Measles infection alert for NSW North Coast, August 2023

Measles was officially declared eliminated from Australia in March 2014, which means that outbreaks in Australia

now start with a single non-immune individual contracting infection while overseas and coming/returning to Australia. [National Centre for Immunisation, Research and Surveillance, Fact Sheet, 2019]

After a two and a half year respite Measles popped up on the public health radar in New South Wales again in February, March, April and July 2023.

With a low number infections being identified on incoming international flights up to late July 2023 and one case with no identified source.

The latest instances triggering limited period alerts for Rose Bay, Randwick, Minnie Waters, Coffs Harbour and Woolgoolga.

Those most likely to be susceptible to measles are infants under 12 months of age who are too young to be vaccinated, anyone who is not fully vaccinated against the disease, which may include some adults, and people with a weakened immune system. [NSW Health, 21 July 2023]

NSW Health, Measles alert for Mid North Cost and Northern NSW, extract, 7 August 2023

The Mid North Coast and Northern NSW Local Health Districts are urging people to be alert for signs and symptoms of measles and to get vaccinated if not up to date, following the notification of a case in the region.

It is likely the case acquired their infection whilst travelling in Bali, where a high number of cases have occurred in recent months. The case visited several locations in NSW while infectious, and contact tracing of potential high risk persons is underway.

Dr Valerie Delpech, Acting Director, Northern NSW Population and Public Health Directorate, said anyone

who was in the same locations as the cases should be alert for signs and symptoms of measles until 18 August, and check their vaccination status.

People may have been exposed to the case in the following locations:

• Coffs Harbour University football field, AFL North Coast under 10 competition – on Sunday 30 July between 9am-10am

• Woolgoolga AFL sports field, AFL North Coast under 12 competition – on Sunday 30 July between 11am-12pm

• Hazard reduction burn, Minnie Water Road, Minnie Water – on Monday 31 July 8.30am-5.30pm

These locations do not pose an ongoing risk to people…..

COVID-19 NSW STATE OF PLAY 2023: Counting Dead People - Part 3 "Will we choose to prevent Covid deaths?"

 

https://youtu.be/QHW1y-FpyII

The Jon Snow Project

In Northern NSW by the week ending 11 February 2023 — in a published NSW Respiratory Surveillance Report which includes basic death demographics —  211 people had been newly confirmed (via PCR or RAT) as having contracted COVID-19, 11 people were admitted to hospital with COVID-19 infections and 4 people were reported to have died from COVID-19.

Statewide in New South Wales in that week ending 11 February 2023:

• a total of 5,587 people were diagnosed with COVID-19;

• 180 people were hospitalised with confirmed infections;

• 61 people were reported as having died from COVID-19; and

• all COVID-19 deaths were individuals aged between 50 and 90+ years of age.

NOTE: In the last 4 weeks up to 16 February 2023 — based on PCR test results only with all RAT results excluded — there were 135 confirmed COVID-19 cases recorded in Tweed Shire, 54 cases in Ballina Shire, 38 in Clarence Valley, 24 in Byron Shire, 22 in Lismore City, 11 in Richmond Valley and 3 in Kyogle Shire.

In Northern NSW by the week ending 18 February 2023 — in the most recently published NSW Respiratory Surveillance Report which includes basic death demographics —  189 people had been newly confirmed (via PCR or RAT) as having contracted COVID-19, 13 people were admitted to hospital with COVID-19 infections and 2 people were reported to have died from COVID-19.

Statewide in New South Wales in that week ending 18 February 2023:

• a total of 5,777 people were diagnosed with COVID-19;

• 201 people were hospitalised with confirmed infections;

• 46 people were reported as having died from COVID-19; and

• 2 COVID-19 deaths were children aged between 0-9 years, 1 was an adult between 40-49 years of age and the remaining 43 deaths were of individuals aged between 50 and 90+ years of age.

STATE OF PLAY: By 2022 the Earth was an est. 1.14°C hotter than its pre-industrial era average. Australian had warmed on average by 1.47 ± 0.24 °C since national records began in 1910. WHO warns that global heating of even 1.5°C is not considered safe & every additional tenth of a degree of warming will take a serious toll on people’s lives and health.

 

World Health Organisation, Climate change and health, excerpts, 30 October 2021:

The Intergovernmental Panel on Climate Change (IPCC) has concluded that to avert catastrophic health impacts and prevent millions of climate change-related deaths, the world must limit temperature rise to 1.5°C. Past emissions have already made a certain level of global temperature rise and other changes to the climate inevitable. Global heating of even 1.5°C is not considered safe, however; every additional tenth of a degree of warming will take a serious toll on people’s lives and health......

