Thread by @MackayIM

Crap.
No known travel history.
In Auckland, New Zealand.

https://twitter.com/PriapusIQ/status/1293116661608980486

But fast action is almost gaurantees from a well-prepared, expert and now veteran healthcare system.
"a wakeup call against any complacency"

"We have done this before"

JA noting the importance of finding the origin. Have not determined the source as yet. No link to an isolation facility or high risk individual. Need to go hard and go early. Strong rapid response best long-term economic response.

Tomorrow, Auckland will move to Level 3 restrictions for 3d starting midday tomorrow. Stay home, act as if you and those around have #COVID19, schools and childcare tomorrow except for kids of essential workers

No mucking around here. 👍🇳🇿 This is the only proven way (NZ proved it) to shutdown a respiratory virus outbreak.
4 cases from some household.

*same

🦠7 other people in family; 4 (man in 50s + wife + preschool & primary school children) tested(+)
🦠man had fever+cough
🦠work colleagues of 1 family member showing symptoms
🦠aiming to test (for free) everyone working on borders & in quarantine facilities *with* any symptoms

🦠masks advised where physical distancing difficult e.g. public transport
🦠nzherald.co.nz/nz/news/articl…

🦠some family members had symptoms for 5d before testing
🦠work in at least 2 workplaces
nzherald.co.nz/nz/news/articl…

🔬New Zealand have been doing a lot of tests per confirmed case
🔬tests per 1,000 pop had-as you'd expect with no community transmission-declined over past 3 months
🔬health.govt.nz/our-work/disea…
🔬ourworldindata.org/coronavirus/co…

🦠"There is no immediate link we have found as yet to a managed isolation facility, and there is no connection to a high risk person, such as those who work at the border,” Ardern said.
🦠stuff.co.nz/national/healt…

🦠"Their close contacts were then tested, including six family-members. Of those, three were found to also be positive – including a preschool-age child who does not attend an Early Childhood Education facility."
🦠stuff.co.nz/national/healt…

🦠"Mt Albert Primary School in central Auckland has been closed as someone who lives in the affected home is a pupil at the school."
🦠stuff.co.nz/national/healt…

🦠"The father of the family is a man in his 50s who works the night shift at a facility in South Auckland that has links to Auckland airport."
🦠tvnz.co.nz/content/tvnz/o…

The line of cars outside the Otara pop-up testing centre in south Auckland snaked back as far as the eye could see, on Wednesday morning
embed.scribblelive.com/embed/post.asp…

Media conference this morning from PM Ardern.
📸PH response-family in Iso @ home
📸1 case, 20sF travelled to Rotorua (tracing underway); need for vigilance for symptoms there and countrywide

📸tracing work ongoing
📸testing all close and casual contact
📸workplaces not public-facing
📸currently 12,000 tests/day - looking to increase that

📸Have seen impacts in e.g. Victoria/AUS, HK & Vietnam of slower response; NZ learned from that & responding as they are; quickly (hammer)
📸testing very important role-but needs to be focussed; can pool and scale up testing which they will do

📸all aged care facilities closing doors to everyone but staff & essential deliveries (sector-driven) and keeping staff from spreading across facilities

📸genomes sequencing in play and will help tell NZ whether restrictions go beyond 3d - alongside all the testing results that are flowing in
📸also testing surfaces to look at workplaces and "freight"
📸NZ'ers are still arriving, from overseas, into "a Level 4 environment"

📸6-7,000 individuals being tested
📸confident we didn't have community transmission (no ILI upswing) during the preceding months
📸looking at all options and ruling them out. Have ruled out false(+). Haven't ruled out surfaces of object from overseas

📸NZ also hasn't had widespread mask use, not mandated but "encouraging quite liberal interpretations of face coverings"
📸 managing distribution swabs to ensure supply; confident of supply of PPE & swabs
📸genomics timeline: ESR will hopefully provide results for Friday decision

📸masks not mandated - main concern that not everyone is prepared/got them. Also want to get message out that you can fashion your own mask. Mandating mask use has not been ruled out though. Strongly encouraged in Auckland
📸also see health.govt.nz/our-work/disea…

📸an extension will impact election date (~1 month away); already planned for a 'Level 2 election"
📸could move it within legal parameters (up to 25NOV)

📸MIQ-Managed Isolation and Quarantine
📸miq.govt.nz/being-in-manag…

🦠Student from Auckland's Mt Albert Grammar tests positive for Covid-19
🦠Close contact of the Auckland family
tvnz.co.nz/one-news/new-z… via @1NewsNZ

