Minutes:
Technical Advisory Group for COVID-19
Date:
Friday 24 July 2020
Time:
10.30am – 12.00pm
Meeting URL:
2
Location:
Out of scope
Meeting ID: 948 2567 1811
Password: TAG
or Numeric Password: 498734
Chair:
Dr Ian Town
ACT
Dr Anja Werno, Professor David Murdoch, Dr Erasmus Smit, Dr Matire Harwood,
Members:
Professor Michael Baker, Dr Nigel Raymond, Assoc Prof Patricia Priest, Dr Sal y
Roberts, Professor Stephen Chambers, Dr Virginia Hope
Ministry of Health Attendees:
Asad Abdullahi, Dr Harriette Carr, Dr Juliet Rumbal -Smith, Louise Chamberlain,
Dr Niki Stefanogiannis, Dr Richard Jaine, Sarah Mitchell
Guests:
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Apologies:
Dr Bryan Betty, Dr Caroline McElnay, Dr Collin Tukuitonga, Andi Shirtcliffe, Dr
Shanika Perera, Margareth Broodkoorn, Dr Tomasz Kiedrzynski
1.0
Welcome and Previous Minutes
Dr Ian Town welcomed all Members and Attendees in his capacity as Chair of the Technical
Advisory Group for COVID-19.
Minutes of the last meeting (10 July 2020) were accepted.
2.0
Update on open actions
There are no open actions.
3.0
Ministry of Health update on COVID-19 response
The Chair gave an update on current issues being worked on in the Ministry:
•
Ministry is following Alert Level 1 protocols, focusing on planning and readiness.
•
New Minister of Health continue to be very engaged and has become quite familiar with the
political, scientific and strategic issues around the COVID-19 response. In Parliament,
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questions are answered clearly and factually, and the minister is working closely with the
Director General of Health to ensure the communications are aligned as far as they can be.
•
A new Directorate has been established within the Ministry to focus on the COVID response
and is being populated with qualified people to support the preparedness and the
resurgence response.
•
A detailed review of the COVID-19 response amongst the Executive Leadership Team was
undertaken last week facilitated by the Emergency Manager. Free and frank discussions
about improvements included bringing data and intel igence in a timely manner; a better
strategic understanding of surveil ance; a more formal structure in place for coordinating the
response across all the government agencies including the adoption of the CIMS structure.
• Vaccine Strategy is a fundamental part of the long-term planning for NZ and has a direct
impact on borders, economy, tourism and travel. The science platform for the Vaccine
Strategy has been approved in principal (led by Professor Graham Le Gros from Malaghan
Institute of Medical Research and Associate Professor James Ussher from the University of
Otago). The Platform wil progress some NZ candidates for a vaccine, working with various
other global bodies to ensure NZ Science program is understood and integrated with work
developed by other countries.
• Scientists from NZ, UK, Singapore and Australia are considering working col aborations
discussing manufacturing and supply chain issues. The Ministry’s Immunisation Group has
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been activated with urgency to advise the government about priorities of vaccine
deployment.
• A meeting to discuss the initial advice on a prioritisation framework for a COVID-19
vaccination was held on July 17, 2020. A good example of the new process of engaging key
members of the wider TAG network supporting Ministry discussions.
ACT
• The Ministry has been asked to provide updated advice on the use of face masks in the
community, including timing of implementation, type of masks (e.g. medical-grade and
handmade cloth masks), manufacturing and distribution. This wil occur as part of
Resurgence Planning.
• Members of the Ministry Public Health team have been in regular contact with Australian
colleagues. More specifical y around the Australian situation, it is been interesting to see
how useful genomics have been in determining that just two MIQ cases were responsible for
the rapid escalation of outbreaks.
• Poor training and understanding IPC basic principles and other protocols have allowed for
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rapid dissemination amongst the community, along with over confidence in testing and
contact tracing capability. Some of these risks have been identified in the context of an
outbreak in NZ.
TAG feedback:
• Query about the number staff being tested in Australian facilities compared to the NZ plan.
• Dr Sally Roberts and Margareth Broodkoorn, MoH Chief Nursing Office been in touch with
colleagues from Sydney who are running the IPC advice in Australia. The situation in
Australia showed that hotels have developed their own IPC processes, highlighting the
importance the current work being done to standardise and monitor the IPC advice and
processes across NZ.
• It was suggested that a working group to examine the community part of the testing strategy,
trying to anticipate where the breaches at MIQ facilities will occur.
o Ministry agrees that the immediate and urgent response to contact tracing point of
view is crucial.
4 0
Testing Strategy
Communications regarding community testing for COVID-19 and ensuring access to testing facilities
were sent out to the sector on Wednesday night. A copy has been included in the agenda circulated
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to TAG members.
• There has been concern around lower testing rates in the community resulted from some
confusing advice, public perception around lower risk and reluctance to be tested.
• Low testing rate could impact the capacity to quickly identify border leakage.
