Analysis: What should NZ's new Covid-19 rules look like? – New Zealand Herald

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During a visit to the University of Auckland PM Jacinda Ardern said that the Covid traffic light system will be reviewed, and potentially scrapped in the next "couple of weeks". Video / NZ Herald
Experts are urging the Government to keep core Covid-19 measures in place, warning that calls made today could shape the health of Kiwis over decades to come.
After nearly 150 days under the orange setting,
Covid-19 Response Minister Ayesha Verrall wouldn’t detail what was on the table ahead of the next Cabinet decision, but the Government appears to have signalled mask mandates may be dropped in all but the most high-risk health settings.
Most of New Zealand’s restrictions have gradually been lifted.
Vaccine mandates remain only for certain health and disability roles; masks are required on domestic flights, public transport and in public facilities and retail businesses, but not in cafes, bars and restaurants.
While a seven-day isolation period remains in place for infected people and their household contacts, quarantine-free travel into the country is now open to everyone – provided they’re vaccinated and take two rapid antigen tests (RATs) on arrival.
Last week, Prime Minister Jacinda Ardern told media the review would look at whether all settings – not just those within the traffic light framework – were fit for purpose.
National’s Covid-19 spokesperson Chris Bishop called for the traffic light system to be scrapped altogether.
His party also wanted mandatory masking retained only in high-risk healthcare settings, vaccine mandates for health workers to be ditched, and the isolation period shortened to five days, with a test-to-release option for household contacts.
Act leader David Seymour preferred going further and ending all Covid-19 restrictions, instead leaving it to companies and individuals to take their own actions.
But experts have urged against completely abandoning our last lines of defence – masks and home isolation – stressing the virus hasn’t gone anywhere.
“Even with more people having now been exposed… and with the emergence of the Omicron variant and subvariants, reinfections are increasing in a way not seen with earlier variants,” Otago University immunologist Associate Professor Dianne Sika-Paotonu said.
“The actual Covid-19 community case figures are still likely much higher than those being reported currently, with Covid-19 related deaths continuing to be reported each day.”
Experts agreed, however, it was time to consider whether the traffic light system – initially designed to promote vaccination during the Delta outbreak, and introduced before Omicron washed over the population – was still practical.
“It’s got so clunky and has such poor coverage of interventions that it’s not really helping us so much anymore,” Otago University epidemiologist Professor Michael Baker said.
Instead, Baker saw it possible to create a fresh, enduring framework that was “simple, understandable and meaningful”.
This upgraded system needed to work in periods of declining rates, he said, “which we are seeing now, but also when rates are rising, which will happen if we get more waves of Covid-19 infection, which is likely”.
“At the very least, we need a system that is more nuanced, potentially with a couple of graduations in each of the orange, green and red levels.”
Fellow Otago epidemiologist Dr Amanda Kvalsvig added: “If it’s well-designed, a single system can protect New Zealand from the Covid-19 variants that we know about, as well as future Covid-19 variants and the other infectious disease outbreaks that are in our future.
“As cases come down from the high earlier levels, we have some breathing space to prepare.”
They saw ongoing potential for mandated masking in schools, colleges, indoor facilities and healthcare settings – but not necessarily in airy, properly-ventilated spaces like shopping malls.
“Once the prevalence of infection gets down to a low level, then I think it’d be reasonable to remove mask mandates in some indoor environments – particularly ones where not much transmission is probably happening anyway,” Baker said.
The risk was very different in places where older and more vulnerable people were living, where people were more likely to be infected, or in contained, crowded and close contact conditions.
“Public transport is an obvious example,” he said.
“Masking in the green level, for the foreseeable future, should at least be in health and aged care facilities.”
University of Auckland epidemiologist Professor Rod Jackson agreed the Government should consider keeping up masking in schools, which he described as a hot-spot for super-spreading.
“Another important thing is getting our kids vaccinated, and boosting as many people who are eligible,” Jackson said.
“We don’t know what the next variant is going to look like, so we need to have our immune system as primed as possible.”
As for home isolation, Baker certainly didn’t want to see New Zealand follow the UK and completely remove the legal requirement.
