Why were we waiting?

At last we will be able to cross back and forwards across the Tasman without the need to quarantine from April 19th.

Why has it taken so long?

. . . On Tuesday Jacinda Ardern announced the Director-General of Health, Doctor Ashley Bloomfield, deemed the risk of transmission of Covid-19 from Australia to New Zealand is “low and that quarantine-free travel is safe to commence’’.

But on further inquiry from Newsroom, Covid Response Minister Chris Hipkins revealed he’d been in regular discussions with Bloomfield for six months and the health boss’ “assessment that Australia’s a low-risk country has been consistent for some time’’.

The hold-up was Bloomfield’s advice that “the systems have not been in place to allow for safe green zone travel both ways between both countries’’.

The systems officials have been working on have been focused on airports and how travellers make the trip from one end to the other safely, keeping bubble travellers separate from other incoming flights that may have Covid-positive passengers, and the contact tracing and processes for opening, pausing and in some cases closing the bubble if there were an outbreak in either country.

Talk to airports and they’ll tell you they’ve had their systems ready to go since August last year when health officials gave the all-clear to Christchurch, Auckland and Wellington.

The only advice the Ministry of Health has come back to airports with since then is extra cleaning when the bubble opens up, and other routine measures.

In the case of Wellington Airport, no managed isolation and quarantine flights land directly in the capital from overseas countries, so mitigating risks around mixing up trans-Tasman passengers with those potentially exposed overseas is and always has been non-existent.

And despite the political pressure ramping up from both National and ACT, the Government has been happy to continue with the go-slow citing a “cautious’’ approach in the name of public health and safety.

The reality is other than tourism operators and those whose businesses are directly impacted by tourist arrivals, most other New Zealanders accept it’s worth taking the time to get it right. . . 

In other words the government didn’t want to risk any political capital, preferring to pander to the fearful rather than promoting the low risk of opening a Trans-Tasman bubble.

It put polls before people – the ones separated from family and friends, the ones who couldn’t get to visit ill relatives before they died, the ones who couldn’t go to funerals, the ones who missed celebrations.

And it played on the pandemic paranoia for political gain with no heed for the financial and emotional stress tourism businesses, their owners and staff are under nor for the economic cost to the country of the needless delay.

If don’t look can’t learn

National is calling for an investigation into the Valentine’s Day Covid-19 cluster:

The National Party is calling for an inquiry into the Valentine’s Day cluster to see where our response went wrong, and what lessons we can learn.

The scope of the inquiry would include:

• The performance of contract tracing
• Communication of public health messaging
• Whether the testing regime met expectations
• If saliva or antigen testing should be used more fully
• The legality of orders issued around testing and self-isolation

The contact tracing was well short of the 80% benchmark recommended by then medical researcher, now MP Dr Ayesha Verrall last year.

Communication was confused.

A lot of tests were done but we don’t know if the regime met expectations.

Other countries and private businesses here are using saliva tests. We need to know if more could and should be used here.

That Director-General of Health Ashley Bloomfield issued a section 70 health order on isolation and testing for contacts and casual contacts of the February cluster on Friday raises questions about the legality of requirements before that.

“National thought the call to go out of Level 3 in February was bold and ambitious. At the time we didn’t know the source of the original case, there were two new community cases that day and not all of the high school students had been tested,” Leader of the Opposition Judith Collins says.

“It has since resulted in a week long lockdown for Auckland. These lockdowns are costing the economy half a billion dollars each week. It’s the reason this yo-yoing in and out of lockdown must be avoided.

“This week we’ve found out that our contact tracing isn’t the ‘gold standard’ the Government would have us think. We haven’t met critical measures in the latest two outbreaks, and all locations of interest haven’t been disclosed to the public.”

Ms Collins says it is clear public health messaging needs to be improved.

“This week a young woman was vilified by the Prime Minister and her Government for following the advice she received. This has highlighted the lack of urgency shown by the Ministry of Health to follow up on unanswered texts or calls.

There are reports that the young man who went to the gym had been told he didn’t have to self-isolate after his test too.

“How the domestic border is managed needs improvement too. There were long queues of people trying to get back to Auckland last weekend, and late on Friday afternoon students trying to head home from boarding school were blocked from being reunited with their families at the border with no reasonable explanation.

“We should always be aiming to improve our response, so we should have an inquiry into why Auckland had to back into Level 3 less than two weeks after coming out of a lockdown.

