Revisions to COVID-19 position statement on pre-consultation testing
ASE made this Official Information request to Ministry of Health
The request was partially successful.
From: ASE
Dear Ministry of Health,
On 19 Nov 2021, The Ministry of Health released a COVID-19 "Ministry of Health position statement on pre-consultation testing of unvaccinated individuals in healthcare settings".
Several days later, that position statement was revised, dated 25 Nov, and marked as version 2.0, with a slightly different title, "Ministry of Health position statement on routine pre-consultation testing of unvaccinated individuals in healthcare settings".
Among the changes between these two versions of the position statement, the earlier version, but not the updated version, stated:
"The absolute risk of transmission will be highly dependent upon the prevalence of disease in the community.
"When the rate of community spread is zero or very low, the risk of transmission from any consultation will be very low, unless a person is known to be at higher risk because they are symptomatic or a close contact of a confirmed case. [bold in the original]
"In addition, in this situation the difference in the risk of transmission between vaccinated and unvaccinated people will be negligible. When the prevalence of disease in the community is high, the risk of transmission from any individual is not negligible and is likely to warrant application of mitigations for all consultations.
"When there is high COVID-19 vaccine coverage (i.e., above 80 percent of eligible people are fully vaccinated), transmission is more likely to occur from a vaccinated than an unvaccinated individual." [bold in the original]
And, "Vaccination status is one of many risk factors for infection and transmission. There is currently no evidence that the application of an alternative pathway based solely on vaccination status, or the routine incorporation of unvaccinated asymptomatic individuals into a high-risk pathway is justified."
And, "Asymptomatic infection is the issue, not the vaccination status of the patient." [bold, and on its own line in the original; not bold, and not on its own line in version 2.0]
Can The Ministry of Health disclose all changes between these two documents, and the reasons for all such changes?
Can The Ministry of Health disclose what basis of evidence was used to support its 19 Nov position statement (eg data, research, and other information)? In particular, what basis of evidence was used to substantiate the assertions which were removed or de-emphasised from version 2.0 of this position statement?
Can The Ministry of Health disclose how such changes/revisions to this position statement are beneficial to public health, on the basis of evidence-based public health policies? Or, were such changes based on something other than evidence-based public health policies?
Aside from public health goals, supported by evidence-based risk/benefit and cost/benefit analyses, what other influences led The Ministry of Health to revise this position?
Thank you,
ASE 202111290
From: OIA Requests
Kia ora,
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From: OIA Requests
Kia ora,
Thank you for your request for official information. The Ministry's
reference number for your request is: H202116888.
Please be advised that due dates for requests received from 29 November
2021 onwards take into account the following periods:
Christmas (25 December 2021)
Summer Holidays (25 December to 15 January)
New Year's Day (1 January 2022)
Day after News Year's Day (2 January 2022)
Your request has been logged and you can expect a reply no later than 17
January 2022 as required under the Official Information Act 1982.
Due to the COVID-19 global pandemic response, the Ministry is experiencing
significantly higher volumes of queries and requests for information. If
we are unable to respond to your request within this time frame, we will
notify you of an extension of that time frame.
If you have any queries related to this request, please do not hesitate to
get in touch.
Ngā mihi
OIA Services
Government Services
Office of the Director-General
Ministry of Health
E: [1][email address]
-----Original Message-----
From: ASE <[FOI #17762 email]>
Sent: Monday, 29 November 2021 4:40 pm
To: OIA Requests <[email address]>
Subject: Official Information request - Revisions to COVID-19 position
statement on pre-consultation testing
Dear Ministry of Health,
On 19 Nov 2021, The Ministry of Health released a COVID-19 "Ministry of
Health position statement on pre-consultation testing of unvaccinated
individuals in healthcare settings".
Several days later, that position statement was revised, dated 25 Nov, and
marked as version 2.0, with a slightly different title, "Ministry of
Health position statement on routine pre-consultation testing of
unvaccinated individuals in healthcare settings".
Among the changes between these two versions of the position statement,
the earlier version, but not the updated version, stated:
"The absolute risk of transmission will be highly dependent upon the
prevalence of disease in the community.
"When the rate of community spread is zero or very low, the risk of
transmission from any consultation will be very low, unless a person is
known to be at higher risk because they are symptomatic or a close contact
of a confirmed case. [bold in the original]
"In addition, in this situation the difference in the risk of transmission
between vaccinated and unvaccinated people will be negligible. When the
prevalence of disease in the community is high, the risk of transmission
from any individual is not negligible and is likely to warrant application
of mitigations for all consultations.
