Leading epidemiologist Sir David Skegg says New Zealand has been "let down by its allies" in its fight to eliminate Covid-19.
Skegg is the chair of an independent panel of experts who yesterday provided advice to the Government on its ongoing Covid response strategy.
The Prime Minister responded this morning. She has set out a plan to start re-opening the borders from next year, starting with a trial between October and December of self-isolation for vaccinated New Zealanders arriving back into the country.
That would be followed by the phased resumption of quarantine-free travel in the future. The plan would eventually see three "pathways of travel" into New Zealand.
For full coverage of the Government's blueprint, click here
Virus 'still winning the war'
Speaking at this morning's press conference, Skegg said despite vaccine development the virus was "still winning the war".
New Zealand's allies could have pursued an elimination strategy, Skegg said, but they chose not to.
"Many of the countries that could have eliminated Covid-19 either never tried, or threw in the towel."
Each country had done its own thing. The independent channel chaired by Helen Clark showed a weakened World Health Organisation unable to provide the leadership required.
There were also new variants, including Delta, making the virus more difficult to control.
Referencing Winston Churchill, Skegg asked how he could have had a detailed plan to defeat the enemy at the beginning of the war.
"Nor can we pretend to have a detailed plan with how we can reconnect with the world over the next year or two."
The priority was to get as many New Zealanders as possible protected by vaccination by the end of the year. But by then there could be a new variant, more challenging than Delta.
There would be, though, more known about vaccine efficacy, better testing, and even potentially anti-viral technology that could "completely change our attitude to this virus".
There however still needed to be a strategy, he said. The first question his group looked at was if elimination was still viable. Many people had said elimination was impossible.
"Well they were wrong," Skegg said.
He compared the New Zealand situation with that of Scotland, which had a similar population. Here 26 people had died; there more than 10,000.
"We dodged a bullet," Skegg said.
But reopening borders and new variants raised further questions. The experts concluded that at this stage elimination was not only viable but the best option.
"It allows us to enjoy a lifestyle relatively unaffected by the ravages of Covid-19 and protect our health service and economy."
The United Kingdom had a great vaccination rollout, with 84 per cent of adults having antibodies from vaccination or past infection. Yet last week they still had 627 deaths from Covid - equivalent of 48 a week here, based on population.
There were also heavy social and work restrictions, with enforced mask use and a fear of contagion.
This was a real thing in the world today.
"I hope not to spend the rest of my life shielding from others. I don't want to spend the rest of my life looking at beautiful faces covered by masks. We are going for gold and we may not succeed, if we don't achieve high vaccination."
Along with high vaccination there also needed to remain precautions at the border.
The group had suggested a gradual reopening, with quarantine-free travel from low and medium-risk countries, with proof of vaccination, testing and contact tracing measures.
This would occur from the beginning of next year, when everybody had a chance to be vaccinated.
The group did not favour setting a vaccination target, rather aiming for getting everybody vaccinated.
Lockdowns destroy business confidence: Rob Fyfe
Rob Fyfe told the press conference that, looking through a business lens, what destroyed confidence and viability was lockdowns.
"Businesses need to do everything they can to support people to be vaccinated."
There were many tools, including border measures, but lockdowns were the inevitable consequence where they failed.
Businesses could help people be available to be vaccinated and create understanding.
They could also encourage QR scanning and testing.
Strategies need to recognise Māori community
Dr Maia Brewerton said in terms of the Māori response, it was important the strategies and vaccination rollout recognised community.
"At the heart of being Māori, you put your whānau and community ahead of yourself. That was very much what happened around New Zealand. It is not unique to Māori ... but it is very important what we do is led by our communities."
It was clear from the rollout not one size fit all. The rollout needed to be dynamic, adapt where needed, especially to reach out to the marginalised and vulnerable.
"We need to focus on those who are not accessing the vaccine, change the rollout if need be to meet those people, ask what we can do differently. Nobody knows a community like that community, a whānau like that whānau. People want the vaccine, but are not able to access it."
The Pasifika perspective
Dr Api Talemaitoga said equity needed to be at the heart of the vaccination rollout.
From a Pasifika perspective, there needed to be greater focus on education, location of vaccinations, but also on community.
It was worrying that hesitancy was used as a blame, and took away the focus from education.
In terms of venue, Talemaitoga said it needed to be centred around the community and what those communities value.
'If we do our jobs well we will get high rates of coverage': Bloomfield
Dr Ashley Bloomfield said he never felt vaccine hesitancy was the problem.
"We know most people if they have information from someone they trust, offered a vaccine in a setting by someone they trust they take up that offer. If we do our job well we will get high rates of coverage."
Skegg said it was important as many as possible were vaccinated, because if not it would be less effective.
