Monday, 7 March 2022

Free Press, 7 March 2022


THE HAPS 

The West unites behind the extraordinary leadership of Ukraine President Volodymyr Zelenskyy. Where, though, is New Zealand’s response? We depend on collective security and a rules-based order but our Government was not ready to join. New Zealand business has led the way. ACT’s Move On campaign keeps moving, thank you if you have supported it at www.moveon.kiwi 

THE NEXT PANDEMIC 

It may be too early to say New Zealand’s Omicron wave has peaked, but not by much. Sure, daily case numbers are a measure of testing as much as anything, and we shouldn’t take them so seriously. But, for what it’s worth, we are now at about 4,000 cases per day per million people.

The Australians had a week at that level before tested cases declined. On that basis we may be a week away from the Omicron tide subsiding. Then what?

Even Labour who cannot imagine Governing without COVID controls are promising to start removing them when the wave peaks. We may get back to normal faster than Jacinda can get a face-saving letter from Sir David Skegg, as she did for the border opening.

Let’s imagine for a moment that Labour really can let go of COVID control. Then there will be the inevitable (and long overdue) Royal Commission of Inquiry. If it’s any good it will find a clumsy Government response has been saved by oceans of debt, the literal oceans that kept the virus out, and massive sacrifice by a compliant population.

It will find that any task the Government could actually influence, from testing to tracing to vaccinating to making transparent, commonsense rules were disastrous. Competent execution is (or should be) the easy bit.

Of course the Government should have established a Taiwan-style Epidemic Response Unit that brought together more expertise than the Ministry of Health could ever muster. It should have worked with, instead of against, business. It should have embraced technology for testing and tracing instead of the-Ministry-of-Health-always-knows-best.

It should have co-created rules with each sector and had more human vaccine policies. ACT’s already said all that.

The big questions are about the strategy itself. Government should have had a more balanced approach to different needs. The strategy should have balanced COVID-19 with all of the other challenges New Zealanders face. That’s the hard bit.

At some point a riddle will have to be answered: Why did so many countries with very different cultures and political systems all sacrifice so much more to save a life from COVID than they ever would for anything else? We don’t fix every dangerous corner, we don’t fund every cancer drug, and we don’t ban motorbikes (even though they’re very dangerous and have gotten more so this century).

We often accept people dying because saving a life would take resources away from other things, including saving lives in other ways. If that sounds tough, it’s a perfectly normal way of thinking for people who work at Pharmac, or the Ministry of Transport for example.

If we’d been like the U.S we would have had 12,500 extra deaths over the COVID period. Like the U.K, 10,000 extra deaths. Like Sweden, 5,000. Those figures sound bad, but they need some more context. 30,000 people die in New Zealand in a normal year, so we would have expected 60,000 deaths in New Zealand over the last two years if COVID never existed.

Then there’s the age. Policy makers talk about QALYs, or Quality Adjusted Life Years. The death of a 90 year old is very sad, but the death of a 9 year old is an heart wrenching tragedy. The mean age of those who died from COVID in England and Wales was 80, life expectancy there is 81.

It’s easy to read too much into these statistics, we shouldn’t conclude that New Zealand’s COVID response (so far) has allowed 10,000 people to live one year longer. No doubt it’s more complicated than that.

But at some point we’re going to have to ask and answer the question: Were the years of life saved from COVID worth shutting down the country, putting a generation out of the classroom and into enormous debt? Had we known all this at the start, would we have made different decisions?

Probably not this time. Practically every country, culture, and political system acted the same way, just to different extents. Even Sweden had more stringent restrictions than New Zealand for large parts of the past two years. But we can’t afford to make the same mistake next time.

There will be another pandemic in our lifetime, perhaps within this decade. It’s unlikely, but possible, that there will be a worse variant of COVID. Some people say COVID was a one-in-one-hundred year occurrence. Bird flu, swine flu, zika virus, ebola, if you think about it there is something like it every few years, COVID was just the one that got out of hand due to its particular characteristic.

We’ll need answers about key questions. How do we deal with uncertainty in the early stages of a pandemic? How (if) we use our strategic advantage of isolation, such as closing the border temporarily to get a better picture? What cost benefit analysis we apply to saving lives from an epidemic as that picture clears? Should the analysis applied to pandemics be different from other decisions?

If Omicron really is peaking, and it is the last significant variant before COVID becomes another endemic flu-like virus, then we’ll need to turn our minds to how we deal with the next one while we’re still paying for this one.