Minutes
The Technical Advisory Group for COVID-19 Teleconference
Date:
21 February 2020
Time:
9:00 am- 10:00 am
Location:
National Health Coordination Centre (NHCC), 133 Molesworth St Wellington
Chair:
Dr Caroline McElnay
ACT 1982
Attendees:
Professor Michael Baker
Professor Stephen Chambers
Dr Virginia Hope
Dr Shanika Perera
Dr David Murdoch
Dr Erasmus Smit
Dr Shanika Perera
INFORMATION
Ministry of Health staff:
Dr Caroline McElnay
Dr Harriette Carr
Dr Tom Kiedrzynski
Dr Geoffrey Roche
Dr Richard Jaine
Dr Niki Stefanogiannis
Andi Shirtcliffe
Lucia Anselmi
Asad Abdullahi
Laura Seary (delegate for Dr Juliet Rumball-Smith)
Apologies:
Dr Bryan Betty, Dr Juliet Rumball-Smith, Dr Nigel Raymond, Dr Sally Roberts
RELEASED UNDER THE OFFICIAL
Documents tabled:
• Minutes of the last meeting (13 February 2020)
• Agenda for this meeting
• David L. Heymann and Nahoko Hindo on behalf of the WHO Scientific and Technical Advisory
Group for Infectious Hazards. “COVID-19: what is next for public health?
The Lancet. Feb 12,
2020.
Item Notes
ACT 1982
1
Minutes of last meeting – Thursday, 13 February 2020
Draft circulated – any corrections as soon as possible.
Matters arising:
Case definition:
INFORMATION
It had been agreed that there would be no changes to the case definition for the time being.
It was noted that all passengers of the cruise ship
Diamond Princess currently in Yokohama Bay
would be considered “close contacts of a confirmed case”, owing to concerns that infection
prevention and control measures were compromised. Those passengers wil be in quarantine
upon return to New Zealand.
Situation Report distribution
It was confirmed that daily distribution of the Situation Reports was appreciated by TAG
members.
Risk assessment template
Asad to re-circulate the new ESR draft risk assessment template for comment. –
Actioned.
2
Situation Report
Diamond Princess cruise ship in quarantine, Yokohama Bay, Yokohama, Japan.
RELEASED UNDER THE OFFICIAL
Caroline provided an update on the quarantine and case management of passengers aboard the
Diamond Princess. There has been considerable liaison with colleagues internationally to discuss
the removal of passengers and their management upon return to their home countries. Australia
sent Paul Armstrong on Saturday night (15th February). The emerging consensus is that quarantine
was not effectively maintained and that passengers were stil being exposed to the virus, hence a
recommendation that New Zealanders be removed from the ship and go into self-isolation. This
approach is consistent across Canada, the United States, the UK and Australia.
Other key points from the discussion on the
Diamond Princess:
• Japanese authorities include asymptomatic people who have tested positive as cases.
Around 53% of confirmed cases were asymptomatic. No further information has been
given on the clinical progression of disease in these cases
• Final figures on all those who had been tested are not yet available. There is currently no
summary of all passengers and what proportion had tested positive.
• Quarantine aboard the ship is understood to have been a request to passengers to stay
in their rooms; it is assumed that ship board activities such as food preparations
continued as usual, and crew moved about. Food was left outside passenger rooms, and
rooms were not cleaned by crew.
• Paul Armstrong had reported that there may have been two transmission waves; the first
soon after the quarantine period began, and a second when a number of crew became il .
• Data is being published online by the Japanese Ministry of Health Labour and Welfare. 1
New Zealand passengers brought back from Japan
Six New Zealanders from the
Diamond Princess arrived in Auckland last night; two other New
Zealanders tested positive before they could leave Japan and were not permit ed to board by
ACT 1982
Japanese authorities. Australia had around 20 or 30 passengers who were not able to board;
170 boarded the flight, 6 were moderately symptomatic.
