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Helen Clark, Peter Gluckman and Rob Fyfe issue a conversation paper looking at how and when New Zealand could step up its re-engagement with the rest of the world

Helen Clark, Peter Gluckman and Rob Fyfe issue a conversation paper looking at how and when New Zealand could step up its re-engagement with the rest of the world

By Peter Gluckman, Helen Clark & Rob Fyfe*

In any complex and prolonged crisis, a transparent and adaptive strategy is needed. This has never been more obvious than in the COVID-19 pandemic. Just after COVID hit our shores, initial discussions centred on adopting a “flattening the curve” strategy. This involved accepting there would be some influx of disease, but by using behavioural and hygiene measures, viral transmission would be slowed and our hospital system would not be overloaded, as was being seen in northern hemisphere countries.

But soon after cases started appearing, a clear shift in strategy was made – sometimes expressed as “keep it out, stamp it out”. In epidemiological terms, elimination of the virus became the goal. For New Zealand, adopting that strategy was scientifically plausible, as we had a low number of infections and could use our island geography.

But it required huge effort and sacrifice by all New Zealanders – the burden of which will continue to echo for many years. With the border closed, it would then be a case of effective testing, contact tracing, and isolation to eliminate the virus. Through very good messaging, particularly helped by the ‘bubble’ metaphor and relying on the country’s inherent social cohesiveness, the lockdown was a spectacular success. But in that success there are also challenges.

It is now clear the messaging around the state of contact tracing, personal protective equipment (PPE) and the management of isolation were not always accurate and that there were deficiencies in the system.

Trust is essential for a government in handling any crisis, especially when civil cooperation is required over a long time, and this is not helped by obfuscation. Indeed, in recent times that trust has been weakened by revelations of quarantine and tracing failings, and reassurances proving to be less certain than first claimed, with much remedial action required. Nevertheless, we’ve achieved our goal of being almost certainly free of community spread.

The public has shown remarkable forbearance and support for the sacrifices of lockdown. But people’s anger at process breakdowns was to be anticipated, given the early phase of the pandemic, during which most of us enjoined in a collective and cohesive blitz mentality, had passed. This is entirely as we would expect our emotions to evolve as we transition through a prolonged crisis.

To many epidemiologists, elimination means the reduction to zero of an infection in a defined geographical area. But as epidemiologist Sir David Skegg noted in his advice to the Epidemic Response Committee before lockdown was imposed, many others in the epidemiological community pragmatically define elimination as the reduction of case-transmission to a predetermined very low level. These distinctions may appear subtle, but they become critical in our collective thinking about the path ahead.

The former creates an expectation of keeping the virus out absolutely and indefinitely and that even one case coming in could be seen as a failure. The latter accepts that cases will occur and that processes need to be in place to ensure community spread is not established. Given the nature of the virus, the former definition is impossible to sustain unless we are prepared to continue aggressive and foolproof testing and quarantine at the border for a long time.

As smugglers have known for centuries, border controls are never foolproof. We do better than most because of our geography and a long experience in biosecurity, but human failures will occur, and at some time a case will break through. Universal quarantine for arrivals, aggressive testing, and contact tracing remain our main protection.

Further, defining a strategy for locking down is relatively easy (although requiring much sacrifice), one for reopening to the world is harder. Much depends on what is happening in other countries. From the moment of going into lockdown, work was needed on defining a strategy and the processes that would be required to move past total quarantine. Any such strategic analysis must be transparent and preferably developed through a collaborative process, because whatever is done will change the risk landscape significantly.

Many stakeholders continue to be at the mercy of such decisions, and those stakeholders are not just businesses, they are indirectly every New Zealander.

Therefore, we need to be thinking about defining our longer-term strategy. Is New Zealand prepared to hold itself in its state of near-total isolation for the indefinite future? Even opening the Trans-Tasman bubble looks further away than it did a month ago with resurgent community spread in at least one Australian state.

