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Covid update: Director-General of Health says all five of the new cases are linked to the Auckland cluster

Covid update: Director-General of Health says all five of the new cases are linked to the Auckland cluster

There are 5 new Covid-19 cases in the community - and one case identified in isolation, bringing a total of six new cases.

All five of the new community cases have been linked to the Auckland cluster. Also on Wednesday it was announced there would be a new group to help the Ministry of Health with border security.

There have been no further cases in relation to the so-far one-off case of the maintenance worker at Rydges Hotel in downtown Auckland whose infection had been linked through genome testing to a positive case that had returned from the United State and had been staying at Rydges.

Investigations are still under way as to how the worker contracted the virus, given that he is not believed to have had any contact with the person who actually had it. It is believed possible he got it from a contaminated surface, or alternatively perhaps through an intermediary - someone else who had caught it at Rydges. All people at the facility were tested on Friday and have now been tested again.

There are now 96 active cases, including 74 in the Auckland cluster, 21 in isolation at the border and the one case relating to Rydges.

Director-General of Health Ashley Bloomfield and Prime Minister Jacinda Ardern provided the update on Wednesday.

Bloomfield said the number of confirmed cases in New Zealand was now 1299.

There are now five people in hospital, one in Auckland city and four at Middlemore. None of the people are in ICU.

Bloomfield said testing continued at high levels with 23,038 processed on Tuesday, bringing the total number of tests to 639,415.

Over one and a half million people have now downloaded the tracer app.

Prime Minister Ardern indicated that so far the "roll out" of the "resurgence plan" was working, while acknowledging some of the changes she was announcing on Wednesday including more defence force personnel being brought into the isolation facilities and at the border.

Asked about his comments the other day about Level 1 in future possibly looking a bit more like a level 1.5, Bloomfield said the country had done will in getting down to Level 1, but his comments were to say that in future Level 1 might include us "accepting" we might have to do some things we had not done at that level before including use of masks and physical distancing in some situations.

The Ministry of Health put out the following release later on Wednesday:

There are six new cases of COVID-19 to report in New Zealand today.

One case is an imported case – a woman in her 50s who arrived in New Zealand from Qatar via Sydney on August 14. She has been in managed isolation at the Sudima Hotel in Rotorua. 

The other five cases are in the community and they have all been linked to the recent outbreak. 

These six new confirmed cases bring our total number of confirmed cases of COVID-19 to 1,299, which is the number we report to the World Health Organization.

There are 125 people from the community who have been moved into the Auckland quarantine facility, which includes 61 people who have tested positive for COVID-19 and their household contacts. 

There are five people receiving hospital-level care for COVID-19, one in Auckland City and four in Middlemore. 

A note on this, people who have COVID-19 and are in hospital are isolated and carefully managed separately from other patients. The public can be confident that our DHBs are managing this effectively, as they did in the first outbreak of COVID-19 in New Zealand. We have heard reports of people who are reluctant to get an ambulance or go to hospital – hospitals continue to be safe places to receive medical care, and people should feel confident going to hospital to receive treatment.

Yesterday our laboratories processed 23,038 tests for COVID-19. 

That brings the total number of tests completed to date to 639,415. 

On testing, people should only get tested if they are symptomatic, connected to a case or are concerned that they may have come into contact with a case. This will help with our lab capacity right now.

Close and casual contacts 

Since August 11, we have identified 1983 close contacts of people who have tested positive for COVID-19. We have traced 1,861 of those people and they are self-isolating, and we are in the process of contacting the rest.

We are hearing reports of some confusion among people calling Healthline as to what different groups of people need to do, so we are providing clarification on that:

Close contacts

Close contacts are people who have had quite close exposure to a confirmed or probable case of COVID-19 during the case’s infectious period – for example, living in the same household or being within 2 metres of a case for 15 minutes or more. They are likely to be at a higher risk of being infected through that exposure. We are asking people who have been identified as a close contact to get a test and stay in self-isolation for 14 days to reduce the risk of spreading COVID-19.

Casual contacts

Casual contacts are people whose exposure to a case was shorter or further away and they don’t meet the criteria for a close contact. They are likely to be at lower risk of being infected following exposure. We are asking people identified as a casual contact to monitor their health for 14 days after exposure and seek advice from their GP or Healthline if they become unwell or develop any symptoms of COVID-19. 

