Yesterday the government announced a new approach to addressing Covid, and a new path out of alert level three for Auckland. Courtesy of the Science Media Centre, here’s what the experts think.
The prime minister and the director general of health have revealed the latest step in New Zealand’s Covid-19 response plan. The three-step “roadmap” was laid out at yesterday’s press conference, where Jacinda Ardern and Ashley Bloomfield detailed Auckland’s slow move to easing restrictions. Read all about it here.
Experts across the motu have responded to the plan, which will see Aucklanders able to connect with bubbles (one at a time) in outdoor settings with groups of up to 10 people.
‘More spread and more Covid cases’ – Professor Shaun Hendy, Te Pūnaha Matatini
This relaxing of restrictions will see more spread and more Covid cases in the community over the coming weeks. These new freedoms should reduce the risk of super spreading compared to level two, but still open up considerable opportunities for new spread. The government will be hoping that any growth in cases that result is slow enough that vaccination can get ahead of the outbreak, before it puts significant strain on our testing and tracing system, not to mention our hospitals.
The next steps in the plan, which involve reopening retail and even some hospitality, really won’t be safe until the vaccination programme is very well advanced. This will probably not be the case until well into November. Until then or unless vaccination take-up accelerates, Auckland is unlikely to be able to return to level two and there is a greater risk that restrictions will be be needed in other parts of the country. The best thing we can do now is get vaccinated or encourage our friends and family to do so.
Meeting other families and friends outside is lower risk, but definitely not zero risk, so it will be important that people who choose to do so exercise caution and wear masks. If you are not vaccinated I would suggest avoiding meet ups until you’ve at least had your first shot and if you are meeting friends or family ask them whether they have had theirs yet. Fully vaccinated people are far less likely to catch the virus if exposed and less likely to pass it on, so meet ups of vaccinated people pose far lower risks. This move really does put the responsibility for preventing spread in the hands of the public, so it is vitally important that everyone does their bit.
‘A high degree of risk remains’ – Dr Dianne Sika-Paotonu, immunologist, University of Otago, Wellington
How Aotearoa New Zealand responds and treats the needs of the most vulnerable during this Covid-19 pandemic, will indeed reveal our moral compass as a society and define who we are as a nation for generations to come.
The consequences of any premature changes such as easing restrictions too quickly given our vaccination rates at this time, along with the adverse health impact already seen for our vulnerable in Aotearoa New Zealand, will be dire.
If we are not careful, we will be at serious risk of allowing our health system to become overwhelmed, given it was already under strain and burdened even before the Covid-19 pandemic began. One only has to consider the situation in other countries with their high hospitalisations and deaths, for a reality check.
Accelerated vaccination, testing and Covid-19 prevention efforts must continue in a way that reduces barriers and builds trust for people – with the appropriate and targeted approaches focused on getting help and assistance out to those who need it most. Caution and compassion will be needed moving forward, as a high degree of risk remains for all in Aotearoa New Zealand, but especially for our most vulnerable communities.
‘A reasonable approach’ – Professor Michael Plank, Te Pūnaha Matatini
We are entering a new phase of the pandemic, where unfortunately community transmission of Covid-19 and ongoing measures to limit it are part of the new normal. Vaccines will blunt the effects of the virus, but we have a long way to go to get the high vaccine coverage we need.
Accepting that elimination isn’t possible doesn’t mean waving the white flag and letting it rip. Left to its own devices, the virus would spread like wildfire through our unvaccinated and partially vaccinated population, and risk overwhelming our healthcare system. So until the number of people fully vaccinated is much higher, we have no alternative other than to suppress transmission as much as possible. The government will need to pilot a very tricky route that avoids overflowing hospitals.
The roadmap for relaxing restrictions is a reasonable approach, starting with relatively low-risk outdoor gatherings and progressively reopening higher risk settings as the situation allows. But it will be crucial to remain adaptable and responsive to changes in the number cases and the healthcare demand they will generate. It may yet be necessary to adjust or tighten restrictions to prevent cases spiralling out of control. The Australian state of Victoria has gone from around 20 cases per day to 1500 in just six weeks, and there are currently 96 Covid patients in ICU. This could happen here and it would put immense pressure on our hospitals.
The Auckland boundary will remain in place for now. But if, as is likely, case numbers continue to grow, it will become progressively harder to keep the outbreak contained to Auckland. The rest of New Zealand should prepare for the inevitability of community transmission. Regions that experience outbreaks may need to be put under restrictions like those in Auckland.
While our vaccine rollout is still in progress, we remain extremely vulnerable to out-of-control outbreaks. The government needs to pull out every stop to maximise vaccine uptake, particularly in Māori and Pasifika populations and other groups where coverage is low.
‘Proportionate and compassionate’ – Dr Rawiri McKree Jansen (Ngāti Raukawa, Ngati Hinerangi), National Hauora Coalition
Matike maranga, maranga ake ai!
