Comment: A world-class response to a future pandemic could be jeopardised by the ongoing politicisation of the health response to Covid-19.
In the collective rush to obsess over avoiding every little mistake in a pandemic response that both the Labour- and coalition-appointed commissioners of the Royal Commission found was fundamentally a success, we risk failing to learn the lessons from what went right.
This is highlighted in the Government’s response to the two phases of the Royal Commission, released Wednesday. On paper, it seems a reasonable and thoughtful plan to implement many of the commission’s recommendations, setting New Zealand up to respond better to the next pandemic.
But whether it will actually be carried out that way remains to be seen, as, despite the response in theory being predicated on a “future-focused” approach, the Government remains committed to relitigating the past.
To some extent, improving in the future does require looking to the past. That is the point of the entire Royal Commission exercise. An overly litigious approach to doing so, however, leads to drawing the wrong lessons from what happened.
The Covid-19 response ran for more than two years, with aspects managed across nearly every government department, with the involvement of businesses, communities and households. It was not undertaken by a handful of bureaucrats in the Ministry of Health building on Molesworth Street, but by, at times, literally the team of five million.
That there were mistakes is no surprise. Expecting perfection in such a scenario is absurd. However, we should expect those in power to aspire for perfection, even knowing they will fall short.
To be sure, the Covid-19 response was imperfect. Some mistakes were more egregious than others. The Royal Commission highlighted in particular that “better coordinated communications to providers on emerging risk would have supported providers providing clearer information on risks to consumers”, while noting “the evidence shows that the government made numerous efforts to communicate vaccine safety issues, including the emerging risk of myocarditis and pericarditis”.
In other words, there was no cover-up of the potential, however unlikely, of harm from the vaccine. But the government could have communicated it better, as that message did not always clearly make it to the ground.
On other aspects of the response, there are legitimate arguments to be had either way. The significant percentage of funds spent during the Covid-19 Budgets on non-Covid policy has raised eyebrows – although this was known at the time, and not a revelation uncovered by the commissions.
Certainly, the government of the day acknowledged that, for example, the Jobs for Nature programme was not going to reduce the spread of the virus, but was instead economic stimulus to insulate against the impact of the pandemic and associated health measures. Whether that stimulus was necessary, or only added fuel to the smouldering cost-of-living coals which would soon burst into a conflagration, is an important debate to be had.
Then there are the areas where critics simply overstate their case. The current Government has repeatedly falsely claimed the Royal Commission finds the Auckland lockdown in 2021 went on longer than officials recommended.
What the commission actually finds is that officials in September of that year recommended Auckland move from Level 4 to “Level 3 Step 1” five days before the move occurred. At no stage did officials recommend ending the lockdown early – in the end, it ran until December. To say the lockdown went on longer than recommended is to say the lockdown ended on October 5, 2021, just seven weeks after it began. Most Aucklanders would say it was twice as long as that.
Indeed, the commission did not find, even with the benefit of hindsight, that the lockdown did go on too long. Instead, it says, “it may be that outcomes would have been the same or not significantly different overall if decision makers had reassessed their strategy, changed their decision-making process, or been provided additional data in the way we have suggested”.
Understanding which critiques are valid and which are overblown is crucial to ensuring the pandemic preparedness programme is focused on the right areas.
The Government’s response makes many of the right noises. Up front, it says it will be guided by four principles: Future-focused, transparent and accountable, coordinated and supports joint efforts, and agile and proportionate.
Health Minister Simeon Brown has committed to “a multi-year programme to strengthen New Zealand’s pandemic preparedness through clearer governance, refreshed plans, stronger legal safeguards, more resilient health and public health capabilities, more robust decision-making frameworks, improved economic and fiscal readiness, and continuity of essential services”.
He says the Government has accepted “in some form” all 63 recommendations from the two phases of the commission.
“In some form” does a lot of work in that claim. For example, on advice from the Ministry of Health, Brown has rejected the recommendation to implement bespoke pandemic response legislation and instead decided to review and update the Health Act’s epidemic control measures.
Some of the most consequential recommendations for a future health response have been accepted in principle, but with none of the funding needed to implement them.
In particular, perhaps the core recommendation on the health side of the ledger is to “ensure the health system can rapidly scale up key public health functions”. This capability is what set New Zealand apart from Taiwan back in 2020 – we went into lockdown because we had an underdeveloped public health system, sapped by decades of underfunding. Taiwan kept the virus out without a lockdown, avoiding significant economic damage, off the strength of its public health capability.
It requires investment up front in building up testing, contact tracing, genomic sequencing and other functions that can then be scaled up in the event of a health emergency. Will that investment be made?
This recommendation “is accepted in principle as the intent is supported, but full implementation is contingent on funding beyond current baselines”.
Asked whether New Zealand’s pandemic preparedness might be jeopardised by a failed Budget bid, Brown says, “Ultimately there’s work that needs to be done, but you know, primarily we’ve said actually in terms of future responses to pandemics, any expenditure needs to be timely, temporary, and targeted. That’s exactly how we’ve approached the conflict in the Middle East. Not spraying the cash bazooka around, pushing up inflation.
“New Zealanders expect money to be spent wisely, making sure we’re ready, but also any response needs to be spent in a way that ensures it’s respecting of taxpayers’ money.”
The same question marks surround the response to recommendations to develop a plan for quarantine and isolation measures, ensure the health system has the data capability to deliver a pandemic response, ensure health and disability service continuity during a pandemic, improve ventilation in public hospitals and develop options for improving ventilation in other public spaces.
All are “accepted in principle” or “partially accepted”, with implementation contingent on money that hasn’t actually been promised.
“I’m very disappointed that the actual job of strengthening pandemic responses is inadequately resourced,” says Labour’s health spokesperson Ayesha Verrall.
“It’s clear that the National Party have not learnt the lessons of the pandemic. By not resourcing the recommendations to strengthen the health system, a government facing a pandemic is forced to use more restrictive measures, rather than allowing the health system to manage illness.”
Brown also faces something of a political conundrum in following through with the unfunded promises in his response.
The Government’s rhetoric on Covid-19 has been primarily focused on the economic response, where a range of recommendations are not just accepted in principle but accepted outright. Ask a minister about the health response and they will invariably turn to talking about debt and inflation.
Indeed, Brown’s response above does just that, responding to a question about investment now in public health capabilities by ruling out a “cash bazooka” in a future economic response to a health emergency.
Perhaps some constituents might feel let down if the Government actually takes a mature approach to shoring up the health response to a future pandemic.
That could give the impression, which the Government has studiously avoided, that Brown and his colleagues agree with the Royal Commission reports, which fundamentally validated the strategic and tactical decisions made by those in power during the Covid-19 pandemic.
New Zealand got the vast majority of its response to Covid-19 right. There are few other countries one would rather have been in through 2020 and 2021. We risk forgetting that if we focus only on the ways the response could have been even better.
Says Verrall: “The discourse around Covid is so politicised that there is a high likelihood that the next government to face a pandemic makes the mistake of fighting the last war and therefore doesn’t do public health measures or economic measures in the appropriate way because of the risk of politicised consequences.”
And while Brown may worry about political consequences for stumping up the cash for something like a national quarantine and isolation capacity, Verrall believes failing to do so could cut the other way too.
“The vast majority of people who could or will vote for this Government will want New Zealand to have a sensible pandemic plan, and will expect their government to deliver it. And there is a competition for a small number of voters between National and New Zealand First that this Government is pandering to in some of its commentary on the Covid response.”
Insofar as Brown finds himself in a political trap, it is one of his own making.