“Going into lockdown should be our last resort and that means making sure our response to any community outbreak is comprehensive.

“If anything, this week has shown New Zealand there is a lot we can work on in our response when community cases arise. We should always be aiming to improve, so an inquiry into the Valentine’s Day cluster is appropriate.

Among the improvements needed is a more nuanced response to lockdowns. If Sydney can contain community outbreaks by locking down suburbs but leaving the rest of the city, and the state, free, why can’t a similar approach be taken here? Does the whole of Auckland have to go to Level 3 and the rest of the country  to Level 2 every time there’s community transmission somewhere in the city?

If the government doesn’t take a very serious look at what happened – what went well and what didn’t – it won’t learn and if it doesn’t learn any mistakes made this time could well be made again at huge cost to individuals, families, businesses, events and the country.

Who else is assiduous?

As news of more virulent cases of Covid-19 overseas and in managed isolation facilities here increased, the chances of someone in the community testing positive grew, and now it’s happened:

The person, a 56-year-old woman who has recently returned from Europe, tested negative twice during her 14 days in managed isolation at the Pullman Hotel in Auckland. However, after leaving managed isolation, the woman became symptomatic in Northland and sought a test, which came back positive. . .

The woman lives with just one person, her husband, who is not symptomatic but has been tested. Four other close contacts from the couple’s travels around southern Northland have been identified, contacted and tested and their contacts are also being traced. Testing centres would be set up around Mangawhai. The woman had been travelling around southern Northland together because she had been overseas. “They were not meeting friends, just spending that time together,” said Director-General of Health Ashley Bloomfield.

The woman was “extremely assiduous” in using the NZ COVID Tracer app to scan QR codes, Bloomfield said. He said she also had the Bluetooth tracing function enabled and the Ministry of Health would notify others who had Bluetooth enabled and may have been in proximity for long enough to be a close contact. . . 

That she has taken great care to use the tracing app makes it easy to know where she’s been and the Bluetooth tracing will alert others using it.

But what about people who don’t either don’t have Bluetooth function or aren’t assiduous about using the app?

I didn’t download the app until Auckland was locked down for the second time when I realised how hard it would be to remember where I’d been in the last fortnight.

Since downloading it I have been assiduous about using it even though some businesses don’t make it easy to see and then scan the QR code before or as soon as you enter.

But from what I’ve observed I’m in a pretty small minority and my observation is backed up by official figures:

In November, there were an average of 866,000 scans per day.

That dropped to 516,000 in December and has slipped to 465,000 per day in January so far – almost half of November levels.

Director General of Health Dr Ashley Bloomfield said people needed to stay on high alert as the virus spread quickly, and cases continued to increase globally.

He asked people to take the time to scan in with the app, or record their own diary so contact tracing could take place quickly if there was another outbreak. . .

 Given the need to do contact tracing quickly, why weren’t the places the woman who’s tested positive had visited made public immediately?

The Government’s delay on revealing the locations the Northland woman who has tested positive for Covid 19 has travelled is reckless and risks making a dangerous situation much worse,” says ACT Leader David Seymour.

“How can people self-isolate and get tested in a timely manner if the Government won’t tell them they’ve been somewhere they may have contracted the virus?

“People want to take personal responsibility at times like this but the Government needs to be transparent and treat them like adults.

“Hopefully the Northland woman’s assiduous use of QR scanning and having Bluetooth turned on by will give tracers a big helping hand, but the potential for the virus to have spread over the days since she tested positive is of huge concern.

“She deserves real kudos, but appallingly low use of the app by most others means tracing is going to be extremely difficult. . . 

The official line is that businesses visited were being notified before they were identified.

Why?

If the woman was infectious when she visited these places other visitors and staff are at risk. Their health and that of everyone else they’ve been in contact with should come first. If they haven’t been diligent about using the app, publicising places of potential risk is the only way to alert them and that should be done without delay.

Public awareness and safety ought to take precedence over privacy concerns for the businesses.

Besides, given the time it’s taking to alert the businesses, it’s likely they would find out sooner with a public announcement than a personal call.

The sooner they find out, the safer it would be for their staff and customers, many of whom won’t have been assiduous in their use of the app.

Who do you believe?

Nurses in MIQ hotels are complaining about staff shortages and 20 hour working days:

Twenty nurses have been pulled away from other jobs around New Zealand to staff Auckland’s managed isolation facilities.

