Hipkins suggests delta makes elimination of covid impossible as a longer-term strategy; Morrison formally ends Australia's elimination strategy; Wilson floats overseas flight pause; Gull-Z merger on
Some people don’t understand what a “she cession “ is or how and why this is a critical consideration in terms of social cohesion and well-being or economics. Can this be explained to those who don’t understand this? I absolutely agree with you the lack of action on the Public Finance Act, lack of investment in public services and infrastructure long term and tax on wealth are the fundamental problems successive Governments have failed at focussing instead on controlling people’s private lives and depriving citizens of their legal and human rights instead of where they are mandated to act and perform. Good stuff.
As a Western Australian I can tell you that 'Australia' has not abandoned the elimination strategy, even if its called by another name like suppression. Perhaps the Murdoch/Morrison propaganda machine may be calling for an end to it through the News Corp op-ed, but the rest of the country, outside of NSW, is on the same page. This is testing and straining the Federation like nothing else in recent memory. It will have deep long term consequences for the future of Australia. So please don't confuse the rest of Australia with pitiful NSW. And perhaps don't rely on what 'Australia' is doing to formulate your argument that NZ is the last juristriction to pursue elimination. https://www.theguardian.com/australia-news/2021/aug/23/morrison-facing-state-resistance-over-reopening-plan-as-nsw-covid-crisis-worsens
There are a myriad of reasons why WA won't consider reopening any time soon. Like NZ the hospital system in one, with two of the largest hospitals in Perth on Code Black for ICU daily, meaning beds are already full without Covid circulating. I have friends and family that work in these hospitals, they're concerned about Scotty's push. So please don't believe his spin.
And then there's the Lambda variant, which may also be a game changer when it comes to vaccines. So perhaps the precautionary principle shall prevail a wee bit longer?
It's pretty clear from the outside that NSW failed because its restrictions weren't strong enough for Delta, and that Gladys and her crew prioritised freedom over public health, achieving neither. Victoria still has a chance, but they appear to be on the cusp of giving up as well.
Australia took a risk in the Alpha/Beta outbreaks by using something closer to our L2/L3 instead of L4, and that worked well enough for them back then to pivot from containment to elimination - but that was never a clear outcome. They thought they could use the same measures this time to control a much more infectious virus, but it has not worked. Look to the more authoritarian Asian countries to see how Delta can be swiftly wiped out - it is absolutely possible, it just requires harder restrictions, much more resources spent on public health, and massive shared effort.
The international situation even in countries that are highly vaccinated is not good, and is in many cases worsening, and certainly not something NZ can cope with given the state of our health system. I think that you would find a decent portion of NZ would be quite happy to lock the borders even tighter and wait for better therapeutics, antivirals, and more effective vaccines, even if it damages our international economy.
Our first responsibility is to the health and wellbeing of New Zealanders. If we can't vaccinate our younger children, and they are getting sick and suffering long-term health problems or even death from the virus, there is no discussion to be had - we have to keep the virus out. If we *can* vaccinate, but the vaccines wane in efficacy over time as it suggests they are, the most sensible position is again, to strengthen the border even further and keep the virus out.
If the world as a whole can't find an answer to preventing and treating COVID infections in the short to medium term, the answer for NZ may lie in building a dedicated "airlock" for persons entering the country. Dedicated, purpose-built MIQ facilities outside any population centre. We could repurpose one of our military airbases and send international flights directly to these facilities, keeping the risk outside our main centres. Dedicated workforces with mandatory daily testing and limitation of their movements and interactions with others while part of the MIQ workforce.
