Dr Anthony Fauci on the vaccine development against Covid-19
New Zealand made up its own plan to tackle the pandemic, one that was not only a huge economic risk, but also a professional one.
And just because New Zealand is small and isolated, it wasn't a given that the virus would be eliminated, the country's leading epidemiologist Professor Michael Baker says.
Baker was responding to comments by Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the USA, who gave kudos to Kiwis for managing to put a stranglehold on the virus.
In a chat with Herald columnist Dick Brass, Fauci said New Zealand was unique in that "it's an island".
"You know, it's a unique situation. It's an island. They have the ability to shut things down and open things up quickly.
"They have a population that has done very well in listening to the kinds of public health messages that have come from the central authorities. So when you talk about who's done well and who's not done as well, New Zealand always rises to the top as a country that has actually done really quite well."
However, Baker said just because we were an island it didn't make it easy. And just because we had a smaller population, didn't mean it would be easier to eliminate.
"Countries not only in the Pacific, but also Ireland and Scotland, with similar populations to New Zealand were all now struggling with the virus as they decided to open their borders to allow tourists in.
"Our isolation helps a little bit but you only have to look at the Tasman and Pacific.
"You just have to go to French Polynesia who said 'oh our tourism won't cope' so they opened the country up and they've had the similar experience to big countries with the virus.
"French Polynesia has a terrible epidemic now in Tahiti, and many deaths.
Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases in the USA. Photo / Supplied
"Iceland is the same, they said they couldn't surivive without the tourists and they opened and they've now got quite high rates of the disease and the economy has not bounced back because essentially tourists don't want to go when there is the threat of the virus."
Baker said the elimination approach had proven to be successful.
"Even though I know Fauci said all options were on the table and considered, as far as I know Europe in general and North America never really looked at elimination seriously as far as I could tell."
However, he said New Zealand got there on its own and without much needed advice by the big players of the health and science world including the World Health Organisation [WHO].
"Even the WHO has not really said very much about the far more vigorous elimination model which is protecting hundreds of millions of people at the moment.
"Look at China, 1.4bn people, essentially no community transmission of Covid and they have an even lower mortality than us, they've got about 3 per million, we're about 5 per million but it's a meaningless comparison really beause we're all in the same position, both countries have said we're going to have elimination and zero community transmssion as our goal."
The model has been followed "very successfully by a whole ring of countries" around Asia and to some degree South Korea, Japan and Singapore although with results not as high.
Baker said he initially took inspiration from China and its elimination approach and suggested that Hawaii could have done the same, but again, decided to let in tourists so that businesses could survive.
"China took an elimination approach, that's where I got my inspiration from in the fact that China stopped it.
Somewhere like Hawaii could have easily eliminated this .. I talked with the state epidemiologist early on and she was really keen but in the end she said basically the business interests were too strong and 'they won't let me do this'."
He said costs to a government of managed isolation shouldn't have been a barrier, all a county needed was "basically a government who is committed to it".
"You need enough infrastructure to roll it out and then need a safety net to protect people whose businesses may have failed, so you're sharing the costs around to take that approach.
"Most countries did not conceive of doing this and missed the opportunity."
Baker said he had also spent a lot of time talking to epidemiologists in Scotland, Ireland, and England who were "desperate to take the elimination approach" but didn't have the government support.
"I don't know if it was seriously considered in most countries.
"Many countries stuck with the mantra that it was just like influenza."
"We eliminated it with non-pharmaceutical intervention... the whole world has to decide whether it's going to eliminate or just control it, and that hasn't even been discussed as yet."
As for a vaccine, New Zealand was now in the enviable position of not having to much to grab the first one that came on offer.
"If you're stuck with the virus circulating actively it's a very different set of decisions. New Zealand is in a position to take, I wouldn't say a leisurely approach, but a very considered approach as to the vaccine.
"And also, we don't have to take the first vaccine that's available so I think that does put us in a much safer position in many ways."
But to get where New Zealand is now, was a path the country rode alone.
"In New Zealand we were all waiting for the organisations that have huge capacity to give us a steer as to what to do and that's the WHO, the US CDC, European Centre for Disease Control and Public Health England which we normally go to and they were saying nothing useful, so we did make up our own strategy.
"At times I thought that's a bit worrying that we're the only country with that strategy, but I think at times countries in Asia didn't articulate it in the same way, they just got on and did it."
