A Gisborne doctor has questioned whether the region really has only one case of Covid-19 - the lowest figure in the country - and is urging locals not to get complacent.
The clinical manager of the city's community testing centre Dr Fergus Aitcheson said he could not be confident the number was right until more testing was done.
As at 4pm on Tuesday, 321 people had been tested for the disease with 66 results still to come back.
Dr Aitcheson said as proportion of the population, the Gisborne region should be doing 1 percent of all the tests across the country, but was below that. at about 0.74 percent.
One reason was the low numbers of tests being done over the weekend - just 18 last weekend - although he said there was a bounceback on Monday, which meant they were tracking back to the 1 percent figure.
He was concerned there may be barriers of cost or distance to getting assessed by a GP - and whether there was some "diagnosis anxiety out there, some whakamā (shame) perhaps."
"We're also wondering whether there is that psyche, 'we've only case, we haven't got it here'.
"Our communications are very much against that and we're encouraging people who conform to the Ministry's case definition to seek testing."
Jim Green, head of the East Coast's district health board Hauora Tai Rāwhiti, said he was mindful there could be people with Covid-19 who had very few or no symptoms.
"And so we are really trying to find where other people might be that have the virus in their community."
At more than 300 tests the rate was comparable to that around the rest of the country, Green said.
"And we've doubled the rate of testing in the last week as the case definition has changed."
Testing is available on the coast and the western part of the district as well as the centre in Gisborne, he said.
Dr Aitcheson said until there was greater community testing, there could be no certainty that there weren't more Covid-19 cases in the region.
"No one can be confident that there's not community transmission going on at an asymptomatic level until we employ that surveillance strategy, and then the longer that runs, the more confidence will grow that our national target, which is elimination, is being achieved."
Once a surveillance plan was released and rolled out, it would then be up to the testing centres nationally to "gear up for this big drive so we can get that certainty that we all need."
Director-General of Health Dr Ashley Bloomfield said on Monday he had seen a copy of the draft surveillance plan and it would be finalised "in the next day or two." He said randomised testing may be apart of the surveillance plan.
Epidemiologist Sir David Skegg told the Epidemic Response Committee on Tuesday that the government needed to urgently finalise a surveillance plan to get a clear picture of the prevalence of the coronavirus in the community.