Elspeth Frascatore’s column in the Spinoff this week gives a useful insight into where the COVID-19 debate is up to today.
If you read her piece, she is clearly exhausted and exasperated. Anyone who’s spent any time listening to health professionals, let alone being one, knows that hospitals are a war zone at the best of times. There is never enough people, never enough resources, and never enough time.
That problem is bigger than COVID-19. Northland Base Hospital was reported full in February in the middle of summer before the Omicron wave hit. There’s no question that COVID-19 will make it worse, not only for medical professionals, but for patients missing care while their treatments are cancelled for a COVID-19 wave even before it comes.
We should respect the load that medical professionals are carrying always, and now especially. But the column also showed the dangers of being exhausted and exasperated in the COVID-19 debate. We can’t afford a loss of rationality, and empathy for others along with it.
Here’s another thought that was conspicuously absent from the column. Medical professionals are not alone in suffering from COVID-19.
I know kitchen staff who have passed out trying to work with masks on. There are tourism operators who have worked on their business for 20 years, and lost it all in two.
There are orchardists who have lost their seasonal workers from overseas and watched fruit rot on the ground with nobody to pick it.
The foreign workers who have stayed cannot go home, and couldn’t when neither New Zealand nor their home country had any COVID. If they do, they can’t re-enter. If they can’t come here next season, they won’t have an income. I met one who hasn’t met their two year old child. That child was born in the Solomon Islands, but he cannot go home. He has to stay here to earn money for a child he cannot meet.
I have lost count of the business owners who’ve had to mortgage and in some cases sell their homes to keep them going.
I talk to principals who say they’re now an extension of the public health response. They spend so much time coordinating with their local Public Health Unit. They are deeply worried about what lost learning will mean for their students, but have little time to fix it.
The Spinoff really should carry a column from all of them, but where would that get us?
Probably to the sensible conclusion that we need a rational and inclusive debate on how to proceed with COVID-19. What are the costs and benefits of different policies, and can we be sure the benefits of a policy exceed the costs?
That kind of analysis deserves to be debated on its merits, rather than demonised. ACT’s policy document Move On, calls for masking to continue, as does Elspeth’s column. We have common ground there, and it’s good to acknowledge common ground where it exists for a start.
The whole document, in fact, is about how we should analyse the costs and benefits of different policies. The main benefit we analysed is the effect on reducing the spread of Omicron and the levels of hospitalisation. More common ground worth acknowledging.
For example, keeping the border closed. Before COVID-19 there were 20,000 arrivals in New Zealand on an average day. Putting aside the fact that half the airlines that used to fly here have quit, if 20,000 people did arrive tomorrow, that would be 0.4 per cent added to the population.
If the people arriving had the same rate of COVID-19 as people here, it would add 0.4 per cent to daily cases, and hospital admissions. Except it wouldn’t. Other countries will have less COVID-19 than New Zealand soon, if not already. Pre-departure testing would prevent most of those who do from boarding planes to come here. People who travel are generally healthier and less likely to need hospitalisation.
What benefit, then, do we get from keeping the border closed, and painfully opening it between now and October? We might reduce hospitalisation rates by somewhere between 0 and 0.4 per cent. In real numbers, there are currently about 400 in hospital. Statistically, the border might have added one more at this point, but probably not. Is maybe saving one hospital bed to date worth the many personal and commercial costs of isolating the country?
What about domestic isolation? The CDC says the incubation period is 2-3 days and the infectious period is days 4-6. And yet, the Government asks people to isolate for ten days if they or a household member tests positive.
The most likely outcome of unworkable isolation rules is that people won’t scan and won’t test, quickening the spread. We’ll never know, but patterns of scanning and testing numbers are consistent with that theory. If a policy doesn’t work we shouldn’t do it. We should follow Singapore who have 72 hours isolation periods and release people with a negative self test. (I’m told by Singaporeans that Rapid Antigen Tests are at the supermarket, next to the Kinder Surprise, but the ridiculous restrictions on importing tests is another story.)
Then there’s the decimation of business thanks to people staying home lest they get pinged and have to isolate. The streets are dead. At least now they can’t be a contact thanks to scanning a QR code, but why do we still force businesses to display them, and make them liable for any customer who doesn’t scan? Policies that deliver no benefits for fighting COVID should be stopped.
Move On goes through these and other COVID-19 restrictions. It simply asks ‘what benefit do we get for what cost, and if the costs outweigh the benefit, why are we doing it? Perhaps we should stop?’
Thankfully, this kind of rational and empathic thinking is widespread in the medical profession. For example, Brian Betty is the Medical Director of the Royal College of GPs. He is worth quoting at length:
“For the last two years we've dealt with Covid in the sense of Delta, which is a very dangerous disease, we've had an elimination strategy ... and I think it's built up quite a fear or anxiety in the community about Covid.
However, in the last four to five weeks, the situation has changed dramatically with Omicron, which is not Delta - it's much more like a common cold, flu-like illness. And I think we need to move into a space very rapidly of thinking we're going to live with this and get back to some sort of normality.”
“We need to be de-escalating this down to get into a position where most of us are just going to have a mild to moderate illness, that we're going to get through like any respiratory illness in winter, and we need to be moving on, and perhaps the way we're approaching it at the moment is causing more problems than good, and we may have reached a pivot point with that.”
Or perhaps we could take the response from another Doctor at Auckland City Hospital after Move On was released.
I want to say that you have my full support with your current policies re: covid. We need to move on with the pandemic, especially where border restrictions are concerned. It seems crazy that MIQ still exists, and even isolation seems absurd.
This is the kind of debate we need, but there is one more thing we can take from Elspeth’s column that, perhaps unintentionally, makes a point about the current state of COVID-19 debate. She says that I have ‘emerge[d] to echo, amplify and even extend’ the demands of protestors.’
For one thing, that’s not true. You can draw a line from ACT’s first COVID-19 policy paper in August 2020, A Wellbeing Approach to COVID, through COVID 2.0 and COVID 3.0 in 2021, to Move Onnow. The idea that ACT’s critique of the Government’s COVID response ‘emerged’ because of the protest is not a fair assessment, to say the very least.
But enough about us, here’s the wider issue. There ARE people with completely unhinged views and very low trust of media and orthodox information sources. As a society we face a real challenge around trust and respectful dialogue. If your first response to someone questioning the Government’s COVID-19 response is that they’re probably a neo-Nazi, as some media seem to believe, that is not going to build social cohesion.
Instead we need to make sure people can question the Government’s COVID response, and any other policy for that matter, within the mainstream media without being shouted down or demonised. The alternative is less trust, and more people seeking darker corners of the internet. That is something nobody wants.
At this point in the pandemic, everyone is tired. I get that. But it’s also the worst time to abandon reasoned discussion and start criticising people for writing things one has not read. Our best hope is finding that illusive balance of empathy and rationality so we can unite behind good ideas.