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Vaccination programme needs to be fully rolled out before borders can be slowly re-opened, health experts advise Government

Vaccination programme needs to be fully rolled out before borders can be slowly re-opened, health experts advise Government

New Zealand’s border restrictions shouldn’t be relaxed until the vaccination programme is fully rolled out.

Once this is likely to have occurred by early-2022, a phased approach should be taken to re-opening the country’s borders.

These are two key take-outs from three reports, commissioned by Associate Minister of Health Ayesha Verrall, and completed by a group of experts in epidemiology, infectious diseases and public health.

The group, chaired by Professor David Skegg, said border rules could initially be relaxed by extending quarantine-free travel to countries beyond Australia (currently paused) and the Cook Islands, and reducing the time vaccinated New Zealand citizens or residents, who have gone overseas for a short trip, need to spend in managed isolation.

However, it said because it’s “entirely possible that Delta may have been displaced by an even more transmissible variant (with other unique characteristics) by the end of this year,” it’s unrealistic for detailed re-opening plans to be made long in advance.

The group repeatedly stressed the importance of getting New Zealand’s adult vaccination rate “as near as possible towards 100%”.

It said vaccinations reduce the likelihood of infection and the likelihood of an infected person becoming seriously ill. Vaccinations also reduce the likelihood of the virus spreading.

The group concluded herd immunity is unlikely to be reached here or internationally, particularly as children aren’t vaccinated, and because much more transmissible variants of COVID-19, like Delta, will emerge.

It acknowledged that once borders re-open - even partially - people carrying COVID-19 will inevitably enter the country, regularly.

If the population is only partially vaccinated, outbreaks might be too large for our public health units to extinguish them by testing, rapid tracing and isolation of contacts.

“Raising of alert levels would be almost inevitable, and the vaccine roll-out could be impeded. Moreover, treatment services would probably be stretched beyond capacity,” the group said.

“The New Zealand health system is still poorly resourced to deal with any large outbreak of a disease such as COVID-19. As we entered the pandemic, the provision of intensive care beds (per capita) in New Zealand was less than one third of the average among 22 OECD countries.”

The group noted the health system is already likely to come under more strain as re-opening borders will increase cases of influenza in the winters of 2022 and 2023.

The group said the degree of protection would be higher if 12-16-year-olds were vaccinated too.

It acknowledged “it is possible that a variant resistant to the vaccine could emerge before we are ready to open our borders”.

“Even with current settings, New Zealand is liable to experience an outbreak similar to that in New South Wales over the coming months - although presumably we would go into lockdown more quickly,” the group said.


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New Zealand may even continue to face “localised” lockdowns once borders re-open.

The group said steps need to be taken to prepare for slowly re-opening borders.

“These include the selection and piloting of rapid testing at international airports, review and likely expansion of the contact tracing capacity of public health units, mandating of QR scanning at some types of venue, exploration of special measures to assist tracing of returning travellers, and review and strengthening of health system capacity and management systems for dealing with large outbreaks of COVID-19,” it said.

The group suggested, “In the early phases of re-opening, a reduced time in an MIQ facility, say for five to seven days, would seem more realistic. This could be followed by additional testing once or twice in the second week.

“The reduced quarantine scheme could start with people who have visited low-risk (or medium- and low-risk) countries for a limited period - say up to one month.

“Because children are currently not eligible for vaccination, we suggest that the scheme should initially be confined to vaccinated adults.”

The group said it was not only viable, but optimal for New Zealand to maintain its elimination strategy once borders start re-opening.

That is, focussing on zero-tolerance towards new cases, rather than a goal of no new cases.

The Government will respond to the group’s reports on Thursday.

The group’s members includes, David Skegg, Nikki Turner, Philip Hill, Maia Brewerton, David Murdoch and Ella Iosua. Rodney Jones and Shaun Hendy are special advisors.

The three reports, which are 18 pages long in total and written in plain English, can be read here

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Remember we welcome robust, respectful and insightful debate. We don't welcome abusive or defamatory comments and will de-register those repeatedly making such comments. Our current comment policy is here.

112 Comments

It took 3 months for this. I can only imagine the cost involved too. We all knew their findings about a year a go right?

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Brock Landers was pretty adamant we wouldn't be opening borders next year. At all.

So clearly not everyone "knew" what you consider to be obvious.

Anyway, would you prefer the government not get official advice for their decisions? Just use their own personal reckons?

Steven Joyce (who would have been finance minister if National won in 2017) reckoned when we were going from level 3 to level 2 lockdown that our elimination strategy was "pie in the sky". I'm glad we have a government that seeks expert advice instead of just using their personal reckons.

