New Zealand's leading health officials believe it's inevitable that COVID-19 will re-emerge in the community, despite it being 95 days since a case was acquired locally from an unknown source.
"Not if, but when" was Director-General of Health Dr Ashley Bloomfield's response when questioned on the likelihood of a COVID-19 resurgence in New Zealand.
There are currently 22 active infections in the country, all of which were detected due to routine testing in managed isolation and quarantine facilities. Yet as the pandemic continues to rage overseas, with Victoria entering a stringent, stage four lockdown for six weeks, Dr Bloomfield issued a sobering reminder that the response isn't watertight - and things can slip through the cracks.
"It's not a matter of if, but when, we get the virus back in the community," he said.
"We're preparing as if it will happen, and it's just a matter of when. Of course we're all the time strengthening our procedures."
Speaking to The AM Show on Wednesday, Dr Bloomfield outlined the Ministry of Health's 'resurgence plan' for when COVID-19 does find a foothold in the community for a second time.
"We've got a really well-developed resurgence plan. The key [element] of that is we avoid trying to go up the alert levels, particularly going into a lockdown situation, by deploying the full range of things," he said.
"The idea is to deploy all the tools in the toolbox to prevent having to go up an alert level."
When a new case of COVID-19 is contracted due to community transmission, the ministry's response will centre around many of the key elements implemented earlier this year.
Although the COVID-19 response did not introduce masks as a public health message or mandatory protocol earlier this year, Dr Bloomfield told The AM Show "there may be a place" for face coverings next time around.
"We may well be introducing masks in crowded spaces, such as public transport. We've seen they've had some value in countries that have got community transmission," he said.
"We didn't use them last time, but we've got a strong sense there might be a place for them this time."
Although masks have been a topic of hot debate throughout the pandemic, health officials worldwide typically agree that coverings may offer some protection against COVID-19 in public spaces. Although their effectiveness has been questioned due to missizing, frequent adjustments and user error, masks have been introduced in the UK and a number of US states as a public health measure.
An integral part of the COVID-19 response, contact tracing focuses on locating individuals deemed close or casual contacts of a confirmed case. Once located, contacts will be tested for the virus and may need to isolate.
In May the Government launched its official app, NZ COVID Tracer, to aid contact tracing efforts. All New Zealanders are urged to register and actively record their movements to ensure they can be easily identified in the event of a future outbreak.
Isolation is another key element to the COVID-19 response. Although there is currently no evidence of community transmission, numerous cases have been caught at the border or in managed isolation facilities. New arrivals are required to isolate for a mandatory 14-day period at one of the 32 facilities nationwide and undergo two tests before they are permitted into the community.
Isolation is also used as a strategy to ensure active cases, or contacts of active cases, do not spread the virus. Self-isolation requires individuals to remain at home for the mandatory 14-day period or until they are considered recovered.
Testing in the community
Health officials have been attempting to bolster testing rates, particularly among the New Zealand public. The ministry's resurgence plan will focus on "high testing rates in the community", Dr Bloomfield said, to rule out the possibility of COVID-19 going undetected and to find any additional cases.
Currently, anyone presenting flu-like symptoms is urged to get tested - in the event of an outbreak, those who are symptomatic are required to stay at home and call Healthline for further instructions.
"The best way for us to know if it is out there is to keep up our testing in the community," he said.
A combined effort
Dr Bloomfield noted that as New Zealanders are permitted to move freely around the country under alert level 1, a future outbreak of community transmission would likely require a "combined" response rather than regional lockdowns.
"Because of the fact that we're moving around the country, [it] may well be that the response needs to be nationwide rather than regional," he said.
After a man who travelled to South Korea from Christchurch tested positive upon arrival, there has been an ongoing effort to ensure the man was not infected, or infectious, while in New Zealand. As the man had been in Auckland, Christchurch and Queenstown prior to his positive result, close contacts, casual contacts and the wider community have been tested as a precaution.
"We're pretty confident. At the moment, everything's looking good," Dr Bloomfield said in regards to the case.
It's believed the man's two tests - both of which returned positive results - may have picked up lingering virus following a prior infection, Dr Bloomfield said. It has also been speculated that he contracted COVID-19 while transiting in Singapore.
"There's always opportunity to do better, we're not resting on our laurels here. We've got 32 managed isolation and quarantine facilities - I've visited several, they are excellent and the staff there do great work - but we do know [the virus is] tricky," he said.
"We're remaining vigilant - if someone does carry the virus out of managed isolation, we need to make sure we find it quickly."