New Zealand’s current coronavirus border policies fail to reflect the current Northern Hemisphere surge in cases and the consequent enhanced risks to COVID-19 management in New Zealand
There are big contradictions within New Zealand’s coronavirus border policies. There is potential for these contradictions to become more serious with Northern Hemisphere COVID-19 levels now exponentiating upwards again.
Prime Minister Ardern has been saying in recent weeks that there is a high likelihood of further outbreaks in New Zealand and that New Zealanders must be ready for it. What we are not hearing is official acknowledgement that as the Northern Hemisphere approaches its winter, the risks are highly likely to increase further.
Given that new outbreaks are already to be expected, then the situation is not under control. Without further actions, the prospects are going to further deteriorate.
A quick analysis of worldometer data shows that the seven-day case rate in the United Kingdom is now five times what it was in July, and clearly on an exponential trail. Gatherings are now restricted to six people.
In France, the seven-day rolling average is now 20 times what it dropped to in June. Spain’s daily rate, with new restrictions now in place, is still more than ten times what it was back in June.
Germany, Switzerland, the Netherlands, Belgium and almost everywhere else in Europe are now also on strong upward curves although not always as dramatically as the aforementioned countries. Almost everywhere it is coming again. There are no readily acceptable solutions for Europe.
The American situation is more complex, with the overall pattern being influenced by the recent declines in the Sunbelt States. However, at least half of American States are back on an upward curve.
As for Asia and much of South America, it is clear that case rates are currently at record levels. In India, the daily recorded new case rate now exceeds 100,000 on most days, with the real rate undoubtedly much higher. In Indonesia, the capital Jakarta is back in lockdown with the heath system buckling.
Quite simply the proportion of travellers arriving in New Zealand who can be expected to test positive is on the rise. And therein lies the problem. The more travellers who are carrying the disease, then the greater the risk of an outbreak.
When things go wrong, the tendency is to blame operational mistakes. The reality is that such mistakes always occur in large scale operations. The New Zealand border operation, with between 400 and 500 people entering on most days, is very large scale. Yes, mistakes will happen.
We have learned many things over the last six months both from our own New Zealand experience and also by looking overseas. First, we learned that Level Four restrictions, combined with most Kiwis playing their part in the Team of Five Million, really do work. Second, we are learning right now that it is much harder to shut down an outbreak under Levels Three and Two. Also, there is considerable evidence of fatigue and frustration developing in relation to acceptance of COVID-19 restrictions.
The current Auckland outbreak is now closing in on 180 cases, all coming from a single escape episode of the COVID-19 organism. It has created a cluster approximately twice the size of any of the prior clusters, and it is still propagating. The national cost of that one escape of the organism will clearly be in the billions of dollars, plus great human cost.
Going forward, and now knowing what we do, combined with increasing difficulties getting everyone to play their part in the Team of Five Million as grumpiness and frustration increase, then surely we need to take renewed assessment of the situation.
Most of the people currently arriving in New Zealand come from Australia. Clearly these people need to go into managed isolation, but there is also a need to recognise that the risk from each of these persons is much lower than from almost everywhere else in the world.
So, this is not to argue for any relaxation in relation to Australia. But it is to argue that each person people coming from most other parts of the world needs to be assumed as being individually infectious and managed accordingly, and hence go into the highest level of quarantine until proven otherwise.
Currently there are two operational levels of isolation in New Zealand. There is the standard level which people go into when they arrive in New Zealand on the assumption that they are most likely negative for the disease. Then there is the higher level of isolation for people who are demonstrated to be infected. The argument here is that if the risks from people arriving from Europe, Asia and the Americas are to be minimised, then each person arriving from these regions has to be assumed as infected, and hence go into full quarantine, until proven otherwise. That may well reduce the numbers that can be accepted each day.
It is now increasingly evident that the next six months are going to be critical. By March 2021, or maybe earlier, it will be evident as to whether a successful vaccine has been or is going to be developed. Timelines for the rollout should be known. In the interim, New Zealand cannot afford an ongoing series of outbreaks like the present Auckland outbreak that has shut down much of the economy and normal life across the country.
If there is no success in developing a vaccine within the next six months – and personally I am putting considerable hope in the Moderna vaccine based on messenger RNA (mRNA), but it could be another vaccine – then that will be the time when alternative strategies will be needed. One way or another, it is reasonable to expect increasing clarity well before that.
