The government has announced changes to booster jabs, quarantine stays, and the border in an effort to keep Omicron out
of the country.
Covid-19 vaccine booster doses can now be booked four months after the second jab, down from six months - and boosters
will be mandated for all border and health workers. The phased border opening with Australia has been pushed out to the
end of February, and MIQ stays have been increased to 10 days, with the self-isolation component removed. The vaccine
rollout for 5-11 year olds will begin on 17 January.The SMC asked experts to comment.
Lesley Gray, Senior Lecturer, Department of Primary Health Care & General Practice, University of Otago, comments:
"I welcome the changes to MIQ to undertake the whole period of isolation in a MIQ hotel/facility rather than the recent
change to 7 days plus 3 days at home with a day 9 test from home. It is very difficult to monitor home isolation for
international returnees. If we were to identify a case of Omicron in a recent returnee when they had already travelled
back to their home or place of self isolation, there is a risk they would have been in contact with NZ community
en-route and very real potential for transmission in those important last three days.
"I also welcome the ‘early’ notification that the Australia and Aotearoa New Zealand border opening will be delayed.
Whilst I appreciate the stress this will place on people who may have already booked and need to be with their loved
ones ASAP, this at least gives some prior notice so that people have time to plan and reschedule. At the time the phased
border reopening was announced, we did not know that the Omicron variant of COVID-19 would be highly transmittable and
present in Australia so soon. We still await information on how severe this variant may be to more vulnerable
populations. Many countries are still dealing with significant transmission of the Delta variant.
"Whilst Aotearoa New Zealand has had very few COVID-19 deaths, each death is significant and our Māori and Pacifica
populations are disproportionately represented in the numbers of people infected.
"MIQ is currently a key feature to keep out (and drastically minimise) likelihood of community transmission at this
"Finally, currently we have few numbers of active Delta variant cases in the community and MIQ is doing its job. We have
high numbers of vaccinated people now and continue to see increased rates of 1st, 2nd and booster doses. At the moment,
NZers can enjoy their summer break so long as people are taking a ‘vigilant’ holiday (vaccinate, mask up, hand hygiene,
scan and track your movements, well ventilated rooms when indoors and lots of outdoor summer time)."
Conflict of interest statement: "I am currently a named investigator on two Health Research Council grants – one looking
at the equity of COVID-19 response and the other looking at contagion network modelling."Professor Michael Plank, Te Pūnaha Matatini and University of Canterbury, comments:
"The package of measures announced today will help protect New Zealanders’ health from the threat posed by the Omicron
variant of Covid-19. There is still a lot of uncertainty about Omicron, particularly how its severity compares to Delta.
However, we do know that it can spread extraordinarily fast and that two doses of the vaccine, although still much
better than nothing, is likely to be less effective for Omicron than for Delta. Increasing evidence suggests that a
third dose of the vaccine restores immunity to a much higher level.
"New South Wales is currently having a very rapid Omicron outbreak and the variant is also spreading in several other
Australian states. Going ahead with border reopening plans in January, even with the home isolation scheme, would mean
that Omicron would almost certainly get into the New Zealand community within weeks if not days. Delaying reopening
plans to the end of February gives us a chance to keep Omicron out until the majority of adults have received their
third dose of the vaccine. Increasing the MIQ stay to 10 days and shortening the pre-departure test period from 72 to 48
hours are sensible ways to reduce the risk of the highly transmissible Omicron variant leaking out of MIQ. Adding a
requirement for a rapid test on the day of the departure would be a useful extra measure.
"Hopefully these measures will keep Omicron contained at the border. But if Omicron does find its way into the
community, the government has said it intends to use the red level of the traffic light system to try and control its
spread. It’s unlikely this would be sufficient to prevent rapid spread of the variant if community transmission became
established. Rolling out booster doses as quickly as possible is therefore essential to minimising the risk that Omicron
overwhelms our healthcare system."
Conflict of interest statement: "Michael Plank is partly funded by the Department of Prime Minister and Cabinet for
research on mathematical modelling of COVID-19."Professor Nick Wilson, Department of Public Health, University of Otago, comments:
"The Government’s continuation of a very cautious approach to Covid-19 is very welcome from a public health perspective.
