What is the Covid-19 Exit Strategy of 'Zero Covid' countries such as Hong Kong?

[philosopher]

This weekend the entire state of Victoria in Australia and Auckland in New Zealand have been put into snap lockdowns due to a few cases being found in the community. In the past couple of months Perth and Brisbane have also been put into short lockdowns when community cases were found.

New Zealand Covid outbreak: Ardern puts Auckland into three-day lockdown

Three members of South Auckland family tested positive, prompting Jacinda Ardern to place region into level 3 measures

www.theguardian.com

Lockdown measures will be introduced across Auckland from midnight on Sunday, while restrictions will also be increased elsewhere in New Zealand, after three local cases were reported over the weekend. Prime minister Jacinda Ardern said the government was taking a cautionary approach to the cases, and acting under the assumption that the cases involved new, more transmissible strains of the virus. The source of the cases is not yet known.

Victoria to enter lockdown with fans barred from Australian Open

Australia's state of Victoria shuts down over a dozen Covid cases but the Grand Slam will continue.

www.bbc.co.uk

The Australian state of Victoria will enter lockdown for a third time in a bid to suppress an outbreak of the UK strain of coronavirus.
Officials this week found 13 cases stemming from a quarantine worker who became infected at a Melbourne hotel.
The lockdown will begin on Friday midnight and end on Wednesday.

Clearly both counties have adopted a Zero Covid strategy of eliminating Covid, hence the need to implement a lockdown over a few or some cases even a single case and very strict border controls. However, unless both countries are content with very strict border controls and the ever present risk of snap lockdowns continuing permanently, at some point both countries are going to have to reopen to rest of world. However unless other countries manage to eliminate Covid, by opening up they are going to risk reimporting Covid back into their countries, which goes against their elimination strategy.

So the question is how do these two countries intend to get out of this conundrum?

 

[Simon11]

The other issue they both have is that neither have begun vaccinations from what I have read, so that will hold them back reopening with the rest of the world!

 

[duncanp]

I think they are counting on vaccinating their entire populations before opening up to the rest of the world.

But even then, vaccinations don't provide complete protection from disease, nor do they stop transmission entirely.

Answers on a postcard to Scott Morrisson and Jacinda Ardern.

 

[richw]

Personally I think their strategy is going to back fire. everyone saying how well they’ve done to not have many cases. I’m not sure that will be a good thing longer term.
So far no vaccinations and so few cases to help build natural immunisation.
I can see their exit strategy taking a lot longer than places that have had millions of cases combined with vaccinations for that reason

 

[duncanp]

And what are Australia and New Zealand going to do about the Olympic Games this summer? (Assuming they happen at all, which I think is somewhat doubtful at the moment)

All the athletes and officials will have to be quarantined on their return and tested before release, but how can they guarantee that there will not be a "quarantine leak" or that a false negative in a test will not result in community transmission of the virus?

I think countries closer to home such as the Isle of Man and the Channel Islands are going to have exactly the same problem.

 

[Yew]

I think they are counting on vaccinating their entire populations before opening up to the rest of the world.

But even then, vaccinations don't provide complete protection from disease, nor do they stop transmission entirely.

Answers on a postcard to Scott Morrisson and Jacinda Ardern.

Thats a common cognitive bias, humans place unreasonable value in going for 90% to 100%, versus say from 40% to 50%. This argument isn't one of rational thinking.

 

[philosopher]

I think they are counting on vaccinating their entire populations before opening up to the rest of the world.

But even then, vaccinations don't provide complete protection from disease, nor do they stop transmission entirely.

Answers on a postcard to Scott Morrisson and Jacinda Ardern.

To me that strategy only really works if vaccines reduce transmission by an extremely high percentage. While this could be the case with the original Covid variant, with the SA variant in which vaccinated people still can be reinfected, albeit with only a mild illness, this seems unlikely.

