CORONAVIRUS COVID-19: NZ is at Alert Level 2 with extra restrictions for Auckland

COVID – 19 Updates for IDFNZ Patient Members:

 IDFNZ and KIDS Foundation members - please don't feel you are alone even when you may be isolated at home; IDFNZ support services will continue on throughout the COVID-19 situation – members can email us if they have queries or if we can help in any way please get in touch.Check out our facebook page too https://www.facebook.com/pg/IDFNZKidsFoundation.

Any IDFNZ KIDS Foundation patient members that are hospitalised are encouraged to let our support office know as we can assist with continued hospital assistance. Email info@idfnz.org.nz and we will contact you.

Check the IDFNZ Facebook too for further information and daily updates.

*Special note for PID patients on Immunoglobulin therapy - There is no need to stockpile supplies of immunoglobulin ; supply continues as normal. 

Keep calm and keep safe.


LATEST NEWS:

 New Zealand is at Alert level 2 with extra restrictions for Auckland.  ( next review will be September 14th )

Auckland is at Alert Level 2 with extra restrictions 

Auckland moved to Alert Level 2 at 11.59pm Sunday 30 August. There are extra restrictions on social gatherings, funerals and tangihanga in Auckland at Alert Level 2.

Guidance on life at Alert Level 2

The Auckland region is everything in the Auckland Council boundary — from Wellsford in the north to Pukekohe in the south.

Auckland boundary map [JPG, 914 KB]

Restrictions for Auckland region

At Alert Level 2 in Auckland, social gatherings can have a maximum of 10 people. Funerals and tangihanga may have up to 50 people, and have to meet other conditions set by the Ministry of Health. 

Gatherings and events at Alert Level 2

Funerals and tangihanga at Alert Level 2


What you should do

Masks now need to be worn on public transport

Alert Level 2 is not life as normal. You can still go to work and school, but you should:

  • keep your distance from other people in public
  • wash your hands
  • sneeze and cough into your elbow
  • keep a track of where you’ve been and who you’ve seen
  • wear a mask if you can.

Protect yourself and others from COVID-19

People at higher risk of severe illness from COVID-19 are encouraged to take additional precautions when leaving home.

We'll continue to:

  • keep tight controls in place at our borders
  • test for COVID-19
  • find and self-isolate anyone who is unwell, as well as their close contacts.

Get tested for COVID-19 if you have cold or flu symptoms. Tests are free.

Businesses

Businesses can open to the public if they are following public health guidance, which include physical distancing and record keeping.

Gatherings

No more than 100 people at gatherings, including weddings, birthdays, funerals and tangihanga.

If you're unwell

  • If you’re sick, stay home. Don’t go to work or school. Don’t socialise.
  • If you have symptoms of cold or flu call your doctor or Healthline and get advice about being tested.
  • If you have been told to self-isolate you must do so immediately.

Personal movement

At Alert Level 2, you can leave home, but you should follow public health measures and consider others around you.

Physical distancing

Keep your distance when out and about:

  • 2 metres in public and in retail stores, like supermarkets and clothes shops.
  • 1 metre in most other environments like workplaces, cafes, restaurants, and gyms.

Masks

At Alert Levels 2 the risk of COVID-19 being present in the community is higher. You should wear masks in situations where physical distancing is not possible, like on public transport or in shops.

Gatherings, events, and public venues

Events at home and outside of your home can have up to 100 people:

  • weddings
  • family events
  • religious services
  • funerals and tangihanga
  • private functions, like a birthday at a hired premises.

Play it safe — keep surfaces clean, wash your hands, and maintain safe physical distancing where possible.

A person in charge of a social gathering, should ensure records are kept for contact tracing purposes, except where every person in a gathering knows each other. This includes in your home, community hall, or other space.

You should not participate in any gatherings if you have COVID-19 symptoms or if you need to be in isolation for any reason.

Public venues

Many public venues can open at Alert Level 2. This includes:

  • museums and libraries
  • cinemas
  • restaurants, cafes and bars.

All public venues should keep records to enable contact tracing.

Exercise, sport and recreation

You can do your usual exercise and recreation activities, provided you can do them safely.

This includes activities that were restricted previously, including:

  • walking, biking and hunting on public conservation land
  • swimming at a public swimming pool, but there will be restrictions
  • going to the gym, but there will be restrictions
  • boating and motorised watersports.

Community sports are limited to groups of 100 in a defined space. A sports field can have multiple defined spaces by keeping:

  • people in groups of up to 100
  • groups separate either through consistent 2m physical distancing when outdoors or barriers.

