SARS-CoV-2 Virus Elimination Strategy For New Zealand

According to this report published 3 April 2020 in the New Zealand Medical Journal by Michael G Baker, Amanda Kvalsvig, Ayesha J Verrall, Lucy Telfar-Barnard & Nick Wilson, the essential elements of an elimination strategy for COVID-19 are likely to include: [my comments on New Zealand’s current approach inserted in italics]

“1. Border controls [tick] with high-quality quarantine of incoming travellers; [no, as proper quarantine is only currently happening for some, not all, of those arriving into NZ]

2. Rapid case detection [tick, sort of, I've heard of some testing delayed up to 3 days and some test results taking 5 days to come back] identified by widespread testing [no, not currently happening in NZ, even members of a household of a known case aren't eligible for testing until they show symptoms as they don't meet the case definitions, therefore their own close and casual contacts aren't being traced, and no surveillance testing in place as yet], followed by rapid case isolation [tick], with swift contact tracing [tick, except as noted above] and quarantine for contacts [no, proper quarantine not currently happening in NZ, see Taiwan for how to do it properly];

3. Intensive hygiene promotion (cough etiquette and hand washing) [tick] and provision of hand hygiene facilities in public settings [tick, partly, still lots of EFTPOS terminals without Paywave and a shortage of hand sanitiser];

4. Intensive physical distancing, currently implemented as a lockdown (level 4 alert) that includes school and workplace closure [tick, except that anyone can now sell their second-hand essential items on Trademe, potentially dispatching shed SARS-CoV-2 virus all around the country by courier], movement and travel restrictions [tick, sort of, it sounds like there are still a lot of people travelling between multiple residences and this may increase over Easter], and stringent measures to reduce contact in public spaces [other than with public transport and the closure of public facilities, I'm not aware of other measures being in place - the army could be patrolling popular beaches and congregation spots perhaps?], with potential to relax these measures if elimination is working [here's hoping ...];

5. A well-coordinated communication strategy to inform the public about control measures and about what to do if they become unwell, and to reinforce important health promotion messages. [tick, sort of, still unclear guidance on mask wearing which should have been implemented and enforced during an earlier Level 2, so that the country didn't need to ever get to Level 4. If you are still in doubt about this, consider whether the world would be in the midst of a global pandemic had 80%, even 60% of the global population worn masks, of any sort, in public for the first three months of 2020, and 100% on international flights?]”

So, for elimination to work there are several aspects we need to do well and it would seem are doing about half of them well. That really doesn’t seem good enough.

At this rate, we could be in for a long Alert Level 4 shutdown. Either that, or we will pay the price of implementing a shutdown and not succeed in eliminating the virus, which would be a double blow economically and stretch the healthcare system over a much longer period, putting more lives at risk.

Time to increase the required measures to achieve a rapid elimination Prime Minister Ardern?

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