Will underfunded NZ Public Health screw up vaccine roll out?

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One of the biggest concerns for NZ is how our underfunded NZ Public Health system will manage to stand up to any Covid influx.

It’s been cruelly underfunded for 35 years by neoliberalism and is being asked to perform a level of service beyond its capacity.

We have been lucky at the border, we have been lax with track and trace so our last line of defence, the poorly underfunded health system, is all that stands between us and full blown public health crisis.

America is having enormous problems rolling out its vaccinations, so are the UK and Europe and the recent history in NZ suggests we will also have major problems.

This is after all the same health service that screwed up the measles epidemic...

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Christchurch GP Dr Hammond Williamson​ was not so optimistic.

He feared the roll-out would be a “disaster” as the Ministry of Health had provided little to no information about how it would work, and what would be expected of him and his colleagues.

Williamson worried the mistakes made in the distribution of the 2020 flu vaccine, which saw some clinics supplied with too few doses and others provided with too many, would be repeated with Covid-19.

“Communication about it was terrible. On the news repeatedly the public was told GPs had [the vaccines, but] they were delayed weeks and weeks,” he said.

…with the new mutations of Covid so much more contagious and with the math telling us that for every 1000 infected through MIQ, 1 will get through, our lax track and trace culture will see the first members of an outbreak presenting at hospital before it’s caught, and by then it will be in the community.

Lots of optimism about the vaccine overlooked the complexities of the roll out while undergoing an enormous surge in cases.

I just can’t see the borders opening until 2023 and that reality demands a bigger vision from the Government.

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19 COMMENTS

    • Agreed Ada, that was my thought. You would’ve thought however that during the “Rockstar economy) days, Key , Joyce, English etc, N.Z”s health system would be very resilient to a pandemic, clearly not. N.Z. governments response has been very much a day to day proposition. That said, it has still been one of the best, if not best responses to the pandemic globally. Yes there have been mistakes, but simply put, anyone complaining, a plane waits for you to America or Europe or even South Africa

      • The response was good but it was one of the easiest countries to get it right in. A wealth Island of 5 million 99% of whom are happy to comply with regulations .
        . For some reason this government is reluctant to enforce using the sign in app and many experts say we are not protecting our front line workers enough.
        We have been lucky so far but when that luck runs out are we prepared.
        After 3 years in office you cannot keep blaming the National government for all the current shortcomings

  1. The underfunding has been by both ‘blue’ and ‘red’. In their defense what is becoming more and more apparent is that the ‘health’ response has been clouded by wider economic considerations such as not having proper quarantine facilities.

    To be fair any major failing should fall squarely on the government. We are now effectively 11 months in therefore all bases should have been covered by now and plans in place. There has been ample money in the system to ensure funding is where it should be. This isn’t the fault of the Health sector that is an issue for the government.

    Likewise the government has had well over 3 months to plan a vaccine roll out. It’s an embarrassment that the Health and Covid Ministers took a 2 month holiday while they should have been overviewing, testing and verifying a plan and structure. Take a holiday later when all is in place – no one would have an issue with that. That we are still stumbling and bumbling shows no lessons have been learnt and a degree of arrogance.

    Yes it will be a fuck up but will (little) Aotearoa care?
    Nup – as long as their houses go up in value – sweet as!

  2. NZ operates a dual health care system – approximately 40% of NZer’s have private health insurance and gain access to health care via the private sector. In order to support and sustain the private health care sector it is imperative that the public health system remain a poor performer in comparison. Many initiatives that could be undertaken have to be avoided so as not undermine the market drivers that the private sector depends on.

    • Private health care generally does not cover long term or expensive care. As soon as the shit hits the fan, the private sector that carries out fairly mundane operations for the most part (hip replacements, cataracts) pushes any emergency or long term care onto the public health system. And that is where NZ is going to be fucked because our health system is no used to being used much, half the equipment is missing (aka PPE as shown in Covid) or unmaintained to cope. Already a bizarre amount of health operations are cancelled due to machines not working or qualified health care workers not being available. (yes NZ has rushed to ‘save money’ by getting in unqualified ‘support workers’ but these skills are worthless when you need real skills and qualifications. In fact in OZ it was the use of unskilled casual labour that helped spread the pandemic there. AKA security guards having sex with the quarantined people they were supposed to be isolating and then going back to their apartment blocks and spreading it…

  3. I don’t think the problems with a vaccine roll out will be due to underfunding of health but more the incompetent, self interested health ministry, lack of practicality and penny pinching in the wrong areas and their inner circle of cronies.