"When there is high COVID-19 vaccine coverage (i.e., above 80 percent of
eligible people are fully vaccinated), transmission is more likely to
occur from a vaccinated than an unvaccinated individual." [bold in the
original]
And, "Vaccination status is one of many risk factors for infection and
transmission. There is currently no evidence that the application of an
alternative pathway based solely on vaccination status, or the routine
incorporation of unvaccinated asymptomatic individuals into a high-risk
pathway is justified."
And, "Asymptomatic infection is the issue, not the vaccination status of
the patient." [bold, and on its own line in the original; not bold, and
not on its own line in version 2.0]
Can The Ministry of Health disclose all changes between these two
documents, and the reasons for all such changes?
Can The Ministry of Health disclose what basis of evidence was used to
support its 19 Nov position statement (eg data, research, and other
information)? In particular, what basis of evidence was used to
substantiate the assertions which were removed or de-emphasised from
version 2.0 of this position statement?
Can The Ministry of Health disclose how such changes/revisions to this
position statement are beneficial to public health, on the basis of
evidence-based public health policies? Or, were such changes based on
something other than evidence-based public health policies?
Aside from public health goals, supported by evidence-based risk/benefit
and cost/benefit analyses, what other influences led The Ministry of
Health to revise this position?
Thank you,
ASE 202111290
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From: OIA Requests
Kia ora ASE
Thank you for your request for official information, received on 29
November 2021 requesting:
“Can The Ministry of Health disclose all changes between these two
documents, and the reasons for all such changes?
Can The Ministry of Health disclose what basis of evidence was used to
support its 19 Nov position statement (eg data, research, and other
information)? In particular, what basis of evidence was used to
substantiate the assertions which were removed or de-emphasised from
version 2.0 of this position statement?
Can The Ministry of Health disclose how such changes/revisions to this
position statement are beneficial to public health, on the basis of
evidence-based public health policies? Or, were such changes based on
something other than evidence-based public health policies?
Aside from public health goals, supported by evidence-based risk/benefit
and cost/benefit analyses, what other influences led The Ministry of
Health to revise this position?”
The Ministry of Health has decided to extend the period of time available
to respond to your request under section 15A of the Official Information
Act 1982 (the Act) as further consultation is required.
You can now expect a response to your request on, or before, 25 January
2022.
You have the right, under section 28 of the Act, to ask the Ombudsman to
review my decision to extend the time available to respond to your
request.
Ngâ mihi
OIA Services
Government Services
Office of the Director-General
Ministry of Health
E: [email address]
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From: OIA Requests
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Tēnā koe ASE
Please find attched a letter regarding your request for information.
Nga mihi,
OIA Services
Government Services
Office of the Director-General
Ministry of Health
E: [1][email address]
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From: ASE
Attn Ministry of Health
Thank you for that update.
To be clear, does this mean that the content of the 19 Nov position paper (Ministry of Health position statement on pre-consultation testing of unvaccinated individuals in healthcare settings) effectively remains the official position of The Ministry of Health? Does this mean that The Ministry of Health maintains that the evidence supports the sections that were removed in the subsequently revised release(s) of this position paper?
"We also became aware of the mis-use of information by those opposed to vaccination by quoting sentences out of context, which the revision has addressed." ― What examples of such misuse of this information are held by The Ministry of Health?
How has The Ministry of Health considered more effective ways of communicating this information so that it could not be taken out of context, rather than simply removing it from subsequently revised releases of this position paper? eg, what meeting notes and emails are associated with these revisions?
Also, please address the earlier questions which were not answered:
• Can The Ministry of Health disclose all changes between these two documents, and the reasons for all such changes? [if I understand correctly, there was also a version of this position paper released on 18 Nov 2021; this question should then be revised to ask: Can The Ministry of Health disclose all changes between all revisions of these documents, and the reasons for all such changes?]
• Can The Ministry of Health disclose what basis of evidence was used to support its 19 Nov position statement (eg data, research, and other information)? In particular, what basis of evidence was used to substantiate the assertions which were removed or de-emphasised from version 2.0 of this position statement?
Thank you,
ASE
From: OIA Requests
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From: ASE
Attn Ministry of Health,
In addition to the previous follow up of this request (your reference H202116888),
Please provide the feedback and consultation referred to here: "The statement was revised following feedback from and consultation with healthcare professionals, to ensure the position was clear and to avoid confusion."
Thank you,
ASE
From: OIA Requests
Kia ora,
Thank you for your follow up request for official information. The
Ministry's reference number for your request is: H202200610.
