Scott Morrison has urged New Zealand to ‘come out of the cave’ and open up to the world once our vaccination rates ramp up. So what is happening in the world’s most vaccinated countries? George Driver takes a look.
New Zealanders in lockdown are enviously scrolling through images of European summer, where life in some countries appears to be returning to normal.
Croatia is experiencing a mid-summer tourism boom, with thousands lined towel-to-towel on its beaches. In the UK, hundreds of thousands of people are attending events around the country, with about 300,000 turning up to Wimbledon alone.
Meanwhile, New Zealand – currently in the midst of the democratic world’s strictest lockdown – is being urged to follow suit and give up on elimination.
Last week, Australian prime minister Scott Morrison said we can’t stay in the “cave” of Covid-19 elimination. We need to rejoin the world and reduce restrictions, he argued. A few commentators in New Zealand have said we should follow other countries’ lead. But what does life outside of the cave look like?
A handful of countries have surpassed a 70% vaccination rate, giving a glimpse into what opening up with high levels of vaccination might look like. I have looked at the five countries with the highest vaccination rates in the world (excluding territories and microstates): United Arab Emirates, Singapore, Portugal, Denmark and Uruguay.
Their experiences to date will likely make New Zealanders tentative about opening up until we reach higher vaccination rates. On average, these countries are getting 105 cases each day per million people and a death every two days per million people. At that rate, New Zealand would have 2.8 Covid deaths and 541 cases each day. But cases and deaths can be expected to fall as vaccination rates continue to climb.
Restrictions in these countries are at about level 2.5 in the New Zealand classification. Numbers at events and restaurants are limited and mask-wearing and physical distancing is mostly mandatory in public places. Vaccine passports are widespread, with the vaccinated getting perks like being able to attend larger events, and dining and drinking indoors again.
But most of these countries are also opening up further. Denmark plans to drop all Covid restrictions this month, except at the border, while Singapore and Portugal plan to roll back restrictions when the vaccination rate reaches 80% and 85% respectively.
In the context of what some of these countries have been through recently, with thousands of deaths and tens of thousands cases, it’s a remarkable improvement. They are beginning to remove strict controls that have, in some cases, been in place for more than a year.
But it also looks remarkably worse than what New Zealand has been through over the past year. Last month an expert panel, chaired by Sir David Skegg, recommended we continue with elimination as a long-term strategy, even as the borders open, by stamping out cases with lockdowns and other controls as they arise.
But support for a long-term elimination strategy appears to be weakening in the face of delta. Last week, epidemiologist Michael Baker said we should stay the course in the medium term until vaccination rates are up, then we can “choose our future”. Covid-19 response minister Chris Hipkins has said it’s “too early to tell” if elimination is still viable and that delta raises some “pretty big questions about what the long term future of our plans are”.
But does the experience of other countries show that opening up will mean accepting more deaths and more restrictions than we’ve had during the past year?
University of Otago epidemiologist professor Peter McIntyre says New Zealand will eventually have to join the ranks of the countries opening their borders and reducing restrictions due to delta’s infectiousness. But that doesn’t mean we will see the same number of cases and deaths when we do.
“What we will be seeing when we open up, if we have high vaccination rates, will be quite different to what these other countries are experiencing,” McIntyre says.
That’s because the other countries have been reaching high vaccination rates while battling high case numbers during the height of the pandemic, which is different to introducing the virus to a Covid-free country with a high vaccination rate.
“When the virus does arrive, if we can have appropriate use of public health measures like masking, ventilation, distancing, testing and contact tracing then we can keep numbers down as low as possible,” says McIntyre.
“But we won’t keep cases down to nothing. There are going to be people in hospital with Covid, there are going to be people who die, but we want to keep that down so hospitals can cope and it will hopefully not be so different to what happens with influenza.”
New Zealand also has the chance to learn from other countries who are starting to dive into the unknown as they open up.
At the moment, here’s what’s happening in the world’s most vaccinated places.
United Arab Emirates
Vaccination rate: 74.2%
Total Covid-19 cases: 717,374 / 71,509 per million
Total Covid-19 related deaths: 2,039 / 203 per million
Daily cases: 1,023 / 102 per million
Daily deaths: 3 / 0.299 per million
Lockdown stringency: 54.63
Beyond the microstates and territories of Gibraltar, Malta, Iceland and Pitcairn Island, the UAE is leading the world in vaccinations, with 74% of the country fully vaccinated.
Cases are declining but are still averaging over 1000 a day with three Covid deaths a day.
According to the stringency index, its level of restrictions is between New Zealand’s level three and level two.
There are different restrictions in each of the seven emirates. According to CNN, Dubai reopened to visitors who could present a negative Covid test in August last year and has now opened up quarantine-free travel to fully vaccinated travellers from select countries.
Mask wearing and physical distancing is still compulsory in most public places, but people can go to concerts, restaurants and cafes. Large events are limited to 70% capacity and only the fully vaccinated can attend them.
In Abu Dhabi, access to a range of public places is restricted to those who are vaccinated, including restaurants, malls and gyms.
