179 CMAAO CORONA FACTS and MYTH New Zealand Eliminates
Dr K Aggarwal
With inputs from Dr Monica Vasudev
1045: Successful Elimination of Covid-19 Transmission
in New Zealand
NEJM Excerpts: Despite
New Zealand’s geographic isolation, introduction of SARS-CoV-2 was imminent
because of the large numbers of tourists and students who arrive in the country
each summer, predominantly from Europe and mainland China.
New Zealand began implementing its pandemic influenza
plan in earnest in February, which included preparing hospitals for an influx
of patients. It also began instituting border-control policies to delay the
SARS-CoV-2 was behaving more like severe acute
respiratory syndrome (SARS) than like influenza, which suggested that
containment was possible.
By mid-March, it was clear that community transmission
was occurring in New Zealand and that the country didn’t have sufficient
testing and contact-tracing capacity to contain the virus.
Informed by strong, science-based advocacy, national
leaders decisively switched from a mitigation strategy to an elimination
The government implemented a stringent countrywide
lockdown (designated Alert Level 4) on March 26. After 5 weeks, and with the
number of new cases declining rapidly, New Zealand moved to Alert Level 3 for
an additional 2 weeks, resulting in a total of 7 weeks of what was essentially
a national stay-at-home order.
In early May, the last known Covid-19 case was
identified in the community and the person was placed in isolation, which
marked the end of identified community spread. On June 8, the government
announced a move to Alert Level 1, thereby effectively declaring the pandemic
over in New Zealand, 103 days after the first identified case.
New Zealand is now in the post-elimination stage. The
only cases identified in the country are among international travellers, all of
whom are kept in government-managed quarantine or isolation for 14 days after
arrival so they don’t compromise the country’s elimination status.
New Zealand remains vulnerable to future outbreaks arising
from failures of border-control and quarantine or isolation policies. Most
jurisdictions pursuing containment (including mainland China, Hong Kong,
Singapore, South Korea, and Australia) have experienced such setbacks and have
responded with rapid reescalation of control measures.
New Zealand needs to plan to respond to resurgences
with a range of control measures, including mass masking, which hasn’t been
part of the response to date.
New Zealand’s total case count (1569) and
deaths (22) have remained low, and its Covid-related mortality (4 per 1
million) is the lowest among the 37 Organization for Economic Cooperation and
Public life has returned to near normal. Many parts of
the domestic economy are now operating at pre-Covid levels. Planning is under
way for cautious relaxing of some border-control policies that may permit
quarantine-free travel from jurisdictions that have eliminated Covid-19 or that
never had cases (e.g., some Pacific Islands).
The lockdown and consequent deferral of routine health
care have undoubtedly had negative health effects, although total national
weekly deaths declined during the lockdown.
To mitigate adverse economic effects, the government
instituted a spending program to support businesses and supplement the incomes
of employees who lost their jobs or whose jobs were threatened.
There are several lessons from New Zealand’s pandemic
science-based risk assessment linked to early, decisive government action
interventions at various levels (border-control measures,
community-transmission control measures, and case-based control measures)
Minister Jacinda Ardern empathic leadership and effectively communicated key
messages to the public
combating the pandemic as the work of a unified “team of 5 million” — which
resulted in high public confidence and adherence to a suite of relatively
burdensome pandemic-control measures.