Covid 19 – Moving Away From Hard Elimination

Keeping Perspective on How Well New Zealand Has Done

This is an excellent Twitter thread by Dr Jin Russell which is worth repeating here..

Kia Ora everyone. This is a thread for people overseas, to put context around what is happening in Aotearoa New Zealand with our Covid-19 strategy. The first point to make is that though we are now shifting away from hard elimination, we couldn’t have picked a better strategy

Some headlines will say we have “failed” in our attempt to eliminate delta. This misses a key point. Our Go Hard, Go Early lockdown nationally, led to such a hard suppression of the virus, that our daily case counts are still low overall. Our outbreak seeded from NSW, compare:

NZ’s Alert Level 4 was effective even against delta, and while it was in place, we prevented uncontrolled exponential spread. We have prevented 1381 chains of transmission so far. Daily case counts are less than 50.

In real terms, we have saved lives. We have sadly had 1 death in this delta outbreak, bringing our total to 27 deaths from covid. This means that currently, our hospitals are able to operate without overwhelm. We would like to prevent this

NZ has experienced only two true national lockdowns. The first was in March 2020, and we went on to eliminate covid for 100 days. The second national lockdown was in August 2021. If you live outside of Auckland, you’ve experienced incredible freedoms for most of the pandemic

Auckland’s most recent lockdown was so effective, that the rest of NZ was able to come out of lockdown after a couple of weeks, meaning that schools and workplaces were open again around the country, at Alert Level 2 – which is a light setting only – distancing, masks.

Our Deputy Prime Minister, Grant Robinson, recently reported that NZers have enjoyed 464 days of no workplace closures over the entire pandemic, compared to say 78 in the US, 75 in the UK. Importantly, this has meant schools have been open for the most part as well.

Elimination has also been beneficial for the economy. And while I don’t want to minimise at all the hardship we have seen over this time, particularly on tourism, we have done well compared to other more hard hit countries

A key success of elimination has been that we will face re-opening with four crucial weapons: 1. Safe and effective vaccines 2. Very highly vaccinated healthcare workforce 3. Lessons from successful reopenings elsewhere 4. Some effective treatments for those hospitalised

For instance, in reopening schools, we have the benefit of studies and ECDC and CDC guidance showing how to do this as safely as possible. We can look to learn from guidance produced elsewhere, for instance, Victoria, who have produced a great plan:

A challenge we face is to quickly get our vaccination levels as high as poss. Almost 80% of the eligible population has had their 1st dose, almost 50% their 2nd dose. Our early general vaccine rollout went so fast that at peak we vaxxed 1.5% of the population in a single day

But sadly the pandemic increases inequities, and we are seeing the virus spread along inequitable lines in our society. This is not unexpected, given the social drivers of spread seen overseas. We need to urgently get equity into our vaccine rollout

Thanks goodness we have quite amazing community health organisations who are rising to the challenge. And we need to significantly invest here to enable them to do this crucial work.

There is a myth overseas that NZers have been oppressed into compliance. But the overwhelming majority of NZers have supported the elimination strategy, and backed PM Ardern’s government to win a historic election majority. Even up till very recently

Latest Roy Morgan poll for September 2021

The elimination strategy has been *so* popular in fact, that we were caught a little off guard by the shift to hard suppression, and so we are needing to psychologically recalibrate. I hope this is understandable. We’ve had huge events at Level 1. It was incredible

We were so deep into Level 1, that when the All Blacks played the Bledisloe Cup to a half empty stadium just days before the Auckland August Delta outbreak started, the poor stadium turnout…made headline here.

But the most important point is this. We have saved thousands upon thousands of lives through elimination. https://thelancet.com/journals/lanwpc/article/PIIS2666-6065(21)00165-6/fulltext… /17

COVID-19 vaccine strategies for Aotearoa New Zealand: a mathematical modelling study

And we continue to save thousands of lives through committing to a cautious approach.

So we need to stay the course. We have to continue to chase down the virus, and vaccinate as fast as possible, because our hospital capacity is too low, and we are NOT SENSITISED TO LOTS OF COVID-19 DEATHS AND DON’T WANT TO BE

So now, even though we are allowed very small picnics and barbecues in Auckland, we continue to stay home as much as possible, and wait till our vaccine levels reach the same level of immunity or higher, seen elsewhere, but without the deaths, the long covid, the disability.

Please send us your best thoughts and prayers. We are not done yet and we have a lot of work to do. But what I’ve seen from NZers over the past 18 months has made me so bloody proud to live here. Kia kaha

Addendum: when all is said and done, the New Zealand Covid-19 story will be a public health case study. Even if we falter from here, what we have achieved to date with elimination, leadership and collective action has been remarkable. I am truly privileged to bear witness to it.

Dr Jin Russell

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