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Brock will be proved right, the boarders will not fully reopen anytime soon.

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Jacinda is giving a speech on Thursday about what the government is planning to do.

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A speech by Jacinda... on planning....
- 100k new houses
- 1 billion trees
- pause on immigration
- reduction in child poverty
- addressing the housing crisis

There are plans, and then there are plans. I won't be holding my breath.

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Last I looked, they were ahead of schedule on the billion trees.

What people don't really seem to understand about that policy, is over 10 years we normally plant 500 million. The policy was only to double the planting over 10 years, not actually that ambitious really.

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Thank you Pravda

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Yes, I wish the MSM in this country would do a better job of reporting facts and dispelling misinformation and lies. But they aren't doing it, so I'm happy to point out the facts when I spot someone being misleading in the wild.

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At this point in time you are factually correct.

At the time the statement was made though, it was clear to all, that it was not the intent.

As with the "Year of delivery" it has been retconned after the fact to better fit the current narative.

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At the time the statement was made though, it was clear to all, that it was not the intent.

Er, what? At the time the statement was made, the promise was that we would go from planting 500m trees over 10 years, to planting 1b trees over 10 years.

Article from July 2018: https://www.nzherald.co.nz/business/ten-years-1-billion-trees-making-th…

Article from November 2017: https://nz.pfolsen.com/market-info-news/wood-matters/2017/november/clar…

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Lanthanide - I thought it was an additional 1 billion trees ? Anyway the current average of 50 million trees planted every year are 80% replants !!
I'm in forestry investments if they are counting current plantings then only 20% should be counted !

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The coalition agreement, where it was first publicly announced, is here: https://www.nzdoctor.co.nz/sites/default/files/2017-10/Labour%20and%20N…

Regional Economic Development and Primary Industries
• A $1b per annum Regional Development (Provincial Growth) Fund, including:
• Planting 100 million trees per year in a Billion Trees Planting Programme.

Doesn't say anything about these being "additional", or "new", or "above and beyond" or "not including what the industry already does".

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Does that factor in all the ones cut down ? I forgot to notify Jacinda recently when I dug a couple out.

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They will never open borders like 2019 again we now have nightly news telling us the climate is doomed and covid is endemic so they will leverage this to only allow the super rich and powerful to travel due to carbon reduction taxes and pandemic costs and inflation pushing airfares back to 1980 ticket pricing.

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No one is suggesting the borders be opened as per 2019 settings.

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I'd prefer some action & bold moves rather than report after report...

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Well as the report says, those actions and moves will come next year.

Why would you want to open the borders now, before it is safe to do so?

Weird.

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This report could of been done last year and/or not taken 3 months for simple conclusions. Our roll out of the vaccine could of been efficient and nearly finished by now - we're one of the worst in the world. The borders could of slowly started opening by now. Yet, we're still sitting duck's if the virus creeps back in with a level 4 lock down pending. All talk, no action. Next year is not that far off and we're no where near ready.

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Ok Nostradamus.

Frankly although I think our world leading response could've been better, so far it's been a resounding success.

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If you're happy with a sub par effort, that's good for you. Just don't complain next year when we're still waiting on another report, vaccination numbers are low and we're in another lockdown.

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I'm happy that I'm living pretty much as I was in 2019 without any of the 3-12+ month restrictions other countries have had to endure.

Personally doesn't meet my definition of "sub-par".

And yeah, if you're predicting things are going to fail, and casting judgement based on your prediction, rather than the current track record, of course it looks bad.

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You must have low standards, I guess that's one way of being happy.

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Apparently living a life unaffected by COVID is a low standard.

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NZ is affected by covid. You're living in your own little bubble mate.

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The fact is the *majority* of people in this country are living their life relatively unaffected by COVID.

Those that are directly affected, eg businesses without customers, or who are struggling without access to imported labour - well, what exactly do they want the government to do? If they could eliminate COVID globally they would. In absence of being able to do that, the government is doing what it can do, which is allowing the majority of the people in this country live their life relatively unaffected by COVID.

That's the simple truth anyone claiming the government has done a bad job (as you are claiming) has to grapple with - the fact that on any reasonable scale, the government has done a very good job, certainly when comparing to pretty much every other developed country on the planet.

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Given the sporting analogies all over this thread… one could argue that the Government, on balance, has done a good job in respect of COVID in its initial response. But COVID will be a game of two halves. And our second half performance, so far, is bad. There is a real risk our sub-optimal vaccination programme and inability to make meaningful improvements to our health infrastructure mean that we may, in the end, lose.

