OPINION:
The Prime Minister's communication skills have again successfully delivered a lockdown. With luck, events will unfold in a similar way to last autumn. In a month, we'll move out of level 4 before spending a fortnight in level 3, and get back to normal by November.
But then what?
Jacinda Ardern's top Covid adviser, Sir David Skegg, laments that New Zealand has been let down by our allies. Presumably he mainly means Australia but his point applies to almost the whole world, except a few other remote islands.
No other country has achieved lockdowns as tough as New Zealand's, and thereby executed an elimination strategy. Especially with the Delta strain, almost everyone else has accepted that Covid is here to stay. Instead of being preoccupied with national self-congratulation, they have focused aggressively on early vaccination.
Even then, they have accepted vaccination isn't foolproof, given a hard core of anti-vaxxers in most societies, the likely need for annual booster shots and emerging evidence that the Pfizer vaccine stops serious sickness but doesn't block transmission.
Other countries have not aimed at anything as ambitious as elimination but less heroically at minimising morbidity and mortality to stop Covid overwhelming their health systems.
This was initially Ardern's stated objective too. As she told the nation on March 14, 2020, two weeks after Covid arrived in New Zealand: "Our smaller number of cases [relative to other countries] has helped us to manage them in the right place, and with the right support. The majority of our cases have not required our hospital system to care for them. The key continues to be leaving our hospital system for those who need it most. All of this points to one strategy which has guided our decision making — spread the cases, and flatten the curve."
Nine days later, on March 23, 2020 — after becoming concerned about our limited number of beds in intensive care units (ICUs) and University of Auckland modelling that "tens of thousands of New Zealanders could die from Covid-19" — Ardern dropped her "flatten the curve" line and announced the first lockdown.
Even then, she didn't use "elimination", let alone "eradication". Her stated objective remained to "contain the spread and prevent the worst" and thereby "slow the virus down and prevent our health system from being overwhelmed". It was only later that the myth of St Jacinda was backfilled to argue that she sought elimination all along.
In any case, Ardern's use of "elimination" differs from the dictionary definition. She says it is about having zero tolerance for outbreaks and moving quickly into lockdown whenever Covid shows up.
Skegg agrees but advised her in late July that New Zealand was liable to experience a New South Wales-style Delta outbreak "in the coming months". The Beehive did well signalling that this would mean an immediate level 4 lockdown.
It also got the message across that it really, truly, absolutely wants to open the border as soon as possible, announcing plans — now presumably redundant — to trial self-isolation for Kiwis returning home this October.
So here we are in lockdown again, a bit earlier than Skegg suggested. In fact, Delta may have been circulating for a couple of weeks, and cases will surely rise. Still, with a population prepared to follow their leader and obey the world's toughest lockdown rules, there is a chance we will again be one of very few countries to temporarily achieve eradication, despite Delta being so much more contagious than last year's Covid.
But Australia won't be in the club with us. Nor will Fiji. Nor anywhere else important to us familially, culturally or economically, except perhaps smaller Pacific states. Even once we reach the undefined level of vaccination Ardern says would lead to the borders reopening, Covid will keep arriving, spreading, making people sick, putting some of us in ICU and even killing a few.
If Ardern's definition of elimination means lockdown every time, then her strategy will have run its course not long after we emerge from this one.
Meanwhile, her Government's shameful performance in preparing the public and the health system for that imminent reality should be a national scandal.
More than a year since Ardern was forced to switch from flattening the curve to elimination, the Ministry of Health reports no material improvement in ICU capability.
Skegg reported in early June that New Zealand had less than one-third of the ICU beds per capita than the average of 22 OECD countries. We were ranked 21st, followed by Mexico. While speculating about "some expansion of facilities over the last year", he said "this is likely to be modest".
He was right. There were 334 ventilators and 358 ICU beds at the end of the first lockdown. The Ministry of Health says there are just 284 fully staffed ICU beds across public hospitals. While there are 629 ICU-capable ventilators, including 133 in reserve, the number of nurses trained to work with them improved by just 1 per cent. The problem that forced Ardern to opt for her ultra-tough strategy is as bad as ever.
Little new can be said about the vaccination fiasco. We have the slowest rollout in the developed world, not all frontline border and MIQ workers are yet vaccinated and there was no chance of reaching population immunity until mid-December, even without this week's pause.
Given Skegg's warning, it is scandalous vaccination centres didn't have personal protection equipment (PPE) on site to operate uninterrupted when we moved to level 4. The blame lies not with those on the front line, but with Wellington bureaucrats who failed to order vaccines in line with the rest of the world and who have a lamentable record on distributing PPE.
Those same bureaucrats took us from the front to the back of the vaccination queue, allegedly to save $40 million. Yet they paid $38m to upgrade vaccination software for Covid, when the existing supplier said it could have been done for $50,000. Incomprehensibly, they are now resisting pre-ordering booster shots.
More than a year after first proposed, there is no border let alone nationwide saliva-testing programme. The reasons are disputed by the various suppliers of that technology, but all unite with the Beehive in blaming the Ministry of Health.
Yet Ardern and her Beehive should not be let off so easily. For months, ministers and strategists have privately pointed the finger at the bureaucrats for every failure while claiming success for Ardern's rhetorical achievements.
But those bureaucrats report to ministers. If their performance is as poor as claimed, then the buck stops at the top and the time for whispers is past. If the Beehive does not believe senior bureaucrats are capable of preparing the health system for a post-elimination strategy, it should say so publicly and get in people who are.
- Matthew Hooton is an Auckland-based public relations consultant.
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