100 days without Covid spread and what comes next
New Zealand is today poised to mark 100 days without community transmission of Covid-19. From the first known case imported into New Zealand on February 26 to the last case of community transmission detected on May 1, elimination took 65 days.
We relied on three types of measures to get rid of the virus: ongoing border controls, a lockdown and physical distancing to stop community transmission, and case-based controls using testing, contact tracing and quarantine.
These measures have achieved low case numbers and deaths compared with high-income countries in Europe and North America that pursued a suppression strategy.
New Zealand is one of a small number of jurisdictions — including mainland China, Hong Kong, Taiwan, South Korea, Vietnam, Mongolia, Australia and Fiji — pursuing Covid-19 containment or elimination. Most have had new outbreaks. Taiwan, Mongolia, Fiji and New Zealand are the exceptions.
Australia adopted very similar responses to the pandemic and most states and territories are in the same position as New Zealand. But Victoria and, to a lesser extent, New South Wales are seeing a resurgence.
The key difference is that New
Zealand committed early to a clearly articulated elimination strategy and pursued it aggressively. An intense lockdown proved highly effective at rapidly extinguishing the virus.
New Zealand has the lowest Covid19 death rate in the OECD at just four deaths per million people.
Elimination of the virus allowed New Zealand to return to near-normal fairly rapidly and minimised economic damage compared with Australia. But the economic impact is likely to keep playing out in the months ahead.
Getting through pandemic
We have gained a much better understanding of Covid-19 in the past eight months. Without effective control measures, it is likely to continue to spread globally for months to years, infecting billions and killing millions. The proportion of infected people who die is slightly below 1 per cent.
This infection also causes serious long-term consequences for some survivors. The largest uncertainties involve immunity to this virus, whether it can develop from ex
posure to infection or vaccines, and if it is long-lasting. The potential for treatment with antivirals and other therapeutics is also still uncertain.
This knowledge reinforces the huge benefits of sustaining elimination. If New Zealand were to experience widespread Covid-19 transmission, the impact on Ma¯ori and Pasifika could be catastrophic.
Critical measures to get us through this period include the use of fabric face masks, improving contact tracing with suitable digital tools, applying a science-based approach to border management, and the need for a dedicated national health agency.
Maintaining elimination depends on adopting a strategic approach to keep the risk of Covid-19 outbreaks at a low level. Several measures can contribute to this goal while also allowing incremental increases in international travel:
● Resurgence planning for a bordercontrol failure and outbreaks with state-of-the-art contact tracing and an upgraded alert level system.
● Ensuring all New Zealanders own a reusable fabric face mask with their use built into the alert level system.
● Conducting exercises and simulations to test outbreak management procedures, possibly including “mass masking days” to engage the public.
● Exploring processes to allow quarantine-free travel between areas free of Covid-19, notably various Pacific Islands, Tasmania and Taiwan.
● Planning for carefully managed inbound travel by key long-term visitor groups such as tertiary students who would generally still need managed quarantine.
Building back better
New Zealand cannot change the reality of the global pandemic. But it can leverage possible benefits. A recent Massey University survey suggests seven out of 10 New Zealanders support a green recovery approach. We should also conduct an inquiry into the Covid-19 response so we can improve our future response capacity.
Crucially, we need to establish a
specialised national agency to manage serious threats to public health and provide critical mass to advance public health generally. Such an agency appears to have been a key factor in the success of Taiwan, which avoided a costly lockdown entirely.
Business as usual should not be an option for the recovery phase.
— Michael Baker is a professor of public health, Amanda Kvalsvig is a senior research fellow and Nick Wilson is a professor of public health, all at the University of Otago.