Thursday 26 August 2021

 

A certainty during the daily propaganda sessions that have returned since the latest Level 4 lockdown began has been the plethora of statistics released by the Director-General of Health. From the number of new cases, the clusters to which they belong, the places of interest they may have been, through to how many persons might have been exposed to the virus at those sites, the figures serve a useful, if at times confusing purpose. 

They provide an overview of the scope of what is happening, but in a way that reinforces the crisis officialdom is keen for us to appreciate. More deviously, in areas such as numbers of tests carried or vaccination rates (often lumped together with vaccination bookings) they create an impression of the organised roll-out of a well-developed government plan, quite at variance with reality. 

Often contained within these figures is arguably the most important one of all – the numbers of people being hospitalised as a result of contracting the virus. But it is frequently one of the least commented on and under-reported. Yet it may be the best marker of the impact the virus is having on the community. According to the latest figures from the Ministry of Health, just 148 people have been hospitalised in New Zealand for Covid19, since the first case became known here in February 2020. 19 of those patients have ended up in intensive Care Units. Since the outbreak of the Delta variant in Auckland a couple of weeks ago, 12 people have been admitted to hospital with one form of Covid19 or another, and so far, none have needed to be placed in Intensive Care. 

The relevance of the hospitalisation figures is becoming even greater as our slow vaccination rate improves. Already medical experts are saying that for people who have been vaccinated and contract the otherwise virulent Delta variant the impact will be more akin to a heavy cold, and they are extremely unlikely to die as a result. Officials from the United States’ Food and Drug Administration and the Centre for Disease Control and Prevention have speculated Covid19 is likely to end up no different from other infectious diseases that sicken people but can be controlled through vaccines and drugs. 

That scenario may be some time off yet for New Zealand. However, it highlights current international thinking – for example, epidemiologists at the Boston University School of Public Health are already saying the most realistic outcome of the current crisis will be to establish a level of community immunity so that most people who get Covid19 in the future experience no more than the equivalent of a bad cold. This also points the way for a future approach based on securing the wellbeing of those identified as most at risk of becoming seriously ill from Covid19 and following vaccination, leaving the rest of the population to get on with life. 

This is where the hospitalisation figure assumes its real importance, both as an indicator of those seriously at risk from the virus, and of the true danger its spread poses to the wider community. Over the last eighteen months one of the most puzzling aspects of Covid19 in New Zealand has been that the number of serious cases requiring hospitalisation has been comparatively light. Neither the number of hospital admissions, nor the projections of likely levels of community cases, have lived up to some of the gloomy predictions made throughout that time. 

This is not because of the restrictions put in place to control the pandemic, nor the measure of luck we seem to have been blessed with so far. Rather, it is far more likely due to our geographic isolation and the sparse dispersal of population throughout our country. That certainly explains both the prevalence of cases that have been identified being in Auckland, our most concentrated population centre, and the generally low level of cases in the South Island. 

With most other countries, including notably now Australia, moving on from the elimination strategy we continue to adhere to so slavishly, it is going to become increasingly impossible for us to keep the virus out of New Zealand, unless we are prepared to shut our borders completely, and in perpetuity. That would mean absolutely nothing – people (including New Zealanders seeking to return home), exports, imports, ships and aircraft – entering or leaving New Zealand, a clearly impractical situation. The notion that New Zealanders are somehow physiologically and epidemiologically so different from almost the entire rest of the world that a strategy that has worked nowhere else will work here is simply blinkered and delusional. 

As more and more New Zealanders become vaccinated, the potential risk of the virus to our country will diminish significantly. So, we must start focusing our Covid19 response far more on protecting the most vulnerable, and therefore likely to be at the greatest risk of requiring hospitalisation, rather than continuing to spread our resources thinly across the whole population and putting intrusive restrictions on the lives of the vast majority of the population never likely to be negatively impacted by Covid19. The good news – to quote the government’s sickening pet phrase for starting the daily flow of propaganda – is that low levels of hospitalisation since the start of the pandemic, now bolstered by improving vaccination rates, mean that we are in a strong position to take this approach, without compromising the wider safety of the community. All we need is the political will to face the facts and do so. 

