New Zealand eliminates Covid-19 | Hacker News Reader

New Zealand eliminates Covid-19

thelancet.com

119 pointseverybodyknows118 comments

As a New Zealander my opinion on the government changed for the better after the pandemic. They listened to health professionals and implemented their advice. Far too many governments have industry in their ear overriding anything else. In a twist of irony, our economy is going to pick up faster than other countries as a result.

As your cousin across the ditch, I feel similarly about our government. People prepared for the worst, and their preparation seems to have so far prevented the worst.

I hope Australia can follow you eventually, or at least keep things at a low level

Australia did so well, a low level lockdown compared to us but acted earlier. You should be proud. You will get down to our level soon enough.

> We will still see cases…but only cases in people who have arrived from overseas.” Travellers from abroad will be quarantined as part of efforts to prevent transmission in New Zealand.

> As New Zealand now eases its restrictions and its economy slowly reopens, there are discussions about how it can open up its borders while ensuring that everyone is protected

What's the end-game here, assuming the disease goes endemic in the rest of the world (as seems likely)

If they're truly serious about this long term I guess a drastic shift away from the tourism industry which happens to be gigantic in New Zealand.

It's honestly difficult to see how this is sustainable.

It doesn't have to be incredibly sustainable. It only has to hold up until there's a treatment or a vaccine available. Since there's not really any tourism happening for a while anyway, NZ will be relatively fine for a long time with this strategy.

It's 5.8% of GDP, 20.4% of exports. [0]

That's a large figure, but it's not as if New Zealand lacks any kind of other industry. There's a massive primary industries (dairy, meat, logging, wine, plus others) where the country hasn't yet fully exploited it's opportunities yet for secondary value-add processing.

As a completely anecdotal observation, most tourists go to the South Island, where roughly a fifth of the population lives. The North Island is four times as densely populated. This disparity sometimes leads people to believe that country is entirely dependant on tourism, with a few sheep thrown in.

[0] https://tia.org.nz/about-the-industry/quick-facts-and-figure...

I'd imagine a big issue would be dealing with shipping and business travel, besides having to write off 6% of your GDP. The disease spreads so rapidly, one case of a dock yard worker coming into close contact with a crew member, or a surface they touched, and commutes by bus each day, and you lock down your whole country again.

> with a few sheep thrown in.

It's a lot more nuanced than that, they're fluffy and warm on those cold winter nights

>That's a large figure, but it's not as if New Zealand lacks any kind of other industry

It's also 15% of employment though, which isn't surprising because there's a lot of low wage service work done in that sector, it employs a huge chunk of the population.

For reference, both in terms of GDP contribution and employment that is larger than the contribution of the entire automotive industry to Germany.

And being German and seeing how people are starting to get worried about the economy, I can't see this working long term politically.

If you tell people in the tourism industry they now need to become dairy farmers at the other end of the country I think you'll be surprised how quickly the country opens up again.

One of our larger markets is Australia, so we're looking at establishing a trans-Tasman "bubble", when they get it under control too. Other countries would be added based on their status - Taiwan has been mentioned.

But who knows, we could see a large upsurge in domestic tourism given our lack of foreign travel options - although that would require some pain in our tourism industry, as prices tend to be considered excessive by Kiwis.

In 2018 domestic tourism was $23B, international $17B (excluding airfares). So we were already more than half domestic. Since international travel is severely restricted now, expect domestic tourism to increase. Australia was more than half of our inbound international tourism, and there's a good chance we'll be able to resume that. So the tourism industry will suffer but it need not collapse.

New Zealand has vast natural resources and a very small population. They will be fine without tourism. Of course it will have an impact... you'll see more people on old Androids than iPhone 11 but they will be fine.

Hmm, mainly water and soil tbh. We're not exactly flush with mineral deposits - a few gold mines here and there, but most of our coal deposits are low quality lignite, and our current government has already signalled where we're heading by banning new offshore oil/gas permits.

That said, we have a strong software development scene, and I'd like to see that grow more.

By natural resources I meant agricultural productivity.

If there ends up being a NZ-AU bubble, as is being talked about, that is likely to allow some tourism. That might grow to include other Asia Pacific counties with good virus stats.

New Zealanders will be able to patronize their own tourist industry, as a start. Then there is talk of allowing travel between Australia and New Zealand, because Australia also has low case numbers. Other countries also are getting to low case numbers, so those could also be added to the list in time.

