As politicians and officials alike scramble to get to grips with the spread of Omicron, the redundancy of a months-old strategy offers a sense of how quickly the pandemic is evolving
The Ministry of Health’s Covid-19 testing strategy is being overhauled barely three months after it was first unveiled, with the mutating virus forcing health officials to rip up their existing playbook.
The Omicron variant was first identified in mid-November last year, and was declared a variant of concern by the World Health Organisation on November 26 – just one day after New Zealand’s new testing strategy was released by Associate Health Minister Ayesha Verrall.
The strategy outlined how the move away from an elimination approach would be affected when it came to testing policies and processes.
It indicated that symptomatic testing should be done using PCR tests when Covid was contained, spreading and even sustainable – although in the latter case, it noted rapid antigen tests (RATs) could be used first “at very high prevalence” with positive tests confirmed by PCR (an approach the Government has scrapped for the current outbreak).
However, archived versions of the ministry’s testing strategy and guidance page show that links to the strategy were quietly removed some time after February 21.
In a statement, Bloomfield told Newsroom the strategy had been removed “as it needed to be updated in light of Omicron, the rapidly evolving outbreak and to reflect the latest evidence”.
“We are working from the latest evidence but have not had the opportunity to update and post the strategy on the website,” Bloomfield said.
Following Newsroom’s enquiries, the ministry had updated its website to note the strategy was currently being updated, he said.
“With anticipated progression from the elimination phase and the implementation of a reconnection plan, there is a pressing need to ensure that Covid-19 testing is adaptable and fit for purpose.” – Covid-19 testing technical advisory group
The strategy was developed in part as a response to the findings of a rapid review from the Covid-19 testing technical advisory group last October, which raised a number of concerns about the ministry’s approach to testing.
While the country’s laboratories had performed well overall during the pandemic, the emphasis on an elimination strategy meant there had been “a relative slowness to introduce saliva testing and to prepare for rapid antigen testing”.
“With anticipated progression from the elimination phase and the implementation of a reconnection plan, there is a pressing need to ensure that Covid-19 testing is adaptable and fit for purpose.”
At the time of the report, there was no leadership role within the ministry covering all testing activities, while diagnostic labs had expressed concerns about their ability to plan for the coming months without a clearly articulated testing strategy.
“As a result, planning is underway across many regions, with duplication of effort and a lack of consistency, and without clear direction around what volumes of testing will be required to support public health efforts and hospital capacity.”
The group had recommended the development of “a clearly-articulated future-focused Covid-19 testing strategy that is based on scenarios for the purposes of laboratory planning”, as well as stronger testing leadership within the ministry “to help break down the silos that have developed within the testing space, and strengthen external engagement”.
A spokeswoman at the University of Otago, where group chair and clinical microbiologist David Murdoch is based, said he did not have time to speak to Newsroom due to his new role as vice-chancellor.
New chief testing advisor, innovation team
Bloomfield told Newsroom the ministry had been working to address the review’s findings, and had appointed both a chief testing advisor and a programme director of equity in December last year.
Officials were also working with stakeholders on new testing criteria, while the ministry was improving modelling of demand for testing and refining those models as new policy decisions were made.
“To improve our horizon scanning and considering new tests we have established an innovation team and in partnership with [the] Ministry of Foreign Affairs and Trade we are reviewing other countries' experiences with use of testing technologies,” he said.
Separately, the director-general clarified the differing numbers given in relation to New Zealand’s ‘surge’ capacity for PCR testing.
While a January 25 announcement about increases to test capacity had referred to surge rates as being sustainable for seven days, Bloomfield said last week such surges could only be handled for “a few short days”.
He told Newsroom the surge rates quoted had been based on lab predictions about how long they could sustain high demands of testing, which was based on all new equipment and technology being in place.
“The rate of positivity, and therefore pooling of single testing, changes the overall sample handling and throughput in the labs.”
National Party Covid response spokesman Chris Bishop told Newsroom the biggest problem with testing had been the over-reliance on nasal PCR swabs and "sheer bloodyminded refusal to look at supplementary and alternative testing techniques".
"For a while this didn’t matter, as we had an elimination strategy which was very successful. But once Delta hit our lack of backup plan was exposed, and we’ve been scrambling since then."
The lack of RATs was due to the Government refusing to allow them into the country until late 2021, while saliva testing had been recommended in September 2020 but was still not being used despite clear deficiencies in nasal PCR capacity, Bishop said.
