New Zealand's alert level settings will be reviewed by Cabinet on Friday, and while public health officials are confident they're on top of the Auckland cluster, other experts don't expect a quick move to alert level 1.
Back on Sunday night, Auckland shifted out of lockdown to what is called alert level 2.5. That allowed greater movement around the city as well as in and out of it, businesses to reopen with health protocols in place, and for schools to reopen. However, mass gatherings are still limited to 10 people.
The rest of New Zealand went to alert level 2 when the Auckland August outbreak emerged and remains at that setting, allowing larger gatherings than in the Super City. But face masks and the display of QR codes are now mandatory on public transport nationwide.
With dwindling community case numbers - just one was recorded on Thursday - high testing rates, and the vast majority of infected people being close contacts of already known cases, public health officials are confident the cluster is contained.
The director of Auckland Regional Public Health Service Dr William Rainger on Thursday said New Zealand can be confident we "are on top of this".
"The epidemic curve peaked about two weeks ago, it is undulating downwards. We have had the Mt Roskill church congregation, which has given it a little spike, but the direction of travel is downwards."
It was a message echoed by Health Minister Chris Hipkins, who said it was the nature of new cases that was important. Apart from a recent case which is under investigation, all community cases are either epidemiologically or genomically linked to the one cluster.
"The ones that aren't connected are the ones to worry about," Hipkins said.
Both officials said we can expect to see cases emerge for the coming weeks and emphasised the need for continued testing and for people to isolate if they are close contacts and become unwell.
The Prime Minister said we have only had the current settings in place for a matter of days and we don't want to get ahead of ourselves. The rules at present are meant to run until Sunday.
With alert level 1 essentially removing all restrictions but those at the border, would public health and modelling experts advise the Government to stay at the current levels or shift downwards?
Professor Michael Baker
Professor of Public Health Michael Baker opposes a move right now.
"We can't really move down a level yet because we are still seeing cases at the moment, things that happened 10 days ago because we are always looking backwards. We need at least another week at this level 2.5 in Auckland," he told The AM Show on Friday.
"The essence is we want to clobber the virus and be as kind as we can to people. We want the kids back at school, everyone back at work, but it is just too soon. We are doing a great job, but you have to be patient when you are trying to stamp out this virus."
However, New Zealand does have a few advantages now that we didn't have back during our first lockdown earlier this year. That includes knowing more about the virus, encouraging mask-use and mandating it on public transport, and having a far higher rate of testing and contact tracing. QR codes also must be displayed at businesses.
Dr Rainger said on Thursday that at the peak of an outbreak, 500 contacts could be contacted each day and in the last week, 85 percent of close contacts had been contacted within 48 hours - above the so-called gold standard.
Even at alert level 2.5, testing numbers have remained around 10,000 per day, far higher than at the end of the earlier lockdown.
But Prof Baker would still like to see zero new cases being reported before a move.
"I think that is very desirable. Next week we will see the effects of being at alert level 2.5 in Auckland and if the cases continue to track down, that will be a very good sign. We can't guarantee that at the moment."
Professor Shaun Hendy
Speaking to RNZ, modeller professor Shaun Hendy said more time is needed at alert 2.5 and 2 to see how the settings are working.
"I think it would be wise to figure out how well the current settings have worked before we change them. That is the challenge in managing this disease, you do have to wait a while to understand if the measures you are taking are being effective. I think you just have to move at this sort of fortnight to fortnight pace."
Prof Hendy said because of the alert level change on Sunday - which allowed Aucklanders to move in and out of the region - it is possible someone with the virus has travelled to another part of the country. However, testing has yet to find evidence of that.
"Given that we have free-flow of travellers around the country, we probably do need to keep the rest of the country at level 2. There are risks now that Aucklanders are travelling again of an outbreak in another part of the country," he said.
"Of course, if we are in level 1, then that outbreak can grow very rapidly whereas at level 2, there is a chance that it won't take hold at all or it will grow slowly and so we will be better able to contain it. I would say it is quite risky at the moment."
He reminded Aucklanders leaving the city to continue applying the same rules to themselves when in different regions as they would at home, such as not going to large gatherings.
Professor Nick Wilson
Public health professor Nick Wilson told NZME that extending the current settings would provide extra assurance.
"The Government is likely to stay at the current alert level settings because we are not really seeing enough evidence of really good control. We have still got cases appearing every day in the community and to really be confident, I think the Government should be waiting until we are seeing days of no new cases and we have got more evidence that the contact tracing is getting absolutely everyone. "
He'd like to see masks being mandated beyond just on public transport. By requiring coverings in places like restaurants and in workplaces, physical distancing rules would be less necessary,
"I think we could move faster with using masks better. There has been a very good uptake of masks in buses around the country. If we improve mask use in Auckland in workplaces, schools and other settings, we could probably accelerate progress to elimination gain.
On The AM Show on Tuesday, the Health Minister said at that time it was too early to move to alert level 1.
I think we want to just make sure we have absolutely got this current cluster nailed down. We are reasonably confident of that. The new cases that we are seeing are known contacts. They are identified people that we tested for a reason. That is one of the things that we look to," he said.
"We just need a little bit more time to make sure that we have got that absolutely nailed down, that there is no further spread in the community. That is why, of course, we are doing all of this big surge in testing to identify".
He said it was possible for the country to move to alert level 1 without finding the original source for the Auckland cluster.
