Chris Hipkins says New Zealand has not abandoned its elimination strategy, only that there is confusion over the definition of the word “elimination”.
“I think the word elimination, the way it’s been used and the way it’s been interpreted across a variety of different places, it means different things to different people,” the Covid-19 Response Minister said.
“The Government’s use of the word ‘elimination’ has been relatively stable right the way through.
“Because we’ve had periods of ‘eradication’, people have come to confuse those two things together, i.e. elimination means getting back to zero cases.
“That’s never been the definition of the original elimination strategy … we are continuing to try and pursue Covid-19, we are continuing to try and drive cases out.”
Hipkins said alert level restrictions remained in place because the country hadn’t given up on driving the virus out.
When asked why the Government had decided to allow Aucklanders to step down from Alert Level 3 with some new freedoms , despite there still being community cases, Hipkins said: “The alert level system relies on a high degree, a very high degree, of voluntary compliance.”
“We’re coming into a period where we are likely to see quite significant growth in cases," he added later.
Whether the Government has moved away from an “elimination strategy” depends on what a person defines elimination to be — the one set by the Government or its definition in epidemiology.
Prime Minister Jacinda Ardern had signalled since September that Aotearoa would eventually transition to a different approach to handling Covid-19 to reflect higher vaccination rates.
However, there continue to be disparities in the vaccine rollout among different parts of the population, such as for Māori and people with a disability .
An August report by the independent Public Health Advisory Group, led by epidemiologist Sir David Skegg, investigated whether the elimination strategy was viable when international travel resumes.
The group’s report defined elimination using Director-General of Health Dr Ashley Bloomfield’s statement in April 2020: “The elimination approach focuses on zero-tolerance towards new cases, rather than a goal of no new cases.”
“In approaching the present question, our group is happy to follow this interpretation, which treats elimination as a process, rather than as a permanent outcome,” the report read.
“Although the term ‘elimination’ is well established in epidemiology, it is unfortunately used in different senses even by specialists, and is frequently misinterpreted as meaning ‘eradication’.”
Since that report’s release, the Ministry of Health’s website states the elimination strategy meant keeping out, preparing for, stamping out, and managing the impact of Covid-19.
Bloomfield first signalled it was a “possibility” New Zealand may not return to having zero Covid-19 cases in the community in late September, taking into account that Delta was more contagious than other variants.
In an early report of New Zealand’s elimination strategy, the Ministry of Health said in April 2020 the elimination strategy aimed to eliminate transmission chains in the country and prevent the emergence of new transmission chains from overseas.
“Elimination of Covid-19 (or any disease) means reducing new cases in a defined geographical area, in this case Aotearoa/New Zealand, to zero (or a very low defined target rate),” the report read.
It noted the elimination strategy could help avoid the virus’ disproportionate impact on Māori, Pasifika, and people living in socioeconomic deprivation.
ESR, taking the definition of the term in epidemiology, defines elimination as “reducing the number of cases of the disease being spread within a geographic area or country to zero”.
Meanwhile, it defines eradication as “permanently reducing the number of cases of a disease in the world to zero”.
Suppression was defined by ESR as a “control strategy that aims to keep the number of cases very low for as long as possible”.
“This approach requires putting in place strong measures to reduce the opportunity for the infection to spread. This will include various forms of quarantine or isolation of infected people,” it said.
“Although there will continue to be cases of infection under a suppression strategy, the aim is that numbers will be low enough that the healthcare system will not be overwhelmed.”
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