Wellington, New Zealand, in May as restrictions began to be eased Marty Melville/AFP via Getty Images
New Zealand has been widely praised for its aggressive response to covid-19. At the time of writing, the country had just 10 active cases. But Michael Baker, the doctor who formulated New Zealand鈥檚 elimination strategy, says that even some of his colleagues initially thought it was too radical a plan and resisted its implementation. 鈥淪ome likened it to using a sledgehammer to kill a flea,鈥 he says.
The first case of covid-19 in New Zealand was recorded on 28 February. Like most countries, it initially planned to gradually tighten its control measures as the virus gained momentum. But Baker, a public health expert at the University of Otago who is on the government鈥檚 covid-19 advisory panel, believed that this was the wrong approach. 鈥淚 thought we should do it in the reverse order and throw everything at the pandemic at the start,鈥 he says.
Baker was inspired by the World聽Health Organization鈥檚 report from its joint mission to聽China in February, which documented how the country largely contained covid-19 when it聽was already in full flight. This convinced Baker that New Zealand could also stop the virus from spreading and even wipe it out entirely if it implemented a strict lockdown as soon as possible.
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Other experts, however, argued聽that New Zealand should聽take a lighter approach like聽Sweden, which never fully locked down. Many believed the spread of covid-19 was inevitable and that an elimination strategy would 鈥渘ever work鈥, says Baker. Others thought that locking down the country would lead to mass unemployment, poverty and suicide, which would outweigh the benefits of containing the virus.
The government ultimately decided to go with Baker鈥檚 advice, possibly because of his public health track record. In the 1980s, for example, he helped establish the world鈥檚 first national needle exchange programme, which has聽meant that rates of HIV among聽injecting drug users in聽New Zealand are some of聽the聽lowest globally.
鈥淚 thought we should do it in the reverse order and throw everything at the pandemic at the start鈥
On 25 March, when New Zealand had only 205 covid-19 cases and no deaths, the government implemented one of the strictest lockdowns in the world, only permitting people to leave their homes for essential reasons like buying food and going to the doctor. This followed the closure of New Zealand鈥檚 borders to non-nationals on聽19 March.
Baker felt 鈥渧ery moved鈥 by the government鈥檚 decision, but also anxious, because he didn鈥檛 know if聽it would work. 鈥淎s a scientist, you feel very worried if you鈥檙e giving advice when the evidence base isn鈥檛 totally there yet, particularly when it鈥檚 something that could be harmful to people,鈥 he says.
However, putting the entire country into home quarantine early on extinguished community transmission and gave authorities time to strengthen testing and contact tracing capacities, which聽were initially 鈥渞eally quite聽woeful鈥, says Baker.
The country has recorded only 1515 covid-19 cases and 22 deaths to date, and hasn鈥檛 had any new, locally acquired cases since 22 May. The current active cases are all citizens in supervised quarantine after returning from overseas. On 8 June, New Zealand lifted all its restrictions except for its border control measures. 鈥淭here was this amazing sense聽of聽relief,鈥 says Baker.
He is proud of New Zealand鈥檚 success, but says it is important not to become complacent or smug. Baker warns that other countries that have seemingly got on top of the virus, such as China and South Korea, have experienced subsequent outbreaks.
Last week, New Zealand was聽shaken by the news that two聽women had tested positive for聽covid-19 after returning from the UK and being allowed to leave quarantine early to visit a dying relative. Extensive contact tracing is now under way.
To guard against a second wave in New Zealand, Baker thinks masks should be worn on public transport, aircraft and at border control and quarantine facilities. For him, one positive thing to come out of the pandemic is that it has shown how proactive government measures can protect the public from avoidable hazards. Baker hopes this will inspire more ambitious action on climate change and biodiversity loss.
鈥淧eople are saying, 鈥業 can鈥檛 wait to get back to business as usual鈥, but there are a whole lot of things that we must do better,鈥 he says. 鈥淚 hope that is the lesson we learn from this terrible event.鈥
Michael Baker is a professor of public health at the University of Otago, New Zealand, and an adviser to the government of New Zealand.
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