 

[brad465]

Personally I think their strategy is going to back fire. everyone saying how well they’ve done to not have many cases. I’m not sure that will be a good thing longer term.
So far no vaccinations and so few cases to help build natural immunisation.
I can see their exit strategy taking a lot longer than places that have had millions of cases combined with vaccinations for that reason

Of the two I admire New Zealand's leadership more, partly as I'm biased to a centre-left persuasion, but even that aside in Australia their strategy seems a complete mess, given not just locking down for a handful of cases, but subjecting Melbourne to a 112 day lockdown last year shows how they're not so capable of eliminating it and shows their quarantine system shouldn't be getting the praise it has been, further highlighted with this latest lockdown and another in Perth recently. Australia also clearly didn't take zero-covid in their stride to the point they were confident of allowing full attendance at the Australian Open (prior to the latest lockdown), instead having a reduced attendance.

Their Governments regardless though do have their populations' interests at heart, but I just don't think the manner in which they've gone about it is sustainable and reality will come around before long. Part of me is, I must confess, glad that these incidences of new transmission have emerged, because it highlights the zero-covid flaws and ultimately those peddling it here lose traction over it.

 

[duncanp]

Of the two I admire New Zealand's leadership more, partly as I'm biased to a centre-left persuasion, but even that aside in Australia their strategy seems a complete mess, given not just locking down for a handful of cases, but subjecting Melbourne to a 112 day lockdown last year shows how they're not so capable of eliminating it and shows their quarantine system shouldn't be getting the praise it has been, further highlighted with this latest lockdown and another in Perth recently. Australia also clearly didn't take zero-covid in their stride to the point they were confident of allowing full attendance at the Australian Open (prior to the latest lockdown), instead having a reduced attendance.

Their Governments regardless though do have their populations' interests at heart, but I just don't think the manner in which they've gone about it is sustainable and reality will come around before long. Part of me is, I must confess, glad that these incidences of new transmission have emerged, because it highlights the zero-covid flaws and ultimately those peddling it here lose traction over it.

So if Australia and New Zealand are relying on vaccinating their way out of this, someone should be asking them "OK, how many doses of each vaccine have you ordered? When are the doses going to arrive? When does the vaccination program start? When does the vaccination program end?, What is you plan for reopening the country to the rest of the world?"

I don't think the prime ministers of both countries know the answers to those questions, or if they do they are not making them public, lest the population stop believing that the sun shines out of their backsides.

 

[brad465]

So if Australia and New Zealand are relying on vaccinating their way out of this, someone should be asking them "OK, how many doses of each vaccine have you ordered? When are the doses going to arrive? When does the vaccination program start? When does the vaccination program end?, What is you plan for reopening the country to the rest of the world?"

I don't think the prime ministers of both countries know the answers to those questions, or if they do they are not making them public, lest the population stop believing that the sun shines out of their backsides.

From what I've heard they've ordered them but are not rushing to administer them as they don't seem to feel there is an emergency need for this, given they supposedly had it all under control. Australia in particular suggested despite rolling out the vaccine later this year their borders are unlikely to reopen in 2021, which makes no sense at all and highlights their expectations are too high.

This article in the Financial Times (I can't copy text under their copyright rules) talks about New Zealand rolling out a vaccine to health workers in April and the rest of the population from June, but was receiving criticism for needing to be done faster:

Subscribe to the Financial Times

A subscription to the Financial Times provides you with the insights and perspective you need to succeed, now.

on.ft.com

 

[Bantamzen]

From what I've heard they've ordered them but are not rushing to administer them as they don't seem to feel there is an emergency need for this, given they supposedly had it all under control. Australia in particular suggested despite rolling out the vaccine later this year their borders are unlikely to reopen in 2021, which makes no sense at all and highlights their expectations are too high.

This article in the Financial Times (I can't copy text under their copyright rules) talks about New Zealand rolling out a vaccine to health workers in April and the rest of the population from June, but was receiving criticism for needing to be done faster:

Subscribe to the Financial Times

A subscription to the Financial Times provides you with the insights and perspective you need to succeed, now.

on.ft.com

Well that worked out well for them then.