🦠"hoped rapid contact tracing would clarify the extent of Auckland's situation quickly and help it avoid becoming another Melbourne"
tvnz.co.nz/one-news/new-z…

🦠"Is it time for a radical rethink of quarantine?"
-centralised facilities perhaps?
stuff.co.nz/national/healt…

🦠Of the *new* cases, 13 have been linked back to this family, while one is an overseas arrival who was in quarantine.
bbc.com/news/world-asi…

🦠new cases include children, all in Auckland
🦠One is a girl aged 1-4 while the other is a boy aged 5-9. Another girl who tested positive is aged 10-14, while a teenage male (aged 15-19) is among the new cases
🦠expect further cases
nzherald.co.nz/nz/news/articl…

🦠Americold surface swabs were done this morning and results would "hopefully" available later today, Bloomfield said (3 positives are from here; another 7 are family members of them).

🦠Ardern said the "most likely" scenario was a human-to-human spread but they wanted to rule other options out.
🦠6,000 tested yesterday, >10,000 swabs collected; demand is high

A little on Americold. Being cold doesn't necessarily have a role in incre4asing risk (I'm not excluding that though); it may be more about *how* the workers work & interact in & outside the facility as has been seen in meatpacking examples.
americold.com/what-we-do/

🦠2 new cases in Tokoroa, NZ linked to Auckland cluster
🦠12 new cases & 1 new probable all up
🦠13th case is new and is still being characterised
🦠nzherald.co.nz/nz/news/articl…
🦠tvnz.co.nz/one-news/new-z…

🦠Still no word on surface/freight testing?

🦠not worried about testing "kit" or swab supplies
🦠pooled sampling for low-risk testing
🦠loving this considered, publicised, systematic & prioritised testing detail & NZ approach
🦠~36,000 tests done to date for this event
🦠no (+) test in Wellington thus far

🦠media question about whether sea/air Ports might have been a "blind spot" - crews loading/unloading but not entering NZ - lots of testing being done; lots of people cross through
🦠maritime order prevents ?most ppl coming off ships; also distancing of those who offload

🦠testing times have extended - record number fo swab processing (many working 24/7) [don't forget, labs are being smashed every time there's a cluster]
🦠similar to UK strain in NZ since March but also similar to ongoing cases among managed quarantine/isolation facilities

🦠surfaces: if we find it it may help with puzzle but may be hard to extract "DNA" [RNA] from surfaces
🦠58.3% of those in MIQ have been tested in past 48h
🦠would have liked to have seen more tests done

🇳🇿29 cases all linked to cluster; 1 other case still being investigated
🇳🇿>30k test in 48h [damn good]
🇳🇿signs outbreak found early in its life
🇳🇿earliest (maybe not origin) case worked in Amricol cool store, onset ~31st July
🇳🇿no link to source found as yet

🇳🇿genomic sequence suggests virus NOT dormant (sequence differs from earlier Wave) - appears to be new to NZ
🇳🇿more testing than ever before for SARS-CoV02
🇳🇿speed likely to have made material difference to containing spread; 60% reduction in travel on Tursday

🇳🇿can expect to see more cases in this cluster-just based on known incubation period
🇳🇿it *is* possible to contain outbreak without knowing origin; important to establish a perimeter to stop it growing

🇳🇿NZ to maintaining current settings for 12 more days (full total of 2-weeks (move down to Level 2 aimed for 26th August)

🇳🇿nothing to suggests NZ needs to move to Level 4 (L4) lockdown; cases linked this far
🇳🇿best economic response is a good health reposnse
🇳🇿L3 allows more activity (economy runs at ~80% cf 60% at L4)
🇳🇿wage subsidy scheme extended

🇳🇿maintaining elimination - NZ economy getting going faster than almost anywhere else under this approach
🇳🇿people have been coming forward *early* on in their symptoms - critical measure for success in isolating cases & contact tracing

🇳🇿"We're evidence-based" [noting learning from HK and AUS]

15AUG2020
📸7 new cases (none in managed iso); 6 linked to cluster, 1 remains under investigation (so now 2 still to be linked, but expected to be part of Auckland cluster)
📸details can be seen at:
📒 health.govt.nz/our-work/disea…
📒health.govt.nz/our-work/disea…
📒health.govt.nz/our-work/disea…

📸56 active cases, 37 from Auckland cluster
📸1,090 close contacts; 934 have been contacted-all in self-isolation
📸no close contacts of the 2 Tokoroa cases have tested positive