"The arrival of the vaccine in New Zealand must herald a discussion of how we shape the path ahead ... the politically difficult decision will be at what point will there be enough vaccine protection within our population to relax the elimination approach." - Sir Peter Gluckman, former chief scientist.
Yo-yoing lockdowns shows we need a new Covid strategy.
Elimination is a tactic and was never a sustainable goal.
We have not eliminated Covid-19. WHO lists New Zealand has having active Covid cases. We contain Covid-19 in quarantine which occasionally escapes. We may need annual Covid vaccinations for years.
The country's success in reducing community cases has paralysed policy development. Where is the plan to return to normal?
We will never have everyone vaccinated. One in four says they will refuse. There is no vaccination for children.
To have a road map to normalcy we need to move past elimination to realistic goals.
Here are achievable goals; "minimise the impact of the disease", "enable society to function as normally as possible" and "minimise and mitigate the economic consequences".
These are the goals of the official New Zealand Influenza Pandemic Plan. The forward explains the plan "establishes a framework for action that can readily be adopted and applied to any pandemic, irrespective of the nature of the virus and its severity".
The plan was abandoned because as our Prime Minister admitted "the nation's health system simply couldn't cope with a big outbreak". Targeting elimination was not a reason to abandon the rest of a carefully crafted Pandemic Plan.
The officials were right. It is not possible to sustainably maintain elimination. While the economy is doing better than treasury's dire predictions, the Government is borrowing around $100 million a day. It is not sustainable.
At some point we have to find a way to co-exist with Covid-19 as we do with a large number of horrible diseases. The road map to normalcy goes through reopening the country.
If you accept the advice of the Pandemic Plan, then drawing up a vaccination list is easy.
There are two principles for priority. Those most at risk of catching Covid-19, and those most at risk of dying from the virus.
The New Zealanders most at risk of Covid-19 are those who travel to Covid-19 hotspots. Why they are going is irrelevant. Whether they are diplomats representing the country or sportsmen or businessmen or they are crazy pandemic tourists, they are at risk. Vaccination is a health decision not a moral judgment.
Next at risk are front line border workers and frontline health workers.
Then the priority is those that Covid-19 has most killed, rest home residents. The priority is rest homes, followed by the elderly and those with medical conditions. One needs to add those we compulsorily detain.
Once the vulnerable and frontline has been vaccinated Covid-19 is less deadly than hepatitis, HIV/Aids, Mers and Ebola, none of which we quarantine for.
When we have vaccinated those at risk New Zealand can return to normal. We can open travel with every country that is Covid free. If the Government was not so risk-averse we could already have a travel bubble with Australia.
While the pandemic rages we should insist on pre and post-flight Covid tests. Those travelling from Covid hotspots should still be quarantined until we can implement vaccination passports.
We should continue with suppression. Testing should be improved by using saliva tests. Making available cheap, do-it-yourself tests that give a result in 20 minutes would greatly improve community detection.
The Government Covid App is second rate but it is madness not to use it. Use of the app to enter known at-risk environments should be compulsory. Better that than a lockdown.
Better testing and better tracking and tracing will suppress Covid-19.
It is desirable that as many people as possible get vaccinated. It increases herd immunity.
The Government's policy of "everyone vaccinated" is not achievable. Buying Pfizer for the whole country, "available in the middle of this year" only makes sense if the Government has no plan to reopen the country until there is mass vaccination. We could be waiting a long time.
If the Government's priority was to quickly return to normalcy then their vaccination purchases would be very different.
New Zealand ordered five million doses of Johnson & Johnson's, one dose, normal refrigeration, vaccine. The company, with Merck, is manufacturing 100 million doses by the end of May.
The PM should get her jab, go to America, used her celebrity status to get a million doses of the J&J vaccine plus an agreement to manufacture the vaccine in New Zealand.
With the J&J vaccine New Zealand could vaccinate the at-risk and the vulnerable and be back to normalcy before the Government's latest Pfizer vaccines purchase arrives.