133 Molesworth Street
PO Box 5013
Wellington 6140
New Zealand
T+64 4 496 2000
27 April 2022
M.R.M
By email: [FYI request #18644 email]
Ref:
H202203012
Tēnā koe M.R.M
Response to your request for official information Thank you for your request under the Official Information Act 1982 (the Act) to the Ministry of
Health (the Ministry) on 23 February 2022 for:
Can you please provide me with all documentation relevant to the government's decision
to provide free packs of 3 RAT's for travellers incoming to N.Z. effective from 21/2/22. This
is to include all related financial information ... costings, budgets, etc.
Please provide me with the name of the RAT supplier.
One document, titled
“Briefing 20212663 – Testing regime and escalation pathway for medium-
risk travellers” has been identified within scope of your request and is attached to this letter as
Document 1. Where information is withheld, this is noted in the document itself. Where
information is withheld under section 9 of the Act, I have considered the countervailing public
interest in release in making this decision and consider that it does not outweigh the need to
withhold at this time.
Please note, RATs provided to incoming travellers can be one of many which have been
authorised for use in New Zealand by the Director-General of Health. A list of the approved
RATs for use in New Zealand is available at:
www.health.govt.nz/covid-19-novel-
coronavirus/covid-19-health-advice-public/assessment-and-testing-covid-19/rapid-antigen-
testing-rat#regulatory. I have been advised that the Cabinet paper,
‘Reconnecting New Zealanders: Commencing
phased reopening of the international border’ has also been identified in scope of your request;
however, the release of this document is more closely aligned with the functions of the office of
the Minister for COVID-19 Response, Hon Chris Hipkins. For this reason, I have decided to
transfer the decision on releasing this document to Minister Hipkins’ office under section
14(b)(ii) of the Act. You can expect a response from his office in due course.
I trust this information fulfils your request. Under section 28(3) of the Act, you have the right to
ask the Ombudsman to review any decisions made under this request. The Ombudsman may
be contacted by email at:
[email address] or by calling 0800 802 602.
Nāku noa, nā
Darryl Carpenter
Group Manager COVID-19 Testing and Supply
COVID-19 Health System Response
Document 1
Briefing
Testing regime and escalation pathway for medium-risk travellers
Date due to MO: 2 December 2021
Action required by:
3 December 2021
Security level:
IN CONFIDENCE
Health Report number: 20212663
To:
Reconnecting New Zealanders Ministerial Group
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Contact for telephone discussion
Name
Position
Telephone
Dr Ashley Bloomfield
Director-General of Health
s 9(2)(a)
INFORMATION
Bridget White
Deputy Chief Executive, COVID-19 Health
s 9(2)(a)
System Response
Minister’s office to complete:
☐ Approved
☐ Decline
☐ Noted
☐ Needs change
☐ Seen
☐ Overtaken by events
☐ See Minister’s Notes
☐ Withdrawn
Comment:
RELEASED UNDER THE OFFICIAL
Document 1
Testing regime and escalation pathway for
medium-risk travellers
Security level:
IN CONFIDENCE
Date:
2 December 2021
To:
Reconnecting New Zealanders Ministerial Group
Purpose of report
1.
This report provides advice on options for the COVID-19 testing regime and how
ACT 1982
symptomatic arrivals will be managed for the medium-risk traveller pathway.
Summary
2.
The Reconnecting New Zealanders approach will see increasing numbers of arrivals
through the medium-risk traveller pathway, with up to 75,000 arrivals per week expected
once Step 3 is in place by the end of April 2022. The Government has agreed the broad
requirements for the medium-risk traveller pathway, including a day 0/1 t
INFORMATION est on arrival
and a subsequent test on day 5/6 prior to release from self-isolation.
3.
While two PCR tests would provide the greatest assurance that we are detecting most
cases of COVID-19 among arrivals, a combination of a PCR test and serial Rapid Antigen
Testing (RAT) is recommended. The PCR test should be administered as the day 0/1
arrival test to ensure a higher degree of compliance from travellers also noting that the
majority of positive cases in managed isolation and quarantine (MIQ) are identified on
day 0/1 testing.