The Covid 19 hospitalisation figure should be the first figure published every day. It should neither be hidden nor downplayed. We ought to be celebrating how small it has been so far and focusing our primary effort on keeping it low by using it as the key driver for the development of future policy, not merely treating it as an incidental extra as we have been.       

 

 

Thursday 19 August 2021

 

Last week, all the talk was of the proposed roadmap out of Covid19 – this week we are back into a Level 4 lockdown. I am not opposed to this short, sharp lockdown caused by the outbreak in Auckland of the Delta variant of Covid19. It was necessary and the right thing to do, especially given our embarrassingly low rates of vaccination. 

But what I am opposed to is all the sickening hype that has accompanied it. Especially since everything has been so predictable. From the first signs of the emergence of the Delta variant the government should have been fully aware of the inevitable risk to New Zealand, given its capacity for rapid spread and our abysmal approach to rapid community vaccination. When Covid19 Response Minister Hipkins first threatened a “short, sharp lockdown” last week, the government’s planning for such an event should have been in full swing. 

Then, when the case was detected on Tuesday, the lockdown button should have been pushed immediately. It did not require the staged drama of the Prime Minister, her deputy, and others rushing back to Wellington for an emergency Cabinet meeting to decide what to do. The plan should have been in place and able to be activated at literally a moment’s notice. 

Indeed, it is unimaginable that any responsible government would not have a contingency plan well in place for such an emergency, suggesting that the real point of the contrived urgency was more about showing the government was bold, decisive and in control. If, as the Prime Minister has implied, they were awaiting further information before reaching a decision, then that suggests the government and the Ministry of Health were hopelessly ill-prepared for such eventualities, something the public should be extremely concerned about. It must be hoped that the Prime Minister’s hints were yet more spin, not an accurate reflection of the real state of play. 

Nor did the lockdown decision require the false concern of how the decision would be conveyed to the public. It should have been announced immediately it was decided upon. But, instead, as is customary with this government, there was the predictable silly pre-announcement that there would be an announcement a few hours later. 

And when the announcement was eventually made, the sanctimony and arrogance were palpable. All New Zealanders wanted to know was when we would be going into lockdown and for how long. Even then, they were kept in suspense when it was announced that the Prime Minister was running ten minutes late – a deliberate ploy to attract attention if ever there was one. Worse, when she eventually deigned to appear it was to be a further twelve minutes of generalities and slogans before she eventually got to the point we had all been waiting to hear. 

All the appeals to live in your bubble, remember you are part of the team of five million, and to be kind are so much humbug. All they do is raise the hairs on the back of the neck more rigidly. Just as bad is the obsequious way the Director-General of Health begins all his waffling presentations thanking the country’s health workers, for just doing the job they are paid to. Nurses and midwives threatening strike action over unresolved pay claims might prefer he demonstrated his support for them in a more tangible way. And when the announcements were eventually made I would have liked some critical analysis from TVNZ’s political editor, not the drooling sycophancy about how good the Prime Minister is in such situations that was dished up instead.  

The government’s primary focus once it became aware of the case should have been on giving people and businesses as much time as possible to adjust to what was being imposed on them. Delaying the announcement several hours until the 6:00 pm television news and then not even turning up on time to deliver it suggests the process was more about keeping the focus on the government, than meeting the public’s concerns. 

Moreover, if we really are a team of five million all playing our part, then the government should have shown its trust in us by releasing in unredacted form all the advice available to it so that we can see for ourselves the extent of the risk we faced, the government’s pre-planning to deal with such an event and the basis for its decisions. Now, of course, that will never happen, confirming the cant of the government’s approach that we are in all this together. 

I would prefer the government when dealing with complex but not unexpected situations like this week’s outbreak to keep its focus solely on the facts, without the extraneous, embellishing drama. People simply need to know what is happening, how it affects them, and what they need to do. They can work the rest out for themselves without the saccharine laced platitudes masquerading as announcements that have become so much a part of the process. 

We will get through the current situation for no other reason than people’s focus on their own and their families’ wellbeing. It has nothing to do with being kind, staying in bubbles, or being part of some mythical team of five million. That is all just so much unctuous poppycock. People will respond because they appreciate it is in their best personal interests to do so. Anything else is just puffery. Therefore, we deserve to be respected as mature and responsible beings, capable of sound decision-making, not errant children to be given morality lectures at our leaders’ convenience. 

