Coronavirus: Geography vs. Policy
I nearly got into a ridiculous Facebook battle with a man I can only describe as a science denying, right wing nut job regarding New Zealand’s success beating back covid. I extracted myself from this conversation because I don’t have the bandwidth for crazy or Facebook insanity, but his main points were:
Lockdowns don’t affect death rates (which I won’t get into too much here, but his own studies and articles stated - at the end where he probably didn’t read - that lockdowns are very effective is decreasing the overall number of cases and therefore decreasing the overall number of deaths.)
Only New Zealand’s geography protects it from coronavirus. Policy had nothing to do with it.
I can’t tell you how many times I’ve heard this second argument from people. I can only imagine it is an effort to self-protect and make excuses for America’s failures because it would be so much easier if the US’s failures weren’t so closely tied to policy and New Zealand’s success was only because of geography. But here’s the deal: New Zealand’s politicians had to make some hard decisions and implement new policies never before seen in this country, and that’s why we succeeded.
To put things into perspective, New Zealand is comparable to Colorado, which has a similar population and land mass size. Colorado has had over 48k cases and 1,849 deaths while New Zealand has had about 1,600 cases and 22 deaths. And New Zealand isn’t as small as people think. It’s actually larger than the UK, which is also a couple of islands, and has had 308k cases and over 46k deaths. Additionally, New Zealand has 4 deaths per million, the lowest in the OECD, while the US has 488.
And New Zealand was on the path of joining covid hotspots. Our first case was reported on February 28. Back in April our coronavirus count was skyrocketing upwards and there was evidence of both traceable and untraceable community transmission. However, the government made the decision to require self quarantine starting on March 16 and to go into a strict lockdown starting on March 25. At the time, there were 205 confirmed and probably cases. The US had 205 cases on March 5, only 20 days prior. By March 25, the US had 51,970 cases. By contrast, on April 14, 20 days after March 25, New Zealand had 1,366 confirmed and probable cases. How would things be different if on March 5, the US government had implemented clear, nationwide guidance on staying home, taking safety precautions, quarantining travellers and limiting entrance into the country?
For the next seven weeks, everyone in New Zealand stayed home. And I mean really stayed home. This worked for a couple of reasons:
The government rolled out extensive pay check protection programs that companies could quickly and easily apply for if they thought their business would decrease by 30%. (Side note - many companies found that they did not actually decrease their business by 30% and millions of dollars have been returned because it wasn’t needed.) This meant that people were incentivised to do the right thing and stay home and companies were incentivised to keep people on the payroll. It made returning to “normal” a lot easier once we were out of lockdown.
There was daily communication about the state of coronavirus in the country, changes and updates to the policies in place as adjustments needed to be made, and clear instructions on what was going on and what to expect. There are still daily 1:00 pm updates from the government. There’s no confusing messaging, no bashing of the scientists or modellers, no conflicting signals. The amazing communication made the lockdown tolerable.
Testing is easy, quick, and free. If you’ve read about my experience getting tested, you know that they take community sampling incredibly seriously. Plus everyone in quarantine gets tested on day 3 and day 12 to make sure they’re safe to enter the Kiwi bubble. That’s not to say that testing has always been this way. There were problems at first with ample supplies and needing a referral, but part of what makes the New Zealand response great is that it is nimble. When problems become evident, the government has been able to quickly make policy changes to improve our response and the government is able to communicate the changes thanks to the handy 1 pm daily update.
New cases are stopped at the border. The self-quarantine approach didn’t work as people couldn’t be trusted to actually self quarantine. Now, all people entering the country stay in government approved quarantine facilities around the country. Basically, people are put up in hotels for two weeks and supposed to stay in their rooms. This hasn’t been a perfect system as people occasionally make a break for it and for awhile people were getting permission for compassionate early leave that turned into a disaster when two British women turned out to be positive after driving from Auckland to Wellington. However, all of the cases in the country now are in quarantine. Yes, geography helps with this one, but there is a decent policy in place to take advantage of it. (And yes, I think the US could’ve done something similar. There is no reason why the US can’t stop flights into the country as it did with flights from China and Europe. There is no reason they can’t fully close road crossings as they’ve already done partially with Mexico and Canada.)
The thoughtful policy responses continue even though we’ve been community-spread free for three months. The government is carefully watching what’s happening overseas, especially in Australia where a community outbreak came out of two cases in quarantine. And the government is preparing New Zealand if there is a second wave. Just yesterday, the government stated that it is time for Kiwis to add face masks to their existing emergency supply kit. (In New Zealand, everyone is encouraged to have an emergency supply kit of food and water in the case of a natural disaster because, you know, volcanoes and earthquakes are real.) However, the government had already done a national inventory and knew that there are currently 12 million masks currently for sale in the country. There shouldn’t be crazy shortages if people don’t hoard, and many people already have masks at home. This is also a preventative measure. Again - imagine what would’ve happened if in the United States on March 5 the government had said, “hey guys, this could get bad. Please have masks on hand.” Yes, there would’ve been mad dashes for masks, but it would’ve saved lives, too.
So yes, New Zealand is smaller than the US, but there are still 5 million people here and the government has done an incredible job of developing a series of policies that have let us lead a normal life inside a Kiwi bubble. Stop trying to diminish the hard work we put into a true lockdown because other governments and societies have chosen a different path.
Fortuitously, just have I wrote this, the New Zealand Herald came out with an incredible article on this very subject. I encourage you to check it out here and to look for the New England Journal of Medicine New Zealand elimination playbook that should be published soon.