These groups are prevented from intermingling or sharing common facilities at the same time.

Sporting events

Professional leagues can go ahead at Alert Level 2 because they take place in controlled workplaces. The details for these events will be developed with Sport New Zealand and WorkSafe.

High Performance Sport New Zealand activities can take place at Alert Level 2 using a controlled workplace approach in consultation with WorkSafe.

Workplaces and businesses

At Alert Level 2 businesses can operate if they’re able to do so safely.

Golden rules for business at Alert Level 2:

  • Do everything you can to reduce the risk of COVID-19 transmission at work — we all have a part to play in keeping each other safe. 
  • COVID-19 is still out there. Play it safe.
  • All businesses can operate if they can do so safely. Alternative ways of working are still encouraged where possible.
  • Talk with your workers to identify risks and ways to manage them.
  • Ask everyone, workers, contractors and customers, with cold or flu-like symptoms to stay away from your premises.
  • Keep groups of customers at least 1 metre apart, or 2 metres for retail businesses.
  • Keep contact tracing records of anyone who will have close interaction for example workers, contractors or customers. Retail businesses are not required to keep contact tracing records.
  • Reduce the number of shared surfaces, and regularly disinfect them.
  • Wash your hands. Wash your hands. Wash your hands.

Engaging with customers

At Alert Level 2 businesses can have customers on their premises.

Retail

Retail businesses, including malls, markets, and takeaway shops:

  • need to keep customers 2 metres apart
  • do not need to keep records of customers to enable contact tracing. 

There is no maximum number of customers allowed in a store, as long as they can keep 2 metres apart at all times.

Services can also be provided on customers’ premises, for example, cleaning and home help.

Hospitality

For dine-in customers, restaurants, cafes and bars should:

  • have customers seated
  • keep groups of attendees separated 1 metre apart
  • have a single server per group, where practical
  • keep records of all customers and workers to enable contact tracing 

People can order and collect from a counter, except for on-licence and club-licence premises.

Businesses can operate with defined, separated areas. The 100 person maximum applies per area, as long as intermingling in common spaces, such as entrances, exits and toilets, can be prevented. This also applies to separate businesses that operate from the same location.

Work involving close personal contact

For some businesses, close personal contact is required to deliver a service. This includes:

  • hairdressers
  • home help providers.

These businesses can operate if they have public health measures in place like:

  • keeping contact tracing registers 
  • keeping customers 1 metre apart, including while they’re waiting 
  • good hygiene practices
  • disinfecting surfaces in between customers.

Doing business safely

Businesses should maintain hygiene measures, including physical distancing, hand washing and regularly cleaning surfaces.

All businesses are encouraged to use alternative ways of working if possible.

If workers have symptoms of COVID-19, they should stay home.

Travel and transport

You can travel, but make sure you do it in a safe way.

You can travel to other regions that are at Alert Level 2. You should not travel to regions at a higher Alert Level.

You should:

  • keep records of what travel services you use and who you have been in contact with
  • keep your distance from groups of people you don’t know
  • minimise the number of places you stop on the way to your destination.

Tips for minimising risk while travelling:

  • If you can, try to avoid travelling on public transport at peak times. Consider alternative ways of travelling, like cycling or walking.
  • While waiting for public transport avoid standing close to strangers, and avoid sitting next to someone you don’t know when on board. Follow the instructions from your transport operators.
  • Maintain good hygiene – wash your hands often, sneeze or cough into your elbow.
  • Keep track of your journey, including where and when you boarded and where you’re sitting.
  • If you can, try to take public transport at off-peak times.
  • Avoid sitting or standing next to someone you don’t know.
  • If you’re flying or taking other forms of transport that involve bookings, follow the physical distancing instructions from your transport operators.
  • You must not travel if you are displaying symptoms of COVID-19, awaiting a test, or if you need to self-isolate.

Education

Early learning services, schools and tertiary education facilities are open to all ages.  It is safe to attend all forms of education. Additional public health measures are in place. It is important that all learners can continue their education.

On the advice of public health officials, any educational facilities connected to a confirmed or probable case of COVID-19 must close on an individual or group basis to allow contact tracing, and then potentially for a further 14 days.

Early learning services and schools

All Early Learning Centres and schools will be physically open, including Years 11 to 13. Distance learning will be available for those unable to attend school, for example where people are self-isolating.

Early learning services and schools are safe environments for children, young people and staff. Additional public health control measures are in place to prevent the spread of disease and to support contact tracing.

