Less than three days ago, I gave credit to the Government for moving ‘hard and early’, in a paraphrase of Prime Minister Jacinda Ardern’s words. I thought there was a realistic chance that the travel restrictions and limits on mass events might be sufficient to hold COVID-19 at bay. I no longer think that is going to be sufficient.
My change in thinking arises because of the increasing awareness I have as to the number of tourists who have still been entering New Zealand in the last week from high-risk countries. Also, there are several thousand Kiwis who, aided by AirNZ laying on wide-body jets, managed to get into New Zealand on Sunday night without being required to self-isolate. I am also influenced by concern that not everyone who should self-isolate is going to do so.
I take note of the Prime Minister’s statement of Monday 16 March in regard to cancelling mass events with more than 500 people. I doubt greatly whether that will make a crucial difference. That group size is far too large.
I also note the Prime Minister’s words about Taiwan, where they have had some but not total success without shutting schools. However, in Taiwan, students at their desks are separated by plastic partitions. Also, it is standard practice for parents to test the temperature of their children before they leave for school in the morning and this data is fed into the school’s on-line database. These sorts of behaviours, and there are others, are profoundly different to how we operate in New Zealand.
There is now a very high probability that within the next week we will see evidence for community transmission. This transmission will have already occurred now, but the incubation takes a while to show up. By then at the very least we need to have all steps in place to press the lockdown button. Even that may be too late.
The real question is whether to do it in the next few days when no one has died or is seriously ill, or wait until we are surrounded by illness and death.
A serious lockdown would mean no schools, cinemas, nightclubs, gyms, bars, shopping malls or church services. Workers in essential trades such as plumbers and electricians would still be able to attend to breakdowns, together with essential maintenance of infrastructure. Office workers could only work from home. Supermarkets would stay open as would pharmacies. Of course, health-care workers would continue to carry out all duties.
The one exception might, at least in the short term, be schools. The social consequences of shutting schools are profound, but that is what much of the world is now doing.
All of the above sounds awful and it would be very stressful. But this is what Italy, Spain, France and Germany are already doing. The USA and Canada are also rapidly shutting down.
As for the United Kingdom, there are frightening tales coming out of the United Kingdom in the last two days from their officials and politicians that the UK Government intends to rely on herd immunity. This means allowing and even encouraging all young and middle-aged people to become infected, with all people over 70 years of age required to stay in their homes for four months while this is going on. I kid you not.
The herd immunity theory relies on the assumption that once enough people are infected and thereafter develop immunity, then the transmission rate from person to person will drop below a level of one and the disease will thereby die out. However, with increasing evidence for very high transmission rates, with each infected person on average possibly infecting between four and six additional people, there is a very high risk that the strategy will fail. This is because the herd immunity may not be effective until as much of 85 percent of people have been infected. In any case, it is not only old people who die from this disease.
The reason the UK is thinking of doing this is because they fear they have already lost the war and have no other option.
If we act quickly in New Zealand then there is a good chance that we could quickly eliminate the disease from our country. But if we pussy-foot around then the UK scenario could well come into play.
If we look at Italy, which let the disease run ahead before bringing in draconian measures, then the death rate is now approaching eight percent of all cases, with this death rate climbing further each day. This is a very different story than was evident some one-to-two weeks ago.
Every other European country is destined to follow the same path as Italy unless they can succeed with their total lockdowns. With hindsight, they have all been too slow.
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If New Zealand goes for a strong control process then everyone would have to self-isolate in family or other living groups. Act quickly and there is a good chance we could eliminate the disease in three to four weeks, or at least be getting close.
Right now, there is a mass flow of Kiwis coming home, all of whom are meant to go into self-isolation on arrival. This is more likely to work in an environment where everyone is self-isolating and hence those who cheat can be identified. In any case, once group events are completely stopped, then the opportunities for super-spreading by any self-isolation cheats are greatly reduced.
By the end of the month these incoming Kiwis will be down to a trickle. It would be reasonable and realistic for anyone coming in thereafter to require approval and to undergo a Government-administered quarantine at their own expense. If Kiwis want to come home, then now is the time for this to happen.
Hopefully the Government is already working on the scenario that I have laid out above. It would come as a shock to most New Zealanders, but community attitudes have been undergoing a remarkable transformation in recent days. If we were to act quickly – certainly before the end of this week – then we may well have achieved freedom from the virus by the end of Easter. The international drawbridge would then have to stay up, but life could go back to becoming relatively normal within the country. I think it is worth a try.
The risks from not doing this are now too great.
*Keith Woodford was Professor of Farm Management and Agribusiness at Lincoln University for 15 years through to 2015. He is now Principal Consultant at AgriFood Systems Ltd, and has had a longstanding interest in epidemiology. He can be contacted at firstname.lastname@example.org