It’s Elimination All the Way, Baby!

On the AM show this week Sir David Skegg, chair of the Strategic Covid-19 Public Health Advisory Group on Covid-19 talked about a phased border reopening beginning next year, providing the government sees a successful vaccine take-up rate. The Strategic Advisory Group provides independent advice to “Hon Dr Ayesha Verrall, Associate Minister of Health (Public Health), about the future of the elimination strategy and the phased re-opening of borders”.

There are two other government Covid-19 advisory groups: the Technical Advisory Group, established to provide the Department of Health with information on Covid-19, and the Technical Advisory Group (CV Tag).

Nothing wrong with three advisory groups covering much the same ground when they’re all telling you the same thing, is there? Like keeping all your eggs in one basket.

There is no need to wait until the government releases the Strategic Advisory Group report on Thursday 12 August as David Seymour has already commented on the guts of the Skegg report which is nothing new at all.

New Zealand would love to achieve Iceland’s immunisation rate which has over 90% of the adult population fully vaccinated, but when Delta arrived in Iceland it brought a surge in Covid-19 cases.

It appears likely that vaccination does not prevent transmission of Covid-19 variants, but that the illness is generally less severe.

The Icelandic government panicked at the surge in cases, reinstating masks, social distancing and travel restrictions because the vaccine did not appear to be stopping transmission of the Delta variant.

The delta variant of the virus, which originated in India, is more than twice as contagious as the initial strain and has become the dominant strain of the virus in Israel.

Haaretz

Israel, like Iceland, has a high number of fully vaccinated people and began developing Covid-19 treatments after it became clear that the vaccine was not stopping transmission there either, although the cases are less serious. Israel tested their latest therapy in Greece because of insufficient numbers of serious cases in Israel.

Some 93% of 90 coronavirus serious patients treated in several Greek hospitals with a new drug developed by a team at Tel Aviv’s Sourasky Medical Center as part of the Phase II trial of the treatment were discharged in five days or fewer.The Phase II trial confirmed the results of Phase I, which was conducted in Israel last winter and saw 29 out of 30 patients in moderate to serious condition recover within days.

The Jerusalem Post

With such positive advances in Covid-19 treatment overseas, one could reasonably have high hopes for New Zealand. Forgive me for bringing you back to reality with a thud.

The following transcript from Newshub’s AM show Wednesday 11 August with Eric Young, Mark Richardson and Amanda Gillies is below. Read it and weep.

BFD Transcript:

Eric:

What is the primary recommendation of this advisory group?

Sir David:

Well, I guess the most fundamental bit of advice is that we believe that we should try and maintain our elimination strategy, and try and continue to have a different life from most other countries as we reopen the borders.

But we are advising that we shouldn’t reopen the borders until everyone’s had a chance to get vaccinated, which we hope will be done by the end of this year.

So, we are hoping that we can start a phased reopening early next year.

Eric:

When you say everyone have the chance to be vaccinated, so do you feel we need to be at what level? 70, 80, 90, 100% vaccinated?

Sir David:

Well, originally it was going to be 100% but we need to be as near as possible as we can to 100% because it’s clear that even at 90%, we won’t have some sort of magical state of herd immunity where we can stop doing all the other things.

So, it really is important that we all take that opportunity this year.

Eric:

What happens if people don’t take that opportunity though, what happens if we always end up at 80 or 85% vaccination?

Sir David:

Well, um you know, if it was lower than that we would have a real problem but assuming that we are going to have to reopen… if people don’t get vaccinated New Zealand will face a different kind of future and we will have a lot more Covid and we will have hospital admissions and deaths but obviously we can’t remain cocooned off from the rest of the world forever.

Mark:

Yeah, I don’t want to seem callous or cold in any way, death is a part of life, um… and it’s horrible when anyone dies but isn’t it more a case of… once we’ve got to a point where you know our hospital system will not get overrun then… then we just have to accept that this disease will be with us forever, and it will, just like influenza and the like takes some lives?