 

[duncanp]

Well that worked out well for them then.

I can't help but indulge in a bit of schadenfreude. (Taking pleasure in other people's misfortunes)

They have been so smug and complacent about how they have got it right, and the rest of the world have got it wrong, and now it is going to come back and bite them on the bum.

And in breaking news, Auckland has been ordered back into a three day lockdown.

Just how many more of these lockdowns are there going to be in the future. And this is before they have officially opened their borders to the rest of the world.

Covid: New Zealand Auckland lockdown ordered

The move comes after three new local cases of Covid-19 were reported in Auckland.

www.bbc.co.uk

New Zealand's Prime Minister Jacinda Ardern has ordered the country's biggest city Auckland to go into lockdown after the discovery of three new local cases of Covid-19.
The measures will last three days and require residents to stay at home.
Ms Ardern said the country was going "hard and early" after the cases were identified.
New Zealand has won widespread praise for its handling of the pandemic, going months without community transmission.
The country closed its borders entirely to almost all non-citizens or residents early on in the pandemic, aiming to eliminate the virus.
New Zealand, with a population of five million, has recorded just over 2,300 cases of Covid and 25 deaths.
The measures in Auckland require its 1.7 million residents to stay at home except for essential shopping and work. Schools and non-essential shops will close, and entry in and out of the city restricted.
Ms Ardern said three days should allow the government to get more information and get more testing done, and would also help determine if there was any community transmission.
"New cases of Covid-19 in the community was something none of us wanted to happen," Auckland Mayor Phil Goff said, adding the restrictions were the "best way to stamp out the virus".

The rest of the country moves to a higher level of alert, with schools and businesses remaining open but people encouraged to find alternative ways of working if possible.
The lockdown forced the postponement of two races in sailing's America's Cup, one of the few major sporting events with no restrictions on spectators.
The three community cases were announced earlier on Sunday - a mother, father and daughter from South Auckland.
It is unclear how the three contracted Covid. The mother works in the laundry department for an airline catering facility, while New Zealand media said the father was a self-employed tradesman.
New Zealand's Director-General of Health Dr Ashley Bloomfield said his team was "working under the assumption that it is one of the new variants".
He added that the initial focus on investigations was the mother's workplace "because of its obvious connections to the border".
Opposition leader Judith Collins urged New Zealanders to follow the advice of health officials.
But she called for border workers to be vaccinated, saying: "If this proves to be another border failure that is unacceptable. Our border should be rock-solid by now."

 

[Freightmaster]

...in breaking news, Auckland has been ordered back into a three day lockdown.

Just how many more of these lockdowns are there going to be in the future. And this is before they have officially opened their borders to the rest of the world.

What I don't understand is why are lockdowns needed at all for such low numbers of cases??

The zero Covid champions on here and social media in general are always claiming that
one of the major advantages of keeping prevalence extremely low is that any outbreaks
can be managed by Track-Trace-Isolate, so lockdowns are not required.

I can understand that being an issue in this country as our TTI setup is frankly rubbish,
but why do New Zealand and Australia have to keep resorting to lockdowns when they
have effective track and trace systems in place?






MARK

 

[Yew]

What do they imagine a three-day lockdown will even achieve, when people can be infectious for 10 days?

 

[RuralRambler]

What I don't understand is why are lockdowns needed at all for such low numbers of cases??

Once exponential growth has started, it's hard to stop. There have been reports of one infected person infecting 20 or so others. So 3 people could become 60 very quickly, possibly before test and trace has a chance to kick in.

 

[Bantamzen]

Once exponential growth has started, it's hard to stop. There have been reports of one infected person infecting 20 or so others. So 3 people could become 60 very quickly, possibly before test and trace has a chance to kick in.

I think the point @Freightmaster was making is that why is the R value as important once people are largely protected from serious illness? The vaccine isn't going to stop spread so much as it is going to protect the vaccinated from becoming ill. We have become way too fixated on infection numbers (often erroneously referred to as cases) which of course drives the R number. Its time to stop micro-analysing individual data sets and start looking at the bigger picture, and one piece of that is understanding that with the vaccine an increase in R does not necessarily translate into serious illness & pressure onto the NHS.