4.
Each airport receiving international arrivals will have trained healthcare staff present to
identify and manage symptomatic passengers. If a symptomatic passenger is able to
continue their journey to their final destination for self-isolation via private transport
they will be released and advised to undergo the same testing regime as any other
traveller. If a judgement is made that the passenger is unable to transport themselves to
self-isolation safely, they will be referred to a managed isolation facility. Officials are
considering options to address the issue around managing passengers arriving at
Queenstown Airport due to the absence of second
RELEASED UNDER THE OFFICIAL ary or tertiary health facilities and no
managed isolation facility.
5.
An individual who tests positive during their period of self-isolation will be advised to
immediately contact Healthline and will be managed according to COVID-19 Care in the
Community model.
6.
Work is underway to determine how arriving passengers who are in breach of their
conditions of entry will be dealt with, including an appropriate public health response
Document 1
and compliance and enforcement measures. Further advice will be provided to you on
this issue.
Recommendations
We recommend you:
a)
Note that Step 1 of the Reconnecting New Zealanders Strategy is due to
Noted
commence on 16 January 2022.
b)
Note that management of returnees under the medium-risk pathway will be
Noted
based on a high-trust, low-touch model.
c)
Note that on 24 November 2021, the Cabinet Social Wellbeing Committee
Noted
(SWC-21-MIN-0200 refers) agreed the broad requirements for the medium-
risk air traveller pathway, including a day 0/1 and day 5/6 COVID-19 test.
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d)
Note that the Ministry of Health has considered options for the day 0/1 and
Noted
day 5/6 COVID-19 test.
e)
Note that the Ministry of Health recommends a combination of a PCR test
and serial Rapid Antigen Testing is the most effective testing modality for
Noted
medium-risk pathway arrivals.
f)
Agree that arrivals under the medium-risk air traveller pathway be required
Yes/No
to submit a PCR test on day 0/1 and complete a series of at least three (day
INFORMATION s
3, 5, and 7) self-administered Rapid Antigen Tests before leaving self-isolation.
g)
Note that BEB are providing further details on the operationalisation of day
Noted
0/1 PCR test for returnees at the Reconnecting New Zealanders Ministerial
Group Meeting on Friday 3 December 2021.
h)
Agree that temperature scanning at the border for any pathways is stopped
Yes/No
as evidence shows this has very little benefit in enhancing controls at the
airport.
i)
Agree that any escalation judgement for symptomatic people be made
Yes/No
through a test, possibly a RAT test conducted by a health practitioner present
at the border
j)
Agree that symptomatic returnees who test positive at the border can go
Yes/No
home or to their place of quarantine and undergo a confirmatory day 0/1 PCR
test, pending an assessment that they can safely and privately transport
themselves to their location.
k)
Agree that if symptomatic returnees are unable to transport
RELEASED UNDER THE OFFICIAL themselves safely
Yes/No
and privately to their place of isolation, they will be referred into a managed
isolation facility until they meet the existing low risk indicators.
l)
Note that there are still outstanding issues around management of people
Noted
who return a positive test at Queenstown Airport.
m)
Note that returnees who test positive during their period of self-isolation will
Noted
be managed under the COVID-19 Care in the Community model.
Document 1
n)
Note that officials are still considering management of returnees who fail to
Noted
meet their public health conditions for entry.
o)
Note that a digital testing system is under development to capture testing
Noted
information of returnees including RAT test results.