Hard agree: we have to go hard on vaccinations. Hard agree: elimination has served us well, protected us well, and now we have an unrelenting focus on vaccinations.
And I appreciate the roadmap, and agree that staying at level three is necessary for achieving the lift in vaccinations. The amendments appear proportionate and compassionate.
‘Significant increase of risk’ – Dr Dion O’Neale, Te Pūnaha Matatini
The roadmap looks like a significant increase of risk for wider transmission, given that there is still ongoing community transmission with unlinked cases. Preventing spread of Covid in the community requires two components: minimising the number of interactions and also minimising the chance of transmission for those interactions that do still occur. Allowing people to meet up in groups of up to 10 people and with two households is a significant increase in the number of interactions and the number of possible pathways for Covid to spread. Something that could mitigate this would be an expectation that people only meet up with a limited number of households in total, or a limited number per week.
Even with people only meeting up in pairs, this change moves us to a situation where the Auckland is essentially reconnected from a contagion point of view. Limiting people to meeting outside will help to reduce the risk of transmission when people do meet up but that is a case of playing Russian Roulette with fewer bullets in the gun as opposed to minimising the number of times you play it.
This move has also come at a point where there are still large sections of the community with very low vaccination numbers, in particular Māori and of course younger people for whom vaccination is not yet an option.
At steps two and three of the roadmap, there is a lot of faith being put in the transmission reduction that comes from people being mostly outdoors, and hopefully vaccinated. The gathering size limits at these higher steps will do very little to slow spread of contagion if someone is infectious.
Potentially reopening schools in two weeks’ time, with only older students required to wear face coverings and only older students able to be vaccinated also looks like a significant increase in transmission risk.
A focus on schools is key – Dr Jin Russell, developmental paediatrician and PhD student, University of Auckland
ECEs are re-opening where bubbles of up to 10 are possible in Auckland. Schools are tentatively set to re-open on the 18th October. With the transition away from an elimination strategy, we are now confronted with the difficult decision of determining what is best for children in this moment.
When children are infected with Covid-19, they fortunately typically experience a mild or asymptomatic illness. Hospitalisation of children can occur but this is uncommon. Children with pre-existing health conditions are at higher risk of severe illness, similar to the pattern seen for other respiratory viruses.
Overall, the plan to re-open education settings is a reasonable move. Overseas experience has shown that the harms to children from prolonged school closures is significant. Schools provide so much more than formal education. Schools are “essential services” for children, necessary for children’s wellbeing, learning, socialisation, and development. However, we need to immediately take steps to ensure that schools open in the safest way possible.
The direction of transmission in school settings is first adult-to-adult, then adult-to-child, and lastly child-to-child. A report on Covid-19 transmission within schools and ECEs from Australia, analysing delta data, found that infected children transmitted the virus to other children at school in only 2% of cases, while the likelihood of adults transmitting to children within schools settings was greater.
This means that one of the best ways we can protect children and re-open schools safely is to aim for 100% of teachers and staff, and 100% of eligible students, to be vaccinated. Overseas experience also shows that by implementing a suite of measures – including improving ventilation, taking activities outside, masking, and other measures, schools can drive the risk of Covid-19 transmission to very low levels.
When schools re-open, it would be a smart move to have the vaccine delivered within schools, available for both eligible students and parents.
A plan to incentivise vaccinations – Dr Bodo Lang, senior lecturer in department of marketing, University of Auckland
While New Zealand’s initial response to the Covid pandemic has resulted in minimal lockdowns and comparatively low rates of fatalities and sickness, the delta variant poses a new challenge for New Zealand. And with new challenges new solutions are needed.
The key to minimising both human and commercial casualties are high vaccination rates, ideally 90% or higher. Mass communication, such as advertising, has its limits when wanting to persuade an audience to engage in a desired behaviour. Commercial marketers know that emotional and rational appeals can only convince so many people to change their behaviour. At some point, particularly when faced with consumers who are resistant to change, other strategies need to be pursued. In commercial marketing such strategies can be broadly summarised as ‘sales promotion’. In essence, marketers provide extra incentives for engaging in the desired behaviour. Think “Buy one, get one free”, “25% off” and similar strategies.
Driving behavioural change in light of the delta virus is no different. Providing clear incentives for engaging in the desired behaviour – being double-vaccinated – has become paramount. Such incentives can take a variety of forms, such as entering people into a Covid lottery or giving out prizes to those who have had two vaccinations.
However, the incentive that may be the most powerful is to reward those who have been fully-vaccinated by giving them back what they desire the most: regaining greater personal freedom. This can take a variety of forms, such as allowing those who have had two vaccinations to be able to take part in public life again. Think bigger personal bubbles, being able to visit bars, restaurants and cafes, and pursuing other commercial and non-commercial activities to a greater extent again.
To minimise both the commercial and human casualties from Covid in New Zealand, the next phase of the government’s campaign needs to provide clear, personally-relevant incentives for New Zealanders to become fully vaccinated. If vaccination is our goal, then let’s make being vaccinated even more attractive.