New Community Case Of COVID-19 – Expert Reaction



There is one new community case of COVID-19 in New
Zealand, Dr Ashley Bloomfield announced today.

The
person is a man who works on ships that have been at the
Ports of Auckland and Port Taranaki. The man returned
returned a positive COVID-19 test result on Saturday. Dr
Bloomfield said there is no evidence of community
transmission at present.

The SMC asked experts to
comment on the announcement.

Associate Professor
Siouxsie Wiles, School of Biological Sciences, University of
Auckland, comments:

“The new case of COVID-19
outside of managed isolation and quarantine is a person who
works onboard vessels which come in from overseas. This
means it is unlikely this is a case of community
transmission but is a case in the community in a border
worker who we know are at risk, even though they routinely
wear PPE. It is most likely that the person became infected
after being on an international vessel to carry out
maintenance sometime in the last two weeks. Genomic
sequencing may help further identify the source of his
infection. He has previously tested negative during routine
testing but developed symptoms on Friday. Importantly, he
immediately got tested and went into isolation. This will
have limited the time he was in contact with others in the
community while infectious.

“This latest case is
both an example of our border controls working as intended
and the tricky nature of the virus. While using PPE helps to
limit the spread of COVID-19, it is not an impenetrable
defence. Hence the routine testing, and border workers
seeking a test if they feel unwell. I’d like to thank the
worker for getting tested so fast, as this will have limited
the risk of the virus spreading any further.

“In his
briefing, the Director-General of Health mentioned the ‘Swiss
Cheese Model
‘. This was first described by
Prof James Reason of the University of Manchester, UK, over
20 years ago. The ‘Swiss Cheese Model’ describes how the
barriers and safeguards put in place within a particular
system are not impenetrable – they have holes in them,
like some types of Swiss cheese. A hole in one layer of
defence isn’t a disaster if there are lots of other layers
of defence to fall back on. So think of PPE as one layer of
Swiss cheese, and routine testing of border workers another.
But just as important is people getting tested as soon as
they develop any symptoms and going into isolation.

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No conflict of interest.

Professor
Michael Baker, Professor of Public Health, University of
Otago, Wellington:

“This newly identified COVID-19
case in a port worker is important as it appears to be the
first New Zealand case linked to a seaport and
shipping.

“It is also continuing a pattern we are
seeing of occasional cases and outbreaks linked to breaches
in border biosecurity. Since the large Auckland August
cluster, we have seen three small ‘outbreaks’ linked to
MIQ facilities, two in Auckland and one from Christchurch,
and now this case linked to a seaport. Given the COVID-19
pandemic is continuing to intensity globally, we can expect
to see a continuing risk of these kinds of
breaches.

“The first priority is of course to
investigate and control this potential outbreak as quickly
as possible. But we also need to thoroughly investigate this
case to identify how they became infected so that we can
avoid this error happening again.

“Seaports have
received less attention than airports, but are obviously
area of vulnerability for NZ, as this case appears to
show.

“The rapid identification and management of
this case suggests that all of the testing and contact
tracing systems are working well in NZ.

“This case
also did all the right things in terms of seeking testing as
soon as he developed symptoms.

“It is still too
early to know if any of his contacts were infected. However,
the information available at this stage suggests that this
outbreak should be contained very effectively.

“The
risk of COVID-19 outbreaks from shore leave by shipping
crews was assessed in a recently
published
modelling study which also shows how
this virus can be imported through ports.”

No
conflict of interest.

Professor Michael Plank, Te
Pūnaha Matatini and University of Canterbury,
comments:

“The Ministry of Health today announced a
new case of Covid-19 in a man who works at Ports of Auckland
and Ports of Taranaki. This case is an example of our
testing system working as it designed to. The man was tested
promptly after developing symptoms and his close contacts
were quickly traced, tested and isolated. The Covid tracer
app may be used to notify people who have scanned into
places the man visited recently. The risk of onward
transmission is relatively low, although anyone with
symptoms should still stay at home and get
tested.

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“Although this is New Zealand’s first
community case of Covid-19 in over two weeks, there is no
evidence so far that it was caused by community
transmission. The most likely scenario is that the man was
infected while working on a ship. Genome sequencing is
currently underway and results are expected in a few days.
These will help establish whether or not there is a link to
the recent Auckland cluster.

“This case reinforces
the importance of regular testing of all border-facing
workers. Modelling shows that testing weekly rather than
fortnightly significantly reduces the risk of an outbreak
starting from a border worker. This case is also a reminder
that, although we have eliminated community transmission of
COVID-19, that doesn’t mean it won’t come back. To
prevent another outbreak, everyone needs to use the Covid
tracer app to record their movements and if they become
unwell, stay home and get tested.”

Conflict of
interest statement: I am partly funded by MBIE for research
on mathematical modelling of COVID-19.

Dr Amanda
Kvalsvig, Senior Research Fellow, Department of Public
Health, University of Otago, Wellington,
comments:

“This new case is not unexpected, given
how high infection rates are around the world. The person
concerned has done the right thing in being tested straight
away and the public health response has been thorough. I
hope more information will emerge about exactly how this
person became infected, to guide future precautions around
ports, and in particular to protect people who live in those
places.

“This case illustrates the risk of having
minimal Covid-19 measures in place in New Zealand
communities while the pandemic is still accelerating
elsewhere. If this person had travelled by bus instead of by
car during the time when he was likely infectious but had no
symptoms, he could have infected a large number of people.
There are several overseas examples of bus travel as a
‘superspreader’ event, which is unsurprising when you
have a large number of people sitting close together sharing
the same air.

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“We can’t afford to rely on good
luck to stay safe in a pandemic. The Government needs to
re-examine the evidence on mask wearing urgently, and build
mask use into public transport settings from Alert Level 1
on up. There may also be value in requiring some individuals
to wear a mask while in transit through communities if
they’re in a high-risk occupation, and this possibility
should be explored in the light of the current
case.”

No conflict of
interest.

Professor Shaun Hendy, Director of Te
Pūnaha Matatini, comments:

“This case has been
detected in someone with a clear connection to the border,
so the risks of a significant community outbreak are low.
Nonetheless this is a reminder that we all need to be
vigilant. We need to keep getting tested if we develop any
of the symptoms of COVID-19, keep up our use of the app, and
remember to take our basic hygiene
precautions.”

Conflict of interest statement: Te
Pūnaha Matatini is funded by the TEC, but is also currently
working under an MBIE contract to supply COVID-19 modelling
to
government.

© Scoop Media

 



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