Our Prime Minister has been adamant that all New Zealand citizens have a right to come back to New Zealand. As a general principle, that cannot be argued against. It is a legal fact. However, there are many basic rights that have to be constrained for the greater good. For example, all New Zealanders have the fundamental right to travel freely within New Zealand, but most have accepted restrictions on internal travel for much of the last six months in the interests of that greater good.
Something else we have also learned over the last six months is that the New Zealand export economy, apart from the service industries of tourism and education, is remarkably resilient. New Zealand has shown that it can survive and indeed prosper without people criss-crossing the world all of the time, as long as cargo continues to flow, in the same way that it has been doing.
If New Zealand could get back to Level One, and stay there with extra tight borders from all high-risk regions of the world, then Government could focus on the specific groups who are disadvantaged, with the rest of the economy humming along.
The one country that I have purposefully not mentioned until now is China. Although some people are reluctant to acknowledge it, the evidence is clear that China has an exceptionally low level of COVID-19 relative to its population.
If matters were a simple case of logic, then people arriving from China would be treated like those coming from Australia, and placed in the current level of managed isolation. However, sometimes it can be too much to ask that decisions are made only on logic.
Seasonal workers from the Pacific Islands are also low risk. The existing isolation rules would seem appropriate for them, with similar isolation perhaps being appropriate before they return to their Pacific Island homes, depending on New Zealand’s COVID situation at that time. I have long been an advocate for seasonal work schemes for Pacific Islanders, ever since undertaking investigations on behalf of the Australian Government more than 20 years ago. These schemes are not just for the benefit of New Zealand (or Australia), but as the best way to stimulate bottom-up development in the Island communities. It is win-win.
At the risk of repetition, there is a need to emphasise that the suggestion here is not to exclude New Zealand citizens. Nor is it to argue against the compassionate needs of people caught outside the country who, for various reasons, do not currently have citizenship or permanent citizenship, but were on that pathway when caught outside the country.
Rather, what is being suggested is that restrictions on people entering New Zealand have to be proportional to the specific risk. Also, it is very clear that the risks associated with people from some parts of the world are many times greater than those coming from some other regions such as Australia and most of the Pacific Islands.
So, the argument is not to loosen the requirements for those coming from Australia or any other similarly low risk regions, but to increase the level of management for those coming from higher risk parts of the world. That might include daily monitoring of those from high-risk regions in the initial period following release from quarantine so as to minimise the risks from false negatives. However, the biggest risk may will be from quarantine-management staff who are in contact with returnees while the returnees are in quarantine. Unfortunately, all of these factors emphasise the reality that the number of high-risk returnees does need to be constrained.
If New Zealand continues with its current systems, then there are two scenarios. New Zealand may succeed in keeping out COVID-19 through a combination of luck and good management. Alternatively, New Zealand may go the way of Victoria with one or more further outbreaks and never succeed getting back to Level One. That would be a real disaster.
Of course, there are some who say that we have to learn to live with this virus. That may indeed be what does finally happen. But in making such judgments it is important to acknowledge the mayhem and death associated with that policy.
One of the bigger flaws is to use Sweden as an example of living with the virus. The reality is that life in Sweden is far from normal. It is just that to a considerable extent they rely on voluntary actions rather than compulsion. However, Sweden does still have restrictions on social gatherings and sporting events, and Sweden does have one of the higher COVID death rates, more than 100 times higher per capita than New Zealand.
To those who say it is only old people who die, it is worth noting that there are now more than 7000 individually identified cases of health workers across the globe who have paid the extreme sacrifice. This is nothing like the seasonal flu. Britain alone has lost over 600 healthcare workers and the USA more than 1000. And all of this was despite lockdowns. If countries are forced to live with the virus then it is not going to be pretty.
I have a reasonable international network, including regular internet chats with my own university and high school cohorts from many years ago, who laid down their roots widely across the world. They and other international folk that I have met on the journey of life keep telling tell me how lucky we are here in New Zealand.
I sometimes wonder whether my international friends will still be saying the same thing in another six months. I think many of us Kiwis have had our confidence dented by the last six weeks. The evidential need is for amended policies that are proactive, not just reactive, and which reflect New Zealand’s unique situation.