Tertiary education

Tertiary education facilities are open.

Tertiary education is a safe environment for students and staff to return to at Alert Level 2. Tertiary education facilities will implement public health requirements and physical distancing as appropriate for the context, and will work closely to ensure a safe environment where students can continue their learning.  They will need to maintain distance learning capability to help manage within these constraints, and ensure safety of staff and students at risk of COVID-19.

Workplace-based learning will be conducted within the specific rules applicable to the relevant industry.

Self-isolation, quarantine and testing

At Alert Level 2, people who are a probable or confirmed case of COVID-19, or who are a close contact of a case, should self-isolate for 14 days, or until cleared by a doctor.

People arriving from overseas will continue to be placed in managed isolation for 14 days, or quarantine if they are showing symptoms.

Anyone with symptoms of COVID-19 should get tested — contact your doctor or Healthline on 0800 358 5453.

                                                                









Previous Updates:


 Post Covid Back to school Information  Level 1   

Is it safe for our medically fragile children to return to school?

School starts back at level 1 for most children, many of our families have asked if this is safe for medically vulnerable children.

IDFNZ recommendation is to weigh up risks, talk to your medical team or school principal about any concerns and explore all options available to you. Ask to view for yourself the precautions in practice before making a final call if need be – get all the facts you need to feel comfortable.The key consideration is if MOH has determined there is no community spread of COVID-19 at this time.

Starship has prepared a very informative letter  covering off useful facts about COVID-19, advice around what is known about risks to transplant children and answering questions around return to school. This may be helpful for all member parents to read.

For PID patients it might also be helpful to view the attached UK immunology stratification of PID conditions as weighed against Covid-19, to better understand the specific risk for each condition. Further questions can be raised with your specific medical team.

ASCIA have also provided a new information brochure; This information has been developed for parents and carers, to guide decisions about school attendance for children with primary immunodeficiency (PID) during the COVID-19 pandemic.

 Public health measures implemented by Australian and New Zealand governments have been successful in controlling the spread of SARS-CoV-2, the coronavirus that causes COVID-19. This means that plans are being made in most regions to re-open schools for face to face learning.

For parents of more vulnerable children, including those with PID, the decision to send their children back to school is complex. The type and degree of immunocompromise varies widely between children with PID, so it is important to ask your child’s clinical immunologist if you have specific questions.See brochure here for more details.



Covid -19 News Update April 29th , 2020

Over the last five weeks we have been able to support members by distributing information via our website and Facebook, as well as by email and over the phone. Thank you to everyone for keeping in touch and letting us know how we can help in these uncertain times. Families have done an amazing job of coping with life at level 4 and the outlook is optimistic with level 3 now in sight. The reality for immune compromised individuals however is that real caution needs to be maintained until a vaccine is available for the wider population, to reduce risk for the vulnerable in the community. IDFNZ will continue to provide information and resources moving forward with a regular e-news update to summarise new information as it arises. We hope this is helpful to you and encourage you to engage and respond to me with any questions.

NZ Immunoglobulin Supply 

New Zealand Blood Service has assured that there is no shortage of plasma, no reason for individuals to stockpile. NZBS are working closely with plasma donors to ensure the supply chain is maintained, we are doing our bit to thank and encourage plasma donors as part of our Facebook posts – you can help by liking the posts, and adding notes of encouragement.

Individual Treatment Plans may be reviewed

NZ Immunology Specialists (NZCIAG), are looking after the interests of immunodeficient patients that rely on immunoglobulin therapy and liaise closely with NZBS. Please do not be alarmed if your treatment plan is reviewed.

In order to minimise opportunities for contact and potential infection with COVID-19 as well as preserving supplies of immunoglobulin, NZCIAG recommend that all patients receiving immunoglobulin should have their current treatment reviewed by their supervising consultant. If patients are well and their steady-state IgG is > 7g/L they recommend increasing dosage interval by an additional 1-2 weeks for intravenous and 2-3 days for subcutaneous.  

This is a consensus decision involving adult and paediatric immunology services on a national basis, in conjunction with the Blood Bank. All patients will be closely monitored through this process – please let your doctor know if you have any questions or concerns.

Note : To be clear: SCIG/IVIG patients please carry on as normal,do not make changes unless specifically instructed by your medical team. Each patient will be reviewed by their Supervising consultants  - it is their responsibility to decide any changes patient by patient


 NZCIAG have answered other questions raised by patients receiving immunoglobulin therapy:

I have really bad lungs and I am worried about not getting enough immunoglobulin

Your clinician will know whether it is OK to reduce the amount you get – some people will be on a dose where no reduction is appropriate.