The hoped-for early links with Singapore have similarly evaporated. Are there Pacific countries that we could now open up to with green lanes? Some other countries are starting to create green lanes, but they have not adopted the elimination strategy. The latter places higher expectations on the system.

While we pin our hopes on a vaccine, it could be much further away than the hype suggests. Can we afford to wait out another year, two years, or even more in almost total physical isolation? And at what cost? This is not just affecting tourism and export education, but also the many ways in which New Zealand projects and leverages its place in the world.

On arrival, everyone is quarantined for 14 days, then tested around days 3 and 12. However, even that has not been foolproof, requiring tougher actions to make it more robust. Then there is the problem of volume management. With more flights resuming, more Kiwis are returning home. Among them are those who were trapped overseas by the virus, but now others who have been away much longer are choosing to come home because of our relative safety. As more flights open up, the flow could become a flood.

How will we manage? Will returning New Zealanders need to reserve a place in quarantine before arrival? And who among them should bear the cost of quarantine or part of it?

What solutions should we consider over the longer term? For example, could we develop a regime of approved tests – both antigen and RNA-based – before departure? This could be combined with rapid testing on arrival, then a shorter quarantine for those from low-risk countries. Could we develop better protocols for managed self-isolation for low-risk entrants? Could we allow long-term tourists, business travellers, and tertiary students in on such a basis? Could universities quarantine offshore students wishing to return?

Volume management and cost must be the primary reasons for not doing so now. Do we need to balance that against the priority of non-resident New Zealanders wanting to come home? These are difficult, value-laden ethical and legal questions, but they need to be asked. To what extent is the political cycle affecting necessary discussion and decisions?

Ultimately, these questions have been and will remain about risk management and communication. At what point will New Zealand accept less than absolute elimination? Such a goal is likely unrealistic over a long term. Even if a highly protective vaccination is developed, it may not provide absolute protection and coverage will not be absolute, so cases will always occur. Actuarial calculations might allow protocols to be established that could mean shorter quarantine or even self-isolation for some. Of course, any such loosening without protections increases the risk of the virus appearing in the community, but there are possible ways through that. What about mandatory tests every day or second day and a shorter quarantine for people from low-risk countries who want to enter?

Any change from current practices would require highly effective, high-speed contact tracing supported by quarantine of first- and second-degree contacts and would need to be carefully piloted. What incentives are needed so that people cooperate as the pandemic drags on over the next year or more? How can we maintain or introduce hygiene practices that economies like Taiwan have used effectively throughout the outbreak?

The costs of failing to develop an effective automatic tracking system may come to haunt us. Any simpler border system will meet public expectations and public-health needs only if track, trace and isolation are rapid and effective. The costs of the COVID-card-type methodology are small compared with the costs of continued complete lockdown. If we required such a tracing system for all incoming passengers and provided a large number of New Zealanders had adopted it, then we would have more alternatives, at least for low-risk entrants.

Singapore introduced a similar card this week. There are other systems that could be used. The Google/Apple joint development using a cellphone’s embedded Bluetooth technology has progressed to overcome many of the earlier objections and is being introduced in some countries. However, some limitations remain, including technical challenges associated with repurposing phones as proximity devices, giving sufficient visibility over the performance of the system to public health officials. Any such system relies on voluntary compliance.

The ethical arguments against such technologies have perhaps been overstated in their generalisation. Yes, there are apps that might provide private information to third parties or governments, but Google, Uber, and many others already have access to that information on almost everyone with a smartphone. The Bluetooth systems proposed do not automatically provide information to anyone. The Government could quickly establish an independent oversight mechanism to approve download of the data.

Failure to even start discussions towards seeking societal approval for use of these technologies further reduces our options. While we may have limited options, we do need a transparent process towards developing a reconnection strategy. Do we continue as we are now indefinitely, relying on strict quarantine and a giant moat? Even with current controls, the number of cases at the border will likely grow as more New Zealanders drift home. Do we need to start exploring alternative strategies that might at the appropriate time allow increased border flow, thus allowing more of New Zealand to flourish? And when would that be? What would be the criteria?