Why does it take 5 years to train an ICU nurse? Should we not question this statement? One assumes that the 5 years means in addition the three years it takes to get a Nursing Degree and a year or so as a working graduate. We have a swath of very good nurses who are experienced in their various fields already, working competently in our Health System. While I was working as an RN, I took on jobs that other's didn't want, which involved a fast learning curve, and I can tell you that I learned far more out of school than I learned in New Zealand's nursing educational institutions. This was thanks to fellow workers, nursing and medical who shared their amazing knowledge and skill. So I can't see any reason why, in this COVID-19 Delta crisis, a nurse with ambition to become an ICU nurse (or a paediatric ICU nurse, which entails the skill of working with babies and children - people who are not just small adults) should not be able to buddy up with a skilled ICU nurse over a 2 1/2 year period (or less) to learn this speciality, hands on. The work is 1 to 1, so unlike Theatre work, or Emergency nursing, lends itself to a mentoring system of fast-tracking new recruits to the speciality. Also, as they are critical to our present crisis, ICU specialist nurses (and especially those in Paediatrics) should be well remunerated in recognition of the contribution they make during a pandemic, to the welfare of the whole nation. Perhaps such a scheme would also raise the public perception of nurses as a whole body, as critical workers and entitled to better respect from the tight purse-strings of successive governments.
Interesting question, but I defaulted to what the ICU specialists were saying. Yesterday the govt said they could do some 'surging' in extreme circumstances and had done some training of non-ICU nurses to handle it. But still not ideal.
No, not ideal. Surging is band aid stuff, better than nothing but not ideal. As a predicted increase in need for ICU trained staff has been with us for over 18 months now, one would expect that the Health Sector and Education Industry would have collaborated to start the process of training enough nurses to cover attrition as well as to staff at least a second Paediatric ICU unit in, say, Christchurch or Dunedin. The track record of Health and Education collaboration with regard to how many and what type of nurses are predicted to be needed in the foreseeable future is not good. Time these sectors started talking to one another.
A pretty upsetting but important listen. I wonder if anyone will connect the dots between lack of nurses and our messed up immigration settings too. We should be offering whatever it takes to attract and keep nurses here, as well as training the ones we have, and making nursing a really attractive career option for young people. And for the love of god let's do the cap gains tax and stick all of it into our health infrastructure. This needs a huge push now, not at some indeterminate point in the future.
Thanks Char. I agree on all those things, except for the Capital Gains Tax. I'd prefer a 0.3% flat land tax per year to raise $3b a year, which could be used to service $200b of debt raised over 20 years to pay for housing and climate infrastructure to reach carbon zero by 2050 and have a median house price to average household income multiple of three by 2050, along with median rents being no more than 30% of disposable average income by 2050. And of course to properly fund our public house system.
The bubble with Aussie is history - returnees despite what your humanity expects or legality demands requires nurses to put their lives on the line. Vaccine efficacy being questioned. 4 months for Pfizer? Who wants to volunteer?
Steve. I agree the bubble with Australia is over, at least into late, late next year, and probably not until 2023. It effectively tied us to Australia's success and outsources our elimination strategy to Australia, which just failed.
Is ScoMo right when he says post Vax Covid has mortality and hospitalizations "like the flu", or us he being a sophist?
Also, it still seems like having ventilators even without fully trained nurses is better than not. Is there any data on how much impact is the bed and how much is the training?
Fantastic article, thanks Bernard. I agree with 99% of what you have written. I would have loved you to go further and say that the "option" of suspending all international flights is in fact absolutely not an option in any way, shape or form. As you stated, it would be morally and legally wrong but the mere mentioning of the idea places us Kiwis overseas under even more stress. Unfortunately, there is large portion of the population back home who would love nothing more than to see that happen. We are already fighting a complete farce of an MIQ Booking System, we don't need this idea being floated any more than it already has been. There are people in all sorts of situations overseas that make them eligible for an emergency allocation but they are simply not being granted unless there is a media frenzy. There are people staying illegally in countries around the world due to expired visas that have been declined emergency allocations. Closing the borders completely to these people would cause even more damage.
Interesting... however last time, NZ was the only country which succeeded in elimination... that Australia has failed does not mean that NZ will fail too... working from home is becoming more and more normal: https://blog.shopless.co.nz/work-from-home-jobs-nz/
Some people don’t understand what a “she cession “ is or how and why this is a critical consideration in terms of social cohesion and well-being or economics. Can this be explained to those who don’t understand this? I absolutely agree with you the lack of action on the Public Finance Act, lack of investment in public services and infrastructure long term and tax on wealth are the fundamental problems successive Governments have failed at focussing instead on controlling people’s private lives and depriving citizens of their legal and human rights instead of where they are mandated to act and perform. Good stuff.