What if I get sick when you change my dose?

It depends – if you catch a cold we won’t suggest any change.  If the reduced dose is too low for you we can go back to your original treatment.

I’m scared about coming into hospital and getting infected?

Part of the reason for this change is to reduce the number of potential contacts that you have with people who may be infected.  However, we have screening processes in place for all people entering hospital. You should contact your clinician if you become unwell before a planned appointment.

Will I get COVID-19 from immunoglobulin?

The process of manufacture of immunoglobulin (donor screening, testing, purification etc) means that there is no risk of becoming infected.

Will immunoglobulin protect me against COVID-19?

There is no evidence for this.

Further Q + A can be viewed on our IDFNZ website

ASCIA has listed similar information for Australasian PID patients.

Members can view similar questions raised by European PID patients listed on the IPOPI website

Remember IDFNZ is here to help – if you have further questions please get in touch 




Earlier posts:


We are thinking of our members across New Zealand in these difficult times as this global situation escalates. Please keep safe and keep calm, the various Public health measure we see coming into effect may seem an inconvenience, but they are for your protection. Please do not panic but take all practical steps to protect yourselves.


 March 24th Government  raised the Covid-19 Virus alert level to level 3 


Note:  All IDFNZ patient members fall into the category of being immunocompromised, some members also have additional risk factors to consider.


For your safetywe urge you to heed this advice to self-isolate/ stay at home - it is important that friends and family, particularly children, do not visit.

For the moment this might mean talking to wider family on phone, Skype or other methods. Use online delivery services for groceries and essentials. All family members living in the same home should take precautions.


Keep in touch with your medical team with regards to accessing medicines and medical treatment.


Most Clinicians and General practitioners are now working from home and consulting by telephone, email, Skype or Telehealth. Many sent out texts, emails and notices over the weekend notifying patients that general outpatient clinics are being suspended and giving specific advice to individual patient groups.


Keep medical contact details handy. Do not turn up at your doctor’s surgery or hospital – contact by phone or email first to seek advice.

Should any member of your family be unwell or show symptoms call the dedicated Healthline 0800 number for COVID-19 health advice and information

The number is 0800 358 5453 (or for international SIMs +64 9 358 5453). 

It is free and available 24 hours a day, 7 days a week.

People calling that line will be able to talk with a member of the National Telehealth Service. They have access to interpreters.


PID patients on Immunoglobulin treatment New Zealand Blood Service have assured IDFNZ that they will be doing everything they can to ensure that the supply of plasma products continues as normal.  In the medium term there is sufficient product in New Zealand or within the wider supply chain to cover us for at least 6 months. Note :There is no need to stockpile supplies of immunoglobulin.


NZBS is working with blood donors to try to ensure that they continue to collect enough blood and plasma to support the ongoing plasma product fractionation plan.  They have begun emergency planning to ensure ability to provide future product is monitored very closely. 


At the present time NZBS believe that they will be able to continue supply of essential product to all those that require it.  We will keep you informed if that situation changes.


For your specific treatment regime - Please keep in touch with your nurse specialist / immunology team for instructions around IVIG hospital appointments, and SCIG plasma and consumable supplies. Our advice is to ensure you have consumables and product to last you at least 6 months.


IDFNZ holiday homes – Because our holiday homes are located in public Campgrounds, all bookings are hereby cancelled, and we are not taking any new bookings for your protection until further notice.


IDFNZ Patient Events and meetingsAll events have been cancelled for the foreseeable future.


Please feel free to email any questions you may have to info@idfnz.org.nz – we will do our best to assist. Check our facebook and website for other updates.




Earlier  Updates:

Information for PID and Immune compromised Patients in New Zealand

The Ministry of Health is monitoring this situation closely. All  public health measures related to this virus are advised on https://www.health.govt.nz/our-work/diseases-and-conditions/novel-coronavirus-2019-ncov#statsu. There is lots of information and advice posted on this website  - please keep checking.

Advice is to keep calm, but be vigilant as the  situation unfolds. Patient members have asked how this affects the PID and Immune compromised members of the community. 


Coronavirus (COVID-19) Advice -Department of Clinical Immunology and Allergy, Auckland Hospital

Many types of coronaviruses exist, and they can infect both people and animals. The current outbreak of coronavirus disease 19 (COVID-19) started in mainland China, but cases have now been reported in many countries worldwide including New Zealand. Ethnicity does not predict risk.