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Are you living in a cave nifty?

Most of the world dreams of the response and outcome we had and have got.

It's astonishing how many kiwi's bag the shit out of where we are.

Take a step back for a minute.

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Take a step back, we're living in a small island in the middle of no where. We've got a massive advantage over many countries in the rest of the world.

It's odd how striving for better is critised & slammed.

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You're being slammed for being in denial about the successful situation we find ourselves in, not for wanting something better.

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It's like the All Blacks just scrapping through with the win. They had all the odds for them but they had continuous unforced errors. They didn't have a proper game plan, they got over confident and cocky. They got surprised when the opposition scored a number of tries.

This has been the 3rd consecutive game like this.

Fans after the game were happy with the win but looked for reasons again as to why they didn't perform when they were the clear favourites. Other counties are starting to get better than them.

The coach could be rolled after this and key players are on the line. There's areas for improvement and results need to be proven going forward to be the best team.

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Interesting analogy, but not very relevant to a global pandemic:
1. This is life and peoples livelihoods, not entertainment
2. The All Blacks play how many games per year?
3. Rugby has a set list of rules, known players and totally known scope. The rugby ball stays the same size and shape and you always know where it is at any given time.
4. Rugby players are 100% totally responsible for what happens on the field. They aren't having to set policy and give instructions for 10,000+ other people to follow, and hope that they can follow those instructions without making mistakes.
5. There is no rule book for how to deal with a COVID pandemic. We started with an influenza epidemic plan, which provided some early guidance but quickly turned out to be ill-suited for a COVID pandemic. We've watched other countries and learned as best we could from their experiences.
6. No other country has really done a better job. When the All Blacks barely scrape through, you can look at past games and see times when they did much better. Right now we can look at hundreds of other countries and see how they are all mostly doing much much worse.

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You are a typical boomer mate. Your property price went up 20% so you are happy. To hell with anyone who has family overseas or who's business depends on an open boarder.

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Funny, I thought I was a millennial.

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Apologies thats just how you come across in your posts

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You're clearly not getting it.
I'll leave you to your unaffected bubble. Keep them standards low, stay happy.

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And I'll continually remind you how good the COVID response in this country has been, despite your gnashing of teeth and complaining that it's not perfect. And I won't be wearing a mask while I do it.

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@donny11 you seem to be under the misinformed opinion that outside New Zealand other countries are letting people travel internationally with ease. In reality most other countries also have a ban on international travel (expect for their own citizens). For the most part our restrictions on travel are similar.

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@Nifty1 your response is absolutely delusional. The rest of the world would absolutely kill to be where NZ is right now - every other developed country is grappling with either endemic covid or months long lockdowns to combat outbreaks. We also have a super strong economy despite eliminating international tourism. Meanwhile kiwis are living their lives in NZ in pretty much the same manner as before covid, with the only major difference being a lack of international travel and international visitors (something which every other country is also without). NZ is Absolutely amazing by any measure, only an idiot would fail to see that.

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"Anyway, would you prefer the government not get official advice for their decisions? Just use their own personal reckons?"

Isn't this exactly how this Government operates?

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I thought the criticism was too many working groups.

Guess I need to keep up with the latest double speak coming out of National.

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You can label it as National propaganda or you can look at the history, which is that there have been instances where the Government claims to be waiting for advice then doesn’t wait for the advice to be submitted or sits on that advice or ignores it entirely. This has nothing to do with National. In fact, the Prime Minister herself loves telling the story that it was a phone call from friends in London that led to the lockdown. The Government and our democracy as a whole would do a lot better if we were less tribal and willing to call out our own ”team” for their failures. In NZ, we seem to be willing to do this endlessly with the All Blacks or the Warriors, but once it’s political our teams can do no wrong it seems. In a few years, you will be as disillusioned with the Ardern years as many National members now are with the Key years. I am already lamenting the state of our democracy.

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In a few years, you will be as disillusioned with the Ardern years as many National members now are with the Key years.

Lol, no.

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Yep money would have been better spent on a new dedicated MIQ facility that with the right design could be used for emergency housing after the pandemic. We just live in hope that another even worse variant will not come along and all those homeless people will leave the motels right ?

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Yes, employing 3 people to write 3 letters over the course of 2 months costs the same as building a brand new MIQ facility.

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Maybe not, but we have had 16 months since the border shut. Ample time to plan and construct a dedicated MIQ facility. The countless billions spent on propping up the housing market would have easily covered the costs to build.