Maybe even tourists "from anywhere" could be allowed to visit if they just agree to isolate upon entry for N days first. Private hotels and resorts could offer isolation packages. For many tourists, travelling to New Zealand is already expensive so they usually come for longer because it's a once-in-a-lifetime trip... adding N days of isolation to the start of the trip might not be so bad, especially if there are good deals to be had.

For me, the biggest question is whether visitors will be able to get travel / health insurance to cover them in New Zealand. I suppose the New Zealand government could sell such insurance, or they could back a private insurer.

Years ago I used to spend time in NZ when I was part of the US Antarctic program which stages out of Christchurch. In the late 90's when I was going down there, one of the airlines had my favorite promotion ever: for NZ$99 (about USD$59) they would give you a round trip ticket to somewhere. You'd find out where you were going after you bought the ticket, and they'd guarantee it was a same day round trip. I always thought what an incredibly fun and cheap way to spend the day in a beautiful country.

"For me, the biggest question is whether visitors will be able to get travel / health insurance to cover them in New Zealand."

Or the NZ healthcare system could just cover visitors with the understanding that the benefit outweighs the cost?

It needs to be sustainable until there is either a vaccine or a cure, which is not going to take forever.

Have a normal life within the country, and possibly also a trans-tasman bubble including Australia and perhaps the Pacific Islands, assuming they can keep it under control too. Anyone not coming from those areas has mandatory 2 week managed quarantine. Then wait for a vaccine.

Australia, China, and quite a few other countries will probably be in the "eliminated" group.

> What's the end-game here, assuming the disease goes endemic in the rest of the world (as seems likely)

Test and trace. With cases near zero, it's very feasible to test every inbound flight (or require test results from the passengers) and every potential contact of every new case. When the likelihood of an infected person going undetected goes down far enough, R0 goes from >1 to <1 and outbreaks shrink over time instead of spreading.

This works. It's not cheap, but it's a lot better than trying to ration hospital resources in a pandemic outbreak.

I would say, they should test irrespective of whether the traveller had tested negative in their home country.

There can be difference in testing kits quality or perhaps just a false negative.

Only if those tests aren't more valuably deployed for some other purpose. Nothing in epidemic control is about perfection. You'll never be able to catch every single transmission. The goal is to reduce the average rate of transmission among the whole population, such that the average number of people infected by one new case (the "R0" number that keeps getting thrown around) goes below one. Once you do that, you win.

I won't go endemic in the rest of the world because countries with competent governments are going to eliminate covid19. Leaving the US and couple of other fucked up countries as pariahs.

An unfortunate headline, considering that we have yet to eliminate Covid-19 in New Zealand, as the article itself discusses.

I didn't see the article as disagreeing with the headline. I thought the headline was using "eliminated" in the epidemiological sense: "Elimination to everyone means that it is gone. But in epidemiological terms, it means bringing cases down to zero or near zero in a geographical location."

I see what you're saying but HN is not a community of epidemiologists so I'd also say the headline is misleading and hence, inappropriate.

Although it's generally considered bad form to alter headlines in HN, and the Lancet is a medical journal.

Again, I see what you're saying. However, isn't it bad form because it may alter the meaning and hence, mislead? Then why would the converse - leaving it alone and hence, mislead - also not be bad form?

The link and (HN) title are presented to the HN readership, if it is followed then the article's own title will be presented in the correct context.

Regardless, this is a minor point and I'll quibble no further.

I can appreciate that, there’s just been enough confusion around the meaning of elimination that I feel a lot of people will just assume we’re done with it.

I don’t think the headline should be changed unless the article title changes, more just that if their goal is science communication I think they’ve done a poor job of it.

“New Zealand on the cusp of Covid-19 Elimination” might be a better term.

Also, our government hasn’t specified what threshold would be considered elimination so the latter part of that definition isn’t super helpful.

This is highly misleading for a disease that can exponentially explode from a handful of cases to a national emergency within a span of a few weeks.

New Zealand is as close to "contained" as is possible to get without a vaccine. Pop the cork, for goodness sake. There's not a lot of good news to go around.

Yes we have cause to celebrate, but as we approach another lowered level of lockdown it’s important to remember that we are still battling this virus.

If the numbers ramp up again because people don’t take the precautions seriously then we won’t be celebrating anymore.

Today's numbers if anyone cares

https://www.reddit.com/r/newzealand/comments/gfjby8/coronavi...

A few days ago Taiwan reached no new cases for 14 days. They're still banned from the WHO, though.

One wonders what will happen next? Will people need to quarantine for 21 days upon entry?

