GUEST BLOG: Ian Powell – Covid-19 elimination strategy, smug hermit kingdoms and Kim Jong-Key

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'Im so fearful

There has been a growing number of voices calling for an end to New Zealand’s elimination strategy in the fight against Covid-19. Much of it comes from impulsive media ‘shock-jocks’ through sensationalist but misleading sound-bytes claiming that it has failed. Some of it is more measured and cautious but misses the boat by suggesting that the Government is considering a backdown.

But the most prominent has been former Prime Minister John Key in a Sunday Star Times column (26 September). Without specifically referring to it, he makes a blatant attack on the elimination strategy.

Key begins with an absurd unfavourable comparison with the remarkable American Apollo 13 space recognition mission in 1970. Then, in sound-byte style, he denigrates New Zealand’s Covid-19 response as being akin to a smug hermit kingdom and North Korea, and driven by the use of fear.

Understanding the elimination strategy

Putting political and ideological agendas to one side, much of this apprehensive comment comes from a misunderstanding of what the elimination strategy is suggesting it is an outcome and equating it with lockdowns.

The elimination strategy is about eliminating community transmission of the virus. But it isn’t an express outcome. Instead it is a process for how the country as a whole responds to cases of community transmission that is characterised as hard and fast. This contrasts with the alternative mitigation strategy – slower and softer.

Elimination begins with stronger border controls strengthened by public health measures which range from the basics such as good handwashing to restrictions such as physical distancing and mask wearing.

It is not about having no community transmission cases. But it is about zero tolerance towards community transmission cases wherever and whenever they occur.

Lockdowns

Elimination doesn’t automatically equate to lockdowns. Lockdowns are the firmest response measure of last resort. In 2020 Taiwan managed to restrict its pandemic death rate to an extraordinary 0.3% per one million people without a lockdown. Ths was achieved by very quick effective measures, including border closures and widespread mask wearing; the latter was well-established through earlier epidemic experiences.

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In 2020 lockdowns were very effective in New Zealand. But if they hadn’t been reinforced by ongoing border controls and public health measures (including later in the year masks) then they would have been ineffective. In Europe and North America, which largely followed a mitigation strategy, the gains of lockdowns were severely eroded with subsequent deadly pandemic waves.

The net effect has been that New Zealand is not only one of the few countries that continues to have a death rate of less than 100 per million; it is also one of the much fewer countries to have a single digit rate (5). Key ignores the significance of this achievement.

Contrary to John Key’s North Korea claim, New Zealand has been in lockdown much less than those living in other developed economies. As a consequence we have also had much more freedom. Further, our economic performance has been the best in the Organisation for Economic Cooperation and Development. Again Key ignores this significance.

Elimination and Delta

The elimination strategy has also served New Zealand well in responding to the more contagious and therefore more deadly Delta variant. It halted the exponential growth that is presently running riot in New South Wales and Victoria (the rest of Australia avoided this by following the elimination strategy).

While Delta is leaving a long tail difficult to completely eliminate, the trend is currently bouncing around with daily cases ranging from 9 up to the mid-20s but overall downward and contained within Auckland.

It would have been safer to keep Auckland in Level 4 for a further week but moving to Level 3 isn’t necessarily unsafe. It is nevertheless a calculated risk. It would have also been better if, having moved to Level 3, there had been a requirement that those returning to workplaces be fully vaccinated while Auckland remains at this level.

Clearly there is a lesson to be learnt from the origin of Delta in New Zealand (New South Wales). Either we entered the now paused travel bubble with Australia too early or alternatively it should have only been available for the vaccinated on both sides of the Tasman.

Elimination in 2022?

What does 2022 mean for the future of the elimination strategy? This is an important discussion that is appropriate to discuss now. An example of a constructive contribution is the Sunday Star Times column (26 September) by economist Shamubeel Eaqub.

From my perspective it starts with vaccination levels. Evidence is emerging that high vaccination rates reduce but don’t remove the threat of Covid-19. Data is already emerging in the United Kingdom of increasing infections among school children following the end of the long holiday break. Singapore with an 80% vaccination rate is having to impose restrictions.