Very good point on human rights. Don't get me started on housing... cheers
As a Western Australian I can tell you that 'Australia' has not abandoned the elimination strategy, even if its called by another name like suppression. Perhaps the Murdoch/Morrison propaganda machine may be calling for an end to it through the News Corp op-ed, but the rest of the country, outside of NSW, is on the same page. This is testing and straining the Federation like nothing else in recent memory. It will have deep long term consequences for the future of Australia. So please don't confuse the rest of Australia with pitiful NSW. And perhaps don't rely on what 'Australia' is doing to formulate your argument that NZ is the last juristriction to pursue elimination. https://www.theguardian.com/australia-news/2021/aug/23/morrison-facing-state-resistance-over-reopening-plan-as-nsw-covid-crisis-worsens
There are a myriad of reasons why WA won't consider reopening any time soon. Like NZ the hospital system in one, with two of the largest hospitals in Perth on Code Black for ICU daily, meaning beds are already full without Covid circulating. I have friends and family that work in these hospitals, they're concerned about Scotty's push. So please don't believe his spin.
And then there's the Lambda variant, which may also be a game changer when it comes to vaccines. So perhaps the precautionary principle shall prevail a wee bit longer?
Thanks Amy. You're right there's a lot of pushback on ScoMo's plan from the Labor Premiers in Queensland, Victoria and especially WA. Fair enough. But he is the PM and he has the biggest, most powerful and most populous state of NSW on his side too. https://www.theguardian.com/world/2021/aug/24/ending-lockdowns-with-80-vaccinated-could-cause-25000-australian-deaths-new-modelling-suggests
It's pretty clear from the outside that NSW failed because its restrictions weren't strong enough for Delta, and that Gladys and her crew prioritised freedom over public health, achieving neither. Victoria still has a chance, but they appear to be on the cusp of giving up as well.
Australia took a risk in the Alpha/Beta outbreaks by using something closer to our L2/L3 instead of L4, and that worked well enough for them back then to pivot from containment to elimination - but that was never a clear outcome. They thought they could use the same measures this time to control a much more infectious virus, but it has not worked. Look to the more authoritarian Asian countries to see how Delta can be swiftly wiped out - it is absolutely possible, it just requires harder restrictions, much more resources spent on public health, and massive shared effort.
The international situation even in countries that are highly vaccinated is not good, and is in many cases worsening, and certainly not something NZ can cope with given the state of our health system. I think that you would find a decent portion of NZ would be quite happy to lock the borders even tighter and wait for better therapeutics, antivirals, and more effective vaccines, even if it damages our international economy.
Our first responsibility is to the health and wellbeing of New Zealanders. If we can't vaccinate our younger children, and they are getting sick and suffering long-term health problems or even death from the virus, there is no discussion to be had - we have to keep the virus out. If we *can* vaccinate, but the vaccines wane in efficacy over time as it suggests they are, the most sensible position is again, to strengthen the border even further and keep the virus out.
If the world as a whole can't find an answer to preventing and treating COVID infections in the short to medium term, the answer for NZ may lie in building a dedicated "airlock" for persons entering the country. Dedicated, purpose-built MIQ facilities outside any population centre. We could repurpose one of our military airbases and send international flights directly to these facilities, keeping the risk outside our main centres. Dedicated workforces with mandatory daily testing and limitation of their movements and interactions with others while part of the MIQ workforce.
Why does it take 5 years to train an ICU nurse? Should we not question this statement? One assumes that the 5 years means in addition the three years it takes to get a Nursing Degree and a year or so as a working graduate. We have a swath of very good nurses who are experienced in their various fields already, working competently in our Health System. While I was working as an RN, I took on jobs that other's didn't want, which involved a fast learning curve, and I can tell you that I learned far more out of school than I learned in New Zealand's nursing educational institutions. This was thanks to fellow workers, nursing and medical who shared their amazing knowledge and skill. So I can't see any reason why, in this COVID-19 Delta crisis, a nurse with ambition to become an ICU nurse (or a paediatric ICU nurse, which entails the skill of working with babies and children - people who are not just small adults) should not be able to buddy up with a skilled ICU nurse over a 2 1/2 year period (or less) to learn this speciality, hands on. The work is 1 to 1, so unlike Theatre work, or Emergency nursing, lends itself to a mentoring system of fast-tracking new recruits to the speciality. Also, as they are critical to our present crisis, ICU specialist nurses (and especially those in Paediatrics) should be well remunerated in recognition of the contribution they make during a pandemic, to the welfare of the whole nation. Perhaps such a scheme would also raise the public perception of nurses as a whole body, as critical workers and entitled to better respect from the tight purse-strings of successive governments.