    Example, the IT roll out of the tracing app which was a disaster. Apparently a few developers that the ministry sourced, were tasked with this important task, that failed.

    The Measles roll out, not only terrible in NZ, but spread to Samoa. I went into an A&E and was charged over $100 to ‘check’ for measles …. not surprisingly to me how Measles spread around NZ.

    We have very few hospital places available as our health spend for actual services has not kept pace with our enormous increase (as a percentage) of population in NZ. https://en.wikipedia.org/wiki/List_of_countries_by_hospital_beds

    Our success with Covid is due to luck and our geographical location and by world standards small population that did what they were supposed to…. but we can still have a huge outbreak as government neoliberals are desperate to open the borders. Already people are flying to other countries like Fiji and OZ, to easily outwit our officials of their place of origin.

    There can easily still be a huge outbreak in the Pacific, led by countries like NZ, desperate to get Pakistani cricketers and Russian Fishers (all with Covid) and plane loads of people from Asia for their meagre student fees and cheap labour for visa ponzi’s and the OZ criminals back on their charter flights…

  4. And how come we’re not spending billions on upgrading and also repairing our run down health service, ahead of any probably covid-leak or similar?
    A bit like buying fire insurance when there’s a fire storm very nearby and the insurance company is kindly allowing you to purchase fire insurance AT NO EXTRA cost than normal.

    • Health care is run largely by managers, accountants and lawyers in NZ and policy from those groups dictating how to spend the health money, which is getting more centralised.

      NZ copes, because we already have a lot of health infrastructure that was built decades ago, aged doctors still going, and we have a reasonably healthy ‘no 8’ wire practical population that don’t flock to the health centres unless absolutely necessary…. BUT that’s all changing now as people now flock to emergency care for stubbed toes and colds and we just put in another 1 million people in the last decade, many of who are high needs aka pensioners and children.

      If we get a Covid outbreak then all hell will break lose and we will have our ‘Cyclone Katrina’… centralisation, poor planning, red tape, frauds and lack of practicality will show up. https://www.cato.org/blog/hurricane-katrina-remembering-federal-failures

      We see it in NZ with a disaster, aka with White Island/Pike River, everyone was aware of the dangers, but those in charge like Worksafe did nothing practical to stop it. There was no planning in place for disaster to happen and when it did, they did not have the facilities in place to save people. Furthermore in the White Island case ‘private’ individuals that helped the victims are now being prosecuted by work safe. Worksafe who should be prosecuted themselves for their own failures, are pathetically going after the scientists too (a tactic in Italy) but the scientists were later exonerated. https://www.sciencemag.org/news/2015/02/why-italian-earthquake-scientists-were-exonerated

      With Pike River, company directors and managers and the builders and consenters for the unsafe mine were prosecuted properly and nobody put in jail for the deaths. Worksafe impractical and managerial culture is part of the problem.

  5. What will happen if Covid spreads in NZ…. and we don’t have the hospital beds that other countries have….

    Covid 19 coronavirus: ‘Haunting’ – Kiwi woman’s pain after brother dies of virus in the UK
    https://www.nzherald.co.nz/nz/covid-19-coronavirus-haunting-kiwi-womans-pain-after-brother-dies-of-virus-in-the-uk/CT7LK35MVKCA6LBUKSHUAER2AY/

    “He woke up at 3am one morning struggling to breathe and called for an ambulance but there were none available and no bed spaces free at the local Croydon Hospital, she said.

    Three days later, she said, he couldn’t breathe at all and an ambulance was dispatched to take him to St Helier Hospital. He went straight into the intensive care unit.

    “His wife said [to me] that as soon as they wheeled him out of the house she knew he wasn’t coming home again.”

    With the hospital bursting with patients, Dinnick’s wife Kenda couldn’t visit or call the hospital. She had to wait for the doctor to call with updates every other day.

    A day after being admitted into palliative care and 28 days after being diagnosed with Covid-19, Dinnick died.

    Like thousands of other families, there will be no funeral for Dinnick. He’ll be cremated at the hospital and his ashes sent to his wife.”

