The Government's reported plan to scrap the traffic light system is premature and will leave New Zealand with few options to respond to more severe variants or other pandemic threats, Marc Daalder writes
Comment: No one ever wants to predict the future with Covid-19.
Ask an epidemiologist, a virologist, a public health doctor, even a minister or the captain of the Covid-19 response what the virus has in store for us next and they'll all demur.
"I dearly wish I had a crystal ball," Andrew Old, the head of the new Public Health Agency, told Newsroom last month.
That's what makes it so concerning that the Government is reportedly considering doing away not only with all health measures but also with any framework to manage new Covid-19 threats.
We don't know whether the next variant will be milder or more severe. We don't know if it will present with classic symptoms or novel ones. We don't even know what part of the SARS-CoV-2 evolutionary tree it might appear from. But we do know there's going to be a next variant.
It's increasingly clear that Covid-19 will continue to evolve in leaps and bounds, new dramatically evolved variants overtaking one another like ocean waves constantly lapping on the shoreside. This is a major difference from the slow and steady mutation we see in other infectious disease threats, like influenza.
Imperial College London virologist Tom Peacock recently said it is "now clear the jumping/variant/saltation evolution of SARS2 is an intrinsic property of the virus - although we also see flu-like stepwise drift, I think the 'variant evolution' will continue to be the main driver of variation going forwards".
This aligns with the conclusions of the Government's variant plan, which warned irregular, fitful mutation means Covid-19 won't fall into consistent patterns anytime soon.
"Endemicity - in the sense of the pattern of spread of Covid-19 becoming more 'predictable' with potential seasonal variation - is not guaranteed in the short- or medium-term," the plan stated.
"We are likely to see three-four pandemic waves a year for the short- to medium-term, due to evolution within Omicron and waning of protection, albeit 'mild' disease due to vaccines and prior immunity. Either way, this would still be a substantial increase in the overall burden of disease, even though the severity is lower compared to the start of the pandemic."
Given the difficulty of predicting the coronavirus' spasmodic evolution and the clear threat it continues to pose, we need to be prepared to manage the virus in the future.
Case numbers and hospitalisations are now at their lowest levels since February and the average daily death toll of five is a record low in the context of Omicron. There is more of a justification to remove health measures now than in the past - though the scrapping of mask mandates and other protections still limits the freedom and safety of the most vulnerable New Zealanders.
But, according to the New Zealand Herald, the Government plans to go beyond cutting protections. Instead of tweaking the traffic light system or moving to Green, the Herald reports, it will do away with the system entirely, leaving nothing in its place.
This would be a foolhardy move, when even the Government's own variant plan spells out an uncertain future of recurring pandemic waves which represent "a substantial increase in the overall burden of disease".
The fortunate situation we find ourselves in is unlikely to last forever. New variants could push baseline case numbers to levels where masks and other protections are still warranted, as happened after the first Omicron peak.
New variants and rapidly waning immunity will also fuel new waves, necessitating the imposition of more stringent but short-lived health measures to flatten the curve and dampen transmission.
The problem is that, with no framework like the traffic lights or alert levels to enable the reintroduction of protections on either a semi-permanent or temporary basis, the Government simply won't. We'll all suffer a much higher burden of disease and death for that failure.
This isn't idle speculation. We just witnessed this with the BA.5 wave in July. Already, as I wrote then, the traffic light system had been so thoroughly gutted that the Government had few tools to help flatten the peak.
Instead, it did nothing. Case numbers didn't rise as high as feared, but efforts to keep the virus out of the most vulnerable demographics failed. In the second week of July, more people died in New Zealand than in any previous week on record. Two weeks later, the record was broken again.
There have only been 12 weeks in the past decade when more than 800 people have died in New Zealand. Eight of those have come this year, amidst the Omicron wave.
Even after accounting for population growth - including in the oldest age groups - more people died than expected every week bar one between the start of March and the end of July.
Failure to protect the vulnerable among us has consequences. And if the Government fully axes the traffic light system, it will be giving up even the option to protect our most vulnerable. Such a move would unilaterally disarm New Zealand in the middle of a war against a virus that has no intention of slowing its own offensive.
Instead, the Government should replace the traffic lights with a framework for managing widespread community transmission of Covid-19 in the long term (or rework them into that system).
The measures in this framework would need to be sustainable in the context of fragile and waning social licence. Think investments in ventilation and indoor air quality as well as masks in certain contexts, rather than more onerous restrictions like gathering limits or lockdowns.
A prudent, precautionary approach - once the catchcry of this Government's response to Covid-19 - would keep a flexible toolbox at the ready in the face of a clouded future.
The next variant is coming. It makes no sense whatsoever to neuter our ability to respond to it.