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Dr Ashley Bloomfield
Rt Hon Jacinda Ardern
Te Tumu Whakarae mō te Hauora
Prime Minister
Director-General of Health
Date:
Date: 2 December 2021
INFORMATION
Hon Grant Robertson
Hon Chris Hipkins
Minister of Finance
Minister for COVID-19 Response
Date:
Date: 7/12/2021
RELEASED UNDER THE OFFICIAL
Hon Nanaia Mahuta
Hon Kris Faafoi
Minister of Foreign Affairs
Minister of Immigration
Date:
Date:
Document 1
Hon Michael Wood
Hon Peeni Henare
Minister of Transport
Associate Minister of Health
Date:
Date:
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Hon Dr Ayesha Verrall
Hon Aupito William Sio
INFORMATION
Associate Minister of Health
Associate Minister of Health
Date:
Date:
Hon Meka Whaitiri
Minister of Customs
Date:
RELEASED UNDER THE OFFICIAL
Document 1
Testing regime and escalation pathway for
medium-risk travellers
Background
7.
Following the implementation of the Reconnecting New Zealanders (RNZ) Strategy we
expect to see a managed increase in the number of people crossing the border from the
middle of January. The RNZ Strategy will be implemented in three steps:
a. Step 1 (Jan 2022): New Zealanders in Australia (~5,000 arrivals per week anticipated)
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b. Step 2 (Feb 2022): New Zealanders in the rest of the world (~20,000 arrivals per
week anticipated)
ACT
c. Step 3 (April 2022): Non-New Zealanders (~75,000 arrivals per week anticipated).
8.
Laboratory capacity is expected to have reached 60,000 tests per day by the time Step 3
is implemented. The figures for Step 1 and Step 2 in the tables below have been
calculated based on the existing capacity of around 40,000 tests per day.
Testing regime for medium-risk pathway travellers
INFORMATION
9.
On 24 November 2021, the Cabinet Social Wellbeing Committee (SWC-21-MIN-0200
refers) agreed the following broad requirements for the medium-risk air traveller pathway:
a. a negative polymerase chain reaction (PCR), Loop-mediated Isothermal
Amplification (LAMP), or antigen pre-departure test within 72 hours prior to
boarding;
OFFICIAL
b. acceptable evidence of being “fully vaccinated” with an approved vaccine;
THE
c. declaration of all required information (using Nau Mai Rā), including contact details
(provided prior to boarding for contact tracing purposes), and that the individual
has not been in a very high-risk country in the past 14 days;
d.
UNDER
a seven-day self-isolation requirement;
e. a day 0/1 test on arrival; and
f. a day 5/6 test prior to release from self-isolation.
Day 0/1 and day 5/6 testing
RELEASED
10.
The appropriate testing modality for medium-risk travellers depends on the objective of
the testing regime. If we are attempting to detect and isolate cases of COVID-19 early in
their infection, a testing regime that gives a high level of confidence that we are
detecting most if not all cases of COVID-19 is appropriate. If the objective is limiting the
exposure of COVID-19 in the community by providing some confidence that individuals
are not infectious when they leave their isolation period, consistent with the COVID-19
Protection Framework, a regime that catches most but not all cases is acceptable.
Document 1
11.
In any scenario where Rapid Antigen Testing (RAT) is part of the testing modality, a
single RAT on its own is unlikely to be effective in detecting all COVID-19 cases coming
through the border. There is also an increased risk of false positives. For a RAT regime to
be effective, serial testing will be necessary.
12.
We have identified four options for a testing regime:
a. Two PCR tests (day 0/1 and day 5/6)
b. Serial RAT (three times during the self-isolation period)
c. Serial RAT and a day 0/1 PCR test
d. Serial RAT and a day 5/6 PCR test.
Option 1: Two PCR tests
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13.
Day 0/1 and day 5/6 PCR tests will provide the greatest assurance that the majority of
COVID-19 cases in travellers will be detected but will impose a significant burden
ACT on
testing and laboratory capacity, even with the planned increase in laboratory capacity.
Requiring multiple PCR tests is likely to also create equity issues as travellers will be self-
isolating all over the country and may not be able to easily access PCR testing facilities.
