Why it’s important for the new coronavirus to be classified here as a notifiable infectious disease

Special powers of medical officer of health

Under section 70 (Special powers of medical officer of health), for the purpose of preventing the outbreak or spread of any infectious disease, the medical officer of health may from time to time, if authorised to do so by the Minister or if a state of emergency has been declared under the Civil Defence Emergency Management Act 2002 or while an epidemic notice is in force, do a variety of things. The medical officer of health’s powers include the power to:

• require persons to report themselves or submit themselves for medical examination at specified times and places;
• if the spread of the disease would be a significant risk to the public, require people to report, or submit themselves for medical testing, at stated times and places;
• if the spread of the disease would be a significant risk to the public, require people, places, buildings, ships, vehicles, aircraft, animals, or things to be tested as he or she thinks fit;
• require people to remain in the health district or the place in which they are isolated or quarantined until they have been medically examined and found to be free from infectious disease, and until they have undergone such preventive treatment as he may in any such case prescribe.

Health practitioners to give notice of cases of notifiable disease

Under section 74 (Health practitioners to give notice of cases of notifiable disease), every health practitioner who has reason to believe that any person professionally attended by him or her is suffering from a notifiable disease or from any sickness of which the symptoms create a reasonable suspicion that it is a notifiable disease shall:

• in the case of a notifiable infectious disease, forthwith inform the occupier of the premises and every person nursing or in immediate attendance on the patient of the infectious nature of the disease and the precautions to be taken, and forthwith give notices in the prescribed form to the medical officer of health, and, if the disease is specified in section A of Part 1 of Schedule 1, to the local authority of the district;
• in the case of a notifiable disease other than a notifiable infectious disease, forthwith give notice in the prescribed form to the medical officer of health.

A health practitioner who gives notice of a notifiable disease must not disclose identifying information of the patient or deceased person if the disease is specified in section C of Part 1 of Schedule 1. (The diseases in that section are AIDS, gonorrhoeal infection, HIV and syphilis). A medical officer of health may, however, require a health practitioner to disclose identifying information of the patient or deceased person if disclosure of the identifying information is necessary to respond effectively to a public health risk.

Medical laboratories to give notice of cases of notifiable disease

Under section 74AA (Medical laboratories to give notice of cases of notifiable disease), the person in charge of a medical laboratory to whom test results of an actual or suspected notifiable disease are reported, or of which s/he becomes aware, must immediately tell the health practitioner for whom the test or other procedure concerned was undertaken, and the medical officer of health, of the infectious nature of the disease. S/he must not disclose identifying information of a person who is, or has been, or may be or may have been, infected with a disease specified in section C of Part 1 of Schedule 1 (described above). A medical officer of health may, however, require the person in charge of a medical laboratory to disclose identifying information of the person who is, or has been, or may be or may have been, infected with a disease if disclosure of the identifying information is necessary to respond effectively to a public health risk.

Duty of occupier of premises as to infectious disease

Under section 75 (Duty of occupier of premises as to infectious disease), when any person is suffering from any sickness of which the symptoms create a reasonable suspicion that it is a notifiable infectious disease, the occupier or other person in charge of the premises in which the first-mentioned person is living has a duty to consult a medical practitioner, or to notify the local authority of the district of the existence of a disease suspected to be a notifiable infectious disease.

Duty of master of vessel in harbour as to infectious disease

Under section 76 (Duty of master of vessel in harbour as to infectious disease), when any person on board a ship in any harbour is suffering from any sickness of which the symptoms create a reasonable suspicion that it is a notifiable infectious disease, the master of the ship has a duty to notify the medical officer of health of the existence of a disease suspected to be a notifiable infectious disease.

Medical officer of health may enter premises

Under section 77 (Medical officer of health may enter premises), the medical officer of health, or any medical practitioner authorised by the medical officer of health or by the local authority of the district:

• may at all reasonable times enter any premises in which s/he has reason to believe that there is or recently has been any person suffering from a notifiable infectious disease or recently exposed to the infection of any such disease; and
• may medically examine any person on those premises for the purpose of ascertaining whether that person is suffering or has recently suffered from any such disease.

Medical officer of health may give directions to individual posing public health risk

Under section 92I (Medical officer of health may give directions to individual posing public health risk), if a medical officer of health believes on reasonable grounds that an individual poses a public health risk, the medical officer of health may give the individual a range of directions that s/he thinks are necessary to prevent or minimise the public health risk posed by the individual. If the disease that the individual is believed to have is not a notifiable infectious disease, every direction given to the individual must have the prior approval of the Director-General of Health. The directions the medical officer of health may give include directing the individual to:

• accept supervision by a named person or a person for the time being holding a named office, including
  providing that person with information on any action, occurrence, or plan that is relevant to the public health risk posed by the individual; and
• comply with instructions to prevent the spread of the infectious disease.

