The elimination of Covid strategy is not so much defeated but changing circumstances means that policy has to evolve.
Our elimination stance was never sustainable or at least it would not be until the rest of the world also eliminated Covid-19. Elimination of the virus was a strategy we adopted in March 2020 as the best means available to deal with the current stage of the Covid Crisis.
The elimination strategy was not wrong. Had we gone down, the admittedly incompetent, path of Britain or the US, we would have had 10,000 deaths from Covid rather than the current 27. It saved other New Zealanders from bouts of ‘Long Covid’ which seems to be an unpleasant form of CFS – Chronic Fatigue Syndrome. It kept pressure down on our health services and while, regrettably, some waiting lists have lengthened they would be a lot longer had the virus been active in New Zealand.
Certainly the elimination strategy has caused some economic damage but probably less than the impact of the looser regimes elsewhere. But the elimination strategy involved a considerable disengagement from the rest of the world, a stance which could not be maintained indefinitely given the degree of global interdependence.
So we had a ‘re-entry’ problem. How could New Zealand move from its existing elimination stance of trying to stamp out all breakouts of Covid-19 to one where there would be greater international engagement and therefore greater risk of entry of the virus?
The re-entry problem was evident from day one of the elimination strategy. However, the circumstances in which it would apply have changed substantially. When I first thought about it, I had in mind there would be an international vaccination regime similar to that which had ruled for smallpox which led to the complete elimination of the condition. This is not going to happen in the immediate future for two reasons.
First, there are numerous countries which are going to have low vaccination rates. We cannot fully cut off from them and they are reservoirs for the virus to mutate, possibly undermining the existing vaccines.
Second, the existing vaccines – miracles though they are, especially the speed at which they have been developed – are not fully effective, unlike many of the vaccines which we normally think about. The existing Covid -19 vaccines do have considerable effect but:
- if you are vaccinated, you are less likely to be infected, but some will be;
- if you are vaccinated and infected, you are less likely to pass on the virus, but sometimes you will;
- if you are vaccinated and infected, you are less likely to be hospitalised, but sometimes you will be;
- if you are vaccinated and hospitalised, you are less likely to suffer Long Covid (CFS), but sometimes you will;
- if you are vaccinated and hospitalised, you are less likely to die, but sometimes vaccinated people will die, albeit very occasionally.
These conclusions are increasingly attested by the evidence from international research and experience. They are a no-brainer. (Perhaps the one condition for not being vaccinated is not having a brain.)
The consequence of a lack of universal vaccination and the available vaccines not being fully effective is that New Zealand is going to be re-entering a world where Covid-19 is more widespread than we first expected.
But there is another complication. Viruses mutate and the most vicious mutation becomes the most widely spread. At the top is the Delta version, which is much more virulent than the earlier varieties – much more.
What this means is that Covid is much harder to contain (especially as it is infectious three or so days before its symptoms are evident). The unfortunate consequence is that it was easier to break through our border controls and once it was here it was harder to eliminate. We have not yet done so in Auckland. I am struck that the Waikato outbreak is a repeat of the pattern. Delta broke through the Auckland cordon and I am guessing that it will be difficult to eliminate it in the Waikato. I see no reason why we can be confident that it won’t happen elsewhere – even if we improve interregional border controls.
The effect of the virulence of Delta has ended the elimination strategy earlier than expected. This is not a defeat. It is just that the re-entry phase has started earlier. My hope had been that we would be opening up early in 2022, not six months earlier. I favoured the delay so we could learn from other countries’ experiences. What now does the next phase look like – given that we have not had the advantage of this learning?
One step is to push up the vaccination rate as high as possible. There are all sorts of guesstimates as to what an appropriate vaccine rate is. My guess is 110 percent; that is the optimum personal rate is 100 percent, but it won’t be enough. Sure, we may have a benchmark rate – currently it seems to be 90 percent of adults – but that is a practical guide only.
A second step is that we are moving to a ‘vaccine passport’ regime. (Allow me an irritation. All sorts of politicians are saying that they told the government. They overlook that it takes time to roll out a program and that the bureaucracy was working on the roll-out long before the thought had occurred to them.)
One of the privileges of being a New Zealander is that you don’t have to carry state identity papers. A vaccine passport has some of their characteristics – as does your driving licence and your international passport. The vaccine one is not quite the same thing as the state registration which occurs in less liberal regimes, although insofar as it becomes compulsory at certain venues, it is drifting that way. The difference is that it is not about your relationship with the state but your relationship with other New Zealanders. As economists put it – clumsily – it is about an ‘externality’. You can involuntarily give and catch the virus from another, so the ordinary principles of market liberalism involving voluntary exchanges do not apply.
There will be other things that need to be done. We can only see ahead dimly, although we do not lack critics with superb hindsight. I am greatly amused by their demand for a ‘plan’. Once upon a time the right opposed planning arguing that we did not know enough to do so with certainty, while the left advocated planning. The reversal tells us much about how our politics is about opportunism and pragmatism rather than principle.
One area which obviously needs further attention is the control of people flows at the border. There does not seem to be an effective regime. Given that it involves a rationing system there will always be grumbles but there is a widespread impression that it is being badly managed. The repeated failures suggest that the administration needs a complete overhaul.
Is there a general lesson to be learned from all this although, given we are in a war against a virus, perhaps it is not a time for reflection? Even so we would do well to be mindful of the (slightly adapted) advice of Karl Popper: at any stage of your thinking be as clear as you can about your problem, and watch the way it changes and becomes more definite.
Doing this in the case of the Covid response will lead you to conclude that the government is not suffering a defeat of its elimination policy but is moving on as circumstances have changed.