Coronavirus: No new COVID-19 cases in New Zealand - so where to from here?

Monday marked a milestone moment in New Zealand's battle against SARS-CoV-2, the strain of coronavirus responsible for COVID-19. No new cases were confirmed for the first time in seven weeks, almost a week after the country shifted down to level 3 of the alert level response. 

Eighty-six percent of the 1487 confirmed and probable cases have now recovered from the virus. The occasion is "worth celebrating", said Director-General of Health Dr Ashley Bloomfield - but the hard work does not end here. 

"Clearly these are encouraging figures today, but it is just one moment in time," Dr Bloomfield said during Monday's daily press conference.

"The real test is later this week, when we factor in the incubation period for the virus and the time it takes for people to display symptoms, which is generally five to six days after exposure."

This means that although there have been no new cases in the past 24 hours, people who have contracted the virus since moving out of level 4 lockdown may still present symptoms within the coming days. 

"That's when we will have an indication if there are any new cases coming through that might be emerging in the community as a result of our shift from level 4 to level 3. We cannot afford to squander all the hard work and effort of the past weeks," he said. 

Clusters, which are used to define an outbreak of 10 or more cases linked to a single location or event, are only deemed as closed when there have been no new cases for two incubation periods, or 28 days. Only three of the 16 significant clusters nationwide are considered closed as of Monday.  

The Director-General noted that the move to alert level 3, which Prime Minister Jacinda Ardern has described as a "waiting room" of sorts, has seen many New Zealanders adopt a more frivolous approach to Ministry of Health protocol. Although no new cases have been recorded as of Monday, the more people who flout the rules, the more likely we are to squander our advantage. 

"We did see at the weekend that it can be easy to start slackening off. We need to maintain discipline and keep pushing on and sustain the advantage that we have fought so hard for," he said. 

Infectious disease physician Dr Ayesha Verrall told Stuff the most significant indicator of New Zealand achieving its "keep-it-out, stamp-it-out" goal will be when there are consistently no new locally-acquired cases - or contacts of a known case. It's likely that a number of cases will continue to be recorded due to infected people returning from overseas. 

She also noted that New Zealand is more likely to detect new outbreaks of community transmission than other countries due to widespread testing and the relatively low burden on our healthcare system, meaning we can afford to be "out there looking for the needle in the haystack".

As reiterated by both Ardern and Dr Bloomfield, Verrall told the outlet that to truly achieve the goal of elimination - which is not zero cases, but zero tolerance to new cases - it's imperative that New Zealanders are immediately tested if they present any symptoms. The faster tests are processed, the quicker authorities can contact trace.

Symptoms of COVID-19 can include a dry cough, fever, fatigue, nasal congestion, a runny nose, sore throat, and aches and pains.  

What will happen with alert level 3?

"We are still wanting to be sure that there is no undetected community transmission," Dr Bloomfield said. "We've had a week of testing asymptomatic people [within the community] in a range of settings and that continues this week."

District health boards and public health units have received detailed testing advice regarding the environments, locations and sample sizes they should be aiming to cover, such as supermarket staff, healthcare workers and rest home residents.

"It's only later this week that we can be confident that we are, or are not, seeing new cases popping up in the community," he said.

"That's why it's very important we maintain the current posture...This is just a point in time and it remains very important for us to [be] disciplined."

In a week's time, Cabinet will make the decision about whether New Zealand is able to move down to alert level 2

"I think the Prime Minister and I have been clear that it's not just the number of cases or the pattern, but the level to which people are taking seriously the expectations around physical distancing, hygiene measures and not squandering the advantage we have created.

"It is symbolic of the effort everyone has put in - but we need to continue to be vigilant."