I thought Taiwan already did this? Or do you mean if they open borders with NZ, would they still need to quarantine before they can go explore Taiwan?

Taiwan is actually at 26 days of no local cases as of today.

To your quarantine question, we currently only allow citizens to fly into Taiwan and those visitors have a mandated and tracked quarantine for them and anyone in the private home they are staying. If they have symptoms or do not have a private home they can quarantine, there are quarantine hotels they can wait out their 14 days. Anyone in quarantine is given a daily stipend.

Worth noting, while Taiwan is an island, it has a population density as high as 10,000 per square/KM in some areas. Taiwan had no business, school campus or public transportation shut downs. Strictly masks, hand washing, temperature checks, and social distancing.

New Zealand didn't go into full lockdown until 26 March.

An estimated 80,000-100,000 people attended the Newtown street fair on 8 March - https://www.stuff.co.nz/dominion-post/news/wellington/120103....

For other countries a date like 26 March was, or would have been, way too late.

For context, on 8th March (the date of the Newtown festival) there had been a cumulative 224 tests undertaken and only 5 positive results, all of which were linked to recent overseas travel. [1]

Through what seems to be sheer luck, NZ managed to avoid importing any cases from China during the "first wave", and it wasn't until the outbreaks took hold in Iran, Italy, and New York that we began to see our first imported cases -- starting with our first case on February 28th, where the source of infection was Iran. (It's important to note that by the time the first case was detected, nearly 200 tests had already been performed -- all were negative.)

However the number of cases arriving from overseas began to ramp up incredibly fast in the following two weeks, during which time a series of increasingly severe border restrictions were introduced starting on the 16th of March, and finally culminating in the full Level 4 lockdown starting on the 26th. At the announcement of the lockdown (on the 23th) New Zealand had a total of just 102 cases [2].

[1] https://www.health.govt.nz/news-media/media-releases/covid-1... [2] https://www.health.govt.nz/news-media/media-releases/36-new-...

For comparison, New York stay at home order went live on March 22 when they had 7000 cases while for New Zealand it was 500 cases on march 28 when the order went into effect.

It's important to note that the term "eliminated" does not mean that we have no cases of Covid-19. The govt uses terms like "eliminated" and "eradicated" to mean different things with subtle differences, so they can be used to measure progress. From the article (in case you didn't read) "Elimination to everyone means that it is gone. But in epidemiological terms, it means bringing cases down to zero or near zero in a geographical location"

The best analogy I've found is that "elimination" is like retirement. It is a stage rather than a point in time.

Detailed stats on coronavirus in NZ available here: https://www.health.govt.nz/our-work/diseases-and-conditions/...

People seem to forget that in this area of the world, the yearly season for corona viruses starts in June... Same for Australia.

So unless they can maintain this type of lockdown for the next 6 months, they will see a resurgence, just as they see every year corona viruses spread starting in June.

A lot probably has to do with temperature and general climate.

I ironically think that Europe and US east coast may be in the best position, they went through hell and some of their areas are probably very close to herd immunity.

> So unless they can maintain this type of lockdown for the next 6 months, they will see a resurgence, just as they see every year corona viruses spread starting in June.

The difference is, is that most corona viruses are present all year round, and in significant numbers.

Provided the border remains secure (easy enough on a remote island with only a few international airports), and the existing cases are allowed to burn out, with effectively zero cases remaining by the time we reach "normal", I don't see a resurgence over winter as being that likely.

As a bonus, due to lock down, our influenza numbers are also hugely down as compared to most years. Whilst this absolutely won't be eliminated, I do expect numbers through out winter to remain lower than normal because of the severe reduction in numbers at the start of winter.

It's so alien in these times to see a functioning government that's working to better its society.

I wonder if they (or similar places) will decide to open tourism if they can test everyone coming in and out.

Don't think so. Testing on entry doesn't really help because the tourist could be incubating the virus. We have to quarantine and not many tourists want to spend the first two weeks of their holiday locked in a hotel room.

In the medium term the main hope for tourism is a) domestic and b) Australia also achieving elimination and opening our border to them.

There might also be some creative options to explore. E.g. let people pay big $$$ to be whisked away to an isolated luxury lodge (government approved!) for the first two weeks of their holiday.

Huh, with enough testing kits (and 2 day turnaround time on them?), why not test every arriving tourist, and quarantine them for 2 days until their test returns negative. Of course there's a danger that they get infected between the test and the quarantine (e.g. they share a bus to the quarantine location with an infected), so if someone you may have come into contact with is infected, then your 2 day quarantine becomes a 14 day one (or can they retest you on e.g. day 4 and let you go on day 6?)