    Of course in NZ, there is someone who can make a profit from suffering, our neoliberal ways highlighted….
    New Christchurch Hospital parking charges some of the highest in the country
    https://www.nzherald.co.nz/nz/new-christchurch-hospital-parking-charges-some-of-the-highest-in-the-country/EAE5LLZOIU5KEVUHZYPKSV2UZA/

    • “His wife said [to me] that as soon as they wheeled him out of the house she knew he wasn’t coming home again.” very sad indeed, heartbreaking actually and it could have been a very different outcome

  6. It won’t be a lack of money, the Govt will find the budget for the rollout, its definitely going to come down to planning, the right resources in place and organisation of those resources, communications to GP’s and logistical / procurement decisions that will need to be made at the MoH by incompetents, so yeah it will be a complete ffn disaster. I’m going to sit back and watch the chaos unfold there will be untold stories coming from MSM about all the fuck ups that will be down to you guessed it the people running the circus. Also, can the Govt stop pandering to the death cult capitalists and just shut the ffn border to high-risk countries??These people have had plenty of time to get home and now they bring an extra ffn gift of disease with them. Poor and brown people will pay for this, not the wealthy returning “kiwis” and other temp visa travelers. its only a matter of time folks, I suggest staying away from large “public”gatherings is the smart thing to be doing at this time.

  7. So the economy sort of is important then eh?

    “underfunding” We can only fund if we have a strong economy.

    As for vaccines itself, it is precisely because NZ is a relatively rich economy that we can elbow developing countries out of the way to get the vaccine at all.

  8. ” It’s been cruelly underfunded for 35 years by neoliberalism and is being asked to perform a level of service beyond its capacity ”
    Yes the expectation that a health system can run on the smell of an oily rag was always going to be tested aside from many who already have died that don’t make the news because the were expendable casualties of a system that if it is going to deliver care and compassion cost cutting and razor thin budgets were always going to fail then the next wave of coronavirus and its impact will have a frightening effect.
    I remember Jenny Shipley’s plan for the americanisation of the New Zealand health service to be delivered on the back of Ruth Richardsons neoliberal onslaught of 1991.
    This from wikipedia
    ” One of the most ambitious and controversial aspects of the Fourth National Government’s programme was the comprehensive overhaul of the public health system. The system of democratically elected Area Health Boards was abolished and replaced with Crown Health Enterprises (CHEs), run according to the prevailing new public management ethos that created an internal market for the provision of hospital services and required the CHEs to make a profit. The degree of corporatisation of hospital services was scaled back after the 1996 election.[6] Thirty-eight public hospitals were closed down during the term of the Fourth National Government ”
    Despite the return to health boards the health system is still run as profit making business designed to give limited services where possible and above all make that all important profit margin.
    Just what we need when we have to expect and rely on our hospitals to function when they are needed in extraordinary circumstances and we are at serious risk.

    • It’s by design to fail the masses but profit the few always the way of Neoliberal systems. If we get a full pandemic here that system will not cope. But those in the private system will be happy. Probably those that are profiting from the public system truth be told.

  9. This is an opinion piece that I wrote that expresses my opinions on the current situation in New Zealand right now:

    I wanted to express my deepest concerns about New Zealand’s rather late vaccine roll-out and how complacent our government has been about the rules and regulations, as well as safety protocols, of our MIQ facilities, especially in light of the new UK and South African strains. 

    It is I think in our country’s best interest to consider moving quarantined people from quarantine hotels into military bases or other such locations, away from big cities like Auckland. This would minimise the chance of there being any sort of contact between a positive covid case and people in a highly populated area. Also, these hotels are not purpose-built for quarantining people, since they have poor ventilation and they have tight corridors where people are in close proximity to each other.

     It certainly worries me that people in quarantine are using shared open spaces with each other, like for exercise and so on. One thing that could help deal with some of this is to give smokers smoking patches and not allow them outside to smoke. And it has been proven that these new strains are so contagious, they can be spread through fecal matter from bathrooms like it is the case in Brisbane with that quarantine hotel that had an outbreak themselves just a few days ago.

    Border workers should then be paid more to deal with under-staffing and live on-site with those in quarantine and not be allowed to hold any other jobs so as to reduce contacts and chance of contagion. To reduce their chance of getting covid themselves, they should be all given N95 masks and face shields instead of the thin and flimsy surgical masks they are being given. 

    I also feel that everyone who wishes to come to our country should be forced to quarantine for 21 days instead of 14, since there was a case of a person from South Africa with the new strain from there who was still infectious after 18 days. 

