25 August COVID-19 health key messages

Latest COVID-19 health key messages Approved messages for use in your communications Consistent messaging helps us to coordinate our efforts to respond to the COVID-19 pandemic. This document provides approved key messages from the Ministry of Health.

You may share this messaging with your internal and external audiences. New sections and changes to messages are in red.

25 August 2021

New Zealand to remain in lockdown The Prime Minister has announced that all of New Zealand will remain at Alert Level 4 until 11.59pm on Friday 27 August 2021. Changes to Alert Levels will be reviewed following public health risk assessments, and Cabinet will meet again on Friday 27 August 2021.

Auckland will remain at Alert Level 4 until 11.59pm on Tuesday 31 August 2021. Auckland’s settings will be reviewed by Cabinet on Monday 30 August 2021.

New community cases announced There are 62 new cases of COVID-19 in the New Zealand community to confirm today. This brings the total number of cases in the community outbreak to 210.

The total number of community cases in Auckland is now 198 and 12 in Wellington.

All the cases have or are being transferred safely to a managed isolation facility, under strict infection prevention and control procedures, including the use of full Personal Protective Equipment (PPE).

Read the full media statement here

Testing requirements for managed isolation and quarantine (MIQ) facilities From Wednesday, 25 August 2021, an additional testing requirement has been introduced for returnees staying in MIQ facilities.

When a returnee is confirmed to have COVID-19 through their Day 0/1 or Day 3 test, any other returnees who have been staying nearby are now required to be tested on Day 6 or 7 of their stay.

This Day 6/7 test is in addition to the existing Day 0/1, Day 3 and Day 12 tests required for all returnees.

The new testing requirement is due to the likelihood of a returnee within the same cohort as a confirmed case sharing common spaces with them such as corridors and lobbies.

The new test will allow us to detect cases earlier and limit the spread of the virus.

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Revised primary care quick reference guide The Ministry has published a revised Primary Care Quick Reference Guide.

The guide is a summary of information for community healthcare providers involved in assessing and managing undifferentiated respiratory illness and queries regarding COVID-19 risk and need for testing.

The latest version updates use of P2/N95 particulate respirators, PPE for symptomatic patients, notification advice, and isolation exemption for vaccinated essential healthcare workers who are household members of close contacts.

See the Ministry’s COVID-19 Primary care page.

Update to section 70 to allow health worker exemptions On 20 August 2021 a Section 70 notice was applied to household members of a person who has been at a location of interest or has been categorised as a close contact. This requires the household members to isolate at home until the close contact has received a negative day 5 test result.

There is an exemption that enables people who provide essential health services, who are household member of a close contact, to return to work earlier than the five days specified if they meet the following criteria: • • • •

they are fully vaccinated (received two doses of the Pfizer/BioNTech vaccine). they are not a close contact themselves the close contact has tested negative (must be a RT-PCR test) the entire household is asymptomatic.

This update has been made to make sure that we support essential healthcare services to manage at safe staffing levels.

Information on the Section 70 and locations of interest in New Zealand are available on the Ministry of Health website

COVID-19 vaccine update Yesterday 56,872 first doses were given, and 23,161 second doses were given, bringing yesterday’s total doses administered to 80,033. This is the biggest daily total to date by more than 16,000 doses.

More than 2.93 million doses of the COVID-19 vaccine have been administered to date. Of these, 1.88 million are first doses and more than 1.05 million are second doses.

More than 167,000 Māori have received their first vaccination. Of these, more than 96,000 have also had their second vaccinations.

More than 109,000 doses have been administered to Pacific peoples. Of these, more than 65,000 have also received their second doses.

View the latest vaccine data and statistics on our website

Post vaccine symptom check • •

The Post Vaccine Symptom Check is a mobile-based survey which will help the Ministry of Health to monitor reactions to the Pfizer COVID-19 vaccine in New Zealand.

We’re already tracking reports of serious and non-serious reactions after either dose of the Pfizer vaccine using our current reporting system.

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The Post Vaccine Symptom Check is an additional way for us to collect data.

Collecting data about reactions to the vaccine helps us to confirm that the safety of the vaccine in New Zealand is the same that was seen in clinical trials.

Up to 10% of New Zealanders who have received a dose of the Pfizer COVID-19 vaccine will be randomly selected to participate in the Post Vaccine Symptom Check.