The greatest absurdity of this week’s announcements, in response to a situation brought on almost entirely by our poor vaccination rates, was the abrupt decision to suspend vaccinations, only to be just as abruptly overturned less than 24 hours later. It suggested a complete lack of forethought, planning and organisation. Or, as the ever-curmudgeonly Eeyore of Winnie-the-Pooh fame would say, “They haven’t got Brains any of them, only grey fluff that’s blown into their heads by mistake, and they don’t Think.”

   

 

Thursday 5 August 2021

 

The monolithic Managed Isolation and Quarantine System (MIQ) is rapidly becoming a huge millstone around the government's neck. Moreover, it could yet become a lasting metaphor for the bureaucratic inertia that seems to have replaced the government's once agile and sure-footed response to the pandemic crisis. 

Every day now there seems to be a new story suggesting the MIQ system is too inflexible, cumbersome and no longer fit for purpose. Whether it be constant reports of the inequitable nature of access to MIQ places, the inordinately long waiting times for places, or the frequent admissions that large numbers of places that are being held in reserve day for a rainy day that never seems to come, the inevitable conclusion is that the system simply is not working. Its heavy-handed approach is more reminiscent of the Gdansk shipyard mentality of the Muldoon era over forty years ago than the way contemporary New Zealand works. 

Yet the government seems increasingly paralysed when it comes to doing anything meaningful about it. Minor tweaks here and there from time to time have not been enough to sort out all the problems the inflexible system has created. More and more people are being adversely affected by the delays, more and more families angered by being unable to visit parents and children overseas, all because they cannot be assured of a place in MIQ when they want to return home. And with reports indicating that hundreds of thousands of New Zealanders working overseas are wanting to come home on a permanent basis, the problem is set to get far worse. 

Moreover, many of those seeking to return have already been fully vaccinated and are struggling to understand why they should be denied the right to return to their own country freely and when they want, because of a rigid and bureaucratic system that treats vaccinated and non-vaccinated people the same, and New Zealanders no differently from anyone else. The Human Rights Commission currently has cases before it, arguing that the MIQ system breaches human rights. It is a surprise, frankly, that they have taken so long to emerge. 

Things have to change and change fast. The government's response so far has been weak and timorous. It is unwilling to acknowledge there is even a significant problem to be addressed, with no real answers other than "we'll look into that" every time a new anomaly or unfairness is raised. The roadmap beyond the pandemic due to be released next week, following work done by a team led by prominent epidemiologist Sir David Skegg is unlikely to offer any immediate solution either. 

This is the time for some of the bold leadership the Prime Minister liked to talk about last year but seems to have forgotten since the election. So far, the government has been able to rely on low levels of vaccination, and consequent higher levels of risk, to justify its mandatory detention scheme for those arriving at the border. That excuse will wear increasingly thin as – slowly – more New Zealanders become more fully vaccinated, and as vaccination rates in other countries soar. Detaining people who are Covid19 free and fully vaccinated will become an increasingly difficult proposition to sustain as more and more vaccinated New Zealanders, here and abroad, become impatient to start moving freely and safely around the world again. 

The government should immediately change its practice to enable all New Zealand citizens and permanent residents who have been vaccinated and are Covid19 free at their time of arrival in New Zealand to self-isolate at home for up to ten days, rather than be bundled into a state controlled MIQ facility the way they are at present. Many other countries manage things this way, using bracelet technology to monitor compliance so it should not be difficult for New Zealand to follow suit if the political leadership and will was there. 

That would allow New Zealanders to have more control over their own lives once more. More MIQ space could then be freed up for those arriving at the border who are not New Zealand citizens or residents, as well as being a pragmatic step towards opening New Zealand once more to the rest of the world, something the government seems stubbornly and infuriatingly loath to do. 

The last time New Zealand went through a period of a heavy reliance on centralised regulation, and ever more regulation to enforce the regulations was during the Muldoon government in the early 1980s. It eventually imploded when it became clear there was no plan to move beyond that state. The present government’s approach to border control and MIQ is veering towards a similar, ultimately unsustainable, situation today. 

When and how the government responds to the MIQ chaos will show whether it is prepared to show the leadership a transition to the post Covid19 environment will require, or whether it will remain content to just drift along the way it has been for most of this year.