The pandemic shows no sign of ending. There are some hopeful signs with the idea that omicron will turn out to be a milder illness and once it becomes the dominant strain we will be able to adapt to a different, kinder kind of pandemic response. Big ifs in that, with scientists, doctors, politicians and the public all jumping to their own conclusions before we have solid data.
I will always argue the precautionary principle for the New Zealand pandemic response. We are in a unique position with having low community rates contained within distinct parts of the country, and omicron is still only knocking at the border. We have time to wait and see how this plays out overseas. We are incredibly fortunate, and much of that is due to the early advisors who at the start of 2020 told the government to go for elimination rather than simply flattening the curve and having a Labour government that understood the value of valuing people.
The rest of the world was mostly unable to try that (for a range of geographical and political reasons), and we got to witness just how bad free covid is.
So here we sit and wait. The government has sensibly delayed the changes at the international border that were due to start mid January. By then we should have solid and a better range of data from a number of countries with different geographical, socioeconomic, population density and political factors, upon which to make decisions. This isn’t about fearfully retreating from the rest of the world in the hopes that omicron never arrives. As Lprent said so succinctly a few days ago,
I don’t think we can keep it out.
But we do need to throttle the number of sources of import (ie the start points of the geometric progression) for the moment until we do understand how it spreads and what effects it has on the medical system.
Looks like the government has pushed everything out for about a month – seems about right. Let SA, UK, USA and Aussie test it for us.
I would add to this, that we cannot know how omicron will impact on long covid, because of the longer term nature of that post-viral syndrome. I argued in Long covid, omicron and the precautionary principle the rationales for taking a conservative approach and why we should be taking long covid very seriously.
It seems prudent to point out the differences between abstract data and theories about covid and how things play out in the real world. Data when looked at in isolation might be suggesting that we can loosen restrictions because omicron looks milder, but meanwhile, in Australia and the UK, both with high omicron rates, systems are struggling.
A good overview in the Guardian of the complexities of omicron meets real life. Hospitalisation rates are lower (“a moderate reduction”), but other factors come into play
And this (my emphasis),
It is too early to assess the risk of admission to intensive care and death, but the researchers say greater reductions in risk are possible.
We’re just not there yet. There is also the issue of less severity being offset by greater number of infections (lesser severity doesn’t necessarily equate to fewer serious infections).
In Australia where the federal government appears to be moving to a ‘let it rip’ approach, New South Wales is already struggling. This from the Sydney Morning Herald this morning,
NSW hospitals are facing looming staff shortages, with hundreds isolating and others asked to reconsider taking Christmas leave as the Omicron surge forces the state government to reintroduce mask mandates and density limits.
With about 1500 hospital workers across the state’s health system in isolation due to COVID-19, some staff have been asked to reverse holiday leave to bolster the workforce as the outbreak grows.
NSW COVID-19 restrictions are returning for the holidays, just days after being scrapped, as new cases today surged above 5000.
NSW reported a record-breaking 5715 new cases on Thursday, prompting Premier Dominic Perrottet to impose tighter restrictions.
While Mr Perrottet said the “key indicators” of success for the state were not based on pure case numbers, his biggest concern was the impact the rapid spread of infections was having on health workers, with thousands forced to isolate recent weeks.
“While we are seeing low numbers in [intensive care], very manageable numbers in ICU, it is more in relation to making sure that our health system can be well-manned during the summer period,” Mr Perrottet said.
Maybe the ‘let it rip’ people think hospital staff should just not get tested or self-isolate. If hospitalisation is lower with omicron, then won’t natural immunity just sort of sort everything out eventually? She’ll be right once everyone has had the virus. I’m sure hospital staff would love to be at the forefront of that that particular experiment. There are all sorts of risks associated with this apporach, including staff burnout and the impacts of long covid that only become apparent in 6 months time.
Meanwhile, we should remember that hospitals become dysfunctional if they can’t be cleaned and serviced, let alone medically staffed. And because this won’t be obvious to many, this flows on to other health care services. Think elderly care homes not being able to get staff as they’re shifting to hospital work. Read the SMH piece for details.
The rapid rise in cases comes as the state’s paramedics report record numbers of triple zero calls, with wait times of up to an hour for the highest level life-threatening emergencies.
Screenshots of NSW Ambulance’s control centre status board, seen by the Herald, show that on Wednesday the average response time for P1, or potentially life-threatening cases, was 58 minutes across the Sydney metropolitan area.
P1 category cases include unconscious patients, people having an acute heart attack or choking.
My emphasis again.
I feel like I’ve just named a few of the issues here. The bigger picture is complex. It’s a novel virus that recreates itself and we are still trying to figure how to adapt.
So, just in case it doesn’t end soon. What if we are in a long emergency? Should we be thinking about medium and long term adaptation rather than holding out for a reprieve that might be just around the corner or might never come? How does this relate to the other long emergencies rolling in, the climate and ecological crises? How resilient are we in the face of a global financial crisis or a big earthquake in New Zealand? How do we think about and prepare for compounding crises?
I think it’s fair to say that a lot of people don’t have good capacity for thinking about such things because the pandemic stress is already more than enough. But climate and ecology tell me that covid is resiliency training. Personal and community. This is something we can try and hide from, or it’s something we can front up to and engage with that helps us cope now and prepare for the future. If that sounds too grim, to my mind it’s not. I’ve spent most of my life around people who build systems that are both life affirming and resilient and future proofing. In those circles it’s normal to take both into account.
This is similar to what I write about the Powerdown (and not coincidentally, there is much in the powerdown knowledge base that can help us with covid adaptation). We can set up new systems with the tools we currently have that provide both a response to the situation we are in now, as well as basing how society organises around the age of uncertainty rather than some unreal neoliberal idea of perpetual BAU safety.
To give a really simple example of how to use crisis as opportunity, and to solve multiple problems in ways that enhance rather than simply mitigate. The point was raised yesterday that people rely on public libraries and making them inaccessible (through lockdowns or mandates) can have big impacts on those that need those spaces. The solution here isn’t to not have a pandemic response that includes restrictions, but to look at how to make the lives of people better who are unduly affected by the response.
Do they need access to books? New Zealand libraries already have book buses and homebound services that can be adapted. Do they need internet access? The government, or even local government should be looking at making sure everyone in New Zealand has affordable internet access in whatever way that works for them. Do they need a place to socialise? Create more outside urban spaces suited to the local climate.
Whole systems design also means that multiple functions and needs meet. Outside spaces with good airflow limit covid spread, create micro-climate cooling for overheated days, help people feel better (forest bathing), give kids more access to nature, and help biodiversity and carbon sinks.
How we respond to the pandemic is on all of us.
Shout out to the Standaristas who’ve been putting up such good covid explaining links and synopses.