By Guest Author 21/04/2020


Dougal Sutherland, Te Herenga Waka — Victoria University of Wellington; Arindam Basu, University of Canterbury; Malcolm Campbell, University of Canterbury; Martin Berka, Massey University; Michael Baker, University of Otago, and Richard Shaw, Massey University

New Zealand will begin easing its national lockdown from next Tuesday, but only after a five-day extension of some of the world’s strictest COVID-19 restrictions.

New Zealand will then remain at alert level 3 for two weeks, before a further government review and decision on May 11 about whether to relax restrictions further.

 

Prime Minister Jacinda Ardern said the sacrifice New Zealanders have made to date has been huge, but the short extension of level 4 conditions – to cover a public holiday long weekend – locks in the gains made and provides added certainty.

Waiting to move alert levels next week cost us just two more business days but gives us much greater long-term health and economic returns down the track. It means we are less likely to have to go backwards.

She also reiterated New Zealand’s goal of eliminating COVID-19.

Elimination doesn’t mean zero cases, it means zero tolerance for cases. It means when a case emerges, and it will, we test, we contact trace, we isolate, and we do that every single time with the ambition that when we see COVID-19, we eliminate it. That is how we will keep our transmission rate under 1, and it is how we will keep succeeding.

As of Monday April 20, New Zealand has had 1,440 cases of COVID-19. 12 people have died from COVID-19 in New Zealand, while 974 people have recovered.

Below, New Zealand experts in public health, psychology, economics and politics give their take on the government’s decision.

A cautious welcome from a leading elimination advocate

Today’s announcement about stepping down the response levels is a welcome one. Last month New Zealand made the big decision to adopt an elimination goal in response to COVID-19 and go into a very tight lockdown. That move has achieved much in terms of reducing virus transmission and giving us time to get key systems working to ensure we can sustain elimination.

The discussion now is all about coming out of alert level 4 in a way that provides a high level of certainty we will achieve elimination. This is very different to coming out of lockdown in most countries, where the goal is just to suppress transmission rather than achieve elimination.

There are reasons we need to be cautious. The modelling work conducted by Te Pūnaha Matatini suggests we need two more weeks in lockdown to improve the chances of virus elimination. There are also concerns about partial opening of schools and early childhood centres at alert level 3 when there is uncertainty about the role of children in COVID-19 transmission.

That said, the move to level 3 on April 28 is probably a manageable compromise. We need to get businesses working again for the health of people and the economy.

– Professor of public health at the University of Otago Michael Baker

New clusters will emerge, but COVID-19 is under control

As Prime Minister Ardern stated today, the effective reproduction number is now less than 0.5 (~0.48). If you contrast this to the situation roughly one month back, this number was around 2, and the infection was taking on an exponential growth.

In the absence of a vaccine, New Zealand have been successful in containing the epidemic using strong public health measures. When you combine this with increasing numbers of tests and contact tracing, the claim that community transmission is under control and transmission rate is low is fully justified.

Contact tracing works best during the “tail” of the epidemic, either during the first phase when the epidemic is “rising” or situations such as this in New Zealand when the infection is “dying out”.

We have ramped up our contact tracing at this stage and this will be sure to interrupt the chain of transmission of new outbreaks, as contact tracing and isolation will quickly bring the effective reproduction number under control. We may continue to see some new clusters emerge but they can be quickly addressed and mitigated.

– Associate professor of epidemiology and environmental health at the University of Canterbury Arindam Basu

Relief and a renewed sense of purpose

Many New Zealanders will likely feel a sense of relief about the government’s announcement that we will come out of level 4 lockdown next Monday night. Most seemed to be hoping for this response and to have stayed at Level 4 for any longer may have prompted exhaustion and frustration.

However, we are now on the home straight and the finish line is in sight. Moving out of level 4 with too little warning could have increased panic again, with schools and businesses rushing to prepare themselves and in doing so risking tripping up before the race is completed.

The allowance for businesses and schools to be restocked and cleaned this week may give people a sense of purpose and some level of control over their situation, perhaps cleverly diverting any restless energy into something productive. The timeline for when we might move out of level 3 further helps us psychologically, as clear expectations and boundaries assist us to feel calm and stick to the limits for one more week.

– Clinical psychologist at Te Herenga Waka — Victoria University of Wellington Dougal Sutherland

How every Kiwi can help catch future outbreaks

One key aspect of our response to COVID-19 continues to be understanding where the virus is being transmitted. Regardless of how the decision could have turned out today, we really do need to keep track of our movements.

This means we should keep a diary of where we’ve been and who we’ve been with for the foreseeable future. If we ever become infected with COVID-19 or a close contact of someone who has the virus, tracing 80% of all our close contacts within three days is the “gold standard”.

We can all help speed this up by tracking our movements. To remind us where we’ve all been, we could use social media check-ins, Google location history, or, if we have been shopping, we can look at our receipts or credit card and EFTPOS records.

There has also been discussion about technology and apps as one solution to controlling the pandemic. But, let’s not forget, we need COVID-19 testing for any apps to work. No tests, no point in an app, because these apps rely on testing. The apps are only ever a support to the hard work of testing and contact tracing.

– Associate professor in health and medical geography at the University of Canterbury Malcolm Campbell

Protecting lives as well as livelihoods

I am delighted with the decision of our government to extend the level 4 restrictions by only five days. The prime minister noted that our estimate of the transmission rate of the virus dropped to 0.48. This is not only far less than elsewhere in the world, but also less than the assumptions made by some modellers. It highlights how rigorously most Kiwis adhere to level 4 restrictions.

Political realities aside – and noting that the key coalition partner obviously had to be taken on board – the decision gives us the ability to take sufficiently good control of the epidemic before allowing some 400,000 New Zealanders to return to some form of paid employment, which is essential for their well-being.

I am particularly delighted the prime minister was again able to find the middle ground and balance the protection of our lives and livelihoods.

– Professor of macroeconomics at Massey University Martin Berka

The politics of uniting a coalition government

The prime minister made it clear today’s decision was based on the recommendation of the director-general of health. So there is science in here – but there is politics too.

Jacinda Ardern heads a coalition government containing ministers from three different parties. The challenges of holding a multi-party government together in the best of times are formidable, and call for a range of political leadership skills that are not always required of single party governments. These are not the best of times, of course, so the fact no one in Ardern’s government has – so far – publicly broken ranks on the government’s approach to the COVID-19 crisis speaks volumes for the way the government is being run.

One other advantage of coalition governments is they can bring a wider range of perspectives and voices to policy decision making than is sometimes possible under single party government. When three parties govern together they necessarily bring a significant swathe of public opinion into the process. Decisions, therefore, are likely to be supported and to endure in ways that do not always occur when there is just one party at the cabinet table.

But no matter how many parties there are in government, there can only be one government and one message. The prime minister’s job today was to ensure each of the governing parties’ perspectives contributed to the final decision to come out of alert level 4.

It is still too soon to tell, but the early indications are that she got the call right.

– Professor of politics at Massey University Richard Shaw

Dougal Sutherland, Clinical Psychologist, Te Herenga Waka — Victoria University of Wellington; Arindam Basu, Associate Professor, Epidemiology and Environmental Health, University of Canterbury; Malcolm Campbell, Associate Professor in Health and Medical Geography; Deputy Director GeoHealth Laboratory, University of Canterbury; Martin Berka, Professor of Macroeconomics, Head of School of Economics and Finance, Massey University; Michael Baker, Professor of Public Health, University of Otago, and Richard Shaw, Professor of Politics, Massey University

This article is republished from The Conversation under a Creative Commons license. Read the original article.