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The problem for something like that is, as-always, the risk. We didn't know how the pandemic would unfold - Avian Flu, Zika and Ebola ended up mostly being hot air. Start building something and risk it not being required because the virus goes away. Start building something and risk it being totally inadequate for what is eventually needed. Start building something and end up not needing it because the virus begins circulating in the community anyway and so you end up with a system where people isolate at home rather than needing MIQ facilities.

Also for all the investment in a purpose-built MIQ facility, would it really end up being better than what we've had so far? We haven't had any community spreads since February, so the current system seems to be working well. The biggest risk is perhaps simply the number of people you let into the country, more-so than the facility used to house them - having more MIQ capacity, even if it was in a purpose-built facility, may actually increase our overall risk of a COVID cluster arising.

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Uhh the government didn’t spend any money “propping up the housing market” - not sure where you are getting that idea from. The independent reserve bank (like every other central bank) lowered interest rates and purchased bonds to support the economy/jobs which was grinding to a halt 18 months ago. However none of the reserve bank activity is using money which is available for general government spending - that’s not how it works.

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Regardless of the effectiveness of the vaccine reopening borders is inevitable so we'll just have to learn to live with the virus.

Once vaccinated the effects of infection are only typically "flu like" anyway.

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The government doesn't want to reopen.

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Any facts to back this up?

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Thanks for the link to those three reports.

My main take-outs:
1. reaching 'herd immunity' such that NZ can just re-open fully isn't going to happen, ever
2. high vaccination rates will help reach a point where we can slowly & partially re-open to some places & people, but
3. we'll still have infections in NZ that will need to be stamped out, by contact tracing, isolation and, possibly, further lockdowns
4. we aren't ever going back to life before COVID, the world has changed
5. I probably wont see my Aust domiciled mum this calendar year, sigh.

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I see this as really being the short to medium term situation.

Things will probably look more like how they were pre-COVID in 5-10 years.

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Why? How?

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1. COVID is likely to evolve further. Diseases generally become less lethal over time because selection pressure stifles the deadlier strains from spreading.
2. New, more effective vaccines will be developed.
3. Vaccines hesitancy will decline and conspiracy theories will be shown to be made up crap.
4. New rapid and accurate tests will be developed
5. New treatments for COVID will be developed

A feasible reality is in the future we may have a rapid and accurate 15 minutes packaged test a doctor can administer you. You stay in the office until you get the result, then if positive you're given a prescription of pills to take 4 times a day for 5 days and told to isolate at home for 3 days and take the pills.

Even just having an accurate 15 minutes packaged test can change things dramatically - airlines could test passengers prior to boarding, for example.

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Thanks

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Lanthanide -- thats a pretty good summary and i suspect that you are right on the money -- my only concern is that we are vaccinating so so so so slowly - and therefore our risk remains incredibly high - when we could have been in a situation where at least 60% of the population were fully vaccinated by now which would have limited the risk - we could also have increased the number of ICU beds available- made sure we have a large number of ventilators and of course started building MIQ facilities -- as they will be needed for years - and Covid wont be the last pandemic

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- when we could have been in a situation where at least 60% of the population were fully vaccinated by now which would have limited the risk

No one has demonstrated how this is actually possible, apart from *claiming*, without *evidence*, that we could have had more doses of vaccine sooner than we did.

I do contend that the government's pfizer-only strategy, at the time the decision was made, was a bad choice, though.

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That's such a speculative assessment. And your naivety pertaining to the government's ability to action any recommendations or plan is frankly laughable.

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Yeah, it's not like we have any empirical evidence of how successful our COVID response has been.

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Like it or not the government’s strategy from the outset, has regarded our hospital system as being barely adequate to cover general admissions existing pre CV19 and obviously still existing. Iceland with over 85% of its population vaccinated is now experiencing an influx of delta variant patients that is seriously impacting on their health system. It is a pointer to a potential NZ outcome. Cannot imagine our government is going to abandon their strategy unless that sort of risk is either minor or controllable. When that might be? Not any time soon methinks. Like it or lump it in other words.

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Got any reference for Iceland's hospitals struggling?

This article doesn't mention it https://www.google.com/amp/s/qz.com/2044284/icelands-rising-covid-19-ca…

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NZ Herald yesterday. Regret not versed to do links. But If you go to the Tauranga article alongside, yesterday there is a post at 1.52pm with the link.

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Searching for Iceland on the herald turns up no obvious results. Searching for Tauranga came up with 3 articles yesterday, mostly about COVID and ships in Tauranga. None of those had a link to an article about Iceland.

Given how effective the vaccine is at preventing hospitalisations, and the article I linked to saying Iceland has 90%+ vaccination rates, I find it unlikely that their health system is struggling with COVID at the moment.

