In the 10-part series What's the Plan? The Herald's political and specialist reporters examine the big issues facing New Zealand and how the main political parties plan to deal with them. Here, Derek Cheng compares the policies for Covid-19
The Covid policy landscape was a sparse desert at the start of August, when New Zealand was basking in community transmission-free bliss.
But that all changed with the new outbreak. As shortcomings were exposed and the Government moved to contain it, political parties came up with fresh ideas on how to keep New Zealand Covid-free.
There is now broad agreement with elimination in the short-term: keeping the community Covid-free by quarantining imported cases, detecting any outbreaks early through ongoing testing, and stamping out community cases through rapid tracing and isolating contacts.
But there is less detail about the medium- to long-term approach. How should we leverage our relatively Covid-free status to attract the world's best and brightest? What lifeline can we give the international tourist ($18 billion a year) or foreign student ($5b a year) sectors?
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New Zealand has been the envy of the world, with far fewer cases and deaths per capita than most other countries - and generally a more open economy and freedom of movement as a result.
Success so far is down to a number of factors including our marine borders, low population density, and the later arrival of Covid, which allowed breathing space to see what was happening overseas.
The Government response has had to be decisive yet agile - but also reactive as it responded to new research and to plug gaps in the system.
Kiwi lockdown compliance was a key factor, as were the Government's decisions including shutting the borders and listening to public health experts in moving to elimination. The seven-week lockdown at levels 4 and 3 stamped out the virus at a time when New Zealand was facing thousands of deaths and a much more damaging economic fallout.
It might not have been necessary for so long had our public health units (PHUs) not been so underfunded by successive governments. Contact-tracing has improved massively from an abysmal point in mid-March to more or less hitting the gold standard in the latest outbreak.
But Auckland was still sent into level 3 for 19 days because of the outbreak's nature: An unknown source, the more vulnerable Pasifika community, and exposure in churches and on public transport.
It also threw the low daily testing numbers into sharp relief, as well as the failure to have border-facing workers regularly tested and the low rate of genomic sequencing of positive cases.
The Government is now requiring border-facing workers to be tested weekly or fortnightly, and is rolling out a community testing programme to target people with cold and flu symptoms as well as those connected to high-risk places or people.
It has also made mask use on public transport for levels 2, 3 and 4 compulsory, along with QR codes for businesses. To enhance contact-tracing, CovidCards in Rotorua and in a managed isolation and quarantine (MIQ) facility will be trialled.
Despite a handful of escapees, the current border controls have mostly contained imported cases. Only three border workers (a Ministry for Primary Industries official, a maintenance worker at Rydges Hotel, and a nurse at the Jet Park Hotel) have tested positive.
The source of the August outbreak may also have come from an MIQ facility, but there is no evidence so far.
All overseas returnees stay in Government-run MIQ hotels for 14 days, and must test negative before they can leave. Roughly 7000 people are held in MIQ at one time, and about 14,000 returnees a month can be housed.
The National Party wants border controls to be further strengthened by requiring returnees to test negative within three days of boarding a flight home, as well as pass a temperature check.
The requirement for a pre-depature test was given renewed impetus following a flight from India that had 17 cases on board, and another with 10 cases.
Those flights prompted epidemiologist Michael Baker to call for strict measures - a pre-departure test and a week in quarantine - before people could board a flight to New Zealand from Covid-risky countries.
But asked how she would respond to a new outbreak detected in Christchurch on Christmas Eve, National leader Judith Collins said she would put the city into lockdown but would "be very concerned" to move the rest of the country into level 2.
That would leave a lot to chance. The outbreak could have been spreading for days, even weeks, and throughout New Zealand - especially given the amount of travel at that time to spend Christmas with loved ones.
National also wants a Bluetooth device to be rolled out for contact-tracing, and for all MIQ workers and overseas returnees to carry a CovidCard - which could help detect a new outbreak close to its likely source earlier.
And National wants every Covid-positive person to be resampled within 24 hours for genomic sequencing, a record kept of people who have been declined tests - which could shed light on where testing practices are coming up short - and mandatory day-three testing for overseas returnees in MIQ.
How to keep up daily testing remains vital. The Greens want ongoing use of pop-up testing centres, which were used on the few days in July when the daily target of 4000 tests was met.
The Greens say the messaging to GPs needs to be clearer so a test is recommended if there is any chance that a symptom might be due to Covid-19. At level 2 or higher,
higher-risk businesses, such as bars, should only be allowed to serve customers who sign a register or scan the QR code.
NZ First also supports "over-testing", including random retesting of people after they've left MIQ, as well as in the communities they've returned to.
Easing border controls beyond the short-term are somewhat reliant on evolving testing and treatment technology.
The Government has said special purpose-built MIQ facilities are being explored, and has outlined criteria for loosening the border including a quicker turnaround time for tests, the ability to treat a large number of people, and whether there is a vaccine.
It is unclear how foreign students could be allowed to return next year without allowing private MIQ facilities. About half of the 110,000-odd such students a year are currently in New Zealand, meaning it would take four months at the current MIQ capacity to let the rest in - while keeping everyone else out.
Labour wants 10 per cent of MIQ capacity to be used for foreigners, particularly for migrant workers with specialist skills to plug labour market gaps. It also wants a $12 million a year fund to attract offshore investment.