 

[duncanp]

Thought I would post this article from The Telegraph about Australia's COVID strategy, and how they are paying a heavy price for so called "freedom".

I hope this makes all the Zero COVID brigade in this country sit up and think.

Here in Australia we are paying a heavy price for 'freedom'

Australia's Covid strategy is the envy of the world. But people should be careful what they wish for

www.telegraph.co.uk

Here in Australia we are paying a heavy price for 'freedom'​

Australia's Covid strategy is the envy of the world. But people should be careful what they wish for

Australia’s success against Covid has seen it held up by many around the world as a model for tackling the virus. Our pubs are open, people can go to concerts, spectators – at least at the start of the tournament – have been allowed to watch the tennis at the Australian Open and we even celebrated New Year’s Eve in a manner unthinkable in most countries. We certainly have done a good job of stamping out the virus.

However, to suggest that the Aussie approach is all rainbows and butterflies would be a grave mistake. Suppression has been achieved primarily through a ruthless use of “circuit-breaker” local lockdowns and the introduction of hotel quarantine for all people entering the country.

We live in constant fear of new outbreaks, the response to which is immediate and brutal. The whole state of Victoria, for example, is currently in a five-day lockdown after just 13 cases were linked to a quarantine worker in a Melbourne hotel. Even after a long period of success – Victoria went 28 days without any locally generated cases – freedom can come swiftly to a halt. We have no choice but to sit with our fingers crossed hoping that it’s not our state or, worse, our workplace that gets the notification.

This is a nightmare for businesses. One week, restaurants and bars have more customers than they can handle; the next they are trying to turn themselves into a takeaway overnight. Even in the good times, it’s hardly a return to what used to be normal. We have to scan QR codes, stick to capacity limits, masks are everywhere and in the pubs there’s no dancing and you have to stay seated. I’ve watched some of my favourite cafes, restaurants and bars close their doors for good; with the rules as they are it has been impossible to get enough bums on seats to keep businesses afloat.

Travellers coming into the country face an even tougher system than the one being introduced in Britain and the numbers of new arrivals allowed are strictly rationed to prevent the system being overwhelmed. Even for a relatively isolated country like Australia, this has huge impacts. I have a Canadian friend who is trapped here with no hope of seeing her family back in Montreal for the foreseeable future. She faces a long and agonising wait.

Those who want to travel within the country can face similar worries as travel between states is heavily restricted. I have been unable to visit my grandparents in Tasmania as they reach their nineties, or to meet my beautiful niece in Western Australia who is almost 2 years old already. It’s been hard not knowing the next time you’ll see your family, or even if you ever will see those who are elderly or ill.

The fact is that driving down cases, as we have been doing, can provide respite. It can save lives and it can buy time to test vaccines, which has been given by politicians as one of the justifications for Australia’s slow progress – an excuse which is now unravelling. Yet the side effects are huge and suppression is not going to get us back to normal. Our current situation may seem idyllic – but it carries a heavy price that shouldn’t be overlooked.

 

[RuralRambler]

I think the point @Freightmaster was making is that why is the R value as important once people are largely protected from serious illness? The vaccine isn't going to stop spread so much as it is going to protect the vaccinated from becoming ill. We have become way too fixated on infection numbers (often erroneously referred to as cases) which of course drives the R number. Its time to stop micro-analysing individual data sets and start looking at the bigger picture, and one piece of that is understanding that with the vaccine an increase in R does not necessarily translate into serious illness & pressure onto the NHS.

I appreciate that. Trouble is that if you wait for the couple of weeks to see if infections turn into serious illness and then another couple of weeks to see if illness turns into death, you're a month or so of potentially exponential growth, so by the time you see it's effects, it's probably too late for test and trace as numbers will be too high again. There's no easy answer.

