A next-level Covid strategy
We’ve been successful in containing Covid-19. Now what? Susan Edmunds hears perspectives from science, economics, business and politics.
Thanks to our bubbles and levels, lockdowns and distancing, New Zealand has been hailed as a world leader in responding to Covid-19. We now have zero active community cases of the virus and are operating at alert level 1 again.
The economy is in better shape than many initially feared and the death rate is the lowest in the OECD.
But a growing number of people are asking: What now? There are concerns that many retail and hospitality businesses in particular could not cope with another lockdown, and the Government’s ability to support the country through them has limits.
Businesses have received $14 billion in wage subsidies so far.
A new government is set to be installed within weeks, leaving some wondering whether the Covid-19 strategy will change in the months ahead.
The Government has so far been pursuing ‘‘elimination’’ to stop the transmission of Covid-19 in New Zealand.
That does not mean eradicating the virus but being confident that chains of transmission in the community are stopped and future imported cases can be contained. Epidemiologist Professor Michael Baker says this is the approach we are likely to take for the ‘‘foreseeable future’’ and it should remain effective and sustainable, with fine-tuning.
Some safety measures – such as masks on buses – could become a permanent fixture in winter months.
But at some point, New Zealand could consider a shift in direction.
As a vaccine and better treatment are developed over the next year, we should be able to switch to a suppression approach.
‘‘This shift would be a highly considered and planned change subject to the availability of effective vaccines and/or therapeutics to protect public health and the economy in New Zealand,’’ Baker says.
‘‘The most likely scenario is that it eventually becomes just another coronavirus that’s established in human populations – it will become a manageable threat, maybe in the realm of something like influenza.
‘‘It’s still not a trivial illness but at that point there would be no need to adopt an elimination model where you don’t tolerate any transmission in the country at all.’’
But he says it will be important to be more strategic and less reactive to the virus.
A high-level Covid-19 science council and national public health agency should be established, he says, to debate the best way forward and deliver it, and provide better data for the public on how the strategy is working.
More investment in scientists developing more efficient ways of testing and managing the country’s response would also pay off, and there should be a post-election official inquiry into the response to date.
Baker says elimination is the dominant goal of the Asia-Pacific region.
New Zealanders hear a lot about what Europe and the United States are doing, but they are in a different position because they did not assess the risk rapidly enough, he says.
Baker says there is still strong community support for an elimination strategy. ‘‘People say it’s expensive and has negative effects but compared with what? Where would you rather be?’’
He says New Zealand has built up a reputation of being a good risk manager, which could be valuable for this country in the future.
‘‘What are we doing to build on that? We are spending $1 million or $2m a day on testing. If you spent one day’s budget on funding scientists to work out how to do it more efficiently you could probably save a large portion of that spending.’’
ACT leader David Seymour wants to see a change of attitude, so that we are no longer focusing on being fearful of the virus or grateful for our position compared to the worst cases in the world.
He says the strategy should be to ask each day: ‘‘What is possible today that wasn’t yesterday?’’
New Zealand is comfortable with people flying between the North and South islands.
‘‘What’s so special about the North Island – or the South Island – that’s different from Western Australia, for example?’’
He says better adoption of technology would also help New Zealanders live a more normal lifestyle. The official Covid tracing app still has about 1 million scans a day, a figure that dipped towards the end of last week, which Seymour says indicates a low chance of anyone with the virus recording a visit.
Working with the private sector on contact tracing could be a good move.
‘‘If we had Bluetooth contact tracing, the last outbreak would have been a non-issue,’’ Seymour says.
The focus must shift to maintaining an R rate – that is the measure of the number of people one infected person passes the virus on to – of less than one, and isolating cases as they arose.
Shutting New Zealand off from the rest of the world is not sustainable and going into lockdown at every outbreak will also not be a long-term strategy, he says. Thought should be given to allow the private sector to play a part in managing international arrivals.
National has pledged to establish a border protection agency to manage Covid-19 at the border and requiring international travellers to provide evidence of a negative test before they arrive in New Zealand.
It also says it would invest and seek to rapidly deploy Bluetooth technologies to enhance contact tracing, making these mandatory for border facility workers and district health board staff who treat or test patients
Health spokesman Shane Reti says National recognises the need to also prepare a second line of defence, behind our border, so any incursions can be identified, traced and isolated quickly.