It might even be best from an economic perspective if it prevents large outbreaks of the Omicron variant in NZ – that
then result in people travelling less and avoiding retail and hospitality settings. While there is still a lot of
uncertainty around the Omicron variant, especially the risk of severe disease, it is wise to try to keep it out of NZ as
long as possible and until more is known about this variant. So these specific measures of earlier booster shots, the
rollout of the paediatric vaccine, and the adjustments to MIQ are all excellent. But perhaps the most important measure
announced today is the delay to loosening international border arrangements for travellers from Australia to the end of
"Despite these encouraging moves there are still additional measures that would help. These include: (i) temporarily
turning down the tap on international travellers from countries with the worst Omicron outbreaks (at least for 2-3
months); (ii) adding rapid antigen tests at the airport for international travellers coming to NZ; (iii) making further
improvements to MIQ facilities in terms of ventilation and avoiding shared spaces such as exercise areas; and (iv)
re-designing the Alert Level system so that it can rapidly eliminate any outbreaks of the Omicron variant that arise in
the NZ community."
Conflict of interest statement: "Nick Wilson has no competing interests. He gets no funding for any of the research he
does on Covid-19."
Dr Matthew Hobbs, Co-Director, GeoHealth Laboratory, and Senior Lecturer in Public Health, School of Health Sciences,
University of Canterbury, comments:
"Omicron is the fastest spreading variant we have seen. It is becoming the dominant COVID-19 variant in many countries
where travellers are coming to NZ from. A handful of daily cases in the community can accelerate to thousands of daily
cases within a month without intervention. The UK for instance, has seen records broken in terms of highest daily case
totals."Transmissibility and severity
"We are now more confident that Omicron is significantly more transmissible than prior variants. However, evidence on
severity is very preliminary and mixed. Perhaps of concern, and in contrast to some evidence from South Africa, a recent
study from Imperial College London showed no clear evidence that Omicron had lower severity than Delta. However, it
really is too early to say this with any confidence and the next few weeks will provide more answers."The NZ border
"In New Zealand, the cautious ‘wait-and-see’ approach to COVID-19 has served us well throughout the pandemic. It is
apparent this will again be the case when grappling with Omicron. Though it will be disappointing for many, through
reviewing and postponing current border reopening plans New Zealand has bought itself some much needed time while it
works out how much of a problem Omicron could be - like the last time we closed
the Trans-Tasman bubble. Although the government will likely face scrutiny for re-tightening some restrictions, these
are essential to keep Omicron out of New Zealand, with many other nations around the world (i.e. UK, Netherlands,
France, Germany etc) now re-imposing some restrictions due to Omicron case growth. It also provides us with a few more
crucial months to get the booster shots up and roll out the paediatric vaccines."Boosters and paediatric vaccines
"A booster dose with Pfizer is very likely to provide better protection than a two-dose course against the Omicron
variant. However, this will also be challenging. We will need to shift our mind-set to move from thinking two doses is
enough, to three doses. If people still think they’re fine with two doses this is actually a false sense of security
with Omicron. Booster shots will be important for those working in things like MIQ, healthcare and for those vulnerable
in the population. A strong equity focus is needed in the booster and child vaccination programme to protect the most
vulnerable communities. Prior research
we conducted last year for more generic childhood immunisation coverage showed that inequities were persistent over
time from 2005 to 2017 so this needs to be, and can be addressed within the COVID-19 paediatric vaccine roll-out."MIQ and the traffic light system
"While MIQ protocols have been improved these will need constantly reviewing in light of new evidence and may need to be
tightened more to reduce even further the risk that Omicron spills out into the community. For instance, the more people
with Omicron allowed into MIQ, the higher the chances of a breach so it may be that numbers need to be reduced to more
effectively manage our MIQ facilities. Other changes could also be made, for instance, the vaccination requirement for
arrivals could be raised to 3 doses of the vaccine to reduce the risk of Omicron coming to New Zealand. Finally, current
settings within the traffic light system need updating to better reflect the risk posed by Omicron as parts are no
longer fit for purpose if we have Omicron in the community for example."The bigger picture
"Let us remind ourselves of the devastation caused beyond our borders and how quickly the less transmissible original
strain of COVID-19 spread around New Zealand in March 2020. Overall, the rethink on borders, boosters and MIQ is needed,
justified and welcomed. However, protocols will need to be reviewed in light of new and emerging evidence as it
develops. We also know that COVID-19 is an airborne disease so we also need to think about other things we can be doing
like upgrading ventilation in schools, workplaces, and other indoor environments.
"More broadly, we also need to shift our domestic focus to a global perspective. The root of this issue is that the world isn’t doing enough to stop the spread of COVID-19
. While some countries, including New Zealand, have had domestic success at controlling COVID-19, wealthy countries
around the world continue to hoard vaccines. This ultimately gives the virus more opportunities to replicate and mutate.
Omicron should act as the wake-up call to ensure worldwide equitable vaccine delivery before even more concerning
No conflict of interest declared.