Wellbeing Approach to Covid-19

The concept of wellbeing has been lost as New Zealand has scrambled to contain Covid-19. While the virus has been largely beaten with few deaths and no community transmission, we have lost sight of the many costs imposed by lockdowns that are unaffordable.

The response to Covid-19 is about more than just the border. No matter how careful we are, there will always be outbreaks so long as Covid-19 is endemic in the world. It is about more than just preventing deaths from the virus. There are other threats to our wellbeing, including our health. A total response to Covid-19 is about overall wellbeing in a world where we cannot guarantee against an outbreak.

Some have engaged in the debate over whether the elimination strategy should be continued. To discontinue it is to consciously choose for some people to die for the greater good, an intolerable calculus for New Zealand. Instead, we need to ask how elimination can be made affordable.

It is not affordable to continue with rolling lockdowns. Being free of Covid-19 is one dimension of wellbeing. We also have to think about a generation of students’ one shot at life-defining exams, the mental health of small business owners run ragged, non-Covid healthcare such as missed elective surgeries, and families who can’t travel to Auckland for funerals.

Then there are financial costs. If we take one estimate from a major bank, a Level 3 lockdown in Auckland costs $440 million a week. 16 days is $1 billion. That is Pharmac’s entire budget for all taxpayer-funded medicine for a year.

In addition to the cost of lockdowns, New Zealanders face the uncertainty generated by the threat of them. Who would invest in hospitality right now? Who would invest in events? Better wellbeing depends on investment in the future, but investment requires certainty, and the lockdown strategy imposes massive uncertainty on everyone.

Clearly, we must do better. Unfortunately, the Government has not sought to do so. Throughout the Covid period, the Government has almost fetishized comparisons with countries doing worse.

For instance, whenever the Government makes comparisons with Australia, it is with Victoria, seemingly ignoring that that has been an indulgent mistake.

At a national level, the Government has chosen comparisons with Sweden, as if that country’s approach is the only alternative. This is another indulgent mistake. Instead, we must compare ourselves with, and seek to emulate, Taiwan, the country that is the clear winner on a wellbeing basis.

A Wellbeing Approach to Covid-19
  • New Zealand needs a Wellbeing Approach to fighting Covid-19
  • Our response can’t be only at the border, we need deeper layers of defence
  • We should seek to emulate Taiwan, the clear winner on a wellbeing basis.
ACT’s approach
  • A multi-disciplinary Epidemic Response Centre
  • Government as referee, not player: allow arrivals to isolate at an Airbnb and be electronically monitored; strict punishment for rule-breakers
  • A risk-weighted response: treat different countries and travellers with different levels of caution
  • A technology-driven response: use innovations such as the Covid Card, GPS locatable cell phones and Datamine’s ëlarm.

The Taiwanese Model

On the face of it, Taiwan should have been a Covid disaster. The tiny island with a high population density (smaller than the North Island with 23 million people) is deeply integrated with China. It even had direct flights to and from Wuhan.

However, Taiwan has achieved the astonishing record of only seven deaths (outperforming New Zealand by a factor of 12). Most astonishingly, it achieved this without any lockdowns. In fact, Taiwan allows people arriving in the country to isolate at home. How is any of this possible?

The Government of Taiwan did not go hard and go early. It went smart and went much earlier than New Zealand. While the New Zealand Prime Minister was visiting Fiji in late February, the Taiwanese response had been fully implemented for a month. In fact, the Government of Taiwan wrote to the WHO warning of the danger on 31 December last year.

The full Taiwanese response involved policies that are outlined here. If we want to enhance New Zealanders’ wellbeing, we must stop indulgently comparing ourselves with the worst and start striving to be the best.


ACT’S WELLBEING APPROACH TO COVID-19


1. Well Organised Government Response

ACT would establish a specialist multi-displinary epidemic response unit similar to Taiwan’s Central Epidemic Command Centre. The Ministry of Health has a charismatic leader but not the ability to deliver the range of outputs required to fight a pandemic. In fact, there are a wide range of criticisms that can be levelled at the management of healthcare normally. Even if these criticisms are not sustained, the Ministry of Health appears to be fully occupied keeping up with its normal job.

