Covid Delta Outbreak: The three things the Government must do right now

Article originally published 18/09/2021 in The New Zealand Herald and republished here with permission.

A month into level 4 restrictions and many people are at breaking point. 

On Zoom and google hangouts, I see the strain written across the faces of my colleagues, family and friends.

I see the stress in those who have lost everything in the last 18 months, forced to close businesses that were unable to survive the repeated lockdowns Auckland has endured.

I see it in the heartbreak of families who are grappling with the reality that they are separated from loved ones in other countries and who have no idea of if and when they might be reunited. 

And I see it with the increasing numbers of Kiwis who are struggling with their mental health and are seeking help with our primary health care business Tend.

Lockdown is taking a massive toll on New Zealanders, especially for those of us in Auckland who are enduring our fifth lockdown in the past 18 months.

For many Aucklanders, I’m hearing frustration at not feeling like a team of 5 million but instead the sacrificial 1.6M who are repeatedly asked to put everything on the line to keep our country safe.

This lockdown is all the more difficult because it didn’t have to be this way.

Each lockdown provided an opportunity to learn lessons to prevent another, yet we failed to learn these lessons.

As Delta spread around the world, it became inevitable that it would find the gaps in our defenses, forcing the country back into lockdown.

Despite the rhetoric, this lockdown isn’t about going hard and early, it’s about a failure to prepare.

And the greatest failure was not addressing the significant issues with our health infrastructure.

When COVID first emerged early last year, our health system was unable to manage a significant outbreak. A widespread outbreak would have seen our hospitals quickly overwhelmed.

That is why I’ve been a strong supporter of our elimination pathway.

Elimination provided us the time we needed to address our health infrastructure issues and to protect our population when vaccinations became available.

My home country of Sweden took a different approach, letting the virus spread in an effort to achieve herd immunity. The result was that 15,000 people died.

For context, 15,000 people is approximately the population of Queenstown. 

As a result, Sweden was forced to change strategy and enforce restrictions. Most of my Swedish friends spent Christmas in their household bubbles and didn’t see their families and friends properly for nearly six months.

Despite having some of the world’s best health infrastructure, COVID took a huge toll on the Swedish hospital system.

Their “healthcare debt” has grown exponentially as the country battled COVID and struggled to keep up with general healthcare requirements.  

And the pressures of COVID have resulted in a disenfranchised health workforce quitting in droves as they were pushed beyond their limit. 

Yet Sweden’s healthcare system is far superior to New Zealand’s. If Sweden’s failed to cope, ours would have completely collapsed.

But there was light at the end of the tunnel and Sweden started vaccinating their population in December. As a result, in two weeks Sweden is dropping all restrictions reaching over 72% vaccination. 

Elimination was presented as providing New Zealand choices, but this is not true. The reality is we had no choice. Elimination was our only option.

But we had the choice to prepare our health system for an outbreak of COVID, and we made the choice not to.

While the rest of the world started vaccinating, we were still preparing to begin. 

And New Zealand still ranks near the bottom of the OECD for per-capita ICU beds.

New Zealand has 4.6 beds for every 100,000 people. Compare that to the UK who have 6.4 beds per 100,000, or Australia with 8.9. Germany has a staggering 38.7.

Worse, in May last year, there were 358 ICU beds in New Zealand. A year later, there were just 284 fully staffed ICU beds.

And while the Ministry has invested in additional ventilators and says they can surge ICU capacity, our hospitals don’t have the staff to manage more patients.

I was told recently that Auckland hospital has a staggering 240 nurse vacancies across the hospital.

This is just one of many examples that highlights our failure to prepare. But it doesn’t have to be this way.

There are three urgent steps the Government can take right now to help us prepare for the future and prevent future lockdowns.

Firstly, we need to shift our MIQ facilities out of the centre of our largest city. It is illogical that we are quarantining high-risk travellers in our country’s economic hub.

How can our COVID quarantine facilities be the Jetpark Hotel and the Novotel Ellerslie?

While this might have worked in the short-term, it is time we constructed purpose-built facilities outside of Auckland that are not only comfortable for those being quarantined, but minimise the risk of unintentional spread into the community.

Secondly, the Government must set and communicate a very clear vaccination target for our population. 

It’s admirable that the New Zealand Herald is taking the lead on articulating a vaccination target, but shouldn’t this be a role of the Prime Minister? Otherwise, how do we know what we need be striving towards?

And we also need to learn from what other countries are doing to ensure we reach this target and vaccinate as many people as possible. 

In Denmark, where Covid is no longer considered a threat to society and restrictions have been lifted, vaccine passports are needed to access bars and restaurants which encourages young people to get vaccinated. 

We need to be creative with our vaccination communications and look at providing incentives (such as lotto tickets and vouchers) to encourage vaccination.

And we need to take vaccinators out to where people are rather than expecting people to come to a vaccination centre.

As we look towards the summer, there is no reason why we can’t have vaccine pop-up centres at beaches, festivals and sporting events.

Not setting a target looks like putting politics above our people. Is it the fear of failure and accountability that is holding back the target being articulated? 

Finally, we need to urgently build up our health infrastructure and address our chronic workforce shortage. 

We need to pay our valued healthcare workers more and ensure they have a high degree of work satisfaction. 

Because we can’t do this without them. 

There is no point in buying more ventilators if we don’t have the staff to manage them. 

We need to be actively promoting and recruiting healthcare professionals from overseas and we need to be making it easier for them, and their families, to enter the country.

I have many friends in Sweden who are doctors or nurses, who are burnt out and are ready for a change. 

We need to understand that we are competing on the world stage for this valuable resource and that means we need to make New Zealand the best place in the world for healthcare workers to live and work. 

Because the reality is that we are going to have to learn to live with COVID. Elimination can only ever be a short-term option. 

That means ensuring that we continue the drive to vaccinate our population with boosters as they become available and having a clear strategy around what success looks like. 

And it means ensuring that we have the capacity in our health system, as well as access to the latest medicines, to manage the inevitable peaks we will suffer as unvaccinated Kiwis continue to fall seriously sick.

Because we cannot continue to lockdown our country once we are largely vaccinated. 

Instead, let’s focus on how we prepare New Zealand to reintegrate back into a world that is learning to live with COVID.