Where to from here? Herald Covid-19 experts on the future for NZ

Herald journalists have been following Covid-19 and its impact on the world since it emerged in Wuhan in 2019. Experts in their fields, Derek Cheng, Jamie Morton and Liam Dann have been keeping New Zealand informed about the pandemic from a political, scientific and economic point of view. Now, as we battle an outbreak of the Delta variant in our community they offer their expert opinion on what this means for the future of NZ.

Derek Cheng: Deputy Political Editor

How long will we be in lockdown?

Auckland won't move out of level 4 until the Government can be confident there are no infectious people in the community spreading Delta from bubble to bubble. They could be essential workers, supermarket-goers or simply rule-breakers. They could be undetected cases linked to mystery ones. In a best-case scenario, the number of infectious cases in the community could fall to zero this coming week, leading to level 3, and then level 2 after another week of no sign of cases who aren't already isolating. The worst-case scenario is that this number not only rises after movement in the community, but an essential worker also takes the virus beyond Auckland's boundary. If the outbreak flares up, Auckland would need to stay in lockdown until vaccination coverage starts to flatten the curve - which might not be until the end of the year.

Will life go back to normal when we come out?

Things will be Delta-tweaked, as we've already seen with tighter restrictions on gatherings and more mask-wearing at level 2. This accounts for the possibility of airborne transmission from fleeting encounters. Level 1 may be able to stay as it is now - with maximum freedom, but now with mandatory record-keeping - but the trade-off would be tighter border restrictions to minimise the number of Delta cases coming into the country. Lockdowns may still be used, but as more of us get vaccinated, they won't be needed as much as they are now.

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Can we still eliminate Covid - or are we going to have to learn to live with it?

It's hard to say what next year will be like, but pursuing elimination for now at least gives us a choice. It's also the best thing to do while we remain so unvaccinated. Once vaccination coverage is sufficient for the borders to start reopening, however, the virus will come into our communities and - as we do now - we will rely on rapid testing, tracing and case isolation, and even localised lockdowns to minimise its spread. We may still be able to quickly stamp out any incursion into the community. We may also not need to if vaccines and Covid treatment have evolved to a point where we can live with it without hospitals being overrun or people dying needlessly.

Is vaccination the answer?

It's not the only answer but it's certainly the loudest. It minimises the chances of catching the virus, and if you do, it minimises the chances of death or severe illness. Countries we like to compare ourselves to have had vaccination rates plateau at around 53 (US) to 68 per cent (Canada). Clearly, no one is going to get 100 per cent coverage, and even if they did, vaccines aren't 100 per cent effective so people would still get sick. Some public health measures and border restrictions are still needed.

A sign at Te Kauwhata stating only essential travel allowed. Photo / Mike Scott

When will we reopen our borders?

The current outbreak doesn't necessarily push back the timeline of early next year. The Government's plan to reopen was predicated on having everyone vaccinated who wants to be, with enough coverage among certain groups. This will hopefully be achieved by the end of the year, regardless of whether we beat the current outbreak. But reopening was also predicated on starting from a position where the virus is eliminated, which would give us the best chance of continuing that strategy, should we choose to. If we're not there as the clock ticks 2022, we may want to strive to return there - if possible. This would give us options on how to live in a Covid world that will be with us for some time, and which could still throw a more deadly variant our way. And that might mean a little longer in Fortress NZ.

Jamie Morton: Science reporter

How long will Auckland be in lockdown?

That partly depends on Aucklanders continuing to play their part under Level 4, and not giving the virus a chance to spread. Mathematically, there's the all-important "R" value, which is simply how many people are being infected by each positive case of Covid-19. Before lockdown, Delta's R, potent as it is, was sitting above six. When the number is high, the virus spreads faster. With the virus now having been starved for weeks, we can safely assume it's well below one. Perhaps even as low as 0.4, as current modelling shows. The Auckland-centred outbreak might now be eliminated within weeks, provided we keep the pressure on it. When will Auckland join the rest of the country at "Delta Level 2"? That depends on officials' appetite for risk - and with Delta, that tolerance level will be extremely low. It's also worth noting that more than 20 community cases during this outbreak haven't been epidemiologically linked - and that will make officials nervous. It only takes one rogue case to re-ignite an outbreak.

Will life go back to normal when we come out?

As we've already seen around the rest of New Zealand, life even at level 2 is much different than it used to be. It now means masking up in most public places - including supermarkets and shopping malls - and the measure is also recommended, but not required, in schools. Scanning and record-keeping are now required in a lot of settings. A bar or restaurant can't have more than 50 people seated at a time. Experts have gone as far as arguing that these busy venues shouldn't have even been allowed to open under the new level 2. When Auckland's lockdown finally lifts, it's likely that this is what people can expect. And at level 1, we might anticipate other tweaks that mean "normal" life in New Zealand won't be the same.

Can we still eliminate Covid - or are we going to have to learn to live with it?

