Tristram Ingham

Our Covid ‘bubble man’

‘You must be super rich now because you’re famous.’’

This announcement was news to Dr Tristram Ingham, but according to his nephew it couldn’t be any other way. ‘‘You’re the bubble man!’’

Eight-year-old Coen is right – about one of those things, at least. Ingham is the brains behind the bubble, the man who came up with the concept that defined New Zealand’s coronavirus public health messaging.

It’s weird being the ‘‘bubble man’’, the University of Otago researcher says. ‘‘I’m not into being known.’’

As the country locked down in March, bubbles quickly became synonymous with staying safe. The idea was simple to understand, which Ingham guesses was what made it go global.

‘‘That was what it was about – how do you get someone like Coen, who’s not really into public health, to know what to do?’’

And so the bubble was born. Simple, easy to visualise, ‘‘inherently beautiful but fragile’’.

It did away with the jargon of public health and quickly became embedded in our collective Covid consciousness. Ingham was looking for something that would keep the disabled community safe, but autonomy had to be central.

You build your bubble, you decide who is in it, and ‘‘you could pop the bubble if you didn’t look after it’’.

Ingham is a senior research fellow in the department of medicine at the University of Otago, Wellington. With a clinical background and experience working in the disability sector, he was drafted in by the Ministry of Health to advise on its Covid-19 response for disabled communities.

Ingham is himself disabled, a wheelchair-user living with muscular dystrophy.

He knew the messaging for the disabled community had to be empowering. This was the point when the country was teetering on the edge of level 4: rumours of lockdown swirled, lines snaked around supermarket car parks, and shelves were ransacked of toilet paper as quickly as they were stocked.

Anxiety was high for everyone, but especially for people with disabilities. There was a lot of fear about whether carers would be available, and how vulnerable clients could be kept safe from infection, Ingham explains.

‘‘Build your bubble’’ was the answer he pitched to the ministry. It went alongside messages like ‘‘don’t be scared, be prepared’’ and aligned with the concept of hibernation. The idea was ‘‘you didn’t have to wait for the tidal wave to come, you could do something.

‘‘Effectively it was a social contract with people, a set of rules you negotiated with family members or housemates.’’

It was particularly useful for disabled people thinking about getting the right care situations in place, Ingham says – himself included.

He cancelled his usual carers, knowing they brought with them the risk of infection.

His daughter-in-law lives down the road, so she became part of their bubble, helping with tasks like meal prep. But with her child and the child’s other set of grandparents also in the picture – one of whom was an essential worker – building their bubble was tricky.

In the end the grandparents isolated from each other, even sleeping in separate rooms so the grandmother could be part of the child’s bubble while the grandfather continued working. Negotiating that was made a lot easier by the idea of protecting their bubbles, Ingham says.

But he doesn’t shy away from the reality of those weeks trapped at home, without carers or support networks, with supermarkets stripped of the basics, online delivery slots impossible to secure and no PPE. ‘‘Lockdown was pretty traumatic.’’

Ingham lives with his wife Bernadette Jones in Wellington. They’ve been together since 2011, after meeting through their work at the University of Otago. They also worked together through lockdown. It was non-stop. ‘‘The concept of weekends became meaningless.’’

Working with the Disability Rights Commissioner and the Office for Disability Issues, Ingham was feeding back from the disability community to government, developing messages and policy ‘‘as fast as we could’’.

In the heat of Covid, he helped achieve things in the disability sector for which people had been advocating for years. All of a sudden, disabled people were given the autonomy they’d been asking for, as criteria were loosened for things such as what disability support money could be spent on.

Now the ‘‘million-dollar question’’ is whether the red tape will be tightened again. ‘‘There’s a real sense that these changes need to continue,’’ Ingham says.

While he was busy throughout lockdown, undeniably it’s the flash of inspiration he had beforehand that has become his most well-known work. The first time he heard Prime Minister Jacinda Ardern talk about bubbles there was a moment of disbelief: ‘‘I was like, did we really come up with that, or have I just heard that somewhere?’’

Before long, the bubble was everywhere: in headlines, cartoons, the PM’s daily briefing and talk of the trans-Tasman bubble. Then it was adopted overseas, popping up in Boris Johnson’s press conferences, Fox News bulletins. Even in Germany there was talk of ‘‘Blasen’’ or ‘‘die Bubble’’.

It’s quite a lot for someone whose interests lie in tackling inequity, not making headlines. As a researcher, Ingham’s focus is on equity for Ma¯ ori and disabled communities, and in particular ta¯ ngata whaikaha, or Ma¯ ori disabled.

He’s always had a deep-rooted sense of fairness. ‘‘Even watching TV programmes where the bad guys seem to be winning, I hate that.

‘‘It’s a bit trite to say you like helping people but I do. I get a lot of vicarious pleasure from seeing other people benefit.’’

Ingham started in clinical medicine, but felt ‘‘like the ambulance at the bottom of the cliff’’. ‘‘I went into research to try to build the fence at the top of the cliff. To an extent I have been able to do that by shining a light on inequities.’’

From his early high school days, he was set on going into medicine, but it was a second-choice career. What he really wanted to do was fly.

Unfortunately, his disability meant becoming a commercial pilot wasn’t on the cards. As a teenager, he got his private pilot’s licence through Scouts, and then left the career in aviation to his younger sister.

Medicine was always there, though: ‘‘Growing up with a disability you have a heightened awareness of your body and how it functions and a sense of wanting to learn how to fix problems.’’

The 47-year-old grew up in the eastern suburbs of Auckland before moving to Dunedin to study medicine. From there, he landed a job at Capital & Coast DHB and then moved to a research role at Otago University, in Wellington, where he’s been since.

Ingham also chairs the Muscular Dystrophy Association of New Zealand , sits on DHB disability advisory committees and advises Wellington City Council on accessibility. Most recently, he’s been involved with My Life – My Voice charitable trust, working with the ministry on providing disability support that is disabledperson led.

Too often, a disabled person’s voice is not at the table, he says, ‘‘or if it is it’s not given the volume it needs’’. He talks of being at a high-level government meeting where a service provider turned around and said while they didn’t mind ‘‘asking’’ disabled people what they wanted, ‘‘we certainly don’t want them on our committee – we want people with skills’’.

Being the only disabled person in the room, that was horrifying, he says.

It’s just one instance of battling against a society that refuses to see how ableist it is, he says. The needs of the disabled community are seen as a ‘‘nice to have’’, not a ‘‘need to have’’. But while the disabled community is spoken about as if it’s niche or marginalised, it makes up as much as a quarter of the population, according to the Office for Disability Issues.

While Ingham has transitioned back to his day job now, he hasn’t put Covid behind him; there’s now a lot of interest academically in what lessons can be learnt and what happened to the disability voice during the pandemic. Covid ‘‘ripped the Band-Aid off the festering sore of inequity in New Zealand’’, he says. How well it will be patched up is another of those million-dollar questions.

As for Ingham’s own millions, he’s yet to get his ‘‘bubble man’’ cheque in the post. Coen, however, is pretty sure he’s hiding something: ‘‘I know you’re really rich because your toilet’s really shiny!’’

‘‘I went into research to try to build the fence at the top of the cliff.’’