100 days without COVID-19: what worked for New Zealand

100 days without new cases: what worked for New Zealand and what we can learn.

New Zealand Prime Minister Jacinda Ardern

Michael Baker, University of Otago; Amanda Kvalsvig, University of Otago, and Nick Wilson, University of Otago

On Sunday, New Zealand marked 100 days without community transmission of COVID-19.

From the first known case imported into New Zealand on 26 February to the last case of community transmission detected on 1 May, elimination took 65 days.

New Zealand relied on three types of measures to get rid of the virus:

1. ongoing border controls to stop COVID-19 from entering the country
2. 
a lockdown and physical distancing to stop community transmission
3. 
case-based controls using testing, contact tracing and quarantine.

Collectively, these measures have achieved low case numbers and deaths compared with high-income countries in Europe and North America that pursued a suppression strategy.

New Zealand is one of a small number of jurisdictions – including mainland China, Hong Kong, Taiwan, South Korea, Vietnam, Mongolia, Australia and Fiji – pursuing COVID-19 containment or elimination. Most have had new outbreaks. The exceptions are Taiwan, Mongolia, Fiji and New Zealand.

Australia adopted very similar responses to the pandemic and it is important to note that most states and territories are in the same position as New Zealand. But Victoria and, to a lesser extent, New South Wales are seeing a significant resurgence.

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The key difference is that New Zealand committed relatively early to a clearly articulated elimination strategy and pursued it aggressively. An intense lockdown proved highly effective at rapidly extinguishing the virus.

This difference can be seen graphically in this stringency index published by Oxford University’s Our World in Data.

CC BY-SA

There are key lessons from New Zealand’s COVID-19 experience.

A vigorous, decisive response to the pandemic was highly effective at minimising cases and deaths. New Zealand has the lowest COVID-19 death rate in the OECD.

Total all-cause deaths also dropped during the lockdown. This observation suggests it did not have severe negative effects on health, although it will almost certainly have some negative long-term effects.

Elimination of the virus appears to have allowed New Zealand to return to near-normal operation fairly rapidly, minimised economic damage compared with Australia. But the economic impact is likely to keep playing out over the coming months.

 

Getting through the pandemic
We have gained a much better understanding of COVID-19 over the past eight months. Without effective control measures, it is likely to continue to spread globally for many months to years, ultimately infecting billions and killing millions. The proportion of infected people who die appears to be slightly below 1%.

This infection also causes serious long-term consequences for some survivors. The largest uncertainties involve immunity to this virus, whether it can develop from exposure to infection or vaccines, and if it is long-lasting. The potential for treatment with antivirals and other therapeutics is also still uncertain.

This knowledge reinforces the huge benefits of sustaining elimination. We know that if New Zealand were to experience widespread COVID-19 transmission, the impact on Maori and Pasifika populations could be catastrophic.

We have previously described critical measures to get us through this period, including the use of fabric face masks, improving contact tracing with suitable digital tools, applying a science-based approach to border management, and the need for a dedicated national public health agency.

Maintaining elimination depends on adopting a highly strategic approach to risk management. This approach involves choosing an optimal mix of interventions and using resources in the most efficient way to keep the risk of COVID-19 outbreaks at a consistently low level. Several measures can contribute to this goal over the next few months, while also allowing incremental increases in international travel:

resurgence planning for a border-control failure and outbreaks of various sizes, with state-of-the-art contact tracing and an upgraded alert level system

ensuring all New Zealanders own a re-useable fabric face mask with their use built into the alert level system

conducting exercises and simulations to test outbreak management procedures, possibly including ‘mass masking days’ to engage the public in the response

carefully exploring processes to allow quarantine-free travel between jurisdictions free of COVID-19, notably various Pacific Islands, Tasmania and Taiwan (which may require digital tracking of arriving travellers for the first few weeks)

planning for carefully managed inbound travel by key long-term visitor groups such as tertiary students who would generally still need managed quarantine.

Building back better
New Zealand cannot change the reality of the global COVID-19 pandemic. But it can leverage possible benefits.

We should conduct an official inquiry into the COVID-19 response so we learn everything we possibly can to improve our response capacity for future events.

We also need to establish a specialised national public health agency to manage serious threats to public health and provide critical mass to advance public health generally. Such an agency appears to have been a key factor in the success of Taiwan, which avoided a costly lockdown entirely.

Business as usual should not be an option for the recovery phase. A recent Massey University survey suggests seven out of 10 New Zealanders support a green recovery approach.

