Matthew Hooton: NZ Covid defences no more ready for Omicron than we were for Delta

We're at risk of doing our smug hermit kingdom thing again.

As New South Wales in particular and Australia generally struggle against Omicron, we're celebrating dodging a DJ Dimension outbreak and having fewer than 250 new Delta cases in the community over the last week. The way we're going, we could soon be Delta-free.

But we've been here before in late 2020 and the first half of 2021, after beating the original strain. We then spent too much time gloating rather than getting ready for the next phase. The Government's Delta plan never advanced beyond confirming there would be an immediate level 4 lockdown after one case.

In the meantime, its own PR campaign said getting New Zealand vaccinated wasn't a priority compared with elsewhere. Whānau Ora providers and others who wanted to start planning back in February how best to jab hard-to-reach and vaccine-hesitant communities were told they weren't needed.

Even earlier, in September 2020, Heather Simpson and Brian Roche formally advised Covid Minister Chris Hipkins that "all efforts should be made to introduce saliva [PCR] testing as soon as possible", alongside nasal PCR testing.

They lamented that "on current plans, widespread introduction is still more than 2 months off, even though in other jurisdictions saliva testing, involving large numbers of tests per day, has been well established for several months".

Yet, another fifteen months later, saliva PCR tests still remain limited to some workers at the Auckland-Northland and international borders, in MIQ hotels and in Auckland health-care facilities.

Similarly, business leaders and the Opposition lobbied through 2021 for rapid antigen tests (RATs) to become available, both nasal and saliva.

Only in November did the Government finally bow to pressure and lift its inexplicable ban on technology widely used in the rest of the world.

While much less accurate than PCR tests, RATs give faster results. They're useful to more quickly detect community spread and for people who want a daily test.

In spite of that, RATs remain available only in some healthcare settings, government agencies and selected pharmacies; for unvaccinated people seeking to travel out of Auckland; and in some select private businesses that pay for them. Importation is still strictly regulated.

This lack of urgency has the feel of last winter. We look hubristically across the Tasman as Omicron rips through NSW and Victoria and feel superior to the dim-witted Aussies. Yet everyone knows Omicron is coming.

Completely closing the border is off the Government's agenda. It says it remains committed to its "Reconnecting New Zealanders to the World" programme, albeit on a slower timeline than originally announced – causing further fury among the hundreds of thousands of Kiwis trapped abroad for nearly two years without DJ Dimension's triple MIQ-lottery success.

Also off the agenda are lockdowns. Hipkins specifically said before Christmas that the Government's response to Omicron would be the red traffic light, with anything else an absolute last resort.

It is clear from NSW, with 93 per cent of people aged 12 or over now fully vaccinated, that vaccination doesn't stop spread. Yesterday, from a population of 8.2 million, it reported 34,994 new cases and 207,667 active cases, with 1609 in hospital, 131 in ICU, 38 on ventilators and six more deaths.

The equivalent New Zealand numbers would be 130,000 active cases, 1000 in hospital, 80 in ICU, 24 on ventilators and four deaths. Around 22,000 new positive tests would have been reported.

NSW's outbreak is still growing but its testing capability is maxed out at roughly 110,000 a day, of which around a third are positive.

With around 40 per cent of people who test positive not experiencing any symptoms, epidemiologist Professor Tony Blakely of the universities of Otago and Melbourne believes new daily cases are probably five to ten times those discovered each day – or between 175,000 and 350,000 yesterday in NSW alone.

The outbreak is also spreading, with infections in Victoria rapidly approaching NSW's rate, and Melbournians strangely getting sicker than Sydneysiders. Professor Blakely thinks 60 per cent of Australians will become infected with Covid by the end of this month. There is talk of half the world's population being infected in the next few weeks.

If border closures and lockdowns are off Hipkins' agenda, then it's most likely Omicron will arrive here very soon and perhaps infect half of us before too long.

Some people will die but most of those infected won't even know they have been. We will be right back to March 2020, when Jacinda Ardern was talking about flattening the curve to protect the public health system from being overwhelmed, rather than aiming at elimination.

As shown during Delta, contact tracing falls over at just 200 positive tests a day. The NSW experience suggests we should plan for one hundred times that.

Meanwhile, the Ministry of Health says New Zealand can currently do no more than 40,000 PCR tests a day, although it expects that to rise to 60,000 next month. It doesn't say how many will be saliva PCR tests as opposed to the more uncomfortable nasal PCR tests but either way it won't be enough. Even at 60,000 tests a day, per capita testing will be much lower than NSW is achieving now, and its system is already overwhelmed.

According to the Ministry, New Zealand has three million RAT kits with another six million ordered. That's less than two per person, whereas Scott Morrison claims to have ordered 200 million, enough for nearly eight per Australian.

Neither is enough, especially if the asymptomatic "worried well" start demanding them. With RAT kits already running out in larger, wealthier and better-connected countries than Australia and New Zealand, both orders seem optimistic. Not just PCR tests will need to be strictly rationed, but whatever RAT kits Morrison and Ardern finally secure.

This is not Armageddon. In the scheme of things, very few of us will be hospitalised or die. But Omicron will change the political and economic context of Covid, just as it has everywhere else. In the short-term, all other health care except for immediately life-threatening conditions will need to be suspended.

We'll all know lots of people who are sick. We really will need to be kind to one another. Let's start by not being too smug towards our cousins in Australia and our other friends beyond.