Broadly speaking the higher the vaccination rates the less restrictions of various forms will be required. This is illustrated by the modelling implications from Professor Shaun Hendy’s team misrepresented by the former prime minister as a fear tactic. The implications and caveats of this modelling are well-explained by Newsroom journalist Marc Daalder (24 September):

If vaccination rates reach a sufficiently high level (90% or higher) then it is possible to envisage some restrictions in place to combat community transmission, but without further lockdowns. In order to protect the rights of the vaccinated or the very young there may need to be constraints on the rights of the unvaccinated such as overseas travel and attendance at large gatherings.

But there is too much unknown about the pandemic. This time last year we didn’t know of the Delta variant. There are no shortages of high population countries elsewhere where the virus can further mutate into even more contagious variants next year. When John Key calls for a plan he means prescriptiveness including specific dates. That’s inflexible.

The elimination strategy may need to continue next year. But it also may evolve into an effective form of containment. Right now we can’t prescribe this; at best we can anticipate scenarios.

It is clear from John Key’s opinion piece is that had his approach to responding to Covid-19 prevailed in 2020 New Zealand would not have adopted and continued with the elimination strategy. Consequently thousands more New Zealanders would have died, we may have had longer but less effective lockdowns, and the country’s economic performance would be discernibly poorer. Using Key’s own turn of phrase we would have been much closer to his stereotype description of North Korea and the hermits would be much unhappier.

His opinion piece has attracted much comment but it fails to get to the first base as a basis for a constructive discussion about the future development of the Aotearoa’s Covid-19 response.

Ian Powell was Executive Director of the Association of Salaried Medical Specialists, the professional union representing senior doctors and dentists in New Zealand, for over 30 years, until December 2019. He is now a health systems, labour market, and political commentator living in the small river estuary community of Otaihanga (the place by the tide). First published at Otaihanga Second Opinion

25 COMMENTS

  1. elimination
    [ɪlɪmɪˈneɪʃ(ə)n]
    NOUN
    the complete removal or destruction of something.
    “the elimination of extreme poverty is a key objective” · “a global commitment to the elimination of nuclear weapons”

  2. So John Key misunderstands and is absurd, about sums it up for me, add in the media shock jock( Hosking, Key’s bromance buddy) and hardly surprising Nationals support is tanking.

  3. Elimination at what cost?
    This above is very much presented from a theoretical medical perspective fairly much what Jacinda and her team of “experts” have followed and perpetuated.
    Now thats fine if your only concern is the health of the populace.
    And if your income has not been at risk through the lock downs then you probably see this as the right and correct response to Covid.

    However if your income has been destroyed or threatened by the lockdowns then the economic well being of the country is more important

    Being healthy but potentially being destitute is the option being presented here.

    The rioters in Melbourne understand and reject this prospect.

    There is a rising tide of that sentiment here now.

    • It’s not even good for the health of the population, long term. This is because elimination is unsustainable. The virus will get in and there will be a general infection of the population. It’s just a matter of when.

      The optimal strategy is to maximize the vaccination level then open up quite quickly while the vaccines are fresh and effective. The best way to gain full immunity is to be exposed to the real thing.

      • Only problem is people who have previously had covid and recovered and got supposedly herd immunity have got infected with the delta so in fact there is no herd immunity .

    • Everyone is being anal about the word elimination and that it means 100% no virus. Common sense says you dont need 100% elimination to function and processes will change before then, has any virus is been 100% eliminated? Stop spreading fear.

      Finally what good is a healthy economy if you are dead? Because that is a real outcome to think about. Economies will recover dead people wont. Didn’t it only take weeks for businesses to recover from lockdown as the population went out and spent what little money they had which meant businesses needed to rehire staff and once again will be making good profits.

      • Stop with the common sense.
        Apparently there are quite a few that will accept death as an outcome, yet I’ve yet to see anyone prepared for it to be them.

  4. Yes Sam the strategy has always been to win the next election.
    All the promises not fulfilled will be forgotten.
    Year of delivery has worked well for KFC and McDonalds.

  5. Great article Ian.

    I think Key and co are recognising that the Pandemic challenges the mythology of market rule and so are desperate to stem its decline and fall by stoking up fears of ‘socialism’ destroying the market.

    Yet, what we are seeing is the result of market rule for millennia. The destruction of nature and the disruption of habitats by global warming releasing hitherto unseen viruses upon humans.

    But market rule means rampant and worsening pandemics and herd culling. It suits the small ruling class that owns most of the world’s wealth. The ‘strong’ sacrifice the ‘weak’ to the virus as a ‘force of nature’. This is eugenics, or the ‘un-natural’ selection of the weak by the strong.