National says the Government's approach involves too many agencies and lacks accountability. Today it is expected to release a longer-term border strategy, including having a NZ Border Protection Agency set, inspect and enforce MIQ conditions that any provider can apply to meet.
The focus would continue to be keeping New Zealand as Covid-free as possible.
Foreign workers are currently allowed in under strict criteria, but it wasn't ideal when Avatar workers self-isolated in a Wellington hotel, where at least one of them came into close contact with other guests.
This is unacceptable to NZ First, which wants all MIQ facilities to be government-run, preferably by the Defence Force and on Army bases. It also wants a national border force agency.
The idea has the backing of University of Otago public health experts, who say it should be the Air Force base at Ōhakea, which would make an outbreak in densely populated Auckland less likely.
Labour has said there isn't enough space to hold 7000 people at a time with the right safety precautions, such as separate bathrooms.
Act wants the Government to set MIQ safety standards, and if they are met - either by educational institutes or even Airbnbs - then foreign workers, students and tourists should all be allowed in.
New Zealand should aim to be like Taiwan, Act says, where harsh lockdowns have been avoided on the strength of public health measures such as physical distancing, more mask-wearing, and the use of cellphone tracking for those in isolation.
It is also calling for an Epidemic Response Committee, as Taiwan has, to be responsible for the national strategy. Similarly, the Greens back a national public health agency.
The Greens also want early leave from MIQ to be scrapped if the health risk is too high. This might trigger court action, which has previously stung the Government's rules for compassionate leave.
Only the Māori Party backs public health experts' calls for mass masking in congested indoor environments.
It also stands out as the only party against elimination, preferring containment - though it is unclear what that means - along with "bubble-wrapping" of vulnerable populations including Māori, Pasifika, the elderly and those with comorbidities.
The Māori Party doesn't want any international students or foreign tourists before a vaccine is available.
Speed can be all the difference in contact-tracing
Rapid and effective contact-tracing is a key pillar of keeping us safe by ring-fencing cases and their contacts before they might infect others.
Capacity has come a long way since mid-March, when the system could trace 10 active cases a day and the 12 regional public health units had different IT systems that couldn't talk to each other.
Now it's all been integrated and workload can be shared, National Investigation and Tracing Centre lead analyst Claudia Rees says.
That has enabled surge capacity to trace hundreds of cases a day, as well as the ability to look across multiples systems for someone's contact details.
When a person's laboratory result comes back positive, the national centre and the relevant PHU are notified.
Officials then make contact to give advice and do a risk assessment before a proper investigation - which can be a series of interviews to determine movements, and close and casual contacts.
Identified close contacts are told to isolate and get tested, and are then given daily follow-ups to check their health or welfare needs, any symptoms, or if they're isolating properly.
It is helpful if the case has been using the Covid Tracer App, which has seen a surge in uptake during the current outbreak.
The national centre can generate a code for the case to put into the app.
"They do that while we're on the phone to them and all of their contact locations will populate the National Contact Tracing Solution [system]," Rees says.
"That makes it a lot faster to get a full pathway of where the case has been. I then look through those and decide which ones are maybe a bit more high risk, or ones I want to send out a push notification for."
High-risk ones might be indoor events where people are packed closely together and have been singing or exercising.
Rees can then create an "exposure event".
"Everyone will get a notification on their app who scanned in at the same time as the case."
Rees also has an overview dashboard of the day's work tasks.
"You can see the cases opened recently we are actioning, the total close contacts and how many are awaiting contact, and other parts like any symptomatic close contacts or any who are essential workers.
"It just gives us that really good overview, maybe where some risks are or where immediate attention needs to go to, and also where we might need more people."
Tracers' work has been well above the gold standard recently; from August 28 to September 3, 94 per cent (80 is the target) of close contacts were in isolation within 48 hours of a positive test result.
Covid-19: The policies
Labour
• 14-day MIQ for all overseas arrivals who must return a negative test before leaving.
• Regular testing of border-facing workers.
• CovidCard trial in MIQ and in Rotorua community.
• 10 per cent of MIQ space allotted to specialist foreign workers, and $12m a year fund to attract offshore investment.
National
• Mandatory negative test for overseas returnees before boarding a returning flight.
• Mandatory day-three test of returnees in MIQ.
• NZ Border Protection Agency to set, inspect and enforce MIQ conditions.
• Proactive testing in high-risk or remote communities.
• CovidCard for all MIQ workers and overseas returnees for their 14-day isolation.
The Green Party
• Establish national public health agency.
• Pop-up testing centres to keep up daily testing.
• Higher-risk businesses (clubs, bars) required to only serve customers who sign in or scan QR codes at level 2 or higher.
• MIQ charging only for Kiwis going overseas after the current charging regime was announced
NZ First
• Over-testing, including random retesting of overseas returnees who have finished isolation as well as their communities.
• Increase MIQ capacity and move them to Army bases.
• National border force agency.
• Charge all overseas returnees for MIQ.
Act
• Govt to set safety MIQ standards for overseas arrivals and foreigners allowed in if standards are met.
• Different measures for overseas returnees based on risk.
• Cellphone tracking of people meant to be in isolation.
• Epidemic Response Committee to oversee national strategy.
Māori Party
• All overseas arrivals to test negative at their last port of exit.
• Returnees from any Covid-ravaged country to be tested on arrival and quarantined.
• Containment rather than elimination, with localised lockdowns.
• No international students or foreign tourists before a vaccine.