A text message will be sent from the Ministry of Health, to ask whether you had any reactions to the vaccine.

You can either reply YES, NO or STOP to opt out. If you reply YES, you will be invited to complete a short survey and will be sent a unique URL by text message.

You will receive a text 6 days after both of your COVID-19 vaccines, and also 43 days after your second vaccine, unless you opt out.

Additional messages • Responding to this text message will help support ongoing safety monitoring of the Pfizer COVID-19 vaccine used in New Zealand.

• The information provided in the survey will not be followed up on from a healthcare practitioner. If you have any concerns about any reaction you experience, seek medical attention or call Healthline for free at 0800 358 5453.

• More information about the Post Vaccine Symptom Check can be found on the Medsafe website • Taking the survey is optional. If you don’t want to participate in the survey, you don’t have to give a reason, and it won’t affect the care you receive.

• If you decide to take part now, but change your mind later, you can opt out of participating in this survey at any time.

• If you do not receive a text, you can still report any reactions you have to the Pfizer vaccine through Centre for Adverse Reactions Monitoring (CARM), even if they are mild. Reactions may include fever, headache, fatigue or sore arm.

• The World Health Organization has recommended strengthening and enhancing the ability to monitor reactions after receiving COVID-19 vaccines.

• Other countries, including Australia and America, already have a system like this in place to capture more information about reactions people have after receiving a COVID-19 vaccine.

Testing text scam There are reports that some people have received text messages saying they have tested positive for COVID-19.

Please note that all positive test results are notified by a phone call. Only negative results are notified by text message. If you receive one of these text messages informing you of a positive test, please ignore it.

In addition, if you haven’t received your test results within 5 days, please call your GP or the testing centre where you were swabbed.

Testing update If you were at a location of interest at the specified times, or have cold and flu symptoms, please call Healthline on 0800 358 5453 for advice on getting tested.

By calling Healthline for advice on testing, people who have been at locations of interest at relevant times are logged into the contact tracing system. This means their swab can be tracked and processed faster by the laboratories.

We continue to work with District Health Boards to meet testing demand and set up additional testing centres if needed. These include pop-up centres in Auckland, Waikato and Wellington and dedicated testing centres for close contacts only. GPs are also providing large volumes of testing.

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The expected turnaround time from getting a swab taken to receipt of the results ranges from 2 to 5 days in nonsurge times. As part of our response to the current outbreak, we have been prioritising the processing of tests for people who are close contacts, who have been to locations of interest or are symptomatic.

Testing volumes currently being processed by labs are at unprecedented levels, with numbers of tests nationally around five times higher than usual levels. Over 170,000 tests were completed over the past five days, with a record high of 41,404 tests processed on 20 August.

Laboratories are working hard to minimise the turnaround time for processing tests. This has included staffing to be able to process tests 24/7 to meet demands.

All positive test results are notified by phone. Only negative results are notified by text message. If you haven’t received your test results within 5 days, please call your GP or the testing centre where you were swabbed.

When you go for a test, please wear a mask, scan in to the QR codes located on site and take your NHI number with you if you can. This is likely to speed up the process. You’ll be able to find your NHI number on a hospital letter, a prescription or prescription receipt. The Ministry has a new 0800 number to find out - 0800 855 066.

If you need to get a test, please return home immediately following your test without stopping at any other locations like a supermarket or a pharmacy.

If you are booked to have your COVID-19 vaccination, and you are waiting on a COVID-19 test result, you will need to cancel this vaccination appointment and reschedule when you have a negative COVID-19 test result. You can be vaccinated once you have a negative test.

Everyone can get tested – you do not need to be a New Zealand citizen or resident. And don’t worry, your details won’t be shared with anyone else. Remember to be kind to the staff. They're working as quickly and as carefully as they can.

Yesterday, 49,745 tests were processed across New Zealand. The total number of COVID-19 tests processed by laboratories to date is 2,812,976.

Contact tracing As of 9am today, 20,383 individual contacts have been identified and 62% have had a test. The majority of these contacts are close contacts.

Aged Residential Care and Disability Residential Care • •

Aged residential care and disability residential care are essential services and must continue to be available.

Essential personal care services, such as toileting, washing and feeding, should be provided as usual.

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Some home help, such as house cleaning, may be available if it can be provided safely.

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Essential supported living services will continue.

