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Home / New Zealand

Covid-19: Experts respond to 'mixed bag' of rollbacks

Jamie Morton
By Jamie Morton
Multimedia Journalist·NZ Herald·
12 Sep, 2022 05:18 AM7 mins to read

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Prime Minister Jacinda Ardern has announced that the country will scrap the traffic light system from 11.59pm tonight.

Epidemiologist Michael Baker has described a sweeping roll-back to our Covid-19 settings as a "mixed bag" - and the lack of a fresh plan to move to as a lost opportunity.

The Otago University professor was happy to see masking requirements kept in healthcare and aged-care facilities - as has already been signalled.

But he was disappointed they'd no longer needed to be worn on public transport, which he described as a "crowded, contained and high-contact environment".

"That may be the only transport option for low-income New Zealanders - and they're going to be more exposed to infectious people for long periods than others," Baker told the Herald from Manila.

"So I think we're missing an equity opportunity."

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Baker saw changes to isolation requirements - meaning only infected people needed to stay home for seven days - as reasonable.

"We know that two-thirds of people are still infectious at five days, and a quarter are at seven days," he said.

"It's always a compromise, but seven days is reasonable - and I'm pleased that we didn't shorten or abandon that period."

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Although Australia recently shortened its isolation period to five days, the changes put New Zealand in the "middle ground" of what different countries required.

But he questioned lifting vaccination mandates - including for healthcare workers - as well as vaccination requirements for air crew and travellers coming into the country.

With perhaps two per cent of travellers carrying the virus, he said this could be an ongoing source to seed new outbreaks here over time.

"It is inconvenient - but it's one of the realities we face, and we need a carefully-reasoned response to imported cases."

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Baker's biggest criticism, however, was the lack of a new framework, now that the Government had decided to drop the traffic light system.

"The immediate problem is that Covid-19 is highly likely to produce new waves in the medium term, that may or may not be more severe than what we've seen," he said.

"So I just think it's a missed opportunity not to actually continue that idea [of a framework].

"The traffic light system was quite poor, but we could have easily evolved it to develop a very good, a very high-quality system for categorising the level of risk."

Covid-19 modeller Professor Michael Plank said that, with cases, hospitalisations, and deaths at their lowest since February, it was a "good time" to review what measures were needed.

"Covid-19 is shifting from being an acute threat to an endemic disease. That doesn't mean it's harmless or that we can forget about it," he said.

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"But it does mean that some of the interventions that were crucial to flattening the curve and protecting health system capacity in the acute phase are less effective as we move into the next phase."

Plank said blanket measures such as mask mandates in places like retail, schools and workplaces were likely to have a marginal effect on the number of infections in the long term.

"The reason is that, at any given point in time, the large majority of the population will be immune to the virus and so the majority of masks will be having little or no effect," he said.

"Masks do have downsides and it's important to weigh those against the benefits they provide.

"Many countries have lifted mask mandates without experiencing a significant increase in sickness or death as a result."

But Plank said this needed to be balanced against the fact mask wearing still gave protection to individuals who are at higher risk.

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"It makes sense to target measures to high-risk settings such as healthcare and aged residential care," he said.

"Mask requirements may also need to be reintroduced for example if a new variant threatens to cause a major wave."

Covid-19 modeller Dr Dion O'Neale pointed out the Government hadn't introduced a test-to-release policy to isolation requirements, which could mean many confirmed cases might be isolating for longer than needed.

"While test-to-release may not be a requirement of the new Covid-19 settings, it is still something that people may choose to follow and the continued free availability of RATs makes that more practical than it otherwise would be."

Fellow modeller Dr Emily Harvey was also pleased to see isolation requirements continue.

Reminder that you should look at the government’s public health guidance for what you should do, NOT at the bare minimum legal requirements.

What you should do to keep yourself and others safe has not changed. It’s only the legal requirements that have changed.

— Emily Harvey (@emilynz) September 12, 2022

"We know that isolating confirmed cases of Covid-19 while they are infectious is a crucial piece of public health policy, that prevents a large amount of onward transmission, while only causing disruption to the number of people who are confirmed infections," she said.

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"In terms of largest reduction in transmission for the least disruption, this is the most important policy to keep."

Generally, she said isolation requirements, requiring daily testing for household contacts, and giving clear guidance for people to stay home when they were sick would do much to curb spread.

"However, what we are missing is a clear strategy around improving ventilation and making indoor air safer."

O'Neale also noted it would have been good to see a move toward an expectation of widespread "systemic protections", such as clean air and ventilation requirements.

"It is also important to remember that, as always, government-mandated requirements are a minimum level of what can be expected of people, as opposed to what is sufficient to keep everyone safe in all situations," he said.

"We know that masking works best when everyone in a room is wearing a well-fitted mask.

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"With the removal of masking requirements, it will be increasingly important for individuals to choose to mask up in order to protect those who are more vulnerable to Covid and to make sure that others can still safely participate in everyday life."

Otago University epidemiologist Dr Amanda Kvalsvig pointed out Covid-19 was still circulating, and causing deaths every day.

"Reduced measures mean that disabled and immune-compromised people will now be sharing public spaces with unmasked people who could be a household contact of a case and actively infectious."

She likewise saw a need for action on better indoor air quality.

"But without safe access to public spaces, many disabled people will have to make choices no-one should have to make, between a lockdown - but this time, a private one with no endpoint - or taking on the risk of a life-changing or life-limiting infection."

Looking ahead, Kvalsvig warned against complacency in the face of a pandemic by no means over.

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"New Zealanders are being promised a Covid-free summer, but that lovely outcome is not in the power of any Government to promise," she said.

"We have a high level of certainty that new variants will appear with capability to evade immunity from infection or vaccines."

What we didn't know, she said, was when they'd appear - or how serious they'd be.

"A far more reassuring message would be for the Government to demonstrate that it's aware of the challenges and is actively preparing for both expected and unexpected threats to public health," she said.

"That reassurance would include a much more realistic and absolutely achievable aim of having systems in place to ensure that people can enjoy summer even if it coincides with the arrival of the next variant outbreak."

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