The book I am currently working on – tentative title ‘In Open Seas’ – looks at the current and future New Zealand. One chapter describes the policy towards Covid using the trope of warfare. It covers an important period in our history but it also shows how policy evolves and why, as Jacinda Ardern said, it was difficult to plan. This is as far as I have got (edited).
It is helpful to think of the Covid Crisis from 2020 as a world war or even the War of the Worlds, although in the H.G. Wells story the Martians were killed off by the viruses. This time the viruses were the invaders. It has been the biggest domestic invasion for over a century.
It has been a world war because every country has been invaded although this time there has hardly been a coalition of countries to defend themselves. Individual countries amassed resources and regulations in a whatever-it-takes approach towards the invader. That included measures disruptive to normal social life just as in previous wars; border closures and lockdowns meant that families were separated for long periods. (There were complaints that fathers would not be present at their children’s births; I have friends born during the Second World War who did not meet their fathers until after it ended; some never met their fathers.)
Signs of the war became public in January 2020, but the first big policy decision was the closure of borders in February. It did not require hindsight to wonder what would be the exit strategy. Perhaps the view was it would soon be over (as they expected when the First World War began with its ‘home by Christmas’). It was not a foolish assessment; the 1918 influenza epidemic lasted months. The aim was to keep the mortality rate down in the interim; in 1918 there had been about today’s equivalent of 35,000 New Zealand deaths.
The government agency responsible for MIQ places handled the job badly. There has been a constant news thread of either poor decisions or people complaining of their place in the queue. The government does not appear to have addressed any failure of the agency. Perhaps ministers and bureaucrats have been so focused on the immediate crisis that they have not been able to give much thought to long term restructuring.
There was an increasing concern about the pressure on intensive care beds. (New Zealand seems to be under-resourced compared to similar affluent countries.) In March 2020 the country went into lockdown with the aim of ‘flattening the curve’, that is, to slow down the increase in cases reducing pressure on ICU beds.
Then suddenly, the strategy changed to an ‘elimination strategy’, assuming that with border closures and a rigorous lockdown could eliminate the Covid virus from New Zealand. It almost worked; it might have if Covid had been a repeat of the 1918 influenza cycle.
The lockdown included a major fiscal package in which the government abandoned the public debt target announced before the 2017 election without much pretence that debt levels would soon return to the pre-Covid levels. This was partly possible because other countries were also loosening their fiscal stance, and also because borrowing rates were low so the burden of interest servicing remained low. It was an abandonment of the Austerianism – cutting back government spending and lowering public debt – which had dominated international policy after the Global Financial Crisis of 2008.
The public began to talk about vaccination against Covid, perhaps precipitated by the very successful influenza vaccination rollout of April 2020. This lay person observed that: first, there might be no vaccine ever; second, in any case development of vaccines took time – years; third, the successful vaccines would have a very high rate of efficacy for a longish period. Wrong on all three counts. By the end of the year there were vaccines against Covid, but their efficacy was not as high as expected.
For many, the first lockdown was a bit of a lark; perhaps it was because it was different, certainly because it was short. Covid seem to have been eliminated in New Zealand. The war raging offshore reinforced the complacency. But the borders still had to be secured and that could not be maintained forever, given that New Zealand was a small open society.
Aside from the usual grumbling, the majority of the population seemed reasonably satisfied with the situation. They accepted the role of government leadership and the advice based on the medical science – more so, it would appear, than in some other countries.
There were some dissidents but they did not appear until the vaccine debate. There were four more visible centres of contention. One arose from the difficulties associated with border control. A second was domestic businesses which were suffering from the lockdown despite the government subsidies; many would become more vocal in 2021.
There were a small group of economists and near-economists who argued that the lockdown (and later policies) were not cost effective. Their conclusions depended upon assumptions which seemed debatable. More realistic assumptions – in my judgement – gave different conclusions.
(I also looked at some of the modelling purporting to demonstrate the need for the lockdown. Again some parameters seem to be chosen to justify the conclusion. Models (and forecasts) tend to be very sensitive to not-always-articulated assumptions. Their results are often put forward with a confidence that a more nuanced analysis justifies. The research evidence is that the greater the confidence of a prediction, the more likely it is to be wrong. The practical experience is that the greater the confidence, the greater the attention the media gives it. ‘Expert predicts’ is best treated as an oxymoron.)
The fourth group of dissenters were those clustered around political opposition to the government. They did not markedly disagree with the government but thought they could run the policies better. Sometimes they did not seem to have fully understood the issues; sometimes their gripe was that the bureaucracy was not moving fast enough; an easy point to score, but hardly preparing an opposition for the task of government.
Uncomfortably for a liberal democrat, there were calls to skip due process – like having new medications first cleared by Medsafe – justified by the exigencies of war. And yet when the Government rushed the ‘traffic-light’ legislation though parliament, the same critics complained that due process was not being followed. Probably the haste was from trying to get the traffic-light regime in place as quickly as possible. The critics would have been furious if due process had been followed delaying the introduction of the regime.
Suppose that early on the Covid Crisis had been formulated as warfare. What would have been the Opposition’s approach to the war effort?. Perhaps it would have argued ‘this is a war, we need a war cabinet of the Government and Opposition to prosecute the war’, while holding the government to account on other matters. (There had been a ‘National Ministry’ between August 1915 and August 1919 and a ‘War Cabinet’ between July 1940 and August 1945.)
