Wednesday 13 May 2020

Documenting what led to lockdown

Marc Daalder goes through last week's document dump and plots out the path to lockdown.

You need to read the whole thing and subscribe to Newsroom. 
When Ardern announced the alert level system on March 21, it was met with an immediate outcry by epidemiologists and other health professionals for a move to Level 4.

Baker, who had been calling for lockdown for the better part of a week, reiterated his view on RNZ shortly after the announcement. He was convinced New Zealand's testing wasn't ready to find the cases out there and also raised a handful of concerns about contact tracing.

In the end, it was the contact tracing that would prove the slowest to scale up. A report on contact tracing commissioned by the Ministry of Health from University of Otago infectious diseases expert Ayesha Verrall found Public Health Units (PHUs) were overwhelmed by the case numbers they faced in late March.

"When New Zealand moved to Alert Level 4 on 25 March, many PHUs were at or beyond their capacity to manage cases and contacts, even with increasing support from the newly established [National Close Contact Service]. During that week, nationwide daily case numbers ranged from 70-86," Verrall wrote.

Even two weeks into lockdown, only 60 percent of contacts could be easily reached by phone and PHUs had no insight into what happened to cases they referred to the centralised NCCS. Verrall wanted to see the PHUs and NCCS able to trace all the contacts of 1000 new cases every day, up from just 70 on March 25.

In fact, the documents released by the Government show that by March 18, PHUs could trace fewer than 50 cases a day. On the same day, 39 Covid-19 cases entered the country. The situation was quickly spiralling out of control.

Exactly why the country was so unprepared for Covid-19 remains unclear. Newsroom has previously reported on international assessments in which New Zealand scored just 54 out of 100 points for pandemic preparedness. Domestic epidemiologists, including Baker and fellow University of Otago expert Nick Wilson, had long raised these concerns.

Nonetheless, the country's poor preparedness meant there was no viable alternative to lockdown. While countries like Taiwan and South Korea have managed to chart a suppression or elimination path without resorting to lockdowns, they also have far more robust public health systems than New Zealand.
In February and March, I just wasn't expecting failure to scale up contact-tracing to be the problem. I'd thought that part was simple - just hire more people. Not doing it proved expensive.

Newsroom also provides this helpful timeline.


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