It could mean the health service would be swamped, meaning delays for elective surgery, and for things like cancer, heart attacks and stroke.
"I hope we can be unselfish and care about each other, we also need to care about the whole.
"I hope we can beat the world at vaccination as well."
Asked about 12- to 15-year-olds being vaccinated before the school holidays, Bloomfield said "watch this space".
They were still awaiting trial results and evidence around efficacy and safety.
"We are watching like a hawk," he said.
'We have to open up': John Key
Meanwhile, former NZ Prime Minister Sir John Key says the Government should adopt a telethon-style approach to boost vaccination numbers and open up our borders by Christmas.
Key told Newstalk ZB's Mike Hosking this morning that, rather than aiming for elimination, the focus should switch to relaxing travel bans and getting everyone a double jab in the coming months.
"We have to open up. We can't sit back forever where businesses and families can't get in or out of New Zealand."
With the elimination strategy being abandoned in countries across the globe, including Australia, the Government should admit it was no longer a viable strategy, Key said.
Instead, it was important to get the population fully vaccinated and live with the virus.
Key said the way to achieve this was to set vaccination targets that were constantly screened, very much like telethon target totals.
"If you sit there and are going to say we are going to open up the borders by Christmas and we're going to give everyone the chance to be double jabbed by Christmas, why wouldn't you just be constantly running it on the corner of the TV every single day between now and then with the days left and the number of people jabbed?" he asked.
Earlier advice painted sobering picture
His comments came after Sir David Skegg said borders will re-open next year after the vaccine rollout finishes, but only then will experts be able to see if enough of the population is vaccinated to stay the elimination course.
Skegg was speaking to the Herald after an expert panel he chairs released its advice to the Government, and ahead of today's press conference.
The group's advice, released yesterday, paints a sobering picture of an uncertain future in a world still gripped by Covid-19, where overseas travel is limited to the fully vaccinated and herd immunity is unattainable, making public health measures an important part of the elimination puzzle as border restrictions are eased.
The advice included a caveat that no one really knows what the Covid-hit world will look like in three to five years, or even in six months' time, which makes making promises about when the borders will reopen problematic.
That was in part the reason the group didn't provide a target for when the borders could start to re-open and enough people were vaccinated for life to continue much as it does now - with few community Covid cases that are quickly stamped out as they arise.
Skegg added that the number of unvaccinated port workers at the border remained "a major concern", especially in light of the 98 port workers in Tauranga who had a Covid-scare with the Rio de la Plata - only nine of them were fully vaccinated.
"I was shocked by the low vaccination uptake by port workers in Tauranga. Hopefully this is now being addressed."
In Australia, an expert panel similar to Skegg's one has suggested 80 per cent vaccination coverage of the eligible population before international travel might be opened up more.
"There is no way of determining this [level of vaccination coverage] with any precision," Skegg told the Herald.
"We assume the re-opening of borders will start in a phased and carefully monitored way early next year, when the vaccination rollout is completed.
"Then we will discover whether the vaccination coverage achieved, together with our recommended precautions, such as rapid testing of travellers on arrival, plus strengthened public health and social measures, will be enough to maintain elimination of Covid-19."
More open borders would inevitably lead to some outbreaks, but with a high level of vaccination coverage and public health measures - including localised lockdowns - these could be quickly stamped out.
Skegg said having large cohorts of unvaccinated people in different pockets of New Zealand could endanger not only them, but the vaccinated as well.
"The hospitals would be swamped and that would affect all kinds of people, including those needing urgent cancer treatment. That has been a major problem in other countries, such as the UK."
The first phase of the re-opening, the group suggested, should be for fully vaccinated Kiwi travellers returning from short overseas trips to low-risk countries.
That was in part because their vaccination status would be reliably known, including which vaccine they've had - aspects that may not be so easy to certify in other travellers.
Skegg couldn't say how long it would take to transition from there to quarantine-free entry, but piloting each phase would provide some insights to the timeline.
He said it would be ideal if the quarantine-free travel bubbles with Australia and the Cook Islands became travel corridors for the fully vaccinated.
That is already in the Government's thinking.
Covid-19 Response Minister Chris Hipkins said yesterday re-opening the transtasman travel bubble might only happen for New Zealand citizens or those who are fully vaccinated.
The panel also points out the health system is still poorly resourced, and Skegg has recommended a review of how the system would deal with Covid-19 outbreaks.
"The relatively low provision of ICU beds per capita is certainly a concern."
It was difficult to say for how long Covid-19 outbreaks and the possibility of localised lockdowns would be part of the new normal.
"It is too hard to predict. This pandemic keeps surprising everyone, and that is likely to continue."