US Surgeon-General Jerome Adams receives the Covid-19 vaccine in Washington, DC. Photo: Getty Images

With the Covid-19 vaccine purchase and roll out plan announced last week, the second quarter of 2021 cannot come soon enough for New Zealand. It will be then the vaccine gets administered to the first, most important group in the queue – our frontline or high-risk workers.

I know the feeling when you have an immediate family member working as one of those high-risk workers who leaves their home every day to go to their work, hoping to not bring the virus home with them.

After digesting a bit of logic for not able to get the vaccine as early as some other countries, we all hope the plan works as we cannot let our high-risk workers down again. Each and every time this group raised their concerns for their safety and protection from the virus, they were settled by assurances, sometimes deflections or even blaming miscommunication or lack of enough evidence to make it sound astute.

The control and containment of the virus at our borders comes down to three main things excluding the obvious basic hygiene, social distancing and contact tracing measures.

Covid-19 is still running rampant around the world and vaccines won’t arrive here until March. Should New Zealanders be saving for the next rainy day, or spending their money supporting local businesses in the lazy, hazy days of summer? Click here to comment.

It’s regular testing, appropriate protective gear and an effective vaccine.

The government announced a new Covid-19 testing strategy in June that was about regular testing of border and quarantine workers.

But despite it being a basic measure to control and contain the spread and giving the impression that those high-risk workers were being tested quite frequently to catch any cases as early as possible, it was revealed in August that more than 60 percent of border workers were never tested.

No surprise that this issue has been picked up by the Simpson-Roche report into Covid-19 response.

It looks like New Zealand will hold the dubious position of the last of the developed countries to administer the vaccine to their high-risk workers.

This big failure to look after our high-risk workers was then blamed on miscommunication between the Ministry of Health and the Cabinet. A fresh announcement in September required all border workers to take regular tests or face fines of between $300 and $1000, as if it was the high-risk workers’ fault all that time.

The next important thing along with testing is protection or infection prevention mechanisms for these high-risk workers which takes me to the next point – appropriate protective gear.

The government was quick in dismissing the calls from Professor Michael Baker back in May, going into level 2, when he called for mass masking to be implemented. Simple cloth or surgical masks were seen to be effective only when worn by infected people, not in protecting other wearers from getting infected.

The Ministry of Health said at that time that there was little evidence that wearing those masks was effective. It was said that people in South East Asian countries routinely wear masks when going out, because they have a cold and they don’t want to spread germs. In New Zealand, the message was simply to not go out if you have a cold.

Well, there was nothing wrong with that logic – if only everyone infected knew they were infected, and followed the rules.

So the bigger question is that if these surgical masks were only good enough to stop the infection spreading from an infected individual, then why were the high-risk workers required to wear those surgical masks until this month? They are not spreading the virus; they are the ones who need protection. These are the people who are dealing with positive and possibly positive people every day they are at work.

Why then did it take so long for the government to provide N95 masks to these high-risk workers?

Unfortunately, this move to provide N95s didn’t come from government as a proactive approach, but only after pressure from health workers and embarrassing headlines about staff wearing just surgical masks.

What kind of evidence was needed to understand that fitted N95 respirators are the masks that can protect these workers, better than the ordinary surgical masks? Did we not know that in some situations while providing healthcare or other support, strictly maintaining a two-metre distance may not be practical?

Fitted N95s can protect the person wearing it from getting the infection, as it filters the air that the wearer gets through it to inhale. In simple terms, it does that by filtering out at least 95 percent of particles including bacteria and viruses larger than 300 nm in size.

If you are puzzled thinking about the size range of coronavirus (known to be 50-200 nm in diameter) let me remind you that coronavirus is mainly transmitted through respiratory droplets which are usually between the size of 5,000 to 10,000 nm – big enough that they cannot get past a properly fitted N95 mask to the inhaler.

Even if the size is smaller like the size of a droplet nuclei or aerosol, as they are referred to, remember that the particles that we generate or exhale are usually big enough most of the time for N95 masks to be effective.

We have had around 500 cases so far brought in by international returnees, including staff working at the border or in managed facilities.

All these high-risk workers go to their work hoping the system is going to look after them.

Implementation of N95s earlier may not have completely eliminated the chances of all these individuals getting infected but would have definitely kept the numbers lower and most definitely would have shown the system is not taking this group of high-risk workers for granted.

Finally, coming to the long-awaited vaccines.

New Zealand was one of the later countries to import Covid-19, which was good – but it looks like it will hold the dubious position of the last of the developed countries to administer the vaccine to their high-risk workers.

Whatever the reasons are for New Zealand high-risk workers to have to wait for so many more months than other countries, I hope the system will not let them down again. It must take place in the second quarter of 2021 – as promised.

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