The internet and video conferencing can take us only so far. We will need face-to-face contact if we are to maintain and grow the flow of goods and services into New Zealand.

This country needs its global connectivity. We have gained significant advantage through our stringent lockdown and early elimination of the virus allowing the domestic economy to reactivate. But we will rapidly progress to a position of relative disadvantage if our trading competitors are able to engage with our customers and suppliers in ways that are not possible for us. The alternative would be to remain in a state of effective national isolation, which could even last into 2022 or beyond. That may be our best option now, but that won’t always be the case, and we need at least to explore alternatives.

Of course, we want to keep the virus out. The elimination strategy has worked, but at some point we’ll need to reconsider the balance of objectives. The pandemic continues to evolve. The decisions needed will be best removed from the politically charged environment of an election season and therefore it would be
premature to reach conclusions. In any event there is still too much viral uncertainty.

But we do need to start a process that is evidence-based, using a breadth of transparent inputs to explore the options. Taking the knowledge of the pandemic’s evolving behaviour into account, we must prioritise exploring the ways in which we can more completely re-engage with the world.


*Helen Clark was Prime Minister from 1999 until 2008, Peter Gluckman was Chief Science Advisor to the Prime Minister from 2009 to 2018, Rob Fyfe was CEO of Air New Zealand from 2005 to 2012.

This conversation paper was issued by the University of Auckland.

Acknowledgements

This paper was peer reviewed by David Skegg. Andrew Chen provided advice on contact tracing.

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41 Comments

Easy solution: shut the border, borrow and give until a vaccine is available

Hard solution: open border with designated countries through bilateral agreements which would be very slow and could be risky

I'd vote for the easy solution. NZ's the 5th wealthiest country in the world so still a lot to squander.

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Not even close:
https://www.visualcapitalist.com/richest-countries-in-world/ At number 10, Italy has US$3.8 trillion of private wealth.

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You are showing you age. NZ was No1 per capita 120 years ago and it has been downhill ever since. The last couple of decades being marked by low productivity, long hours, exports as a fraction of GDP declining. Gloom.

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These two sentences sum it up; "In any event there is still too much viral uncertainty. But we do need to start a process that is evidence-based, using a breadth of transparent inputs to explore the options."
Other discussions not mentioned is essentially deciding who lives and who dies.

Fundamentally realising that the authorities will accept a degree of mortality, in other words some must die, to enable the country to fully re-engage with the world again. And who pays the health costs? This is a question not being discussed in the marijuana legalisation debate as well, but the evidence of COVID is that even if you survive the virus, there will be ongoing last health impacts of varying degrees.

Personally I think the lessons of COVID are about priorities and resilience. With little of substance coming from our Government with less than three months to an election, we are not getting a lot to figure out where they are taking us. Recent articles on this site on MMT proffer some possibilities, but again nothing from the Government to consider if they are even thinking along these lines. Which is interesting as some of the MMT actions seem to be exactly how the Government is funding it's COVID response program. Now if they could just take this a little further to develop our resilience until the world is safe to re-engage with....?

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Murray you know from your military service that in reality NZ, and its economy, is just a bit player on the world stage. More or less like flotsam & jetsam we follow in the wake of the decisions and actions of the big players, like it or lump it.In reality how much and for how long would the world miss us if both our main islands sunk. NZ has to turn within itself and somehow create more independence, beyond the essential imports, vehicles, iron, oil, cotton, sugar etc and etc. Before we were flooded with garments produced in mainly asian sweatshops, we had the LWRs, Lichfield, Sew Hoys, Hallensteins, Deanes and on, producing perfectly fine clothing and employing accordingly. Also light industry, PDL, Skope, Andrews & Beaven. Can we not turn back to that, even if the cost is greater, the creation of employment fuels the economy. On the other hand, for the life of me, I cannot even begin to understand, that in times when a degree of austerity is undeniably upon us, that the government can willy nilly, commit $15mill at least, to 800 metres of a walkway in Christchurch, $18750 per metre, when suburbs are still wallowing around in streets unrepaired and restored since the 2010/11 EQs.