    The other reason I give is that this will give our MIQ facilities time to give people coming to New Zealand two doses of the Pfizer vaccine. It has been recently shown in Israel that even just one dose can give between 33 and 60% immunity from from asymptomatic infection. More information is soon incoming about what the second dose can do to reduce asymptomatic infection, but this will of course be higher. 

    The New Zealand government may be worried about side effects and health concerns from these very new vaccines or think there is not enough safety data on them for a nation-wide roll-out, but I am not advocating for this at all. I am advocating a limited roll-out which our country can monitor quickly and we can even digitize our health records like Israel has and make note ourselves with our own tests of side-effects of these vaccines. It wouldn’t rob other countries worse affected than us by covid and the pandemic of much needed vaccine, since we would only be using it to protect our borders and MIQ. 

    It makes no sense at all not to do this and just wait for things to happen that are inevitable, like the ticking health and economy bomb we have right now in our MIQ facilities that could off at any moment and plunge us back into a level 4 lockdown, which may be longer and more arduous than the first. 7 of the 8 outbreaks we had in our country from August to mid-November were all linked to the border and not to our community. I agree with the government that washing our hands, signing in to places with the NZ Covid tracer app and staying home when unwell are important, but most of the spread that has happened here since August last year is nothing to do with Kiwis complaceny… but rather, the government! Covid can’t spread into the community in New Zealand if our borders are air-tight, which time has shown that they aren’t as impenetrable from covid as Jacinda Ardern, Chris Hipkins and Ashley Bloomfield would like us to believe. 

    And further, a covid-negative PCR test 72 hours before coming to New Zealand is simply not enough… there have been many false negatives and people can catch and contract covid on airplanes or in airports coming here! This simply won’t do. I am not advocating for New Zealand to close off our borders indefinitely to high-risk countries, but only for a couple of months, until vaccines have been rolled out to our MIQ facilities and we have done a complete overhaul of our quarantine locations in New Zealand. Until that time, we would ban literally anyone from South Africa, South America, the UK, India, Bangladesh and the United States from coming in and bringing in the virus with them.

     We should accelerate our vaccine approvals to late January like Australia and start vaccinating in mid February like Australia too. It is embarrassing that even relatively poor countries like India, South Africa and Samoa are ahead of a fairly wealthy country like us with our quality healthcare system in vaccine rollouts. It is our only way out of this current pandemic and the only we could have an air-tight travel bubble with Australia, the Pacific island nations, Taiwan and other safe nations without having any sort of outbreak. I am sick and tired of Jacinda Ardern and her cabinet continuously promising such things and then never doing anything to deliver upon it. 

    The virus doesn’t care for fair or unfair or “to just wait and see.” We must always be ahead of the virus to vanquish it and think ahead of it. I am totally flabbergasted that one of the reasons New Zealand doesn’t want to roll-out the vaccine earlier is because we don’t have community transmission. That might not always be the case! I find it appalling that epidemiologists and government officials are even considering the possibility the level 4 lockdown that would indeed happen if we even had one case of either of the new more infectious strains in the community… it would be a disaster of epic proportions for New Zealand and our MIQ facilities couldn’t handle it, since we are at 96 percent capacity already! A situation like this would shutter businesses across our country, causing more people to go bankrupt and businesses never to open again, more illness, more deaths, more suicides from poor mental health, an overwhelmed healthcare system with lack of ICU beds and just a horrible way of life in general.

    Just look overseas to the UK and what is happening there with covid and ask yourselves if we want that for New Zealand as well…. I think not!

  10. I wanted to express my deepest concerns about New Zealand’s rather late vaccine roll-out and how complacent our government has been about the rules and regulations, as well as safety protocols, of our MIQ facilities, especially in light of the new UK and South African strains. 

    It is I think in our country’s best interest to consider moving quarantined people from quarantine hotels into military bases or other such locations, away from big cities like Auckland. This would minimise the chance of there being any sort of contact between a positive covid case and people in a highly populated area. Also, these hotels are not purpose-built for quarantining people, since they have poor ventilation and they have tight corridors where people are in close proximity to each other.

     It certainly worries me that people in quarantine are using shared open spaces with each other, like for exercise and so on. One thing that could help deal with some of this is to give smokers smoking patches and not allow them outside to smoke. And it has been proven that these new strains are so contagious, they can be spread through fecal matter from bathrooms like it is the case in Brisbane with that quarantine hotel that had an outbreak themselves just a few days ago.