Nurses say they’re concerned about serious staff shortages and burnouts, and claim some are expected to work 20-hour shifts.

One registered nurse, who asked to remain anonymous, said while she takes pride in protecting Kiwis in isolation hotels, she is now disillusioned and fed up.

“I know many other nurses who are feeling despondent, despairing, frustrated and angry,” she told Newshub. . . 

She said the situation changed for nurses after the Northern Regions District Health Board took over employing staff from healthcare agency Geneva. Pay was slashed and nurses started leaving.

The nurse said shortages are widespread across Auckland’s isolation hotels.

“I would describe them as being critically low and dangerous,” she said.

She added those on the job are sometimes asked to work extra hours.

“It can amount to 20 hours straight, which is very unsafe.” . . .

The DHB, Director General of Health Ashley Bloomfield and Minister in charge of MIQ Megan Woods all say there is no problem.

Health workers said they had insufficient personal protective equipment (PPE). Officials and politicians said they were wrong but there were right.

Health workers said there was a shortage of flu vaccines. Officials and politicians said there wasn’t but there was.

Now nurses are saying there are staff shortages and unsafe working hours. Officials and politicians say they’re wrong.

Who do you believe?

Team let down

We were told to stay home in our bubbles and we did, even though we now know that the government wasn’t acting lawfully in ordering us to do so for the first nine days.

A Full Bench (three Judges) of the High Court has made a declaration that, for the 9 day period between 26 March and 3 April 2020, the Government’s requirement that New Zealanders stay at home and in their bubbles was justified, but unlawful.  . . 

The government, not surprisingly has seized on the word justified.

It should however be concentrating on unlawful so it learns from its mistake and doesn’t repeat it as it has repeated several other mistakes most glaring of which are those that led to most people working at the border where they could be exposed to Covid-19 not being tested for the disease.

When most of us did, and continue to do. what we are told to do to keep ourselves and others safe it is galling to be let down when those doing the telling aren’t doing all they should be doing.

As Shane Reti, National’s health spokesman said:

 New Zealanders did their part. We all did our part. We’re asking the Government, “Did you do your part?” We believed. We stayed at home. We did our best to keep our businesses running. We did our best to keep people’s jobs. People missed their operations, their diagnostic tests, their school exams. We all did our part. Has the Government done theirs?

You see, we believed we were all part of a team—a team of 5 million. Well, the team of 5 million turned up and on game day, the coach didn’t have the right gear. We all trained during the week. We all went to practice. We all understood the plan. On game day, the coach didn’t have the right gear and hadn’t started the clock. When we were told that Jet Park, our highest quarantine facility for positive cases, we were told all staff were being tested weekly—all staff were being tested weekly. Now we know they weren’t. Yet Ashley Bloomfield said he gave the Minister full and very regular updates on isolation testing. Who do we believe?  . . 

Who do we believe?

 Karl du Fresne shows it is hard to know who to believe::

The big picture is one of a fiasco. Consider the following.

By common consent, the Covid-19 tracing app is a clunker. It seemed to work fine on my phone until several days ago, when it suddenly went into meltdown. After repeated attempts to re-activate it, I gave up.

The police checkpoints around Auckland are a joke, massively disrupting daily lives and economic activity for no apparent purpose. In one 24-hour period more than 50,000 vehicles were stopped but only 676 were turned back. That means people spent hours trapped in stationary cars and trucks for an almost negligible success rate against supposed rule-breakers.

Even worse, people with valid reasons for travelling – for example, trying to get to work or deliver essential goods – have reportedly been turned back or made to wait days for the required paperwork. Others, meanwhile, have been waved through. It all seems totally haphazard and arbitrary, with decisions made on the spot by officers who don’t seem to be working to any clear and consistent criteria. . . 

Then there was the panicked decision – or at least it looked that way – to test 12,000 port workers and truck drivers within a time frame that was laughably unachievable (and perhaps just as well, since it would have caused more business chaos).  

And once again, there were mixed messages about eligibility for testing – a problem that first became apparent when the country went into lockdown in March. The official message then was “test, test, test” – yet people seeking tests, including those showing Covid-19 symptoms, were repeatedly turned away. And it’s still happening.