    Eugenics gels with the white supremacist fascism on the rise as most of those culled throughout history and into the future will be black or brown people. It creates a breakdown in solidarity in among the working masses around resurgent racism, sexism and nationalism.

    So in the end, defending ‘elimination’ or ‘zero-Covid’ from the ravings of the rightwing, and the feral behavior of lumpen elements, is actually vital in building the social solidarity we need to stop the otherwise inevitable slide of society into fascism and human extinction.

  6. Thank you Dr Ian for excellent summing up. The opposition and naysayers never understood we are fighting a virus that has no concern for our economy, their impatience is a sign of their values. Having underfunded the public health sector for 9 years Key wants it to totally collapse with unchecked virus spread. What has become very clear is that our economy is not fit for purpose to deal with such events but I see no suggestions from the rich end of town as to how it can be adapted.

  7. Yes thank you Dr very much for such a clear argument and explaining exactly what Key was doing which is to say rattling sabers, creating discontent and fear based on spurious arguments and lies.

  8. The intrusion of former Prime Minister Sir John Key with his “smug hermit kingdom” comment has perfectly encapsulated the nature of the divisions and the choices before us.
    Key did not come into the debate out of the blue. For the past year or more there has been a cacophony of voices in New Zealand (albeit a small minority of the total population) who have been demanding that New Zealand’s border be either kept open or re-opened while Covid was still cutting a deadly swathe through the nations of the world. This pressure led to the ill-conceived and disastrous “trans-Tasman bubble” and was never rebuffed in principle by the Labour government, which then threw into doubt its own commitment to the elimination strategy as the current outbreak in Auckland proved difficult to contain. So the Labour government itself set the scene for Key’s intervention. As long as “elimination” was the working and clearly articulated strategy his argument would have been seen as ludicrous. With the elimination strategy eclipsed by the vaccination strategy, his comments had a semblance of reason.
    Having said that Key’s choice of language is revealing. Why would he talk of a “smug hermit kingdom” rather than a “happy hermit kingdom”? The word “smug” is intended to invoke shame, guilt and fear. What shame is there in being a happy, open and functioning society somewhat estranged from the rest of the world? None at all, but Key knew that for all sorts of reasons the word “smug” would strike a chord of guilt among New Zealanders who had friends or relations suffering in other countries, and among those good souls who feel empathy for the people of the entire world, and particularly among those who have been indoctrinated with the colonialist mantra that “where Britain (or Australia or the US) goes we go; where she stands we stand”. In other words it is the duty of New Zealanders to suffer alongside their “traditional partners” in the Anglophone nations. John Key is therefore elevating the principle of colonialism above all common sense. Having New Zealanders suffer from Covid will not ease the suffering of those in Britain, Australia or India by one iota. All it will do is reinforce the notion that “Where Britain goes we go…” even if that be to the depths of hell.
    When we get down to it, despite Sir John Key’s efforts to induce feelings of shame and guilt over “the hermit kingdom”, “opening up to the world” is not a moral stance. There is no suggestion that, for example, New Zealand should forgo shipments of vaccines to help those countries more tightly held in the grip of Covid. The campaign against “the smug hermit kingdom” is colonialism pure and simple. It presumes that New Zealand should not be allowed to find a better way than the “rest of the world” which actually translates as those nations which comprise the western imperial order, namely Britain, the United States, Australia, Canada and western Europe, because if New Zealand did find a better way for itself it would inevitably loosen and even sever its connections to the old imperial system. So that is why New Zealand’s success in eliminating Covid was so intolerable to “the rest of the world” and to the colonialist political classes within New Zealand. The fear is that success of mana motuhake would not stop with the elimination of Covid, but would go on to impact the economy, culture, political institutions and all other aspects of New Zealand society.
    When we talk of “the suffering of New Zealanders” under Covid, let us not be deceived into thinking that all will suffer equally either from the disease itself or from the measures taken to control the disease. The John Keys of this land can retreat to their mansions in Parnell or their condominiums in Hawaii. They are less exposed to the risk of infection, they have the best nutrition, and if infected they have private access to the best medical care. The incomes of those in the banking and financial sector are increased rather than diminished by lockdown restrictions. By contrast, itinerant workers, manual workers, the self-employed, the homeless and those living in overcrowded conditions are doing it hard.