Climate-sensitive health risks

Climate change is already impacting health in a myriad of ways, including by leading to death and illness from increasingly frequent extreme weather events, such as heatwaves, storms and floods, the disruption of food systems, increases in zoonoses and food-, water- and vector-borne diseases, and mental health issues. Furthermore, climate change is undermining many of the social determinants for good health, such as livelihoods, equality and access to health care and social support structures. These climate-sensitive health risks are disproportionately felt by the most vulnerable and disadvantaged, including women, children, ethnic minorities, poor communities, migrants or displaced persons, older populations, and those with underlying health conditions.

Figure: An overview of climate-sensitive health risks, their exposure pathways and vulnerability factors. Climate change impacts health both directly and indirectly, and is strongly mediated by environmental, social and public health determinants.

Although it is unequivocal that climate change affects human health, it remains challenging to accurately estimate the scale and impact of many climate-sensitive health risks. However, scientific advances progressively allow us to attribute an increase in morbidity and mortality to human-induced warming, and more accurately determine the risks and scale of these health threats.

In the short- to medium-term, the health impacts of climate change will be determined mainly by the vulnerability of populations, their resilience to the current rate of climate change and the extent and pace of adaptation. In the longer-term, the effects will increasingly depend on the extent to which transformational action is taken now to reduce emissions and avoid the breaching of dangerous temperature thresholds and potential irreversible tipping points.

Nature, Climate change is making hundreds of diseases much worse, excerpt, 12 August 2022:

Climate change has exacerbated more than 200 infectious diseases and dozens of non-transmissible conditions, such as poisonous-snake bites, according to an analysis. Climate hazards bring people and disease-causing organisms closer together, leading to a rise in cases. Global warming can also make some conditions more severe and affect how well people fight off infections.

Most studies on the associations between climate change and disease have focused on specific pathogens, transmission methods or the effects of one type of extreme weather. Camilo Mora, a data scientist at the University of Hawaiʻi at Mānoa, and his colleagues scoured the literature for evidence of how ten climate-change-induced hazards — including surging temperatures, sea level rise and droughts — have affected all documented infectious diseases (see ‘Climate hazards exacerbate diseases’). These include infections spread or triggered by bacteria, viruses, animals, fungi and plants (see ‘Mode of transmission’). The study was published in Nature Climate Change on 8 August.

The study quantifies the many ways in which climate change affects human diseases, says Mora. “We are going to be under the constant umbrella of this serious threat for the rest of our lives,” he adds.

Literature review

Mora and his colleagues examined more than 77,000 research papers, reports and books for records of infectious diseases influenced by climatic hazards that had been made worse by greenhouse-gas emissions. More than 90% of the relevant papers had been published after 2000. Ultimately, the team found 830 publications containing 3,213 case examples.

The researchers discovered that climate change has aggravated 218, or 58%, of the 375 infectious diseases listed in the Global Infectious Diseases and Epidemiology Network (GIDEON), and the US Centers for Disease Control and Prevention’s National Notifiable Diseases Surveillance System. The total rises to 277 when including non-transmissible conditions, such as asthma and poisonous-snake or insect bites. The team also identified nine diseases that are diminished by climate change. [my yellow highlighting]

Research paper "Over half of known human pathogenic diseases can be aggravated by climate change" (Mora, C. et al, August 2022) can be accessed at:

https://www.nature.com/articles/s41558-022-01426-1

On the subject of COVID-19…..

World Health Organisation, Zoonoses, excerpt, 29July 2020:

A zoonosis is an infectious disease that has jumped from a non-human animal to humans. Zoonotic pathogens may be bacterial, viral or parasitic, or may involve unconventional agents and can spread to humans through direct contact or through food, water or the environment. They represent a major public health problem around the world due to our close relationship with animals in agriculture, as companions and in the natural environment. Zoonoses can also cause disruptions in the production and trade of animal products for food and other uses.

Zoonoses comprise a large percentage of all newly identified infectious diseases as well as many existing ones. Some diseases, such as HIV, begin as a zoonosis but later mutate into human-only strains. Other zoonoses can cause recurring disease outbreaks, such as Ebola virus disease and salmonellosis. Still others, such as the novel coronavirus that causes COVID-19, have the potential to cause global pandemics. [my yellow highlighting]

North Coast Voices readers may have noticed that "zoonoses" are mentioned in "Climate-sensitive health risks" and that zoonoses, as one of the nine categories listed  as such health risks in the graphic insert, are considered to be strongly mediated by environmental, social and public health determinants.