If a direction requires an individual to refrain from carrying out a specified activity and a medical officer of health believes that the persons responsible for the activity need to be informed to prevent or minimise the public health risk posed by the individual, the medical officer of health may contact such persons and tell them about:

• the direction;
• the public health risk posed by the individual’s engagement in the activity; and/or
• ways of minimising that public health risk.

Despite anything in the Privacy Act, if a person requires another person to provide information under section 92I:

• the person required to provide the information must comply with the requirement and be advised that the information must be provided for the effective management of infectious diseases; and
• nothing in the section limits the right of an individual to access or disclose information about him or her under that Act or any other Act.

Medical officer of health may give directions to contacts of individuals posing public health risk

Section 92J (Medical officer of health may give directions to contacts of individuals posing public health risk) applies if a medical officer of health believes on reasonable grounds that:

• an individual has been in contact with a person who has, or may have, an infectious disease; and
• if the disease has been transmitted to the individual, the individual poses, or is likely to pose, a public health risk.

In that situation, the medical officer of health may give the individual certain directions that the medical officer of health thinks are necessary to prevent or minimise the public health risk posed by the individual. If the disease that the individual is believed to have is not a notifiable infectious disease, every direction given to the individual must have the prior approval of the Director-General of Health. The directions that may be given include directing the individual to:

• accept supervision by a named person or a person for the time being holding a named office, including providing that person with information on any action, occurrence, or plan that is relevant to the public health risk posed by the individual; and
• comply with instructions to prevent the spread of the infectious disease.

If a direction requires an individual to refrain from carrying out a specified activity and a medical officer of health believes that the persons responsible for the activity need to be informed to prevent or minimise the public health risk posed by the individual, the medical officer of health may contact such persons and tell them about:

• the direction;
• the public health risk posed by the individual’s engagement in the activity; and/or
• ways of minimising that public health risk.

Despite anything in the Privacy Act, if a person requires another person to provide information under this section:

• the person required to provide the information must comply with the requirement and be advised that the information must be provided for the effective management of infectious diseases; and
• nothing in the section limits the right of an individual to access or disclose information about him or her under that Act or any other Act.

Direction for medical examination

Section 92K (Direction for medical examination) applies if a medical officer of health believes on reasonable grounds that:

• an individual may have an infectious disease (for example, because the individual has been in contact with a person who has an infectious disease);
• the individual’s medical practitioner or a medical officer of health has requested the individual to undergo, within a specified period, a medical examination to establish whether the individual has the infectious disease;
• the individual has not undergone that examination within that period; and
• if the individual has the infectious disease, the individual poses a public health risk.

In that situation, the medical officer of health may direct the individual to undergo 1 or more medical examinations and may specify the places where those examinations are to be conducted and the health providers who are to conduct them. The medical officer of health may also direct the individual, until those examinations are completed, to do various things. Those things include:

• accepting supervision by a named person or a person for the time being holding a named office, including providing that person with information on any action, occurrence, or plan that is relevant to the public health risk posed by the individual; and
• complying with instructions to prevent the spread of the infectious disease.

If a direction requires an individual to refrain from carrying out a specified activity and a medical officer of health believes that the persons responsible for the activity need to be informed to prevent or minimise the public health risk posed by the individual, the medical officer of health may contact such persons and tell them about:

• the direction;
• the public health risk posed by the individual’s engagement in the activity; and/or
• ways of minimising that public health risk.

Despite anything in the Privacy Act, if a person requires another person to provide information under the section:

• the person required to provide the information must comply with the requirement and be advised that the information must be provided for the effective management of infectious diseases; and
• nothing in the section limits the right of an individual to access or disclose information about him or her under that Act or any other Act.

Confidentiality in relation to information provided or obtained under direction

Section 92U (Confidentiality) states that, despite anything in the Privacy Act, information provided or obtained under a direction under Part 3A may not be used or disclosed by anyone except for the effective management of infectious diseases, but nothing in the section limits the right of an individual to access or disclose information about him or her under that Act or any other Act.

District Court may make public health order

Under section 92Z (District Court may make public health order), on an application by a medical officer of health, the District Court may make a public health order in respect of an individual if the court is satisfied that the individual poses a public health risk. Under section 92ZA (Public health order may impose certain requirements on individual), such an order may impose on an individual certain requirements the court thinks are necessary to prevent or minimise the public health risk posed by the individual. They can include requirement (among various others that are listed):

• to be supervised by a named person or by a person for the time being holding a named office, including providing that person with information on any action, occurrence, or plan that is relevant to the public health risk posed by the individual;
• after the views of the individual have been taken into account, to be subject to public health surveillance, with or without the aid of electronic communication devices, by a named person or by a person for the time being holding a named office or by a named organisation; and
• to be treated for the infectious disease by a specified health provider.