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https://www.nzherald.co.nz/world/covid-19-coronavirus-iceland-deals-wit… i think you will find that like NZ its such a small health system that it can be easily overwhelmed --- in reality our health officials were concerned about the impact of one UN evacuee from Fiji and the impact so how we will cope with say 200 - which would suck up a thousand staff i dont know - its takes 4.2FTE to provide one to one cover over a week -- and the reality is that we are looking at a lot more than one staff designated just to a covid patient at any particular time - so that 1000 staff for 200 ICU beds is a huge underestimation

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Thanks for the link.

It looks to me like they're really assuming it is going to get worse from here, whereas the UK recently had a sharp decline in their COVID spread despite opening up. Probably too early to say what will happen in Iceland - could easily be very bad as they are predicting, but it might also have a UK-style turnaround.

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The UK graphs are very interesting - despite teh huge surge in cases to over 50,000 a day during the football, they have dropped below 20,000 already despite no extra restrictions - in fact all restrictions were removed and still the numbers went down -- Most importantly there has not been an associated spike in hospitalizations or deaths - a very small increase yes - but its tiny in comparison https://coronavirus.data.gov.uk/ is a good link -- clearest evidence yet that mass vaccination is incredibly effective in reducing deaths and serious illness from Covid

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Did the UK mainly use AstraZeneca, they initially ordered 100m doses of AstraZeneca and 40m of Pfizer? Is their falling rate more to do with the mix of vaccines used? They also extended the 2nd Pfizer dose out to 12 weeks rather than the initial advice of 21 days likewise it was 12 weeks also for 2nd AstraZeneca.

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they definitely mixed 3 or 4 vaccines but i could not tell you what the ratio was - but that data does suggest there is no loss by extending out -- but the biggest gain is from the first vaccine -- and they prioritized getting as many first vaccines in as opposed to doubles - the BBC pretty much does a daily update or every couple of days - so there is a link below with most of the data

https://www.bbc.com/news/health-55274833

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Pushing 2nd vaccine out to 12wks would allow many more to receive 1st vaccine.

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dp, apologies

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Yes that seems to be being recognised now. But kpnuts & Lanthanide provide some good points in that observing the status & progress in both the UK & Iceland, is going to provide NZ authorities with very good guidelines for future trends and outcomes, hope so!

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Given the slow rollout I see scepticism, not the program itself, as the most difficult challenge we face over the next few months. We have the vaccine and staff to deliver the program itself.

Even in my bubble of middle class over-educated friends I hear a lot of scepticism and misinformation.

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I've had the vaccine and people say I'm brave. I've run out of words.

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People said the same thing to me - including the Nurse- but thats because I'm not a huge fan of needles and may have been shaking a little with nerves :)

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I was very brave. So brave she let me take two lollipops.

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I didn't get even one lollypop :(

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Hah We actually needed bravery because the only place to be vaccinated was not accessible to disabled & elderly people, then closed off access even to able bodied people to get out even after we fought our way in and were being vaccinated, then had to navigate with multiple security staff to be carried & manhandled around the roof of the building to be able to get to the exit in -1 degree chill. No one allowed the opening of the gate barrier preventing our access (seemingly not done because reasons). Even after the complaints from the first vaccination and from the disability community & advocates for the second vaccination no changes had been made and the same process occurred again. Except with an added lack of support staff. Sooo yay the govt is still discriminating and denying access to the most vulnerable and only those willing to suffer sub par dehumanising conditions, with severe pain and injury get through. Note a high percentage of disabled people do not even have adequate transport to vaccination sites and the Ministry will not fund it. Congrats the system works to abuse more people for something as simple as a vaccine rollout. Even the flu, polio and measles vaccination campaigns were not this shambolic and abusive.

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In there, a nugget of core information: We are likely to see a Delta variant outbreak before we hit our vaccination marks. There is serious rumblings that Level 4 as we know it may not be enough. And fewer businesses would be able to mark themselves as 'essential' in the event it does happen.

Now is the time for the financial relief packages to be outlined, the payroll providers to update their software so it can actually functionally pay out a wage subsidy and the extension of the recently-yeeted fixed asset threshold. There's no reason we shouldn't be doing these things in advance.

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In general I'd agree.

The problem is if the government were to outline such a contingency, National would slag them off as "expecting to fail", regardless of the fact that National would not have managed COVID as well as this government has (see my earlier comment about Steven Joyce's view, and recall National repeatedly saying we should have opened borders last year).

Probably they should do it anyway, but the political environment is still a consideration.