 

[Bantamzen]

I appreciate that. Trouble is that if you wait for the couple of weeks to see if infections turn into serious illness and then another couple of weeks to see if illness turns into death, you're a month or so of potentially exponential growth, so by the time you see it's effects, it's probably too late for test and trace as numbers will be too high again. There's no easy answer.

There isn't, but we can't sit on our hands and hope for the best, just as Australia & New Zealand are rapidly finding out. At the beginning of the pandemic vaccines were seen as the exit strategy by experts and politicians. We now have them, and we have a good idea the impact they will have. In this country we have the opportunity to call it end game, in the countries talked about here they need their politicians to get off their hands & get the vaccines rolled out.

 

[Freightmaster]

I appreciate that. Trouble is that if you wait for the couple of weeks to see if infections turn into serious illness and then another couple of weeks to see if illness turns into death, you're a month or so of potentially exponential growth, so by the time you see it's effects, it's probably too late for test and trace as numbers will be too high again. There's no easy answer.

In other words, you are saying what many of us on here have been thinking for months now: zero covid
as a policy is unsustainable in the long term unless countries who implement it never open their borders
to tourism (i.e. no quarantine for non-residents on arrival), irrespective of whether the population of that
country has been vaccinated or not, because vaccines are not 100% effective.

So with that in mind, how will Australia/New Zealand ever get back to '2019 normal'???





MARK

 

[Bikeman78]

Thought I would post this article from The Telegraph about Australia's COVID strategy, and how they are paying a heavy price for so called "freedom".

I hope this makes all the Zero COVID brigade in this country sit up and think.

Here in Australia we are paying a heavy price for 'freedom'

Australia's Covid strategy is the envy of the world. But people should be careful what they wish for

www.telegraph.co.uk

Wow. The restrictions sound worse than Sweden.

 

[brad465]

Thought I would post this article from The Telegraph about Australia's COVID strategy, and how they are paying a heavy price for so called "freedom".

I hope this makes all the Zero COVID brigade in this country sit up and think.

Here in Australia we are paying a heavy price for 'freedom'

Australia's Covid strategy is the envy of the world. But people should be careful what they wish for

www.telegraph.co.uk

I highly doubt many of the Zero Covid brigade would take this seriously, unless it was reported somewhere they trust more, which is definitely not the Telegraph.

 

[duncanp]

Wow. The restrictions sound worse than Sweden.

And the point is that these restrictions are hurting business just as much as our lockdown in the UK

The article mentions cafes and bars that have closed for good, and each time there is a lockdown, it pushes more businesses closer to the edge.

There is also the plight of Australian citizens trapped abroad who are unable to return home, and as mentioned a Canadian citizen in Australia who is unable to return to Montreal.

Australia and New Zealand are really gambling on a quick rollout of the vaccine, but even that isn't going all that well as this sentence from the article illustrates.

It can save lives and it can buy time to test vaccines, which has been given by politicians as one of the justifications for Australia’s slow progress – an excuse which is now unravelling.

 

[kristiang85]

From what I've heard from my friends in Australia, that sounds very accurate.

 

[duncanp]

Wow. The restrictions sound worse than Sweden.

And the point is that these restrictions are hurting business just as much as our lockdown in the UK

The article mentions cafes and bars that have closed for good, and each time there is a lockdown, it pushes more businesses closer to the edge.

There is also the plight of Australian citizens trapped abroad who are unable to return home, and as mentioned a Canadian citizen in Australia who is unable to return to Montreal.

Australia and New Zealand are really gambling on a quick rollout of the vaccine, but even that isn't going all that well as this sentence from the article illustrates.

It can save lives and it can buy time to test vaccines, which has been given by politicians as one of the justifications for Australia’s slow progress – an excuse which is now unravelling.

I highly doubt many of the Zero Covid brigade would take this seriously, unless it was reported somewhere they trust more, which is definitely not the Telegraph.

That says a lot about the Zero COVID brigade - they stick their head in the sand and ignore the news and reports which don't fit in with their narrative.