The main route of infection is by respiratory droplets, produced by coughing or sneezing. These droplets can land on surfaces and will remain infectious for a short time. Most transmission overseas has occurred within households.  At the moment no cases in New Zealand have occurred from being infected from another infected person in New Zealand. There is no risk of infection from receiving immunoglobulin.

As yet there is no vaccine to prevent or treat COVID-19 and no medication.

Patients with immunodeficiency are generally at risk of infection, although it is unclear what the specific risks of COVID-19 are in this group.  We don’t know if immunoglobulin has any protective effect against COVID-19. It does however protect against other infections, including seasonal influenza (the flu). Getting the influenza vaccine once it is available is also important.

Handwashing is the most important form of prevention. Soap and water should be used for at least twenty seconds; alcohol-based hand gel can be used if soap and water are not available. People should cover their nose and mouths when coughing or sneezing. Maintain at least 1 metre distance from people who are coughing/sneezing.

Surgical masks can help prevent those who are infected from infecting others. They need to be correctly used to be effective and changed regularly with proper technique. Current Ministry of Health advice is that these are only recommended for unwell people with respiratory symptoms (coughing/sneezing).  High-level protective masks are being kept for hospital use.

Travel advice is changing rapidly and travel insurance may not cover people who travel to places with large numbers of cases. Depending on spread, people may end up having to self-quarantine for 14 days on their return. We advise checking the Safe Travel website (www.safetravel.govt.nz)  for up to date information.

IF YOU ARE CONCERNED THAT YOU MAY HAVE COVID-19 PLEASE DO NOT COME IN TO HOSPITAL

Phone dedicated Healthline no.   0800 358 5453  Available 24/7, has interpreters

If you are unwell and have an appointment please phone before attending

Day stay:  0800 466 254  Outpatients:  307 4949 ext 27038 ( Auckland Hospital)

If you feel unwell and have an IVIG or other hospital clinic appointment scheduled  please phone your clinic nurse specialist in advance to discuss .


Patients on Scig / IVIG treatment

FREQUENTLY ASKED QUESTIONS:

Will I get COVID-19 from immunoglobulin?

The process of manufacture of immunoglobulin (donor screening, testing, purification etc.) means that there is no risk of becoming infected.

Will immunoglobulin protect me against COVID-19?

We don’t know. It will provide protection against other infections such as influenza that may make COVID-19 illnesses worse.

Can I get vaccinated?

There are no vaccines available yet for COVID-19. You can obtain influenza vaccine from your GP.

Should I wear a face mask?

Ministry of Health guidelines are that these are only recommended for people with respiratory symptoms (sneezing, coughing).

Should I get an N95 mask?

These are only recommended for in-hospital use.

Should I still travel internationally?

Travel advice is changing rapidly. Check with the Safe Travel website (www.safetravel.govt.nz) and your travel insurance.

Should I still go to work/school?

Close household contact with cases is the main risk. Certain types of employment (e.g. customs, healthcare, work requiring extensive overseas travel) may also be increased risk. You need to discuss this with your employer and your specialist.

Should I still come to my appointment?

Yes, unless you are unwell (phone first) or have been told to self-isolate.

I read this thing on the internet…

Much of what is being said on the internet and social media is inaccurate and unhelpful. Check authoritative sites such as the Ministry of Health (for NZ), the CDC, and WHO. The Immune Deficiencies Foundation (US) have a COVID-19 page for PID patients (https://primaryimmune.org/coronavirus).

If you have specific concerns not addressed here please discuss with your specialist


Starship Hospital -Pointers for  Paediatric Liver Transplant patients

The situation is rapidly evolving and we can’t respond to multiple individual queries from families. The most up to date  information will be on the MoH website and families should also have the Healthline number in case they need it. Just a few pointers:


WHO Recommended Precautions

The World Health Organization’s and the Centers for Disease Control and Prevention’s recommendations to reduce exposure to and transmission of the coronavirus 2019-nCoV include but are not limited to:

·  Avoid close contact with people suffering from acute respiratory infections

·  Avoid close contact with anyone who has fever and cough

·  People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands) and wear a respiratory mask

·  Frequent handwashing by using alcohol-based hand rub or soap and water, especially after direct contact with ill people or their environment



Useful Websites:

New Zealand  MOH : For official updated  local information refer to https://www.health.govt.nz/our-work/diseases-and-conditions/novel-coronavirus-covid-19

ASCIA information about COVID-19 

The IDF USA web page also offers helpful updates including WHO reports: https://primaryimmune.org/news/update-video-helpful-resources-covid-19