It may be that a potential exists for the SARS-CoV-2 virus to alter its nature in unexpected ways as the climate continues to change. If Australia's response to the virus remains almost entirely politically driven as it has been since the second half of 2021 and does not return swiftly to a predominately science based policy and public health implementation, then any increase in virulence will likely markedly weaken the nation's social and economic bonds. Alternatively, if a new highly infectious zoonosis with significant morbidity emerges and, because our governments and their health agencies have not leant the lessons of the ongoing COVID-19 pandemic, the nation will not be anymore prepared than it was in January 2020.

So what is currently in the SARS-Cov-2 viral soup swirling around us as we go about our daily lives?

 

 

The NSW Perrottet Government decided in late 2021 that it would ignore the SARS-CoV-2 pandemic. It no longer publicly report instances of COVID-19 infection in a meaningful way. As well as removing in stages all mandatory health measures, including an obligation to get tested or to isolate if unwell. 

Therefore the general public knows little about the viral soup that now swirls arounds Australia's public spaces, transit systems, workplaces and even our homes.

So as a new cluster of Omicron subvariants make themselves felt this month in New South Wales: the population is generally under-vaccinated; the viral transmission rate is rising; the number of people testing positive is growing by approx. six to eight thousand confirmed cases every 7 days; hospital admissions due to COVD-19 are climbing; and somewhere between 22 to 39 deaths are occurring over 7 day periods.

With all statistics belatedly supplied by NSW Health indicating an increase in the already massive under reporting, once all pretence of a public health approach to this pandemic was abandoned.

So how many SARS-CoV-2 subvariants are there now?

Well since the original subvariants Apha, Beta, Gamma and Delta gave way to Omicron, there have been so many more subvariants of concern spawned in Australia and around the world.

Here is an outline of what is currently in the viral soup......

Doherty Institute, News, 3 November 2022:

From Centaurus to XBB: your handy guide to the latest COVID subvariants (and why some are more worrying than others)

The Omicron variant of concern has splintered into multiple subvariants. So we’ve had to get our heads around these mutated forms of SARS-CoV-2, the virus that causes COVID-19, including BA.1 and the more recent BA.5.

We’ve also seen recombinant forms of the virus, such as XE, arising by genetic material swapping between subvariants.

More recently, XBB and BQ.1 have been in the news.

No wonder it’s hard to keep up.

The World Health Organization (WHO) has had to rethink how it describes all these subvariants, now labelling ones we need to be monitoring more closely.

What’s the big deal with all these subvariants?

Omicron and its subvariants are still causing the vast majority of COVID cases globally, including in Australia.

Omicron subvariants have their own specific mutations that might make them more transmissible, cause more severe disease, or evade our immune response.

Omicron and its subvariants have pushed aside previous variants of concern, the ones that led to waves of Alpha and Delta earlier in the pandemic.

Now, in Australia, the main Omicron subvariants circulating are BA.2.75, and certain versions of BA.5. More on these later.

 

Viral genomes from Australia: once we had Alpha and Delta waves. Now we have waves of Omicron subvariants. Author provided

We still don’t fully understand the driving forces behind the emergence and spread of certain SARS-CoV-2 subvariants.

We can, however, assume the virus will keep evolving, and new variants (and subvariants) will continue to emerge and spread in this wave-like pattern.

How do we keep track of this all?

To monitor these subvariants, the WHO has defined a new category, known as “Omicron subvariants under monitoring”.

These are ones that have specific combinations of mutations known to confer some type of advantage, such as being more transmissible than others currently circulating.

Researchers and health authorities keep track of circulating subvariants by sequencing the genetic material from viral samples (for instance, from PCR testing or from wastewater sampling). They then upload the results to global databases (such as GISAID) or national ones (such as AusTrakka).

These are the Omicron subvariants authorities are keeping a closer eye on for any increased risk to public health.

Newer versions of BA.5

The BA.5 subvariant that arose in early February 2022 is still accumulating more mutations.

The WHO is monitoring BA.5 versions that carry at least one of five additional mutations (known as S:R346X, S:K444X, S:V445X, S:N450D and S:N460X) in the spike gene.

