COVID-19 is a tightly rolled ball of nucleic acid and protein, sitting on the fuzzy line separating the living world from fancy chemistry. It cannot see the cells it invades, it knows nothing of the havoc it causes in the human body, and is entirely indifferent to the existence of human society. Despite this, the virus is a remorseless inquisitor. It offers no do-overs, resits, or special exemptions when it examines our health systems, the altruism of individuals, the quality of leaders, the flexibility of businesses, the capacity of infrastructure, or the subtlety of thinkers. And even in New Zealand – one of the success stories of the pandemic – the results have not all been encouraging.
The shortcomings are most visible in our efforts to chart a course into an uncertain future. Recently, Sir Peter Gluckman, Rob Fyfe, and Helen Clark – a leading scientist, the former CEO of a major company, and an ex-Prime Minister, came together to produce a “conversation paper” Re-engaging New Zealand With the World. However, despite a dream team of authors, it flew into a barrage of criticism.
Some of it was personal – very personal. Gluckman is a polarising figure in New Zealand science and as first author he was seen as being largely responsible for the content of the document. Gluckman is a leading biomedical researcher and was our inaugural Prime Minister’s Chief Science Advisor, holding the role for almost a decade, during which he was widely praised for building a strong network of science advisors within ministries. At times, though, Gluckman appeared to read his title as simply Chief Scientist, rubbing many scientists the wrong way as he accumulated influence within the system. He received an additional appointment as “Special Science Envoy” for the Ministry of Foreign Affairs and Trade while pursuing a programme of “science diplomacy”, an activity whose outcomes are often unclear, and led the formation of the National Science Challenges. These carved up over half a billion dollars of science funding and despite specific success stories, the overall programme is the subject of simmering dissatisfaction within parts of the community.
Ultimately, this paper was not a peer-reviewed work and the attention it received was due to the reputations of its authors, as much as the quality of its contents. Some academic settings use “anonymous review” where the authors’ names are omitted during assessment and it would have struggled to get past this sort of watchdog (either in academia, or as an Op-Ed) as it slides over issues, rather than digging deep. But it was offered to the world as a conversation paper and it did get people talking, so from that perspective it was a roaring success.
Scope and Scale First and foremost, a document entitled “Re-engaging New Zealand with the World” may simply be wildly optimistic in July 2020. Right now, numbers are growing exponentially in the United States and a reopening England flirts with a similar fate, while the pandemic sets daily records for new inflections across the globe. Moreover, many of those who do recover suffer ongoing impairment, and it is far from clear whether immunity is persistent.
COVID-19 could thus come to define the next decade in the same way World War II shaped the 1940s, and we are just months into the saga. We can hope that things will get back to normal sooner rather than later (and there is always hope – the first vaccines are about to be tested), but there is no guarantee that the new normal will resemble the old one, and we need to be prepared for that.
Reopen New Zealand: Yeah, or Yeah, Nah?
Tradeoffs Singapore, Tokyo, Hong Kong, and Seoul have come close to elimination and then rebounded, despite excellent public health systems and populaces with no qualms about masking, before we even mention the news from Australia. It is clear that even a small number of active cases in a community requires ongoing vigilance. With COVID-19 there is a huge difference between “a few” and “zero”, even if some epidemiologists see a very low caseload as justifying a claim of “elimination”.
In New Zealand, our schools, bars, ski-fields and workplaces all operate as they did last year. But heading into a local business recently, I noticed that its COVID-tracer QR poster had fallen to the floor, and that it appeared to have been there for some time. However, I couldn’t really complain, since seeing it made me realise that I had stopped using the app myself a week or so ago.
And I am not alone. Daily scans have dropped to less than 10,000; half a million people set up the app, but at most 1 in 50 of them uses it regularly. The quality of daily life in New Zealand is unattainable almost anywhere else in the world right now, and tourist spots are jammed by holidaying New Zealanders rediscovering their own country. However, the flip-side of this normalcy is that it increases our vulnerability to any COVID cases that do sneak across the border.
Border Math There seems to be broad consensus that two weeks of quarantine and testing will reveal cases of COVID-19 being brewed by those arriving in New Zealand. In the month of June, around 10,000 people crossed into the country. Given that arrivals spend roughly half a month in quarantine this requires 5,000 beds, and building this system at short notice has been a major logistical exercise. On the other hand, before COVID-19 around 20,000 people entered the county each day, counting both returning New Zealanders and incoming tourists.
Each possible breach of quarantine makes headlines, but it seems that the vast majority of the people crossing the border are complying with their requirements. In June, just under 20 arrivals tested positive, apparently with no cases leaking into the community.
The Next Line of Defense We can always make quarantine more rigorous but any human system will slip up. Moreover, if we increase the numbers of people coming into New Zealand from places where COVID is present we will be rolling the dice more often. On top of which, we may still see slowly developing cases that sneak past all attempts to detect them in a fortnight, and would evade even a perfect implementation of the current rules.
So, sooner or later, we are going to need to track down COVID cases in the community. Part of the answer is to improve the contact tracking system and hiring the people to make it work, but it will only be as good as our ability to tell a contact tracer where we’ve been and who we saw over the previous days of our busy Level One lives. Any solution to this problem needs wide uptake to be effective, and for that it must be easy to use. And if our experience with the current COVID app is anything to go by, “easy to use” means “completely automatic”.