• Teleconference held with multiple groups from the sector including members of the Royal
New Zealand College of General Practitioners (RNZCGP), the Royal New Zealand Col ege
of Urgent Care. (RNZCUC), Healthline, the Council of Medical Colleges along with
members of the Ministry Public Health and Primary Care teams as wel as DHB leads.
• The discussion was around how to properly support the Ministry’s’ surveil ance response
and there was a request clarity of the existing testing advice and the new approach,
meaning our essential groups for testing remain plus offering and encouraging to swab al
those with clinical criteria for COVID-19.
• A table outlining the essential groups for community testing will be provided along with
another piece around taking specimens.
TAG Feedback:
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• Challenges as the definitions have changed. Concern of not having the capacity for regular
testing where we know the risk is high - border and MIQ staff.
• Clarification that the Higher Index of Suspicion (HIS) criteria have not changed and
represent those who are our highest priority for testing, also, that there is a separate testing
ACT
strategy for MIQ, and community testing is one subset of the Testing Strategy.
• Query to what the turnaround time is, as the delay in receiving a response may lose the
impact in the public perception.
o The turnaround is the same and the priority to notifications remain for positive tests
• Query to the denominator and reasoning for testing, as well as the testing costs and where
we are getting the best risk-reduction value in terms of spending.
o Cost of test is $70 plus fees for the person taking the swab. The previous problem
has been the multiplicity of referrals pathways for testing - captured in contact
tracing. People coming through NZ borders wil be assigned a National Health Index
number (NHI number), also their tests wil be loaded into the cont
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- currently 11 out 12 PHUs are aligned with that, providing the denominator and
reasoning for testing.
• From an IPC point of view, the goal is protecting the staff. We have not seeing any
community transmission and while the situation in Melbourne is quite complex, our
processes are tight.
o The biggest protection is stil the ‘14 days”. In terms of Public Health interventions, it
is the crucial backstop. Maintaining the standard level of service and keeping staff
at their pick performance is real challenge.
5.0
Resurgence Planning
A copy of the Resurgence Planning Overview Brief to the Executive Leadership Team was included
in the agenda circulated to TAG members.
• The document is the result of work started immediately after last TAG meeting and involved
the review of the response structure and decision to adopt a more standard CMIS structure
for any further resurgences.
• Several scenarios for achieving preparedness have been developed by the Al of
Government (AoG) Team.
• A more detailed plan wil be brought to TAG members once available.
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TAG feedback:
• Support of the CMIS approach. The degree of training within the sector may have changed
significantly since it was last used in a major response. The sector may be familiar with
CIMS Level 2 training. Perhaps some easily accessible introduction/ webinar/ podcast would
be helpful.
o There is a recognition of importance of training, understanding roles and
responsibilities in the incident control. Training program wil start next week.
• Importance of learning lessons from the situation in Victoria. It was suggested that the
scenarios may need adjusting in the light of the Victoria situation.
o TAG Chair has been in contact with the Chief Health Officers for Australia and
Victoria. Effective public health control causing the least disruption to people’s lives
and the economy is the goal in any response.
6.0
Review of TAG and Subgroup Structure
The Science and Technical Advisory (STA) Manager presented the TAG and
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subgroup re-set.
Proposed TAG and
subgroup re set 24.7.2
Highlights include:
• Aside from the structural changes, it was pointed out the type of work required has changed
ACT
- more need for multi- and inter-disciplinary expertise.
• The current model is administratively burdensome and time-consuming.
• TAG is set up to have more detailed discussions at a more strategic level with longer, but
less frequent meetings.
• TAG membership wil be refined
• Subgroup Chairs will be asked to remain as SME leads
• TAG subgroups disestablished as TAG-related committees, but:
o Can continue to meet as non-TAG groups if wanted – but not under TAG
administration
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o May be asked to convene for a request for advice if it is a ‘single discipline’ question
o We wil work with SME leads to identify whether the current members should be
asked to stay on as expe t advisors (anticipate that almost al current subgroup
members wil be asked to remain)
o Temporary working groups can be convened with required expertise from the
Ministry, ‘pool’ of expertise from previous TAG and subgroups, and specific new
expertise that we don’t currently have
• ‘Request for advice’ is a question, issue, problem, area for investigation, something we want
to know, and it can come from anywhere/anyone – internal Ministry work, Ministers, STA
work programme (forecast of priority areas for investigation), and experts.
7.0
Māori Health Perspectives
• Appreciation given to HRC for a recently announced focus on research into COVID-19
impacts on Maori
• Clarification on the testing criteria is welcomed - it has been confusing for Māori health
providers.
• Census questions to ensure quality Māori ethnicity data. Impact of the lockdown stil present,
people’s access to surgery, having to manage long-term conditions and chronic disease.
8.0
Pacific Health Perspectives
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• No update
9.0
Subgroup Activity Updates
Infections Prevention and Control
• Due to current workload, IPC Subgroup is still meeting twice a week. Work is being focused
on MIQ, making sure the message from IPC perspective is consistent across NZ and
reviewing Alert Levels Guidance Documents