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I'm not entirely sure about that - if you want to play hypotheticals, I have a hard time believing that Mr Social Investment, husband of a GP and man with strong opinions about the sanctity of life Bill English would have chanced his arm on something like a global pandemic. I don't think he was wired the same as the management consultant wing of the party. It's not the same party it was under his watch, which is as much our loss as it is theirs.

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Yes, Bill English is probably the singular element that could have made a National response more like what we've seen from Labour. I'm not aware of any public statements from him about COVID (Key has made a few) since he was out of Parliament before it all kicked off.

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100% agree that the current mob would not engage in good faith though, not a shred of doubt there.

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I disagree. If we swapped the roles, the response would have been identical. And Labour right now would be an opposition like a dog chasing cars in the same way the National Party is right now. The strengths and weaknesses of NZ's approach sits entirely with our institutions, and the long-term success and failure of our COVID response will be dictated by the effectiveness of our technocrats of making good choices and taking people with them. Right now, MOH needs to be performance managed. Andrew Little, to his credit, has been willing to call them out in a variety of areas. The next 3-4 months will be critical.

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dp

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Only way to keep NZ safe is to keep borders closed if opened to government would be held accountable for the carnage. This virus will kill even if vaccine is taken up throughout country look at other places in the world lockdowns all the time and still people really sick and dying, at the moment people in NZ can go out visit family travel freely why change that when you don’t have to, look at it in a years time after more research has been completed.

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People will die as a direct result of the borders not being opened, too. At least we have a vaccine for COVID.

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Could you elaborate on that a bit? How will people die as a direct result of the border not being open?

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It's generally immeasurable, but the two most likely causal chains is that if we keep the borders closed to foreigners and only allow NZers in, then we'll likely end up with fewer skilled healthcare workers such as doctors and surgeons coming here. How many people might die from injuries or illnesses that could have been saved had the healthcare workers been let in? It's impossible to know or measure, but that doesn't mean it won't happen.

The other likely causal chain if borders stay shut for extended periods is suicides, both in NZ and elsewhere, eg from families not being able to reunite and the stress driving them over the edge. Again, not really possible to quantify this, but that doesn't mean it won't happen.

The longer the borders stay shut, the worse both of these influences become. Also if the borders stayed shut for a very long time (say current, or stricter settings, for another 18+ months) it will likely result in lower overall economic growth, which in turn has costs on human health in general.

The point is, even if it can't be accurately quantified, keeping the borders shut *will* cost lives, in terms of outrights deaths and also lowered life outcomes (eg if someone is unemployed for 2 years it has a great toll on the rest of their life trajectory in terms of earning potential). Opening the borders will cost lives from COVID.

Focussing only on the lives lost when the borders are opened (for which we have a vaccine), and totally ignoring the lives lost when the borders are kept shut, is not a sensible thing to do. At some point you also do need to take into account the value of a human life, and the deaths of frail people in their 80s+ who may not have lived much longer and may not have had a great quality of life anyway, morally does need to be weighed against the costs being imposed on the rest of the population.

Morally for me, the most troubling situation is those people who cannot medically take a COVID vaccine. They're in a very unfortunate position, mostly through no fault of their own.

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> then we'll likely end up with fewer skilled healthcare workers such as doctors and surgeons coming here.

Despite the borders being closed theres still some migration happening right? surely if anyone can get in it will be doctors and surgeons with the level of skill that we don't have the internal expertise to train ourselves.

Back in the before times of mass immigration, we were importing some doctors and surgeons as well as huge numbers of retail managers, chefs and students. We never actually got anywhere in addressing the healthcare worker shortage because we kept pumping up the general population.

> The other likely causal chain if borders stay shut for extended periods is suicides, both in NZ and elsewhere, eg from families not being able to reunite and the stress driving them over the edge.

I'll post a source when I'm not on mobile but from memory the suicide rate has decreased over the last year. Wouldn't this effect have started to be evident by now? Also, why can't families reunite - its more difficult but not impossible to travel, surely if its genuinely a matter of life and death then 2 weeks in MIQ is a small price to pay.

> eg if someone is unemployed for 2 years it has a great toll on the rest of their life trajectory in terms of earning potential

Unemployment is down and it seems that wage growth is happening as well. I would argue that this is because of the border closure(less immigration meaning employers must compete for workers). The economy is a complex thing with ~5m moving parts, I don't think you can point to a change in one input(immigration) and say that this is objectively good or bad but on balance the economy seems to be ticking along pretty well.

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Despite the borders being closed theres still some migration happening right? surely if anyone can get in it will be doctors and surgeons with the level of skill that we don't have the internal expertise to train ourselves.