More information on this can be found at Contact tracing for COVID-19.

All Aucklanders

Auckland is in Alert Level 3, so everyone within the Auckland city boundary is being asked to stay home unless they are an essential worker, or unless they are travelling for an essential purpose, like getting groceries or medication, or accessing medical treatment. Everyone in Auckland, and indeed all of New Zealand, should closely monitor their health – if you develop symptoms of COVID-19 please seek advice from Healthline or your GP about getting a test – this will help us stamp out any cases in our community quickly. 

Genomic testing

Genomic sequencing continues fill in more pieces of our puzzle about the route of transmission for the Managed Isolation facility maintenance worker at the Rydges Hotel.

Yesterday we reported that partial genome sequencing results indicated no link to our existing community cluster.

The full genome sequencing and matching has now been completed. It found the genome type called clabe B1 is one commonly seen in the US.

There have been four positive cases in New Zealand with the virus with this genomic sequence, but the full sequencing now confirms the closest match is with the July 31 returnee from the US.

Investigations on how the worker at the Rydges became infected continue.

Serology testing

On a related note there has been some discussion about whether serology testing – a blood test confirming the presence of antibodies to the virus – would be useful in this and other scenarios.

Serology tests are an important part of our suite of investigation tools and we are looking at how we can use these in the most systematic, efficient and effective manner.

Serology testing of these contacts may provide another piece in the puzzle but will only tell us someone has been exposed to the virus, not which strain.

We have already used these tests to find out more information about this cluster, particularly in households to see if anyone else has had the virus. 

Pak n Save

Yesterday we mentioned Pak n Save Glen Innes in Auckland as a site which had been visited by a shopper who is a confirmed case of COVID-19.

The investigation continued yesterday and further scoping revealed this person had in fact visited the supermarket once while infectious – on the 12th of August.

We apologise to Pak n Save Glen Innes and Foodstuffs if that caused any issues.  

As we indicated yesterday this person was considered a low risk and employees and other shoppers are also considered to be at low risk.

NZ COVID Tracer 

The total number of New Zealanders who have now registered to use NZ COVID Tracer is 1,556,138 – and more than 908,000 of those have been in the last eight days.

106,464 businesses have now got their QR codes across a total of 266,137 unique locations.

It’s been great to see the New Zealanders using the app and businesses using the QR codes. 

We’ve received a high volume of requests for QR codes from businesses and the team are working through these as fast as possible. Enforcement of the order to display the codes will be pragmatic. For business, while you’re waiting, please make sure you have a suitable alternative process in place such as a pen-and-paper register.

We have had some feedback that some QR codes are displayed in places that are not easily accessible for people with disabilities. A request for businesses to please check they have at least one QR code in an easy-to-reach location with the top of the poster approximately 130cm from the ground. Ideally, this should be the poster at the entrance to your premises. Remember you can print more than one copy of your QR code.

For any app users experiencing issues – there is an app support team you can contact on 0800 800 606 or help@covidtracer.min.health.nz

Exemptions 

There is advice on travel into and out of Auckland on the All of Government COVID-19 website.

Travel in and out of the Auckland region is restricted. 

There are a limited number of personal exemptions being granted, such as returning home or attending a medical appointment.   

There are also exemptions for work purposes – such as moving freight, emergency services, postal services or media.

People can apply for exemptions from the Ministry of Health. We are aware that there are a number of people who have lost loved ones who are applying to attend a funeral or tangihanga that requires movement either in to or out of the Auckland region. 

Travel in to or out of regions at Alert Level 3 is not permitted unless some quite specific conditions are met, and an exemption is granted.

Advice for individuals seeking exemptions, the process and what information is needed to consider their request will be on our website today.

We recognise this will be challenging for families in mourning, however this is the best way to keep our communities safe and contain the spread of COVID-19.

We welcome your comments below. If you are not already registered, please register to comment.

Remember we welcome robust, respectful and insightful debate. We don't welcome abusive or defamatory comments and will de-register those repeatedly making such comments. Our current comment policy is here.

