registering and then using it to keep a track of movements and to assist that we've now got um 318 278 qr codes that have been created and the number of these being created on a daily basis has dropped right away reflecting the fact that we have nearly all of our businesses and premises that have got qr codes in place and i'd like to thank them for doing that minister thank you director general over the last two weeks our covert 19 defence systems have gone into overdrive as the resurgence plan has taken effect countless dedicated workers up and down the country have applied enormous effort and brain power to wrestle control of the new auckland cluster under extraordinary pressure they've just been getting on with it quietly working away day and night to make us all safer we all of us owe them a huge debt of gratitude and i personally would like to thank them for their incredible dedication and professionalism the numbers they are delivering day after day be a repeating here since wednesday the 12th of august more than 100 000 aucklanders have been tested across the country the number of people who have been tested in the la uh in the last two weeks stands at 194 000 so in just two weeks our dedicated workforce has delivered more than a quarter of all of the testing for covert 19 that new zealand has done since the beginning of the year that's a very impressive feat over the course of just two weeks on contact tracing where we go out and find all of the people that someone with covet 19 might have come into contact with they are reaching the gold standard goal of 80 of people being contacted within 48 hours the scale and speed of this response should give new zealanders a real sense of pride but also confident that our systems and the people who make them work are able to mobilize so quickly and effectively that work is ramping up again this week as we shift to a more aggressively targeted approach this drive means the ministry of health will be working with district health boards public health units and communities to target an additional 70 000 tests across new zealand in the next seven days this target would mean around seventy percent of the tests being carried out will be in auckland around seven thousand tests a day uh with an additional three thousand tests a day across the rest of the country the seventy thousand test target will include the routine tests completed on guests and managed isolation facilities testing of all managed isolation facility workers and high risk border workers and those at the ports and at the airports the usual testing of symptomatic people in the community and targeted testing of asymptomatic people in some targeted communities community testing in auckland will also continue to be a key priority with a specific focus on south auckland public health officials are paying very close attention to ensuring specific community communities in that area have good access to testing and to any ongoing support that they may need work is underway to scope out increased use of mobile testing units being deployed to strategic locations including identified schools and churches to target the key populations this will see regional dhbs deploying at least six additional mobile testing units and pop-ups to further improve community coverage they're actively working with maori and pacific health providers and with churches and other community organizations to identify testing sites that help to increase the public's access these new testing sites are complementary and additional to those community testing centers that are already in operation they'll be active for two or three days at a time and then they'll move on to ensure that we're getting good coverage of all of the irrelevant priority areas in the city sites are being finalized but they will include sites prioritized to increase access to testing for pacific and maori communities in particular the current plan includes sites in ranui glennonis and manurewa which are being set up tomorrow afternoon overall they're in our community 20 community testing centers in metropolitan auckland 17 of which are pop-ups that have been established since the new outbreak was detected over the last couple of weeks free testing is also available at 19 urgent care clinics and 46 designated general practices where people can be tested without the need to enroll and i want to reiterate here once again there is no charge for being tested for covert 19. i want to thank the tens of thousands of aucklanders who have recently been tested and also the leaders in the community who are supporting the testing effort within their communities it's challenging to keep up this pace but it is doable and the public also has a big role to play here yesterday testing numbers dropped below 5000 and dhbs are beginning to to report signs of testing fatigue amongst the public the government's message is please don't relax now we need to continue our testing effort and we need the cooperation of all new zealanders in that process finally a quick update on the use of masks on public transport mask making mask mandatory on public transport has been based on the best advice of medical and scientific experts allowing us to reopen our economy a bit more while we continue to work to stamp out the virus we announced it yesterday to give people plenty of time to hear about it and to prepare and on thursday i'll be setting out more detailed operationalization of that including how the rules will work in practice and what we're asking of passengers and transport operators as we've done throughout our response we'll continue to base our decisions on the most up-to-date evidence and to roll out a range of support within the community so i'd like to end by acknowledging the efforts and sacrifices of all new zealanders and aucklanders in particular everyone is playing their part in driving out covert 19. it's hard and it's hugely appreciated please know that everything that we are all doing and we're doing everything that we can is focused on creating the