It might be the case that a seven day quarantine with a test on the fifth day (for example) would be enough, but I imagine their government would want to see data confirming that.

It's probably not the case that someone can be tested on arrival and assumed not to be incubating the virus at as-of-yet undetectable levels.

I'm not an expert but my understanding is that you can be infected and test negative for several days before becoming infectious and testing positive.

It seems like it would be a good idea to test people on arrival and before leaving quarantine, AND quarantine them for 14 days. I think China does this, and I think NZ doesn't, and I don't know why we don't.

Didn't a bunch of billionaires recently hunker down in their private bunkers in New Zealand? Does this mean they are trapped there now?

I followed this in the press.

Mostly, wealthy Americans just applied for (and received) NZ passports and maybe bought a house "just in case."

You can look at aerial photos of the few airports in NZ to see if their private jets are still parked there.

Because until fairly recently small houses sold for $50,000 in NZ, and obviously foreign money would jack those prices up, the NZ govt. started talking about making their passports harder to obtain.

They also currently require a "travel document" from Americans, to reciprocate for US entry policy:

https://www.washingtonpost.com/lifestyle/travel/americans-wi...

For context: New Zealand only has around ~5 million people and is pretty remote, relative to the rest of the world.

By comparison Ohio has ~11 million people, Canada has ~38 million people, and California has ~40 million people.

This is awesome for the Kiwis, but they are small and isolated.

> Siouxsie Wiles, associate professor and head of the Bioluminescent Superbugs Lab at the University of Auckland...

So this is totally off topic, but is the spelling of her name Siouxsie common in NZ or maybe Australia or elsewhere? I've only seen Siouxsie spelled that way once, so I'm just curious if she was maybe named after Siouxsie Sioux or this is a common spelling that I've just never seen.

Australian here, never met or heard of anyone in Australia with 'Suzy' spelled like that.

Looks like she changed her name to that: Siouxsie Wiles MNZM (born Susanna Wiles)

https://en.wikipedia.org/wiki/Siouxsie_Wiles

NZer, never seen it before

Nah, its not common. She's a "cool" science communicator complete with pink hair to appeal to the kids.

(That's not to undermine her at all, she's fantastic.)

Today is May 7, why does it say Published May 9?

For what it's worth, In New Zealand, they're over half-way through May 8th. (12:39PM)

And it looks like that the Publish date is the Issue Date of their magazine, which appears to be every Saturday: https://www.thelancet.com/journals/lancet/issues

> Testing has been focused on people with symptoms, with tracing of both close contacts and casual contacts. However, more widespread testing is now being introduced.

Might be a bit early to proclaim it’s been “eliminated” based on a single day of no new reported cases considering the asymptomatic aren’t widely being tested.

Someone with a better clinical understanding than I do can probably shed more light on this, but the NZ Director General of Health briefly touched on this, saying there is a difference between elimination and eradication in medical lingo. That may also apply to the Lancet article. I’ll try to find more later if no-one else answers this better.

That's right, and there was a brief controversy here when the Director General and the Prime Minister said that NZ had eliminated COVID and that was taken by most people to mean that it no longer existed here. They later had to backtrack somewhat and explain the difference.

Basically elimination means that the disease is totally under control, and any new cases can be dealt with via testing and tracing. Eradication means that the disease is completely wiped out and no longer exists here.

Elimination means removal of something. Eradication means it will never come back. So maybe they meant (or should have meant) that the risk of exponential spread has been eliminated.

Correct. The US has "eliminated" measles (since there are almost no cases and it's not difficult to contain), but the world has "eradicated" small pox (since the virus itself literally only exists in a couple of research labs in the entire world).

No new community transmission cases for weeks, all new cases linked to known clusters, and we're trending towards zero active cases nationwide -- every day for over a month there has been a decrease in active cases.

https://www.newsroom.co.nz/2020/05/06/1101216/covid-19-in-nz...

many regions haven't had a new case in weeks

This is covered in the article, and I posted this comment above:

For the last few weeks there has been widespread testing of asymptomatic people. E.g. teams showing up at a supermarket and testing everyone, testing everyone associated with a school that had a pretty large cluster.

It is true that still most tests are on symptomatic people. But if there was undetected community transmission then you would expect some of those people to develop symptoms and eventually get tested and test positive. (Currently the PM is saying "if you have a sore throat or a sniffle, get tested" --- the bar for symptoms is extremely low.) So it's reasonable to assume that there isn't significant undetected community transmission.

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