Glaring discrepancies between what was being said at Beehive press conferences and what was actually happening “on the ground” have been a recurring feature throughout the coronavirus crisis. Many were highlighted by Newshub’s investigative reporter Michael Morrah. He revealed, for example, that nurses and health workers were said to have ample protective equipment when clearly they didn’t.  Similarly, Morrah exposed a yawning credibility gap between what the government was saying about the availability of influenza vaccine and what was being reported by frustrated doctors and nurses.

Somewhere the truth was falling down a hole, but the public trusted in the assurances given by the prime minister and Ashley Bloomfield. Many will now be thinking that trust was misplaced.

The most abject cockup of all was the failure (again exposed by Morrah, though strangely not picked up by the wider media for several days) to test workers at the border. Former Health Minister David Clark told the public weeks ago that border workers, including susceptible people such as bus drivers ferrying inbound airline passengers to isolation hotels, would be routinely tested. This seemed an obvious and fundamental precaution, but we now know it didn’t happen. Nearly two thirds of border workers – the people most likely to contract and spread the coronavirus in the community – were never tested. Some epidemiologists believe the Covid-19 virus was bubbling away undetected for weeks before the current resurgence.

On one level this can be dismissed as simple incompetence, but it goes far beyond that. People might be willing to excuse incompetence up to a point, but they are not so ready – and neither should they be – to forgive spin, deception and dissembling. Misinformation can’t be blithely excused as a clumsy misstep, still less as “dissonance” (to use Bloomfield’s creative English). On the contrary, if misinformation is deliberate then it raises critical issues of trust and transparency.

At a time of crisis, people are entitled to expect their leaders and officials to be truthful with them, especially when the public, in turn, is expected to play its part by making substantial social and economic sacrifices. If the government doesn’t uphold its side of this compact, it forfeits the right to demand that the public co-operate.  That’s the situation in which we now appear to find ourselves. The bond of trust that united the government and the public in the fight against Covid-19 has been frayed to a point where it’s at risk of breaking. . . 

We’ve been asked to do a lot, to trust a lot and we’ve been let down.

That the government has  drafted in Helen Clark’s former chief of staff Heather Simpson and NZTA chair Brian Roche to sort out the border  is an admission of how badly mismanaged it’s been.

Theirs is no easy task and while it won’t be one of their KPIs, helping the government win back trust will be part of it.

Good news today:

More people now to check that other people checking on those people being checked by others are actually checking and being checked.https://t.co/dUczOWjS0T

— Chris Penk (@ChrisPenknz) August 19, 2020

 

Let’s not blame the messenger

Jack Vowles thinks some in the media are overreacting in their coverage of the isolation omnishambles:

In the wake of a scattering of new cases from overseas, Stuff journalist Andrea Vance has slammed the Government for setting “allegedly unrealistic expectations” that Covid-19 would be eliminated in New Zealand. She believes the public feel they have been lied to.

Fellow Stuff journalist Tracy Watkins says the “border fiasco” has caused “incalculable damage” and “a massive breach of trust”. John Armstrong, in a column for the 1 News website, describes the situation as “calamitous”.

All are over-reacting. . . 

Social media also has plenty of posts mistakenly blaming the messengers and trying to dampen down the message too.

It must come as a shock to those who are used to a very soft approach, sometimes bordering on adulation, of Jacinda Ardern that the shine has come off her halo and her clay feet are showing.

But if the media and opposition MPs hadn’t been telling us about the omnishambles, she and her government wouldn’t have taken any action to deal with it.

The fourth estate and opposition are doing what they’re supposed to – showing us that the government has not been doing nearly as well as it should be in isolating incoming travellers to ensure Covid-19 doesn’t spread beyond those who have it when they get here.

In spite of protestations that everything is under control, there are obvious shortcomings in systems and processes:

No hold ups, oversights or obstruction. It actually takes this long – over a week – to find out how many of the 55 people granted compassionate leave weren’t tested when they should have been.

Since June 9, a negative test and at least a week in isolation were meant to be mandatory before compassionate leave from managed isolation could be granted. But that has only been the practice since June 16.

Both of those rules were bent for two Covid-infected sisters who drove from Auckland to Wellington , but who weren’t tested until after they arrived in Wellington.

The subsequent outrage was understandable, given what should have happened, the sacrifices everyone has already made, and the obvious risk of one case quickly turning into dozens.

That outrage then heightened as stories of broken protocols came forward. Mixing and mingling at isolation facilities. Testing being voluntary when it should have been compulsory. Leave for a funeral when that was meant to be banned . Even runaways .