The possibility was not pursued. Instead Labour won the October 2020 election with 50.0 percent of the votes (38 percent of the eligible population) to National’s 24.6 percent (19 percent). It was the first time since the introduction of MMP that a party had won a majority of the seats and could form a government by itself. People’s votes are determined by numerous factors, but the majority must have been comfortable with the government’s Covid policy of total elimination. (A disorganised National Party did not help.)
But the elimination policy was not sustainable insofar as it depended upon border restrictions. As long as Covid was rampant elsewhere, New Zealand remained under threat.
Wars accelerates technical change. The defenders had vaccines by the end of 2020 although they did not arrive in New Zeland until the middle of 2021. But they were not as effective as had been hoped. More positively, the vaccines reduced substantially the chance of getting the virus, reduced substantially the chance of transmitting the virus and reduced substantially the chance of suffering serious health effects (including death and long-Covid) from the virus. In summary, the vaccinated are much less likely to die – or suffer in other ways – than the unvaccinated, but they still might.
The invaders also improved their weaponry. The Delta mutation of the virus is more than twice as contagious as previous Covid variants and seems more virulent on other dimensions as well. (One wonders whether the elimination program during the April 2020 lockdown would have been as effective had it been dealing with the Delta variant.)
So the newly elected Ardern-Robertson Government had a strong election mandate for the elimination strategy but the continuation of the strategy was not practical. It continued with the strategy as it felt its way through the next phase. The big change was vaccination. For a time it seemed that it would take the country to near the elimination ideal in a less onerous environment.
But there was no longer a glorious victory. Instead, disillusionment set in among the civilians hunkered down in lockout trenches. The privations for those in Auckland at the centre of the battle seemed to be endless, and the Delta troops sometimes broke past the cordon around the city. A repeat of the elimination strategy did not seem to be working, probably because it was easier to pass on Delta.
There was a small group who refused to get vaccinated, although the reasons for their vaccine hesitancy were not investigated. The general view was that the hesitant were misinformed or were antagonistic to medical science. These are personal reasons. Little attention was given to structural failures such as rural location, low socioeconomic status, Māori, young people and those isolated. We don’t know how large the group is whose non-vaccination is explained by delivery failure.
The personal-reasons explanation led to considerable emphasis on penalising the individuals who failed to vaccinate, particularly by limiting their access to situations such as some employment and entertainment which had the potential to spread the virus. Compared to some other countries this ‘mandating’ was a much more top-down strategy.
It not just a matter of reducing pressures on health services – there has been no mention in New Zealand of withdrawing services to the non-vaccinated. The vaccine hesitant (who are not the anti-vaxxers who deny any efficacy of the treatment) overlook that they are also compromising others’ health. The anti-smoking campaign got a lot more purchase when the consequences of passive smoking became evident; it was a key lever in the passing of the smoke-free legislation in 1990. Transmission of Covid is also involuntary. Perhaps we could leave the market to sort out the involuntary exchange by individuals suing those from whom they caught their Covid (impractical in the case of passive smoking) but common sense suggests that mandating is more practical (and preventive).
What should be mandated involves a finer judgment. (My local taxi company has required all its drivers to vaccinate because of customer concerns. However it is not a monopoly so that unvaccinated drivers – and passengers – can use other suppliers.)
Māori were devastated by an invasion of epidemics in the nineteenth century which did more damage than warfare. During the 1918 influenza epidemic, the Māori mortality rate was eight times that of non-Māori. They are still more generally health compromised. Their leadership was staunch and vigorous. Yet Māori vaccination rates were markedly below those of most other ethnicities, especially among the young (they are similar for older groups) and in low socioeconomic status areas whether rural or urban. (The same patterns are not evident for Asians, Pakeha or Pasifika.) This suggests Māori are not as socially cohesive as other ethnic minorities.
So the war against Covid evolved; sometimes policy appeared evolution on the hoof. The government committed itself to a benchmark double-vaccinated target of 90% of the eligible population. It then had to slowly change the target to something more practical. Was it aware when it set the target that it would have to be weakened? One of the rules of politics is when building a house, first build the backdoor – the escape route. Perhaps it knew that the target was not sustainable but it thought that to have maximum effect – to get as many vaccinated as possible – it had to appear totally committed to it. Whatever, in some circles the evolution was seen as a policy backdown from the elimination strategy to something else – but what?
The public was understandably confused. My guess is that most have got the most important issue for them correct – the importance of being vaccinated – but they may not have a grasp of the next five items necessary to understand the future.
The government is replacing the Alert system of the first lockdown with a ‘Traffic-light’ system which is really an admission that the elimination strategy has ended and that the Covid incursions would have to be tolerated.
In the long run it looks as though that, a bit like influenza, a low level of Covid will be a permanent feature of the world and New Zealand; a sort of guerrilla warfare to be contained but not eliminated. It is possible there will be more effective vaccines; mutations which avoid the current vaccines also seem likely. The expectation is that everyone will need a regular (annual) vaccine boost (like for flu). To what extent there will be public policy restrictions (including masks) and discrimination between the vaccinated and unvaccinated is likely to depend upon how militant the Covid terrorists are.