A Taiwan Health Command Centre versus an Election Risk in NZ

Taiwan’s politicians gave the responsibility for COVID-19 to a specialised management team. In contrast, the response to COVID-19 in New Zealand was controlled essentially by the PM.

Jacinda Ardern took charge in early 2020. She used the Covid-19 response as an opportunity to increase her popularity as it gave her the capacity to mitigate any personal ‘electoral risk’, as Professor Gorman of Auckland University School of Medicine aptly put it. She put her need to win the election before the health and wellbeing of New Zealanders.

Ardern is a career politician who came to the job with no governance experience. Dr Ashley Bloomfield, the Director-General of Health, was part of the TV daily electioneering broadcast alongside Ardern.

He became Ardern’s wonk”.  

Hosking 9 April 21

New Zealand had no community COVID-19, but harsh lockdowns were Ardern’s elimination strategy. Subsequently, GDP dropped, there were job losses, more people on benefits with foodbanks having to double their capacity, there have been the expected price hikes and businesses have gone to the wall.

Psychological distress, anxiety, family violence and suicides have increased. The rising level of homelessness and poverty, especially among children, is unacceptable. Many New Zealanders are experiencing isolation, loss of income and a chronic fear of coronavirus.

The inept political governance under Ardern’s leadership is impacting negatively on people’s health and wellbeing.

Ardern’s inexperienced group of politicians were not prepared for a pandemic. New Zealand was late with all its COVID-19 responses.

The actions of closing the border, contact tracing, distributing PPE, implementing testing, securing MIQ, mask policy, and acquisition and roll-out of vaccinations were all slow and awkward.  

Ardern, who wanted to be re-elected, continually told New Zealanders the opposite of what was really happening. She made statements to avoid ‘electoral risk’, constantly reassuring the public that she had closed the borders “hard and early”. By doing this she kept everyone on edge and fearful, but – for the present – safe.

New Zealand implemented one of the most stringent lockdowns in the world to reach the same outcome as Taiwan – eliminating the virus. […]

Thanks to its close trading links with Wuhan, Taiwan was able to act very early, on the same day the World Health Organisation was alerted to the outbreak.

Stuff 22 Oct 20

Taiwan on the other hand completely outclassed New Zealand in pandemic management. Taiwan began screening incoming passengers from Wuhan on the 31st of December 2019.  It was not until the 19th of March 2020 that Ardern closed New Zealand’s borders. 

In comparison to New Zealand, Taiwan had the odds against it during an outbreak of an infectious disease. Its population is 23 million people which is 5 times that of New Zealand and has a density of 652 people per km whereas in New Zealand its’s only 18 per km. Taiwan is very near China (an enemy and is only 81 miles from Wuhan, the epicentre of this coronavirus), yet remarkably they only suffered 11 deaths compared to 26 deaths in New Zealand.

Most importantly the Taiwan NHCC stood apart from government. They had no ‘electoral risk,’ therefore could work devoid of political bias.  

Taiwan was ready and already had a National Health Command Centre (NHCC) set up in the wake of the 2004 SARS outbreak. The NHCC is part of a disaster management centre that focuses on response to large outbreaks and acts as the operational command point for direct communications among central, regional and local authorities.

JAMA (Journal of American Medical Association) Network reported a unified central system that includes the Central Epidemic Command Centre, the Biological Pathogen Disaster Command Centre, the Counter-Bioterrorism Command Centre, and the Medical Emergency Operations Centre.

This vigorous and fast coordinated response allowed Taiwan to avoid the harmful lockdowns imposed in New Zealand. Work continued as normal for the Taiwanese.

There are potential lessons from the Taiwan and New Zealand health responses to the COVID-19 pandemic.

Probably the most fundamental difference between the situation of Taiwan and New Zealand was that in Taiwan responsiveness to pandemic diseases and similar threats is embedded in its national institutions. Taiwan established a dedicated CDC (Centre for Disease Control) in 1990 to combat the threat of communicable diseases.

By contrast, the equivalent organisation in New Zealand (the NZ Communicable Disease Centre, a business unit within the Department of Health) was closed in 1992 with its functions transferred to a newly formed Crown Research Institute (ESR) and then contracted back to what became the Ministry of Health.

In addition, Taiwan established a National Health Command centre (NHCC) in 2004 following the SARS epidemic. This agency, working in association with the CDC, was dedicated to responding to emerging threats, such as pandemics, and given the power to coordinate work across government departments and draw on additional personnel in an emergency.

The Lancet Regional Health Western Pacific, 21 Nov 21

Prime Minister Ardern continues to want New Zealanders isolated, even when that is inflicting stress on them. Ardern has still not stepped away from decision making for COVID-19. She mandated that New Zealanders be locked away from others, sometimes even in childbirth and death.

One recent startling example is viticulturists and orchardists losing their livelihoods due to Ardern’s blatant refusal to let the usual Pacific Island pickers into the country. She refused, despite knowing that the workers wanted to earn for their families back home, were COVID free and that the horticultural sector would suffer financially.

Instead, Ardern both increased the minimum wage and said an emphatic ‘NO’ to these workers. The experienced orchard managers, who know how to read a balance sheet and know where money comes from, were hardheartedly told to plough their crops into the ground and were denied a handout. Businesses are closing because they cannot produce or trade.

The Prime Minister continues to politicise the narrative around COVID-19 however the latest polls show that she is beginning to lose popularity and that her ‘electoral risk’ is increasing.  

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Jacinda Put New Zealanders’ Health and Wellbeing Second

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