NZ coronavirus lockdown – Expert Reaction

The country will move to the highest COVID-19 alert level on Wednesday.

With 36 new coronavirus cases confirmed today, and two previous cases being treated as community transmission, the Prime Minister has announced an immediate rise to COVID-19 Alert Level 3 – Restrict.

Within 48 hours of the announcement, the country will move to Alert Level 4 – Eliminate for four weeks. Schools will close, air travel and public transport will only be for those who work in essential services, and non-essential businesses must immediately close.

The SMC asked experts to comment on the news.

Professor Philip Hill, McAuley Professor of International Health, University of Otago, comments:

“I support strongly the encouragement of the Prime Minister for people to go outside within the rules.

“This is because the amount of time people are close to each other inside households increases their chances of transmitting all infectious diseases to each other.”

No conflict of interest declared.

Professor Shaun Hendy, University of Auckland, comments:

“This is a good decision. It now seems likely that COVID-19 community transmission has been taking place in New Zealand with two cases now unable to be linked to overseas travel. By going to Alert Level 3 and then 4, we should be able to significantly reduce person to person contacts over the next few weeks and slow the spread down. This will give the testing regime and our Ministry of Health contact tracing teams a good chance of containing and stamping out the disease. By moving early, we have a chance of minimising the length of time we spend at Level 4.

“It is important now that people take this seriously and follow the government’s advice. Prepare but don’t panic. Minimise unnecessary contact with others and try to head to the supermarket just once a week. Avoiding catching it yourself is the best way you can protect the vulnerable people in our community.

“We will likely see the number of detected cases continue to rise over the next few weeks, but once they begin to fall the government will be able to consider dropping the Alert Levels. We may also see Alert Levels drop in some parts of the country if the government becomes confident that we are not seeing community transmission there and can restrict travel sufficiently from regions at higher levels.

“I am very impressed that the government has managed this in a stepped manner despite intense pressure from many commentators. If we had gone to Alert Level 4 on Saturday, I suspect we would have seen scenes at our supermarkets like those we have become familiar with from overseas: long queues, crowded supermarkets, and empty shelves. Hopefully, the government has given people a chance to prepare for what might be a long struggle with the disease.”

No conflict of interest declared.

Dr Dougal Sutherland, Clinical Psychologist, Victoria University of Wellington, comments:.

“It’s important to consider the broader psycho-social impact of school closure plans on children.

“When schools send students home and have them work remotely the accompanying sense of isolation and loss of social contact could lead to increased levels of loneliness for some young people, and even triggering of depression for others.

“Being isolated from peers and lacking the support of teachers could lead to elevated levels of anxiety for some kids and teens as their fears run wild without the calm rationale of adults around them. This anxiety could be made worse by loss of the daily structure that comes with regular classes and timetables. Daily routines and structures help provide a sense of predictability and stability and without these life becomes less certain.

“On the other side of the coin, loss of structure and supervision could lead to increased levels of antisocial behaviour and delinquency for some youth. Bored teens with lots of unstructured and unsupervised time on their hands doesn’t necessarily lead to good outcomes.

“For students who have specific learning needs or are neurodivergent the inability to have more individualised support from teachers could negatively impact their learning and engagement with school. These students often find self motivation and staying on task, traits which are in high demand when working at home, much more difficult than neurotypical kids.

“These possible consequences highlight how crucial schools and teachers are, not only for education, but for a child’s broader social and psychological development. Of course, the Government would only introduce such measures if public health needs demand it, but these measures could have hidden costs.

“There are measures that schools can take to reduce the potential for psychosocial disruption. Instigating and enforcing regular work timetables and routines may help with structure and containment of anxiety.

“Regular checking-in with students may help keep them stay connected and be supervised. Where possible, using virtual teaching platforms that have visual and audio connections can help maintain a sense of community and reduce the sense of isolation. Most young people need few reminders to use social media, but schools can support this by reminding students about the importance of social contact and keeping well.”

No conflict of interest declared.

Dr Sarb Johal, psychologist, comments:

“We are Alert Level 3 for Covid-19. We will be at Level 4 in 48 hours. And we will stay at Level 4 for at least four weeks. I commend and fully support this decision. We have a window to make a difference in managing the transmission of this virus. It is not going to be easy. Everyone will need to play their part.

“The decision taken by Cabinet today is extraordinary but it provides a level of certainty. And with certainty comes the ability to focus and prepare.

“For many, this will bring up feelings of anxiety and perhaps worry about the future too. Changes often do, especially when they are as momentous as these. So, remember, we are not alone. New Zealanders should know that they can reach out – support will be rapidly scaled up to make sure that we can address isolation and lack of contact. It won’t be perfect, but we will get there.

“And if people around you need to go for testing, please be kind. Be empathetic. Wash your hands, stay physically distant, start ramping up your plans to stay socially connected, and make sure you schedule things you enjoy doing. It sounds like a strange thing to say, but when people are stressed and anxious, they often forget to do the things that they know will make them feel better.”

No conflict of interest declared.

Associate Professor Arindam Basu, College of Education, Health & Human Development, University of Canterbury, comments:

“The government has moved as soon as they sensed community transmission. This has shifted the picture, as it signals that the spread of infection is no longer dependent on ‘imported infections/cases’, but instead human-to-human transmission within the country from anyone who may have been exposed.

“This also indicates no one knows for sure when that transition happened and a large pool of actual cases already exist that will continue to grow over the next few days to weeks using a pattern of spread referred to as ‘exponential’ spread. Actual new cases today are roughly four times the number of true cases 10 days ago, but we do not get to see this number as we can test only so many people who will meet test criteria.