New Zealand’s elimination of COVID-19 has drawn attention worldwide, with a description just published in the New England Journal of Medicine. We support a rejuvenated World Health Organization that can provide improved global leadership for pandemic prevention and control, including greater use of an elimination approach to combat COVID-19.The Conversation

Michael Baker, Professor of Public Health, University of Otago; Amanda Kvalsvig, Senior Research Fellow, Department of Public Health, University of Otago, and Nick Wilson, Professor of Public Health, University of Otago

This article is republished from The Conversation under a Creative Commons licence. Read the original article.

Have you been impressed by the leadership of NZ Prime Minister Jacinda Ardern? Have we paid enough attention to how NZ achieved this enviable result?

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    COMMENTS

    To make a comment, please register or login
    Chris B T
    10th Aug 2020
    2:14pm
    We are 1 Federal Government with 8 States and Territories (Go My Own Way Attitude) I'll do as I Please.
    Huge Difference when only 1 Form of Government Making Decisions.
    Unless Australia is one nothing to Learn from NZ.
    hyperbole
    10th Aug 2020
    4:02pm
    agree...not comparing apples with apples
    Bakka
    10th Aug 2020
    4:26pm
    There is a relevant comparison.. NZ is 18% larger than Victoria ( geographic) However Victoria has approx 1.6 million greater population. 6.5 million V 4.9 million ..rounded.
    So why was NZ so successful and the 1 state Victoria, such a disaster. ??

