One in 10 people going to Middlemore Hospital's emergency department are testing positive for Covid-19, the Director-General of Health has revealed today.
Director-General of Health Ashley Bloomfield and officials explained today how home isolation will work, and how technology will support it.
Watch the media conference here:
Ministry of Health primary care lead Joe Bourne, and Ministry of Social Development chief executive Viv Rickard presented alongside him.
Dr Bloomfield says phases two and three are both about flattening the curve, to keep people well and out of the health system, and to ensure the country keeps functioning as well as possible.
He says digital technology has and will continue to help officials identify cases and contacts more quickly. "Most cases will now be notified by text message."
He says the texts will contain a link with information about self-isolation, how to inform others about their status, and how to look after oneself and get help if needed.
Cases would be invited to fill out a form online to help ensure they can access health or other supports to help them isolate safely.
"It might be for example that if a person is immunocompromised or has an underlying illness that would be severely impacted ... then they would have a discussion with our teams who will determine what sort of support they might need."
He said they would also supply information on their contacts.
Most people would not require any support and would not require a phone interview, but that option would remain for those who prefer it or who do not have internet access, he says.
He says phone contact will still be available for people.
Dr Bourne says anyone who does not have access to something that allows them to click a link will still have the ability to call a phone number. He says there is capacity.
On top of that, local care coordination hubs will ensure nobody slips through the net.
"They will be monitoring that list and they will be able to see when people have that first contact and first assessment. For those that aren't seen to have that assessment, they will follow that up by any means necessary."
He says the self-assessment form will assess people's clinical needs and their manaaki welfare needs, and the information will be pushed out to providers so they can provide the care required.
Somebody on the "self-management pathway" will typically have little communication, but will be provided with information about how and when to seek more help if needed.
"Finally at the end of the isolation period, people will be automatically notified ... that the period of isolation is complete."
A sample of the text message for the self-service form will be provided, so people are not concerned that it is a phishing scam or something like that.
Isolation begins at the same time as the case in the household returns a positive test. Household contacts will still be isolating for the full 10 days along with cases.
The government will continue to use QR codes, Bluetooth and other locations of interest will still be added to the list if they are high-risk settings.
Bloomfield says about 20 percent of 2258 community cases who were interviewed were provided with a Bluetooth token to anonymously alert people who they were in contact with, and about 90 percent used it.
About a third of those alerts led to people contacting Healthline - about 538 calls over a month.
Bloomfield says it was less than 1 percent of contacts overall, but useful, and the government will continue to use the system until it becomes less useful and begins generating too many alerts, what has been referred to overseas as a "pingdemic".
He says a general rule of thumb for the definition of a close contact is if you have been within 1.5 metres of a positive case over more than 15 minutes. Direct contact such as kissing or sharing cigarettes or vapes would also count, along with spending time in a confined indoor space doing things like singing or shouting.
Photo: RNZ / Samuel Rillstone
Covid-19 tests
Bloomfield says data from rapid antigen tests at Middlemore Hospital yesterday showed about 10 percent of people who showed up to the emergency department tested positive.
He says rapid antigen tests are useful in that circumstance because there is a higher likelihood of people testing positive, due to the location - Auckland has many more cases than other regions, and unwell people are more likely to show up at hospital.
"These are unwell people, they're turning up seeking care."
He says the tests are not sensitive enough to be very valuable in many other settings, and are more likely to generate a false positive or false negative, but they will become more useful as the outbreak grows.
Bloomfield urges people who do not need to be tested to leave the capacity for those who do: people with symptoms, or who have been at a location of interest or been contacted by health officials.
Bloomfield says locations of interest "will still be a thing", but "there will be so many of them that not all will be able to be followed up".
He says contact tracers are going to focus on settings that are the highest risk. This does not include things like supermarkets or public transport.
He says the system will require people to keep doing what we've been doing throughout the pandemic and get a test if they have symptoms.
He urges people to use the Bluetooth function, and says it's important for people to notify their employer if they test positive.
Informing the workplace
Dr Bourne says the Ministry of Health will be working with employers to ensure the text messages can be used as evidence of the fact people have been unable to attend work.
He acknowledges that self-management will not work for all people, but will allow a higher level of care to be prioritised for those who may need it, such as Māori, Pasifika or people with disabilities.
Viv Rickard says MSD's model for providing a welfare response is coordinated with nine other agencies and mirrors the model with the ministry.
"We've stood up things at a regional level, at a local level to support the health response and the welfare needs. We've funded 150 providers throughout the country, out of those providers about 70 are whānau ora providers ... we've got also 12 Pasifika providers."
He says MSD has a section in the self-assessment form.
"Our welfare response will be for those that can't afford to or are unable to access help while they are isolating."
He says the biggest immediate need has been food, and MSD has funded 205 food organisations throughout the country as well.
"There are some people who are going to need support and others will be okay," he says.
How it will work
Ministry of Health's digital team member Michael Dreyer and project manager Merrin McLeod are providing details on the tech.
Message notifications will come from the 2328 phone number, the same number that has been sending vaccine messages.
The text will contain two links - one to the self-assessment form, one linking through for information about what you need to do as a case or contact.
Texts are beginning to be sent out today.
The My Covid Record site has also been updated with a section allowing people to self-report results of a rapid antigen test, and understand how to interpret it.
A positive test indicates people should get a follow-up PCR test to confirm.
New Zealand moved overnight to phase two of the government's plan to handle the Omicron outbreak, signalling a shift to shorter isolation periods and greater emphasis on at-home isolation.
The steady increase in daily Covid-19 cases means it will be harder for contact tracing to cope, so cases and their contacts will be followed up differently by officials with greater reliance on automation and technology.
This includes cases being notified by text rather than a phone call; an online tool to help cases provide details of high-risk exposures to reduce the reliance on intensive interviews carried out by contact tracers; and greater use on rapid antigen (RAT) testing including for the test-to-return-to-work scheme.
The government yesterday revealed rules for self-isolation for incoming international travellers ahead of borders beginning to reopen from the end of the month. Cases and contacts within New Zealand will be expected to follow similar guidelines when isolating at home.
Covid-19 Response Minister Chris Hipkins told Checkpoint last night the systems for having people provide RAT tests results had been established, and there would be options for people without internet access.