Since the global Covid-19 outbreak, we have survived two major virus incursions. As a small business owner, I wrote an opinion article, “Anatomy of the problematic response’’, which was published on the Otago Daily Times opinion page on May 13, 2020. The content and the conclusion of that article, which called upon us to learn to live with the virus, remain timeless.
While our elimination (not eradication) strategy has worked for us, it has been a double-edged sword. It served us well by not exposing our rickety and under-resourced health services and the most vulnerable. On the negative side, the elimination strategy has been a psychological and tactical barrier to prepare us to live with the virus. The proposed traffic light system is clearly intended to live with the virus because all three light systems impact our lives under differing degrees of virus transmission rather than having the luxury of zero transmission.
We need the 90% full vaccination target to avoid inundating or paralysing our inadequate health service system, large-scale loss of lives and social and economic disruptions. Even if we achieve the 90% double-jab target there would be 420,000 unvaccinated eligible adults, 20,000 more than the population of the second-largest city, Christchurch, and as such there is the risk of large-scale hospitalisation.
Our chronically and historically neglected and tired health system is the key component of the traffic light system. The proposed system is based mainly on the extent of community transmission and the ability of our health services to survive the outbreaks. As such, in case of an outbreak, sliding down from Green to Red level will be swift because of a lack of hospital beds and intensive care units.
It is ironic despite the poor status of our health services amidst the pandemic, the Government has been busy with many sweeping reforms, including Three Waters reform which was triggered by four deaths from the Havelock North water contamination incident. In the past 18 months, apart from juggling within the existing hospital systems, there has been no plan or significant funding to prepare our health systems for the virus outbreak and potentially large loss of lives. Our relaxed approach is in stark contrast to China and the UK rapidly building makeshift hospitals within a matter of a few days to deal with the original Covid-19 outbreak.
Since the entire traffic light system is hinging on the rickety health system, it is obvious in the event of an outbreak there will be significant disruption to our primary healthcare, education, business and social activities and freedom of movement.
Given the predicament we are in, the only option is vaccination. Vaccination has been proven to minimise viral infection, virus transmission and hospitalisation substantially. Obviously, I am fully vaccinated.
Vaccination is not one-off since the vaccination efficacy reduces with time. Research indicates the Pfizer vaccine being 53% effective after five months. As such, booster jabs are considered the saviour but must be administered within six months of the last jab and delaying booster jabs would increase ‘‘breakthrough infection’’ of the vaccinated. As we can see, with delayed booster jabs, despite the high vaccination rates, many countries are experiencing high rates of infection after achieving their vaccine targets.
Our quarantine health workers who had the vaccine in February-March 2021 are well overdue for boosters. If we have already had difficulties in encouraging people to receive the first two jabs to achieve 90% full vaccination, how difficult would it be to get the 3.8 million vaccinated every six months? Can vaccination certificates be the carrot?
The traffic light system recognises the vaccinated by vaccination certificate by granting exclusive rights to hospitality, gatherings (including churches and marae), events, close-contact businesses (including haircuts) and gyms. If the above facilities, events and businesses demand vaccination certificates, an estimated 420,000 fellow New Zealanders may be rejected access. Thus, the unvaccinated will be at the mercy of any facilities operating without vaccination certificates, which will require social distancing and masking.
As a nation we were united during the 2020 lockdown but are dividing under the vaccination pressure. The longer it takes to achieve 90% full jab, the greater the animosity. Anti-vaxxers or people consciously avoiding vaccines are a product of our democratic system and are not necessarily anti-government. It is not unnatural for a proportion of the community to be concerned or curious about the fast-tracked vaccine. The unvaccinated must decide between serious viral illnesses leading to death or long-lasting effects against any potential side effects or perceived ideas of the vaccination.
Being a democratic nation, we need to learn to agree to disagree and live with differing opinions, beliefs and values. Vilifying, bullying or ostracising the unvaccinated is neither democratic nor civilised, not even our culture. We are well known for our charity and compassion. What has changed? Covid-19 has substantially changed our sensible way of thinking and acting. As a literate community why are we giving undue attention to Covid-19 when 33,000 lives are being lost annually to other diseases?
How do we live with this nasty and clever virus while upholding our freedom, dignity, quality of life and values? Our Government holds many of the answers. Before enacting the traffic light system, the outcomes of the system must be spelt out. Obviously, the proposed system, which is hospital-centric, has been prepared by the health professionals to manage hospitals. Reducing/avoiding the hospitalisation/deaths need not be at the cost of losing our freedom, dignity and quality of life. Surely there are better ways.
Electronic vaccine certificates may be a valuable tool during community transmission. It can be electronically linked with the QR code system, enabling effective tracing. However, it will be a divisive and blunt tool when used to restrict the movement of the unvaccinated. The vaccinated need not fear the unvaccinated. The Government must reassess the role of vaccination certificates before introducing the traffic light system into law.
Time is running out and several rapid measures are warranted by the Government. Fast-track to achieve 90% first jab by mid-November. Target the 12- to 49-year-olds who are lagging. Delaying the first jab will delay 90% full jab by three weeks. Survey the unvaccinated to assess the reasons for not being vaccinated and address those issues. Provide alternative vaccines to Pfizer if such a step can encourage or accelerate more people being vaccinated. Fast-track the approval of the paediatric vaccine and vaccination for 5- to 11-year-olds.
Roll out booster-jab plans and jabs immediately. Boost our health services and capacity to care for the unvaccinated. If the existing hospitals are unable to be upgraded to withstand any major virus outbreaks, separate national facilities must be built in Auckland and Christchurch along with recruiting the required health services staff. We need to adapt to the virus by outsmarting it.
■ Dr Selva Selvarajah is the founder of Enviroknowledge Ltd, which trains environmental professionals.
