66-year-old Maria McBirney (Ngāpuhi, Tainui, Kūki Āirani) caught Covid in March. Video / Whakaata Māori
A new analysis has shown how New Zealand's pandemic response left it with one of the lowest rates of excess mortality in the world – sparing it the thousands of extra deaths seen even in "elimination" countries like Taiwan and Australia.
But the Otago University public health experts who crunched the data say that, with the Zero-Covid era now well behind us, there's much more the Government could be doing to keep Kiwis safer.
It comes as the Ministry of Health announced another 17 virus-related deaths today, and 3140 new Covid-19 cases.
A new analysis has shown how New Zealand's pandemic response left it with one of the lowest rates of excess mortality in the world. Photo / Michael Craig
In a commentary published today, researchers Dr Jennifer Summers, Professor Nick Wilson, Dr Lucy Telfar Barnard, Dr Julie Bennett, Dr Amanda Kvalsvig and Professor Michael Baker compared our mortality rates against five other high-income jurisdictions in the Asia-Pacific region.
They were Australia, Japan, Singapore, South Korea and Taiwan, which used a mix elimination and "suppression" to force down infection rates before being overwhelmed by Omicron.
Like New Zealand, all of those jurisdictions used these tough strategies to keep the virus at bay while they vaccinated as much of their populations as possible.
While Singapore pivoted away from elimination last July, South Korea continued to use control measures like isolation, quarantine, contact tracing and physical distancing, and managed to avoid general lockdowns.
Although Japan never effectively chased elimination, it did use lockdowns, along with school closures and other public health measures that found widespread compliance.
The arrival of Omicron eventually saw borders reopened, health measures relaxed, and quarantine requirements lifted in the two other countries New Zealand has been repeatedly compared with: Australia and Taiwan.
Although we've since recorded 1.72 million cases – the true number of infections could top three million – and more than 1700 virus-linked deaths, the researchers found other jurisdictions had comparably seen worse rates.
South Korea had experienced the year's largest wave, reaching about 7814 cases per million of population in mid-March.
That compared with 4,213 per million in Australia's January surge and 4294 per million in the peak of New Zealand's first Omicron outbreak.
When the researchers looked at deaths, they found South Korea and Taiwan recorded the highest peaks, with rolling seven-day averages that respectively reached seven and eight per million, in late March and early June.
Smaller mortality peaks were seen throughout the pandemic period in Japan and Singapore – but to a lesser extent in Australia and New Zealand, which only just recorded its deadliest week for Covid-19.
In terms of cumulative Covid-19 deaths, Australia and South Korea reported the highest totals, at 516 and 504 per million respectively.
But the researchers stressed that reporting of deaths and cases varied across countries - and cumulative testing rates in Japan and Taiwan, for instance, were lower compared with New Zealand, Australia and South Korea.
A perhaps cleaner measure for comparison was "excess mortality" – or the difference between how many people died throughout the pandemic from any cause, and how many would've been expected otherwise.
That allowed them to view the effects of shutting borders and squashing transmission: something that temporarily also crushed influenza on both sides of the Tasman, dramatically lowering winter death rates over 2020 and 2021.
It also enabled a glimpse at what Omicron-stretched hospitals may have meant for healthcare for other illnesses.
While they found patterns of excess mortality had fluctuated heavily with Omicron, as at last month, only New Zealand had maintained a reduced rate.
This graph shows the cumulative number of deaths from all causes compared to projections based on previous years, per million people, across Australia, Japan, Taiwan, South Korea and Singapore. Source / Our World In Data
Across the entire pandemic period, New Zealand had minus 215 excess deaths per million, which equated to around 1103 fewer people dying than in a scenario in which the Covid-19 crisis never happened.
If we'd experienced a similar per capita excess mortality rate with other jurisdictions, then the country may have seen 1856 extra deaths (Japan), or 2127 (Taiwan), 2577 (Australia), 3798 (Singapore) or 5167 (South Korea).
Remarkably, there were only nine jurisdictions on the planet which had recorded negative cumulative excess mortality for the pandemic period, of which New Zealand was the largest.
They noted, however, that the ongoing toll from Omicron here was gradually decreasing the magnitude of that reduction - and Baker has previously pointed out the virus has become one of our leading causes of death.
"New Zealand used the elimination strategy to keep mortality low throughout the earlier part of the pandemic, allowing time for development and delivery of vaccines before widespread Covid-19 circulation," the experts said.
"However, there still remain areas in which the pandemic response and management could be significantly improved to reduce the ongoing morbidity and mortality burden, and to protect health workers and health systems."
New Zealand now needed to choose a strategy to minimise Covid-19 infections - particularly with the ever-present risk of Long Covid.
They saw wider potential for masking in schools, colleges, indoor facilities and healthcare settings – while mandates in properly-ventilated spaces like shopping malls could be reviewed.
Finally, they wanted to see the Government stress the need for people to stay home when sick, citing research suggesting some people with Covid-19 could stay infectious beyond a week.
Updated advice, they said, might include an "appropriate isolation period", followed by test-to-release using rapid antigen testing, and wearing a high-grade mask until day 10.
That needed to be backed by sick leave provision, free rapid antigen tests and advice on how to reduce the risk of infecting others in the household.
"Omicron has changed the pandemic landscape substantially, requiring a regular reassessment of the optimum response strategy," they concluded.
"As Aotearoa New Zealand navigates through this next phase of the pandemic, the New Zealand Government should look to other jurisdictions and strengthen public health measures to minimise both the immediate and the long-term impacts of the Covid-19 pandemic."
According to the Ministry of Health's latest update, there are 373 people in hospital with the virus, including six in intensive care.
Five people whose deaths were reported today were from Auckland, three were from Waikato, two were from Bay of Plenty, two were from Hawke's Bay, one was from Whanganui, two were from Nelson Marlborough, one was from Canterbury and one person was from Southern.
Two people were in their 60s, six were in their 70s, six were in their 80s and three were aged over 90.
The locations of the cases in hospital today is Northland (six), Waitematā (52), Counties Manukau (25), Auckland (54), Waikato (62), Bay of Plenty (16), Lakes (11), Hawke's Bay (17), MidCentral (20), Whanganui (two), Taranaki (10), Wairarapa (eight), Capital & Coast (14), Hutt Valley (18), Nelson Marlborough (seven), Canterbury (40), West Coast (one), South Canterbury (three) and the Southern region (seven).