“As the prevalence of the virus is dropping, far fewer people now need to isolate – but that doesn’t mean that isolation is any less important.”
Baker favoured a smarter approach, such as one just put forward by researchers from Covid-19 Modelling Aotearoa.
They found shortening the isolation period to five days, but requiring two negative RAT results to leave home, could cut the number of infectious cases being released by 40 per cent – while also slashing by 20 per cent the extra hours people spent isolating when no longer infectious.
Study leader Dr Emily Harvey said it would be good to see the Government adopt the test-to-exit approach – particularly as relaxed rules led to there being more infected people out and about.
That approach was also used in countries like the US and Singapore, but Harvey added that background measures, like mask use, would remain important in keeping people safer.
Her colleague Professor Michael Plank said that, with a peak of the winter wave behind us, he wouldn’t be surprised if the Government moved further away from legal requirements.
“But, even if it’s not a legal requirement, it would be good to at least see guidance making clear that RATs are a good way to get a good read on whether you’re infectious, and for people to take appropriate precautions.”
Kvalsvig said policy-makers now had plenty of good evidence on Covid-19 to chart a way forward, but saw indoor air quality as paramount.
“This is our ticket through and out of the pandemic because so many infectious diseases including Covid-19 are transmitted through the air,” she said.
“All New Zealanders, regardless of their disability or health status, should be able to access education, work and social settings with confidence that there’s a low risk of becoming ill.
“Measures to keep people safe include optimising ventilation and wearing high-quality respirator masks in situations where ventilation alone won’t be enough to reduce the risk.”
Kvalsvig said there was “no justification” for asking Kiwis to risk their health at work or school.
“At the same time New Zealanders need to know that if they’re unwell, they can stay at home and recover without consequences for their income or education.”
University of Auckland infectious disease expert Associate Professor Siouxsie Wiles said that, being between waves, New Zealand had a “window of opportunity” to make indoor spaces safer.
“Given we’re now living with this long-term, how do we make sure we can get through future waves with the fewest number of infections and the least amount of disruption to our lives?”
Wiles said masks in indoor spaces like pharmacies, shops, healthcare and aged care facilities should remain important protections, as should home isolation and testing.
“If people want to see the end of mask-wearing then we need to replace masks with other public health measures that will protect us,” she said.
“Two important measures immediately spring to mind: improving ventilation and air purification, and publicly reporting on air quality so people can see if a space is safe for them to be in, and making better use of rapid antigen tests.”
Wiles similarly saw a need for more support for people isolating, and better guidance on how to test.
Across the Tasman, Melbourne-based Kiwi epidemiologist Professor Tony Blakely said there appeared to be a “strong political and societal desire to get back to normal”.
That was reflected in Australia’s recent moves to shorten the isolation time to five days, subject to people no longer being symptomatic, and an end to mandatory masks on flights.
Blakely wouldn’t say whether he agreed with those changes, but thought it important to have health measures that were “proportionate” to risks and public acceptance – and which could be changed when the situation did.
“You’re trying to find that balance of proportion and dealing with trade-offs.”
With the virus infecting and killing people each week – and putting Kiwis at risk of Long Covid’s wide range of debilitating symptoms – Wiles however cautioned people against shifting to a back-to-normal mindset.
“What people need to realise is that the world we lived in back in 2019 doesn’t exist anymore,” she said.
“It has a new virus in it. One that unfortunately spreads through the air – and one that can cause devastating impacts on people’s bodies.”
Kvalsvig said scientists and survivors were describing impacts on brain function, small blood vessels – which led to increased risk of heart attack and strokes – and a variety of other impairments.
“This situation is dreadful for individuals, but it’s also highly disruptive for a functioning society.”
She saw the current phase of the pandemic as “challenging”, with new variants arising – and next-generation vaccines capable of providing long-lasting protection yet to emerge.
“They will come, but New Zealand’s post-pandemic stability may depend on how the Government manages this phase over the next six to 12 months,” Kvalsvig said.
“There is a lot riding on the decisions that are being made right now in terms of population health over the next decades.”
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