23 Aug 2020

CovidCard would prove its worth in any isolation breaches - expert

2:52 pm on 23 August 2020

The bluetooth-power CovidCard would be an invaluable tool within the country's managed isolation and quarantine facilities, says epidemiologist Michael Baker.

Man holding Identification white blank plastic id card.

A man wearing a lanyard similar in size to the CovidCard being trialled in Rotorua. Photo: 123RF

Earlier this month the government announced it will be trialled in Rotorua with about 300 people.

CovidCard is a device the size of a credit card - designed to be worn on a lanyard when in public - that aims to detect and record close contacts using bluetooth and store that data for 21 days on a person's card.

Trade Me founder Sam Morgan has been part of a team developing it since March.

Professor of Public Health Michael Baker told Sunday Morning he's a fan of the CovidCard which he describes as a brilliant bit of technology. It needed to be evaluated with some thought given to its role, which could include within the managed isolation and quarantine facilities as well as at first sign of any community transmission of Covid-19.

"We've got to make sure it's going to fit in really well. I think the evidence is very encouraging for it.

"I think the uptake can be extremely high because it could be a bit like, when there's any risk of community transmission, when you leave your house you grab your mask and you grab your card...

"They will be your two key measures for contributing to controlling that transmission very rapidly if we do get outbreaks in the future."

All staff and guests within the managed isolation and quarantine facilties would also wear the card, he said.

"If you had a breach then you can very quickly figure out who had contact with whom at different stages."

He says the government app is limited to a minority and relies on active engagement and does not reach people without smartphones or those who don't do the scanning.

Auckland cluster under control

He says the current Auckland cluster is under control although it is some way from being eliminated, however, there will not need to be three clear days of no cases before changing levels which shows how far the country has advanced since March.

"Because we've got high-volume testing, case isolation, contact tracing and mask use - they're huge improvements.

"That's why I think we're using a far more nuanced approach now."

Testing and follow-up and isolating all contacts of a positive case was the key method for managing a cluster. "That is really very good news for coming out of lockdown earlier but of course the other thing is, we need that high volume testing just to check that there aren't undetected clusters in the community that also need to be shut down."

It was very frustrating to have an open case with the source not known although officials did not need to know where it's from to control it.

There may be answers in the future because molecular biologists will be comparing the genome from these Auckland cases to a global library where there are about 50,000 sequences at present, he said.

"It may identify a match in the future which will help unravel what happened here."

The alert level system needs to be reviewed, he believes. While it had served the country well, mask use needed to be integrated and because the alert level system was being used in regional areas, there might need to be a more nuanced approach such as intermediate levels like 1.5 or 2.5.

The jumps were too big, and at level 1, life more or less returned to normal and this was making some people feel uncomfortable.

At each level the use of masks needed to be specified and in some circumstances made compulsory, such as indoor events.

Impact of children, teens becoming more obvious

Covid-19's impact on children and how much they transmitted the illness was an early area of uncertainty. Schools in the northern hemisphere, especially in Germany, were now experiencing large outbreaks and it was now obvious that in the US and Europe teenagers were spreading the virus readily.

Around a quarter of the current Auckland cases are aged under 20, he said.

It might be necessary to specify the compulsory use of masks in secondary schools depending on which level the country or region was sitting at.

One recent study of 100 people with a median age of 49 who had mild symptoms or even asymptomatic Covid-19 showed that they had persistent heart abnormalities and 60 percent

had evidence of myocarditis while another study of young people showed a seven-fold increase in the risk of stroke.

Both were high quality studies, Baker said, with intense work including the use of magnetic resonance imaging and bio-markers to see the extent of cardiac involvement in the heart study.

Myocarditis could have serious health consequences and there would need to be ongoing monitoring of people to see the long-term effects of catching the virus, Baker said.

Many studies were happening internationally, particularly among countries with a high number of cases, and these would provide a wealth of information in the future.