74 Comments

Phew. Maybe we will get out on the 26th.

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yeah seems like we are coming out the other side. Though it took about 3 weeks from a similar point in April until we went to level 2. Hope it's not that long this time.

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Jenée since I believe you're in the press gallery, could you try and ask this question of Bloomfield or Hipkins?

It's clear now that genomic analysis is important for tracking how this virus spreads, but we've learned that many of the samples previously taken in the MIQ facilities did not have enough RNA to allow genomic analysis to be completed on them, leaving a gap in our knowledge of the strains that have arrived in New Zealand.

Given this, when positive test results are found from a traveller in isolation or quarantine, are these samples immediately sent for genomic analysis? And, if the sample ends up not having enough RNA present to allow genomic analysis, will a follow up swab be taken for the express purpose of allowing that genomic analysis to occur?

Thanks.

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Good question. Have we heard what fraction of existing MIQ swabs could be sequenced?

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I don't recall hearing a specific number.

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The publicly viewable GSAID database does not have any Genomes uploaded from New Zealand since April.233 were uploaded from NZ to the end of April. Not sure if that means anything. I am not a geneticist. But Australia uploaded 77 from July 1st until August 5th.

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They definitely have recent sequences so that database can't be complete.

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The maintenance worker was in the room of the infected traveler from the US a couple of days before they arrived. It maybe the case that the maintenance work passed it on to the traveler. He stated that he thought he had a pre existing cough, indicating that it may have been present for a time.

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No, they ruled that out.

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Cheers.

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Almost impossible. Not just the preponderance of the odds for someone in NZ having vs someone coming in, but also that the worker could have a high enough viral load now to return a positive PCR test.

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Possible, although they only developed symptoms on Tuesday 11th August, which is 11 days after the US traveller left the hotel on 31st July.

We know that people are infectious from 1-2 days before they start showing symptoms, so it would be very unlikely that this maintenance worker was infectious on or about 25-26th July, didn't develop any symptoms for 17 days and managed to infect only the US traveller but not a single other person at the hotel, since all other workers have returned negative tests.

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unlikely as the genomic testing shows it the other way around unless ESR got it wrong
https://www.health.govt.nz/news-media/media-releases/results-covid-19-p…
Genome sequencing shows a returnee from the USA with the same sequence as the maintenance worker was at the Rydges Hotel from 28 July to 31 July before they returned a Day 3 positive test and were immediately moved to the Jet Park quarantine facility on 31 July.
The person returned a positive result for COVID-19 on Sunday 16 August with symptom onset on 11 Augus

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How unique is the Covid19 Genome sequence that infected the returnee from the USA?
Is it prevalent in other parts of the world as well or just the USA ? Is it possible there was another person in NZ(even briefly) like aircrew? That had the same version of the virus and did have contact with the maintenance worker at Rydges?

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According to Bloomfield, the virus mutates just a tiny bit when it moves from person to person and this allows a detailed family tree to be built up. So if they're saying this was the causal link, then it highly likely is.

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Is it possible that the person who went to Jet Park on the 31st July passed the virus onto a worker there who in turn infected the maintenence man at Rydges. Ie 11 days is more than enough time for that to happen
I would be looking for that link.
Also think the Jet park could be a link to the Americold case

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Is it possible that the person who went to Jet Park on the 31st July passed the virus onto a worker there who in turn infected the maintenence man at Rydges. Ie 11 days is more than enough time for that to happen

Yes, they acknowledge that is likely what happened, but they tested all the workers an didn't find any other positive ones. They're now doing the test again, and also are going to do serology tests (looking for antibodies) to see if someone amongst the staff are now negative for COVID-19 but have previously had it, perhaps because they got a very light dose - enough to infect just the maintenance person but no one else.

Also think the Jet park could be a link to the Americold case

They've ruled that out from genomics. The Americold strain seems to be UK or perhaps Australian, whereas the Rydges one is American. They also know who it was in the Rydges hotel had it, how long she had been in the country, and therefore that she didn't have any practical contact with the Americold worker.

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Not sure about that.
https://www.newsroom.co.nz/the-new-zealand-strains-how-the-coronavirus-…
the same article says ESR has the ability to sequence 100 cases per week.
Would still like to know how many they have done from cases in MIQ in last 3 months.

