The full version of the Government's variant plan, released under the Official Information Act, shows no specific responses were drawn up for different scenarios, Marc Daalder reports
There is no specific outline for how the Government might respond to a new, worst-case scenario variant of Covid-19 which causes more severe disease and evades vaccine-induced immunity.
When officials drew up the 'Strategic Framework for Covid-19 Variants of Concern' – more commonly known as the variant plan – they intended to propose how each of five different variant scenarios could be dealt with. But a copy of that plan, released under the Official Information Act, says this response planning "did not eventuate".
"Response plans specifically are situational and will change pending what a new variant presents, the capacity of our health system at the time, the level of immunity in the community to a new variant, among other factors.
"Response plans are not static, but the health system is readied to respond to a new variant of concern should it become identified through ongoing global surveillance," a spokesperson for the Ministry of Health said.
The decision was clearly made late in development of the plan – the version released by the ministry still references the axed appendix on "proposed response to scenarios" in its table of contents and throughout the text.
When the variant plan was announced in late June, then-Director-General of Health Ashley Bloomfield told reporters, "There's an old saying: Plan for the worst and hope for the best. We're not doing any hoping here. We're planning for the best and we're planning for the worst and everything that's in between."
During the same press conference, Covid-19 Response Minister Ayesha Verrall did hint that the full plan wasn't prescriptive.
"Being prepared for a new variant doesn't commit us to a particular course of action. It is much more about retaining capabilities in order to respond should we need to."
However, it was never explicitly stated that the variant response plan contained no real response planning. The plan itself also wasn't released to the public – only a seven-page summary, light on detail, was available. The ministry's spokesperson said this was because "the full plan is a document intended for internal strategic planning and response purposes, and remains under ongoing review".
The full plan released under the OIA also shed more light on the preparedness measures the Government is undertaking and how it expects Covid-19 to affect New Zealand in the short-to-medium term.
It said elimination is "less likely to be used" and would only be called for if a new variant had very high fatality rates, was likely to render existing immunity ineffective, could be controlled through measures like MIQ and where the health system was already under pressure.
Lighter touch border measures might be used in the short-term, while more information is gathered on a new variant. One of the preparedness factors is a commitment to "ensure pre-departure testing can be rapidly re-established".
Based on the time it took for information about Omicron to become available, the Ministry of Health estimated we won't know mortality rates for one to two months after the arrival of a new variant. Real world studies on vaccine efficacy, severity, transmission and other factors will likely take even longer. Genomic information will be available more quickly, within a couple of weeks, allowing the country's surveillance systems to begin seeking out the variant.
"Previously, response measures included MIQ and border measures. This allowed us time to observe the epidemiological situation overseas and build this understanding into our response," the plan noted.
"However, open borders will make it challenging to employ the same approach to waiting for further information. It is likely that a highly transmissible novel variant would rapidly enter our borders and potentially become established."
New variants could require new vaccines, prompting the Government to engage in work on a new, medium-term vaccine strategy. A variant could also be sufficiently mutated that it isn't detectable by the existing rapid antigen tests available in the community.
The ministry spokesperson told Newsroom Cabinet will consider "strategic priorities" for Covid-19 vaccines over the next 12 months in September. They also said the ministry works with other jurisdictions to monitor the effectiveness of RATs in detecting new variants.
When asked whether the country's existing contracts for RATs allow for access to updated versions if needed, the spokesperson said, "Te Whatu Ora – Health NZ maintains a flexible approach to the sourcing, purchasing and distributing approved RATs as required to support the Government’s health response and as appropriate to the current pandemic settings".
According to the variant plan, spread patterns seen in other coronaviruses indicate that a lack of cross-immunity could allow multiple variants to circulate at the same time.
Even without this, though, "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."
The emergence of a new, hyper-mutated variant like Omicron within the next year or so was placed at approximately 30 percent, based on a presentation by American biostatistician Trevor Bedford to the Food and Drug Administration in April.
Continuing mutation and evolution of Omicron subvariants was considered more likely but the irregular nature of this evolution still means the pandemic is not yet over, the plan stated.
"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. It is prudent to document for less optimistic scenarios, as they still remain a possibility."
