Opinion: Taking a pandemic stocktake

At Labour’s annual conference last weekend, Covid-19 dominated Prime Minister Jacinda Ardern’s speech: “Our strong health response now gives us an economic head start, the ability to move from responding to Covid-19, to recovering and rebuilding… So today my ask of you is simple. Don’t put on the brakes when now more than ever is the time that we need to speed up… let’s keep up the momentum… Let’s keep rebuilding.”

The Prime Minister outlined the steps taken to help the economy recover from the hit caused when she imposed ‘the strictest constraints placed on New Zealanders in modern history’. A record $50 billion in borrowing has been providing wage subsidies, loan guarantees, job creation, re-training, and additional welfare support – leaving $20 billion of unallocated spending to ‘assist the recovery’.

While the generous funding pledges now being announced almost daily do not amount to “treating” under the Electoral Act, the scale and proximity to the election are most irregular.

With the PM pitching for a second term on the basis of her track record of managing the Covid-19 crisis, let’s do a quick stocktake of how the two main parties have responded to pandemics.

John Key’s National Government faced the swine flu pandemic in 2009, which affected 1.4 billion people world-wide and caused 600,000 deaths. Jacinda Ardern’s Labour Government has, of course, been dealing with Covid-19, which, at this stage, has 12 million notified cases and 550,000 deaths.

Swine flu is caused by the H1N1 influenza virus and the pandemic, which originated in Mexico, lasted for around 19 months. Altogether, it was estimated that of the 430,000 symptomatic cases of H1N1 in New Zealand, around 116,000 visited GPs, some 1,100 were hospitalised, and 119 patients were admitted to intensive care units. Of the forty-nine deaths attributed to the disease, 86 percent had underlying health complications, most notably, respiratory illnesses, obesity, and substance abuse.

To deal with the pandemic, the National Government adopted the Ministry of Health’s Influenza Pandemic Plan – a mitigation strategy designed to manage an outbreak in such a way as to prevent hospitals from becoming overwhelmed, whilst reducing the impact on society and the economy. While border controls were introduced, and some schools and businesses temporarily closed to reduce the spread of the disease, there was minimum economic and social disruption.

Fast-forward to 2020.

When reports of the spread of Covid-19 emerged in January, the Ministry of Health’s Influenza Pandemic Plan was again enacted. Border controls were introduced, work began on testing and tracing, and an Alert Level system was developed.

By mid-March, with fewer than 50 reported cases and no deaths, but more New Zealanders arriving home from infected areas, the Ministry of Health recommended that the country move to Alert Level 2 for a month. This involved stricter border controls, the introduction of social distancing and good hygiene measures, increased testing and tracing, a restriction on gatherings to 100 people, and a recommendation that those at the greatest risk from the disease – namely the elderly and anyone with underlying health conditions – take extra care.

Two days after introducing Level 2, the Prime Minister, warning of tens of thousands of deaths, ordered the country to Level 3 for two days, and then to Level 4 for a month.

This week’s NZCPR Guest Commentator former Cabinet Minister Barry Brill has analysed the Ardern Government’s response to the pandemic and reminds us how the Prime Minister over-rode the Ministry of Health’s recommendation for “a 30-day pause at Level 2” with her Captain’s Call to lock the country down:

“The Prime Minister impulsively chose to disregard this official advice and instead leaped to the world’s most masochist restrictions – the Lockdown – with the resounding battle-cry of ‘go hard, go early’, and hang the expense!

“Political instincts and theatre easily trumped all the evidence-based science. There was no cost-benefit analysis of any kind. The PM’s historic Captain’s Call was apparently influenced by alarming forecasts from three academic computer models – one from the Imperial College of London, one from Otago University, and one from Auckland University… In announcing her extreme Lockdown decision, Ms Ardern signalled that ‘the worst case scenario is simply intolerable’. All three unvalidated models have since been thoroughly discredited by both peer reviews and real-world events.”

Barry reminds us that in spite of the media and others treating the Prime Minister as a hero for keeping us safe, that is not the reality. He argues that Jacinda Ardern’s Lockdown was “the worst policy decision ever and almost surely resulted in a net loss of New Zealand lives… In retrospect, there is no evidence that our extreme Lockdown saved the life of a single New Zealander.”

We certainly know that in spite of the frail elderly being clearly identified as the group most vulnerable to Covid-19 – especially those in rest homes – Jacinda Ardern’s lockdown wasn’t able to keep them safe. Almost three-quarters of the country’s 22 deaths were of rest home residents.

While they died in spite of the lockdown, many other New Zealanders died as a result of the lockdown: mothers and babies lost their lives due to the disruption in regular health care; gravely ill people were too afraid of the virus to seek medical help from doctors or hospitals; suicides were triggered by financial ruin caused by the lockdown; cancer sufferers were unable to access life-saving tests, operations, and treatment.

Many deaths never made the headlines – like the case of a frail elderly gentleman with a chronically sore foot who lived alone but had friends who ensured he ate properly and took care of his foot. Without their support, by the end of the lockdown he had developed gangrene and died just a few weeks later – a victim of the lockdown.

