Minutes:
Technical Advisory Group for COVID-19
Date:
Friday 26 June 2020
Time:
10.30am – 11.30am
Location:
Zoom Meeting
Chair:
Dr Ian Town
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Members:
Dr Sally Roberts, Prof Michael Baker, Dr Nigel Raymond, Dr Virginia Hope, Dr Shanika
Perera, Prof David Murdoch, Prof Stephen Chambers, Dr Matire Harwood, Dr Anja
Werno, Dr Patricia Priest, Dr Erasmus Smit
Ministry of Health staff - Dr Harriette Carr, Dr Tomasz K edrzynski, Dr Juliet Rumball-
Smith, Dr Niki Stefanogiannis, Dr Richard Jaine, Asad Abdul ahi, Margaret Broodkoorn,
Louise Chamberlain
Guests
Dr Mary van Andel
INFORMATION
Apologies:
Dr Caroline McElnay, Dr Bryan Betty, Dr Collin Tukuitonga, Andi Shirtcliffe
1.0 Welcome and Previous Minutes
Dr Ian Town welcomed all Members, Attendees and Guests in his capacity as Chair of the Technical
Advisory Group for COVID-19.
Minutes of the last meeting (12 June 2020) were accepted.
2.0 Update on open actions
Open actions updated. Actions 42, 47, 48, 49, 50, 51, 52, 53, 54, 55 closed.
3.0
Ministry of Health update on COVID-19 response
The Chair advised intense media and public attention on the Ministry’s COVID-19 response is
expected to continue, due to the current health and political environment and the upcoming
general election.
The Ministry will remain focused on the collective responsibility to maintain the COVID-19 response.
Any commentary provided by the Ministry will be aligned with State Services Commission directive
as is normal in the pre-election period.
The Chair gave an update on current issues being worked on in the Ministry:
• Changes to case definition and Testing Strateg
RELEASED UNDER THE OFFICIAL y have been released. Acknowledgement and
thanks given for the large amount of hard work from many individuals who have contributed
to the development of this work in the current high-pressure environment. In general, the
response from the wider medical and science sector has positive.
• Maritime border control framework has been approved by Cabinet.
TAG feedback:
Surveillance testing:
• Has been challenging to explain surveillance testing within primary care and operationalise
this advice within normal clinical practice
• Different areas of the sector do not necessarily have the same view/understanding of
surveillance testing
• Remains a gap in public and communications
o Communications have been delayed to ensure alignment with the release of the
revised case definition and testing strategy and will now be finalised
• IPC assessment framework is a useful tool and is suitable to adapt for individual prov ders
• Primary Care quick reference guide has been uploaded
Case definition:
• Concerns the removal of prioritised groups from suspect case definition may have equity
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impact
• This has been removed as the updated case definition focuses on prioritising individuals and
separating from testing strategy
• Awhina app document link to be updated
4.0 Results of TAG structure review
TAG was presented with the initial outcome of a review of the TAG structure, requested by the
COVID-19 Response Hub Leadership Team and was thanked for input into the review and the recent
stocktake of advice and strategic priorities (item 5 0)
INFORMATION
A number of internal reviews of the COVID-19 response are being undertaken, covering the earlier,
current and future response, leadership and funding.
Leadership of COVID-19 Response Hub wil shortly be taken over by Sue Gordon, as Keriana
Brooking leaves the Ministry to take up a new role.
• New structure is designed to focus work on planned strategic priorities and support a work
programme centred way of working. At the basis of work programme structure is the
principle of an ‘evidence-based’ response
• Current Subgroups wil no longer be convened as committee-style meetings
• Expert advisors will be brought together as required to complete specific pieces of work
and/or as bespoke working groups based on the piece of work to be completed or
monitored, removing the need for complicated movement of the advice between multiple
subgroup meetings.
o Noted that this system is already frequently used for the development of some
advice eg: ARC, clozapine
• Outcome of the working group wil be the advice – there will no longer be minuted
committee style meetings held. The development of advice can be supported by technical y
trained Ministry staff who can coordinate the consultation
• Consultation and peer review mechanisms can be built in to process, dependent on type of
advice eg: Ministry process, peer reviews, wider consultation
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TAG feedback:
• CIMS has been used successful y in previous responses – helps with making a response
operationally driven and adds a responsiveness to both operational drivers and strategic
directions
o Noted - currently the whole emergency response is being reviewed and the use of a
CIMS structure is being actively considered
• Subgroups currently include individuals with wide experience and expertise – want to
ensure this expertise is retained
• Meetings of full Subgroup have been advantageous, particularly when the full Subgroup
membership provides a national lens and experience
• At times, a strong evidence base for advice is not available, so advice needs to be developed
through consensus and experience
• Peer review or other mechanisms need to be part of process – required to protect
individuals
• There is a risk of narrow advice if only one subject matter expert involved in a working
group
• At times, Subgroup output may have not been requested by Ministry, but there have been
items raised and discussed at Subgroups that have resulted in value to the Ministry
Next steps:
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• STA leadership will consult with Subgroup Chairs next week to identify individuals with
specific expertise who are interested in contributing
• Any further feedback welcomed by email over the next week
Action: Provide any further feedback on outcome of TAG structure review within the next
week
5.0
RfA – Science and Technical Advisory current and strategic priorities
Science and Technical Advisory (STA) Programme Manager is now populating STA work programme
with priorities to be followed by scoping of the work.
INFORMATION
6.0
RfA – removal of nebulisation of medication from the AGP list
TAG discussed the removal of nebulisation of medication from the AGP list.
• Both IPC and Clinical Subgroups support the removal
• Risks raised by NZ Respiratory Clinical Leads are opinion and not evidence based eg: ARC
setting; SARS experience was also related to IPC failures not always related to nebulisers
• TAG agreed there are alternative ways of delivering bronchodilator therapy and in the
current environment, the material risk of nebulisers is extremely low
• Impact assessment received from a rural perspective is not evidence based
• Chair will discuss with Respiratory Clinical Leads
TAG support the removal of nebulisation of medication from the AGP list, with caveats and risk-
based advice.
7.0 Healthcare Worker infection review
Ministry has been considering a review into COVID-19 transmission associated with healthcare
workers. Initial meeting has been held.
• Several related reviews have already been conducted eg: Waitemata DHB, ARC facilities,
Auditor General report into management of PPE
• Some PHUs are currently conducting reviews, particularly ARC related
• Gaps identified around social science researc
RELEASED UNDER THE OFFICIAL h and the HCW experience. The Chair is
discussing priorities and funding with HRC
Ministry will consider all the recommendations from the various reviews into a series of
recommendations. Review will be shared with TAG for information and comments
TAG feedback:
• Conversations held with DHBs recognise willingness to improve communications
