Lifting the Lid: A Critical Analysis of the Covid-19 Pandemic Management in New Zealand

Emeritus Professor Des Gorman
Dr Murray Horn
Research Note
20 April, 2023

A pandemic caused by the SARS-CoV-2 virus (COVID-19) continues both worldwide and in New Zealand. Although estimates are that half the New Zealand population have been infected, more likely almost every citizen has come into contact with the virus in some way. New Zealanders continue to be reinfected by old strains of the virus and by emergent strains. About 0.1% of those who have reported infections have died. At the triennial anniversary of the epidemic in New Zealand, a review is timely to identify what can be done better and to inform future pandemic planning.

Initial strategy was fine, but execution lacked adaptability and agility.

Our concern is not with the initial strategy adopted to manage the pandemic. Our geographic isolation was a huge advantage in initially keeping the pandemic out of the country. While we reacted ‘relatively’ quickly when the virus finally arrived, we had plenty of warning and need not have waited as long as we did. Reacting to local outbreaks by a combination of isolation and lockdown to buy time to build health system capacity and await an effective vaccine also made sense. More effective testing and tracing should have reduced the reliance on costly lockdowns. However, absent a vaccine, the political priority was always going to be on protecting the health system from becoming overwhelmed.

While this initial strategy made sense, the execution of that strategy fell short. We do not intend a forensic analysis of the various missteps and policy flip flops (e.g. mask wearing requirements and rapid antigen testing). Doubtless the Royal Commission will explore those in detail. Given New Zealand did not have a meaningful pandemic plan, we had to “make it up as we went along.” Mistakes were inevitable.

Our concern is not that mistakes were made, but that our response lacked adaptability and agility. As an illustration, consider the key measure of contact tracing performance. This was well below the sensible identified standard during the first outbreak and showed no improvement across successive outbreaks until it was overwhelmed by the ‘Delta’ and ‘Omicron’ strain outbreaks in late 2021 and 2022.

Implementation was poor because it was politicised.

Political involvement was essential given that the strategy required imposing restrictions on personal freedoms of movement and association. However, that involvement need not have extended into the on-going governance of strategy execution. We have many models, like the Reserve Bank, where the essential political decisions are successfully separated from the administration of Government strategy and directives. These models have evolved because Governments have come to accept that there are some critical areas of public policy where politically driven execution of policy undermines the objectives of that policy.

Our main argument is that the politicisation of the execution of the response to the COVID-19 pandemic led to a lack of adaptability and agility and so a response that was more costly than necessary. Managing political risk produced a very natural desire to paint our response as the envy of the world, to claim a monopoly on the truth, to put the best possible “spin” on events, to marginalise criticism and monopolise execution. The facts are made to fit the political narrative in order to maintain public confidence in the chosen response. The use of alarming computer scenarios of widespread hospitalisations and deaths generated a high degree of fear that encourages people to place their faith in authority. None of that is conducive to admitting shortcomings, learning from them, and adapting your response. Moreover, they encourage an extended “at all costs” response rather than a more balanced approach to costs and benefits, especially as more becomes known.

These costs reach beyond the disruption to almost every aspect of life during the protracted “zero- COVID-19” phase and the subsequent impact on inflation, on health worker morale and well-being, on healthcare delayed and on a health system that is now in crisis. The response also became an increasingly divisive issue. Although it is more difficult to quantify, we are now a less cohesive society than we were at the beginning of the pandemic; one that is less trusting of Government and the media. Polling suggests that the initial and overwhelming public support for the Government during the initial phase of the COVID-19 response steadily declined and was significantly eroded by early 2022.

We were not the only country where the management of the pandemic was politicised. In some countries, this was more exaggerated and it's noteworthy their outcomes were very poor (e.g., Brazil, UK, USA).

Recommendations

We draw five related lessons that would leave us far better prepared for the next pandemic:

  1. The lack of a plan to deal with a virus like COVID-19 was telling. Different threats will trigger different responses. While any plan will need to be modified as more becomes known, it is important to have thought through a wide range of scenarios in advance. Moreover, there are critical components of any likely response that need to be identified in advance and regularly tested and reviewed to ensure that they will be effective when needed. These include ensuring sufficient physical capacity can be made available (for quarantine, for testing, tracing and immunisation, PPE stocks, ICU capacity and so on) as well as clarity around who is best placed to do what to both keep threats out and contain any outbreaks. It is telling, for example, that Government has agreements with primary sectors to ensure biosecurity risk is well managed but nothing similar exists to manage pandemic risk. We need a pandemic management plan, preferably one that has broad political support.
  2. Ministerial involvement in execution was counter-productive because it places too heavy a weight on managing political risk, with the implications noted above. Execution of the plan and responding to any explicit and transparent Government directives should be the responsibility of a single co-ordinating body with professional governance that is independent of, and accountable to, ministers.
  3. The response was overly reliant on the public sector. Co-ordination and accountability also need strengthening. The Ministry of Health had little operational experience. Private individuals and organisations that had critical expertise and experience should have been encouraged to participate and used more effectively, with some respective roles agreed in advance (as we do for biosecurity). The responsible co-ordinating body needs to have the authority to call on help across both private and public sectors.
  4. We lacked critical infrastructure, so some infrastructure investment is essential to ensure we have the physical capacity to respond to likely threats without over-reliance on protracted lockdowns.
  5. We did not use the time that the strategy bought us to build health system capacity. Workforce was, and is likely to remain, the limiting factor. Attention to the retention and extension of existing health workers and the recruitment of new workers is the only way in which to boost system capacity in reasonably short order. Protecting the health of these workers, for example by effective PPE, is also critical. While we remain more dependent on immigrant health workers than any other OECD country, attracting and retaining these workers has to be a critical part of this approach.

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