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Coronavirus disease response is a difficult balance

Without complete information or a ready testing regime, it’s hard to weigh the dangers of Covid-19 against the economic and mental health risks, but we can look overseas for guidance.

Usually, no New Zealand government restricts civil liberties or jeopardises entire economic sectors lightly, let alone without compelling facts. Nor has any before undertaken such massive spending on artificial economic stimulus as was announced this week – equal to 4% of the economy and rising.

So far, New Zealanders have submitted to the sacrifices the coronavirus outbreak has required of them, trusting that authorities know what they are doing. However, as the measures aimed at subduing the virus change daily, we should continue to ask questions. New Zealand and the rest of the world are plunging into a recession that could be as deep as it has been swift. That creates its own serious risks to public health, particularly mental health, including suicide. Authorities need to balance those concerns against the risk posed by the virus itself.

Early hopes that the worst would be over by Easter now look cruelly over-optimistic. China, first to be hit with Covid-19, is gradually returning to a semblance of business as usual. This will help the rest of the world recover, but for now, most countries are floundering.

We have much to learn from South Korea, which developed rapid and reliable population testing and tracing capabilities – something we, along with many other countries, now realise we lack. Our first bitter lesson appears to be that we were too slow and conservative in testing, which the World Health Organisation – also possibly overly conservative in its advice – now says is the primary weapon against the virus’ spread.

The world is still fighting this pandemic partly blind, but not every statistic is bleak. There are indications Covid-19’s survival rate is 99% or higher. It is less deadly than the Mers and Sars outbreaks. And health authorities are rapidly clarifying which demographics and which pre-existing health conditions make people most vulnerable. Air pollution and a high smoking rate – more prevalent in countries such as China than here – may be implicated in hospitalisations, as with flu. Further data will tell us whether asthma, to which many New Zealanders are prone, is a risk factor.

The WHO’s pandemic expert, Bruce Aylward, says it appears China’s containment of the virus was down to mass-testing, isolation and quarantines – a more effective approach than general lockdowns and travel bans, which countries such as New Zealand and Australia are preferring. However, an infected person can transmit the disease to others up to 3m away just by talking. The best approach to battling this is not easy to identify, though protecting the most vulnerable, while also saving jobs, is an essential balance to find. Along with following the practical advice from the Ministry of Health, most people should get a flu shot to avoid clogging hospital wards.

In allocating $5.1 billion to payroll subsidies, the Government is trying to support those who will struggle most in the coming downturn. But even the $25 weekly increase in benefits does not mean that all children will be better off. Child poverty has not gone away just because the coronavirus has captured everyone’s attention. Additional measures may yet be required to boost the nutrition of our most vulnerable kids, especially if schools that provide meals at present close.

Although the Government’s package has big numbers in it, whether it has struck the correct balance in supporting the thousands of businesses at risk, remains to be seen. As Opposition leader Simon Bridges says, retaining employment is crucial.

This crisis reminds us that we are capable of responding wholeheartedly to problems, but apparently only when enough of us feel threatened. Diabetes, for example, which is not even our biggest killer disease, afflicts 6% of the population and has a mortality rate of 50% from resultant heart disease and 10-20% from kidney failure, with a 50% likelihood of permanent disability. Yet we do not consider a drastic response is required in the face of those daunting statistics. A similar case could be made about domestic violence or road deaths.

Covid-19 will pass – either because of a vaccine or because it reaches a natural peak and dies away, like the far more lethal 1918 Spanish flu. In the meantime, continuing to support local businesses, which in turn support local jobs, is essential so that when the recovery comes, we are ready to seize it. This strangely restricted life must not become the new normal.

This editorial was first published in the March 28, 2020 issue of the New Zealand Listener.

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