Jacinda Ardern has led the global Covid success story, but other countries have failed when faced with the Delta option.
When epidemiologist Michael Baker went through the growing list of places exposed to Covid in New Zealand, “my heart just dropped,” he says.
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Bars, nightclubs, churches, schools, restaurants and hospitals – the main items on the list were a nightmare for infectious disease specialists. “Almost all the high-risk premises were on the list.
This was two days after the outbreak in New Zealand. The country, which has long been successful in the pandemic, now faces its biggest hurdle since the pandemic began. Over the past two months, New Zealand has watched eradication success stories in the Asia-Pacific region struggle with a variant of Delta. Hong Kong, Australia, China, Taiwan and Singapore have all achieved elimination or are close to it. Delta has arrived to all and many have struggled to contain it.
“Now New Zealand has been added to the list,” said Baker, a professor and leading pandemic response specialist in the country. A nationwide isolation was imposed on Tuesday night after a single case of the disease was detected earlier in the day. Over the following days, the country’s contact tracers and testers struggled against time to determine the origin of the virus in the country and trace how far it had spread before detection. By Friday, the number of cases had risen to 31, in three regions, including New Zealand’s two most populous cities. Health officials have published an ever-expanding list of more than 140 places that infected people may have visited.
Ardern confirmed on Friday that the entire country will remain at its highest level of isolation until at least Tuesday. With just 23% of New Zealand’s adult population fully vaccinated, Delta has the potential to sweep through the country. In the past, New Zealand’s response to the pandemic has been the best in the world . Now both its own citizens and other countries will be watching to see if it can overcome the latest threat.
Obvious weaknesses
New Zealand’s response to the pandemic is ‘one of the toughest of any country – certainly among liberal democracies – but it still has these obvious weaknesses’, says Baker.
Its most obvious weakness is its low vaccination rates. About a third of all New Zealanders have had one vaccination and 19% have both. Among the unvaccinated are many key workers: while health workers and border guards received the vaccines first, supermarket and pharmacy staff did not. “So 10 to 15% of the population are not locked up at home, they’re not in home quarantine, they’re out in the country to work,” says Baker.
Some of New Zealand’s public health measures were also developed early in the pandemic, when the focus was on land and droplet transmission. Over time, the scientific consensus changed – to recognise, for example, that Covid-19 can be airborne and remain infectious in indoor air.
Many countries have gradually adapted to these findings over the past year – some have moved to a culture of near-universal mask-wearing or have addressed issues such as indoor ventilation. But with more than a year without a major outbreak under its belt, New Zealand’s population must now undergo a more radical shift.
“There are a lot of things that go back to the beginning of the pandemic – plastic barriers … and the two-metre distance [indoors] are things that we’ve kept from the first part of the pandemic. And it’s just not as relevant now that we know it’s in the air,” says Dr Siouxsie Wiles, a pink-haired scientist who has become one of New Zealand’s best-known Covid-19 communicators.
This week the government banned the use of homemade masks for the first time. But some of its lower “alert levels” still do not take airborne transmission into account, focusing instead on measures such as social distancing indoors.
“New Zealand has been incredibly slow to do this,” says Baker. “I think we may be the last country on earth that actually has clear instructions on masking in an outbreak situation – and the evidence on the importance of aerosols is overwhelming. But at the moment we still don’t have a developed mask culture in New Zealand.”
A sustainable approach
But even while calling for change, experts also believe that the fundamentals of New Zealand’s response have been in place since the beginning .
In mid-March 2020, at the start of the pandemic, Prime Minister Jacinda Ardern coined the phrase that would define New Zealand’s approach: ‘Act hard and act early’.
“We as a nation have two choices. One is to let Covid-19 develop and get ready. The second is to take all measures to prevent it and eradicate it,” she said. “I do not apologise for choosing the second way.”
Now, more than a year and a half later, the basics of that strategy have not changed. After more than a year of no restrictions on asylum, Ardern has again called on her population to take tough and timely action, leaving the country in the strictest of isolation.
“While I know we all want to block the memory of 2020, we have been here before,” Ardern said on Friday. “We know that the elimination strategy works: cases arise, then fall until there are none left. It’s tried and true. We just need to endure it.”
While this approach has left some foreign commentators bewildered, experts believe it will still hold true in the long term.
“You almost have to respond in a paradoxical way,” says Baker. “Usually we’re so used to saying, ‘If things get worse, we’ll increase our response’.” It’s paradoxical to know that the science says we should respond as much as possible from the start”.
“It’s taken a long time for many governments to think about it in these terms. And, unfortunately, there is no second chance”.