    Will leave the audience to draw their own conclusions.
    bobm
    10th Aug 2020
    4:32pm
    WA has had 120 days free. Only 2.5million people
    Scott
    10th Aug 2020
    4:37pm
    Excellent contribution Chris - more proof that there's no need for 9 state / territory legislatures
    DISCON
    10th Aug 2020
    4:38pm
    gee whiz an article by the conversation paper praising a left winger - who would have thought!!! Well done NZ but most of Australia have done OK - VictoriaStan led by Chairman Dan has failed miserably - as do nearly all neo marxist communist/socialists states
    Rosret
    10th Aug 2020
    7:06pm
    Yep.
    What I have learned is the Labor States have used more restrictive measures to constrain a virus and yet have achieved no more than the other States who have asked the population to adhere to the medical advice.
    In fact the Labor States have done more damage to our economy by locking down the State borders when it wasn't necessary - and now it is.
    NZ has successfully quashed the COVID cases as have many of our States. We have to remember - we have no immunity. Its not over.
    Karl Marx
    10th Aug 2020
    7:50pm
    Rosret, What garbage.
    Locking borders was totally necessary as it now proves. Politics has nothing to do with it. The 2 covid states are Victoria (Labor) & NSW (Liberal) not because of their politics but because they both didn't take it as seriously as all the other states & opened borders to soon whinging & whining about their own economy & not looking else where to see what is working & what wasn't. But the likes of Tasmania (Liberal), Qld (Labor), WA (Labor) & SA (Liberal) said go to hell we are keeping our borders closed. Look what happened. Opening the borders to soon by Victoria & NSW with the support of the Federal LNP government has caused an extended border closure by the non covid problem states that will hurt the economy far worse than if Australia & all states went into total lockdown (like NZ). Vic & NSW have themselves to blame for the state of the economy for not wearing masks in public right from the start & enforcing social distancing rules at all times etc etc. Hundreds of people in Vic are still being caught not at home on a daily basis, what was the figure, oh yes, 800 in 1 day last week, when they are supposed to be under quarantine, disgusting & disrespectful attitude by a lot of Victorians. Look at the deaths, Vic leads the way. Not a good stat to be the winner of.
    For sure the economy will suffer but because of Vic & NSW the economy will feel a lot more hurt for a lot longer.
    Rosret
    10th Aug 2020
    10:13pm
    Tasmania, WA, SA, NT and Qld could all be having interstate travel at the moment. Instead we have been allowing all these travellers from OS continuously from the start of the pandemic that have been the sole cause of the spread.
    Karl Marx
    10th Aug 2020
    11:54pm
    Can't dispute the fact that the virus has been imported to Australia from overseas seeing as it started in China. And early on many many travelers went straight into Victoria & NSW as well as the other states but Vic & NSW ignored the other states who have persisted with border lockdown & control & opened to early without putting in place the mandatory wearing of masks in public & social distancing so while Vic & NSW are still having increases in covid cases the other states aren't & are right in their closing off borders. Victoria especially Melbourne are in complete lockdown & many businesses won't reopen, shame, but that's the result of Vic & NSW opening to early with precautions in place & not the actions of the other states border control. The Australian economy will be in an even bigger mess because of Vic & NSW.
    Karl Marx
    10th Aug 2020
    11:59pm
    Oh & the other thing is that for a month now Australia has placed daily limits on all returning Australians from overseas & also limited all incoming overseas flights to 30 passengers per flight. Also for 4 months plus all returning Australians have had a mandatory 14 day quarantine. Victoria stuffed that one up as well.
    So as you can see it's Victoria & NSW that are to blame 100 % for state borders being closed
    popster
    10th Aug 2020
    4:47pm
    No doubt NZ has done a good job. I would like to know a few things. 1. How many NZ's repatriated to NZ during the months March until now? 2. When did NZ cease all international flights and close their border? 3.Is it still closed?
    Jannie
    10th Aug 2020
    4:56pm
    The way I see it..................THE WORLD IS OVER POPULATED.................
    Our leaders are not seeing the big picture. They need to slow immigration down to a level we can maintain. Our infra structure is stuffed eg over crowded hospitals, the roads are not coping (good at present as people are grounded). Viruses will always be about and in the future they will be of a catastrophic proportions due to over population. Also the idiots that do not understand or want to understand about are on the increase. Issuing fines will not do the job as most will not be able to pay them.
    alfie
    10th Aug 2020
    8:00pm
    Congratulations to New Zealand as a whole. Thanks to the attitude of its people to obey what is being instructed and they got rewarded by their own doing.
    It doesn’t matter what government we have or who is running the show because if we just have one arrogant selfish person within us it will infect the whole country and world. To look for faults that the government did is purely hypocritical because we have no one to blame but ourselves. No matter how much we penalised people if they don’t want to do it then he won’t do it. The people who conform must ensure that their families conform. We have to do this together and follow the instructions. Wear a mask because YOU don’t know whether you have it or not. Better safe than sorry and drop the macho attitude because in this case it only proves that you’re weak between the ears.
    Koro
    11th Aug 2020
    7:50am
    Well done New Zealand. Why doesn't our Australian politicians go for the elimination strategy instead of the pussy footing around to please some people. Thank you Prime Minister Morrison for his horror and expressions of disgust in relation to those willing to let Australian seniors die to enable our millenials to continue on their self serving selfish lifestyle. After all, who set up our society to enable this group to enjoy the spoils? Surely some respect is earned? Maybe they need to lose a loved one or witness severe suffering before the me, myself and I attitude goes. R E S P E C T - an attitude long gone in some areas of life these days. No, I am not a grumpy oldie, just a decent, caring human being with empathy for all and sundry, regardless of colour, sex, creed or age and looking forward to having a long and happy existence enjoying the simple things in life. Let's wake up Australia and get our collective heads out of the sand to beat this monster.
    Katie
    11th Aug 2020
    5:50pm
    Let's look at the obvious reason Australia didn't recover . . . Federal Govt dropped the ball and forced it on the States. They have an obligation to maintain the borders and did initially with Wuhun travellers being isolated on Christmas Island. That worked! So then they dropped that and put o/s travellers in hotel quarantine in busy CBDs - that hasn't worked effectively. We would be in full recovery by now if the Federal Govt had maintain the policy of 14 days on Christmas Island or the like. Not putting infected people in a hotel where they can infect others. They put refugees on islands for 10 years, but can't put o/s travellers on one for 14 days. Go figure. Now we have more than $100 BN in debt and growing all because they won't mandatory quarantine away from the mainland.
    Ted Wards
    12th Aug 2020
    11:58am
    I guess now they have four new cases and have locked down Auckland very quickly it shows how Qld reacted quickly and correctly in the last few weeks.
    Koro
    12th Aug 2020
    12:56pm
    Take my hat off to NZ and Qld who do not hesitate to take swift, hard action when circumstances warrant it. Can our other leaders learn something before it is too late for NSW? First shopping expedition in 3 weeks yesterday and half and half wearing masks and so many, if wearing a mask, had them hanging under their noses???? Fingers crossed respect and common sense will prevail asap.
    Jannie
    12th Aug 2020
    5:18pm
    NO ONE WINS THE VIRUS RULES
    bobm
    12th Aug 2020
    6:23pm
    nil in 100 days for NZ for Corona virus
    What is the score today.
    BillF2
    12th Aug 2020
    10:36pm
    Covid-19 hasn't been defeated or eliminated in NZ, just put on hold. What did it take to achieve that? Only destruction of the economy and people's livelihoods. And now there are four new cases, the sky is falling, and lockdown has to be re-imposed. To quote Monty Python's universe song "pray that there's intelligent life somewhere out in space, cos there's bugger all down here on Earth".
    Farside
    13th Aug 2020
    1:18pm
    NZ - 4 cases yesterday and today 13 community transmitted cases in Auckland and Rotarua
    Jotar
    13th Aug 2020
    6:03pm
    That was after 102 virus free days. Now at 105 days there are 17 known cases thought to have been generated within the "covid free" community. Scary...no more talk of a travel bubble.
    Farside
    14th Aug 2020
    7:05pm
    and a day later 29 confirmed and a further 38 close contacts in quarantine


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