certainty we need to get businesses operating to save jobs and to return to uh to return life to greater normality as soon as it's possible to do so happy to take questions dr bloomfield do you have any more information about the one patient outstanding still under investigation is there results back from the genome sequencing anything like that yet yes there's this particular person who actually is an icu at north shore hospital and that's the community case that's still under investigation we don't yet have any links epidemiologically but the whole genome sequencing has confirmed that the the case is linked to the community cluster so that's helpful uh so far a number of household and workplace contacts testing results are back and those are all negative which is reassuring but it doesn't shed any light on where this person may have been infected at this point do you think we'll ever find out the source of this original outbreak well uh i think there's a high probability we are continuing to look and in particular the value of the whole genome sequencing both in being able to map out this outbreak but also to help us go back and look further back if there is any relationship between the genome sequence we're seeing amongst the cases in the outbreak and earlier cases and managed isolation facilities so esr continues to access and test further samples from earlier myth cases and my hope is that one of those will give us an idea of just how this virus or this this expression of the virus got into the community how would you like to see schools respond to the new who recommendations in regards to face masks particularly for over 12s look that's just one of the things we're working through from a policy perspective at the moment the the government's decision is around use of face masks in level two and above and in public transport in particular we will have another look at the the who advice i would say remembering that the who advice is particularly targeted to countries that have existing community outbreaks wide community outbreaks which we don't have in new zealand so we will look and continue to look at updated wh are excellent so one of the things that i'll set out on thursday and we're just working through the details of this now are the requirements around school buses and whether in fact there are some age cohorts around school buses where the advices that masks would do more harm than good particularly for very young children so we're just working through that now to nail down the final details of that and i'll have that for you on thursday about the movement of children in those older age groups between classes and in communal areas should they be wearing masks the guidance that the ministry of education has sent out to schools suggests that our school certainly shouldn't discourage students from wearing masks if they want to some students are wearing them on their walk to and from school at the moment and that's that's to be encouraged and um and we thank them for doing that um but it isn't mandatory uh in a school setting um schools do have good guidance about the sorts of things that they should be doing um to uh to minimize risk within the school setting will you rule out making masks mandatory in schools um look at this point i've not seen any evidence to suggest that that would greatly increase the level of protection that we have but as with everything and you will have seen this over the last few months everything's always being reviewed hb is reporting testing fatigue how can you be sure that this new testing blitz that you've outlined today will be effective um look we did see an extraordinary response from new zealanders over the last two weeks and and being tested um i think maybe some people are feeling that they can ease off a little bit now actually we haven't quite got this cluster completely um identified yet and so we do need people to continue to um you know take the test when asked to take the test i mean that will include some asymptomatic testing and those priority communities where we need to get our testing numbers up to give us that extra reassurance presumably you've been doing that for the last couple of weeks anyway so what's the difference between the last two weeks and the next two weeks going forwards in terms of persuading people to get the tests if there is this test fatigue look like i said you know making the tests as widely available as possible is a big part of that strategy and we have looked at what sort of testing numbers we'll need i mean my message to new zealanders as it all has always been you know please pay your part by getting a test are these dhbs reporting this text um testing fatigue is it that people are now returning to refusing tests or there is just a city drop off in numbers i think it's just the drop-off in numbers overall that we're seeing but again i'm quite happy if the director general wants to add to that yes just a particular comment thanks minister is that remembering that we have been focused to focus the testing very much uh on symptomatic people and we also know that this winter we've got a much lower prevalence of influenza-like illness so um symptomatic respiratory conditions through winter and that continues actually even in last week's data it shows that so i suspect in that first wave we have tested pretty much everybody who had symptoms during those first two weeks there will be people ongoing over the next week or two who will have symptoms and those people should be tested and as the minister said particularly in um in the across the auckland area we do want to do some testing of asymptomatic people which is what we did last time as we came down the alert levels just as part of surveillance to check there is no asymptomatic infection out there new zealand first is now joined nationals call for a select committee focusing on health is that something you'll agree to look it's ultimately a matter for the select committee as to whether or not they choose to meet this wasn't something in the discussions