Option 1: Two PCR tests
Tests per week Tests per day
Percentage of laboratory capacity
Step 1 (5,000 returnees)
10,000
1,400
4%
Step 2 (20,000 returnees)
40, 000
5,700
14%
INFORMATION
Step 3 (75,000 returnees)
150,000
21,000
35%
Laboratory Capacity
Testing required for this option would tie up over a third of our laboratory
capacity when Step 3 is implemented. This would have a significant impact of
turnaround time for symptomatic testing, especially if there is COVID-19 in
the community and an increase in testing demand. Would impact ability for
OFFICIAL
testing centres (CTCs and GPs) to focus on symptomatic people.
Adding an additional 2
THE 1,000 tests per day at Step 3 will have a significant
impact on turnaround time.
Option 2: RAT every two days
UNDER
14.
Under Option 2 below, travellers would be issued with enough rapid antigen tests kits
for 3 days and be instructed to undertake a test every two days (days 3, 5, and 7) during
their self-isolation. To account for potential false positives and user error, a positive
result would need to be replicated and then confirmed via a PCR test before any further
action is taken.
RELEASED
Option 2: RAT tests every two days (3 per person)
Tests per week
Tests per day
Percentage of laboratory capacity
Step 1 (5,000 returnees)
15,000
2,100
0%
Step 2 (20,000 returnees)
60,000
8,600
0%
Step 3 (75,000 returnees)
230,000
33,000
0%
Laboratory Capacity
No impact on laboratory network. If RATS are required to be performed
under supervision, there would be workforce impacts and equity questions
relating to access for those not living in close proximity to trained workforce.
Document 1
Option 3: A day 0/1 PCR test; RAT every two days (days 3, 5, 7/pre-release)
15.
Under Option 3, arrivals would be required to take a PCR test on day 0/1 and that would
be supplemented with RAT every two days until the end of the self-isolation period.
Arrivals could be given the option of providing a saliva sample at a collection point near
the airport or at a community testing centre (CTC) once they had reached their final
destination. A requirement to provide a saliva sample at or near the airport on arrival will
support a high rate of compliance, especially considering that not all travellers will have
easy access to a CTC at their final destination.
16.
This option, as with option 4, imposes a lower burden on the testing and laboratory
network than requiring two PCR tests.
Option 4: RAT days 1 and 3 and a day 5/6 PCR test
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17.
As noted above, a single day 0/1 RAT is unlikely to be effective on its own. As with a RAT
only option, for Option 4 we have considered RAT testing supplemented by a singl
ACT e day
PCR test, this time administered on day 5/6 rather than on day 0/1. This option is likely
to detect most cases of infection, if complied with, as well as impose a small additional
burden on the testing and laboratory network, for the first two steps.
Options 3 and 4: One PCR and RAT tests every 2 days (3 per person)
Tests per week
Tests per day
Percentage of laboratory capacity
Step 1 (5,000 returnees)
15,000 RAT
2,100 RAT
0%
INFORMATION
5,000 PCR
700 PCR
2%
Step 2 (20,000 returnees)
60,000 RAT
8,600 RAT
0%
20,000 PCR
2,900 PCR
7%
Step 3 (75,000 returnees)
230,000 RAT
33,000 RAT
0%
75,000 PCR
10,700 PCR
18%
Laboratory Capacity
Less impact on laboratory and testing centres, but still imposes a significant
OFFICIAL
burden as arrival numbers increase.
THE
18.
All of the options presented here are consistent with the high-trust, light-touch
approach to the management of persons of similar risk status within the New Zealand
community under the COVID-19 Minimisation and Protection Framework.
19.
Option 3 is the Ministry’s preferred option.
UNDER
20.
PCR day 0/1 is preferred as RAT test on day 0/1 cannot provide assurance that those
infected the pre-departure PCR test and beginning of home isolation will be identified.
Infected the traveller may not show up a positive RAT until after day 1 and any
compliance issues with home isolation requirements (based on the high trust, light touch
approach), increase risk of COVID-19 being seeded in the community.
RELEASED
21.