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Can't disagree with much of what you have said Foxy., because those companies existed in what was then a highly regulated world, and vanished in a very under regulated world. So my question and I guess the big question for the Government is what is the middle ground? A part of this question is why can't we somehow support industry in the regions to deliver decent employment opportunities, offer something else other than the dole. In some respects i think we are almost like Taiwan of the 60s and 70s. Nascent manufacturing industries learning how to do it, and selling to the world. We all knew it was cheap crap, but it was a starting point. i think we can do it better today, learn faster, and grow faster, but I fear that too many are just too risk averse to even try. Those Government projects you mention are safe bets, but they don't deliver employment or any returns. Their priorities are just wrong.

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Middle ground. Yes exactly, nicely put. Possibilities sort of evoke the theme of the second half of “A Town Like Alice.” Just maybe, the new leader of National has identified the potential, by way of the quick reference to small business sustainability, as opposed to their previous government’s infatuation with the world of corporates.

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Fox I'm afraid you're tilting at windmills. The reason why some of the companies you mention are no longer with us is down to one thing only.. they couldn't compete. Why couldn't they compete? because the consumer didn't support them. The basic fact is that we actually produce nothing in NZ (other than primary industries, IT and some Med coys) that isn't a collection of imported parts and components. Light industry is even more precarious. All our heavy industry is majority or totally offshore owned. NZr's generally want "cheap stuff now" They don't want "expensive stuff that lasts" regardless of how well made it is (which is actually a myth - a lot of NZ manufactured product was just plain cr.p quality), and they don't care about anyone's job except their own. This is the age of consumerism and you can't change that.

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No decession will be taken and will play extra safe being election time.

Government will not take any chance by opening border (as just saw the reaction of people and media with one slip at border) and economy till election time has been taken and will be taken care by printing money as Mint is open for one and all.

What better opportunity for an excuse to print and distribute ( tax payers money) under the guise of coronavirus.

Subsidies are must but to provide as cushion and not as bonus so should have been done sensibly and to target people affected and needed for survival. Many have been affected by panademic and deserved but against it many (Heaps) have made a fortune out of wage subsidy and various other government generosity.

Money spend to people / business who did not needed (Who does not like easy and free money) could have been used more for people in need as with border closed and with trave restrictions some business will have to wait long than othe businesses to open shop.

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Why should we open up? Rest of the world needs to get rid of its virus the same way we did.

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And open to 'what'? Imported goods, tourists, foreign students, money launderers? This conversation paper is a whole piece of nothingness.

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We made our bed and now have to lie in it. I have zero tolerance for risk in this area. Get the mess sorted at the border and keep it in place until a vaccine is available. We can adapt to this new way of living. Heck, as a child flying overseas was a non starter. We survived.

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Agree. It's actually in line with Vaclav Smil's view of how we need to live to allow resources to be allocated to where they are needed most, too. Energy used for the most important things rather than strawberries year round and flying thousands of miles for a weekend.

Most of the things we do won't change much under such a scenario: watching TV, reading books, attending shows, eating and drinking, doing sports etc.

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Guess my grand-kids will never meet their grandparents though. No biggie

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In terms of national public interest, you're absolutely right.

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unfortunately thats the price of de-globalisation...
ditch the travel brochures
the future is local and tribal

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Yeah it'll be tribal alright.. complete with thatched huts, horses and carts and candles. Think I'll start breeding Mastiffs - big bitey ones

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A vaccine would make that possible.

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Not for a weekend. But people still traveled during the 1960s. The Big OE was called the Big OE because it actually was a pretty big deal.

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Clearly not a grandparent. Grandparents are usually disappointed by their own children and those who were dumb enough to partner their children but our grandchildren make life worth living.

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Hard to do those things when your hungry kids are clamouring to be fed, which you can't do cos the rent and power bill needed paying first. The authors were totally correct - we need the borders open in a controlled and sustainable way ASAP.