we had around bringing parliament back this wasn't something that was raised by the opposition uh during those discussions um ultimately it will be a matter for the select committee support though as a way for the public and for the opposition mps to get experts in and question them look again that's up to the seat committee what they decide to do um i don't think ministers should tell select committees what they what they do it's something that i've tried to avoid doing in my time as a minister in a range of different portfolios it is something for the select committee to decide what i do want to make note of though is that we are trying to make the people who are managing this response as publicly available as possible you'll see the director general and i here every day um widely available for media interviews outside of this you know this particular forum as well and you do need to allow the people who are doing this work at some point to actually do the work as well so it's it's not a you know it's not a question of saying there shouldn't be scrutiny there absolutely should uh but at some point there does have to be a limit to scrutiny versus time to actually do the work okay sorry can i follow that yes it wasn't actually follow-up it's actually a change of topic but um on jetstar as well um i digress um with jetstar they're saying look we're on our knees with with these restrictions and being spaced out is there going to be any allowance around that can you comment on that in any way is there any way that that people could travel if they were all wearing masks not socially distanced look at the moment the the level two restrictions are the level two restrictions and we're not changing those um air travel of course is an area of vulnerability public transport is an area of vulnerability we are always reviewing those settings um and so i believe i haven't got any changes in that respect to announce today i'll come down there how fast are you in returning all the tests of border workers and miq staff we've spoken to um miq staff that say after 10 days and they still haven't returned the test result hasn't been returned to them so the testing has been done so around 13 000 people at the border or an miq that staff have been tested over the last two weeks and we've had all those test results processed so as you would have seen from the lower numbers um those test results are in if someone had had a positive result they would certainly know by now from that there is a delay sometimes and getting the negative test results to people and that's something that i've been working with the ministry of health we've been looking at whether that process should be standardized the different public health units across the country take a slightly different approach to the way they can report those negative test results back to the people who have been tested um and and so we're looking at whether that process should be standardized but i guess the key public reassurance message here is when a negative test result comes up through the testing people know about that very very quickly so if you're a staffer at one of these facilities and you haven't had a result that can be confident that it's a negative basically depending on when that was taken if it was taken you know if it's more than 10 days since the test was taken someone would have found out about a positive test result by now you've got the settings right in terms of testing at the moment i mean last we've had issues in the past around you know doctors not having enough swabs or where the case definition was at they were they were ruling out more more cases than testing you know are you confident that the settings are right in order to you know again surge the testing so i'll ask the director general to comment in particular on whether the settings are right but on the supply issue i can say that's something that that we take a very active interest in um and i'm confident on the advice that i've received that there is more than enough supply out there um for for terms of swabs in terms of you know testing processing capability to meet the current needs but thanks uh minister so i was on a webinar last night with about five or six hundred gps from around the country and answering questions this was there were no issues that they were raising about swab ppe supplies and so on of course they're all quite tired because there's been an enormous amount of activity over the last couple of weeks it was a great opportunity to thank them for that but i think we have got the settings right in terms of clarity around who's to be tested the funding for that and of course access to swabs and ppe surveillance testing what proportion of that 70k do you expect to be surveillance testing and how are you doing that will there be some kind of incentive for people to come in will you just be sitting outside a supermarket saying hey if you want to be tested you can be look the breakdown obviously that we're going back through all of the managed isolation workforces um and then of course we've got our day three and our day 12 testing which will come within that overall number of 10 000 tests per day but that will leave the majority significant majority of that being testing in the community and as as i said out on my notes that will include some asymptomatic testing as well in those communities where we're really just trying to make sure that we have absolutely run this virus to ground would it be better to keep that surveillance testing going for our level one look you will have seen me standing here um almost every day that i've well every day that i've stood here and in the time that i have been minister of health trying to get those testing numbers back up again um and you know i've made no secret of the fact during that period of whatever it was five or six weeks that i was a minister between when i became the minister and when this latest cluster emerged that we needed to see the testing numbers going up again they were the testing numbers were