What Can Ireland Learn From New Zealand's COVID-19 Response?


Despite the objections from various cohorts in Irish society, New Zealand is a very relevant and a very useful comparator for Ireland. The fact that some of those objections have come from Ireland's policymakers – who presumably do not welcome the comparison – only serves to reinforce the point. New Zealand's responses to the COVID-19 pandemic should be the model on which we build Ireland's contagion risk management framework.

New Zealand is an island nation of about 5 million people. It is a liberal democracy with an advanced market economy. It has well-developed public infrastructure, although its health service has historically suffered from a lack of investment. New Zealand sits just off the coast of another larger island which receives direct flights from Wuhan, and with which it is deeply integrated. Admittedly, it is situated about 4,000km off Australia's coast, but we live in a globalised world and in the context of contagious outbreaks, air passenger volumes count for more than geographic distance.

New Zealand covers a larger land mass than Ireland, but a higher proportion of its population lives in urban areas, putting those people at greater risk in a contagious outbreak. While Ireland is one island of two nations and New Zealand one nation of two islands, there are few nations in the world so similar, even if they live so far apart.


Timeline

On the 24th of January, the New Zealand Ministry of Health set up a team to monitor the viral outbreak developing in Wuhan, China. Three days later, they began screening passengers on flights from China. Three days after that, New Zealand decided to block all flights from China. The ban went into place on the same day the WHO declared that there was no need for international travel restrictions on China.

New Zealand did not have a single confirmed case of COVID-19 in the country at the time. In fact, it would be another 25 days before a passenger from Iran brought the first case into the country. Following the confirmation of that case, New Zealand immediately banned flights from Iran.

New Zealand recorded that case on the 28th of February. Ireland recorded its first case just one day later, on the 29th of February.

On the 16th of March, a mandatory 14-day quarantine was applied to anyone coming into the country. There were no special rules for nationals coming home – anyone could be a risk, so everyone went through the same procedure. Failure to comply would lead to criminal prosecution or deportation (as it did for a couple of people, but only after their 14-day quarantines were completed).

On the 19th of March, the border was closed to all but New Zealand citizens. That decision also included blocking flights from Australia, with whom New Zealand shares a Common Travel Area. Australia closed its border on the same day, demonstrating the clear coordination in their policy-making.

On the 21st of March, New Zealand announced a new four-level tiered warning system and immediately moved to Level 2 (e.g. at-risk demographics asked to stay at home). Two days later they moved to Level 3 (e.g. closing all schools). Two days after that, they moved to the highest level, which was equivalent to the full lockdown experienced in Ireland.

The strictest period of lockdown ended after 5 weeks, on the 27th of April. New Zealand gradually removed the restrictions from there, moving to Level 2 a couple of weeks later, and to Level 1 about 4 weeks after that. For most Irish people, the strictest period of lockdown lasted over 10 weeks, with a long tail of restrictions lasting until August.

At the end of June, New Zealand had recorded 1,530 cases and 22 deaths. Ireland had recorded 25,466 cases and 1,732 deaths. New Zealand’s domestic economy was almost fully functional. Sadly, its export markets were not.

Discussion

Like Ireland, New Zealand came into this outbreak working from its existing pandemic influenza framework. However, their policymakers soon realised that this virus could not be effectively handled with influenza protocols, so they rewrote them. Some have argued that New Zealand's experience with SARS gave them an advantage over Ireland, but both countries recorded the same number of cases – 1. The Kiwis appear to have learned significantly more from that single case than the Irish.

New Zealand’s primary goal was to prevent COVID-19 getting past the border and into the population. That was an ambitious goal but, how could it have been otherwise? When faced with catastrophic risk, a nation’s first instinct must be to ensure survival of its people. In these environments, governments must act quickly and decisively and put the public health first in every decision.

The Irish media narrative is that New Zealand's borders were much easier to protect. This is patently untrue. New Zealand has over 400,000 visitors from China every year, including direct flights to multiple cities. Despite the economic benefit those visitors bring, New Zealand had no qualms immediately cutting off travel from the source of the virus. They didn’t wait until they had a confirmed case. They didn’t wait for anyone’s permission. They didn’t follow the WHO. The people of New Zealand were in the firing line and their policymakers had significantly less time to react. They acted early and decisively because they understood that speed was at least as important as precision, and that an ounce of prevention was worth a pound of cure.

New Zealand expanded their travel restrictions as more countries became infected, building up to total border closure on the 19th of March. They moved quickly to increase their defences in line with the perceived threat of the virus – again, not in response to increasing numbers of cases or deaths.

If there was a flaw in their execution, it was that they didn’t expand their travel restrictions quickly enough. Iran had hundreds of cases and dozens of deaths when that first infected passenger arrived in New Zealand. As the virus spread to different countries, New Zealand should have updated their travel restrictions accordingly.

Though stopping the virus at the border was the ultimate goal, the emergence of COVID-19 in the community didn’t signal failure of their strategy. Through their efforts, they had been incredibly effective at slowing the virus’s progress so there wasn't much curve left to flatten. They won themselves more time to prepare for the outbreak, and they streamlined all subsequent decisions.

With a smaller viral load, the Kiwis had less immediate demand for PPE, testing capacity, or hospital and ICU beds. Their health care workers weren't put at risk. There was less need for restrictions at the civilian level. They had more medical resources available to battle a smaller amount of the virus, so they could be more precise and more comprehensive in their response measures.

 

Ultimately, New Zealand succeeded because they had a goal, they had a plan to get to there, and they implemented the plan effectively. They had a framework for making decisions which allowed them to be quick and decisive in their policy responses. They made good rules on the fly and enforced them strictly.

Underlying it all was a clear commitment that public health was the first and only priority. Here’s a quote from Jacinda that sums it up:

"We must plan and prepare for more cases. We must go hard and we must go early. We must do everything we can to protect the health of New Zealanders."


Key Takeaways

  • New Zealand didn't wait for proof that they needed to act. They started putting their defences in place before the virus was confirmed in the country.

  • New Zealand's existing pandemic influenza protocols were insufficient so they updated them quickly and effectively, and during the most acute phase of the crisis.

  • New Zealand made their decisions quickly and decisively, and enforced their policies strictly.

  • New Zealand put the public health first at all times, and until the emergency was over.