Politics

Covid 19 Omicron outbreak: Derek Cheng – Why Auckland could be in an orange halo next week

ANALYSIS

Pressure on the health system is the key metric when Cabinet meets on Monday to review traffic light settings for the country.

Prime Minister Jacinda Ardern has already said that the traffic light system has the flexibility for different levels in different regions, so is Auckland, which peaked first, about to move to orange?

The peak in cases was at least three weeks ago, likely four weeks by the time a change to orange would start.

“The cases today in Auckland are only 20 per cent of the peak,” epidemiologist Professor Michael Baker says.

“It’s coming down to what may be the new baseline, if that’s the right term.”

And the peak in Auckland’s hospital cases was in the middle of March, according to Covid-19 modeller Professor Michael Plank.

On Friday, out of 2700-odd hospital ward beds across Auckland, only 367 of them were taken up by Covid patients.

“If the trends we’re seeing continue in Auckland, I think a move to orange would be reasonable,” says Plank.

That’s not because there won’t be extra pressure on health care systems at orange. The unknown is how much.

Indoor super-spreader events are restricted in red with a 200-person limit, with everyone seated and separated, and wearing masks unless eating or drinking.

At orange, there are no limits on indoor gatherings, no requirements to be seated or separated, and masks are still required, but can be taken off to eat and drink.

Vaccine passes will also no longer be used, meaning the vaccinated and the unvaccinated are freer to mix.

“If you’re indoors, the ventilation is poor, unmasked people are drinking, and there’s unlimited numbers, there’s potential for an uptick in infections across Auckland,” says Plank.

Remember, too, that as of Wednesday, there were still 352,752 people across Auckland eligible for a booster but who hadn’t received it. Three doses are much more effective against serious illness with Omicron than two doses.

And nearly a quarter of children aged 5-11 – 40,000 out of 168,000 – are yet to have any vaccine dose; 77 per cent have had one dose and 18 per cent have had two.

But the city has also had Omicron sweep through it, with up to a third of Aucklanders catching it – and thereby having a low chance of recatching it within three months.

This is the main reason why Plank believes that a move to orange in Auckland can be justified.

“I wouldn’t have thought that [a move to orange], on its own, would be enough to reverse the declining trends we’re seeing at the moment.”

Baker is more cautious, saying some relaxations are justified, but questioning whether a jump to orange would be too much.

“If we take an optimistic view, you could relax controls. If we take a mid-range scenario of heading up towards another peak, we’d be wanting to hold off on relaxing too much.

“Are we comfortable we’ve got enough barriers to keep transmission at a low level? I’m not convinced of that. I’d like to see a pause and a rethink of the traffic light system.”

Plank also stressed a greater focus on sustainable measures – like improved ventilation, and generous leave provisions to encourage sick people to stay home if sick – “as we come to the end of the sprint with Omicron and move into the marathon”.

Then there’s how Cabinet will view the latest public health advice.

Prime Minister Jacinda Ardern has previously been more cautious than Health Ministry advice on how to manage the pandemic.

But she, too, has pivoted as the pandemic has shifted, and her focus is now on keeping the health system running while letting people get on with their lives with the least amount of disruption.

She has previously set a bottom line – 90 per cent vaccination coverage in the Delta outbreak – to protect a minimum number of people, but later dropped it when the vaccinated were stuck in limbo for too long, waiting for coverage to creep higher.

It was a risky move back then, at the start of summer, but vaccination coverage and warm temperatures pushing people outdoors turned out to be enough to keep Delta in check.

Ardern faces a similar dilemma now with booster coverage sitting in the low 70s.

But there is much more population immunity compared with back then, when most Kiwis had never had Covid-19.

And now she has a new tool in the toolbox, Paxlovid, which will be available on prescription from next week. If given within five days of diagnosis, it’s been shown to cut the risk of hospitalisation and death by about 90 per cent.

There’s even an argument for Ardern to put most of the country into orange, given that peak plateaus are continuing only in a few places, mainly in the regions such as the West Coast.

“If you look at the case numbers this week compared to the same days last week, they’re all lower – quite significantly,” Plank says.

But it would be more in line with Ardern’s cautious approach so far to start with Auckland, which clearly peaked first, and then to see what happens.

That way she can also see how Aucklanders react before making decisions for the rest of the country. Will they continue to be cautious, or relax more, and if the latter, how will that manifest in the number of hospital cases?

Whenever orange comes, spare a thought for health care workers. They work their guts out while at the coal face of seeing out the peak of the wave.

They then face a possible resurgence in demand on health care services because, having already been stretched to the max, restrictions can be further relaxed.

Living with Covid is a marathon event. When will the pressure ease off for them?

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