ScienceMarch 6, 2020

Covid-19 is going nowhere. Here’s what every New Zealander can do


If we truly have a robust plan for Covid-19, there are three ways to take it to the next level, writes former pandemic planner Richard Simpson.

In the same week the media psyched us up about a Lotto jackpot, how surprised can we be that some people went panic-buying at the supermarket over a looming pandemic?

I wrote an article recently about the Covid-19 border activity. After nearly 10 years working in pandemic planning, my view from the outside of this particular response was that the initial border controls were measured and effective.

If we truly have a robust plan for Covid-19, here are three suggestions to take it to the next level. If these are simply “too much to ask”, isn’t this a chance to ask ourselves why that is?

  1. A joint, bipartisan (or “MMP-partisan”?) message from the major parties, giving support to the frontline public sector workers and promoting fact-based, sensible health advice (even if the parties may disagree on implementation).
  2. A voluntary set of principles from the major media outlets and “influencers”, with agreed standards of behaviour around reporting Covid-19, including an agreement not to use misleading or fear-provoking (clickbait) headlines or imagery.
  3. An ongoing public discussion by ourselves – every one of us – about what is the “normal”, acceptable state we want to work toward once this Covid-19 mania is over.

The whole aim of a Coordinated Incident Management System response is to sing from the same song sheet. That is a worthwhile goal. But a coordinated approach, by its nature, usually results in sober, pragmatic, well-meaning but bland messages that strike a chord with nobody in particular. Especially not when shrieking banner headlines challenge our perception of risk and probability.

This watering-down of the official message is heightened because public servants and industry professionals often purposely “stay in their lane”. You wouldn’t feel reassured if your doctor said your smoking may be harming you but at least you don’t smoke as much as your next-door neighbour. Plus, you should be happy the taxes will go to worthwhile government projects, right?

It is the job of frontline workers to prioritise the needs of the individual in front of them and to give the best possible, most comprehensive support with the resources and options available.

It is the job – and the burden – of our politicians to aggregate the health recommendations, the statistics, the cost analyses, and the trends in how population health is likely to improve over time. It is their job to make longterm strategic decisions about funding, resources, options and contingencies that factor in the whole shemozzle – including the effect on our tourism industry, on our global reputation, on our imports and exports.

In this way, a pandemic response is a microcosm of this relationship; a singular event that brings all of these decisions and competing philosophies into sharp focus. After all, our current “macro” crises of obesity, smoking, child welfare, diabetes, youth suicide, heart disease – these are also public health emergencies but in slow motion, and the debate about how best to solve these crises drives our reasons for going to the polling booths this year.

While we can disagree on the best solution, isn’t Covid-19 an opportunity to find some common ground by endorsing the evidence-based health advice and telling all Kiwis we can each do our part?

We ask our politicians to reassure us it is not just about actuarial tables versus milk solid prices. A good politician is someone who builds a story around how these difficult choices are shaped by, and shape, our collective history. Electioneering and point scoring aside, a lot could be gained by a joint show of support for the people in the coalface and a recognition that we all share a common past, present and future.

Two local events marked the start of the Influenza Pandemic in 1918. Firstly, accusations of cronyism and cover-up spurred by the (false) rumour the RMS Niagara brought the Influenza to Auckland, and secondly the pragmatic and expert advice to avoid large gatherings, which was roundly ignored by many people when the (false) rumour spread that the Armistice had been declared. Not a lot has changed.

Because sober, measured advice and information will only be so effective. “Self-interest” for some people will override the most sensible advice, and the topics of risk, need and readiness are so individualised that, for many, no well-meaning-but-generic message is likely to strike a chord.

Emergency management has evolved, especially over the last decade, and there is no need to list the many disasters that have spurred this evolution. Our emergency professionals can cut it with the best around the world, and many of our systems and processes are models of best practice. Risk registers are par for the course in almost all workplaces, and we have a constant feed of verified, vetted information for something like Covid-19 from people with world-class qualifications and evidence.

So why do we still have people panic-buying loo paper?

We know that clickbait sells, but in a post-truth age of Cambridge Analytica and autocratic government profiling, the topic of “personalised” content, “verified” or “curated” information from an expert source is becoming another cause for suspicion and fear, rather than a solution.