The spike gene codes for the part of the virus that recognises and fuses with human cells. We are particularly concerned about mutations in this gene as they might increase the virus’ ability to bind with human cells.

Throughout recent months, BA.5 has been the dominant subvariant in Australia. However, BA.2.75 has now established a foothold.

BA.2.75 or Centaurus

The BA.2.75 subvariant, sometimes called Centaurus, was first documented in December 2021. It possibly emerged in India, but has been detected around the globe.

This includes in Australia, where more than 400 sequences have been uploaded to the GISAID database since June 2022.

This subvariant has up to 12 mutations in its spike gene. It seems to spread more effectively than BA.5. This is probably due to being better able to infect our cells, and avoiding the immune response driven by previous infection with other variants.

 

BJ.1

This was first detected in early September 2022 and has a set of 14 spike gene mutations.

It has mostly been detected in India or in infections coming from this area.

We know very little about the impact of its mutations and at the time of writing, there was only one Australian sequence reported.

BA.4.6 or Aeterna

BA.4.6, sometimes called Aeterna, was detected in January 2022 and has been spreading rapidly in the United States and the United Kingdom.

There have been more than 800 sequences uploaded to the GISAID database in Australia since May 2022.

It may be more easily transmitted from one person to the next due to its spike gene mutations.

Early data suggests it is better able to resist cocktails of therapeutic antibodies compared with BA.5. This makes antibody therapies, such as Evusheld, less effective against it.

BA.2.3.20

This was first detected in the US in August 2022. It has a set of nine mutations in the spike gene, including a rare double mutation (A484R).

Like BA.2.75, this subvariant is probably better able to infect our cells and avoid the immune response driven by previous infection.

There are more than 100 Australian genomic sequences reported in the GISAID database, all from August 2022.

XBB

This recombinant version of the virus was detected in August 2022. It is a result of the swapping of genetic material between BA.2.10.1 and BA.2.75. It has 14 extra mutations in its spike gene compared with BA.2.

Although there have only been 50 Australian genomic sequences reported in GISAID since September, we anticipate cases will rise. Lab studies indicate therapeutic antibodies don’t work so well against it, with XBB showing strong resistance.

Although XBB appears to be able to spread faster than BA.5, there’s no evidence so far it causes more severe disease.

 

How about BQ.1?

Although it is not on the WHO list of subvariants under monitoring, cases of the BQ.1 subvariant are rising in Australia. BQ.1 contains mutations that help the virus evade existing immunity. This means infection with other subvariants, including BA.5, may not protect you against BQ.1.

In the meantime, your best protection against severe COVID, whichever subvariant is circulating, is to make sure your booster shots are up-to-date. Other ways to prevent SARS-CoV-2 infection include wearing a fitted mask, avoiding crowded spaces with poor ventilation, and washing your hands regularly.

Written by

Dr Ash Porter, Research officer and Dr Sebastian Duchene, Australian Research Council Future Fellow.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Tweet of the Month

I don’t appreciate being interrupted while speaking on serious risks of repeated covid infections.

I particularly don’t appreciate being interrupted by shouting LNP MPs who refuse to wear masks.

We all have a duty to look after each other. Here & everywhere.

Put your mask on! pic.twitter.com/u5evZ0k4Oi

— Dr Monique Ryan MP (@Mon4Kooyong) August 1, 2022

Twice the numbers of Australian residents than previously reported - est. 3.90 million people - contracted SARS-CoV-2 COVID-19 between the beginning of December 2021 and end of February 2022

 

An estimated 3,905,966 Australian residents contracted SARS-CoV-2/COVID-19 (probably the Omicron or Omicron sub-variants) between the beginning of December 2021 and end of February 2022.

That is 3.9 million people infected in a three month period.

According to NCIRS - Australian COVID-19 Serosurveillance Network:

"Prevalence of anti-nucleocapsid antibodies was 17.0% (16.0–18.0) overall. Seroprevalence was highest in Queensland (25.8%; 23.3–28.5), followed by Victoria (22.6%; 20.1–25.2) and NSW (21.4%; 19.1–23.9). Seroprevalence was lowest, at 0.5% (0.2–1.2) in WA (Figure 4A). No differences in seroprevalence across jurisdictions were observed following age adjustment compared with unadjusted seroprevalence..."  [my yellow highlighting]

On the last day of February 2022 there were still 204,973 confirmed active COVID-19 cases across Australia and the daily number of confirmed active cases steadily grew during March before peaking at 483,680 cases as the month ended.