too low at that time you're only testing symptomatic people and people imagined isolation and as you've said there's there's been a lot lower amounts of respiratory illness so we may seem to have those numbers quite low if you had kept that asymptomatic testing wouldn't you have seen this earlier well i've asked the director general to comment on this but i would note that that asymptomatic testing is certainly justified in an area where you're dealing with a cluster i think the justification for that becomes weaker if you're not dealing with the live active cases but again i'll ask the director general to comment on that thanks miss so that's uh the key point here is um we did do quite a lot of surveillance testing as we came down through the alert levels once we were in level one and we were confident there was no community transmission occurring we did want to maintain the testing rates across the community and we saw for a whole range of reasons and it wasn't just about testing there was a whole range of behaviours that all of us i think reverted to because we were confident and perhaps a little overconfident there wasn't any uh virus in the community what we have seen though is this outbreak was identified before you know when a symptomatic person went and got tested in general practice and we were seeing those rates come up again and we have seen that the community will respond that's just to your previous question again we've seen where we put these pop-up testing stations in church or supermarket car parks people will come and i'm fully expecting that will happen over the last uh over the next seven to ten days and we've seen the south auckland community in particular has been incredibly responsive to that call for testing and hopefully your okay colleagues won't interrupt you this time do you agree with teammates in politics do you agree with professor michael baker that if masks are worn on public transport including claims there isn't a need for physical distancing as well actually at the moment we have a different view and it's not unusual for me to have a different view on some things with professor baker our viewers that masks are an adjunct to physical distancing that's our current view and it's the physical distancing that remains just as important it's an issue we continue to work through with our transport colleagues advise the government that um the physical distancing on planes needs to remain at the moment that's our current advice okay in the testing framework that you've distributed to gps there's a three-tiered system and when there's an epidemiological link the test is it's more than twice as expensive so ongoing when you're doing the surveillance testing will that be considered that top tier of test and does it not incentivize gps uh to charge for the higher test i mean is there enough checks and balances to make sure that they're charging for the appropriate tier so at the moment there's no co-payment or charge to the patient for any test and by the gps that is invoiced to the ministry of health sure so um if the gp does an assessment as well which might include questioning about a possible link an epidemiological link so it puts the person in a high index of suspicion then yes they can claim a higher fee but the vast majority of the testing clearly over the last couple of weeks because we've been testing widely in the community has not required that additional assessment so going forward with surveillance testing would that be the second tier of cost uh this hasn't come up but it's one of the things we'll look at as to whether we continue to pay a differential payment what we're wanting to pay for though is gp's time where they are having to do a clinical assessment in addition to doing the test in most instances it doesn't require a detailed clinical assessment but we do want to be able to pay them the right amount of money if they do have to do that in addition okay i'm talking about targeting maori and pacifica communities has there been consideration of putting maori and pacifica staff in those pop-up stations and as the mighty pacifica specific messaging that will go with those um targeted pop-up stations or is it just a testing station and a community we've been working very closely with maori and pacific health providers um so that they're very extensively involved in this there's been a lot of consultation with maori and pacific communities information is being made available in a variety of different languages for example including pacific languages so we are working very closely with those communities but again i'll ask the director general if he wants to add to that just to to reaffirm that and many of these um testing teams that are going out uh to establish the pop-up sites have got have explicitly got maori and pacifica staff so that they're able to speak local uh speak the um uh the language of the people who might be coming in the first language if necessary but just to to to make that point actually the planning um the delivery the contact with community leaders the contact with the families where there might be a case that maori and pacific providers have played a leading role in all those areas how many businesses how many businesses have so far been found not to comply with the mandatory qr codes and have any fines been issued no fines have been issued today to my knowledge and we did say that we're going to be taking an encouraging approach here we want to work with people to understand why they're not displaying a qr code if they're not local authorities um have been helping us in that regard working with their local business community to make sure that people are displaying the qr codes we've tried to make that process as easy as possible some people find the self-service kiosk you know that's available online are still a bit of a challenge and there is a manual system where they can request their qr code and it gets sent to them that's operating within a fairly tight turnaround now so that people are getting those qr codes