“COVID-19 at the bottom of the world”

We have all become amateur epidemiologists… “Epidemic curves, flattening the curve, attack rates, etc.” We know all the lingo now, and we all have an opinion..

I am lucky enough to live in the beautiful country of New Zealand. With regards to COVID-19, New Zealand has some inherent advantages. It is an island, 3 hours flight from anywhere else in the world, not that anyone is flying these days. Auckland aside, it is also relatively sparsely populated. In addition to these natural advantages, it also has a very good Public Health system and tight border controls.  People coming into New Zealand are now required to self-isolate for 14 days. All these factors added together are probably why New Zealand has been fortunate enough to avoid widespread community transmission to date. As of today (17th March), there have only been 11 cases of COVID-19 in New Zealand and all the cases have been directly related to overseas travel.

So Kiwis are watching with some anxiety the skyrocketing COVID-19 numbers from Europe and elsewhere in the world, along with the “lockdowns”, the school closures and other drastic measures to try and “flatten the curve”. And we in New Zealand are left wondering just what is in store for us…

In my opinion, the most likely scenario is that we (NZ) will eventually get community transmission, but probably not at the same transmission rates as we have seen in mainland Europe, giving us a flatter but possibly more prolonged epidemic curve, i.e. a “slow burner” of an outbreak.

Next most likely is an outbreak with a fast rise in numbers, a high peak and a rapid decline induced by herd immunity, giving the classic bell-shaped epidemic curve. This scenario would stretch our Healthcare resources to the limits and beyond.

It is probably wishful thinking that New Zealand could completely avoid a COVID-19 outbreak, whilst the rest of the world suffers, although this is not completely implausible. The chances of this happening are reduced further by the fact that our nearest neighbours, Australia, have just had approximately 70 cases in the past 24 hours, so they are “off and running”, so to speak…

If we do manage to stay COVID-19 free in the community, the downside will be that we have a population in New Zealand with no immunity and which will therefore continue to remain vulnerable to a COVID-19 outbreak into the future. This scenario could potentially lead to prolonged travel restrictions both in and out of the country and may not be the ideal outcome that it first looks like on paper.

The worst thing is actually not knowing what is in store for us. We really know very little about this virus, so we are essentially in uncharted territory with regards to disease modelling and management. Public Health decisions globally are being made more on expert opinion as opposed to any strong evidence base, and during a pandemic, everybody becomes an expert, including the politicians!

So all we can do in New Zealand is wash our hands and wave at each other, watch the politicians look increasingly rattled day by day,  check our bank accounts as our pension savings fall through the floor, and wait and see what happens in this unfolding drama.

Due to their geographic isolation, Kiwis are a resilient people. Recent events such as the Christchurch earthquake, the Mosque shootings and the White Island volcano eruption has only hardened the national psyche further. NZ will cope with whatever scenario is played out, and we will recover quicker than most!

Michael

(These views are my own, and do not necessarily represent those of my employers or children.)