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Pragmatism and transparency are the way to deliverance

Peter Dunne

Peter Dunne

Wellington, August 26, 2021

We also need honest notification of facts

A certainty during the daily propaganda sessions that have returned since the latest Level 4 lockdown began has been the plethora of statistics released by the Director-General of Health. From the number of new cases, the clusters to which they belong, the places of interest they may have been, through to how many persons might have been exposed to the virus at those sites, the figures serve a useful, if at times confusing purpose.

Information vs reality 

They provide an overview of the scope of what is happening, but in a way that reinforces the crisis, officialdom is keen for us to appreciate. More deviously, in areas such as numbers of tests carried or vaccination rates (often lumped together with vaccination bookings) they create an impression of the organised roll-out of a well-developed government plan, quite at variance with reality.

Often contained within these figures is arguably the most important one of all – the numbers of people being hospitalised as a result of contracting the virus. But it is frequently one of the least commented on and under-reported. Yet it may be the best marker of the impact the virus is having on the community.

According to the latest figures from the Ministry of Health, just 148 people have been hospitalised in New Zealand for Covid-19, since the first case became known here in February 2020. Nineteen of these patients have ended up in intensive Care Units.

Since the outbreak of the Delta variant in Auckland a couple of weeks ago, 12 people have been admitted to hospital with one form of Covid-19 or another, and so far, none have needed to be placed in Intensive Care.

Control and Prevention like any other

The relevance of the hospitalisation figures is becoming even greater as our slow vaccination rate improves. Already medical experts are saying that for people who have been vaccinated and contract the otherwise virulent Delta variant the impact will be more akin to a heavy cold, and they are extremely unlikely to die as a result.

Officials from the United States Food and Drug Administration and the Centre for Disease Control and Prevention have speculated Covid-19 is likely to end up no different from other infectious diseases that sicken people but can be controlled through vaccines and drugs.

That scenario may be some time off yet for New Zealand.

However, it highlights current international thinking – for example, epidemiologists at the Boston University School of Public Health are already saying the most realistic outcome of the current crisis will be to establish a level of community immunity so that most people who get Covid-19 in the future experience no more than the equivalent of a bad cold.

Hospitalisation statistics

This also points the way for a future approach based on securing the wellbeing of those identified as most at risk of becoming seriously ill from Covid-19 and following vaccination, leaving the rest of the population to get on with life.

This is where the hospitalisation figure assumes its real importance, both as an indicator of those seriously at risk from the virus, and of the true danger its spread poses to the wider community. Over the last eighteen months, one of the most puzzling aspects of Covid-19 in New Zealand has been that the number of serious cases requiring hospitalisation has been comparatively light.

Neither the number of hospital admissions nor the projections of likely levels of community cases have lived up to some of the gloomy predictions made throughout that time.

This is not because of the restrictions put in place to control the pandemic or the measure of luck we seem to have been blessed with so far. Rather, it is far more likely due to our geographic isolation and the sparse dispersal of the population throughout our country.

That certainly explains both the prevalence of cases that have been identified being in Auckland, our most concentrated population centre and the generally low level of cases in the South Island.

Elimination impossible

With most other countries, including notably now Australia, moving on from the elimination strategy we continue to adhere to so slavishly, it is going to become increasingly impossible for us to keep the virus out of New Zealand unless we are prepared to shut our borders completely and in perpetuity.

That would mean absolutely nothing – people (including New Zealanders seeking to return home), exports, imports, ships and aircraft – entering or leaving New Zealand, an impractical situation. The notion that New Zealanders are somehow physiologically and epidemiologically so different from almost the entire rest of the world that a strategy that has worked nowhere else will work here is simply blinkered and delusional.

Reducing risk 

As more and more New Zealanders become vaccinated, the potential risk of the virus to our country will diminish significantly. So, we must start focusing our Covid-19 response far more on protecting the most vulnerable, and therefore likely to be at the greatest risk of requiring hospitalisation, rather than continuing to spread our resources thinly across the whole population and putting intrusive restrictions on the lives of the vast majority of the population never likely to be negatively impacted by Covid-19.

The good news – to quote the government’s sickening pet phrase for starting the daily flow of propaganda – is that low levels of hospitalisation since the start of the pandemic, now bolstered by improving vaccination rates, mean that we are in a strong position to take this approach, without compromising the wider safety of the community.

All we need is the political will to face the facts and do so.

The Covid-19 hospitalisation figure should be the first figure published every day.

It should neither be hidden nor downplayed. We ought to be celebrating how small it has been so far and focusing our primary effort on keeping it low by using it as the key driver for the development of future policy, not merely treating it as an incidental extra as we have been.       

Peter Dunne is a former Minister of the Crown under the Labour and National governments from November 2008 to September 2017. He lives in Wellington. 

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