The Omicron variant highlights that a case entering the community from overseas is still
a risk. The risk from an overseas-acquired case also differs from locally acquired cases in
that they may seed an outbreak cluster in a new population that is not affected by
current regional outbreaks. PCR testing at the border reduces the chance of new variants
entering New Zealand.
Document 1
Options for conducting Day 0/1 PCR test for returnees
22.
Arrivals could be given the option of providing a saliva sample at a collection point at or
close to the airport or at a CTC once they had reached their final destination. A
requirement to provide a saliva sample at or near the airport on arrival is likely to ensure
a higher rate of compliance, especially considering that not all travellers will have easy
access to a CTC at their final destination. Passengers would be expected to provide the
sample unsupervised and deposit it at a collection point prior to exiting the airport
(though not necessarily airside).
23.
It is not feasible to monitor the thousands of people who will be coming across the
border, which is why we have a high trust model. Accepting that, if we want to limit the
amount of risk as much possible a day 0/1 PCR test taken at the airport is the preferred
option. The alternative option of a day 5/6 PCR test with serial RAT is likely to require
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significant resource to monitor and enforce with potentially thousands of arrivals every
week needing to be followed up to confirm that they have taken a test.
ACT
24.
We note that border agencies have identified significant challenges providing the
facilities, people flow and compliance at the airport if samples for PCR day 0/1 test are
taken in the airport, especially airside.
25.
BEB will provide further details on the proposed operationalisation of the PCR day 0/1
test that will also be discussed at the Reconnecting New Zealanders Ministerial Group
meeting on Friday 3 December 2021.
INFORMATION
Escalation pathway for managing returnees on arrival
Managing symptomatic returnees at the border
26.
At each airport a suitably trained health presence will be maintained to provide advice to
travellers on RAT use and to respond to travellers prese
OFFICIAL nting as symptomatic, to make
escalation judgements.
27.
THE
The Ministry recommend that any escalation judgement for symptomatic people be
made through a test, likely a RAT test conducted by a health practitioner present at the
border. It is anticipated that volumes of symptomatic returnees will be low enough to be
manageable and this already is conducted under the QFT settings.
UNDER
28.
The Ministry also recommends that temperature scanning at the border for any
pathways is stopped as evidence shows this has very little benefit in enhancing controls
at the airport and we are not aware of any cases that have been identified through
random temperature checking. This will free-up health resources to be used to support
implementation of RAT for returnees who are symptomatic on arrival.
29.
RELEASED
The public health advice for managing returnees who test positive on arrival is that they
are advised to go home or their place of quarantine and undergo a confirmatory day 0/1
PCR test (as expected of other returnees). The confirmatory PCR test is important given
the limitations with this testing method particularly the lower sensitivity that can lead to
false negatives and false positives. However, the option of going into self-isolation
would only be available to those who can use private transport to get home.
30.
The health practitioner would need to conduct rapid assessment wherein they can
identify whether the symptomatic person/bubble can safely/privately transport
themselves to their place of self-isolation.
Document 1
31.
If they are unable to transport themselves safely and privately to their place of isolation,
the public health advice is they are referred into a managed isolation and quarantine
(MIQ) facility until they meet the existing low risk indicators. This option would ensure
we can utilise existing services (e.g. transportation from airport to facility, testing, welfare
and other support) in facilities to appropriately manage the returnee and the potential
public health risk posed by them.
32.
A specific issue around Queenstown needs to be resolved prior to starting Step 1 as we
expect significant traffic coming via trans-Tasman connection. The issue is the result of
there not being secondary or tertiary health facilities, and there not being an appropriate
isolation facility. To address this, the following options can be considered:
i. No international arrivals to Queenstown at this time; or
ii. Developing an alternative accommodation option to MIQ to allow for
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escalation as required.
33.
Other outstanding questions and concerns around this option include having an
ACT
increased flight schedule on MIQ facilities including transportation, staffing etc.
However, we expect the volume of travellers requiring MIQ under this circumstance (i.e.
those who test positive at the airports) should be quite limited.
34.