Also, and significantly, many media outlets can double-dip at the moment; tapping at our amygdala with clickbait headlines, then making hay by hooting over Aucklanders spilling their lattes in panic.

But this is an opportunity as well as a risk. For all that you might laugh at the loo paper hoarders down at the far end of the bell curve, don’t forget your own preparedness. Don’t go and panic-buy toilet rolls, but maybe check you do have a “Get ready” kit and make a plan with your family.

And while you’re at it, why not check your smoke alarms, the batteries for the torch in your Civil Defence kit, your first aid cupboard and your emergency bottles of water.

This moment is both a challenge and an opportunity for the “mainstream” media and those government officials. How about we challenge the “mainstream: media in our little island nation to aim higher. To aim for an “engaged” and “motivated” public.

I’m not talking about buying a demographically-appropriate campaign of “Monique thinks you’re dumb for not washing your hands”. I’m talking about an honest acceptance by media outlets of their own strategic role and a public commitment to values in this event, rather than a quick profit.

Once more Covid-19 cases make it past the border controls, the next pandemic phase (alongside an ongoing “Keep it Out’) is “Stamp it Out”. The focus in this phase is to figure out exactly how the virus reached the community, to speed the lab tests through, to “ring-fence” it by identifying all the cases and their close contacts and ensuring they are doing the right thing.

We are told there’s still a low risk that Covid-19 will establish itself in the community, but if it does the next phase (which is now widely discussed) is “Manage It”. And that’s where some talking heads are likely to claim the government is washing its hands (pun intended) and saying “now it’s your problem”.

That is not correct, of course. We may (possibly) move to the “Manage It” part of the pandemic phase once there is sustained community spread, so the focus is on putting staff and resources where they can do the most good. Like rolling back many of the border controls, working with rest homes and large institutions, tracking the pressures on the health system for our towns and cities, considering a limit on public events, and coordinating the movement of patients to share the health sector load.

It is confusing enough for the average punter to sort through the flood of official advice to see what’s personally relevant, let alone the influx of “pandemic” articles that are an empty shell for mining ad revenue. But in the end, it’s our responsibility to consider our unique set of risks, to make a plan, to wash our own hands, to take care of our elderly relatives and those whose immune systems are compromised.

Covid-19 panic is sexy because it’s an unknown. After all, “pandemic” sounds a little sci-fi, and – mostly – because for the next six months, we are all part of this movie in the low likelihood the outbreak does take hold in New Zealand. Unlike a lot of disasters, there are no bystanders when it comes to a pandemic, and even if we don’t get sick, or – as is most likely – only get a mild illness if we do catch the virus, we will all have a story. Even if Covid-19 doesn’t spread through New Zealand, the economic impacts, the business disruptions and the strained relations between countries will take years to untangle.

We’re not just breaking out the hand sanitiser and trying not to touch our face for our own sake. As usual, it’s the most vulnerable populations who would bear the brunt. The elderly, Māori and Pacific, people with underlying and chronic health conditions, pregnant women, rural communities. New Zealand is consistently near the top of the OECD stats when it comes to our overweight and obese population, one of the main drivers of comorbidities that can be devastating if you add a Covid-19 or even a seasonal influenza infection. Additionally, during the H1N1 influenza pandemic in 2009, the mortality rate for Maori was 2.6 times higher than for New Zealand Europeans. The mortality rate for Pacific peoples was 5.8 times higher, two examples of the ethnic disparities we still see in nearly all health and wellbeing measures.

So what is the “normal” that we want to get back to? If our definition of success this winter is to maintain the same status quo of illness, infection, sickness and disparities, is that really the type of future we want to aim for?

We have two choices. We can cough into our elbows, take some painkillers and blog about our lurgies, laugh at the loo roll hoarders and ride this thing out for the next few months.

Or we can turn this into an opportunity. We can challenge ourselves not just to keep calm and carry on. To not get worked up but to get “engaged”, get “galvanised”, and challenge our politicians, our journalists and ourselves to step up. Together.

And save the scary headlines until it really does involve something to do with zombies.

Keep going!