So What Next? When we made the decision to move to Level Four our current situation would undoubtedly have looked like a nice problem to have, but we have implicitly chosen Level One freedom of movement over a relatively open border. Travel bubbles might help, but Australia’s resurgent caseload has taken our most obvious big buddy off the table for months to come. (For a detailed and nuanced analysis of the issues that go into the detailed decision making about bubbles and borders, you can’t go past this treatment by the current PM’s Science Advisor and Senior Research and Policy Analyst Rachel Chiaroni-Clarke)
And this is where Gluckman, Fyfe and Clark’s effort comes unstuck, in my view. Their paper leads off with a grab bag of apparently rhetorical questions whose actual answers may be less obvious than the writers acknowledge. For instance, they ask “Is New Zealand prepared to hold itself in its state of near-total isolation for the indefinite future?” and seem to expect a “no”, even though 80% of New Zealanders back quarantine until the virus is proven to be contained.
But it seems that the much of the point of the paper is to advocate for a “COVID card”, a bluetooth-based device that would be worn or carried by everyone in the country, with the goal of automating much of the tracking and tracing process. Once this is rolled out, it is implied, we could soften our border restrictions. The COVID card is not defined in the document, but a group of business and tech leaders – including Fyfe – have been actively lobbying the government to adopt it, and we are promised that “the costs of the COVID-card-type methodology are small compared with the costs of continued complete lockdown”, where lockdown here presumably means border quarantine, not Level Four. But a COVID card that works for the entire country is still vapourware; these things are in limited use elsewhere, but it would require a great deal of work to demonstrate it was effective for New Zealand as a whole.
Ironically, the fundamental reason this paper irritated many members of the science community was that it breaks two rules for science advice that Gluckman himself championed during his time as the Prime Minister’s Chief Science Advisor. One of them is that as scientists we should stay in our lane and avoid offering advice or commentary in areas that are well-removed from our research expertise: bluetooth mesh networks are a long way from any of the authors’ areas of deep technical competence.
More importantly, during his tenure, Gluckman championed the notion of “social license” – that technical innovation cannot simply be imposed by experts, but requires buy-in from the community. This is a complex issue, but it clearly drives New Zealand’s approach to GMOs and nuclear power (two technologies whose dangers may be overstated by their opponents) and is always in play in debates about vaccines, fluoride, 5G, and a “predator free” campaign for a country whose conservation movement advocates the wholesale slaughter of introduced pests. Or, in the words of Jeff Goldblum’s character in Jurassic Park “Your scientists were so preoccupied with whether or not they could, they didn't stop to think if they should.”
Expecting every member of the Team of Five Million to carry a device which records their every moment of proximity with other team members would require an exceptional level of trust and buy-in. But any real acknowledgement of this is missing from the document, which aligns with a wider lobbying exercise that relies on access and influence ahead of public consensus.
Likewise, breezily commenting that “Yes, there are apps that might provide private information to third parties or governments, but Google, Uber, and many others already have access to that information” does nothing to build trust at time when technology companies face deep cynicism and our democracies have been weakened by an onslaught of misinformation and fake news delivered by Facebook and others. Even if it works from a technical perspective, the societal issues faced by a COVID card may be a tougher problem to crack.
More generally, the paper raises the question of the trade-off between the economic costs of keeping our borders closed and remaining rigorously virus-free. It asks if we “can afford to wait out another year?” but given what we are seeing across the Tasman, my guess is that a lot of people will answer that question in the affirmative.
My Own Take We absolutely should look at COVID-card style solutions, app-based models that piggyback on existing smartphones, and anything else we can think of. (And, as a thought experiment, these might be more welcome if the Government tossed in a “KiwiPhone” programme helping us to update our pocket hardware, rather than asking us to carry a new device.) Electronic tracking and tracing could well be part of a belt-and-braces strategy in combination with border quarantine, rather using the card to justify moving to a situation guaranteed to increase the numbers of COVID-19 carriers circulating in our community.
In the shorter term we can presumably scale up the capacity of the quarantine system. Its management is undoubtedly improving, but maintaining and increasing public trust will be essential. At the current rate, roughly 120,000 people can enter the country per year; we could think of tripling that, and the hotel sector might welcome the revenue at a time when inbound tourism has been dramatically reduced. We will need to talk about how places are allocated: some arrivals are more valuable than others – cruise ship passengers contribute far less to the country per head than (say) incoming medical specialists or would-be university students, and we have an obligation to overseas New Zealanders who wish to come home.
There might be good news. If the impact of COVID approaches that of a global conflict, it is oddly reassuring to recall that World War II massively accelerated technological development in multiple domains. The world’s scientific resources are now focussed on COVID to an unprecedented degree, holding out hope of improved treatments and vaccines. But it is also possible that we are at the beginning of an era where instantaneous electronic connectivity is taken for granted but physical presence requires a two week wait at the border.
The 2020s may thus resemble the 1920s: the telegraph and radio connected continents but passenger ships were the dominant mode of international transport: travel was costly in terms of time and money, and not to be undertaken lightly. And for all that a return to “slow travel” may address part of the carbon conundrum facing a warming world, its arrival in this way would be nothing to celebrate given the human cost needed to bring it about.
I have colleagues who are optimistic about vaccines, and I hope they are right. But there is a very real chance that we will find ourselves wanting both the belt and braces — a tracking app (or hardware) and border quarantine, and will only bubble up with countries that have achieved the same level of elimination as ourselves. It would be a different world but it is one we might yet have to embrace and any well-informed national conversation about the future should recognise this reality. Once upon a time, the “tyranny of distance” defined the Pākehā experience of New Zealand, locating immigrants from Britain 12,000 miles from the country they often referred to as Home. But in the years to come that distance might be the best thing that has happened to the people of these islands.
Header image via publicdomainpictures.net — CC:BY 0/Gerd Altmann.