After almost a month in lockdown, another alert level decision looms for Auckland, and while 'mystery cases' have dashed hopes, Prime Minister Jacinda Ardern has given a reminder that may suggest the end is in sight.
While new COVID-19 case numbers are still in the double digits, with 20 registered on Sunday, Ardern said it's important to remember that most of them are household contacts and there is an expectation that more will test positive.
"I would just remind people that within some of those numbers you'll see that often we are still seeing household contacts coming through," Ardern said at the 1pm press conference on Sunday.
"We've gone out and looked at how many close contacts we have who aren't yet required to have their day 12 test, and we do still expect a proportion of them to come back with COVID. Now, they're all safely isolated, but it does give you a bit of an idea that we do still expect to keep seeing those numbers."
There are about 350 very close contacts who are still in their 14-day isolation period, and Director-General of Health Dr Ashley Bloomfield said about 16 percent of them will return a positive test result on day 12.
"This indicates both the importance of keeping people in isolation for the full 14-day period, but it also shows we could expect around another 50 cases just from our very close contacts across the outbreak who remain in isolation and are still to return that day 12 test."
Of the 23 new cases, Dr Bloomfield said nearly half - 11 - were contacts of other cases, which includes a third - seven - who were household members of a case. But 10 were infectious in the community, with more than 40 exposure events linked to a "relatively small number" of them.
There were also initially 10 cases unlinked to the 16 sub-clusters, but Dr Bloomfield said that number was quickly narrowed down throughout the day, meaning there were just three for whom there was no clear epidemiological link.
These 'mystery' cases are causing concern. Otago University Professor Michael Baker, an epidemiologist, has warned that unlinked cases will likely impact the Government's alert level decision.
And he's not alone.
"The detection of mystery cases unlinked to the current outbreak is concerning, and likely to affect the potential for a shift in alert levels for the Auckland region," said Otago University's Dr Dianne Sika-Paotonu, an immunologist.
But Ardern is painting a more optimistic picture.
"We have to remember we still know where the vast majority of our cases are coming from. This is a simple and important reminder because it's an indication of the general control that we have with this outbreak," she said.
"We have high testing rates in those suburbs where we do have some concern that we might have cases we've not yet found."
Deputy Prime Minister Grant Robertson pushed back on Prof Baker's suggestion that mystery cases will prevent an alert level change for Auckland, telling The AM Show that is "not necessarily" the case.
Dr Bloomfield reflected their optimism.
"What is really clear, there is no widespread community transmission in Auckland," he said.
"Yes, we have seen a few cases over the last week or so which, as the Prime Minister said, have taken us a bit of time to link, therefore we're assuming there may be other undetected cases and hence why for the last six days or a week there's been very targeted testing in communities not just of symptomatic people but of asymptomatic people."
Despite 4928 tests registered in Aucklsnd on Sunday paling in comparison to the start of the outbreak when 15,000 were processed on some days, Dr Bloomfield said he's satisfied with testing rates because of where it's happening.
"There has been good rates of testing amongst the geographical areas of focus, including Mt Eden, Massey, Māngere, Favona, Papatoetoe, Ōtara, and Manurewa."
He said "intensive follow-up" is focused on three sub-clusters where there is possible spread beyond households. These include the Māngere church event with 379 cases; secondary community transmission from that initial church event with 164 cases; and the Birkdale social network with 76 cases.
A good sign of progress being made on mystery cases is the Middlemore Hospital incident.
Last week 29 staff were stood down for 14 days after a patient later tested positive for COVID-19. Three others who were at the hospital - including a parent and their five-month-old baby - have since tested positive.
Dr Bloomfield confirmed that the cases are now confirmed as linked to the outbreak.
"Those Middlemore cases are ones that we have been following up, or that the public health unit has. I talked about the gentleman from last weekend, and they've now made the link there very convincingly," he said.
"Likewise, the one that we talked about on Friday, they've found through the genomic sequencing a link back to the original Māngere church cluster. And then it's just trying to find out exactly what the person-to-person transmission was from that."
But this confidence is by no means an indication of an alert level change for Auckland this week. Cabinet will be given the most up-to-date information from health experts to decide on the appropriate course of action.
"What I don't want to do today is speculate on advice that we haven't received yet, because literally our public health teams use all of the data they receive right up to the minute that we make the decision, so we're making it based on the best information possible," Ardern said.
"We are all aware of how tough it is for Auckland and the extraordinary load that they are carrying for us, but the constant reporting I get is that, by and large, the compliance is still really good because people understand why it's happening and what the goal is."
