Community surprised as Auckland moved into alert level 2

Doctors on the frontline of the latest outbreak are on high alert despite the government moving Auckland to level 2.

South Seas Healthcare has tested thousands of people through the Ōtara testing centre this week, most of them from Papatoetoe where the current six-person outbreak is centred.

Staff gathered around a TV in the reception to watch the government's announcement and GP Maryann Heather said they were surprised at the decision.

"It could have gone either way but I guess ... we were thinking we might extend at least till Sunday," she said.

As many Aucklanders breathed a sigh of relief as they come out of level 3, Dr Heather and her colleagues were still in the middle of the latest outbreak.

Some of the positive cases came through their testing centre and the memories of the large August outbreak, centred in South Auckland were fresh.

"For us in South Auckland, we're still quite mindful that we shouldn't relax too much and we still need to make sure that the messages go out there that if you have any symptoms or you have any contact with those people who are positive then you need to make sure you do the things you need to do and get tested," she said.

She was wary about some of the new places of interest, including a nearby Subway store, and that there may be cases lying dormant.

It was more worrying because of the large Pacific population in the area which would be more vulnerable to Covid, she said.

"We kind of err on the side of caution but I guess we just have to go with what the government feels is the right call," she said.

Auckland epidemiologist Rod Jackson was also surprised by the decision.

Though he had faith in Director-General of Health Dr Ashley Bloomfield and his team, he worried there were test results yet to come in from Papatoetoe and about the unknown source of the outbreak.

Most Aucklanders would have tolerated a couple of more days at the higher level - especially because it seemed a lot busier than previous level 3s, he said.

"All the tradies are still working, I think a lot of people are working," he said.

"It's hard on restaurants that rely on having people in, I get that, but I still think we should be cautious and, I do wonder - let's hope they haven't jumped the gun," he said.

Associate Minister of Health Ayesha Verrall told Morning Report the level 3 lockdown was needed until community transmission could be excluded and no unidentified cases found.

"On Sunday we faced a situation where we couldn't exclude there being community transmission. And community transmission is a situation where we want to be at a high alert level.

"What we found instead is that we have a chain of transmission and our contact tracing system can work to contain that."

Genome sequencing on the second family has shown a difference of one mutation from the cases announced on Sunday. "That's still consistent with the cases being linked," Verrall said.

Finding the source was important for future prevention but the key to moving down alert levels was whether there was an unidentified further case. "We've done 20,000 plus tests in the Auckland region since the weekend and we haven't found it."

Verrall said there was greater confidence the contact tracing system could deal with chains of transmission. In the recent Northland community case they were able to quickly follow up on them and and keep them contained.

She said serology tests on staff at LSG Sky Chefs, the workplace of one of the cases announced on Sunday, were negative and had not found a person who infected her.

Close contacts at Papatoetoe High School had all been tested and the school remained "essentially at level 3 or more" through the weekend.

"Also, close contacts are required to isolate for two weeks - so they remain in quarantine."

Close contacts are required to have a second test, while casual contacts have one, but all are required to have a second test if they develop symptoms, she said.

Read more:

• Covid-19: What happened in New Zealand on 17 February
• View updated locations of interest here
• Covid-19 Response Minister on alert level decision

National Māori pandemic group Te Rōpū Whakakaupapa Urutā co-leader Papaarangi Reid said she was comfortable with the level change after a cautious approach taken in South Auckland.

The decision-makers seem to have a handle on the extent of the outbreak, Reid said.

Covid-19 Minister Chris Hipkins said alert levels would rise again if new cases appeared with no clear link to the current ones.

Epidemiologist Michael Baker said the decision was the right one and, unlike the August cluster, there was a plausible link to the border and no evidence of a widespread community outbreak.

The government had worried the current cases could be the tip of the iceberg, but that did not seem to be the case, he said

Baker said he would have liked a move to new levels 2.5 or 1.5, to send a signal the country is not in the clear.

"Unfortunately many people will interpret the situation as business as usual and do very little differently in this environment."

Having many levels as Melbourne does is useful, as it can makes it subtle changes clearer, such as when to wear masks and how many people should be at a gathering

Covid-19 data modelling expert Shaun Hendy said it was still a concern that no source had been found, but indications were a link to the border.

With only a few secondary cases it did not appear to be playing out like the Auckland August outbreak, he said, though knowing the source would give more certainty that there was no undetected cluster.

He would like to see the testing rate be kept up over the next few days.

Hendy said the use of wastewater testing this time has given extra reassurance.

"That does give us reassurance that we're not missing a large cluster that's out there."