Why Government can't drive Covid strategy by looking backwards

Roger Partridge
NZ Herald
1 September, 2021

Unless you're reversing, the rear-view mirror won't help you navigate the conditions in front of you. Instead, you must look ahead. For a successful trip, you should also know where you want to end up.

What is true for handling driving conditions is also true for responding to a tricky virus. New Zealand's elimination strategy in 2020 was spectacularly successful. But with Delta and vaccinations the terrain has changed. Looking back at what worked on the early part of the Covid journey may not help with what is in front of us now.

Indeed, looking backwards is a big part of New Zealand’s current predicament. The puttering start to the vaccine rollout while other countries sped ahead. The obvious shortcomings with our managed isolation and quarantine facilities. The Ministry of Health’s failure to stress-test its contact tracing capabilities or even develop workable Bluetooth tracing capability. And the constant repetition of tired slogans from 2020. All this smacks of excessive satisfaction with past success.

The same could be said of the willingness of Minister of Finance Grant Robertson to apply chunks of the $50 billion earmarked for Covid response and recovery to non-Covid related spending. After triumphing on the first leg, Robertson took his eyes off the costly potholes ahead.

If the Government believed that 170 Covid-free days meant it had conquered Covid, the past fortnight has shattered that illusion.

Yet even as the Government announced the incursion of the Delta variant two weeks ago, it was looking backwards. The “short and sharp” lockdown the Prime Minister said she wanted on 17 August may have been enough pre-Delta. But it was never going to work against the more transmissible Delta strain of the virus. A longer lockdown was inevitable. For Auckland’s nearly two million residents, lockdown looks set to stretch on as long as the Level 3 and 4 lockdowns early last year.

What’s the destination?

The rear-view mirror is also impeding the direction of travel.

When Associate Health Minister Ayesha Verrall released the Government’s Covid Advisory Group report on 11 August, she endorsed the elimination strategy in place since March last year. Explaining that this meant a “zero tolerance” for new cases, Dr Verrall said the strategy “has served us incredibly well” by “stamping out cases when they do arise” with testing, contact tracing and lockdowns.

Looking backwards, elimination has served us well. And New Zealand’s low vaccination rates means the country has no feasible alternative but to use strict lockdowns to try to stamp out the current incursion.

But how sustainable is this strategy going forwards?

The scant remaining balance of the money allocated for Covid response and relief last year may not even meet the Minister of Finance’s obligations under the wage subsidy scheme for the current outbreak. Yet taxpayers can scarcely afford to borrow another $50 billion for relief from this lockdown – or another $50 billion for the next long lockdown after that.

The economic costs of lockdowns are not measured by the cost to the taxpayer alone. The real financial costs are to people’s livelihoods. Economist Michael Reddell calculates that last year’s lockdowns wiped $12 billion from GDP last year. The current lockdown will add billions more to that. Once again, business opportunities will disappear, firms will fail, and jobs will be lost.

Of course, much of the GDP hit in 2020 may have happened anyway, as it did in countries that did not impose lockdowns. And the Kiwi economy bounced back strongly last year, even if it did not make up the losses.

But the same tailwinds may not help the economy if businesses are faced with a never-ending prospect of lockdowns to support a zero-tolerance attitude to Covid going forward.  

Just as the financial costs of lockdown are cumulative, so too are the human costs. Curtailing freedoms comes at a high price. Medical appointments missed. Education foregone. Friends and families cut off from each other, even at times of acute emotional stress during births and bereavements. Even the loss of everyday recreational activities like a day at the beach or in the mountains takes a heavy toll.

On the benefits side, last year’s case for lockdowns has also changed. Vaccines, the prospect of which seemed like a pipe dream 12 months ago, have changed the Covid calculus. Though they may need regular boosting, vaccines are already responsible for plunging case fatality rates in countries with significant proportions of their populations immunised. Meanwhile, treatment options are now available that were not approved in early 2020.

Vaccination success was behind Britain’s “Freedom Day” on 18 July. Though derided in some quarters as “populist,” the criticisms of the UK’s approach may have more to do with the identity of Britain’s prime minister, Boris Johnson, than with the facts. Despite the Delta variant circulating widely in Britain since then, death rates have been about a tenth of pre-vaccination levels.

The same is true across Europe. So much so, that Denmark’s centre-left Government announced last week that it would lift all remaining Covid restrictions on 10 September. Denmark’s health ministry declared that high vaccination rates meant the virus was “no longer a critical threat to society.”

In 2020 Jacinda Ardern shared an Instagram post detailing her contact with Danish Prime Minister, Mette Frederiksen, to share ideas on Covid strategy. Unfortunately, the Ardern Government did not follow Frederickson’s lead by going “hard and early” with vaccinations.

No good options

There are no good options with Covid. But an elimination strategy that was undoubtedly optimal for the first part of the Covid journey, looks much harder to justify for the journey ahead.

A change of course would bring significant benefits. Families separated by the closed borders would have an opportunity to be reunited. Kiwis stranded overseas would have a better chance of returning. Businesses would be able to meet offshore customers and suppliers.

Travellers would need to be vaccinated – and have a negative test result before coming home – but this is no more than counties in Europe already require from international visitors.

More than that, a new course would mark an end of an authoritarian state that at times has seemed more willing to limit our liberty than to learn from its own mistakes.

There are signs the Government can see the road ahead requires a different approach. Last week, Covid-19 Response Minister Chris Hipkins raised concerns about the long-term future of the Government’s elimination plan. And last Thursday, the Prime Minister said elimination was the strategy “for now” but that it was not the Government’s intention to use lockdowns “forever.”

The country cannot change course until vaccination rates are high. New Zealand must vaccinate, vaccinate, vaccinate. To achieve this, the Government should adopt all the incentive schemes that are being used overseas to boost vaccination rates. Vaccine passports, vaccination requirements for critical occupations and even lotteries and giveaways are all tools that can help to bolster vaccination uptake.

The Government should also ensure this time New Zealand really is at the front of the queue for the booster shots that may be necessary in early 2022. It must also improve our contact tracing capabilities. And to improve Covid-surveillance, it must adopt the rapid and high-frequency testing used elsewhere in the world that provides results in hours or even minutes rather than days.

To guard against the next variant being even more virulent than Delta, the country will need backup plans – such as strengthening MIQ safety with purpose-built facilities. (Why haven’t they already been built?) The Government must also increase our health system’s woefully inadequate ICU capacity. New Zealand entered the pandemic with only a third of the OECD average level of intensive care beds per capita. Since then, nothing has changed. It must now.

Looking back, few Kiwis would have swapped their experience during the first year-and-a-bit of the pandemic with anyone else’s around the world.

But whether the road ahead requires the same approach is another matter. There are plenty of reasons for Kiwis to question both the driving and the direction of travel.

 

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