The case of the two sisters begged the obvious question: How many others have been let out early without a test? Each of them could pose a risk of a second wave.

That question has been asked everyday – by journalists, the Opposition, even Ministers’ offices – since June 16, when the sisters’ positive results were revealed.

The answer isn’t just about giving us a better sense of the health risk. It’s also about the depth of failure that has occurred at the border, which feeds into the level of confidence in the ministry, health chief Ashley Bloomfield, the Government and the Prime Minister.

Those border measures are critical. With no signs of community transmission, the greatest Covid danger to New Zealand are the thousands of people returning home from overseas.

You’d think it would be essential to collect their information and put it all into a single database or an integrated system – contact details, symptoms, daily health check results, test results, if any.

That hasn’t happened.

Bloomfield was clear today that there hasn’t been a cock-up. It has taken so long because health officials have had to match names and dates of birth from their systems with information at isolation facilities.

Does this mean there was no proper record of who was in isolation, who was tested and when?

There was another simple way to find out that appears to have been overlooked.

All of the 55 people granted compassionate leave have been tracked down and referred for testing. Yet Bloomfield had no answer when questioned why they hadn’t been asked, when contacted: “Were you tested before you left managed isolation?”

This isn’t the first information failure for the ministry. They don’t know how many healthcare workers were infected in the workplace . Their regional public health units all used different IT systems . . . 

News of the omnishambles has led in a spike of people seeking tests for Covid-19 which isn’t surprising.

People who’ve lost trust in the government to contain Covid-19 at the border are taking responsibility for themselves. Although there is no evidence of community spread that appears to be due to good luck rather than good management, and anyone with possible symptoms will want to make sure a cold is only a cold.

It’s better to be tested as a precaution than to harbour the virus in the belief that it is no longer here and we have the media and opposition MPs to thank for giving us the information to make that call.

Contrary to what the critics are saying, they’re not overreacting, they’re simply holding the government and the ministry to account.

Level 1 must be this week should be today

Jacinda Ardern will announce that we will be moving to level 1 alert level this week.

Her choice not to deter protest marches before they happened last weekend and the admission by Director General of Health Ashley Bloomfield that protesters didn’t need to self isolate because there’s no community transmission of Covid-19 gives her and her government no choice.

That cost them the social licence to continue restricting what we can do and where and with whom we can do it.

If people can protest in their thousands the rest of us can operate businesses at capacity and have more than 100 people at weddings, funerals, worship and sporting and social events.

Many have already moved to level 1.

We flew to the North Island three weeks ago. Passengers were pretty good at maintaining distance from each other. We made the same flight last week, and passengers were far more relaxed about distancing.

We had to sign in to the farmers market yesterday but the supermarket had no queues, no-one at the door restricting entry and cleaning trolleys; and the two-metre dots to indicate social distancing spaces had gone.

The argument for keeping us at level 2 was growing weaker as day by day no new cases of Covid-19 were diagnosed. It disappeared completely with the protest marches.

We should have dropped a level at least a week ago.

The only question about today’s announcement is, when will we get most of our freedom back?

It must be this week and it should be today.

If it’s not today, the political capital the government has built up will be eroded the way its social licence for continuing constraints has been.

Why are we waiting?

The Ministry of Health’s Covid-19 website gives details of case numbers as at 9am each day.

But it’s not updated until at least 1pm.

Why are we waiting until then?

Is there a good reason, or is it only so we can have what is becoming an increasingly tiresome double act for the media from the Beehive?

In the first few days it was a good idea for the Director General of Health Ashley Bloomfield and Prime Minister Jacinda Ardern to give daily briefings, to inform, reassure the public and to answer questions from journalists.

The DG fronting each day is probably still a good idea but the daily pairing with the PM is not.

Seeing only her, highlights the absence of other Ministers. It raises questions about why they aren’t fronting and none more so than Minister, Tourism Minister Kelvin Davis is nowhere to be seen when that sector has been hardest hit by the lockdown.

The tourism sector is imploding, countless jobs are being lost, and many are left with a feeling of uncertainty. . .

What tourism businesses desperately need is a leader to articulate a message of hope. It needs Davis to proactively front the media, on a regular basis, to give an idea of what the Government is doing to save the sector. Because fronting the media gets the message out to operators, who are in the middle of making big decisions about their futures. . .

Davis, like most other Ministers is kept well away from the media.  Giving us only the daily duet is in danger of politicising the Director General because as each day goes by it looks more and more like the purpose is not so much to inform the public as to promote the PM.

