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New Zealand has emerged as a gold standard with its coronavirus response, having ended community transmission on May 22. In sum, the nation of about five million people has seen a total of at least 1,556 confirmed and probable cases, along with at least 22 deaths, according to the New Zealand Ministry of Health. By comparison, as of Friday, the United States has seen at least 4,405,932 confirmed cases and at least 150,283 deaths, according to the CDC.
Academics and the media have pointed to the trust which political leaders and health experts were able to cultivate amongst the population as a key reason for why the results there have been so strikingly different than in other developed countries. But just before the pandemic began, success was anything but assured. By one metric, last fall, New Zealand placed 35th in the world for pandemic preparedness, having scored just 54 points out of 100, as assessed by the Global Health Security Index.
“If it struck like it did in Italy, we were going to be in really big trouble,” said Siouxsie Wiles, an associate professor of microbiology at the University of Auckland, who has been a leading voice on how to combat the coronavirus in New Zealand.
It may well have been that underlying doubts helped drive the country’s leaders to take assertive, early actions, Wiles surmised. On February 3, New Zealand’s government banned non-citizens coming from or through China — a move in opposition to WHO recommendations at that time. By March 16, all incoming travelers were subjected to a 14-day quarantine. By March 20, the country closed its borders entirely. Then, on March 26, with only 102 cases and no deaths, the country went into lockdown, save for essential services and workers.
“There was a really difficult time where we didn’t know if we were 10 days away from Italy or 20 days away and there was a kind of sweet spot. If you act too early, it’s hard for people to get on board because they don’t see the urgency, but if you’re too late, you’re too late,” Wiles said.
While these decisions have been credited by the WHO as helping eliminate the virus in New Zealand, government edicts alone would not have been successful without public buy-in, since the country lacked resources to actually enforce them at scale, according to New Zealand Herald Parliamentary Reporter Derek Cheng.
“They asked us to please stay in our ‘household bubbles’… Kiwis, I don’t know, we were like, ‘OK, sure,’” Cheng told Direct Relief, before noting that public acquiescence was not simply the result of culture, but rather the effect of earned trust built on consistent, clear communications from the government.
Cheng said that in the early days of the pandemic, Prime Minister Jacinda Ardern gave an address that clearly outlined what was at stake and introduced an easy-to-understand, color-based alert system, borrowed from Singapore, that would gauge the nation’s progress in fighting the virus.
“That really set the tone for the communication strategy and was a major factor in the success, I think,” said Cheng, who mentioned that the public health response in New Zealand was “very hurriedly” put together. Still, when, a few days later, the country went into lockdown, people were prepared, he said.
“The messaging from the beginning was, ‘We’re a team of 5 million.’ As a public message, it was very effective,” he said.
Wiles also pointed to the effectiveness of the Ardern government’s messaging strategy. “She never put us on a war footing. Everything was about collaboration, working together, positive language — rather than fear. ‘We’re a team of 5 million,’ I think it was very powerful,” Wiles said.
Beyond the policies and how to sell them to the public, Wiles also noticed that Arden and her ministers were selective in how they discussed the virus.
“One of the things that really impressed me is that the prime minister and government were really careful in the language they used,” she said, referencing the subtle but important distinctions about how to avoid stigmatizing people.
“These Are My Core Values”
Wiles, who gained recognition prior to the pandemic as a finalist for New Zealander of the year in 2018, has learned that facts are not enough when it comes to science, and especially related to communications.
“Some people think scientists are outside this sphere of any kind of influence and it’s not true. My approach has been to explain, ‘These are my core values.’ So when I’m looking at the evidence, this is the way I will interpret it. To make it clear, I would like to minimize the number of people who will get this infection. I’m basically liberal, left-leaning, and that’s how I want us to behave,” she said.
An early example of this manifested itself with the prospect of school closures. While many of her colleagues pushed for schools to be shut early in the outbreak, Wiles pushed back initially because, “You can’t just shut those schools without any thought of where those children will go,” she said. “I wanted a plan to be in place of where to put the children.”
Wiles, who has dealt with online abuse during the pandemic, said that, by explaining how she is analyzing data, it has been easier to bring the public along when her assessments change based on new information — something that has dogged U.S. officials as they change their policies and recommendations, notably with regards to masks.
“Masks were a really hard one,” she said. “For one, they were absolutely needed by someone in contact with somebody with the infection, but they’re not bulletproof, you need to know how to put them on.” Wiles said that in societies with no experience with mass masks, it’s generally “not advised, but that mass masking is really important now in some countries because of the chance you will be in contact with someone who has the infection,” she said.
For the New Zealand government’s part, Cheng reported there has been no official recommendation.
Keeping The Fight Alive
Even with overarching success, the past few months have not been a fairy tale for Kiwis. Cheng pointed out “woeful” contact tracing in early to mid-March and personal protection equipment stocks that had not been checked since 2016. Cheng also criticized the lack of basic data sharing by the government, which required journalists to ask for specifics, which only then would be provided.
In mid-June, after having eliminated the virus for over three weeks, two new cases emerged last week after failures in the nation’s quarantining system for incoming travelers, which allowed two systems to leave isolation without a negative test.
“Faith in the system was shaken. We were told the border was watertight. It was not. Stories have come out that people have not been tested, been granted compassionate leave, escaped managed isolation, and that people have been allowed to mingle. The military would be brought in to oversee it,” Cheng said.
The government has managed the financial fall-out with an existing wage scheme, which covered 1.6. million New Zealanders. There were also interest-free loans, rent support, loans to banks, and a $900 million loan to the national air carrier.
Wiles said that in February and March, until a lockdown was announced, she had trouble sleeping. After a few months, she is back to that same fitfulness, “because of other places,” she said.
“I sort of assumed people would do the right thing when the s*** hits the fan, but the right thing means different things to different people,” she said. Wiles had concerns about the U.S. response back in March, writing “…so many Americans don’t have access to affordable healthcare and paid sick leave, leaves me wondering how on earth they can stop Covid-19 going viral, so to speak.”
But she says now that could not have imagined then what she described as a U.S. federal government that, “would actively work against states that were trying to fix it.”
Despite the seemingly insurmountable case counts combined with a lack of contact tracing and widespread public mistrust of health officials, Wiles strongly urged Americans to keep trying.
“If they give up, that is basically accepting death on scale we’ve not seen and long term consequences for those who get it,” she said, advocating for the U.S. to pursue an elimination strategy, as opposed to one of mitigation and suppression or simply accepting the virus’s presence.
“The really important message for the rest of the world is no one must give up! The further on you are, the harder it is to recover, but it can be done. It just might have to be done at the local level,” she said.