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Strengthening our Supervised Quarantine Process

It may be hard for many of us to comprehend just how much the world outside the shores of our paradise has changed in the past 8 months or so. Across the globe, health systems have been tested by COVID-19.

Today almost 30 million people worldwide were reported to have been infected with SARS-CoV-2, the coronavirus that causes COVID-19. Over 937,000 people globally have been reported to have died from this disease. In the United States of America alone, more than 196,000 deaths have been attributed to the coronavirus, however many credible health professionals believe the numbers of people who have succumbed to this disease far exceed the figures officially recognised globally, and that the death toll may well be double the official number and is still rising.

On 16th April Prime Minister Henry Puna declared the Cook Islands a COVID-19 free zone. Since then, every effort has been made by Te Marae Ora, in fact all-of-government and country to ensure this status remains.

Our national health response has continued to evolve as we gain more knowledge about the behaviour of this coronavirus and how it spreads. This update is provided ahead of the arrival tomorrow of the third cohort in this current tranche of returnees who are undertaking supervised quarantine in Rarotonga.

On the 15th March the Cook Islands border closed to all except flights from New Zealand carrying returning Cook Islands residents and work permit holders. On 24th March, the border closed to all incoming passengers.

On 8th May exemptions were applied to the border closure that allowed for returning Cook Islanders and work permit holders to return to Rarotonga subject to them undertaking 2 weeks supervised quarantine in Auckland and again at the Edgewater. Two cohorts and a smaller group were subject to this regime – a total of 260 passengers.

On 12th June, with the borders still closed the Cook Islands government allowed for quarantine-free travel (travel with exemptions) to the Cook Islands which enabled over 600 Cook Islanders to return home and to re-join their families. This was able to occur by applying robust public health measures at the border, and assessing the public health risks to the Cook Islands population. This risk assessment process is ongoing and includes daily situation reports, the latest published today is #233.

On 13th August another temporary total air border closure came into effect and remained in effect until 30th August when the Cook Islands Cabinet approved the continuation of the air border closure for inwards passenger travel, with exemptions, which include 14 days supervised quarantine on arrival.

At that time Prime Minister Henry Puna noted “This continues to be a challenging time for all of us and many factors have been taken into consideration. We believe we have made a well-informed decision based on advice from Te Marae Ora and other agencies. Cabinet will continue to monitor this situation.”

Exemptions will only be granted to passengers who meet the following criteria:

  • Cook Islanders (as verified via Cook Islands Status stamp)
  • Permanent Residents of the Cook Islands
  • Cook Islands work permit holders
  • Cook Islands resident permit holders

The first of these flights where passengers were required to undergo 14 days supervised quarantine arrived on Friday 4th September. Tomorrow’s flight will be the third such flight. The following table is a snapshot of these returning Cook Islanders and work permit holders.

Date of arrival

Number of passengers

Others who joined returnees in quarantine

Number of approved supervised quarantine properties

4th September




11th September




18th September (to be confirmed upon departure of flight from Akld)





Tomorrow morning all 82 people who entered supervised between 4-6 September will be rejoining the community once they have successfully completed their exit medical clearance. All COVID-19 swabs sent to New Zealand together with the in-country tests from this cohort have returned negative results.

“These returnees are fellow Cook Islanders, our relatives, their spouses and children, people who were referred to New Zealand for medical treatment, and workers or others who usually live here, and I’m pleased we have been able to find a way to safely return our people home, says Dr Herman, Secretary of Health.

“We continue to learn from each arriving cohort and continue to improve our supervised quarantine process.  We also take learnings from other countries to inform our processes acknowledging our context is different to others.

From the first and second cohorts, Te Marae Ora has made changes to their processes, implementing 24/7 monitoring or surveillance, and reviewing the processes for strengthening the vetting process for the supervised quarantine residences. Prior to approval to travel to the Cook Islands, the nominated residence that international arrivals will complete their supervised quarantine process must be approved by the Puna, Police and Te Marae Ora. Taping to cordon off the property is also provided along with the yellow flags. Working collaboratively with the Puna, Police and Health helps ensure our arrivals enjoy are warm welcome home and gives our communities’ confidence in our health protection processes.     

The quarantine process is an established public health measure and one, says Secretary of Health Dr Aumea Herman. “How we design and implement it relies on the context e.g. what we do in Rarotonga would be different in another country. Several factors including the level of engagement with the community and Puna as well as the cooperation of the travellers and their families is important”.

“The public health response we choose is informed by the disease transmission pattern in the country where travellers are coming from, in this case, NZ. the assessed public health risk to the Cook Islands population informs these decisions” noted Dr Herman.

Some members of the public have questioned why the Cook Islands government has not implemented a user-pays option like the one New Zealand has opted for.

Our public health response to COVID-19 must be contextualized to the Cook Islands, rather than NZ. There are many factors to consider beyond that of cost, rather it’s understanding the complexities, uncertainty, and rapidly evolving epidemiology of the disease. 

Further, having returnees able to undertake supervised quarantine in their own homes, having been away for an extended period is not only financially cost effective, but more importantly, good for their mental health and well-being.

Each Puna determines how they will monitor their arrivals in supervised quarantine, in their areas. They know their people. What has been important is seeing the Puna work closely with their communities and providing a range of options for monitoring those undertaking supervised quarantine, based on their connectedness to their people, leadership, and trust.

ENDS: Enquiries to Jaewynn McKay +682 55486