The Ministry of Health is not the organisation to bring together manufacturing and distribution (PPE), software development (contact tracing), operations (testing and isolating). A multi-disciplinary, public and private, taskforce with overarching responsibility for our national strategy, like Taiwan’s Central Epidemic Command Centre, should be established instead.

ACT would have this group established and choose the best people without fear, favour or prejudice. It would involve key leaders in the public sector but also bring in private sector leaders on an equal footing. It would have a transparent relationship with government, which would publicly set policy targets for the Centre. The Epidemic Response Centre would be tasked with achieving these targets.

New Zealand’s Epidemic Response Centre would be tasked with maintaining elimination while maximising overall wellbeing. Its first task would be to improve contact tracing to the standard that lockdowns are not required to contain an outbreak with a single chain of transmission.

2. Government as a Referee, Not a Player

ACT would recognize the role of Government as a referee, not a player in maximising wellbeing in the face of Covid-19. The role of Government should be to set clear rules of the game rather than to be a player itself.

Isolation is a good example of where government has failed to uphold the rules while trying to provide the service itself. While the Government was operating isolation facilities, nobody was responsible for checking dangerously exposed staff were being tested.

In Taiwan, new arrivals can isolate at an Airbnb. However, they are strictly and electronically monitored. If you breach the rules you will be severely punished. The Government should be setting the rules for safety and ensuring people meet them rather than trying to do everything itself.

Similarly, the Government has taken a dictatorial approach to essential services at a cost to safer services. The closure of butchers and greengrocers while supermarkets remained open is one publicly visible example of this. The failure to ensure lockdowns were legal is another.

Instead, the Government should be focused on enforcing rules that minimise transmission rates so that contact tracing can isolate an outbreak with minimal disruption to people’s overall wellbeing.

3. A Risk Weighted Response

ACT would recognise that risk varies and manage it accordingly. Taiwan treats different countries (and we should treat different Australian states) with different levels of caution. Similarly, we should manage different types of people differently.

At the moment we have the same policy for a rail engineer coming to work on the City Rail Link as we do for a deported gang member. The former should be able to isolate privately if suitable rules and digital contact tracing are in place.

4. A Technology Driven Response

ACT would augment our Covid response with better technology. Taiwan used GPS locatable cell phones to track those in isolation, allowing it to isolate cases much more quickly.

With electronic contact tracing, it is unlikely we would have needed to extend the August lockdown beyond three days.

However, the Government’s electronic contact tracing efforts have been a fundamental failure. The actual contact tracing app did not connect a single relevant contact.

Sam Morgan’s Covid Card has great potential. It should be implemented. At $100 million, it would only need to save two days of lockdown to pay for itself. Similarly, Datamine’s ëlarm is being rolled out internationally before our Government gave it a chance.

Similarly, the Government should be constantly investigating rapid testing and temperature testing at key locations such as airports. A multi-disciplinary Epidemic Response Centre makes this possible.

5. A Culture of Openness and Continuous Improvement

ACT would start with honest reflection on our goals and our progress. Taiwan is not ahead of us because they are better or smarter people, but because they had survived SARS and subsequent events. Having fought imperialism and dictatorship to be free and democratic (lazy stereotypes of a pliant Asian population could not be more wrong), they do not rest.

We squandered 102 days on indulgence. We cannot afford to repeat that mistake.


Conclusion

Our response to Covid-19 must consider all aspects of wellbeing. It must seek to make the elimination strategy affordable by ending reliance on expensive lockdowns. It can’t just be about the border – we must have deeper layers of defence. It cannot be purely about government – we must embrace partnerships with the private sector. It can’t rely on twentieth century technology, it must use the best technology available. It cannot be a one-time initiative but must be a continuing effort based on continuous improvement.

If we take this broad-based approach and remain aware of all aspects of wellbeing, then we will be truly better off in every sense. A Party Vote for ACT is a vote to tackle Covid intelligently.

 

A WELLBEING APPROACH TO COVID-19

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