Take yesterday’s announcement of what the step down to Level 2 will entail.

It could have been issued as a media release followed by the opportunity for questions from media.

Instead the PM read it out in minute detail as if to a group of young children, and ones with comprehension problems at that.

Or at least that’s what the first bit sounded like. I gave up listening after a very few minutes because I had better things to do with my time and a PM overseeing what could well turn into the worst economic depression in our history  ought to have too.

Ardern is Labour’s, and the government’s, most popular figure but these daily deliveries are in danger of turning into far too much of a good thing.

Much more of this and she’ll find more and more of her audience will be following Pooh’s example of getting into a comfortable position for not listening.

The Forest was full of gentle sounds, which all seemed to be saying to Pooh, "Don't listen to Rabbit, listen to me." So he got into a comfortable position for not listening, from time to time opening his eyes to say "Ah!" and then closing them again. ~A.A.Milne #ThursdayThoughts pic.twitter.com/I3tJ5VuYds

— A.A.Milne (@A_AMilne) May 7, 2020

The other costs

Every day at 1pm Director General of Health Ashley Bloomfield updates us on the number of confirmed and probable cases of Covid-19, the number who have recovered and those who have died.

It is impossible to count the other costs:

A leading heart failure specialist is among those concerned that lives could be lost through people failing to seek treatment during the pandemic.

And another fears that a drop in pathology testing could mean cancers and coronary disease go undetected for longer, while cancelling or postponing elective surgery could mean some patients end up in hospital in a much more serious condition. . . 

Delays in diagnosis and treatment can mean much worse outcomes for many diseases and ocnditions.

There are other unseen costs:

University of Auckland Economist Dr Ananish Chaudhuri says the immediate emotional power of people dying with the disease could lead New Zealand into an extension of the Covid-19 lockdown with dire consequences, including more deaths.

Chaudhuri, who is currently Visiting Professor of Public Policy, at Harvard Kennedy School, says people over-estimate the costs of immediate and visible dangers, which clouds judgement and calculations of the unseen costs arising from their reaction.

“Extension of the lockdown would aim to save a more certain number of lives now, for an unknown number of lives we will lose over time due to health and economic impacts.

“Unemployment is not just a number; there are human health and fatality costs. When unemployment goes up the life expectancy of those people goes down. Furthermore, there are devastating consequences for communities from high unemployment – depression, poverty, violence, falling education.

“People have tried to claim that extending the current lockdown is a choice between saving lives and losing money, but it’s not. It’s a choice between losing lives now but losing lives later – and possibly a greater number and a greater variety of otherwise healthy people later.”

Chaudhuri points to research showing that the immediate aftermath of the 911 attacks was an estimated 1500 additional deaths on the road, from people driving rather than flying. It arose because in an environment surrounded by concerns over terrorism, people judged they were more likely to die of terrorism than a traffic accident, or even of the more likely event of respiratory illness or heart attack.

“The problem is that we pay more attention to, and value higher, things happening right in front of us – but we don’t pay attention to, or value, even larger things that happen less visibly or more slowly.”

Chaudhuri says an error is being made by those who differentiate between objectives of suppression, eradication, or mitigation.

“It’s a continuum between doing nothing and doing everything – and there’s different costs along that continuum. The challenge is to correctly perceive and calculate those costs.” Chaudhuri says.

It is not a simple case of the lockdown saving lives and freeing us up endangering them.

Lives will be saved by fewer people contracting Covid-19 because of the lockdown and some will be saved by being able to get treatment that would have been denied them had hospitals been overwhelmed with Covid-19 cases. But other lives will be lost and blighted through delayed diagnosis and treatment, increases in suicide, and the emotional and financial toll of business failures and job losses.

I think it was right to go into lockdown and that, if it wasn’t done sooner, large gatherings should have been stopped earlier.

Friends who were invited to a wedding on March 21st received a message a few days earlier from the couple saying their guests health was more important than their wedding and they were postponing it.

On the advice of friends who are doctors we cancelled a 90th birthday we were to host on the 21st too.

That day the government order went out that no gatherings of more than five people should take place but that was too late for those already taking place, at least one of which has resulted in a cluster of Covid-19.

In supporting the lockdown, I acknowledge that it incurs other substantial costs including lives that will be lost. That is why I support the idea of what’s safe rather than what’s essential as the guide for which businesses can operate.