 

[brad465]

That says a lot about the Zero COVID brigade - they stick their head in the sand and ignore the news and reports which don't fit in with their narrative.

While I suspect they are like this, such confirmation bias is not limited to them; any group with specific opinions on any given political situation will have similar attitudes to what they read/listen to.

If these outbreaks in AUS + NZ do get a bit more out of hand I suspect it will make that brigade go quiet and give strong ammunition to those of us against a zero-covid approach.

 

[DB]

While I suspect they are like this, such confirmation bias is not limited to them; any group with specific opinions on any given political situation will have similar attitudes to what they read/listen to.

If these outbreaks in AUS + NZ do get a bit more out of hand I suspect it will make that brigade go quiet and give strong ammunition to those of us against a zero-covid approach.

Probably also worth pointing out that they will be heading into their winter soon too.

 

[brad465]

Probably also worth pointing out that they will be heading into their winter soon too.

I suspect the seasonal effects would have more of an influence from April for them, which in the case of New Zealand is when they currently plan to start vaccinating the population (although a slow process until at least June, maybe needing all winter). For Australia that 112 day lockdown in Melbourne took place in their winter so its probable if they've not got mass vaccinations underway a repeat can happen somewhere.

I found this article about the potential vaccine uptake in New Zealand, which has a rather sizeable proportion of the population being "vaccine-sceptic" at around 30%:

30% of New Zealanders are ‘vaccine sceptics’, so trust is key to COVID-19 vaccine roll-out

Vaccine hesitancy is not new, but it has a new element: few people can remember the devastating impact of diseases such as smallpox and polio and it is hard to see the lives saved by vaccination.

theconversation.com

The emergency approval of the Pfizer/BioNTech COVID-19 vaccine in the UK and the imminent roll-out of several other vaccines in 2021 raises serious questions about New Zealand’s likely uptake of this vital public health response.

Recent research into New Zealanders’ attitudes to vaccination suggest positions have become more polarised over the last decade, with 60% identifying as “vaccine believers” and 30% as “vaccine sceptics”.

This follows a global trend. In 2019, the World Health Organization (WHO) identified “vaccine hesitancy” as one of the top ten threats to global health, along with non-communicable diseases (such as diabetes, cancer and heart disease), resistance to antibiotics and HIV.

The trend also raises legal issues in relation to the right to health. Aotearoa New Zealand recognised this right in 1978. It includes the right to information and the state’s obligation to educate the public about community health issues.

Therefore if this sort of refusal exists when a vaccine is rolled out there, or they only manage to slightly improve trust, I can see their strategy becoming undermined very quickly on opening borders.

 

[DustyBin]

I suspect the seasonal effects would have more of an influence from April for them, which in the case of New Zealand is when they currently plan to start vaccinating the population (although a slow process until at least June, maybe needing all winter). For Australia that 112 day lockdown in Melbourne took place in their winter so its probable if they've not got mass vaccinations underway a repeat can happen somewhere.

I found this article about the potential vaccine uptake in New Zealand, which has a rather sizeable proportion of the population being "vaccine-sceptic" at around 30%:

30% of New Zealanders are ‘vaccine sceptics’, so trust is key to COVID-19 vaccine roll-out

Vaccine hesitancy is not new, but it has a new element: few people can remember the devastating impact of diseases such as smallpox and polio and it is hard to see the lives saved by vaccination.

theconversation.com

Therefore if this sort of refusal exists when a vaccine is rolled out there, or they only manage to slightly improve trust, I can see their strategy becoming undermined very quickly on opening borders.

Based on what we’ve seen to date the answer will be forced, or at least heavily coerced, vaccination. Both countries have terribly authoritarian governments, it makes me laugh how some people hold them up as examples to aspire to....

 

[greyman42]

Based on what we’ve seen to date the answer will be forced, or at least heavily coerced, vaccination. Both countries have terribly authoritarian governments, it makes me laugh how some people hold them up as examples to aspire to....

Yes, some people see them as some sort of paradise with large booming economies that are a dream to emigrate to.