Governing a country means carefully weighing up policies to ensure the damage caused by unintended consequences do not outweigh the benefits being sought. While government agencies usually provide Cost-Benefit Analyses and Regulatory Impact Statements to outline the pros and cons of policy options, as well as identifying costs and risks, Jacinda Ardern used no such analyses to inform her lockdown decision.

In fact, a new report from the OECD, which has analysed the effectiveness of the responses of various countries to the Covid-19 pandemic – not only in keeping infection and death rates low but also in minimising economic and social disruption – has ranked New Zealand ninth, with South Korea first, Latvia second, and Australia third.

Those highly ranked countries relied more on stringent isolation and quarantine measures, border controls, comprehensive testing and tracing, and good hygiene and social distancing practices, rather than on harsh lockdown restrictions.

This week’s news that Britain is opening its borders to 70 countries with returning passengers not required to self-isolate, highlights a significant flaw in Labour’s Covid-19 response.

Instead of following the Ministry of Health’s plan to manage the virus – as John Key had done during the swine flu pandemic – Jacinda Ardern decided on ‘elimination’. As a result most New Zealanders have developed no immunity to the virus. In an increasingly infected world, that will never be able to eliminate Covid-19, the Prime Minister’s strategy, which depends on our borders remaining closed, has left New Zealanders isolated and extremely vulnerable.

Former Prime Minister Helen Clark along with Sir Peter Gluckman, a former Prime Minister’s Science Advisor, and former Air New Zealand chief Rob Fyfe believe that this is unsustainable and they argue that New Zealand needs to ‘re-engage with the world’: “Just after COVID hit our shores, initial discussions centred on adopting a ‘flattening the curve’ strategy. This involved accepting there would be some influx of disease, but by using behavioural and hygiene measures, viral transmission would be slowed and our hospital system would not be overloaded.

“But soon after cases started appearing, a clear shift in strategy was made – sometimes expressed as ‘keep it out, stamp it out’. In epidemiological terms, elimination of the virus became the goal. But it required huge effort and sacrifice by all New Zealanders – the burden of which will continue to echo for many years.”

They ask, “Is New Zealand prepared to hold itself in its state of near-total isolation for the indefinite future?” Other countries “have not adopted the elimination strategy. While we pin our hopes on a vaccine, it could be much further away than the hype suggests. Can we afford to wait out another year, two years, or even more in almost total physical isolation? And at what cost? This is not just affecting tourism and export education, but also the many ways in which New Zealand projects and leverages its place in the world.”

They conclude that unless New Zealand has global connectivity “we will rapidly progress to a position of relative disadvantage”.

These are important questions to which our Prime Minister has few answers.

It’s becoming clear that around the world countries are now beginning to treat Covid-19 as ‘just another flu’, shifting to a management strategy so life can return to “normal”.

That new normal comes with caveats of course, such as good hygiene and sensible social distancing, as well as facemask use in increasing numbers of countries. Since the majority of infected people are now known to be asymptomatic, facemask use in public is seen as an effective way of helping to stop the spread of the virus.

It is something that many New Zealanders called for, but the Director General of Health refused to recommend their use – no doubt because of insufficient stocks.

Professor Mark Woolhouse, an infectious disease epidemiologist at the University of Edinburgh recommends that since Covid-19 is ‘not going away any time soon, if at all’, alternative approaches are now needed: “The chances of dying from Covid-19 are at least 10,000 times greater for the over-75s than the under-15s. Our priority should be to protect the old and others at greatest risk.”

He believes, “When the reckoning comes we may well find the cure turned out to be far worse than the disease. I fear history will judge lockdowns as a monumental mistake on a global scale.”

It is becoming increasingly accepted that countries that are trying to “keep the virus out” are doing a grave disservice to their citizens.

Oxford University’s epidemiologist Professor Sunetra Gupta believes that closing borders in the long term is unsustainable: “You can only lock down for so long unless you choose to be in isolation for eternity so that’s not a good solution. Being self-congratulatory, ‘we have kept it out’, is misplaced.”

She says that instead of lockdowns, governments should be focussing their energies on shielding the elderly and those with comorbidities to protect them as much as possible. She also warns, “There is no way lockdowns can eliminate the virus … and so it’s not at all surprising once you lift lockdown in areas it will flare up again. In places where it has already swept through, a proportion of people are immune and you are not seeing it come back.”

So while in 2009 John Key followed the Ministry of Health’s pandemic plan and the country moved on once the swine flu epidemic had abated, in 2020, Jacinda Ardern ignored the warning that eliminating flu viruses is impossible in the long term and imposed such harsh State controls that ‘fortress New Zealand’ has become our reality.

As the election approaches and our future hangs in limbo, the major parties are asking voters to ‘trust’ them to manage the country out of the difficulties we now face, which include massive debt, skyrocketing unemployment, collapsing businesses, and chaotic border controls.

Meanwhile, seemingly oblivious to this crisis, Labour’s probable coalition partner, the Green Party, is proposing a tax policy that would undermine economic recovery through an annual wealth tax on everything, income tax increases, higher minimum wage, and a guaranteed income for those not in employment that would reduce the incentive to work.

Since Labour hasn’t ruled it out, New Zealand’s future could be even worse than we had thought!

 

 

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