Kia Ora everyone. This is a thread for people overseas, to put context around what is happening in Aotearoa New Zealand with our Covid-19 strategy. The first point to make is that though we are now shifting away from hard elimination, we couldn’t have picked a better strategy /1
Some headlines will say we have “failed” in our attempt to eliminate delta. This misses a key point. Our Go Hard, Go Early lockdown nationally, led to such a hard suppression of the virus, that our daily case counts are still low overall. Our outbreak seeded from NSW, compare: /2
NZ’s Alert Level 4 was effective even against delta, and while it was in place, we prevented uncontrolled exponential spread. We have prevented 1381 chains of transmission so far. Daily case counts are <50. /3
In real terms, we have saved lives. We have sadly had 1 death in this delta outbreak, bringing our total to 27 deaths from covid. This means that currently, our hospitals are able to operate without overwhelm. We would like to prevent this /4
NZ has experienced only two true national lockdowns. The first was in March 2020, and we went on to eliminate covid for 100 days. The second national lockdown was in August 2021. If you live outside of Auckland, you’ve experienced incredible freedoms for most of the pandemic /5
Auckland’s most recent lockdown was so effective, that the rest of NZ was able to come out of lockdown after a couple of weeks, meaning that schools and workplaces were open again around the country, at Alert Level 2 - which is a light setting only - distancing, masks. /6
Our Deputy Prime Minister, Grant Robinson, recently reported that NZers have enjoyed 464 days of no workplace closures over the entire pandemic, compared to say 78 in the US, 75 in the UK. Importantly, this has meant schools have been open for the most part as well. /7
Elimination has also been beneficial for the economy. And while I don’t want to minimise at all the hardship we have seen over this time, particularly on tourism, we have done well compared to other more hard hit countries /8
A key success of elimination has been that we will face re-opening with four crucial weapons:

1. Safe and effective vaccines
2. Very highly vaccinated healthcare workforce
3. Lessons from successful reopenings elsewhere
4. Some effective treatments for those hospitalised /9
For instance, in reopening schools, we have the benefit of studies and ECDC and CDC guidance showing how to do this as safely as possible. We can look to learn from guidance produced elsewhere, for instance, Victoria, who have produced a great plan:… /10
A challenge we face is to quickly get our vaccination levels as high as poss. Almost 80% of the eligible population has had their 1st dose, almost 50% their 2nd dose. Our early general vaccine rollout went so fast that at peak we vaxxed 1.5% of the population in a single day /11
But sadly the pandemic increases inequities, and we are seeing the virus spread along inequitable lines in our society. This is not unexpected, given the social drivers of spread seen overseas. We need to urgently get equity into our vaccine rollout… /12
Thanks goodness we have quite amazing community health organisations who are rising to the challenge. And we need to significantly invest here to enable them to do this crucial work. /13
There is a myth overseas that NZers have been oppressed into compliance. But the overwhelming majority of NZers have supported the elimination strategy, and backed PM Ardern’s government to win a historic election majority. Even up till very recently… /14
The elimination strategy has been *so* popular in fact, that we were caught a little off guard by the shift to hard suppression, and so we are needing to psychologically recalibrate. I hope this is understandable. We’ve had huge events at Level 1. It was incredible /15
We were so deep into Level 1, that when the All Blacks played the Bledisloe Cup to a half empty stadium just days before the Auckland August Delta outbreak started, the poor stadium turnout…made headline here.… /16
But the most important point is this. We have saved thousands upon thousands of lives through elimination.… /17
And we continue to save thousands of lives through committing to a cautious approach.… /18
So we need to stay the course. We have to continue to chase down the virus, and vaccinate as fast as possible, because our hospital capacity is too low, and we are NOT SENSITISED TO LOTS OF COVID-19 DEATHS AND DON’T WANT TO BE /19
So now, even though we are allowed very small picnics and barbecues in Auckland, we continue to stay home as much as possible, and wait till our vaccine levels reach the same level of immunity or higher, seen elsewhere, but without the deaths, the long covid, the disability. /20
Please send us your best thoughts and prayers. We are not done yet and we have a lot of work to do. But what I’ve seen from NZers over the past 18 months has made me so bloody proud to live here. Kia kaha /end
Addendum: when all is said and done, the New Zealand Covid-19 story will be a public health case study. Even if we falter from here, what we have achieved to date with elimination, leadership and collective action has been remarkable. I am truly privileged to bear witness to it.