    Border workers should then be paid more to deal with under-staffing and live on-site with those in quarantine and not be allowed to hold any other jobs so as to reduce contacts and chance of contagion. To reduce their chance of getting covid themselves, they should be all given N95 masks and face shields instead of the thin and flimsy surgical masks they are being given. 

    I also feel that everyone who wishes to come to our country should be forced to quarantine for 21 days instead of 14, since there was a case of a person from South Africa with the new strain from there who was still infectious after 18 days. 

    The other reason I give is that this will give our MIQ facilities time to give people coming to New Zealand two doses of the Pfizer vaccine. It has been recently shown in Israel that even just one dose can give between 33 and 60% immunity from from asymptomatic infection. More information is soon incoming about what the second dose can do to reduce asymptomatic infection, but this will of course be higher. 

    The New Zealand government may be worried about side effects and health concerns from these very new vaccines or think there is not enough safety data on them for a nation-wide roll-out, but I am not advocating for this at all. I am advocating a limited roll-out which our country can monitor quickly and we can even digitize our health records like Israel has and make note ourselves with our own tests of side-effects of these vaccines. It wouldn’t rob other countries worse affected than us by covid and the pandemic of much needed vaccine, since we would only be using it to protect our borders and MIQ. 

    It makes no sense at all not to do this and just wait for things to happen that are inevitable, like the ticking health and economy bomb we have right now in our MIQ facilities that could off at any moment and plunge us back into a level 4 lockdown, which may be longer and more arduous than the first. 7 of the 8 outbreaks we had in our country from August to mid-November were all linked to the border and not to our community. I agree with the government that washing our hands, signing in to places with the NZ Covid tracer app and staying home when unwell are important, but most of the spread that has happened here since August last year is nothing to do with Kiwis complaceny… but rather, the government! Covid can’t spread into the community in New Zealand if our borders are air-tight, which time has shown that they aren’t as impenetrable from covid as Jacinda Ardern, Chris Hipkins and Ashley Bloomfield would like us to believe. 

    And further, a covid-negative PCR test 72 hours before coming to New Zealand is simply not enough… there have been many false negatives and people can catch and contract covid on airplanes or in airports coming here! This simply won’t do. I am not advocating for New Zealand to close off our borders indefinitely to high-risk countries, but only for a couple of months, until vaccines have been rolled out to our MIQ facilities and we have done a complete overhaul of our quarantine locations in New Zealand. Until that time, we would ban literally anyone from South Africa, South America, the UK, India, Bangladesh and the United States from coming in and bringing in the virus with them.

     We should accelerate our vaccine approvals to late January like Australia and start vaccinating in mid February like Australia too. It is embarrassing that even relatively poor countries like India, South Africa and Samoa are ahead of a fairly wealthy country like us with our quality healthcare system in vaccine rollouts. It is our only way out of this current pandemic and the only we could have an air-tight travel bubble with Australia, the Pacific island nations, Taiwan and other safe nations without having any sort of outbreak. I am sick and tired of Jacinda Ardern and her cabinet continuously promising such things and then never doing anything to deliver upon it. 

    The virus doesn’t care for fair or unfair or “to just wait and see.” We must always be ahead of the virus to vanquish it and think ahead of it. I am totally flabbergasted that one of the reasons New Zealand doesn’t want to roll-out the vaccine earlier is because we don’t have community transmission. That might not always be the case! I find it appalling that epidemiologists and government officials are even considering the possibility the level 4 lockdown that would indeed happen if we even had one case of either of the new more infectious strains in the community… it would be a disaster of epic proportions for New Zealand and our MIQ facilities couldn’t handle it, since we are at 96 percent capacity already! A situation like this would shutter businesses across our country, causing more people to go bankrupt and businesses never to open again, more illness, more deaths, more suicides from poor mental health, an overwhelmed healthcare system with lack of ICU beds and just a horrible way of life in general.

    Just look overseas to the UK and what is happening there with covid and ask yourselves if we want that for New Zealand as well…. I think not!

  11. Yes both are guilty of underfunding the public systems, selling valuable state assets but are they both guilty of mass immigration. Its no good bringing more and more people here when our systems/infrastructure can’t cope and who suffers the most?

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