but we are we're trying to be positive about this and work uh constructively with businesses to make sure they're displaying them are you relying on public reporting or is it sort of a balance between public reporting and authorities that you're working with on the ground well what we're seeing is that most businesses are working very hard to comply or necessity in the likes of yourself and perhaps other experts making yourselves available to opposition in peace in the form of the select committee as national and new zealand first have suggested or do you need more time to do the work suggests what i can say is that i've been involved already as have other members of my staff in briefing opposition mps about this particular outbreak so certainly have no trouble in making myself available to brief and partic on particular topics or generally on how things are going and have done that already uh just last week if i could just add to that that um briefings have been provided to the opposition whenever they have asked for them um there was a uh shane ritty i think contacted me yesterday asking for a briefing uh we didn't manage to schedule that yesterday because people were actively working and making sure that we got the announcement out yesterday um but we i think uh endeavouring to schedule that for this afternoon so that they they will have the briefing so we've not been declining them briefings um but if they want those to be in public um through a select committee then that's obviously a matter for the select committee to determine minister with regards to the wearing of masks uh many of our pacifica communities attend churches funerals tangihaana will you require them to wear masks in those close group gatherings well obviously there are some restrictions now on group gathering size that will apply particularly in auckland um for this for this next period of time and we've been clear about that um my advice to people if you're if you're in a group um and you don't know everybody that's in the group or or you know you may only be an occasional contact of with you know in contact with them then we're a mask we're asking all new zealanders when it comes to mask use to be sensible to take a precautionary approach to wear a mask when in doubt um and just you know help to stop the potential spread of the virus also seven community cases today two were from household contacts two were from churches how were the other three infected uh actually i noticed my information that i provided didn't have the other three we will make sure it is in the statement i'm sorry i haven't got any information in front of me but what i can say is and i've read the situation reporters they were all directly epidemiologically linked to existing just that uh case we haven't been able to epidemiologically link it to the original cluster i'd need to check that but we'll make sure that's clear in the statement that goes out i was going to ask follow-up to that which is the 109 cases in the community that aren't the maintenance worker at the ridges have all the rest been uh been connected through epidemiology to the main cluster or they still have cases that you haven't figured out yet there are still some cases that we've been able to show through the whole genome sequencing are linked to this outbreak quite clearly but we haven't yet established the exact epidemiological link and of course we haven't established the exact link right at the start of the of this outbreak where that connected to you know what case that connected to um so the vast majority have got an epidemiological link many have got a link through both and some it's just through the whole genome sequencing how concerning at this point though is it that those links haven't been established but you can't quite figure out how that happened well i must say that particularly where we get a new case where we can't auto initially link it then we we follow that very closely and that was one of the influential things in my advice to cabinet about why we felt it was um it was important to extend the current uh loot levels for another few days until we can much more confidently link any new cases directly to the outbreak the thing that i would just add to that is you know ministers um play a very very keen interest every morning to what new information we've gathered around new cases and around uh you know new information about existing cases that are being investigated and it is like trying to assemble a jigsaw puzzle and each new piece of the puzzle provides you with more information and there are still some gaps in the jigsaw at the moment is very clear we haven't quite identified with any certainty where the origins of this cluster came from yet but each new piece of the puzzle gives us a bit more of a clue as to what that might be going to be doing after these next couple of weeks to ensure you know once the country moves back down to level one that those testing levels do remain at the 4000 a day that you'd set previously so we don't end up in the same situation again where you have an outbreak and and you detect it 10 or 11 days after first symptom onset yeah i think you're likely to see after this whenever that may be that they'll continue to be a very active community presence around testing that won't just be reliant on gp practices and and after hours clinics that will actually involve uh continuing use of pop-up testing sites um we want to keep that surveillance testing rate at a you know at a good healthy level um to give us the sort of reassurance that we're looking for so yes there will be it will look a bit different after this most recent um outbreak compared to how things looked before i just wanted to check in what was happening with the case of the person whose brother went to hobbiton and they previously had covered when they were overseas do we know have we linked that one yet uh not as yet we've um there's been a challenge with getting enough of genetic material from the sample um and so esr is still working on that so it's