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More from @DrJinRussell

4 Oct
ECEs are opening bubbles of 10 in Level 3 for Auckland, and schools are tentatively set to open on October 18th. I'm mum to a school boy and an ECE boy, and have my community paediatrician and child epi hats on. How can this be safe? Okay, let's walk through it. /1
When children are infected with Covid-19, they fortunately typically experience a mild or asymptomatic illness. Hospitalisation of children can occur but, from Australian experience, this is thankfully uncommon. /2…
But we still need to do ALL we can to not expose children to this virus, while we wait for vaccinations for children <12, as children with pre-existing medical conditions are at higher risk of severe illness, and longer lasting symptoms are still being researched. /3
Read 18 tweets
2 Oct
I’m not sure who needs to hear this but it is possible to have a deeply Christian faith and believe this compels you to put the needs of others ahead of your own, to not grasp for power or “freedom”, to not put others in danger during a global plague, to love the vulnerable

1/ “Do nothing out of selfish ambition or vain conceit, but in humility consider others better than yourselves. Each of you should look not only to your own interests, but also to the interests of others” — Phil 2:3-4
2/ “You must have the same attitude that Christ Jesus had. Though he was God, he did not think of equality with God as something to cling to. Instead, he gave up his divine privileges” — Phil 2:5-7
Read 6 tweets
25 Sep
A few weeks ago I started drawing attention to Singapore's Covid-19 response as one NZ can learn from. S'pore has pop 5.7 million, 73 Covid-19 deaths, 83K cases. After reopening commenced on 19 Aug, cases rose exponentially. What should we be learning? /1…
Vaccination currently stands at 84% of the *population* has received 1 dose, 82% population has been fully vaccinated. Now, 5 weeks after reopening commenced, the Singapore government announced the need for increased restrictions. It *did not* lie down and scream "Freeeedom" /2
No, the Singapore government has (rightly) taken steps to protect it's population from Covid-19. The large majority of new cases (98%) have been mild or asymptomatic. This is thought due to the high vaccination rates. /3
Read 22 tweets
14 Sep
Look I appreciate the need to get overseas experts commenting on the NZ response on telly but (a) none are experts on NZ hospital capacity or population health inequities, (b) continuing elimination while we achieve high vax rates does NOT mean we aren’t thinking about the future
I mean, here’s an actual verified Johns Hopkins expert @AmeshAA whom I do respect but who comes across as ridiculous at points simply because he doesn’t understand our extremely limited hospital capacity, need for equity, or long term planning.…
If I were starting off a TV interview and speaking to a country that has done remarkably well with few resources and stretched healthcare, I would do the decent thing and say “Bravo NZ! Great you’re moving on vaccines now! Here’s some extra things to consider…”. Y’know. Tone.
Read 7 tweets
13 Sep
Kia Ora to the overseas folk. For those curious, NZ’s alert level 4 has managed to successfully reduce the R value of the delta outbreak from 6 to consistently <1. In 28 days we have stopped 955 chains of transmission. The lockdown has already lifted everywhere, except Auckland/1
Auckland remains in Level 4, where a handful of “mystery” cases mean we will stay the course. We have prevented hospital overwhelm, which modelling predicted would have occurred by now, had we not effected such a successful lockdown. So far we have had zero deaths from delta /2
We are vaccinating very fast. Some days this outbreak we have vaccinated 1.5% of the population in a single day. Thanks to new shipments of vaccines from overseas, we can keep up the pace. 68% of 12y+ population have had at least 1 dose, 35% fully vaccinated and forecasts high /3
Read 10 tweets
12 Sep
Delta is airborne, schools have been impacted in this current cluster. This morning I spoke with ⁦@SusieFergusonNZ on⁩ ⁦@radionz⁩ about the need to lift our game on ventilation in schools to make an end to damp, poorly ventilated classrooms /1…
2013 NZ study (Wang et al) has shown that often, levels of carbon dioxide in 3 of 6 NZ classrooms exceeded recommended levels (1000 ppm) for 50% of the school day. C02 levels here are a proxy for ventilation. As C02 levels rise, students may also feel headaches, sleepy /2
Not every child can mask, and emerging evidence suggests that improving ventilation maybe as effective as masking. So in looking to the future, and wanting to prevent covid closing schools, this needs to be a priority for investment. Our piece:…
Read 4 tweets

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