‘‘The first line of defence must be strong border management, but a high-quality contact tracing system is a vital second line,’’ he says.
‘‘With strong contact tracing systems and a more sophisticated testing and compliance structure we can minimise the impact of further incursions and protect those vulnerable to the disease.’’
Infometrics chief forecaster Gareth Kiernan expects to see the development of a clearer process to allow selected workers into the country to help a range of industries suffering from skill shortages or a lack of willing workers.
‘‘If National won the election, moves in that direction would probably occur more quickly than under Labour. The latter is likely to place greater emphasis on better training and utilisation of New Zealanders first, particularly if unemployment rises further from current levels.’’
Independent economist Shamubeel Eaqub says the way forward will depend on the summer months, which are critical for tourism.
‘‘I think the Government can and should consider a voucher programme, as rolled out in many OECD countries, to encourage staycationing and domestic tourism.’’
He says there should also be practical flexibility in quarantine facilities to allow international students in and gradually introduce air bridges with ‘‘health passports’’ to ease international connections.
‘‘I think the strategy is more of an evolution (our testing and tracing is now gold standard)
‘‘The most likely scenario is that it eventually becomes just another coronavirus ... a manageable threat.’’
Professor Michael Baker
allowing us to take more calculated risks.’’
Michael Barnett, chief executive of the Auckland Chamber of Commerce, says there’s an acceptance in the Government and from business that there will not be ‘‘business as usual’’ any time soon.
‘‘Business is having to change how it does business. I think [the] Government should be looking closely at how they provide the platform on which business operates... the policies they have, the support they have.’’
Businesses can understand there might be future lockdowns, he says, but they could be enacted differently.
‘‘You’ve had the Government saying supermarkets can open but the butcher can’t. Instead of saying who can and can’t, the Government might look at what’s the environment in which you could operate and then have businesses comply. Rather than just using a sledgehammer, they might look at a tack hammer.’’
Focused lockdowns covering smaller affected regions would help, he says.
‘‘If business knew that was going to happen then that’s a reward for them and they might encourage everyone who comes in to use the QR code.’’
Health Minister Chris Hipkins says there is no plan to shift the strategy from elimination. ‘‘With our approach, we have twice successfully contained the virus, have low rates of infection and death and have more businesses open,’’ he says.
‘‘Since the start of the year, we have stood up a national contact tracing centre, which consistently delivers gold standard contact tracing results within 48 hours; have set up world-class quarantine and isolation facilities and have one of the strongest border-protection regimes in the world.
‘‘The Covid-19 Tracer App has also been extremely useful –particularly during the Christchurch returnees cluster, when we were able to use data it had captured to move quickly to prevent the spread of cases – and we will continue to trial and test other technology.
‘‘Our strategy of a strong health approach, constant improvement, a high degree of planning for any resurgence, stress testing the systems and regular advice from the Technical Advisory Group, made up of experts and scientists, improves our chances of avoiding or minimising the kinds of hard and extended lockdown we are seeing overseas.’’
Hipkins says suppression strategies around the world have led to surges in case numbers and the need for restrictions.
‘‘Our second wave saw short-term restrictions and now a return to level 1, and our resurgence plan is focused on stamping out limited cases quickly.
‘‘A suppression strategy with regular cases would likely mean ongoing restrictions which would be worse for health and the economy. The Government remains particularly concerned about the impact it would have on vulnerable communities, such as Ma¯ori and Pasifika and the elderly.’’
Hipkins says transparency is vital for the process and the Government has been reporting publicly on all aspects of cases and testing.
Publicity campaigns will continue, he says, and would balance key messages in different contexts with an acknowledgement of the risk of ‘‘information fatigue’’ from the public.
Treasury data shows economic activity at the various alert levels was higher than expected, he says. And the impact on economic activity is falling as the efficiency of the Government’s strategy improves.
Each outbreak is contained faster, with fewer health restrictions and more of the economy open.
‘‘So within our overarching strategy, yes, there will constantly be changes.
‘‘There was no playbook for Covid and so it’s natural that we make improvements and advancements as we progress, for example to regional measures and support and to our contact tracing and testing processes.’’