15 June 2020

Etuini Ma’u, Jackie Robinson, Gary Cheung, Sarah Cullum (University of Auckland)

Aotearoa New Zealand has a population of 5 million, with the 780,000 aged over 65 years comprising 15.5% of the population. The Aged Residential Care (ARC) sector comprises 38,000 beds accommodated in over 650 facilities throughout the country.

New Zealand confirmed its first case of COVID-19 on 28 February 2020 and fifth case a week later on 7 March.  As at 10 June 2020, NZ had carried out 291,994 tests, with 1,154 confirmed and 350 probable cases of COVID-19 identified, for a total of 1,504 cases.  Of these, there were 22 deaths; 1,482 have recovered and there are now no active cases.  

The Ministry of Health reports on significant clusters of cases, defined as 10 or more cases who are not part of the same household. Based on this definition, there were 153 cases linked to five aged residential care facilities across 3 regions, accounting for 10.2% of total cases. Of these cases, 39 were residents, 9.2% of the 428 total beds across the affected facilities. There were 16 deaths in ARC Facilities, accounting for 72.2% % of all COVID-19 related fatalities in the country.

Early on in Aotearoa New Zealand’s COVID-19 response, a difference in perspective between the ARC sector and the hospital care health system became apparent, with much of the early clinical and pandemic planning by DHBs focused on hospital/secondary care management.

Following the classification of five clusters of COVID-19 in ARC facilities, the Director-General of Health, Dr Ashley Bloomfield, commissioned a review to quickly learn what was effective and what needed to be improved in order to avoid or better manage any similar events in the future.

Key findings:

• All the initial infections came from outside the facilities and two were associated with overseas travel.
• Three out of five facilities had staff cases first.
• Onset dates ranged from 11 March 2020 through to 28 March 2020 with further outbreak reports ranging from 24 March 2020 through to 10 April 2020 (peak period of incidence throughout New Zealand) and associated secondary cases have continued to present through to mid-May 2020.