If an electrician can visit a safely house when all the fuses blow, why can’t s/he work on a new build or renovation?

If supermarkets and dairies can sell their goods safely why not bakeries, butchers and greengrocers?

If greenkeepers can work on golf courses, why can’t a lone operator mow private lawns?

The rules around a change in levels will be announced today.

To reduce the other costs of the lockdown, they must include a change from allowing only essential businesses to operate to allowing any business that can operate safely to do so.

 

 

 

Still not enough PPE

The message from the top is that New Zealand has enough personal protective equipment (PPE) for people who need it.

The message further down the chain contradicts that:

Newshub has obtained more evidence of the gulf between the Ministry of Health and nurses about what’s happening on the frontline with masks and personal protective equipment (PPE).

An audio recording between a charge nurse and staff member reveals the reality of the frustration heath workers face in their efforts to wear masks to protect themselves from coronavirus.

“If you are telling me that you are insisting on wearing a mask at work, I don’t know what to say – we are stopping other people doing that,” the nurse can be heard telling the staff member.

“We are directed that staff can’t wear masks.” . . 

These concerns are not isolated to just one hospital; a nurse at Burwood Hospital, for instance – where six of New Zealand’s nine COVID-19 deaths have occured – says staff even on the COVID-19 ward do not have adequate protection.

They’re on the frontline of the COVID-19 crisis and want to do all they can to protect themselves and their patients, but requests for masks are being blocked by their managers.  . .

A major healthcare provider says it’s struggling to get even a week’s worth of PPE:

Green Cross Health is a provider of primary health care services through pharmacies, GP clinics and home health care and community nursing.

Group chief executive Rachael Newfield said they were struggling to get PPE for their community health division.

“We undertake 60,000 personal cares, which are close contact carers looking after an individual in their home every week.

“To date, from the 20 DHBs, we have received just 30,000 masks, so that isn’t enough to last a week, if we allow our staff to feel safe and follow the latest guidance,” she said.

Newfield said the amount of PPE they could receive also differed between individual DHBs, and stocks from local suppliers were also tight.

When the message to the public is to protect ourselves why doesn’t the health service have enough PPE for all the staff who need it?

Yesterday a third of people with Covid-19 were health workers.

The number of health workers in New Zealand with Covid-19 has jumped by nearly 60 percent in just four days.

On Wednesday, 64 healthcare workers had contracted the virus but that figure had leapt to 101 by Sunday.

Of the 110 new confirmed and probable Covid-19 cases in the intervening period, 37 of them – more than a third – were health staff. . . 

Not all The health workers contracted the disease through work but that some did makes it even more important that all of them have PPE when and where they need it.

Director-General of Health Ashley Bloomfield said the situation was worrying.

“I’m concerned about any case in a healthcare worker, particularly where it happens in the workplace,” he said.

“We’ve got some information about the cases that are healthcare workers and what I’ve asked the team for particular analysis of is, of the cases that have happened in the workplace, how was it that they were infected? So was that through being part of caring for someone with Covid-19 or was it because they are part of a cluster where they may be a close contact of another staff member?” . . .

And was it because staff don’t have the PPE they need?

The incidence of disease in health workers takes the edge off the hope that comes from the decline in the number of new cases.

That downward trend will have to continue before the government decides to let us out of the level 4 lockdown and giving health workers the PPE they need will help that.

Yesterday Treasury outlined various scenarios showing  the economic impact of the lockdown:

Treasury scenarios released by the Government show unemployment could reach up to 26 percent if the coronavirus lockdown is extended beyond four weeks.

The data shows the range of scenarios Treasury has predicted for the New Zealand economy, based on assumptions of different amounts of time under the four COVID-19 alert levels.

The scenarios show that unemployment can be kept below 10 percent, and return to 5 percent next year, if the Government is willing to provide additional financial support. . .

The economic and social costs of the lockdown are already too high.

We can not afford to have it extended, especially if the extension was due to an increase in infections because health workers don’t have the PPE they need to keep themselves safe.

Confusion and disconnection undermine confidence

There’s general agreement on the need for wider testing to determine how widespread community transmission of Covid-19 is but confusion on whether it can be done:

Healthcare workers say coronavirus tests are being withheld because of limited supply, despite the prime minister’s insistence clinicians have both the resources and permission to test.

