Workers on the front line of New Zealand's border at airports, isolation and quarantine facilities should get unlimited sick leave to help keep Covid-19 out of the community, Professor Shaun Hendy says.
Professor Hendy is one of the authors of a paper looking at how to minimise the risk of the coronavirus getting through our border. He said he considers front line workers to be at the highest risk of causing an outbreak.
He is also calling for weekly Covid-19 testing of all border and isolation workers.
"If we keep the current quarantine going then we could maybe have one case in 18 months that made it through the border that way," Hendy told Checkpoint.
"So obviously now you start to think about people who are working at the border who are coming and going. They might spend time at the facility - a security guard - and then they're going back into society.
"So it's a small risk but it's a significant one, and of course we think that's what happened in Melbourne, Victoria, maybe just one or two interactions between workers and infected people who were isolated that led to the big outbreak."
A weekly Covid-19 test is the best way to minimise risk, he said. "They're not pleasant things, the tests, and you don't want to discourage people from taking them by giving them too many."
Accompanying that with daily symptom checks for staff reduces the risk of a case getting into the community by about 90 percent, he said.
"The problem with the tests is… there are some people, it might take two or three tests before they show positive. Some people maybe never show up as positive, so the test is not perfect.
"So it's about reducing risk with tests rather than relying on tests to be perfect. And of course there's the odd case where you can be infectious over more than the quarantine period. Ninety-nine percent of people will have a passed through the course of the disease, of their infectiousness, during that two-week period, but there's still a tiny risk that could get through.
"Given the volume of people that are coming through, that translates into about one case coming through into the community every 18 months."
If a worker returned a positive test, that would actually be a good outcome as it had been caught early, potentially before spreading to household contacts, Hendy said.
"We've got to remember we're in this for the long haul. We're looking at a plan we have to keep in place for maybe a year to 18 months, until we see a vaccine on the horizon.
"So it's something that we've got to maintain for a long time. It's got to be sustainable and that's going to be a hard thing to do. I think it's worth resourcing well, it's worth us paying attention to, and it's worth us working continually to improve and get it right."
Staff working at the border or at managed isolation facilities should get unlimited sick leave, he said.
"If you're a border worker, maybe you've used up your sick leave. You might just not mention the symptoms. If you realise there's a risk that you might sent home, or some of your family members might have to not go to work for a couple of weeks - I think we've got to take that into account. We've got to look at making sure we're supporting people, these families that are working at the border. They're doing an important job for us and we should be looking after them."
Even those living in the household of a front line worker should be eligible for more sick leave, Hendy said, as well as some financial support for quarantining.
Hendy said he is talking to the government again next week about his recommendations, but so far there has been no commitment to adopt them.
The Ministry of Health told Checkpoint it prioritises testing for those working at the border, including workers at managed isolation and quarantine facilities.
It said there is a programme of daily health checks, and any staff member who reports symptoms consistent with Covid-19 must stay at home, get tested and self-isolate until they receive the result of their test.
The ministry is also undertaking regular asymptomatic surveillance testing of people working in border-facing roles, including those at managed isolation and quarantine facilities, particularly those who have direct contact with international crew and travellers.
There is testing available on-site for staff every two to three weeks.
The ministry said it will continue to review how often the tests are needed.