I don't believe so. Certainly not at a high enough rate to fill the shortages we have in the healthcare industry.

I'll post a source when I'm not on mobile but from memory the suicide rate has decreased over the last year.

Sure. I'm not talking about the rate.

I'm saying if the borders stay shut as they are now (or worse) for a long enough period, people will commit suicide as a direct result of that, when those same people otherwise would not have.

The overall rate of suicides may be lower, my point is that there are specific people who will die as a *direct* result of borders being shut, who would not die if the borders were open.

Also, why can't families reunite - its more difficult but not impossible to travel, surely if its genuinely a matter of life and death then 2 weeks in MIQ is a small price to pay.

Have you not seen any of the stories about how people overseas are completely unable to book any slots in MIQ? As for suicide, it usually isn't rational - being in a very bad place mentally, expecting your family to be visiting soon, only for them to have to cancel for some reason and then being unable to get another booking in MIQ for months could push someone over the edge.

The economy is a complex thing with ~5m moving parts, I don't think you can point to a change in one input(immigration) and say that this is objectively good or bad but on balance the economy seems to be ticking along pretty well.

Yes, overall the economy might be doing well and unemployment might be down overall, but that doesn't help Joe Bloggs who has run a tourism business in Waikickamucow for the last 15 years who has seen their livelihood destroyed by COVID and who isn't able to get a decently paying job otherwise.

If you're going to focus on the *individuals* who directly die as a result of getting COVID after the borders are opened and holding them up as a reason NOT to open the borders, then you should give *some* thought to the *individuals* who directly die (or have worse life outcomes) as a direct result of the borders being kept shut for longer.

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Skilled workers are still being imported. MIQ rooms are set aside for them.
https://www.mbie.govt.nz/business-and-employment/economic-development/c…

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Also, why can't families reunite - its more difficult but not impossible to travel, surely if its genuinely a matter of life and death then 2 weeks in MIQ is a small price to pay.

The problem is that MIQ is fully booked out for 4 months - right through to the limit that bookings are accepted. So it's not just 2 weeks in MIQ, it's needing to stay away for 4+ months, maybe even a year or more - further splitting up families in the interim.

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there is data around about the ave expected number of deaths vis a vis COVID deaths - https://www.bmj.com/content/373/bmj.n1137 but its too difficult for me to explain - but it does give some form of measure - admittedly not specific to a border closure

In some countries they are showing less deaths than expected to non covid reasons -- ie lockdowns reducing travel so road tolls lower, work so accidents and deaths in workplace lower etc -- but there is also evidence in some countries of more excess deaths - due to lack of hospital treatment for other illnesses. In particular the lack of screening for certain cancers has led to more diagnosis being at stage 4 rather than stages 2 and 3 where treatment is an option and has a far greater chance of success.

I personally knew two people who died this year as a result of not being diagnosed early enough - in both cases their access to diagnostic treatment was significantly delayed due to the waiting list increases caused by the lockdowns and staff shortages - In fact their diagnosis only came as a result of emergency hospital admissions not due to their initial reporting of symptoms to a GP - leading to a four month wait for an appointment with a specialist that in the end did not happen.

At the moment - Waitemata DHB for example have only filled 30 of the 100 extra nursing posts they need -- but have significantly more vacancies in their baseline positions - and so are currently over 200 nurses short - and my understanding is most DHB's are teh same

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Sorry, does anyone know (or could find in this article or in their report) the credentials of the so-called specialists involved?
You would think this would be of importance, wouldn't you?

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Think the report is terrible.
Supression doesn't work. Look how delta is spreading in NSW despite a hard lockdown.
Our options are either maintain elimination or live with the virus. There is no third option.

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The problem in Nsw is that they started with a Mockdown instead of a lockdown and gave the virus a nice big head start. They still haven't caught up.

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That's not a hard lockdown. It was late and half-assed, the shops were open and people out and about. They've gradually tightened up, but still nothing like NZ level 4.

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The report is dated 10 June 2021 we were still in the early stages of Delta.
I think the official narrative was Pfizer was highly effective at stopping transmission at this stage (there was no solid data to contradict this). I think the report would consider its self out of date.

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Exactly .
In this light I think a much more likely scenario is a Delta outbreak we are unable to suppress ( no one else seems to be really able to .. ) and us being forced to live with the virus.
We can only hope that the vaccination rates are high by the time this occurs...

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The report comprises 3 letters, the latest of which is dated July 27, which specifically takes the delta strain and its spread in NSW into account.

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I see. By taking into account you mean turning everything thing previously said into loose recommendations that require further though.

