New Zealand should dump elimination strategy to tackle Covid variants

The most consistent aspect of the government’s response to Covid-19 has been that at no point throughout the global pandemic so far has it ever been acknowledged that there is merit in any of the responses other countries have adopted.

The strong implication has been that no country understands the pandemic the way New Zealand does or has the calibre of scientific advice available to it as we do here.

And somehow, the impact of Covid-19 on human beings in New Zealand is different from its impact on human beings anywhere else in the world.

Evidence-based decisions

The government has said throughout that its decisions have been guided by the evidence and focused on the health impacts of the virus. Consequently, the advice it has been guided by has been primarily from the preservation of the public health perspective, with little regard for the wider social and economic impacts of both the virus and the response to it.

Fair enough, given that the near unanimity of the advice it has been receiving was that pursuing an elimination strategy was the best course of action, even if most other countries have moved on from that approach.

It freely acknowledges that New Zealand is now the “last man standing” when it comes to continuing to promote an elimination strategy.

The Expert Advisory Group

This week’s report from Sir David Skegg’s Expert Advisory Group on what New Zealand should do next confirms that approach. Not only was the Expert Advisory Group made up entirely of people with a health background, its very conservative report, by its own admission, focuses solely on the health issues regarding the pandemic, and leaves the wider economic and social issues for the government to address.

For its part, the government seems just as content to continue to see Covid-19 and the response to it as no more than a public health issue and to gear its responses accordingly. There has been no suggestion, for example, that the Skegg report is externally reviewed by a more representative wider group (perhaps jointly convened by former Prime Ministers Sir John Key and Helen Clark?) to ensure that the decisions made upon it best reflect New Zealand’s wider interests.

Cautious response

The government has been lucky so far that there has been no coherent or credible challenge to either its health-centred approach or reliance on a very narrow pool of New Zealand epidemiologists for its advice.

That has enabled it to fashion New Zealand’s cautious response, exemplified by the slow rate of vaccination (now just 16% according to the latest World Health Organisation data), with a remarkable degree of insularity. The lack of other health professionals’ voices being allowed to be heard or taken seriously has also meant the government has operated within its own comfortable echo chamber for the last eighteen months, knowing its tight view of the world is unlikely to be seriously challenged.

The Delta Variant

The advent of the Delta variant has changed a lot of thinking around the world.

The Covid-19 Response Minister is warning that in the event the Delta virus was found in New Zealand the response would be “swift and severe” with the whole country likely to go into an immediate Level 4 lockdown.

Yet the same day, the Minister was making these overly draconian threats to reinforce the public fear the government has relied on from the outset to impose its pandemic response, a panel of international experts at least as distinguished as their New Zealand counterparts was calling for an entirely different approach to dealing with Covid-19 be adopted – precisely because of the Delta variant.

The team, led by Professor Andrew Pollard, who led the prestigious Oxford University Vaccine Team, says it is now time to accept that the spread of the virus throughout the entire population could not be stopped, and that monitoring people with mild symptoms was no longer helpful. Pollard said that “we don’t have anything that will stop transmission, so I think that we are in a situation where herd immunity is not a possibility and I suspect the virus will throw up a new variant that is even better at infecting vaccinated individuals.”

Shifting the focus

His team’s conclusion, delivered to an all-Party committee of British MPs, was that full vaccination would never be enough to prevent Covid-19 spreading. They say that the focus now needs to shift to dealing with those people who become unwell because of the virus, not just recording the numbers of cases in the community.

All of which makes not only the Skegg review’s recommendation that New Zealand should not consider reopening its borders until every eligible New Zealander has had the opportunity to be vaccinated, and the Minister’s wild threats of even more draconian lockdowns should the Delta variant emerge here look unrealistic.

More fundamentally, it knocks the ground out from under the government’s entire response strategy. What the Pollard team is really saying is that clinging to the elimination approach Skegg urges New Zealand to hold onto is doomed to failure; the Delta variant cannot be stopped despite what Minister Hipkins may think or threaten, and vaccination will not produce the herd immunity both Skegg and the government say is a necessary precursor to reopening our borders.

Different strategy needed 

Unless it really is the government’s intention to keep New Zealand in a semi-permanent state of isolation and periodic lockdown, which no rational human being would accept as logical or reasonable, it is time for a serious rethink of our Covid-19 approach, based on the latest international evidence. Such a rethink would upend the timid findings of the Skegg review and focus less on the elusive dream of continuing to eliminate a virus which simply continues to spread, regardless of restrictions, and much more on making sure that proper treatment is available to those becoming unwell as a result of catching it.

A separate report this week that New Zealand has the second lowest number of intensive care beds per capita in the OECD, with only Mexico below it, shows how badly prepared we are on that score and where our future focus needs to be.

It smacks of gross irresponsibility that boosting intensive care capacity to cope with Covid-19 cases has received so little consideration from a supposedly caring government over the last eighteen months. Bluntly, the hundreds of troops currently being used to enforce the failing MIQ system would have been far better utilised building temporary field hospitals to boost intensive care capacity. This is especially so since it now appears that lack of intensive care capacity is the real reason why the government is so reluctant to open the country’s borders.

Latest developments in the evidence-based approach the government says that it is relying upon strongly suggest our current response is now out of step with international reality.

The challenge for the government is whether it will continue to cling to the elimination strategy other countries have abandoned, or whether it is sufficiently adept to refresh its approach in line with the latest evidence now being amassed in the rest of the world.

Peter Dunne was a Minister of the Crown under the Labour and National-led governments from November 1999 to September 2017. He lives in Wellington.
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