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For aged residential care, hospices and disability residential care, family visits are not currently permitted.

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Family visits on compassionate grounds, such as in a palliative situation, will be considered on a case-bycase basis by the facility nursing staff, subject to public health advice, provider assessment and COVID-19 risk screening. Visits will be by appointment only. There is a limit to the number of designated visitors at one time.

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Planned respite services will be suspended, but urgent respite care may be provided.

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Support persons are permitted under right 8 of the Health and Disability Code.

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NGO delivered services, such as social connection, health promotion and education activities are suspended, however other non-contact ways of providing this support are encouraged, such as ZOOM or by phone.

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Retirement villages operate within same restrictions as the wider community, with on-site facilities closed.

Exercise at Alert Level 4 Under Alert Level 4, exercise is restricted.

If you have been at a location of interest at the relevant time, you could be affected in one of two ways – either as a close contact or a casual plus contact. Please call Healthline on 0800 358 5453 for advice.

If you are a close contact, you will need to self-isolate for 14 days. If you are a household member of the close contact, you will need to stay home until the close contact returns a negative day 5 test.

Self-isolating and staying at home have different public health requirements. You can find them here for selfisolating and here for staying at home.

In terms of exercising, close contacts who have to self-isolate cannot leave their property to exercise. But their household members who are staying at home are able to leave the property to exercise as long as they avoid contact with others and do not have any symptoms.

If you are a casual plus contact, you will need to stay at home. You will be able to leave the property to exercise as long as you avoid contact with others and you do not have any symptoms.

You are encouraged to wear a face covering and keep a two-metre distance from others when leaving your home, especially if it is difficult to maintain physical distance from others.

If you are allowed to exercise under Alert Level 4, here are the guidelines: • • • • • •

You can go for a walk, run or bike ride in your local area.

If you do, it must be on your own, or with your household bubble.

You can drive to a place to exercise but it must be close to where you live.

Keep a two-metre distance from others.

Do not do activities that may require search and rescue services, such as swimming, surfing, boating, hunting or tramping.

If you are unwell, do not leave the property.

If you are pregnant and due to give birth If you are likely to go into labour and give birth while the country is in Alert Level 3 or 4 and you have older children, you will need to organise care for them while you are in labour. If you have children, they must continue to follow the rules under Alert Level 4 to stay home.

It is recommended that you identify a trusted person who will become an extension of your ‘bubble’ to provide care for your children. It is vital that this person is not elderly or vulnerable, and that they, and the people in their household, do not have other contacts other than with your household.

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Read more: Maternity care while pregnant and following the birth of your baby during the COVID-19 pandemic

Guidance for aged care providers Our guidance on end-of-life visits has been updated.

The Ministry has updated its Alert level 4 COVID-19 guidance for aged care providers, including: • • •

Alert level 4 guidance for aged care services and aged residential care facilities admission into aged residential care facilities visiting aged care residential facilities.

Read more: COVID-19: Aged care providers

Continuing with childhood immunisation and wearing PPE in Alert Level 4 In Alert Level 4, it is important that general practices and outreach services across the country continue delivering essential health services, including on-time delivery of the childhood immunisation schedule vaccines.

Guidance when in GP clinics • Follow the same process as when managing patients coming into clinics in Alert Level 4 with no respiratory issues. This includes a pre-appointment screening for COVID-19 risk.

• We recommend the healthcare worker to use a medical mask.

• Where at all possible, vaccinate at the side of the child.

• Perform hand hygiene, it is not necessary to wear gloves gown or eye protection, but you should follow your own clinic’s IPC protocols.

• Depending on your clinic circumstances, you may wish to consider offering vaccination services in cars.

IMAC is developing further advice to support this option.

Guidance when in private homes and other outreach service situations While each provider will have their own guidance and protocols in place for use of PPE, our advice is set out in the Ministry of Health COVID-19 PPE guide for community care providers working Alert Levels 3 and 4.

This states that when caring for someone who is not a probable or confirmed COVID-19 case and does not meet the Clinical and Higher Index of Suspicion (HIS) Criteria1, hand hygiene and wearing a mask are required. Please note that at Alert Level 4, everyone with respiratory symptoms is considered high risk.

Always pre-screen for COVID-19 risk before making a home visit.

