Sunday 3 April 2022
New Zealand's COVID Strategy Worked (But It Could Have Been Better)
We did it! Auckland is well past the peak of the Omicron wave and NZ as a whole is entering the "endemic COVID" phase with minimal illness and loss of life compared to other countries. Overall, our COVID strategy has worked well. However, there are a number of things we could have done better that are worth discussing.
As I write this, Auckland is clearly well past the Omicron peak. Hospitalizations "with COVID" in the Auckland region are down to 350, from a peak of around 600 (out of 2700 total hospital beds in the region). ICU patients "with COVID" peaked at 31 and are stable or possibly declining. Our health system was creaking a bit at the peak but did not suffer the carnage seen overseas. Auckland will likely move to "orange light" settings in the coming week. NZ borders will almost fully open at the end of this month. I'm calling it: soon we will have transitioned to "endemic COVID" with better health results than just about any country in the world. Other metrics are also pretty good: e.g., during the pandemic we had 16 months of almost no restrictions apart from border controls.
The essence of our strategy was pretty clear by April/May 2020: eliminate COVID, keep it out at the border and keep stamping it out until we're able to vaccinate everyone. We achieved that: our only big wave has happened after everyone 18 and over had plenty of time to be double-vaccinated (and 12-and-overs had time for at least one dose)**. As a bonus this big wave is Omicron, which is less severe than the earlier variants. In Auckland we have had about eight months total of various levels of lockdown restrictions, but only a few months of the most severe restrictions (if you're vaccinated, at least). This was clearly a sensible strategy and we should do it again under similar circumstances. Switching gears in November/December 2021 to simply slow the spread and accept endemic COVID was also sensible (looking at you, China).
I think the major policy settings were mostly very good, but I see a couple of potential flaws. I wonder whether vaccine mandates for workers in education, health, police etc were worth the trouble; I don't want to go into the pros and cons here, but in hindsight they might not have provided enough benefit. We should have tried to prioritize MIQ usage to stop people using scarce MIQ capacity for holiday travel, but that was never even tried.
A lot of the execution was deeply flawed. For example, in 2020, COVID testing for MIQ workers lagged far behind government expectations. In 2020 and 2021 vaccination procurement was late and vaccination rollout was slow. RAT test acquisition was a fiasco and RAT tests were deployed later than they were needed. Testing and contact tracing consistently failed to meet targets. All these issues were forseeable. For these reasons I think Bloomfield (and probably others) should have been sacked long ago. Fortunately, in each of these areas our execution was just good enough to avoid disaster and stay on track with our strategy. Nevertheless we should be studying those flaws (in an apolitical way) and figuring out how to do better (with future COVID variants or the next pandemic). I suspect a lot of the problems lie with bureaucracy in the Ministry of Health and elsewhere in government.
On the other hand, I've faced enough armchair critics to know that people actually making and executing decisions, with limited knowledge, limited time, and real-world constraints, deserve much benefit of the doubt. I have no sympathy for the people who argue that the NZ government deserves no credit for our results "because it was easy" — you only have to look around the world to see that it was not. I'm very thankful to Ardern, Bloomfield, Hipkins and many others for the situation we're in.
** One very strange thing that happened in New Zealand that no-one talks about: in November/December we relaxed lockdown restrictions and opened up the country internally while Delta was spreading. Everyone traveled for Christmas, met for parties, etc etc ... and Delta cases just kept declining! We came close to eliminating it and probably could have except Omicron took over! No-one paid attention to this because at the time we were all just waiting for Omicron to arrive, but I think it's very surprising and needs to be explained.