Interesting question, but I defaulted to what the ICU specialists were saying. Yesterday the govt said they could do some 'surging' in extreme circumstances and had done some training of non-ICU nurses to handle it. But still not ideal.
No, not ideal. Surging is band aid stuff, better than nothing but not ideal. As a predicted increase in need for ICU trained staff has been with us for over 18 months now, one would expect that the Health Sector and Education Industry would have collaborated to start the process of training enough nurses to cover attrition as well as to staff at least a second Paediatric ICU unit in, say, Christchurch or Dunedin. The track record of Health and Education collaboration with regard to how many and what type of nurses are predicted to be needed in the foreseeable future is not good. Time these sectors started talking to one another.
A pretty upsetting but important listen. I wonder if anyone will connect the dots between lack of nurses and our messed up immigration settings too. We should be offering whatever it takes to attract and keep nurses here, as well as training the ones we have, and making nursing a really attractive career option for young people. And for the love of god let's do the cap gains tax and stick all of it into our health infrastructure. This needs a huge push now, not at some indeterminate point in the future.
Thanks Char. I agree on all those things, except for the Capital Gains Tax. I'd prefer a 0.3% flat land tax per year to raise $3b a year, which could be used to service $200b of debt raised over 20 years to pay for housing and climate infrastructure to reach carbon zero by 2050 and have a median house price to average household income multiple of three by 2050, along with median rents being no more than 30% of disposable average income by 2050. And of course to properly fund our public house system.
The bubble with Aussie is history - returnees despite what your humanity expects or legality demands requires nurses to put their lives on the line. Vaccine efficacy being questioned. 4 months for Pfizer? Who wants to volunteer?
Steve. I agree the bubble with Australia is over, at least into late, late next year, and probably not until 2023. It effectively tied us to Australia's success and outsources our elimination strategy to Australia, which just failed.
Is ScoMo right when he says post Vax Covid has mortality and hospitalizations "like the flu", or us he being a sophist?
Also, it still seems like having ventilators even without fully trained nurses is better than not. Is there any data on how much impact is the bed and how much is the training?
This is a good question Conor. He seemed to based that on the 'Donaghy' report from a month or so ago, which is the Australian version of our Skegg report. But's not clear and there's debate in Australia on that this morning. Here's the Guardian article from Australia I included in this morning's Dawn chorus. https://www.theguardian.com/world/2021/aug/24/ending-lockdowns-with-80-vaccinated-could-cause-25000-australian-deaths-new-modelling-suggests
Very sobering on many levels indeed!
Fantastic article, thanks Bernard. I agree with 99% of what you have written. I would have loved you to go further and say that the "option" of suspending all international flights is in fact absolutely not an option in any way, shape or form. As you stated, it would be morally and legally wrong but the mere mentioning of the idea places us Kiwis overseas under even more stress. Unfortunately, there is large portion of the population back home who would love nothing more than to see that happen. We are already fighting a complete farce of an MIQ Booking System, we don't need this idea being floated any more than it already has been. There are people in all sorts of situations overseas that make them eligible for an emergency allocation but they are simply not being granted unless there is a media frenzy. There are people staying illegally in countries around the world due to expired visas that have been declined emergency allocations. Closing the borders completely to these people would cause even more damage.
Just my two cents.
Interesting... however last time, NZ was the only country which succeeded in elimination... that Australia has failed does not mean that NZ will fail too... working from home is becoming more and more normal: https://blog.shopless.co.nz/work-from-home-jobs-nz/