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Ex Expat,

Fair enough, you are entitled to your opinion and I think that right now, a lot of other Kiwis would agree with you. At 75 and in good health, i might be expected to share that view, but take a different view.

What I think you and others fail to put in the balance re the very significant health issues that arise from long-term unemployment. There are numerous studies on this from different countries and they they unequivocally show serious and long-term physical and mental problems up to higher rates of suicide. This is not being discussed. I do not support an indefinite period of isolation for the country.

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Am just about to crack open this book over the weekend: https://press.princeton.edu/books/hardcover/9780691190785/deaths-of-des…

This is also why it matters that we have been deliberately inflating asset prices to live off the wealth of succeeding generations. Lowering the viability and quality of life for younger and future generations has dire effects and cannot be justified by the desire of today's generations to party on at their expense.

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Surviving this Corona virus may just be the start of a life of debilitating after effects. For instance it thickens the walls of the Alveolars in the lungs leading to a lifetime of ARDS or something like COPD. Faced with a lifetime of gasping for breath and the complications that may arise, you may regret having survived.

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I believe it was the intention to use the testing and monitoring of arrivals into NZ to build an evidence based case to open up the border further. But the cluster fails have delayed the plans. Now we have a cross party "conversation paper" folded into the shape of a kite to be flown for the population to see and comment. By reducing time in quarantine based on being non symptomatic on arrival,country of origin and clear test on day 2 or 3. If we can get the quarantine down to 4-5 days we can effectively double or even triple the number of arrivals. Followup test at community facility a day 10-12 to ensure covid free. Some tourists intending to stay a number of weeks may even tolerate that. International students a no brainer. If you are non resident or a resident returning after being overseas for a year or more then you pay nominal fee $100 per day to cover some part of testing and isolation costs. It wll be a few levels of complication above what we are doing currently. So my faith in the current crew to manage is limited. But it needs to be done for the sake of economic health and to capitalise on the investments we have made already. Hopefully the government is bothering to negotiate the rates they are paying to hotels instead of paying full whack for each room. It's not like the hotels have thousands of other guests lining up for rooms right now.

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Westie, did the PM dept know this paper was coming (you would think yes given the names), for how do you walk back the danger, danger, dangerous emotion the PM has locked in peoples heads?

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H1 helped write it and H2 is on the Prime Ministers payroll. So what do you think. It is about timing now. National is pushing for a plan. Labour are working on a plan. But first they have to manage public expactation. Step 1 get rid of David Clark. Then put the plan out. If they do it before the election National can say yes we agree with the plan in principle with a few tweaks but you guys (Labour) have proven yourselves useless at execution of anything. So we (National) should take it from here. If Labour are too chicken to propose any plan for opening up before the election they will loose more credibility as the flow on pain from lockdown and border closures sets in and the cries from National for a plan grow louder. The focus groups will be going hard out at the moment.

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I have relatives that are still worried about catching the virus (reluctant to visit some public places) even with no community spread. My impression of the sentiment among the public is that we should further lock the boarders down so we don't have to continuously worry about catching COVID and going back into lockdown. Having to use a contact tracing app would imply that we were under immanent danger of catching the disease.
I heard an add from DairyNZ about training people for employment in the industry. The country will be able to adjust to a closed boarder if its force to. It's a pity about tourism and education but the majority of us are employed outside these sectors and it is an exceptionally high risk to everyone else to open the boarder up for these. The freedom of movement and stress can be weighed up against the economic cost.
This may change once the subsidies and mortgage deferrals run out but then one mistake and another shutdown will have more than canceled out any economic benefit.

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they should gift their airpoints to enable some of the the poor migrants trapped here to get home instead of fretting about the loss of their opportunity to go on overseas holidays.

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If you deliberately infected everyone under age 50 , 65% of NZ population, then with currently understood IFR that only results in about 550 deaths in NZ, while getting pretty close to herd immunity. If you selected the lowest risk 65%, made sure that they all had minimum virus exposure, good Vit D level and made use of dexamethasone and now ivermectin to aid recovery, it would be a small fraction of 550, unnoticeable in normal death stats.