“Once the lockdown is in place – and as the PM repeatedly stressed, we must strictly comply with the Ministry of Health instructions – the actual number of cases will start dropping (this would otherwise have taken a long time in the absence of these measures). But that drop will not be captured in the reported positive counts because of the test limitations; they may still show as if the positive cases are going up, but eventually the ‘reported’ cases will drop as long as we are strict with the procedures (hand hygiene, isolation, quarantine). We have to be patient. That time difference might be four weeks, but it can be shorter or longer based on how well we comply and how assiduously the case and contact finding proceed.

“So there is a case to be patient and optimistic, and not to panic at all.”

No conflict of interest declared.

Professor David Hayman, Professor of Infectious Disease Ecology, Massey University School of Veterinary Science, comments:

“Community transmission is a technical term that means that cases cannot be connected. It doesn’t mean that the transmission didn’t happen in New Zealand, but it means it cannot be traced back to the source and here – in the case of COVID-19 – back to travel. In theory, there could be lots of transmission within a community of people, but if they can all be traced to each other that wouldn’t be classed as community transmission. This is why there is some confusion.

“This means that there are likely people infected who have infected others who are not yet identified. This is a concern because it is not now known how much transmission is happening and where it is. With this coronavirus infection that could lead to exponentially increasing numbers of cases. As we have seen, the Government has now increased the restrictions on people to prevent this happening further because of this.

“Infectious diseases by definition must be transmitted from one person to another. The strict measures will limit human contact and so this quite simply means that those infected already cannot then go on to infected others in the community. The infection chain ends there. No one else is infected. This means, if done properly, New Zealand can contain the infection present in the country.

“It is tough and it will be tough. I understand people will be anxious. But this is an essential step to stop people dying in the future. It will hugely disrupt people’s lives and for some it really might lead to significant anxiety. But if we look at other countries that have not acted fast enough the trauma and anxiety will only be more.

“I hope that everyone looks out for each other, because I am acutely aware that some people’s home lives may also cause them to suffer. I hope those most vulnerable in our communities are protected and safe and know where to go and what to do if they are not. But with these actions the length of suffering may be shortened for everyone and save lives, so please think of following the Alert level guidelines as doing an essential service for those around you.”

No conflict of interest.

Dr Rhys Jones, Senior Lecturer, Te Kupenga Hauora Māori, University of Auckland, comments:

“It’s positive that the government is taking decisive action – it’s critical that we do everything possible to eradicate the virus, as we know Māori communities will be most seriously affected. There is a lot of concern in the community about how COVID-19 will affect our kaumātua, as well as many others at high risk due to diseases like heart disease, diabetes, respiratory conditions and cancer.

“It’s also good that there is some warning before we move to Level 4, as it allows people time to prepare. This is important for Māori communities who would face particular challenges having to go straight into full isolation.

“There are huge social and economic inequities as a result of colonisation and racism that has resulted in differential access to society’s goods and services. These are likely to be exacerbated as a result of the lockdown, for a number of reasons.

“Many Māori whānau live in multigenerational households, so if anyone in the whānau is infected with the virus they are more likely to spread it to people at high risk of serious complications.

“The lockdown will cause severe economic hardship, particularly for Māori in precarious employment, who face losing income for a significant period. Māori small business owners will be doing it extremely tough. If services like WINZ are less accessible, people on benefits could face serious consequences. That’s why it’s critical that all essential services from WINZ and other agencies are available over the phone, and any barriers to accessing benefits and emergency payments must be removed.

“That raises another inequity – reliance on doing transactions like this over the phone, or online, will bring into focus inequities in access to mobile phones and adequate internet access. There needs to be a strong push for phones and mobile plans (including data) to be provided to the most vulnerable whānau. One example of this is that GP consultations will be moving to phone or online. Māori patients who don’t have a phone or don’t have credit to pay for calls or data could be seriously compromised in terms of access to health care. And we know that Māori already face significant barriers to accessing health care.

“Māori, with a younger population on average than non-Māori and greater socioeconomic deprivation, are likely to be disproportionately impacted by having to take time off work to look after school-age children. Māori whānau are likely to be less able to manage for a long time without access to services. Essential services will remain open, but Māori whānau will still have less resilience to be able to get by due to underlying social and economic inequities.

“These are just some examples of ways in which Māori are likely to be disproportionately affected. So there clearly need to be specific actions and resources directed at addressing these issues to avoid what we’ve seen in previous pandemics, with Māori being hardest hit.

“What we’ve seen so far from the government has largely been a one-size-fits-all approach. That means that the science and evidence informing the pandemic response is translated into actions that work for ‘middle NZ’. Those things are not always going to work for Māori communities.

“There was a support package for Māori health and business announced by the government at the weekend, which is clearly helpful, but that won’t be enough on its own. For example, there needs to be more funding for Whānau Ora services, and for Māori health providers who are really struggling to get adequate supplies of essential medical equipment and technology for setting up remote consultations.

“There also needs to be more support for whānau, hapū and iwi who are mobilising in response to the pandemic. They will be incredibly important in supporting vulnerable whānau during this lockdown period, but they will need financial support and provision of appropriate information and resources to be able to adequately look after their communities.

“All these factors highlight the need for a partnership approach between the government and Māori. There needs to be Māori co-leadership and participation at all levels of decision making. Equity needs to be central in every decision regarding the COVID-19 pandemic.

No conflict of interest declared.