In New Zealand, and for the time being, yes we can, as the response to this outbreak is showing. But that'll be increasingly tough in the age of Delta. A few quick reasons to stick with the strategy: it's given New Zealand a cumulative Covid-19 death rate nearly 250 times lower than the OECD average, and helped protect our economy. Going by GDP over the first five quarters of the pandemic, New Zealand's was the sixth-best performing in the 38-nation club. On top of that, it's kept our health system from being overloaded and spared Kiwis the long-term problems that follow infection. Epidemiologists say there's no reason our strategy can't hold against even Delta, so long as we go as hard as we can while we're still vaccinating.  South Australia, Queensland, Taiwan, Hong Kong, China and Singapore have already proven it's possible. And going forward, as coverage rates rise, the strategy can be changed. It's a trump card that we shouldn't throw away - and we'd be foolish to go the way of other nations like the UK if we don't have to. In the longer term, and globally, however, worldwide eradication is probably next to impossible. That'll likely mean that the virus could become endemic here when we reopen - albeit with some protection from high vaccination rates, hopefully.

Supermarket shoppers wear masks as they enter Countdown Hobsonville. Photo / Sylvie Whinray

Is vaccination the answer?

It's part of the answer. Much has been said of Australia's 70 to 80 per cent vaccination threshold - a milestone at which politicians across the ditch have promised restrictions can begin to be lifted. It's a federal game-plan that states like New South Wales and Victoria are now having to embrace after Delta outbreaks have taken elimination off the table. But that won't mean there won't be other controls in place across Australia, or that it'll be like living in 2019. Here in New Zealand, Prime Minister Jacinda Ardern has repeatedly pushed the line that the Government will review the options once it has completed its vaccination drive. But again, it'll be unlikely this will spell complete freedom. Modelling studies tell us that achieving population immunity against Delta is unlikely, given this would require uptake among all Kiwis to be close to 100 per cent. Currently, the shot is only approved for people older than 12 - and willingness to get the vaccine among the population has been sitting at only 80 per cent.

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When will we reopen our borders?

At this point, that's tough to say. As the Delta outbreak hit, the Government had already been in the process of opening a self-isolation trial for vaccinated travellers to prepare for a "phased resumption" of quarantine-free travel. It's worth noting that Sir David Skegg's group found that allowing more quarantine-free travel would raise the risk of Covid-19 entering the country again - and even with high vaccination levels, there'd still be some clusters of infection and occasional large outbreaks. By sticking with elimination, we might hope these could be stamped out without more lockdowns, and by public health and social measures such as mass testing, rapid tracing and isolation of contacts, as well as physical distancing and mask-wearing where appropriate. Simply throwing open our borders and letting the virus rip doesn't seem a good option, even in the long term. One modelling paper found that even if we vaccinated nine in 10 Kiwis, doing this led to more than 11,000 hospitalisations - and more than 1000 deaths - in only two years. So the most important question might not be when we reopen, but how.

Liam Dann: Business Editor at Large

How long will we be in lockdown?

Economics doesn't claim any special insight into this. It's ultimately a political call, underpinned by the science. What economists do is model outcomes for various scenarios. For most, the base case is still the optimistic one we're all hoping for - four weeks of level 4 for Auckland, followed by a couple at level 3. While level 2 remains problematic for some specific sectors, it matters less at a macro-economic level. Sydney-based Capital Economics has modelled a scenario where we fail to eliminate and follow the Aussie path of lower-level lockdowns for longer (while we vaccinate). The good news is they still forecast the economy to hold up well.

Will life go back to normal when we come out?

Normal is a pretty fluid concept these days. Will we get back to the gym, meet friends for a beer and get back on the sidelines for kids' sport? Sure, New Zealand has already proved it can do that - through the past 18 months and through other epic events like the world wars. But the world isn't ever going back to the way it was in 2019.
History doesn't work that way. When Covid finally fades from the front pages, the world will have emerged from an accelerated period of technological, social and political change.
It will be a different place. But like everything, it will, eventually, feel normal.

Can we still eliminate Covid - or are we going to have to learn to live with it?

We are already learning to live with it. Thankfully we are learning to live with it at the borders or the fringes of the community. We're learning to live with it, without mass hospitalisations and deaths. Sooner or later, we'll have to tolerate it in the community. But for now, from a social and economic point of view, elimination provides a better outcome. Our borders have never closed to commerce and capital. That's allowed the economy to perform well even with the inflow of people restricted.  No one wants to live this way indefinitely. But doing so for a bit longer will allow us to make choices about our risk appetite, as a nation.

A pop up vaccination centre at the Free Wesleyan Church Of Tonga. Photo / Michael Craig

Is vaccination the answer?

Yes, absolutely. But it isn't a silver bullet, or at least this version isn't. History tells us that humans will win this race. But it has really just begun - scientifically and logistically. We need the whole world vaccinated. And we need more effective vaccines. I'm optimistic about the latter, at least. Although only eight vaccines are approved for full use, more than 100 are in development, according to the New York Times. In New Zealand, getting vaccination rates above 80 per cent would be a game-changer. It would also be a world-beating effort. But that's okay, Kiwis love that kind of challenge.

When will we reopen our borders?

If we can hit those world-beating vaccination rates, I'm hopeful we'll still be able to follow the plan outlined by the PM pre-lockdown, without too much delay. This would mean a careful, targeted reopening through 2022. But we should be realistic about the timeframe for unrestricted travel. Air New Zealand's cautious strategy offers a good touchstone.
It has deferred buying two Boeing 787s for up to four years and has not committed to capital expenditure beyond 2028. The airline is configuring for a lengthy period of partial reopening, along the lines of what we saw with the transtasman and Cook Island bubbles.