It is important that pregnancy, infant and childhood immunisation remain a priority as New Zealand’s immunisation rates have recently been declining. We saw coverage drop following lockdowns last year, with disparities by ethnicity and deprivation particularly leaving many tamariki Māori and Pacific children vulnerable.

Thank you for maintaining the immunisation programme during this challenging period to keep control of other vaccine-preventable diseases.

Please get in touch at immunisation@health.govt.nz if you have any queries.

Immunising children during Alert Level 4 Children can be immunised safely during all COVID-19 alert levels, including Alert Level 4. Your doctor or nurse can explain how it works at their practice, for example whether immunisations take place at a separate location or time from other patients.

Protecting against other serious diseases, like measles and whooping cough remains important during all COVID19 alert levels. For their best protection, immunise on time, every time.

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Childhood immunisation is an essential service and continues to remain a priority, regardless of alert level.

Informed consent for children Those aged between 12 and 15 years who go to their usual healthcare provider or a COVID-19 vaccination centre for a COVID-19 vaccine can provide informed consent, if deemed competent to consent, and be given the vaccine.

As with other vaccination programmes and under New Zealand law, children under the age of 16 years may give or withhold consent to healthcare treatment, so long as they are competent to do so.

It is the role of the healthcare professional to decide whether a child is competent.

A child can be considered competent to consent “when a child achieves sufficient understanding and maturity to fully comprehend the proposed treatment”.

A parent or caregiver is also able to give informed consent on behalf of the young person.

Mental health and wellbeing General • It is important to remember that our approach has worked to date. We have stamped out Covid-19 before and we can do it again.

• This can be an unsettling time, and the uncertainty can have an impact on our mental wellbeing. It’s okay to feel overwhelmed, upset or frustrated.

• Frontline staff who are seeking mental health and wellbeing support can access their organisation’s employee assistance programme, or call or text 1737.

• Please take advantage of free tools and resources available to support your mental wellbeing, this includes calling 1737 if you feel you need to talk to someone, or calling your local GP practice or student health service that can provide advice on how to get help to support your mental wellbeing during Alert Level 4. Further resources are listed on the Ministry of Health website.

• If your feelings are impacting on your day-to-day function or are concerning you, please to talk to others and get support.

• Keeping life as “normal” as you can within the Level 4 rules is important. There are some things that we can do to look after our mental wellbeing: o Stay connected with friends and whānau (distance, not distant). o Limit your time online. o Have a plan! Stick to a schedule or routine. o Move your body daily. o Explore your local neighbourhood (at an appropriate distance). o Go easy on yourself. o Notice and appreciate small moments of joy.

Support for young people •

Things also may be especially challenging for young people, including university students who may be isolating in hostels or halls of residence. For people in this situation looking after your mental wellbeing is important, and can be supported through: o having a routine within your day that includes getting out of bed and getting dressed o some form of physical movement, even within your room

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o one thing that gives you some sense of achievement for the day Youthline’s free call, text or web chat and 1737 are also available for young people who need to speak with someone about their mental wellbeing. In addition, a range of digital self-help tools are available for rangatahi, listed on the Ministry of Health website.

Mental health and addiction services under Alert Level 4 • Mental health and addiction services remain an essential service under Level 4. If you are concerned about yourself, or someone you know, local GP clinics and student health services are continuing to operate and can help link people into the mental health and addiction support that may be needed. Local mental health and addiction crisis services also continue to operate. All the contact details are available on the Ministry of Health website.

• As always, if there is an emergency and you have immediate fears for the safety of yourself or others, call 111.

Speculation about suspected self-inflicted death numbers • Only the Office of the Chief Coroner can release information about suspected self-inflicted deaths.

• People should refrain from speculating about the relationships between the COVID-19 response and suicide risk. Doing so does not contribute to preventing suicide, and has the potential to cause significant harm by undermining a narrative of hope and positivity, and making people less likely to seek help.

• While the COVID-19 response may have significant, long term effects on people’s lives, an increase in suicides is not inevitable.

• International research including data from New Zealand showed no increase in suicide deaths associated with COVID-19 responses in 2020.

Advice for older people The Ministry has updated its information for older people who live alone or in a retirement village on creating a support bubble/buddy during Alert Level 4.

Read more on ‘Preventing the spread of COVID-19 by building safe bubbles’ on COVID-19: Advice for older people and their family and whānau •

Book your COVID-19 vaccinations If you are aged 40+ and haven’t booked your appointments, please call 0800 28 29 26 or visit the Book My Vaccine website to book them in. If you know an older person who hasn’t been vaccinated yet, please share this information with them.