Sir David:

Well, it’s a very different disease from influenza and what we are seeing in other countries… it doesn’t just kill people but it changes the whole way of life. I mean, in the UK at the moment most people are still working at home… um… the number of social contacts is only about a quarter of what it was before the pandemic, 90% of people are still wearing masks when they go outside the house.

I don’t think most New Zealanders want to live like that, I certainly don’t. So, it’s not just a matter of preventing death, although that’s a very important thing as well.

Amanda:

ACT leader David Seymour has come out and he says it’s a disgrace that the government didn’t release the report earlier, he’s said he put a lot of questions to Jacinda Ardern… they haven’t been able to be answered. I know it’s a difficult one for you to answer on that theme but do you have any thoughts on this?

Eric:

Well, the government obviously needed time to read our reports and decide how they are going to respond to them and tomorrow the prime minister will be speaking, I understand, at the Public Forum here in Wellington. So, I think we will hear the government’s response tomorrow and what their plans are for the next six months as we reopen from the beginning of next year.

But I think it is not surprising that they wanted time to look at our advice and decide what they thought about it before releasing it all.

Eric:

How did the arrival of the Delta variant, in the world, not obviously in New Zealand, but how did that play into umm… this… umm…umm report?

Sir David:

Yeah, well it did. If you look at our three letters which have been consolidated you will see a change of tone of the weeks because the more we learn about the Delta variant the more we realise just what a formidable umm… enemy this virus is. It’s a very different virus from the Wuhan virus last year and that’s going to make it more difficult for us to control it.

And one of the reasons we haven’t spelled out in exact detail what we think should happen in the course of next year is that we must expect further mutations of the virus.

This virus keeps adapting and obviously umm… we are going to have to modify what we do as we go along.

Amanda:

When you talk about the Delta variant which is obviously rampant in Australia at the moment, thankfully hasn’t come here, but there was also talk of the Delta plus variant. Has there been an update on that? It reared its head but there doesn’t seem to have gone any further.

Sir David:

Yeah… not really. I would say just one thing: we have got the Delta variant here. I mean it’s in MIQ facility, it’s in at least two hospitals, this is why we really can’t be complacent… at the moment it’s not in the community – we think – but one thing that really worries me is that New Zealanders are terribly complacent, we sort of think that we’ve beaten the virus but we haven’t. We’ve just kept it at bay and it’s really important that people get tested as soon as they have any cold or flu symptoms and scan those QR codes because we could very soon have an outbreak as most states of Australia have had in the last few weeks.

Mark:

Most nasties that we end up of getting here of this nature we import, especially throughout the winter, they come in from overseas, what I suggest is…. because the world won’t beat this… so I am going to run a scenario whereby we probably all get Covid at some point in time but if we are vaccinated, we are protected from it turning into something really nasty.

Sir David:

Well, no, I don’t think that’s true. I think of it a bit like measles. Measles is endemic in many countries, it’s not here, we keep measles under control, it keeps coming across the border but because we have a really high vaccination rate and because of public health measures we stamp out outbreaks of measles when they occur.

If we were all to get infected by Covid, unfortunately, we will have a lot of hospital admissions and deaths and our lifestyle will never be the same again so um… New Zealand has done so well you know we really have done better than any other country but now we are entering a new route and we’ve got the opportunity, I believe, to continue to have a life which is very similar to that before the pandemic. But that’s a rare thing on the planet today.

Eric:

You say a phased approach, what do you mean specifically?

Sir David:

What we are suggesting is that the first group to have either quarantine free entry or at least reduced quarantine would be New Zealanders going overseas who we know have been fully vaccinated with the Pfizer vaccine, which is the best, and coming back from… not from the highest risk countries.

So, that will be the first phase and we’ve suggested a number of precautions that should be taken like pre-flight testing, testing at the airport rapidly when they arrive and so on.

But then we see this being scaled up to increasing the categories of travellers who wouldn’t need to go through the full 14 days of MIQ.

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