A trove of documents released by the Government shows Ashley Bloomfield wanted tighter restrictions on travellers from India while experts said the Government had gone too far, Marc Daalder reports
Director-General of Health Ashley Bloomfield wanted to stop everyone, including citizens, from travelling to New Zealand directly from “very high-risk” countries – a list which now includes India, Pakistan, Brazil, Papua New Guinea, Fiji and Indonesia. This would have effectively been an extension of the 17-day ban on all direct travel from India, which was instituted in mid-April.
The revelation is one of several found in a batch of documents relating to the very high-risk list that were quietly released in late August, while the country was in Level 4 lockdown.
The documents also show that the Ministry of Health has viewed India, Pakistan and Brazil as no longer requiring the very high-risk restrictions since July 8, but has yet to formally remove the designation. As long as it remains, anyone who isn’t a citizen or the immediate family of a citizen has to spend 14 days outside of the very high-risk country before they can fly to New Zealand.
Mystery Skegg letter
Another of the documents is a letter from the expert panel chaired by epidemiologist Sir David Skegg to Associate Minister of Health Ayesha Verrall. The letter evaluates the very high risk system that was put in place in late April and found there was no public health justification for the restrictions on travellers from Pakistan, Brazil or Papua New Guinea.
The existence of the letter is a surprise, as Prime Minister Jacinda Ardern had said on August 11 that all of the advice Skegg had provided to the Government had been publicly released. The letter, written in May, wasn’t made public until August 27.
“We’re extremely surprised that there was other information since we took the Prime Minister at her word,” ACT Party leader David Seymour told Newsroom.
A spokesperson for Covid-19 Response Minister Chris Hipkins said that other than the May letter from Skegg, alongside three letters relating to reopening the borders that the Government had released on August 11, “We have not received any further written advice from Professor Skegg and the group that we convened”.
The spokesperson did not answer a question from Newsroom regarding whether the Prime Minister was wrong when she said in Parliament on August 11, “We’ve released the totality of the advice that we received from Professor David Skegg and the group that we convened”.
Skegg himself confirmed to Newsroom that just four pieces of advice had been provided to the Government.
“Presumably this letter was not included in the earlier release because it was not considered to be relevant to the Reconnecting forum. It was a piece of work that we were asked to do when the committee had just been established – to review a briefing paper that was under consideration by ministers,” he said.
Bloomfield effectively wanted ban extended
In the letter, Skegg advised that the Government’s new very high-risk system didn’t properly appraise the risks from some countries.
The system was put in place after the ban on travel from India ended as a result of a large influx of Covid-19 cases coming from that country. Through April, India was the source of more cases in MIQ than any other country, with 158 people who tested positive originating from the country. The next highest were the United States, with 34, and the United Kingdom, with 33.
The number of cases from India was also rising, from 15 in February to 70 in March to 56 in the first 11 days of April. This prompted the Government to shut off all direct travel from India for 17 days. Anyone who wanted to enter New Zealand had to spend two weeks outside of India before they could board a flight.
In determining next steps for handling the influx of cases, the Government devised a system to classify countries as very high-risk and layer additional requirements on travellers from those places.
On April 12, an initial “approach to managing arrivals from countries with very high risk of Covid-19” was sent to Cabinet. This entertained four options to “directly limit traveller numbers”, including allowing direct travel by citizens and their immediate families but requiring all others to spend one or two weeks outside of the very high-risk country.
However, Bloomfield’s “preferred option” was that “all travellers must have been outside of a very high-risk country for 14 days” – effectively, an extension of the travel ban.
“This will have significant impacts on those who are unable to travel especially if they do not have rights to travel elsewhere, or other jurisdictions restrict travel,” the document acknowledged.
“These impacts could include, but are not limited to: increased risk of infection of Covid-19, humanitarian issues, or loss of family connections, and increased requests for consular assistance.”
In the end, the Government decided to exempt citizens from the requirement, despite noting this “could be seen as negatively drawing a ‘wedge’ between a citizen and resident, when the latter have access to most other rights”. The first version of the very high-risk list, which came into effect on April 28, included India, Brazil, Pakistan and Papua New Guinea. Fiji and Indonesia were added in August.