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Lol. And who will volunteer to be that small fraction of 550.
And who takes responsibility when the actual figures turn out to be not that small fraction of 550?

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A graduate from The Medical School of Mengele one might think.

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Many would be dying to do it.

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Actuarial stuff. But make it a ‘whole of effect’ scenario, comparing it with the lives lost due to other health factors caused by unemployment, mental health, and of course the loss of revenue which would have gone into better health care, safer roads, better education. X -y will be a lot less than 550, and might even be a negative number. Isolationist policies haven’t worked for North Korea. Stay calm, be kind, and make rational, informed decisions. Clark and Gluckman aren’t compassionless idiots.

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If we don't have a vaccine by next election this might be actively discussed, we will be sick of being trapped in NZ by then and we will have better treatment. One of the flaws is 65% is not even close to herd immunity for this virus (the higher the population infection rate they find the higher the R0), its certainly not going to stop it finding its way into every rest home and we see what happens there, so we will have to have a treatment plan that keeps the boomers alive and healthy as well. The other issue is we don't have a good understanding of the long term health complications of the thousands who will get hit hard by the disease.

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The goal of elimination was a strategic mistake IMHO. Two problems have been created. Firstly the stoking of fear among the public about a virus that, for most people, has little to no symptoms. Second problem is politicians have painted themselves into a corner. Politicians will eventually realise the policy is a failure but they'll double down anyway, either because they don't want to concede political points to the opposition, or because of the sunken costs fallacy. According to an MBIE report that I read, tourism earned a similar amount to milk solids in terms of export dollars. Nobody will come to NZ if they have to spend two weeks in quarantine, even if the accommodation is free. NZ may be setting itself up for a slow long grind of a recovery / recession / depression / lowering of living standards etc..

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Unless of course there is an effective vaccine by end of year in time for tourist season, in which case we will be brilliant. If the Oxford vaccine fails though expect a world of pain. The impact of no tourism on the economy will be disasterous.

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Yep, indeed. But I think it's a poor gamble because the probability of there being a successful vaccine is low, while the costs of isolation are guaranteed to be very high.

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"The decisions needed will be best removed from the politically charged environment of an election season ". If Ardern had not been so keen to take all the exposure ( and hopefully glory ) from being seen to manage the response a bi partisan approach could have been adopted prior to lockdown, and carried through to the issues now facing us. She would not have got such a ratings boost, but nor would she now be facing a classic Hobson's choice.

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I dont understand why we decided to change to a stamp it out strategy. I was always for the "flatten the curve" strategy. It frustrates me that we are now in this position.. and will be with all future pandemics. Lock down at the first sign of trouble, freak out, and turn foreigners away. Increased Xenophobia. Increased selfishness. We need to learn more about how ALL viruses work, and change our cultural attitude so that even if you have a sniffle, then stay at home at rest. One person's mild cold, can take another out for a week. As evident recently with our family. Husband unaffected, myself and two children out for a week, and the other child just a snotty for a day or two. They all act differently and drives me crazy that we cannot see our UK family for nearly two years, because some people are freaking out.

This attitude is increasingly prevalent from people around me.. particularly healthy people. Older people annoyed that their choices have been taken away, that they cant go and visit family, when they may not have a lot of time left anyway.

Open the borders, talk about keeping the caseload manageable. Educate people on ALL viral contagions. And let's just get on with it.

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You present an arguable case alright, problem is there is a too high a percentage in NZ, which is not at all unique, of those who will not be educated and take no responsibility for their actions. For example the two famous Highlanders early on. And then think about how that is demonstrated by not only the standard, but the attitude as well, of our driving,intolerant, inconsiderate and selfish readily on display, no thought to the rules or safety of others. NZ was lagging at 39th in the world as far as pandemic preparation. The hospitals already pressured would have quickly been overwhelmed by an influx of CV19 admissions which would have sidelined other everyday cases, oncology, cardiac,injuries and on. I think the government weighed all that up and had no choice other than to cast the big net unfortunately.

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