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That article is from May.

Ashley today said they can use genomics to work out who infected whom.

It's not a case of there being only 1 or 2 two strains in the US, there will be thousands of them, in lots of different combinations of mutations. Just look at the first chart in the link you provided, each colour is a different coutry, so clearly countries have dozens or hundreds of strains.

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Not sure it mutates on every transmission. That would mean Millions of genomes.
https://www.stuff.co.nz/national/health/coronavirus/122444739/coronavir…
According to the 13/08 article 80000 unique genomes have been uploaded worldwide. New Zealand had 1225 confirmed cases of Covid-19, and about 700 of the positive samples have been sequenced. Wonder how many of those missing 500 are from MIQ's in the past 3 months?
That would tell us alot about why the link to MIQ cases has not been established for the outbreak. Recent events indicate we could quickly link one of the early cases to a case in a specific MIQ facility.

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"Wonder how many of those missing 500 are from MIQ's in the past 3 months?"

Very few, if any. According to the MOH there have been 68 positive cases in MIQ since June 17th, https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-no…
I see no reason why almost all of those wouldn't have been sequenced as they came in as a trickle, no more than a few a day, and there is plenty of capacity. I suspect the missing ones are from the earlier outbreaks when numbers were higher and capacity was lower. Also may have been triaged in some way, e.g. multiple members of a household would all have viruses with identical or near identical sequences so little urgency in sequencing those.

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Not all samples that test positive have enough RNA to allow sequencing.

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True. Another factor.

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I see no reason why those 68 cases would not have been sequenced either.ESR has the funding and capacity. Also, you would still have the person in MIQ after the positive test and with their consent, you could request a second sample to get the required RNA if the first sample was not usable for sequencing. If I was trying to impress the public with the quality of management of cases in MIQ. I would be saying. Of the ??? cases in MIQ since ????. We have sequenced the genome of ??? of those cases and therefore we a very confident that the community outbreak is not linked to the MIQ.

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Don't know if that would be the case, but I guess it could be the case if necessary. They seem to be able to access the information, anyway

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Why does Ardern continue to say (and continue to get away with saying) things like we had the longest unbroken run of no community transmission in the world at 102 days? We know for a fact the virus was in the community at some point during that 102 days and spreading, it was just undetected. This sort of mistruth can't be allowed to stand during the campaign period - why does she not get challenged on this?

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Yeah, I would've thought she had the sense not to keep saying that.

IIRC she was challenged on it at one point. I guess the press think there are other things more worthy of asking with their limited time, rather than trying to make the PM look bad over that particular statement.

Which, having said that, is unfortunate that this media scrum seems to be the primary place they can ask questions.

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Because the majority of Labour voters love it and she can do no wrong.
It's a comedy show of excuses and scrambling too plug holes that should have been planned for and eliminated during the lvl 1 period.
Don't let it stress you, we're going to get more of the same for three years after this election with a Green cherry on top.

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Kezza R,

Your one-eyed view does you no credit. Has the government made mistakes? of course and more than one, but along with every other country, they have had to make and implement policy on the hoof and if you know anything about large complex organisations, you would know that what actually happens on the ground may not reflect what those at the top have decreed should happen.
I hope you would not suggest that had national been in power, that they would not also have made mistakes. try and get some perspective.

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National being in power vs. not being in power does not change the gulf between what this government says they are doing, what's actually been happening and what they claim with the benefit of revision. The current government is the Labour government, there is no burden of proof on people who want to criticise it to explain what a hypothetical National government would have done differently.

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Labour supporters make me laugh. If you question Labour you are obviously a National supporter, I am not.
I am looking forward to a Labour / Greens Govt. It is going to be the biggest money scramble / comedy show that NZ has ever seen. I'll be waiting at the bottom of the cliff with cash to help people out.

One or two screw ups are acceptable, one after the other for three years, is a completely different story. You maybe able to brush that aside, many can not. FYI, that makes them logical not a National supporter.

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Well said Kezza - still on strike are we or maybe helping out in the community today?