Medical examination orders

Under section 92ZH (Medical examination orders), the District Court may, on the application of a medical officer of health, make a medical examination order in respect of an individual if the court is satisfied that:

• the individual may have an infectious disease (for example, because the individual is, or has been, in contact with a person who has the infectious disease);
• the individual’s medical practitioner or a medical officer of health has asked the individual to undergo, within a specified period, a medical examination to establish whether the individual has the infectious disease;
• the individual has not undergone that examination within that period; and
• the individual poses a public health risk.

Confidentiality in relation to information provided or obtained under public health orders

Section 92ZS (Confidentiality) states that, despite anything in the Privacy Act, information provided or obtained under public health orders like this may not be used or disclosed by anyone except for the effective management of infectious diseases, but nothing in the section limits the right of an individual to access or disclose information about him or her under that Act or any other Act.

Contact tracing

Subpart 5 of Part 3A deals with ‘contact tracing’, the purpose of which is to obtain information about the contacts of persons with infectious diseases or suspected of having infectious diseases, to:

• identify the source of the infectious disease or suspected infectious disease;
• make the contacts aware that they too may be infected, thereby encouraging them to seek testing and treatment if necessary; and
• limit the transmission of the infectious disease or suspected infectious disease (section 92ZY).

The contract tracing provisions are detailed. Only certain aspects are summarised here.

Section 92ZZ explains that contact tracing, in respect of an individual with an infectious disease or suspected of having an infectious disease, involves:

• ascertaining the identity of each of the individual’s contacts;
• communicating with each contact, so far as this is practicable and appropriate;
• ascertaining the circumstances in which the infectious disease or suspected infectious disease may have been transmitted to or by the contact;
• providing information and advice to the contact about the risks that the contact faces because of his or her exposure to the infectious disease or suspected infectious disease; and
• obtaining information about the contacts of that contact, including information required under section 92ZZC in relation to those other contacts.

The contract tracer may be a medical officer of health, a health protection officer, or a person suitably qualified in health or community work who is nominated to undertake contact tracing by a district health board or medical officer of health (section 92ZZA).

Under section 92ZZC, the contact tracer may require an individual with an infectious disease or suspected of having an infectious disease to give the contact tracer information about the circumstances in which the infectious disease may have been transmitted to, or by, the individual. In addition, an individual with an infectious disease or suspected of having an infectious disease must, if required by the contact tracer, provide information about:

• those people with whom he or she is, and has been, in contact; and
• the circumstances in which he or she believes he or she contracted, or may have transmitted, the infectious disease.

Under section 92ZZF, for the purpose of identifying the contacts of an individual who has been given a direction under section 92ZZC, a contact tracer may approach certain persons and require them to provide the contact tracer with the names and addresses of the contacts of the individual that are known to the person. The certain person are:

• the individual’s employer;
• an educational institution attended by the individual;
• any business or other organisation that the individual has dealt with; and
• an event co-ordinator or other person likely to have a list of persons attending an event.

These persons must provide information in response to a request despite anything in the Privacy Act.

Despite anything in the Privacy Act, if a person requires another person to provide information under section 92ZZF:

• the person required to provide the information must comply with the requirement and be advised that the information must be provided for the effective management of infectious diseases; and
• nothing in this section limits the right of an individual to access or disclose information about him or her under that Act or any other Act.

Under section 92ZZG (Duty of confidentiality), a contact tracer who approaches a contact or approaches a person under section 92ZZF must not, as far as practicable, disclose to the contact or that other person the identity of the individual who may have:

• transmitted the infectious disease to the contact; or
• exposed the contact to the risk of contracting the infectious disease.

Despite anything in the Privacy Act 1993, information provided or obtained by a contact tracer may not be used or disclosed by anyone except for the effective management of infectious diseases, but nothing in the section limits the right of an individual to access or disclose information about him or her under that Act or any other Act.

Who is ‘liable to quarantine’?

Section 96 prescribes the ships and aircraft that are liable to quarantine. For example, except as stated otherwise in regulations, ships arriving in New Zealand from any port beyond New Zealand, and aircraft arriving in New Zealand from any place beyond New Zealand, are liable to quarantine.

Under section 97(1), a person is liable to quarantine if he or she is on board, or disembarks from, a craft (e.g., a ship or aircraft) that is liable to quarantine.

Some additional powers in later provisions (sections 97D and 97E) apply in relation to a person liable to quarantine when section 97(2) applies to the person. Section 97(2) applies to a person liable to quarantine if the medical officer of health believes or suspects, on reasonable grounds:

• that he or she is infected with a quarantinable disease; or
• that, within the 14 days before he or she arrived in New Zealand, he or she has been exposed to a disease that (whether or not it was a quarantinable disease at the time of the believed or suspected exposure) is a quarantinable disease.