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Keep your vaccination appointments The COVID-19 vaccination programme is continuing throughout Alert Level 4, so if you already have a booking please keep your appointment.

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Vaccination centres are operating safely Vaccination sites are operating under Alert Level 4 settings, to ensure you can safely be vaccinated. This means you must have an appointment and come at your allotted time. You must wear a face covering to your appointment.

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If you are required to self isolate or are not well Reschedule your booking for a later date. Call 0800 28 29 26 or visit the Book My Vaccine website

Tangihanga guidelines for whānau The Ministry has updated its guidance for funerals and tangihanga during Alert Level 4.

View the updated guidance on our website

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Mandatory mask wearing at Alert level 4 While at Alert Level 4 the use of face coverings is mandatory for all employees and customers at businesses and services that are open to the public. This includes supermarkets, pharmacies, petrol stations, hospitals and healthcare facilities.

Face coverings remain mandatory: • •

on public transport and at departure points, for example, train stations, flights and bus stops in taxi or ride-share vehicles (drivers and passengers).

You are encouraged to wear a face covering and keep a two-metre distance from others when leaving your home, especially if it is difficult to maintain physical distance from others.

Read more: COVID-19: Use of masks and face coverings in the community and on the Unite Against COVID-19 website.

Exemptions for mask use in Alert Level 4 We know that some people who have a disability or health condition may not be able to wear a face covering safely or comfortably. In these cases, you can get an exemption card to show when needed, for example to bus drivers or at supermarkets. To get an exemption card contact the Disabled Persons Assembly NZ www.dpa.org.nz or by phone 04 801 9100 or at info@dpa.org.nz Please be mindful that some people, like disabled people, might not wear a mask. This is a genuine concern, and disabled people still have the right to food, pharmacies, and other essential services but are currently being jeered at, harassed, and scared to go shopping.

The Prime Minister has reinforced the exemption on face coverings. Some people cannot wear a covering for genuine reasons – such as a health issue which makes mask-wearing impractical. This is a high-trust system, and we trust people to do the right thing. Wearing a face covering is about keeping yourself and others safe.

Information for screening participants In COVID-19 Alert Level 4, routine screening is paused for breast and cervical screening services, except for some required annual cervical screening. At present bowel screening will continue. You can still expect to receive your invitation to take part in bowel screening.

For those who have already been screened, the decision for diagnostic and treatment services will be made by the clinical teams at a local and regional level on a case-by-case basis. The National Screening Unit is advising screening providers to follow Level 4 processes.

Antenatal and newborn screening programmes will continue during the health service response to COVID-19, but with some changes to ensure that health staff, women and babies are kept safe.

This information will be updated as the situation progresses. For up-to-date information on breast, cervical, and bowel screening, and antenatal and newborn screening visit the Time to Screen website

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Maternity services sector The Ministry has updated its guidance for maternity services at Alert levels 3 and 4 for community-based midwives, the use of Entonox in labour and community-based maternity ultrasounds.

View the updated guidance on our website

Staying home during Alert Level At Alert Level 4 people must stay home other than for essential personal movement, such as accessing healthcare or going to the supermarket. Even if you are vaccinated you should still stay at home.

The Student Volunteer Army will be restarting their grocery delivery service from 12pm Thursday 19 August. To place an order visit www.shop.sva.org.nz or call 0800 005 902.

Support is available for older people during Alert Level 4 Anyone can call Age Concern New Zealand on 0800 65 2 105 to get advice and support.

Advice on Alert Level 4 for older people and their family and whānau

If you are not safe, you can leave your bubble If you are the victim of family violence, sexual violence, or there is someone that makes you fearful, threatens or harasses you, seek help as soon as possible. You have the right to be safe. Family violence and sexual violence support lines are open for people to call, email or text.

If someone is in danger, call 111. If you or someone you know is in danger and it is not safe to talk, Police have the Silent Solution – phone 111 and if you do not speak, you will get the option of pressing 55.

Find out more about the help and support available

Access to health and disability services We have added a page on our website with information on how to access health and disability services at Alert Level 4 which covers: • hospitals • general practices • community health services • disability and aged care services • mental health and addiction services.

Find information on how to access health and disability services at Alert Level 4

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