    The “experts” who have been advising the government to open the border are telling us that open borders will put the onus on the individual to make smart decisions about avoiding illness. That is reminiscent of what we were told when the economy was deregulated and privatized in 1984. But then and now, the wealthy have far greater scope than the poor to make “smart decisions” (which all too often are also heartless decisions, but that is another matter). The poor, even if they can see that it would be a smart decision to own a house, are simply unable to buy one. Similarly they will find it difficult or impossible to work from home, to buy the best quality face masks, to travel by private car rather than public transport and so on. Covid freedoms, like market freedoms, will be a mixed blessing for the poor.
    When New Zealand last “opened up to the world”, in 1984, Sir John Key became very wealthy as a foreign exchange dealer speculating against the New Zealand currency on behalf of foreign bankers. At the same time thousands of New Zealand families were cast into poverty by “the workings of the market”, which included the machinations of people like Sir John Key. Ironically, the conditions of gross inequality created by New Zealand’s last great “opening to the world” under the Lange/Douglas Labour government have made the task of eliminating Covid under the Ardern/Robertson Labour government that much more difficult.
    In fact New Zealand’s problems do not stem from its isolation from the world but from its subordination to the political structures of the Anglo-American imperial system and blind submission to the interests of empire. Only a small proportion of New Zealanders materially benefit from colonialism. Sir John Key is one of course. Before his entry into politics he served the foreign banks, after his exit from politics he served the foreign banks, and many would argue that in the space between he served the foreign banks, to his personal financial benefit but at great cost to New Zealand as a whole.
    So if John Key has his way and Jacinda Ardern wavers in her commitment to elimination, we have Covid entering into a colonialist society starkly divided between rich and poor, which will bring to the surface many tensions and conflicts.
    These conflicts tend to be articulated in terms of “freedom” versus “authoritarianism”, although it is not at all the case that “vaccine passports” favoured by Sir John Key are passports to freedom, and one can just as well argue that “lockdowns” have the ultimate effect of protecting freedoms. Lockdowns at least have a legitimate purpose. Vaccine passports serve no purpose other than to punish the non-conformist and infringe the normal civil rights of those who hold them as well as the rights of those who do not.
    Covid has exposed the structural inequality of western societies, including New Zealand, which exist alongside doctrines of freedom and individualism. Because freedom and individualism are the reigning doctrines in our society, they are the means through which people express their response to harsh regulations. The Covid regulations impact most heavily on those who are most deprived. The urban poor and manual workers in particular. In this context the call for freedom from regulations is effectively a call for equality but when coming from other quarters it can also be an intolerable assertion of privilege and entitlement. We are learning to make that distinction, to understand that the demand for freedom may be either perfectly justified on the one hand or a gross abuse of privilege on the other.
    Covid has also exposed the breakdown of mutual trust between the colonial regime (comprising the whole of government, the agencies of state, and the fourth estate) and the people of New Zealand, which has allowed “conspiracy theories” and anti-vaccination sentiment to flourish among the marginalized and alienated – as much as twenty percent of the population, which in a previous generation might have been limited to just a few percent.
    Overall, Covid has brought to the surface the fundamental problems of New Zealand’s colonialist society which will not go away if we merely avert our gaze. The problems will only become more pronounced, and the consequences more dire. The pandemic should have sparked the realization that the social and economic inequality of colonial society is leading us to disaster and that the deceits of successive governments come at a price.
    The pandemic should have allowed us to move away from excessive recourse to unsustainable activities such as travel, tourism and international education. New Zealand has a market economy supposedly founded on the principle that the market is flexible and will rationally adapt to disruptive influences such as a pandemic. Yet that has not been allowed to happen. The government has instead chosen to underwrite and support the economic status quo. The Covid response has not been a market response, and it has not been a planned response. It has fallen between the two, an unplanned and irrational decision to preserve the status quo at great cost and to no good effect.
    Covid should have allowed New Zealand to reduce it’s reliance on migrant labour, and to diversify and strengthen its economic base in the productive sector, both primary and secondary. That process was starting to take place but will be stopped in its tracks by the decision to reopen the border.
    Most of all Covid should have allowed New Zealanders to think of themselves as tangata motu, the people of Aotearoa, rather than as a mishmash of foreign peoples who have landed up by chance in a group of islands at the bottom of the world.
    It should have come as no surprise that the government of Jacinda Ardern and the New Zealand parliament as a whole conspicuously failed on all of these counts. The task of making real transformative change has been put back where it belongs – with the people of Aotearoa themselves.

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