The Government has revealed how it is progressing in implementing recommendations laid out after a review of New Zealand's COVID-19 contact tracing ability.
As New Zealand transitions down the alert level framework and businesses begin reopening, Kiwis return to restaurants and public venues to socialise and bubbles pop, the ability for officials to contact trace becomes crucial.
This is the process of tracking down and isolating people who may have been exposed to someone with the virus. For New Zealand to avoid another spike in cases, it's important this process can be completed before an outbreak occurs.
In April, the University of Otago's Dr Ayesha Verrall wrote a report critical of New Zealand's ability to contact trace, with public health units (PHUs) not having the capacity to do so adequately.
She made eight recommendations to better the process, with the Government quickly responding with a $55 million investment into PHUs to increase staff and for extra resources for the newly-created National Close Contact Service (NCCS). The NCCS was established in March as a central service to support the individual PHUs.
Health Minister Dr David Clark said on Saturday that five of the eight recommendations had been completed "or were now considered 'business as usual'."
- Expanding the capacity of PHUs
- Developing an outbreak preparedness plan
- Ensuring close contacts in home quarantine are contacted each day to monitor their adherence to isolation rules and assess their symptoms
- PHUs getting access to the National Contact Tracing Solution (NCTS), a platform for case management
- Having the NCCS and Medical Officers of Health collaborate to better define referral protocols and triage systems, especially for complex contacts
Dr Clark said PHUs have "tripled their capacity and can now deal with up to 185 cases a day. That's up from about 50 cases a day seven weeks ago". The NCCS, which has more than 200 staff, can make 10,000 close contact calls a day.
An outbreak preparedness plan is in development, while Healthline has been commissioned to provide daily wellness calls. The Ministry of Health is in the process of providing PHUs with access to the NCTS and there has been significantly more collaboration between the NCCS and Medical Officers of Health, although this is seen as a long-term process.
"The three further recommendations are all well underway and Sir Brian Roche and the Contact Tracing Assurance Committee appointed last week are providing oversight and advice on how best to continue implementing Dr Verrall's recommendations," Dr Clark said.
Among the recommendations not yet fully completed is the development of a smartphone application, which is "in progress but with some delay".
Applications being used in several countries around the world use Bluetooth to track individuals' movements and who they may have come into close contact with. If someone with the application contracts the virus, a notification is sent to these contacts informing them of the need to isolate.
Prime Minister Jacinda Ardern has previously said work is happening on some form of a mobile application, but has stressed technology will only be used to complement the 'on-the-ground' work of staff in the PHUs and NCCS. Overseas, issues have been raised about the applications, ranging from privacy concerns to not enough people downloading the apps to them not correctly working with different phone models.
The information released on Saturday confirms the Ministry of Health has engaged a provider to develop an application, with the application's first release allowing users to register contact details and the second allowing people to record their locations using a QR code.
"The contact tracing app is well developed and expected to be released for voluntary registration very soon. The Ministry of Health is working in collaboration with a number of agencies including the Office of the Privacy Commissioner and the Government's own Chief Digital Officer to progress this work," Dr Clark said.
Dr Verrall has written to Director-General of Health Dr Ashley Bloomfield to say she is "pleased" with work to increase PHU capacity and the development of an outbreak preparedness plan. She has also provided further advice about key performance indicators, three of which the Ministry has begun publishing information about.
One shows the length of time between the notification of a case and tracing its close contacts. The target is for this to happen with 80 percent of cases within 48 hours, something which appears to have been achieved between April 13 and 27.
To support the efforts of health officials contact tracing, Kiwis have been asked to keep a diary or record of where they have been or who they may have interacted with.
"Apps are really quite useful in terms of things like contact tracing and telling us where we have been [but] when we have done research using apps, we often find there is a group in the population who don't engage with apps and that gives us some holes in the data, some gaps in the data," University of Canterbury Associate Professor of health and medical geography, Malcolm Campbell, previously told Newshub.
Dr Verrall's report as well her recent review of key indicators can be found here.