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As I said yesterday, its look after number one.
Putting together a property deal. I was going to offer arround what they wanted but shaved off close to a hundred K. Cheers for that.

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Very cool Kezza you really are the MAN. except I think that's ones taken

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I have never in my life voted for Labour. I have voted for National several times.

People may perceive you as a bit slanted on the COVID issue because we live in exceptional circumstances and they expect a certain level of mistakes to be made at all levels. And they don't find the idea based on National's statements and stances over the last 4-5 months that they would have done any better credible.

I don't agree with your perception that lots of folk out there think the government's management of COVID has been flawless, that they "can do no wrong".

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What absolute rubbish. Where else in the world is currently getting better result than here? Anyone with half a brain can see AB is at the top of his game, and you're lucky to have a national leader that actually cares about a good health result. You want to talk circus? Have that discussion with 170,000 dead Americans.

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Maybe because it was not in the community spreading for almost all of that time? Genome testing has shown that this strain is not related to strains previously in the community. Further, if it was just out there somewhere we would expect the current testing to not bring back results that show all cases except the maintenance worker are related to the one cluster.

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but we now know the first case in the community was at americold on the 31st july so it is not 102 days now

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Fine, but I doubt Vietnam has gone and adjusted their 99 days statistic either. It is probably still true that we had one of the longest stretches. And if she used a number other than 101/102 she'd have to spend time explaining that the number she is using is 102 - x (where x is the days we now know it was around), which is really beside the point and only distracts from what she is trying to communicate. There are plenty of things I can criticise about this government, but their communication skills is not one of them.

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A simple tweak of the language is all that's needed: "no reported cases for 102 days" vs "no community spread for 102 days".

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Lets just call it what it is, blatant politicking.

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I think you'll find the point she is making is that NZ has done bloody well compared to all other countries... that doesn't excuse these errors but as a previous commentator has stated, managing this response is a logistical nightmare that none of us can truly comprehend.

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If it was just the CV response they have not delivered on that would be the case.

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Comparing a small and remote island nation with most other countries is making a false equivalence. We had almost the least complex containment challenges of any developed nation. Yet we endure repeat stuff ups and a PM who misleads us with false assurances on critical issues such as the extent of border control testing . How the obvious step of bringing military disciplines to the quarantine program took so long to figure out, is difficult to comprehend. We blunder along in reactive mode, with obviously unsustainable lockdowns the only apparent plan if these virus breakouts continue.

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Yet they make all the big calls correctly. No other country would have gone into lockdown a few hours after finding one family with the virus. Look at Victoria.
We do have some challenges other countries do not such as an unusually large percentage of population living overseas and also being a tourism based economy.

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That is because we DID have that many days without a positive test, that there was something lurking makes zero difference to that

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That isn't what she said though. She said there was no community transmission. If she means no positive tests, then she should say that. It's quite a distinct and different concept.

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That's semantics. Wait till you start to hear people asserting the early lockdown was illegal when in fact it was unlawful. Some will think there is no difference but there is. Illegal means it has been officially declared such and unlawful means there was no law defining it (and my definition might only be sort of right, not absolutely right)

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She is so clever at politicking. I don't support her but respect her ability to sell a mistruth or polish a turd - especially when people dismiss her misleading statements as "semantics". Just brilliant.

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By that logic Kiwi Build hasn't failed because it is still going.

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yes - achieved through not testing enough. We would still have our "Covid-free" streak going had we stopped testing altogether.

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On that, there is no testing enough that we could physically actually do. In order to be absolutely sure of no covid among staff, they would just about need to be tested daily, as they presumably are exposed daily. We have to accept that simply can't be done, so what is the next line of defence? It's having adequate protection and it is us making sure if something slips through again, we can stamp it out very quickly, even quicker than we are doing now.
So, if we follow high hygiene rules, mask up in close quarters with others, social distance and isolate at the slightest indication of illness, I think we can do this.
The problem is the covidiots among us.

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So given covidiots are a reality and repeat lockdowns are gradual strangulation of economic and health wellbeing, bowing to Swedish inevitability seems only a matter of time.

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One thing is for sure, we do not have to

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Not yet, we must keep trying containment. But if the virus keeps escaping we can't do many more lockdowns.

