The Prime Minister at yesterday's post-Cabinet press conference

The great Covid retreat began to be more visible yesterday.

The Prime Minister clearly signalled that Auckland would move out of Alert Level Three on November 29.

She said Cabinet had a “very strong expectation” that would happen because the city’s three District Health Board areas would have reached 90 per cent double vaccination by then.

The move will shift Auckland into the Red Traffic Light zone. That will mean that if Vaccination Certificates are used, life will go more or less back to normal, except there will be a wider use of masks, and gatherings will be limited to 100 people.

And she confirmed that next week she would announce a date for the opening of the Auckland border.

But proposing to relax Auckland’s border with the rest of the country for vaccinated people has provoked a group of medical academics, including some of the Government’s own advisors, to ask why if that border could be relaxed, then why shouldn’t the international border be relaxed for vaccinated travellers also.

Opening the Auckland border means providing for different vaccination rates on either side of it.

While it is conceivable that Waikato could reach the 90 per cent full vaccinated target before Christmas and thus make opening that border easy, Northland is highly unlikely to match it.

There are pockets where the first vaccination level is above 80 per cent; Mangawhai, Waipu, Whangarei, the Bay of Islands and Kerikeri, but otherwise, first vaccinations are in the 70 – 80 per cent range.

Prime Minister Jacinda Ardern said the Government had estimates that between 30 and 40,000 people could be seeking to move across the border at any given time.

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“And these may be on the low side,” she said.

She repeated her promise that Aucklanders would be able to leave the city over Christmas.

“What we need to do, of course, is put in place the protections that we need to give additional reassurance to the rest of the country around that movement,” she said.

“And that’s what we’re working on here.”

Ardern said the system would likely rely on Vaccination Certificates.

But they will need to be checked, and in February, during an earlier lockdown, POLITIK went through a checkpoint at Mangawhai on Northland’s east coast. It took just over a minute to be processed. 

Waka Kotahi says up to 10,000 cars an hour pass through Wellsford around the middle of the day at the peak of the holiday season.

If each car took one minute, then that would require 166 person-hours to process each hour of traffic.

But if the land border presents logistical challenges, the international border is now starting to unravel both in terms of the way it operates and in terms of the policy justification for it.

Yet, the fundamental logic behind the Government’s moves to relax still looks uncertain.

The big question is whether the Auckland outbreak is peaking.

Modelling released by the Prime Minister’s office last week forecast that for the week ended yesterday, there would be 1200 new cases and 15 patients in Intensive Care Units (ICUs)

It was not all that far out.

There were 1037 new cases and seven in ICU.

That modelling provided by the PM’s office extends only as far as the week ended November 29 when it forecasts 1400 new cases and 20 patients in ICU.

However, both that model and the performance against the model so far suggest the outbreak is approaching a plateau, if not a peak.

Meanwhile, MIQ detainees are now allowed to leave after seven days, even though the seven-day stay requirement does not come in officially until November 14.

In fact, the whole MIQ system is looking shaky, as it faces challenges over its legality, the availability of staff and from the outside, academic criticism for its very raison d’etre.

The Government has said that from November 14, new arrivals need to stay in MIQ for only seven rather than 14 days.

A journalist currently in Auckland’s Stamford Plaza last night posted on the “Grounded Kiwis” Facebook page that he arrived on  November 6 “, not knowing how long we’d stay, as the new regime kicks in on  November 14.”

He said the “new regime” would require seven days MIQ followed by self-isolation until a negative result from the day nine test.

“We’ve been informed it will apply to all those already in MIQ who have been there more than seven days,” he said.

POLITIK has learned that in another Auckland MIQ hotel, Rydges, medical staff have been redeployed to assist with locally infected people who are isolating at home.

This has caused delays in people staying at Rydges getting their compulsory tests.

The Director-General of Health, Dr Ashley Bloomfield, yesterday admitted that there was pressure on resourcing the self-isolated people in their homes.

“There is definitely pressure there, but we are rapidly resourcing up and expanding that model to provide both that initial call to people about what to expect and to assess what their needs might be to help them to see if they can remain at home safely,” he said.

“And for the vast majority of people, that is and will be the case, or whether they need additional support, health and or social support at the home end or whether I manage a quarantine facility may be the best place for them.”

What Bloomfield didn’t say was that most of the contact the self-isolating patients will have with the medical system will be by phone or internet.

A Ministry of Health set of guidelines for medical professionals about managing Covid in the community says that for ‘low-risk patients  “, a virtual consultation is expected at least every two days. For ‘at- risk’ patients, the primary care team is required to contact the patient every day or more if required to ensure the patient’s safety.”

Meanwhile, POLITIK understands that the Ministry of Business Innovation and Employment is starting to feel the reverberations from Auckland businessperson Murray Bolton’s successful application for a Judicial Review of the Ministry’s decision to not allow him to self -isolate after a business trip to the USA.

The Court found that MBIE was required to take “other matters” as well as health considerations when it declined the application.

MBIE is not appealing the decision, which has left the door open to other people to apply for a similar exemption.

It is thought a large number will probably do this.

But the biggest blow against the MIQ system came yesterday in a paper authored by a number of Otago University Medical School academics based in Wellington.

The authors include two of the Government’s advisers, Professor  Michael Baker and Professor Nick Wilson.

They say effective management of the Covidpandemic depends on effective risk assessment and management.

“Part of this process is based on achieving reasonably consistent thresholds for what is an acceptable risk in relation to the strategy being pursued.

“Auckland has switched to a suppression strategy (i.e., to minimise the impact of Covid-19 on public health and keep the caseload from overwhelming the healthcare system) where some level of Covid-19 risk is accepted.

“One benchmark for this acceptable risk threshold is set by the fact that hundreds of Covid-19 cases are now isolating at home rather than in tightly managed MIQ facilities.”

The authors say that most vaccinated international travellers arriving in Auckland do not require quarantine and probably only need monitoring and testing at most.

Some extra monitoring and testing (and in some instances still a few days in a facility-based quarantine) may be required for the unvaccinated; and for those coming from higher incidence jurisdictions such as the UK.

In what was highlighted in many media accounts of the paper, they said, “ if you’re at the supermarket in Auckland, a fully vaccinated person randomly teleported from Canada is less likely to infect you than an average resident Aucklander in the aisles.”

The authors argue that the boundary around Auckland should be strengthened  or “if the Government takes a less stringent approach to the Auckland boundary than we recommend, and Aucklanders are not required to quarantine on arrival in other parts of NZ, then most vaccinated international travellers should not be required to either.”

The Prime Minister said yesterday she hadn’t read the study but went ahead to comment on it anyway.

“When you see almost anyone who models what happens overall in outbreaks is if you have no measures at the border, then you do see additional cases, and that causes your outbreaks to grow quite significantly,” she said.

“Even with self-isolation, there are some estimates that if you had 20 thousand citizens, which is how many some estimate will return once the ability to self isolate opens up, you’d have up to 20 cases a week being seeded in the community.”

The reality is that every relaxation increases risk.

But there is also a political risk for the Government in keeping the restrictions too tight or applying them for too long.

That is the delicate balance that the Prime minister must now resolve.