Discussion
The group discussed whether testing of the passengers in Whangaparoa was necessary if they
were asymptomatic. The group
AGREED that the six ex-
D amond Princess passengers at
Whangaparaoa did not need to be tested if they did not have symptoms. The daily health checks
would continue and only those with symptoms would be tested.
INFORMATION
3
Interpretation of SARS-C0V 2 positive PCR results in asymptomatic individuals
- Discussion as above – any further discussion to proceed off-line.
4
Updates from the Subgroups
4a
Lab (Anja, Virginia)
• Dunedin is not yet ready for testing.
• ESR is processing the most tests.
A recent incident at Canterbury Health Laboratories involving false positives.
A recent incident at Canterbury Health Laboratories has highlighted the dif iculties associated
with false positives. The cause of the false positive was found to be due to contamination from a
positive control. It is important to re-iterate to laboratories the need to be vigilant to prevent
contamination.
RELEASED UNDER THE OFFICIAL
Discussion on type of samples that need taken for COVID testing
Potentially nasopharyngeal swabs are better at picking up an adequate number of cells for
testing (compared to throat swabs). More work in this area needs to be done.
Point of care tests.
1 https://www.ni d.go.jp/ni d/en/2019-ncov-e/9407-covid-dp-fe-01.html
ESR wil be assessing point-of-care tests.
4b
IPC (Niki and Sal y)
Main points:
The IPC subgroup met on Wednesday 19h February to discuss cleaning protocols for non-health
settings, following multiple requests from non-health sectors, including camper vans used for
quarantine at Whangaparaoa, schools, student accommodation etc.
The group is developing guidelines for both DHBs and primary care and wil present to the TAG
at the next meeting. The guidelines for primary care wil be clear on what types of masks should
be used.
ACT 1982
Action The IPC subgroup wil provide the guidelines for DHBs and primary care to the TAG for
consideration at the next TAG meeting (Thursday 27 February).
4c
Public health (Harriette and Shanika)
INFORMATION
• a repository of materials has been set up on SIPHAN, and public health units have been
invited to upload materials.
• Tom and Craig are developing health professional advice, which involves collating
existing materials.
• Further work required on realistic capacity of public health units for contact tracing and
contact management.
4d
Epidemiology (Richard, Michael and Virginia)
General
• Discussions are underway on what information would support the Ministry’s approach to
risk assessment of countries with sustained community transmission
.
•
Model ing of impact of COVID-19 New Zealand
RELEASED UNDER THE OFFICIAL
University of Otago (Michael Baker) has been requested to replicate recent Australian modelling
on the impact of COVID-19 for New Zealand. Report wil be shared with TAG.
.
5
Any Other Business
Request for inputs on what needs to be addressed by the MoH
Caroline invited any suggestions on what needed to be addressed to be emailed to her, or for
members to telephone her directly.
Need to coordinate research activity and ensure that it is aligned with operational needs
Key points:
• The need to ensure that research activities aligned with operational needs was noted;
funding for research alone would not be strategical y helpful if utility was not established.
• It was noted that the Health Research Council was capable of mobilising resources
quickly, such as at the time of the 2019 Christchurch shootings.
Further subgroups
• A clinical subgroup and a primary care subgroup will be set up involving relevant
clinicians from TAG. Andrew Simpson, MoH Chief Medical Of icer, will also be involved.
Students from mainland China and border restrictions
ACT 1982
• No decision has been made on international students returning from China for the 2020
academic year.
• Border restrictions wil be reviewed on Monday 24 February.
Health sector readiness
• TAG to consider what factors are applicable in considering whether to open or close
borders, in its advice to Government especially how to assess health sector readiness.
INFORMATION
Suggested agenda items for the next meeting:
1. What data was needed to inform pandemic management decisions
2. IPC advice for primary care
3. Update on any supply chain issues for essential medicines
6
Next meeting: Thursday 27 February 2020, 9:00 – 10:30am
RELEASED UNDER THE OFFICIAL
