Omicron could force more changes to the country's contact tracing system, with the Ministry of Health carefully monitoring the situation in Australia and the UK.
Director of Public Health Dr Caroline McElnay. Photo: Pool / Stuff / Robert Kitchin
Contact tracing is critical to containing any incursion of the new Covid-19 variant, but the system struggled to keep up during the height of the Delta outbreak.
Tracing will be vital to contain any outbreak over the Christmas period as New Zealanders move around the country.
Director of Public Health Dr Caroline McElnay said Omicron was another game changer.
"It spreads fast ... cases get infected very quickly after exposure," she said.
That made rapid tracing of contacts all the more vital, to get them isolating before they could expose anyone else.
The ministry was looking particularly closely at New South Wales were Omicron cases were soaring, McElnay said.
"If we had Omicron in the community and if we had, in particular, some superspreading events, we might start to see a surge in cases quite quickly, and I think that might be challenging for contact tracing alone to be able to bring those numbers down."
McElnay said Omicron, like Delta, spread mainly through homes or places where people spent a lot of time in close contact, so that was where the focus would be if a large outbreak developed suddenly.
Any changes to the system could include a greater focus on tracing the highest-risk cases, with less of a focus on those with very few contacts or who had not been in risky settings, she said.
"Individual cases with very few contacts who haven't been in any high risk locations, we might not spend a lot of time identifying all of those contacts. We may, as we did in Auckland, stop recording all of those locations of interest because we know we're unlikely to get cases from those."
Epidemiologist Michael Baker said that was the right approach.
Contact tracing was a critical part of the country's efforts to try to stop the health system being overrun with Covid.
"If we had a very fast moving Omicron outbreak in New Zealand we would need all the tools we could get working at maximum effectiveness," he said.
The Covid Tracer app being used to scan a QR code. Photo: RNZ / Dom Thomas
It has been a huge year for contact tracers, particularly those in Auckland.
South Seas Healthcare chief executive Lemalu Silao Vaisola-Sefo runs a large team including doctors, nurses, testers, vaccinators and contact tracers.
They had been strongly motivated by helping their community and buoyed by the high vaccination rates, he said, but now everyone needed a break.
"The energy levels slowly diminish over time. The last four weeks have been a really big push for staff."
Auckland's public health unit is walking the fine line of giving tired tracers time off, while making sure they are able to spring into action if needed.
It will have fewer staff working over Christmas and New Year, but many on standby if they need to come back.
McElnay said if there was an outbreak in a small district health board area, like Tairawhiti, the national system would kick in.
There had been big changes since the start of the Delta outbreak, including a national telephone service and an email questionnaire allowing more contacts to be reached.
The system could scale up over a two-week period to be able to trace 1000 cases a day, managing 11,000 initial contacts, she said.