Toby Morris

Siouxsie Wiles: Why we need to stay the course on elimination

There’s some confusion around what ‘elimination’ means in tackling an outbreak. But to abandon the approach while so many remain unvaccinated would be to put vulnerable people at unconscionable risk, writes Siouxsie Wiles. Illustrations and animations by Toby Morris.


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So here we are. Auckland has moved to alert level three. I’ll be honest, I’m nervous. I would have stayed at alert level four for a little longer. I’ve always been more conservative than the government when it comes to moving down the alert levels. But at the same time, they have more information than we do. They know more about where transmission is happening and the likelihood that moving to level three will change that. The approach has always involved seeking to use the least restrictions to get outbreaks under control as fast as possible. They don’t always get it right, but they’ve shown they’re flexible enough to move us back up the alert levels if it’s absolutely necessary. I hope it’s not. We’ll need to wait a week or so and see. 

And they’re right: level four has done its job. If it hadn’t, we’d be seeing hundreds and hundreds of cases a day. Our hospitals would probably have been overwhelmed. Now the government is banking on a combination of level three and the test-trace-isolate-vaccinate strategy keeping us on the road to elimination. Because despite what pundits and naysayers are yelling, that is still our goal. Maybe these armchair epidemiologists have forgotten what elimination means in the context of the pandemic? Here’s something Toby Morris and I prepared earlier.

In epidemiological terms, elimination means to reduce cases to zero or near zero in a particular location. For us that location is Aotearoa. We’ve managed it in Wellington. But the outbreak had got pretty big in Auckland before we even realised it was happening. Now we’re trying to snuff out those few existing transmission chains in Auckland, while hoping they don’t trigger any further transmission chains outside of the Auckland region, like we’ve seen in Upper Hauraki. That’s why the rest of the country remains at level two. That’s why everyone should be doing everything they can to reduce the chances of being a case. You know the drill. Wear masks when out and about. Keep track of your movements by using the Covid Tracer App and scanning QR codes wherever you go. Getting tested as soon as you have any symptoms that could be Covid-19. Not sure what the symptoms are? Here’s a handy guide from me and Toby. You can see translations into a range of other languages here.

If you haven’t been vaccinated yet, make time to do it this week. The vaccine is saving lives. It could save your life. Toby Morris and I have got answers to questions about its safety in young people here, in pregnancy and breastfeeding here, and we’ve explained how vaccines were tested and approved here. If you know someone who is hesitant about getting the vaccine, then please, we need you step up and have a conversation with them about that. Kate Hannah has advice for how to do that here.

There are very few people for whom the Pfizer vaccine isn’t safe. Essentially that applies to people who have had a serious allergic reaction to one of the ingredients of the vaccine, or to their first dose. I can’t tell you how grateful I feel to be able to be vaccinated when so many people around the world, living in countries with widespread community transmission, aren’t likely to have access to vaccines for another year or so. 

As I’ve said before, I’m finding this lockdown really hard. I’m dealing with the concerted efforts by some people to discredit me, and the torrents of abuse that has unleashed. To be fair, this has been happening since the start of the pandemic, but it has gotten so much worse over recent weeks. While that’s been going on, I’ve been turning up online every day to answer people’s questions about the vaccine so they can make an informed choice about whether to vaccinate or not. We need everyone to get vaccinated if we don’t want to have to need level four restrictions to keep delta at bay. 

I’m also trying to keep up with the all the studies about the impacts of Covid-19 in those countries that have chosen to “live with the virus”. The impacts are already huge and still not yet fully realised. A recent study out of the US suggests that so far the pandemic has resulted in 9.08 million years of life lost through to March 2021 in the US alone. More than four million of those years lost were by people aged 25 to 64. The greatest toll has been on Black and Hispanic communities. Are we willing to accept these people as the “dry tinder” of the virus? Are we willing to make that sacrifice? I know I’m not. 

Knowledge like that weighs on me heavily. I worry about who we would be sacrificing if we gave up on elimination right now. I’m also worried about my family and friends overseas. My mum has a form of cancer that means that while she’s fully vaccinated, she’s unlikely to have made much in the way of protective antibodies. That means she and my dad, who live in the UK, have been isolated since February last year. They are retired and privileged enough to be able to stay home and stay safe. But there are many others who are equally vulnerable and have to go to work. This is the normality that those who want us to abandon our elimination strategy are pushing for. You may see stories of people going on holiday and the world getting on with “living with the virus”. In my view this amounts this is happening at the expense of vulnerable people and communities, not to mention unvaccinated children. How can that be right? 

I’ve said it before, and I’ll say it again. We need to ignore the screaming bloviators who are knowingly and unknowingly undermining the collective response that has served us so well so far. Sticking with elimination for now gives us more options in the long run. Yes, delta is hard. But we’ll beat it by doing what we did last time. By working together. Kia kaha.




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