Coivd-19 Lessons from New Zealand

Queenstown from Bob’s Peak

“The places they were using to hold up, they are having a big surge. I don’t want that. I don’t want that. They were holding up names of countries, and now they are saying ‘whoops’,” Trump said. 

“Even New Zealand, you see what is going on in New Zealand. They beat it, they beat it. It was like front page, they beat it because they wanted to show me something. The problem is [a] big surge in New Zealand. It’s terrible. We don’t want that.”

Donald Trump (via CNN international)

To be clear the description of ‘terrible’ is quite a stretch, but there are still things to be learnt from New Zealand, both from what has gone so well, and the recent outbreak.

  • New Zealand: What Trump “Doesn’t Want”
  • So What Went Well?
  • The August Outbreak: What Then Went ‘Wrong’?
  • Things to learn.
  • Conclusion: Never Concluded?

New Zealand: What Trump “Doesn’t Want”.

Despite Donald Trump claiming things in New Zealand are “terrible” and “we don’t want that”, reality is, things in New Zealand are a dream compared to the US.

Despite New Zealand having a bad day the when Trump made these statements, there were only 9 new cases. Cases are so low in New Zealand, that most days the only cases reported are not people who caught the virus in New Zealand, they are instead people who had the virus on arrival in New Zealand, and tested positive while in quarantine). When adjusted for population, a day with 9 cases in New Zealand is the equivalent of a day with 605 cases in the US, that same day the US actually had over 40,000 cases. A very bad day in New Zealand: 2 cases per million people, typical day in the USD: 121 cases per million people.

Yes, for New Zealand, that was a bad day. They had gone over 100 days without a single case of local infection in the country, despite unrestricted crowds return to sporting games, having restaurants, bars and business all open and operating normally. Shows you can re-open when after things are in control. That is how successful the country has been in eliminating spread of the virus.

Even the report on the page I link to for the quote from Donald Trump had trouble grasping the level of success. The reporter notes “Only one state, Vermont, has fewer total cases than New Zealand”. But also note Vermont has had double the number of deaths, and with a population 1/8 the size of New Zealand. Even Vermont has more cases per capita, and more than 10x more deaths per capita. In fact, given the difference in deaths, it is very likely the only reason for less total cases (apart from the smaller population), is less effective testing in Vermont.

So What Went Well?

Rather than hoping that Covid-19 was a hoax, or would simply go away, New Zealand responded to the first wave with clear resilience to eliminate spread. The expression “go hard and go early” was taken seriously. Borders were closed, and a six week, intense “level 4” lockdown with all but essential businesses closed was mandated. New Zealand moved to level 3 lockdown on March 23, and to level 4 just two days later on March 25. The lockdown remained until community spread had ceased, dropping to level 3 lockdown on April 27, and then just over two weeks later back to level 2 on May 14. Level 4 lockdowns had been in place for just under 5 weeks, with an additional 2 weeks and 5 days at level 3.

Just before midnight on June 8th, the country moves to alert level one. Restrictions on work, school, sports, domestic travel and gathering size are lifted. Basically, only border restrictions remain.

New Zealand had almost ‘normality’, experiencing post Covid-19 life, until August 12… Covid-19 has returned!

The August Outbreak: What Then Went ‘Wrong’?

In early August, somehow Covid-19 had re-emerged.

The possibilities (most likely to least likely):

  • A returning New Zealand resident or other traveller had brought the virus through quarantine and back into New Zealand.
    • my ‘pet’ subject here is concern of rare cases of long incubation times
  • The virus had not really ever been eliminated from New Zealanders, and infections had been continuing undetected.
  • The virus had re-entered New Zealand on freight in some form and then started a new chain of human infection (seen as highly unlikely)
  • The virus had been present in other animals and had been then again transmitted to humans (seen as almost impossible)

Arthur Conan Doyle wrote the words for Sherlock Holmes:

How often have I said to you that when you have eliminated the impossible, whatever remains, however improbable, must be the truth?

However, I prefer a slightly altered version:

When you have eliminated the probable, whatever remains, however improbable, must be the truth?

My alternate presentation of the idea of Arthur Conan Doyle.

Returning Travellers?

The most probable, the virus being reintroduced by travellers (either returning residents, or someone with a special exemption), seemed to be eliminated by genomic matching failing to match signature of the virus found in travellers coming through quarantine.

However, my ‘pet’ subject, long incubation times, could perhaps allow a traveller to not be positive in tests during quarantine, and if asymptomatic after quarantine, perhaps not be tested when they would be positive. This would provide a path for the virus to enter a country undetected.

Bubbling in the Background?

The ‘never been eliminated’ has itself been ‘eliminated’, as genomic matching shows the virus as different from any strain previously spreading in the community. This would require a chain of infection that has never been detected in during months of spreading.

Cold Storage of Other Freight.

This seems to leave only the highly improbably, or the almost completely impossible.

Although there is further evidence for the highly improbable path of the virus entering as freight, I still think it is worth re-examining the ‘traveller’ scenario, but now to the highly improbable.

But there is a link with this new outbreak to frozen foods, with the first case detected being a person who works at a frozen food facility. Further, other workers at this facility have also tested positive. Note that China also had an outbreak in an area previously free of infection where refrigerated food was suggested as a source.

Infection from Animals in New Zealand.

This is already an idea with no supporting data. Consider cats for example. It has been shown that cats can infect other cats. If a cat infected a feral cat, the virus could then spread undetected amongst feral cats, possibly even for years. Then a feral cat infects a domestic cat, and that cat infects its owner.

A lot of steps, with not one know case of a car infecting a human to my knowledge. Further, New Zealand, where there has be very, very little virus compared to almost every other country, is an unlikely location for this type of thing to surface first, if it ever does happen anywhere. Count this one as included to cover all possibilities.

The Lessons From New Zealand.

1. Go Hard Go Early from the Outset.

Going further than neighbouring Australia in using level 4 lockdowns to control the initial outbreak meant a significant disruption to the economy. On the other hand, while in Australia they were saying ‘whatever we do we must keep doing for six months’, the clear plan for eradication meant businesses could plan for a much shorter disrutption.

The clear message and the clear plan, at least up to August, meant less overall disruption than in Australia.

2. Stay Vigilant

First in the Australian state of Victoria, and then in New Zealand, it has been shown that just as the entire global outbreak likely started with just one case, all it takes is just one case.

3. Go Hard And Go Early Each Time.

Actually this lesson is not yet proven. New Zealand has again gone hard and early, taking the entire city of Auckland to level 3 lockdown as soon as the new cluster was confirmed, and with cases still in single digits.

The new cluster is not yet contained, check back later when I add the outcome.

Conclusion.

The main conclusion from considering New Zealand that evidence suggests holding measures in place until spread actually stops, means less living with lockdowns and social distancing in the long run. But stay tuned.

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