A new coronavirus testing criteria was released late on Wednesday, permitting the testing of patients with Covid-19 symptoms but no connection to overseas travel or another coronavirus case.

Prime Minister Jacinda Ardern, who announced the expansion of the criteria the day prior, again said there was ample testing capacity at a Wednesday press conference — it just hadn’t been used by clinicians.

But a Wellington GP, who spoke to Stuff on the condition of anonymity, said there were not enough testing swabs for the number of patients presenting Covid-19 symptoms. His clinic had ordered 30, but received five as the laboratory was trying to preserve supplies.  

And some swabs of patients were not run by the laboratory for failing to strictly meet the prior testing criteria.

Staff from two Wellington clinics told Stuff on Wednesday morning they had not received any information from the ministry regarding the expanding criteria, and their clinics would go ahead and test people with possible Covid-19 symptoms until further guidance was issued. 

But at a Canterbury GP clinic, a nurse said her practice had been told to continue using the former, stricter criteria in the absence of an update from the ministry. 

The nurse, who similarly spoke on the condition of anonymity, said the ministry had told clinical leaders there were not enough swabs and the labs did not have enough reagents to test everyone with symptoms.

“We are seeing many people with coronavirus symptoms who we cannot test.”

She said GPs at her practice had used their discretion – as the prime minister and director general of health Ashley Bloomfield had repeatedly recommended – and swabbed people with symptoms, only to have the labs refuse to test them.  . . 

If clinicians think people should be tested, and put them through the discomfort of the swabbing process, how can labs not test them?

In Wellington they can’t get enough swabs from the lab to do sufficient testing in General Practice. Here in Dunedin we send swabs to the lab for testing and they get declined and chucked out. There is clearly a disconnect between what the Ministry says and what the labs do. https://t.co/ZARwVXib3F

— Dr Dan (the “essential” bandage man) (@docdanz007) April 1, 2020

Either the PM is right and there are enough swabs but there’s a problem with the distribution and also with communication between the Ministry, clinicians and labs;  or the doctors and nurses are right and there aren’t enough swabs and labs aren’t testing all they’re sent.

Whoever is right, the issue must be sorted and sorted urgently.

Compliance with the draconian loss of liberty to which we’re all being subjected and the costs imposed by it requires community buy-in, and that requires confidence in what’s being done and how it’s being done.

These mixed messages over testing undermine confidence.

It doesn’t help when the Minister of Health drives 2km to go mountain biking when the police have told us we have to exercise close to home, not drive then exercise.

And the disconnection between key agencies doesn’t help either:

Today’s meeting of the Epidemic Response Committee has shown how disconnected the three key agencies, Health, Customs and Police, are in enforcing the self-isolation of New Zealanders and shows why a quarantine is needed immediately, Leader of the Opposition Simon Bridges says.

“The Director-General of Health has been clear that all returning New Zealanders should be visited by a Police Officer within the first three days of them returning home.

“Today outgoing Police Commissioner Mike Bush admitted while they would like to visit all returning New Zealanders, they’ve failed to do so, confirming officers have been unable to visit all of the more than 4000 people who’ve come back to New Zealand within three days.

Police would like to visit all returnees but have failed to do so. That doesn’t inspire confidence that the lockdown will work.

“Following that admission, Customs Minister Jenny Salesa was asked about how Customs saw self-isolation being enforced, and she said Police were not expected to check up on all returning New Zealanders, instead they could do spot checks. That isn’t good enough.

“There shouldn’t be this much confusion. These agencies need to be a cohesive team. Instead New Zealanders are just seeing more and more mixed messages.

“It is clear from today’s questioning that New Zealand needs an enforced quarantine for those entering New Zealand at the border. For weeks our borders have been porous, with no thermal testing being undertaken and the self-isolation of New Zealanders not being policed well enough. That has to stop.

“Effective quarantining has been the foundation of other countries’ successful responses. Here in New Zealand we’ve been waving people through and trusting them to self-isolate.

“Today’s questioning has raised serious concerns about how well this lockdown is being policed and shows exactly why we need to be quarantining at the border. New Zealanders are sacrificing a lot right now, the key agencies involved in the response need to ensure they aren’t leaving the barn door wide open.”

Never before have New Zealanders been asked to give up so much and at such a horrific economic and social cost.

The government and its agencies can’t expect us to do all we can to comply if they aren’t demonstrating they are doing everything they can, and should, be doing to ensure the lockdown achieves its aim of eliminating COvid-19.