Why don’t we offer the second booster to all?

Last week I told an audience that, for most people, post-pandemic life was harder than it was pre-pandemic. The cost of living only ever goes one way, and poor health and disruptions to education and work have made many people’s lives hell in the past 11 months.

I thought that was a mundane observation, the kind of talking point people roll out in ordinary conversation. But someone in the audience corrected me. We’re not ‘‘post-pandemic’’.

The Ministry of Health issued modelling data last week which suggests the possibility of 11,000 new daily cases and at least 100 hospitalisations a day in the summer peak if new variants drive a third wave. That mirrors the infection rate during July’s winter peak. Clinically, then, Covid19 still exists.

Socially, too, the virus will continue imposing a burden on personal and work lives. Only politically, the audience member pointed out, could we consider a world that is ‘‘post-pandemic’’.

And he didn’t mean this in a good way. Despite the aforementioned infection rate scenario, New Zealand’s protection measures remain nearly nonexistent. Queensland’s state government is shifting from its green traffic light setting to amber, strongly recommending mask use indoors, on public transport, and anywhere social distancing isn’t possible. Of course, New Zealand no longer maintains a traffic light system, relying on people to make personal risk assessments.

Perhaps that is all well and good, but even making a personal risk assessment is difficult when the ministry publishes a Covid-19 update only once a week, though it still publishes daily case information online. By the time you know your area might be entering a surge it’s possibly a week too late. Even access to vaccines in New Zealand – our first and best defence against serious illness – is unreliable, with a second booster not universally available. An Omicron-specific booster is not expected to be available until next year.

On that measure New Zealand is something of an outlier. In Australia adults over 30 can access a second booster. Admittedly, this is partly a question of finance and capacity. Australia is an exceptionally rich country, and its health system is in slightly better shape than New Zealand’s.

In 2021 the Government led a brilliant vaccination campaign, but our system struggles with capacity issues, with many vaccine providers struggling to reach rural communities, Māori, and young people. Yet the ministry reassured the Government that lessons were learned.

We can take it at its word, and with that in mind we could demand: why not a second booster for everyone who wants it? That seems like an easy win for the Government, but so far only those aged over 50 (except for Māori and Pacific peoples), people who work in healthcare, or the immunocompromised can access a second booster.

What makes universal access to a second booster an easy win is that it doesn’t require enforcement. Mask mandates, especially on public transport and in healthcare settings, are effective at reducing transmission, but they require either the goodwill of the mask wearer or someone to enforce the mandate when someone refuses to wear one in bad faith.

That places bus drivers, train conductors, and others in awkward positions. As a bus driver your first duty is to drive, not police passengers. Who can be bothered having a hundred little arguments with creepy anti-maskers? But universal access to a second booster is uncontroversial because it doesn’t require anyone to enforce it. You can either choose to take it up or choose not to. Whatever choice you make is yours.

The aim of Covid-19 protections, whether it was 2020’s alert level system or 2021’s traffic light system, was to prevent the health system’s collapse. In practical terms, that meant preventing serious disease.

In 2020 our only tools for doing so were lockdowns, social distancing, and masking. In 2021, we added vaccines to the toolbox. This year we rely on vaccines and immunity from prior infection.

The thinking is that a booster and a prior infection offer good protection against serious disease if you’re unlucky and catch another infection. This is true enough. But it ignores how approximately one-third of New Zealanders probably haven’t caught Covid-19 (in August roughly a third of the country had reported an infection, another third had probably caught an infection and not reported it or were asymptomatic, and the final third were yet to catch an infection). What about them?

It’s not too late to widen access to boosters, and if it prevents one hospitalisation a day out of the forecast 100 then that is a victory.

New Zealand’s protection measures remain nearly nonexistent.