On 3 April national confirmed active Covid-19 daily cases reached 502,377 before slowly falling to remain stubbornly well above 400,000 until mid-April when cases number began to fall again.

On 1 May 2022 Australia had 326,554 confirmed active COVID-19 cases, by 16 May 385,923 & by 31 May 278,717.

As of 4pm on Monday, 20 June 2022, Australia-wide there were est. 211,622 active cases of COVID-19 recorded by the Australian Government Dept. Of Health.

All these March to June 2022 figures are considered to also be a significant under reporting of actual infection numbers in the general population.

~~~~~~~~~~~~~~~~~~~~~~~~~

Media release, 20 June 2022:

National antibody study confirms COVID-19 cases higher than reported

• At least 17% of Australian adults are estimated to have recently had COVID-19 at the end of February 2022.

• Adults aged 18–29 years had the highest proportion of antibodies to SARS-CoV-2, the virus that causes COVID-19.

• Queensland had the highest antibody positivity rate, while Western Australia had the lowest.

• The next blood donor survey and a paediatric serosurvey have commenced and will provide an updated snapshot to mid-June 2022.

It is estimated that at the end of February 2022 at least 17% of the Australian adult population had recently been infected with SARS-CoV-2, the virus that causes COVID-19, according to results released today from Australia’s most recent serosurvey of antibodies to the virus in blood donors. The vast majority of these infections are believed to have occurred during the Omicron wave that began in December 2021. Based on survey results, the proportion of people infected was at least twice as high as indicated by cases reported to authorities at the end of February 2022. [my yellow highlighting]

The serosurvey was conducted by the National Centre for Immunisation Research and Surveillance (NCIRS) and the Kirby Institute at UNSW Sydney, in collaboration with Australian Red Cross Lifeblood, Royal Melbourne Hospital’s Victorian Infectious Diseases Reference Laboratory at the Doherty Institute and other research partners.

The highest proportion of adults with antibodies to SARS-CoV-2 was in Queensland (26%), followed by Victoria (23%) and New South Wales (21%), while Western Australia had the lowest (0.5%).

The serosurvey method detects higher proportions of infection than routine surveillance based on cases diagnosed and reported at the time of infection, which misses people who didn’t present for a test or whose positive test result was not reported to authorities.

The national antibody survey was conducted in late February to early March 2022, approximately 6 weeks after the peak of the Omicron wave in New South Wales, the Australian Capital Territory, Queensland and Victoria and prior to substantial transmission in Western Australia.

“The general pattern of antibody positivity in blood donors was consistent with the pattern in reported cases to the end of February 2022: New South Wales, Victoria and Queensland having had big outbreaks, and Western Australia having very limited community transmission,” says Dr Dorothy Machalek, lead investigator on the project from the Kirby Institute. “Similarly, young blood donors had the highest rate of infection, matching higher reported case numbers in this age group.”

Researchers examined 5,185 de-identified samples from Australian blood donors aged 18–89 years for evidence of COVID-19–related antibodies. Two types of antibody to SAR-CoV-2 were tested: antibody to the nucleocapsid protein, which provides an indication of past infection, and antibody to the spike protein, which can indicate past infection and/or vaccination.

Evidence of past infection was highest among donors aged 18–29 years at 27.2%, declining with increasing age to 6.4% in donors aged 70–89 years across Victoria, New South Wales and Queensland. In Western Australia, evidence of recent infection was extremely low across all age groups. Nationally, the proportion of the population with antibodies to the spike protein was far higher, at around 98%.

“As expected a very high proportion of the blood donors had antibodies to the spike protein of the COVID-19 virus, with little variation by age group and sex. This was likely due to high vaccination rates among blood donors, as well as in the wider population,” says Professor Kristine Macartney, Director of NCIRS and Professor at The University of Sydney.

“Future rounds of the blood donor serosurvey will allow us to understand how many infections occur throughout 2022,” Professor Macartney said. “We are also conducting a second national paediatric serosurvey that started collection in June and this will give us better insights into transmission in children and teenagers.”

The ongoing blood donor survey, co-led by the Kirby Institute and NCIRS in collaboration with Australian Red Cross Lifeblood, also involves investigators at the Royal Melbourne Hospital’s Victorian Infectious Diseases Reference Laboratory at the Doherty Institute, NSW Health Pathology ICPMR, The University of Sydney and Murdoch Children’s Research Institute.

The residual blood donation samples used in the survey were obtained from Lifeblood’s processing centres across the country and delinked from any identifying information apart from age, sex and post code. Individual results can therefore not be provided back to blood donors.

“Australian Red Cross Lifeblood encourages anyone wanting to contribute to this type of research to become a regular donor. There are many benefits to donating, including finding out your blood type,” says Professor David Irving, Director of Research and Development at Australian Red Cross Lifeblood.

The next round of the Lifeblood donor survey has commenced from mid-June. This time point will estimate SARS-CoV-2 antibody prevalence following the spread of the Omicron BA.2 and other subvariants. Data are provided to all states, territories and the Commonwealth Government under the Australian National Disease Surveillance Plan for COVID-19.

Read the full report here

