The pandemic response is like driving a car

We live in interesting times and there is so much to think and write about. I’ve been mulling the mandate hot potato and some of its more predictable (as in likely) consequences but I’ll leave that for now because I’m getting all steamed up when I start stewing and my thoughts & emotions become a hapless mash.

Government has placed an unhealthy [pardon the pun] emphasis on vaccination to protect Kiwis against Covid-19 and to allow unlocking the cage to let Aucklanders out before Christmas. However, behind and underneath the PR it is clear that vaccination is not a silver bullet by a long shot, as seen in highly vaccinated countries in the Northern hemisphere. It may be Communication-101 to make & keep the message as simple as possible, but no simpler. However, Government may want to give Kiwis a little more credit in understanding complex issues and the associated ‘demands’ that authorities place upon them.

Both Priddy [Dr Frances Priddy, vaccine development specialist and executive director of Vaccine Alliance Aotearoa New Zealand (Ohu Kaupare Huaketo)] and Sika-Paotonu [Dr Diane Sika-Paotonu, immunologist at the University of Otago’s Medical School in Wellington and also Otago’s Associate Dean (Pacific)] said vaccinations alone will not protect New Zealand from more spread of the virus: following public health advice – including gathering outdoors instead of indoors, social distancing and wearing masks – will all contribute to managing the outbreak. Stuff

Indeed, measures such as proper handwashing, proper mask-wearing (incl. PPE for frontline workers), and appropriate social/physical distancing are easy and cheap to implement and highly effective in reducing the risk of Covid-19. They almost certainly have helped keeping many Kiwis safe from the virus and still do so today. New Zealand Covid-19 numbers still remain remarkably low by international standards thanks to the concerted Government and public responses to the pandemic and a healthy dose of luck by virtue of our relatively isolated location and seasonal factors, which have bought us vital time to respond.

Management of Covid-19 has been likened to a Swiss cheese. Although this is quaint I’d imagine that not many people relate themselves and their actions to a Swiss cheese. A more relatable analogy would be the act of driving a car and being the driver.

There’s not a single measure that keeps us safe on the roads. It is the combination of many different things (factors) that integrate into the overall outcome of getting us from A to B in one piece, as they say. The single most important factor is the human one, i.e. the driver. Driving skills and safety awareness take time and practice to achieve a satisfactory standard – a bit like growing up and becoming a mature adult or so I’ve been told. This is reflected in the driver licences associated with each learning phase and skill level. Unsurprisingly, these licences are colour-coded.

Once you have obtained your full licence you don’t become bullet-proof or indestructible, not instantly and not ever, and can you drop all other safety measures. For example, you still have to buckle up, you still have to drive to the conditions, you still have to make sure your car is safe and roadworthy, et cetera. Nobody likes to be told what to do but once you’ve been told & taught the rules and they’ve become ingrained and almost instinctive habits (e.g. fastening your seatbelt when hopping in the car) they do the trick of achieving the desired outcome, which in this example would be to keep you safe on the road, especially if the large majority of road users does the same. The same applies to your vaccination status, which lowers your risk of Covid-19, but this layer of protection is not absolutely 100% perfect and it works better the more people are vaccinated aka so-called herd or population immunity.

We all know that after many years our driving skills may no longer be quite up to standard; we may get sloppy and complacent when it comes to certain things and bad habits can gradually replace the good initial and intended ones. The protection from vaccination also drops over time due to waning immune response. Some (all?) drivers who got their licence many years ago could do with a refresher course and similarly, some (all?) vaccinated people could benefit from getting a booster shot after more than 6 months since their second jab.

We also know, or should know, that many traffic accidents are almost entirely preventable. Even the best driver with the safest car and under the best road conditions can cause an accident if they take unnecessary risks – there’s no easy cure for human stupidity aka brain explosions and a third-party insurance won’t bring anybody back from the dead; prevention is the best option. The same applies to Covid-19 and solely relying on your much-coveted vaccination pass is foolhardy. The opposite is true too: unvaccinated or not-yet-fully vaccinated people (incl. children) are not necessarily ticking time bombs that do and will instantly kill scores of innocent and unlucky bystanders despite their best efforts to be protected.

The future remains a tad uncertain. There’s concern that opening the Auckland borders on 15 December could lead to thousands of positive cases each week. Government, or Dr Ashley Bloomfield rather, seems to think that it won’t be nearly as bad as the worst-case models predict. I’m with Dr Bloomfield on this one. Part of the reason is how many models work, e.g. they use sound data from crash-test dummies to predict the chances of survival from a major impact with an immoveable object (e.g. a concrete barrier). The thing is that in practice (reality) not many people die when their car hits an immovable object because if they did exactly as in the crash tests they would indeed die in the numbers almost exactly as predicted from those tests and with high confidence. Most people (with the obvious exception of temporarily incapacitated ones due to a medical event) would take preventative measures such as slowing down, breaking or swerving and thereby lessen the impact, if any. Government interventions and quick responses and adaptations to changing circumstances work in a similar way, which is why worst-case scenarios almost never crystallise to become reality. Fortunately. This doesn’t make those models useless. Quite the contrary, they show if-then-or-else cases and outcomes and can guide appropriate actions to avoid shit hitting the fan and/or to minimise the fall-out and mess.

High vaccination levels, efficient contact tracing made easier by diligent scanning, and all the other easy preventative/protective measures are likely to avoid sharp sudden spikes in Covid-19 cases in New Zealand this summer. This will help keeping the community spread under control. However, there might be pockets (local communities) with lower vaccination levels where the virus might take hold and then fizzle out before it can grow into larger clusters and/or spread further into the community. In this scenario there might be a substantial increase in overall case numbers but only a gradual increase in severe cases that require hospitalisation or ICU. This is what’s been happening in some countries with high vaccination rates showing very slight and slow increases in the number of Covid-19 deaths. Of course, this still would put a considerable strain on the NZ health system and even low numbers of daily deaths are undesirable. Hopefully, New Zealand can and will do better in this respect – more Kiwis are likely to die on the roads based on current numbers for Covid-19 and road toll, which is another tragic statistic.

If/when you hit the road this summer please stay safe and think of others, so that we can count on rather than count each other, as nobody (!) wants to become just another number in the stats tables.