Elimination is futile

New Zealanders became complacent, even a little arrogant, about the country's Covid-19 status. We managed to keep the disease at bay for more than a year since our last strict lockdown in March and April 2020. We had a couple of more localised and less severe lockdowns in Auckland and a recent one in Wellington, but those were short-lived and we almost forgot that this disease could return. Even when Australia had new outbreaks, we thought the impact on New Zealand would be limited to closing the border rather than being a sign of worse to come. That was until last week when the Ardern Government abruptly announced, on the basis of a single confirmed community case in Auckland, the highest level of lockdown for the entire country. The response seems justified in hindsight with more than 100 community cases now confirmed including some in Wellington.

Most of the rest of the world accepted a long time ago that an elimination strategy was futile and that some level of transmission in the community was not only manageable but would ultimately contribute to herd immunity. New Zealand and Australia thought differently and imagined that their geography could protect them. In the short term, the strategy was successful - both countries achieved zero community transmissions for a while, but at a cost of turning our countries into hermit kingdoms, which don't allow travellers from overseas unless they go through two weeks of confinement in an hotel room.

Most Covid-19 experts believe the disease will become endemic - in other words, it will never be completely eliminated. Thinking of this disease like smallpox, which the world has eliminated, is wrong - you need to think of it like the common cold, which is a coronavirus in many of its variants, or the more deadly influenza. We accept that these diseases are endemic and we are sceptical about claims of eliminating them. So why do we delude ourselves about eliminating the very similar Covid-19?

The more reasonable argument for locking down is that we are doing it until the population achieves herd immunity through vaccination. Unfortunately, the latest news from Israel, which vaccinated most of its population before anyone else, is that infections are now increasing amongst the vaccinated. This may be because the effect of the vaccines wanes over time or due to the more virulent strains such as the "delta" variant, but whatever the reason, we have to accept that for now vaccination isn't a reliable pathway to elimination.

If we are determined to lock down every time we have an outbreak, no matter how small, and we know that the disease cannot be eliminated, that means we will be locking down intermittently for the rest of our lives. Is this really what we want?

Let us not delude ourselves - locking down is a massive and unprecedented infringement of civil liberties. We are all effectively under house arrest. Never before have governments locked down entire populations including healthy people to combat a disease - not for the Black Death, the 1918 Influenza, the polio epidemics of the early 20th Century, or for SARS (Covid-1) in 2002. And notwithstanding how our prime minister presents it, this is not a we're-all-in-this-together, voluntary exercise - the lockdowns are being enforced by the agents of the state with draconian powers and brutal tactics.

I accept that restrictions on social interaction are necessary to combat epidemics, particularly those like Covid-19 that are highly infectious and transmissible while non-symptomatic. However, like all risk mitigations, there has to be a balancing of benefits against costs and a rational consideration of the alternatives. We cannot continue to lock down for the rest of our lives. As I wrote last year when we were in lockdown, it will destroy our economy, our "social cohesion" (to use a phrase our Government seems to be very fond of) and paradoxically our health (through delays and cancellations in treatments of other illnesses), at a cost that far exceeds the that of Covid-19 infections.

Sooner or later we have to have the courage to accept that elimination of Covid-19 is futile and that we can tolerate a level of transmission without the knee-jerk reaction of national lockdowns. The only question is when we will be prepared to accept that. If the Ardern Government had been more competent in negotiating the supply of vaccines and we had been at the front of the queue as they promised rather than the worst in the OECD for vaccination rates, then we might be in a stronger position to accept the ongoing risk of exposure to Covid-19. Add to that the fact that after eighteen months we still don't have a quarantine system that can reliably keep infected people entering New Zealand from infecting the wider community, and we have to conclude that if lockdown is really the only option still available to us, then Jacinda Ardern and her ministers are to blame.

Note: As I was writing this, I saw that Rodney Hide has published on his blog a rough cost-benefit analysis of lockdowns. He concludes that lockdowns are not worth two days of lost economic activity. While I think his analysis is overly simplistic, he's probably got the ratio about right.