94 new cases of Covid in the community, 3rd vax recommended for immunocompromised people

Auckland has seen a surge in Covid cases with 94 reported today - the highest daily number since the pandemic arrived in this country in March last year.

A total of 87 are in Auckland and seven in Waikato.

The tally includes 53 unlinked 'mystery cases' so far.

The 94 cases represents the biggest number of daily cases in New Zealand since the outbreak started in March 2020.

Previously, there had been two days of 89 cases each, in early April 2020.

There are 38 people in hospital today, including five in ICU or high-dependency units.

A total of 84 Covid cases, across 55 households, are isolating at home.

Prime Minister Jacinda Ardern acknowledged that highs and lows in cases is "incredibly hard" on people, but reinforced that New Zealand is not "powerless".

She said cases have sprung up in 124 Auckland suburbs.

The highest number of cases today are across three age ranges that are least vaccinated, 39 years and under.

Ardern said 12 people in hospital were under the age of 39.

Ardern said 158,522 eligible Aucklanders had not had a first dose of the vaccine.

She urged people to get their second dose also, if it has been three weeks since the first.

Ardern said that tests returned on Auckland's North Shore had a high positivity rate and she asked those residents to get tested if they were experiencing any symptoms.

She said cases announced today were a result of "non compliance" of alert level 3 restrictions in Auckland.

Director-general of health Ashley Bloomfield has also confirmed plans to offer a third Covid vaccine for some.

Individuals aged 12 or older who are immunocompromised will receive a third primary dose of the vaccine - different to a booster dose which will be available to the rest of the public.

Booster shots for the immunocompromised

Several studies indicate waning immunity six months on from becoming fully vaccinated, and that booster shots supercharge the immune response.

But public health experts have argued that those at the front of the booster queue should be the immunocompromised, rather than the border workers who were first in line to get a jab in February.

"They aren't your very frailest, most elderly, most unwell people," vaccinologist Helen-Petousis Harris told the Herald recently.

"They are generally quite healthy people who will have, on average, a much more sustained immune response than those other groups. I don't think there's anything anywhere in the world to indicate that you would be unduly worried about them at this point."

She said data from Israel showed that using a booster for those who are the oldest and the frailest has dampened down breakthrough cases.

A study of 4868 people in Israel found a "substantially decreased" immune response, especially among men, six months after the second Pfizer dose among people aged 65 and over, and among the immunosuppressed.

A similar result followed an eight-month study in Qatar, which concluded that immunity "appeared to wane rapidly following its peak after the second dose, but protection against hospitalisation and death persisted at a robust level for six months after the second dose".

These recent studies follow many others in previous months indicating waning immunity, but experts have said that definitive conclusions are difficult as there are many variables, such as what restrictions were in place.

An article in the Lancet last month said of these "observational studies": "None of these studies has provided credible evidence of substantially declining protection against severe disease, even when there appear to be declines over time in vaccine efficacy against symptomatic disease."

The authors added: "Even if boosting were eventually shown to decrease the medium-term risk of serious disease, current vaccine supplies could save more lives if used in previously unvaccinated populations than if used as boosters in vaccinated populations."

This accords with the World Health Organisation's view that administering booster shots when many people in parts of the developing world are yet to get a single dose is morally abhorrent.

Petousis-Harris said administering booster shots should only be considered if it can be done in a way that didn't disrupt efforts to vaccinate hard-to-reach communities.

"You wouldn't want it to be detrimental on where we've got to get to before we're allowed back out to play."

Auckland faces at least two more weeks in level 3, while Waikato's level 3 setting will be reviewed on Friday.

Northland moves to level 2 tomorrow.

Yesterday Ardern said Aucklanders needed to be shown the pathway out of level 3, and on Friday she will release vaccination targets for Auckland - as well as the whole country - and the new traffic light framework for the new normal in a highly vaccinated population.

This morning National Party leader Judith Collins said Ardern was treating New Zealanders like children for not revealing the targets yesterday.

Collins then refused to release her own target, which National will release tomorrow, adding that she didn't think it was a double-standard.

Yesterday there were 60 new community cases, including 57 in Auckland and three in Waikato.

Ardern said the virus was now circulating all over Auckland, and urged everyone in the city to follow the level 3 rules.

But she said the advice from Auckland public health teams was that a circuit-breaker level 4 lockdown would not necessarily lower case numbers.

It would remain a lever that the Government could use if necessary, and if the public health advice recommended it - but it would also only work if people followed the rules.

The Government's vaccination targets are expected to be high enough to prevent the virus from creating an unvaccinated cluster that would put pressure on the health system.

Public health experts have warned that young Māori are on the Delta frontline in Auckland as they are the most unvaccinated group, they make up the biggest share of the current active cases, and many of them live in the suburbs where the virus has become entrenched.

Only 66 per cent of Māori nationwide have had one dose and 45 per cent have had two doses, far lower than the national averages of 85 per cent and 66 per cent.

Yesterday Ardern said crowd-funding for a mobile vaccination clinic in Tairāwhiti shouldn't be necessary, though she conceded that communication between DHBs and Maori health providers wasn't always perfect.

The Government's rollout has been accused of being implicitly inequitable, and Cabinet rejected expert health advice to prioritise Māori and Pasifika aged 50 to 64.

A larger proportion of Māori were also not eligible for the vaccine until later because Māori are on average much younger.

According to Statistics NZ, the median ages for Māori males and females are 25 and 27 years old respectively, much lower than the national median ages of 36.4 and 38.5 years old.

It's also more common for Māori to live in harder-to-reach areas.

Whanau Ora providers sent a proposal to DHBs and the Ministry of Health in February with a plan to reach such areas, including using vaccination buses.

Instead the Government set funding aside for Māori and Pasifika health providers at the start of the rollout, but it's unclear how many jabs this amounted to.

The Herald asked the Ministry of Health for this information on August 25 and is yet to receive an answer.

For more information visit covid19.govt.nz.

This article was first published by the NZ Herald and is republished here with permission.