Is NZ winning world cup of Covid control?
How is our team of five million ranking so far on the global ladder? Of the rugby countries, the best comparison is with Ireland: both islands, accessible only by air, with similar populations. Ireland’s first case was reported on February 27, ours on the 28th. They implemented a ‘‘Stay at home’’ policy one day after New Zealand. Yet Ireland had, by May 12, suffered 23,242 confirmed cases (4707 per million of population) and 1488 deaths (301 per million). New Zealand had 1147 confirmed cases (233 per million) and 21 deaths (4 per million). Ireland had daily peaks of 1515 cases and 220 deaths.
On April 8, a major Dublin hospital reached ICU capacity, while a second hospital reported that 70 doctors and nurses had so far become infected. The median age of infected people in Ireland is 49, and only a quarter of cases are aged over 65.
The epidemic in Ireland is declining, but daily cases are still in the hundreds. The economic impact is shaping up to be at least as severe as here, with a Covid-adjusted unemployment rate for April of 28.2 per cent. Ireland implemented a financial response package quite similar to the New Zealand one.
Why have we done so much better? In summary, New Zealand has organised and managed its control strategy better. Our alert level system is well-designed, and has provided clear guidance on what was expected, with a high level of community compliance.
Testing capacity in Ireland was slow to match demand, and the director of the main laboratory admitted in April that he ‘‘misspoke’’ a month earlier when promising rapid escalation of testing capacity. Contact tracing appears much less effective than here, and the definition and investigation of clusters is not undertaken like it is here.
Complaints about lack of personal protective equipment are common in Ireland, and there have been far more infections in health workers. It has not imposed a travel ban or quarantined arriving travellers. The strong sense of community participation and co-operation in New Zealand seems weaker in Ireland.
Of the other rugby countries, South Africa has had 11,350 cases and, although it implemented an intensive lockdown (no alcohol), the outbreak is growing rapidly. As of May 12, Australia had reported 6964 cases and 97 deaths, making 273 cases and 4 deaths per million, but the less precise lockdown applied means a higher risk of a second wave as restrictions are eased.
France is further down the ladder, with 178,225 total cases and 414 deaths per million. The United Kingdom is at the bottom, with a poorly effective control programme. It reports 226,463 cases, and admits its death rate of 482 per million fails to count many deaths. Using an ‘‘excess mortality approach’’, the true rate is close to 700 per million.
Sweden, which is going the high-risk ‘‘herd immunity’’ route, is at 328 deaths per million and rising, whereas Denmark is emerging from lockdown with 91 deaths per million.
Of these countries (and perhaps all comparable countries), New Zealand is furthest along the track to achieving provisional freedom from Covid-19 (almost no cases, source of all cases identified) and then freedom (no cases for a defined period of time). This approach gets away from arguments about the meaning of ‘‘elimination’’.
The remaining risk is a resurgence of infection if we relax on the brink of success. We don’t need to get everything right, but we do need a package of actions applied with vigour until we get to the goal.
I spent time in two of the three West African countries involved in the large Ebola outbreak. The challenges were a thousand times worse, yet they achieved freedom from Ebola by intensive application of a similar programme, and have remained free. We just need to keep our focus on the goal.