Officials will report on the specifics of managing symptomatic returnees who do not
have appropriate private transportation to get to their place of isolation.
Managing returnees who test positive during their self-isolation period
INFORMATION
35.
If a returnee receives a positive RAT result during their isolation period, a PCR test will be
required for diagnostic purposes. The returnee will be advised to immediately contact
Healthline to arrange a follow-up PCR test after a confirmed RAT test.
36.
Following a confirmed positive PCR test (either day 0/1 or otherwise), a returnee will be
OFFICIAL
contacted by Public Health. They will then be treated the same as a community case and
will be managed under the COVID-19 Care in the Community model.
THE
37.
Under this model, people who test positive will receive an initial assessment within 24
hours of diagnosis to link them with care appropriate to their needs, including any
clinical, welfare and other needs.
38.
UNDER
People who test positive for COVID-19 are required to isolate for at least 10 days in the
first instance. They will receive ongoing clinical and welfare checks and support during
this period, and it is expected that any household members isolate in accordance with
current management of household contacts of community cases.
39.
Further details of the model are outlined in the paper on COVID-19 Care in the
Community paper that will be discussed at Cabinet on 20 December 2021.
RELEASED
Managing returnees who are in breach of their conditions upon entry
40.
There may be returnees who do not meet their public health conditions for entry,
including vaccination requirements or pre-departure testing requirements. In this
circumstance, a person cannot be considered medium risk as their public health risk
status will be unknown and require further determination.
41.
Under the trans-Tasman quarantine free travel arrangements, the vast majority of
passengers who breached conditions struggled to meet the evidential requirements of
Document 1
having a PDT (noting it was the one requirement linked with an evidential standard at
the time). Once the Travel Health Declaration (THD) is operational on 31 March, evidence
of meeting conditions will be assessed in advance of a passenger boarding. However,
the THD will not be operational on 16 January 2022 when Step 1 commences.
42.
Customs has indicated that there will be manual mechanisms in place (e.g. Airport
Liaison Officers offshore and Customs Officers onshore) to check every single
vaccination certificate and PDT for travellers under the medium-risk pathway. This should
mean that only a very limited number of travellers are able to arrive without meeting the
necessary public health requirements.
43.
It is anticipated that a breach of requirements will be enforced through infringements or
prosecutions. However, decisions need to be made about how to quantify and address
the public health risk where a person is found to be in breach of public health
requirements. Officials are considering an appropriate public health response to this
circumstance and will provide further advice.
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Linking end-of-isolation test results to travellers
44.
After analysis of potential solutions, we are proposing to use the testing system to
capture testing information for assurance purposes. This will include capturing the result
from the day 0/1 PCR test at a CTC, and the self-administered day 5/6 Rapid Antigen
Test. We are exploring whether this could be connected to key documentation including
My COVID Record, based on the identifiable information held in the testing system and
Nau Mai Rā.
INFORMATION
45.
While developing the system is achievable, there is a potential for delays while we work
through implementation challenges. We will also need early confirmation of key settings
for Reconnecting New Zealanders to establish this system. In particular, this includes
confirmation of detailed testing and compliance requirements to enable system design
to start by December 7 due to a mandatory stop to any system changes between
December 9, 2021 and January 17, 2022 that significantly limits development time. Given
the complexity of the proposed system, we will also need time for connecting relevant
databases and detailed testing.
46.
We will note that returnee’s monitoring and compliance during their self-isolation period
is yet to be determined, particularly around how we monitor testing results and follow-
up. Officials from Ministry of Business Innovation and Employment, Ministry of Health
and Department of Prime Minister and Cabinet will provide advice on this urgently.
Next steps
47.
Officials will provide further briefings to the Minister for COVID-19 Response on:
RELEASED UNDER THE OFFICIAL
a. Options for managing symptomatic arrivals in Queenstown
b. Options for managing symptomatic returnees who do not have appropriate private
transportation to get to their place of isolation
c. Appropriate response for arrivals who are in breach of their entry requirements.
ENDS.
Document Outline