Charmaine Ngarimu used hand sanitiser and social distancing long before the arrival of Covid-19. Her health depended on it.
A corporate communications high-flier who has led teams and strategies for several public organisations, Ngarimu would always travel with a facemask. She had suffered chronic asthma since childhood, which was seriously exacerbated by even the common cold. When she was younger, she’d end up in hospital.
Even as an adult, she has to treat any infection with steroids and antibiotics. Every winter she would lose a week or two of work, bedridden with influenza. Influenza’s hidden cost to people like Charmaine, and to the economy, is significant.
She is one of the thousands of New Zealanders whose health, even their lives, have been saved by the coronavirus response. “Because people have used better hygiene and stayed home when they’re sick, I didn’t catch any colds or flus last year.”
Knowing what we do now, has New Zealand been doing enough to prevent flu deaths? Click here to comment.
Typically the flu claims 500 New Zealand lives every year; predominantly among the elderly, more vulnerable ethnic minorities, and those like Ngarimu with chronic conditions. Over the past year, that mortality figure has plummeted – and that in turn has sparked argument between experts.
Comparing Covid with the flu has sparked dangerously uninformed political rhetoric overseas; it’s a slightly more nuanced debate here.
In an article published today, Waikato University economics professor John Gibson argues the country’s investment in combating Covid is disproportionate to the number of deaths we’re saving; that to be consistent we should have been investing similar amounts to prevent deaths from flu and other causes.
But University of Auckland Professor Shaun Hendy, who has advised government on the spread of Covid, points out that Covid is 10 times more infectious, and those who are infected are more likely to die. He argues that this past year has shown that the hygiene and social distancing lessons learned from Covid have also saved lives from flu – and should continue to do so if we’re smart.
“A future historian will likely conclude that part of the Covid response was a mania or panic, not proportionate to the threat posed.”
– Professor John Gibson
The number of deaths registered during 2020 was 32,613, down 1,647 from the previous year, according to Statistics NZ. Generally, the numbers of deaths in New Zealand have gradually increased over time (despite increasing life expectancy) because of general population growth and more people in older age groups.
But drops in the mortality rates do happen from time to time, and last year’s sharp fall coincided with lockdown restrictions as a result of the Covid-19 pandemic. Alert level restrictions, including stay-at-home instructions, limits on road and air travel, and temporary business closures may have played a part in the reduced number of deaths, Statistics NZ says.
Gibson’s article, published on the University of Waikato website, says government responses to a health risk must always weigh competing threats to health and wellbeing. “And so the question lingers: to what extent has our national Covid response been in proportion to the actual threat? And what are the less publicised – but no less significant – other consequences of our ‘safety at all costs’ approach?”
It develops on a presentation he gave to the National Economic Forum hosted at the university this month, in which he said the Government has failed to follow prior health risk decision-making benchmarks. “The lack of trade-off analysis raises future uncertainty,” he said. “We did it for Covid so why not do it for flu every winter?”
He worried that the billions borrowed to manage the Covid response and economic stimulus would create a debt burden for the next generation, “and possibly create perverse effects on life expectancy.”
Last year, Newsroom reported that government agencies use a formula that for allocating scarce funds to roading infrastructure that is slowing traffic, choking economic growth, and endangering lives – but now, the economic investment to prevent Covid infection and death is far higher.
The ‘price of life’ was updated in August to $4.53 million – that’s the sum government agencies and councils will spent to avert the odds of a single death on the roads. Now these formulae have new significance. The economic value we place on a human life is the unspoken calculation behind the biggest political question of this year: how much will New Zealand invest in preventing the community transmission of Covid-19? Is any price too high to save us from coronavirus fatalities?
“Given the investment we’ve made now in these new scientific tools, we can use them at relatively little cost in the future to fight influenza – which is a problem. It’s not as big a problem as Covid, but it’s good to be able to turn these tools to flu as well.”
– Professor Shaun Hendy
Gibson’s article today is (by his own admission) provocative: “A future historian will likely conclude that part of the Covid response was a mania or panic, not proportionate to the threat posed,” he suggests. “Early in the pandemic, a widely reported model predicted that Covid could kill 80,000 New Zealanders. That claim was never retracted or corrected, yet it is entirely implausible.
“A fully rational Covid response would reflect updated information, and overly-fearful early predictions would be corrected.”
It was a team led by Professor Hendy that published that early modelling, warning that up to 80,000 people might die in New Zealand, if the country did nothing. Now, Hendy stands by that analysis, though he acknowledges that new information would allow them to downgrade the likely numbers of deaths somewhat.
What has changed? In main, the vaccines have arrived sooner than even the most optimistic vaccinologists dared hope, and the Covid infection fatality rate has proved slightly lower (0.9 percent, rather than 1.0 percent) than Hendy’s model. Counting against that, Hendy says the capacity of the country’s hospital intensive care units has since been found wanting.
Factoring in those and other changes, Hendy estimates New Zealand’s lockdowns, social distancing, hygiene measures and other strategies are averting 10,000 deaths over the course of this pandemic. And he issues a grim reminder: it’s not over yet.
“We know that Covid’s in the order of 10 times more deadly, twice as infectious as the flu, and certainly our hospital does struggle during a normal flu season – we certainly haven’t built a hospital system to cope with Covid,” he says.
“But given the investment we’ve made now in these new scientific tools, we can use them at relatively little cost in the future to fight influenza – which is a problem. It’s not as big a problem as Covid, but it’s good to be able to turn these tools to flu as well.”
Other New Zealand economists have told Newsroom they agree Covid-19 was treated disproportionately – but that’s not necessarily a bad thing. This is a disproportionate disease; it breaks many of the old models. And traditional “price of life” models have observed that communities will spend more to avoid deaths they “dread”, like death from cancer or nuclear fallout.
“People with compromised immune systems, and indigenous populations, are more susceptible to contract or die from Covid than they are from other illnesses. So that’s why it’s important to me that, particularly here, we do the right thing by getting vaccinated. It’s the right thing for the country and our communities.”
– Charmaine Ngarimu
“I do think there has been an element of a ‘dread’ factor with Covid-19,” says economist John Wren. “The dread was looking at Italy and saying let’s learn and if we don’t act now there is no reason to say it won’t happen here.”
This is slightly different from the traditional dread model; which found people were especially repulsed by dying in manners that were perceived to be more unpleasant. What Wren describes here is a more systemic dread that goes beyond individual fears; that rightly recognises the potential of this killer virus to spread in a way that a dangerous road intersection cannot.
“What is the price New Zealand Inc is prepared to pay for the elimination strategy? What are the socio-economic trade-offs; are we happy with the choices made?” Wren asks. “The answer so far seems to me to be yes, the country is.”
Ngarimu, 46, is from Ngati Porou and Te Whānau-ā-Apanui. “People with compromised immune systems, and indigenous populations, are more susceptible to contract or die from Covid than they are from other illnesses,” she says.
“The virulence of Covid speaks for itself. The numbers speak for themselves. That’s the reason the WHO recognises it as a global pandemic, unlike the annual influenza.
“So that’s why it’s important to me that, particularly here, we do the right thing by getting vaccinated. It’s the right thing for the country and our communities.”