“The final decisions on the settings that apply to people travelling from countries classified as ‘very high risk’ was made by Cabinet and based on advice from Officials from a number of agencies,” a spokesperson for the Ministry of Health told Newsroom.
Skegg found limits not justified
After putting the very high-risk system in place, the Government asked Skegg’s group to review it.
In the May 6 letter, Skegg didn’t take issue with the restrictions themselves, but said the Government had devised a flawed rubric for determining which countries were very high-risk.
Those criteria were that more than 15 people travel to New Zealand each month from the country and that at least 50 of every 1000 arrivals in 2021 had tested positive for Covid-19.
In Skegg’s view, the limitations on India were justified by the number of cases that were showing up in MIQ. But too few people travelled from the other three countries for them to pose a significant risk. Moreover, the small number of travellers meant that the 50 cases per 1000 arrivals figure wasn’t reliable.
“For most countries (except India), the numbers are so small that it is not possible to compute rates that are sufficiently reliable to justify categorisation of the risks posed. Even the arrival of one large family who are infected could shift the prevalence estimate materially,” Skegg wrote.
“It appears that statistical considerations about uncertainty have been overlooked.”
Reducing travel from these countries was unlikely to significantly reduce the number of cases in MIQ.
“Whereas limiting travellers from India will have a much greater effect, restricting travel from Brazil, Pakistan and Papua New Guinea will be unlikely to prevent more than one case arriving from these three countries (combined) every 11 days.
“We do not see grounds for continuing the restriction on travellers from Brazil, Pakistan or Papua New Guinea.”
The spokesperson for Hipkins insisted the Government had taken the right approach.
“We continue to take a cautious approach at the border and are satisfied our approach was the correct one,” they said.
“Professor Skegg’s input is highly valued and formed an important part of our considerations. The work done on assessing very high-risk countries was a valuable addition to the thinking and planning for the Reconnecting New Zealand plan.”
Skegg told Newsroom he didn’t expect to be further involved in the work.
“We did not receive any particular response from the Government or the Ministry of Health, other than verbal comments that the advice was welcomed,” he said.
India, Pakistan, Brazil no longer very high-risk
Skegg’s final concern related to the lack of clarity as to how a country could be removed from the very high-risk list.
In July, based off new criteria for risk assessment that Newsroom reported on Tuesday, the Ministry of Health took another look at the four countries on the very high-risk list.
It found that India, Pakistan and Brazil were all no longer very high-risk and that there wasn’t enough information to say what the status of Papua New Guinea might be, although “our best estimate is that the in-country situation is now high-risk”.
However, all four countries are still on the very high-risk list as of September 23, two and a half months after the July 8 briefing.
The briefing said Papua New Guinea was to remain on the list as a result of the uncertainty. India, Brazil and Pakistan were to temporarily remain on the list, but only while “Government considers how to manage the risk that changes in travel flows as a result of changed risk ratings may present to New Zealand”.
The concern appeared to be that reopening travel from these countries would lead to more Covid-19 cases in MIQ, even if it wasn’t so many that it presented a very high risk. But that conflicts with Skegg’s findings that Brazil, Pakistan and Papua New Guinea were likely responsible for less than one case every 11 days, combined.
“Failing to balance risk and do it routinely has real costs, one way or another,” Seymour said.
“The problem with not balancing risk correctly is that somebody loses out. Either we take too much risk and we get more Covid or we don’t take enough risk and people don’t get the opportunity to be reunited with their family or do business or pursue their education.”
Hipkins’ spokesperson said only, “All of the very high-risk countries remain under review”.
The Ministry of Health spokesperson said ministers were responsible for decisions about the list.
“Decisions about which countries are classified as ‘very high risk’ are made by the Reconnecting New Zealanders Ministerial Group,” they said.
“The Director of Public Health and the Director-General of Health provide a public health assessment of the situation in the country and make a determination of the risk posed by that travellers from that country. A number of agencies advise the Reconnecting New Zealanders Ministerial Group on classification of countries and measures to be applied to travellers.”