Vaccination rate: 74.0%
Total Covid-19 cases: 67,459 / 11,425 per million
Total Covid-19 related deaths: 55 / 9.3 per million
Daily cases: 118 / 20 per million
Daily deaths: 1 / 0.169 per million
Lockdown stringency: 44.44
Singapore has been transitioning from an elimination strategy to a “live with the virus” strategy, contingent on high rates of vaccination.
On average, someone dies from the virus each day and 118 people get infected.
Currently its restrictions are a bit higher than New Zealand’s level two, but it’s dependent on vaccination status. According to the government, unvaccinated people can’t drink or dine out, while the vaccinated can be served in groups of up to five. Social gatherings and house visits are also limited to groups of five. Cinemas and events can host up to 1000 vaccinated people, or 50 unvaccinated, while public facilities like museums and libraries are limited to 50% capacity.
But the country plans to open up further once it’s vaccinated 80% of the population, a milestone which the government claims to have reached last week. CNN reports it plans to abolish lockdowns and contact tracing, open the borders to travellers, allow large gatherings and stop counting Covid cases. But the timeline for easing restrictions is unclear.
Vaccination rate: 73.57%
Total Covid-19 cases: 1,036,019 / 101,945 per million
Total Covid-19 related deaths: 17,730 / 1745 per million
Daily cases: 2,218 / 218 per million
Daily deaths: 12 / 1.18 per million
Lockdown stringency: 52.78
Portugal has just come out of its official “situation of calamity” and started lifting restrictions from August 31, but a range of restrictions are still in place.
On average, 12 people are dying from the virus each day and 2,218 become infected. But that’s down from a peak of 330 deaths and 16,332 cases a day in January.
Restaurants and cafes are limited to eight per group and “cultural shows”, weddings and baptisms are limited to 75% capacity. Nightclubs are open, but for drinking only – no dancing – and people have to be seated in restaurants and cafes.
According to UK government travel advice there are also a range of restrictions for the unvaccinated, who can’t eat inside a restaurant on weekends or public holidays, stay in hotels, use gyms, spas, enter casinos and bingo halls or attend major events.
People have to provide a negative test to enter the country, while those from the UK and other high risk countries have to quarantine for two weeks unless they’re vaccinated.
The country plans to remove restrictions further once 85% of the population is vaccinated, with no restrictions on numbers in restaurants and cafes and events, but people would still need a negative test or a vaccination certificate to enter bars and clubs.
Vaccination rate: 71.63%
Total Covid-19 cases: 384,778 / 110,321 per million
Total Covid-19 related deaths: 6,029 / 1728 per million
Daily cases: 86 / 25 per million
Daily deaths: 2 / 0.573 per million
Lockdown stringency: 55.56
Uruguay was one of the world leaders in controlling Covid-19 until a large outbreak took hold earlier this year. It recorded the world’s highest number of deaths per capita on some days, peaking at 7,289 cases and 88 deaths in April.
Now Uruguay is down to 85 cases a day and two deaths and the outbreak looks relatively under control, which is being attributed to the country’s swift vaccine rollout. Nature reports that deaths have plummeted by more than 95% among the vaccinated.
The country’s borders remain closed to visitors, but CNN reports it plans to open to vaccinated visitors in November. It said many bars and restaurants were still closed and masks and distancing are mandatory, with restrictions at about NZ’s level 2.5.
Vaccination rate: 71.35%
Total Covid-19 cases: 344,088 / 58,162 per million
Total Covid-19 related deaths: 2,580 / 444 per million
Daily cases: 946 / 163 per million
Daily deaths: 3 / 0.516 per million
Lockdown stringency: 38.89
Denmark has achieved the second highest vaccination rate in Europe and its restrictions on daily life are currently about the equivalent of a New Zealand level 2.5.
On average it’s getting 946 cases and three deaths a day, down from a peak of 4,508 cases and 43 deaths a day in January.
Restaurants and bars are open, but people need a “corona passport” proving a negative test or vaccine status to dine and drink inside, and discos and nightclubs are closed. People also need corona passports to go to the gym and for indoor events with more than 500 people and outdoor events with more than 2000 people.
But Denmark has announced a bold plan to remove all Covid-19 restrictions, except border controls, on September 10, Forbes reports.
The country has border restrictions including 10 days quarantine, a negative pre-departure test and testing at the airport for arrivals from high-risk countries.
Vaccination rate: 21.61%
Total Covid-19 cases: 3,519 / 686 per million
Total Covid-19 related deaths: 26 / 5 per million
Daily cases: 64 / 12.49 per million
Daily deaths: 0 / 0 per million
Lockdown stringency: 96.3
New Zealand is in the midst of the world’s hardest lockdown, according to Oxford’s Our World in Data, although daily case numbers and deaths are still lower than in the world’s most vaccinated places as we continue to pursue elimination.
Will we stay the course with elimination in six months time? As the world’s most vaccinated countries open up further, and vaccinate more, over the next few months options will become clearer. In the meantime, we still have time to vaccinate and then, in the words of Michael Baker, “choose our future”.
The data above has been sourced from Oxford University’s Our World in Data programme’s vaccination rates and stringency index, while case numbers and deaths are from Worldometer. Territories and microstates have been excluded. Daily deaths and case numbers are a seven day average. Vaccination figures are for the percent of the total population fully vaccinated. Figures are as of August 30.