An additional request was for official information received on 26 January
2021 has been consolidated with your request:
“Please provide the feedback and consultation referred to here: "The
statement was revised following feedback from and consultation with
healthcare professionals, to ensure the position was clear and to avoid
confusion."
As required under the Official Information Act 1982, the Ministry will
endeavour to respond to your request no later than 20 working days after
the day your request was received. If you'd like to calculate the
timeframe, you can use the Ombudsman's online calculator
here: [1]http://www.ombudsman.parliament.nz/
Due to the COVID-19 global pandemic response, the Ministry is experiencing
significantly higher volumes of queries and requests for information. If
we are unable to respond to your request within this time frame, we will
notify you of an extension of that time frame.
If you have any queries related to this request, please do not hesitate to
get in touch.
Ngā mihi
OIA Services
Government Services
Office of the Director-General
Ministry of Health
E: [2][email address]
------------------------------------------------------------------------
From: ASE <[3][FOI #17762 email]>
Sent: Tuesday, 25 January 2022 18:54
To: OIA Requests <[4][email address]>
Subject: Re: Response to your request for information, ref: H202116888
Attn Ministry of Health
Thank you for that update.
To be clear, does this mean that the content of the 19 Nov position paper
(Ministry of Health position statement on pre-consultation testing of
unvaccinated individuals in healthcare settings) effectively remains the
official position of The Ministry of Health? Does this mean that The
Ministry of Health maintains that the evidence supports the sections that
were removed in the subsequently revised release(s) of this position
paper?
"We also became aware of the mis-use of information by those opposed to
vaccination by quoting sentences out of context, which the revision has
addressed." ― What examples of such misuse of this information are held by
The Ministry of Health?
How has The Ministry of Health considered more effective ways of
communicating this information so that it could not be taken out of
context, rather than simply removing it from subsequently revised releases
of this position paper? eg, what meeting notes and emails are associated
with these revisions?
Also, please address the earlier questions which were not answered:
• Can The Ministry of Health disclose all changes between these two
documents, and the reasons for all such changes? [if I understand
correctly, there was also a version of this position paper released on 18
Nov 2021; this question should then be revised to ask: Can The Ministry of
Health disclose all changes between all revisions of these documents, and
the reasons for all such changes?]
• Can The Ministry of Health disclose what basis of evidence was used to
support its 19 Nov position statement (eg data, research, and other
information)? In particular, what basis of evidence was used to
substantiate the assertions which were removed or de-emphasised from
version 2.0 of this position statement?
Thank you,
ASE
-----Original Message-----
Tēnā koe ASE
Please find attched a letter regarding your request for information.
Nga mihi,
OIA Services
Government Services
Office of the Director-General
Ministry of Health
E: [1][email address]
References
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page.
-------------------------------------------------------------------
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From: OIA Requests
Kia ora ASE
Thank you for your request for official information, received on 26
January 2022 requesting:
How has The Ministry of Health considered more effective ways of
communicating this information so that it could not be taken out of
context, rather than simply removing it from subsequently revised releases
of this position paper? eg, what meeting notes and emails are associated
with these revisions?
Also, please address the earlier questions which were not answered:
• Can The Ministry of Health disclose all changes between these two
documents, and the reasons for all such changes? [if I understand
correctly, there was also a version of this position paper released on 18
Nov 2021; this question should then be revised to ask: Can The Ministry of
Health disclose all changes between all revisions of these documents, and
the reasons for all such changes?]
• Can The Ministry of Health disclose what basis of evidence was used to
support its 19 Nov position statement (eg data, research, and other
information)? In particular, what basis of evidence was used to
substantiate the assertions which were removed or de-emphasised from
version 2.0 of this position statement?
Please provide the feedback and consultation referred to here: "The
statement was revised following feedback from and consultation with
healthcare professionals, to ensure the position was clear and to avoid
confusion."
The Ministry of Health has decided to extend the period of time available
to respond to your request under section 15A of the Official Information
Act 1982 (the Act) as further collation and consultation is required
You can now expect a response to your request on, or before, 10 March
2022.
You have the right, under section 28 of the Act, to ask the Ombudsman to
review my decision to extend the time available to respond to your
request.
Ngâ mihi
OIA Services
Government Services
Office of the Director-General
Ministry of Health
E: [email address]
****************************************************************************
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Kia ora ASE,
Please find attached a letter regarding your request for information.
Ngā mihi
OIA Services
Government Services
Office of the Director-General
Ministry of Health
E: [email address]
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