Gradual reopening of NZ from late Feb – Expert Reaction

Aotearoa New Zealand’s border with the world will be opened up in phases, with a five-step plan to prioritise returning Kiwis.

Vaccinated New Zealanders from Australia will be welcomed without an MIQ stay from midnight on 27 February, the Prime Minister has revealed. Two weeks later, on 13 March, vaccinated Kiwis from the rest of the globe can enter.

The Managed Isolation and Quarantine scheme – MIQ – will disappear for most travellers in the staged reconnection, replaced by self-isolation at home, and tests on arrival. Mandatory MIQ will be retained for people who haven’t been vaccinated. The reopening of key visa categories will jump forward in five weeks’ time to tackle worker shortages.

The SMC asked experts to comment on the news.

Dr Emily Harvey, Senior Consultant/Researcher at Market Economics Ltd, Principal Investigator with Te Pūnaha Matatini, and Honorary Academic at the University of Auckland, comments:

“It is understandable that the government is moving to a home isolation model as they reopen borders. It is important that even without MIQ facilities, we make sure that we detect as many infections as possible during this home isolation period.

“Unfortunately the proposed testing regime (Rapid Antigen Tests on day 0/1 and day 5/6) is underpowered and is likely to miss a large number of infections.

“The convenience and low cost of Rapid Antigen Tests makes them well-suited to home-isolation, but due to their lower sensitivity, and shorter window of detection, they need to be performed much more frequently than PCR tests in order to reliably detect the majority of infections.

“The Ministry of Health guidance is that Rapid Antigen Tests need to be performed at a minimum every 2 to 3 days for individuals who are at increased risk of infection. And that PCR tests should be performed if someone develops COVID-like symptoms.

“An obvious improvement to home isolation testing requirements would be providing enough Rapid Antigen Tests for testing daily (or every 2 days). Additionally, anyone in home isolation who develops symptoms should be required to seek a PCR test, regardless of the result of a Rapid Antigen Test.”

Conflict of interest statement: I, along with others from Te Pūnaha Matatini, am funded by the Department of Prime Minister and Cabinet to provide advice on the COVID-19 response and from a Health Research Council grant to look at equity related to COVID-19 in Aotearoa.

Professor Michael Plank, Te Pūnaha Matatini and University of Canterbury, comments:

“At the moment, MIQ is intercepting a large number of cases of Covid-19 at the border, preventing repeated reintroductions of Omicron into the community. This is helping us to slow the spread of Omicron by allowing our contact tracing system to function more effectively and buying time for more people to get boosted. High booster coverage will be crucial to avoid overloading our healthcare system.

“Once the Omicron outbreak really takes off, border cases will start to make less of a difference relative to the expected large number of community cases. One of the concerns with reopening the border is that our current average of 50 border cases per day could easily turn into 500 cases a day if travel restrictions were removed completely and the number of arrivals sharply increased. The staged reopening means that travel numbers will increase progressively rather than in one big jump, which mitigates against this risk.

“The timeframe for the first reopening step on 27 February looks reasonable. By that time, it is likely that daily case numbers will be in the thousands and the vast majority of vaccinated adults will be eligible for their booster. Self-isolation and testing requirements for arrivals will dampen the effect of border cases on community transmission, while removing the bottleneck of MIQ and allowing us to monitor for possible new variants.”

Conflict of interest statement: Michael Plank is partly funded by the Department of Prime Minister and Cabinet for research on mathematical modelling of COVID-19.

Dr Dianne Sika-Paotonu, Immunologist, Associate Dean (Pacific), Head of University of Otago Wellington Pacific Office, and Senior Lecturer, Pathology & Molecular Medicine, University of Otago Wellington, comments:

“MIQ/border restrictions have played a critical role in protecting Aotearoa New Zealand alongside other measures, in trying to slow down entry of the SARS-CoV-2 virus relative to other countries. The MIQ/border workforce must be acknowledged for all their hard work.

“Care and caution is still needed moving forward, however, as we remain in the process of protecting vulnerable communities that include our children, tamariki and tamaiki aged 5-11 years, and getting people boosted to protect them from Omicron – emerging inequities with respect to Māori and Pacific peoples, tamariki and tamaiki are again evident.

“Self-isolation for non-high-risk travellers is a feature of the phased “reconnection plan”, where they will remain responsible for following and fulfilling necessary requirements. Self-isolation will also require new arrivals to be fully vaccinated.

“In order to track incoming COVID-19 cases and identify any new variants that emerge, a total of 3 rapid antigen tests will be supplied to all new arrivals for testing needed on days 0/1, and day 5/6 plus one spare. Any positive results will need subsequent PCR testing for confirmation.

“At this time, there remains work for all to do. It is critical Omicron’s spread throughout our communities is slowed down for as long as possible. It is also important that people get tested quickly and isolate accordingly and follow the appropriate public measures at this time. We must avoid our hospitals from becoming overwhelmed as they have become in other countries.”

No conflict of interest declared.

Dr Lesley Gray, Senior Lecturer, Department of Primary Health Care & General Practice, University of Otago, comments:

“The planned phased reopening of the border will be welcome news for the many New Zealanders who have been stuck overseas during this pandemic. The timeframe of reopening borders between the end of February and October 2022 signals priorities for returning NZ citizens and others with self-isolation and testing similar to other countries. MIQ will continue for any unvaccinated travellers to Aotearoa New Zealand.

“That Aotearoa New Zealand has, to date, managed to eliminate earlier COVID-19 variants and manage Delta in a way that many countries were not able to, is very much aligned with the actions taken to date, including MIQ and the border restriction system. Now that some 94% of the eligible adult population are double vaccinated and the booster programme is underway it is reasonable to look at a staged reopening, however we still have many people including children who are not (yet) vaccinated and those who will be more vulnerable to COVID-19. Therefore the arrangements for self-isolation and associated testing must be rigorous and able to be trusted by the general population. I welcome information on how this will be managed to ensure no returnee breaches self-isolation.

“With the Omicron variant now in the community, much can change between now and the 20th February therefore it is understandable people may be nervous about booking their travel back to NZ, in case the Government has to pause these reopening plans for a second time.”

Conflict of interest statement: Lesley has financial support from Health Research Council of New Zealand-funded studies on COVID-19.