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Home / New Zealand / Politics

Covid 19 Omicron outbreak: Derek Cheng - How you should behave in the new 'new normal', and where the risks are

Derek Cheng
By Derek Cheng
Senior Writer·NZ Herald·
23 Mar, 2022 06:00 AM6 mins to read

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From 11.59pm on Monday 4 April, vaccine passes will not longer be required. The Government will not require mandates in education, police or Defence Force workers and those workplaces using them.

ANALYSIS:

There are two main issues with the changes to the traffic light system and the upcoming relaxation of restrictions.

The first is that, from this weekend, the greater allowance for indoor gatherings and no restrictions on outdoor ones will see a lot more mixing and mingling across the country, including beyond Auckland.

The latest modelling for the country outside Auckland shows the Omicron peak tailing off slightly by then, but peak hospitalisations won't dip for another two weeks after that, and a post-peak long tail is not unexpected.

The model also doesn't account for the changes taking effect from this weekend, which won't apply to the unvaccinated until April 5.

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So hospitals outside Auckland, then, will still likely be in the grip of the Omicron peak. Why the Government didn't delay all of the relaxations until April 5 is an open question.

The seven-day average for case numbers for Auckland, the rest of the country, and the latest modelling - which doesn't account for looser restrictions from this weekend. Source / Supplied
The seven-day average for case numbers for Auckland, the rest of the country, and the latest modelling - which doesn't account for looser restrictions from this weekend. Source / Supplied

More mingling means the possibility of a higher and longer-lasting peak than what otherwise would have happened - and more pressure on an already stretched health system.

How much more? The secondary attack rate for hospitality settings is 6.7 per cent - a small chance of catching it from an infected person, who is seated and separated in the same venue.

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Such restrictions don't apply to indoor events, where there are no ventilation requirements, and masks aren't needed unless you're sharing the space with other groups or members of the public. So a question mark hovers over how much more transmission will occur in these settings.

Prime Minister Jacinda Ardern is hoping that health services will be able to cope with whatever extra pressure there might be.

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And she has the backing of eminent epidemiologist Sir David Skegg: "I would not expect the peak of the outbreak to be pushed higher. There may be more cases in the future, but I believe health services will be able to cope."

He adds: "I am naturally in favour of any practicable measures that can minimise infection and protect people. But all governments have to consider the social and economic costs of restrictions, as well as their acceptability to the general public."

The second issue is that there was nothing new to encourage vaccine uptake for the 950,000 Kiwis who are eligible but not yet boosted, or for the 5-to-11 age group who have been able to get a jab from the end of January; only 54 per cent of this age group have had one dose, while just under 10 per cent have had two (for Māori, those proportions are 35 per cent for one dose and 5 per cent for two).

One of the buffers to this vulnerability is that there are up to 1.7 million people who have caught Omicron in this outbreak, which has seen significantly more natural immunity throughout the country, including among the unvaccinated and the unboosted.

A factor in the size of this peak and subsequent Omicron waves is how people behave and, more than ever, you're being left to consider your own appetite for risk.

Sir David Skegg says there needs to be a comprehensive plan to protect children, who can't be vaccinated if under 5, and who have low vaccination coverage if 5 to 11. Photo / Mark Mitchell
Sir David Skegg says there needs to be a comprehensive plan to protect children, who can't be vaccinated if under 5, and who have low vaccination coverage if 5 to 11. Photo / Mark Mitchell

So how should you behave?

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If you've been boosted and healthy, going about your normal life poses little risk to yourself as you're unlikely to need hospital care, and little risk to the community because you're unlikely to delay someone else's procedure by taking up a hospital bed.

"If you don't have underlying illnesses and you're not particularly elderly, you can still go out and enjoy life - just try and do it safely," epidemiologist Professor Michael Baker says.

That means wearing the right kind of mask in the right setting.

"There are aerosols wafting around, and they won't be stopped well by anything other than a respirator mask like the N95."

His advice is understandably different for the elderly or immuno-compromised.

"Your immune system doesn't have such a good response, even if you're vaccinated, so the only thing you can do in that situation is to actually reduce your contacts quite significantly."

Baker remains worried about school settings, where there is still such low vaccination coverage among under 12s, and only staff and students from Year 4 upwards are required to wear a mask indoors.

The vaccine mandate across the education sector is also being scrapped from April 5, though with such high vaccine coverage already among teachers, this should have limited impact on overall transmission.

Baker says protection in schools could be greatly enhanced by supplying respirator masks across all school years.

High-quality masks used "consistently across educational settings" is also being stressed by developmental paediatrician Dr Jin Russell.

Schools is an area highlighted by the report from Skegg's group.

"While Covid-19 is generally less severe in children than in adults, some children suffer serious early and longer-term effects," the report said.

"Hence there needs to be a comprehensive plan for protecting children from Covid-19."

The Government is formulating this plan, which will hopefully include clear guidance for parents of school children, and will be rolled out in time for winter.

For now, beyond mask-wearing, the Government has ordered 5000 air cleaners for schools, most of which are expected to arrive by winter, and has moved to make rapid antigen tests easily accessible.

Epidemiologist Professor Michael Baker says healthy people who are boosted should go about their lives as normally as possible within the rules - but to use a high quality mask. Photo / Supplied
Epidemiologist Professor Michael Baker says healthy people who are boosted should go about their lives as normally as possible within the rules - but to use a high quality mask. Photo / Supplied

For Baker, he has been keenly watching infection levels in Wellington to inform the risk to his own 11-year-old daughter, who had her second dose last week.

"We've been right on the borderline of pulling her out of school. The main thing we did was to get a second dose as early as possible, and she has a set of high-quality respirator masks that she wears every day."

Another concern, not only for children but for all of us, is Long Covid, and little is known at this stage about how it relates to Omicron.

But even if only 1 per cent of Omicron cases suffer Long Covid symptoms - and the proportion is as high as 20 per cent for previous variants - then that could amount to tens of thousands of Long Covid cases from this outbreak alone.

"The prevalence of Covid-19 infection in our community is so high at the moment that I think everyone should be cautious at present," says Skegg.

"But in the future, most vaccinated people should be able to enjoy a full life, while remembering the precautions that we now recognise as important for preventing all respiratory diseases – such as staying at home when sick and wearing masks in some indoor settings."

There is evidence that vaccination provides some protection from Long Covid, but it is still emerging.

While it seems New Zealand has turned a corner in the Covid era, there is still so much uncertainty that it would be wrong to hold it against anyone choosing prevention as the best medicine.

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