Tag: covid-19

We all know where to get the best information about the pandemic: from the government, Ministry of Health, and the World Health Organisation. But what about when that seems to contradict our own experience, or when our friends on Facebook are telling us something else, or when we simply don’t like what we are hearing?

Throughout the course of the pandemic the (almost) daily 1 o’clock briefings with the prime minister (PM) and director general of health (DG) have been compelling viewing. When we were stuck at home they provided us with an update in case numbers, a view of how successful we were as a country, and simple instructions for behaving and coping with the extraordinary situation. On the days when Jacinda Ardern or Ashley Bloomfield were unavailable, or when no briefing was given, we felt like we were missing something. The message was calming, but also stressing the importance of us all playing our part. We all felt part of “the team of 5 million”. They gave NZ (and the world) the concept of a “bubble” of people we could freely associate with without risking aggravating the outbreak.

The briefings have been incredibly open and honest. After the news and message, the reporters have been able to ask questions. The opposition was also given a forum for questioning ministers, officials, business people and anyone else affected by the fight against the virus. They held the government to account, and questioned the veracity of some of the statements. To most people listening it seems that the PM and DG were being badgered, and disrespected. Some of the reporters received abusive messages. The opposition had to change leader. people really wanted to believe what we were being told.

So why do we have large lockdown protests? Why did someone ignore the requirement to self-isolate, sparking the latest sub-sub-cluster and probably extending restrictions another week or more?

Cognitive Dissonance

One concern is when what people are hearing doesn’t match their personal experience.

During level 4 Bloomfield would often say that there was plenty of masks, testing supplies and flu vaccines in NZ even though they were in short supply all over the world. However GPs and aged care workers were finding it difficult to get enough. It wasn’t like New York, where intensive care nurses were using rubbish bags, and re-using masks, but it also wasn’t good enough. The poblem arises because the Ministry of Health is not a doing organisation, it is a policy organisation. GPs get their supplies from the DHBs. One DHB found that their stock of masks was unusable, another had different policies for who should get masks. People didn’t hear the reasons, or even how complicated it is, they just heard that the information they were given is not completely honest.

Official recommendations have changed over the course of the pandemic. This does not mean that the MoH & WHO are incompetent. It is they are working with very incomplete information, and as time goes on the science becomes clearer. Initially they were not recommending general use of masks, because it was not clear whether there was a net benefit (and masks were needed for medical workers). It was thought that transmission was mostly by contact. After a while the evidence came in that the virus was transmitted through the air and so mask use could be helpful. Some people felt that the changed advice made the MoH look incompetent.

Most people didn’t know any body who had the virus. This is a reflection on how successful we were in eliminating it, but it meant that people didn’t experience its seriousness. On the other hand people did experience the difficulties associated with the counter-virus measures. Some people lost their jobs. Some couldn’t get medical or dental treatment. Concerts were cancelled. Restaurant meals were unavailable. Over time the balance became hard to appreciate.

Noise

Politicians from non-government parties (even NZ First) wanted to disparage the government response. News media wanted to increase their readership and show their independence. That meant that stories where things didn’t go perfectly became highlighted.

There were an endless series of stories from people complaining about conditions in Managed Isolation facilities. Some stories would say that things were too severe, some not strict enough. National party MPs leaked stories to the media, even to the point of releasing a list of names & addresses.

In general, scientific opinion was very strongly in favour of NZ’s response, but there will always be contrarian scientists. A group of academics and business people started a campaign (plan B) pushing for a different response where we allow people to get infected, but protect the elderly and vulnerable. It is based on very questionable science and dodgy statistics, but got a lot of airtime every so often.

To some these had an effect. Any loss of confidence in the competence of the government response had the effect of reducing compliance.

Conspiracy Theories

There are people in NZ who do not trust the government (any government). Some with good reason. Campaigns against things such as child uplifts by Oranga Tamariki, unjust convictions, over aggressive policing, 5G, 1080 poison, vaccination, etc have significant and vocal (if small in number) support. This is not to mention the anti-immigrant, anti-muslim “great replacement” groups.

Material about these are often broadcast on social media. If people see an article shared by someone they know and trust, then they are more inclined to take it seriously. Some people no longer believe anything they see on TV news, or read in the newspaper, because it is at variance from the information that they are reading on Facebook. People who get paid for clicks are incentivised to create material that gets shared like that, so it gets more and more outrageous.

Then the focus shifted to the origin of the virus. Many slick videos pointed to an engineered virus. Some claimed it was China, some the US “deep state”. Others claimed it was a trick by Bill Gates to get us all vaccinated so that he could control us.

