28 August COVID-19 health key messages FINAL

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.

28 August 2021

New Zealand to remain in lockdown The Prime Minister has announced that all of New Zealand south of the Auckland boundary will move to Alert Level 3 from 11.59pm on Tuesday 31 August 2021. Changes to these settings will be reviewed following public health risk assessments, and Cabinet will meet again on Monday 6 September 2021.

Auckland and Northland will remain at Alert Level 4 until at least 11.59pm on Tuesday 31 August 2021. Cabinet will meet on Monday 30 August 2021 to consider how long Auckland and Northland will remain in Alert Level 4 before these settings are reviewed again.

New community cases announced There are 82 new cases of COVID-19 in the New Zealand community to confirm today. All these cases are in Auckland. This brings the total number of cases in the community outbreak to 429.

The total number of community cases in Auckland is now 415 and 14 in Wellington.

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

Read the full media statement here

Advice for in-home carers Any person who enters a home to provide care should: •

stay home if they are sick and get tested if they have any COVID-19 symptoms

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practice good hygiene at all times

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maintain physical distancing where possible

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use personal protective equipment (PPE) as appropriate

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keep a record of their visit for contact tracing purposes.

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In-home carers are strongly advised to get vaccinated. Those who have not been vaccinated and would like to be, can book themselves on the Book My Vaccine website.

Employers of in-home carers must have appropriate guidelines and systems in place aimed at keeping staff safe in the workplace. This includes following the appropriate workplace health and safety guidelines and notifying a carer if the person they are visiting is sick.

National PPE and critical medical supply chain •

The Ministry's national Personal Protective Equipment (PPE) and critical medical supply chain has good stocks of PPE, with at least eight weeks’ of reserves to meet pandemic demand.

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Our national PPE supply chain (as of Friday August 27) holds close to 17 million N95/P2 particulate respirators, 275 million medical masks, 17 million isolation gowns, 1.6 million face shields, 271 million nitrile gloves, and good volumes of hand sanitiser, disinfectant wipes and other items of PPE utilised across the health and disability sector.

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We also continue to confirm orders and receive shipments of more PPE every week. We are aware of freight delays that are currently being widely reported and are working with our government partners to minimise any impacts from this.

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Our National PPE and Critical Medical Supply Chain team is reviewing DHB stock-on-hand for other items where there may be at-risk supplies. Letters of expedition have been furnished to all suppliers where consumables are in backlog or in shortage.

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We can expect demand for PPE to drop back over the next week as it is expected that initial demand involved a lot of ordering up.

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Since Tuesday 17 August 2021, we have distributed 40 million items of PPE for use in the health and disability sector.

Contact tracing As of 9am today, 31,757 individual contacts have been identified and 81% have had a test. Most others are not yet due for a test.

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 on the same floor and in the vicinity of the confirmed case are now required to be tested on Day 6 or 7 of their stay. The Health Lead for the facility will determine which returnees need to be tested based on

the advice of a Medical Officer of Health or their delegate.

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

This additional requirement for some returnees is an interim measure until Day 6/7 testing requirements for all returnees are finalised.

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Length of stay in quarantine A change has been agreed to the departure criteria from quarantine, i.e. Jet Park and the other quarantine facilities/areas. From 27 August, people in quarantine need to remain there for at least 14 days post-symptom onset or positive test result (if they remain asymptomatic). This is an increase from the previous requirement for at least 10 days post-symptom onset or positive test.

The change reflects the prevalence of the Delta variant and the fact it is more transmissible than previous variants. It is estimated that Delta is approximately twice as infectious as the ancestral strain, with positive cases potentially infecting an additional 6 people on average. Recent studies have also shown it is possible that the Delta variant is associated with a longer period of infectiousness.

People released from quarantine must still be cleared by a health professional responsible for monitoring their health and wellbeing. Some exemptions are possible at the discretion of the Medical Officer of Health.

More detailed guidance is being sent to front-line staff.

COVID-19 vaccine update Yesterday 89,316 vaccines were administered - the second biggest daily total to date. Of these 65,011 were first doses and 24,305 were second doses.

More than 3.2 million doses of the COVID-19 vaccine have been administered to date.

Of these, 2.1 million are first doses and more than 1.1 million are second doses.

More than 188,776 Māori have received their first vaccination. Of these, more than 102,000 have also had their second vaccinations.

More than 120,000 doses first doses have been administered to Pacific peoples. Of these, more than 69,000 have also received their second doses.

View the latest vaccine data and statistics on our website

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 and not leave the property. If you are a household member of the close contact, you will also need to isolate at home until the close contact returns a negative day 5 test. Household members should also not leave the property, even to get essential supplies or for exercise.

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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.

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.

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

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

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Keep a two-metre distance from others.

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

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If you are unwell, do not leave the property.

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, or who are household members 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).

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they are not a close contact themselves

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the close contact has tested negative (must be a RT-PCR test)

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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.

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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.

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.

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.

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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.

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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.

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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.

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

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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.

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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.

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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.

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More information about the Post Vaccine Symptom Check can be found on the Medsafe website.

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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.

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

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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.

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

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Other countries, including Australia and the United States, 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.

Aged Residential Care and Disability Residential Care •

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

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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. 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.

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Read more: COVID-19: Aged care providers

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 Levels 3 or 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.

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

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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.

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We recommend the healthcare worker to use a medical mask.

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

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

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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.

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

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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.

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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.

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

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Please take advantage of the 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.

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

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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).

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Limit your time online.

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Have a plan! Stick to a schedule or routine.

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Move your body daily.

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Explore your local neighbourhood (at an appropriate distance).

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Go easy on yourself.

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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:

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having a routine within your day that includes getting out of bed and getting dressed

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some form of physical movement, even within your room

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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, and are 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.

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

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Speculation about suspected self-inflicted death numbers •

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

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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.

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

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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.

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Book your COVID-19 vaccinations If you are aged 30+ 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

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:

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on public transport and at departure points, for example, train stations, flights and bus stops

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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.

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

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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 restarted their grocery delivery service on 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

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general practices

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community health services

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disability and aged care services

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mental health and addiction services.

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

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