still a it's still um it's believed to link to the um current uh well what i should say possibly link to the current outbreak but it also may relate if we look at some of the um test results and the values of the early test result it may just be an old infection that has now been picked up so we're still just clarifying that one okay would it be fair to say then there are two unlinked cases is that good well it should be fair to say there are three because there is also the myth worker um that which we've previously described so yes those are the uh the three i guess the one we're concerned about is the the one who's in hospital because it's yeah it popped up unexpectedly with a hospital presentation just go back to yesterday in the cabinet decision around alert levels and dropping the border and the wall kendall sunday and keep retaining the country in level two what was that your advice what was your advice around where the rest of the country should sit and whether the border with auckland should remain well uh our advice was to maintain the rest of the country at alert level two and to keep auckland at alert level three and uh it was not so much related around the border it was just uh what what we believed based on um epidemiological evidence the pattern of the outbreak and just where we were at timing wise that that was the best there was our best public health advice and and that was one of i mean my advice was one of the things that cabinet took into consideration in their decision do you want it all to remain a little preview on sunday is that right through until sunday there's been a the first confirmed case of reinfection in hong kong um what does this mean for new zealand and specifically does this validate our elimination strategy and or raise problems for herd immunity and effective vaccines i think it's too early to read anything into that uh finding and that's what you heard the world health organisation come out and say as well and i endorse that okay okay last couple of questions we've been contacted by someone who missed a funeral today because the exemption process to get them out of auckland was too slow what is an acceptable time to wait for that exemption process to roll through well i can say our exemption team is working as quickly as possible on them and in fact we were reinforced yesterday with another um i think 20 people who came from other government agencies we're absolutely prioritizing those um urgent and um urgent requests that relate to visiting darwin relatives or attending funerals or tangihanga so in that case i'm i'm very sorry if we missed the deadline there that might have been short but i know the team is very focused on getting those and i'm turning them around and signing them off um regularly during the day okay do you have another question yeah i just want to go back to oh are you going to have one hp i just wanted to go back to the the fees that um gps are charging for tests i mean typically a gp appointment costs between 50 to 75 and you've said that the fair price for a covet test is 250 by that top tier price i mean is this an undercover subsidy for gps who've had a hard time over lockdown well i can say it's not uh and the the amount that is paid for doing a test or doing a full assessment in a test has been carefully negotiated and worked through by the ministry district health boards and primary care so much more expensive than what a gp normally costs for a visit well i'll tell you well it takes into account the extra time it takes if someone is doing a swell but requires the gp to put on ppe there's also the materials involved and as well as the clinical assessment okay in front here can you guarantee martian pacifica communities that they will be martin pacifica in those staffing in those pop-up stations is that a guarantee you can give them well well i don't think i can guarantee that at every pop-up station there will be maori and pacifica staff what i would say i just record after you'll after your last question is that what we have seen is the maori and pacifica providers across auckland making their staff available i know for example the national hill order coalition has made a number of its staff available to assist with these testing teams and so i think there's a very strong likelihood that if people from those communities are going to be tested they will see maori and pacifica staff as part of the teams okay last couple of questions what did you what did you make of judith collins describing you as essentially a part-time helpfulness this morning i completely disagree with her i can certainly tell you it doesn't feel particularly part-time at the moment travel to the south island and lower the alert level um south to one oh look the cabinet looked at all of the different sort of geographical you know considerations that could apply here there is a lot of movement new zealanders are an incredibly mobile people um and so uh differentiating between regions unless you're going to have the hard borders that we have around the level three in auckland at the moment is actually very diff very difficult the case that showed up in hospital has been linked back to the cluster as part of the difficulty there that their medical condition precludes the kind of contact tracing and interviewing would be necessary uh that's not my understanding uh certainly not from when they initially presented to hospital um i guess the concern there is if the first time you find out about a case is when someone presents to hospital then that's a that's a little yellow flag and so that means the person has been infected for a little while for a few days and that's why we're particularly concerned about that case but we've had no trouble identifying or the public health units had no trouble identifying uh household and work contacts they were all isolated and then the question and tested and the question then is how do we trace that case back to the actual wider outbreak epidemiologically all right we'll wrap that up there thanks everybody you