In NZ the practical upshot of this is that some of the people infected in the latest outbreak did not believe the official narrative. There was a reluctance to get tested and a reluctance to isolate properly. Because of this there have been more infections and it has taken longer to control the spread. Probably this will delay our return to level 1 throughout NZ.

Theatre

There are a number of actions which are scientifically known to control the spread of the virus. Hand washing, masks on public transport, distancing, avoiding unventilated indoor spaces are all known to reduce the chances of getting infected. Testing, contact tracing and self-isolation are effective at controlling the spread. In combination these can reduce the reproductive rate below 1 so that an outbreak will die out.

There are some measures that are applied even though they seem to have little or no effect. These include temperature measurement, “deep cleaning” where an infected person has been, wearing masks outdoors. These (very public) measures are often a case of being seen to do something. It may be that they are necessary to reinforce the messages about the effective interventions.

If I wear a mask while walking down the street, I may not be changing the odds of my catching or spreading the virus, but I am helping to normalise mask wearing, and reminding people who see me that we still are in the middle of a pandemic. In our last period at level 1 we seemed to forget.

By the end of March lockdown had become inevitable. There were multiple clusters of virus from Auckland to Bluff. Our health system was not in a state to cope with large numbers of patients. There were questions about supplies of PPE and reagents and laboratory space for testing. Our public health systems and contact tracing were woefully short of capability.

We knew what lockdown looked like from Wuhan and Northern Italy. The two experiences were quite different. They showed that people could survive and that essential supplies could be maintained. They differed in the degree of control of people’s movements. In Wuhan some residential buildings barricaded all doors leaving only one entry/exit and people had only short times they were allowed out for shopping.

The NZ lockdown was going to be a bit kinder. We were to be allowed out for unlimited local exercise. The definition of “local” was fluid, and some pushed the boundaries (including the Health Minister). Generally people understood the conditions and behaved well. The number of people walking and cycling in cities increased dramatically. DOC closed all tramping tracks, including cancelling my booking for a hut over Easter.

It was quiet. Car traffic dropped away and the air was cleaner. Cycling was more pleasant. ACC claims dropped to 20% of normal and over Easter nobody died on the roads. Overall people were healthier and safer (and some even happier) while locked down.

We discovered who were essential workers. Cleaners and supermarket workers gained in status and some even got paid extra. They were the people that were out risking infection to make sure that the rest of us could survive. Many of us could work from home and were largely unaffected, but a number of people were unable to work. The government became very generous, giving subsidies to companies to pay workers when they had no revenue. There has been some abuse, but overall it has avoided some company collapses and large unemployment. The bill is still to be paid.

Initially the lockdown was set for 4 weeks. Then the tail of some of the clusters kept producing cases and level 4 was extended for a bit. When level 3 started everyone held their breath to see if the number of cases would rise again. Luckily they continued to decline and we soon dropped down through the levels to 2.5, 2 and then 1 about 12 weeks after we had first gone to level 2 in March.

At level 1 we had freedom. The only restrictions were on international travel. Nobody can enter the country without quarantine (managed isolation) for 2 weeks. Professional rugby played in front of crowds in the tens of thousands. The NZSO gave a free concert at the Michael Fowler centre. We were the envy of the world. Toastmasters went back to in-person meetings. We had no active cases in NZ, being one of the largest countries in the world to say that.

But it was a nervous time too, and (perhaps inevitably) it didn’t last. In June we had 2 more cases. People had come from the UK and had been given leave to exit quarantine early to drive from Auckland to Lower Hutt to support their father after their mother died. After arriving at Lower Hutt they tested positive. Everyone was surprised that they were allowed out without testing. A new testing regime was instituted in quarantine. The testing picked up more cases which may have been partly because the countries where people were coming from were getting worse. Luckily the 2 cases didn’t seem to infect anyone else, so we could breathe again.

Complacency kicked in again, and the number of people presenting for testing dropped to very low levels. People didn’t use the app much. The health minister started trying to talk up testing. The evidence around the world was showing that wearing masks had real benefit, and could reduce the need for movement restrictions. Changing the message is always difficult, and the parliamentary opposition started intimating that there was something sinister behind it.

Then on August 11th the first community case was found again in Auckland. The family was tested and 4 were positive. Auckland went back to level 3 and the rest of the country to level 2. It turned out that the first case had left work sick 9 days earlier. It is not clear why they weren’t tested at the time, but complacency probably led to it. By the time they were detected they had infected 2 work places and several people on buses. Members of a church also got infected. Genomic analysis linked all the cases together even when there was no direct link found.

So now we are at level 2 (level 2.5 in Auckland). When will we get back to level 1? Do we have confidence in our health systems to cope with another outbreak? How do we get to where travel is more available? When do we get back to normal? What is “normal” anyway?