I don't see any belief that there will be any reopening next year. Too many hopes, coulds and maybes along with conditions that wont be met.

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Seems like this report tells the government exactly what it wants to hear.

Here are my three quick takeaways;
1. Professor Skegg has an impressive academic career, however it looks to me like these guys are all prone to establishment groupthink. I mean Skegg had been an adviser to the WHO and Turner is or was on the WHO SAGE subcommittee. Hendy came up with the doom and gloom SIR models which steered us into closing the borders. How likely is it that these guys would be critical of what NZ’s done so far, or would recommend an about face to the current strategy?
2. A lot of the report seems be cynically re-defining words. Elimination doesn’t mean actual elimination? Herd immunity doesn’t actually mean the virus can’t pass between people? Also Covid19 apparently needs a Maori translation because that’s really important.
3. They seem to be doubling down again. Vaccinate everyone 16 years and older. This seems weird to me because people like Dr Geert Vandeen Bosssche (Who’s a hardcore vaccine advocate who worked for GAVI, the WHO, and Gates foundation) are ringing the alarm bell and saying we should stop mass vaccination immediately to prevent escape variants from evolving.

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Looks like a precarious time to tighten monetary policy when a border shutdown is in place for the next 18 months.

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"The group repeatedly stressed the importance of getting New Zealand’s adult vaccination rate “as near as possible towards 100%”."
A nice cop out statement. Adults 16+ ? Its been suggested that 80% of the total population who are likely to be adversely affected need to be vaccinated. Pick your ages and risk factors. There is no ways this govt or any govt can achieve this "as near as possible towards 100% adult vaccination"
Academics defaulting to the most conservative solutions and hedging their bets on a new strain. Well in 6 months there may very well be a new strain and six months after that another new strain.
This govt will push out the relaxation of restrictions as far out as possible. I was hoping no MIQ for returning vaccinated would be allowed by end 1st qty 2022. I don't see this happening.

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Medsafe has already approved the vaccine for children aged 12 to 15. Government has yet to agree to Medsafe's approval. I wouldn't be surprised if Jacinda announces that in Thursday's speech.

I'm expecting that we'll be vaccinating children under 12 (perhaps 6 to 12?) by December - January. The trials are underway at present and due to report by the end of the year.

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Thats evil. Throwing kids on the bonfire to save their grandparents. You should be ashamed of yourself. There are no long term trials. Children have a long term ahead of them. It has been shown spike proteins head for bonemarrow and ovaries. Cancer and infertility. Are you willing to bet the farm on that?

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My thoughts exactly Belle.

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Because vaccinations are overwhelmingly safer than the alternative of not vaccinating. Or did you miss the overwhelming death, disablement and harm of polio, measles, rubella, etc. Even Gardasil at the point of pre vaccination trials was still miles safer than the high rate of ovarian cancers from the harm from going unvaccinated (and the Gardasil vaccine at the point of trial was often much colder than for Covid vaccination so the likely nocebo effect, people thinking something must be bad because something non related happened and they were superstitious, could be higher). But sure lets play a 'this vaccination is untested' card despite it being one of the most highly tested vaccinations in modern times and having an overwhelmingly high peer review rate and data collection policies around it. Which for the medical industry the rate of peer review often needs to be in the order of hundreds of individual studies of hundreds and thousands of people before becoming standard. Something many deniers seem to miss when they post uninformed cluttered together information.

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At a minimum I'd want solid answers to these questions before even thinking about vaccinating very young people:

What is the risk to 12-15 year olds who contract covid19?
What health complications arise in 12-15 year olds who have the vaccine, and at what frequency do the complications occur?
How could the concept of original antigenic sin, and antibody dependent enhancement apply to these young individuals?
Some thoughts on the latter topic can be found in this journal article https://journals.asm.org/doi/10.1128/mSphere.00056-21

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You do realize that journal articles are not worth much of anything by themselves and without adequate quality peer review and repeated studies. You can literally publish anything these days even in formal medical journals like the lancet and it can be completely fraudulent https://www.vox.com/2014/11/21/7259207/scientific-paper-scam (link changed for better display of false journal articles). Many scientists despair at the lack of integrity and peer review in regards to journal articles but since their funding and scientific standing is often a result of the number of articles published the pangs of ethics only go so far. Efforts to cleaning up the industry and have more scientific practice in publishing and media reporting on journal articles have actually gotten worse with social media and even less scientific review.

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Kind of a weird argument. Your criticism applies to all scientific literature.
The journal I posted was peer reviewed.
THe concept of "oriniginal antigenic sin" or immunological memory was proposed in 1960 and is solidly grounded in a lot experimental evidence.

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