“Quarantinable diseases” are diseases stated in Part 3 of Schedule 1. At present they include, for example, Middle East Respiratory Syndrome.

Obligations of people liable to quarantine

Section 97A imposes requirements on people who are liable to quarantine to comply with directions and supply information. Under the section, a person who is liable to quarantine:

• must comply with all directions, requirements, or conditions given, made, or imposed by the medical officer of health or a person authorised by the medical officer of health under Part 4 of the Act; and
• must, on request by the medical officer of health or a person authorised by the medical officer of health, give any information the officer believes on reasonable grounds to be necessary to enable the management of risks to public health.

In the case of people arriving in New Zealand by craft, the medical officer of health or a person authorised by the medical officer of health may request information by requiring the person appearing to the officer to be in charge of the craft to collect or supply some or all of it.

The information that may be requested from a person includes:

• his or her name;
• his or her recent travel history;
• his or her recent activities;
• his or her previous and present addresses, and proposed routes, destinations, and addresses;
• his or her movements during the 14 days before his or her arrival; and
• whether he or she is experiencing or has recently experienced particular symptoms.

The medical officer of health or a person authorised by the medical officer of health may also obtain from the department of State responsible for keeping it (and the department may supply to the medical officer of health or a health protection officer) any information about a person who is liable to quarantine that the officer believes on reasonable grounds to be necessary to obtain in order to trace the person’s movements or discover the contacts the person has had with other people.

Powers and duties of medical officer of health or health protection officer in relation to quarantinable diseases

Under section 97D (Powers and duties of medical officer of health or health protection officer in relation to quarantinable diseases), if a craft arrives in New Zealand carrying a person to whom section 97(2) applies (as described above), the medical officer of health or a health protection officer may, among other things:

• require the person to be examined; and
• require to be taken from the person any bodily sample the officer may reasonably require.

Surveillance of certain people liable to quarantine

Under section 97E (Surveillance of certain people liable to quarantine),  a person to whom section 97(2) applies (as described above), or who is liable to quarantine and has been quarantined under section 70(1)(f), must give to the medical officer of health all information reasonably required to enable the management of risks to public health.

The medical officer of health or a health protection officer may also cause such a person:

• to be removed to a hospital or other suitable place and detained under surveillance until the medical officer of health or a health protection officer is satisfied that he or she is not infected with the disease concerned or is not able to pass that disease on; or
• to be kept under surveillance at large.

Before being placed under surveillance at large, a person must give an undertaking, in a form prescribed by regulations made under the Act, that he or she will report to the medical officer of health or a medical practitioner at the times and places required.

While kept under surveillance at large, a person must:

• present himself or herself for and submit to any medical examination or testing required by the medical officer of health in whose district he or she may be;
• give to the medical officer of health all information he or she reasonably requires to enable the management of risks to public health;
• if instructed to do so by the medical officer of health, comply with certain reporting requirements; and
• if he or she leaves for another place, tell the medical officer of health, or the medical practitioner nominated by the medical officer of health, and give details of the address to which he or she is going.

Children and people under disability

Under section 97F (Children and people under disability), every person who has the custody or charge of a child or the role of providing day-to-day care for a child, or has charge of a person who is under disability:

• must comply with every direction, requirement, or condition given, made, or imposed in respect of the child or person under disability under any of sections 97A to 97E; and
• must give in respect of the child or person under disability all information required under any of those sections.

Inspection of ships and ships’ declarations of health

Sections 101 and 102 address, respectively:

• inspection of ships or aircraft that are liable to quarantine (including a power to examine people suspected to be suffering from any quarantinable disease or to have been exposed to the infection of a quarantinable disease); and
• ships’ declarations of health on arrival in New Zealand.

Persons on board ships or aircraft suffering from quarantinable disease

Under section 108 (Persons suffering from quarantinable disease), if any person on board any ship, or arriving by any aircraft:

• is found to be suffering from any quarantinable disease; or
• is believed or suspected by the medical officer of health or health protection officer, on reasonable grounds, to be suffering from any such disease, or to have been so recently exposed to the infection of any such disease that he may suffer therefrom in consequence,

the medical officer of health or health protection officer may do all such things and give all such directions in respect of that person as may be prescribed by regulations made under the Act.

Power to board any ship and inspect

Under section 111 (Power to board any ship and inspect), the medical officer of health or health protection officer or any officer of the Ministry of Health, or any person acting under their authority, may board any ship in any port. They may enter and inspect any part of the ship and may inspect, among other things, the passenger list. Where the medical officer of health boards any ship under this section s/he may require any person on board the ship who may be suffering from any infectious disease to submit to any prescribed examination.