~~~~~~~~~~~~~~~~~~~~~~~~~

Seroprevalence of SARS-CoV-2-specific antibodies among Australian blood donors, February–March 2022, The Australian COVID-19 Serosurveillance Network, Final report, 3 June 2022, p. 7. Click on image to enlarge

SOURCES

• Dept. Of Health, Coronavirus (COVID-19) at a glance infographic collection

A collection of infographics providing a quick view of the coronavirus (COVID-19) situation in Australia since 5 April 2020.

• Dept. Of Health, Coronavirus (COVID-19) case numbers and statistics

• National Centre for Immunisation Research and Surveillance

Under reporting of COVID-19 cases in New South Wales is now a sick joke being played on the population

As of 4pm on Friday, 17 June 2022, Australia-wide there were est. 208,173 active cases of COVID-19 recorded by the Australian Government Dept. Of Health.

Of these, 30,302 confirmed cases had been reported in the prior 24 hours.

A total of 2,817 cases were currently hospitalised on 17 June, with 93 in intensive care units and of these 30 people requiring ventilation.

In the 24 hours to 4pm on 17 June 51 people had died as a result of contracting COVID19. As government agencies do not update on weekends it is noted that covidlive.com.au reported a further 64 deaths on Saturday 18 June.

In New South Wales up 4pm on Friday 14 June 2022 there were 85,386 active cases of COVID-19 and in the 24 hours up to 4pm 17 June there were 8,119 newly confirmed COVID-19 cases.

A total of 1,344 cases were currently hospitalised on 17 June, with 45 in intensive care units and of these 18 requiring ventilation.

In the 24 hours to 4pm on Friday, 17 June 25 people had died as a result of contracting COVID-19.

Since the SARS-CoV-2/Covid-19 pandemic first entered Australia and NSW in late January 2020, NSW Health has recorded a total 2,704,725 confirmed cases of COVID-19 – a conservative figure given the ongoing under reporting of infection numbers – and 3,387 deaths.

The seven local government areas in the NSW Northern Rivers region recorded the following newly confirmed COVID-19 case numbers as at 4pm on Friday, 17 June 2022:

Tweed Shire – details not available

Ballina Shire – details not available

Byron Shire – details not available

Lismore City – details not available

Richmond Valley – details not available

Clarence Valley – details not available

Kyogle Shire – details not available

TOTAL 242 cases – 77 confirmed as positive by Polymerase Chain Reaction (PCR) tests & 165 confirmed positive by Rapid Antigen Tests (RATs).

In the four weeks to 17 June 2022 the seven local government areas in the NSW Northern Rivers region recorded the following number of confirmed COVID-19 cases:

Tweed Shire – 443 cases confirmed by PCR tests. All cases confirmed by RATs excluded from the count;

Ballina Shire – 250 cases confirmed by PCR tests. All cases confirmed by RATs excluded from the count;

Byron Shire – 104 cases confirmed by PCR tests. All cases confirmed by RATs excluded from the count;

Lismore City – 167 cases confirmed by PCR tests. All cases confirmed by RATs excluded from the count;

Richmond Valley – 126 cases confirmed by PCR tests. All cases confirmed by RATs excluded from the count;

Clarence Valley – 123 cases confirmed by PCR tests. All cases confirmed by RATs excluded from the count;

Kyogle Shire – 16 cases confirmed by PCR tests. All cases confirmed by RATs excluded from the count.

TOTAL 1,229 cases – this figure includes only cases confirmed as positive by PCR tests and deliberately excludes all positive RAT testing.

Note: Under reporting of COVID-19 infection in the Northern Rivers region over the four week period ending 17 June 2022 is possibly in the vicinity of more than 1,229 persons – bringing the estimated total number to anywhere between 2,458 to 3,687 infected people spread out over the 7 local government areas.