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Hopefully we can rejig it for least disruption, I think it will have to be, but us doing the right thing might have to be mandated, then watch the conspiracy theorists blow a gasket.
Unfortunately, no matter what we do, tourism is a dead duck for now, the world is heading for recession, there won't be many tourists around and we were geared up for "Next please" McTourism

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I guess if Sweden ever gets to the point where Covid isn’t destroying their economy it may be worth looking into. At the moment though the odd two week localised lockdown seems like the cheapest option doesn’t it.

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Since ~85% of cases go undiagnosed, then it‘s possible that NZ had community transmission since March. To shed light on the matter some organization would need to carry out T-cell serological testing to find out how widespread the infection has been.

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They are doing genome testing and the current cases are unrelated to those in March.

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That we knew 100% of the cases is an invalid assumption. As I recall, some 30,000 students returned from China in March to take up their studies. Although we had travel bans in place many circumvented the bans by transiting through a third country.

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Health teams were also doing serology tests on the staff.
they are now doing that for the staff of rydges, that outcome will be interesting, there may be a link person between the traveler and maintenance man whom was asymptomatic

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It depends on what sort of tests they're doing. If it's IgG testing then it's meaningless. It's known that those antibodies fade pretty quickly. Pepole who had COVID often test negative for IgG after a few months.

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Since ~85% of cases go undiagnosed

Way to take something completely out of context. Here's what it actually says:
"We estimate that 86% of all infections were undocumented before the 23 January 2020 travel restrictions."

They were undiagnosed because they weren't being tested. In January. Of this year. Before the western world was doing any serious searching or testing of cases, and there was hardly any capacity for testing.

Completely irrelevant to the situation in New Zealand post June.

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You're missing the point. The vast majority of COVID cases have little to no symptoms. A little diarrhea, maybe a slightly tight chest but that's it. Those people don't bother to go to the doctor.

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Yes but it also spreads very fast, especially at level 1. In 2-4 weeks 1 case could be hundreds. It wouldn’t take long for someone to have symptoms or even hospitalisation and be tested.

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That's not what the part of the article you quoted says.

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And from the always-alert Jo Nova - news of a SARS-COV-2 prevention measure out of UCSF: a little nanobody 'cap' over the spike on the virus which could effectively foobar its ability to lock into lung ACE2 receptor cells. Can be mass-produced once out of the testing phase from bacteria and yeast, at low per-dose costs. Needs (probably, article is coy) some GE of the bacteria involved to create just the right configuration, so dinnae - er - Hold yer Breath here in GE-free Godzone. Ain't real science Wunnerful?

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And this just shows what the obsession over vaccines being The Only Solution is misplaced. This sounds like it could potentially be a very effective treatment, if it pans out. So you go to your GP, they do a test which has a 15 minute turn around time, confirm that you're positive for COVID-19 and give you some nasal spray and tell you to stay home until you're recovered.

That could be a realistic scenario in 2nd half of next year or 2022.

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If we only has a test with a 15 min turn around time is really key in that hypothetical scenario ... the magic nasal spray would of course be great - but not indispensable .
If a cheap and accessible 15 min test existed now the epidemic would be on the vain already - isolation would do most of the rest.

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I believe these exist, at least at the trial stage however they are less sensitive and won't return a positive test until the viral load is fairly high. It could take days longer to return a positive but would enable widespread routine testing that may actually speed up detection.

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Most of the insulin supplied in New Zealand (Humalog) comes from GE modified e.coli bacteria, and has done for many years.

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Ssssh... Just don't tell the Greens.....thin end of the wedge, and so on. Why, next we'll have zero-carbon nuclear at this rate....

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Beat me too it, oldbloke.
Tens of thousands of NZers take drugs produced by GE organisms every day. If a drug for CV19 became available, any GE involvement would be of zero concern to anyone charged with getting it for NZ.

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The infections seem to be springing up in unexpected places and seem to be spreading sporadically.
The health officials and others will have their hands full tracing and containing this spread.
We have to co-operate, not panic and stay at home as much as possible.
We should not go the Melbourne way, by refusing to wear mask, etc.
Hope we can beat this quickly and without much pain and noise.

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