A variant plan that's light on detail leaves New Zealand ill-prepared for future variants which could start spreading here before we even know they exist, Marc Daalder reports
Comment: Months of work from officials to prepare to respond to future variants of Covid-19 have resulted in a seven-page document, sparse on details.
The much-awaited variant plan isn't really a plan. It also doesn't shed any light on what scenarios are most likely to occur, though the Government can be forgiven for not daring to predict the future.
For the most part, the variant plan consists of a list of capabilities that will be useful in tackling any Covid-19 strain, like testing and contact tracing capacity. It also details the internal processes for evaluating the risks from new variants and lays out five potential scenarios.
Those range from a worst case scenario of a variant that causes more severe illness, is more inherently transmissible than Omicron and evades vaccine- and infection-induced immunity to a best case variant which is mild and blocked by our existing immune barriers. Director-General of Health Ashley Bloomfield said the Omicron subvariants BA.4 and BA.5, now spreading slowly in the community, belong to the latter category.
That doesn't mean they aren't capable of causing harm – the daily average number of Covid-19 deaths is 12. Even excluding those who just died "with" Covid-19, rather than "of" it, still provides a daily death toll of nine. Over a year, that's more than 3000 deaths or six times worse than an average flu year.
The lack of detail in the variant plan raises concern that we won't be able to quickly respond to new strains appropriately.
We will no longer have the luxury that we had with Omicron, Delta, Alpha and even the wild-type coronavirus to see how the rest of the world grappled with it. We had two months to prepare for the arrival of the Omicron variant; while other countries struggled with burdensome isolation periods causing worker shortages, the Government was able to design and debut a plan to steadily reduce isolation periods as case numbers rose.
Of course, other aspects of our Omicron response didn't learn the lessons from overseas experience. PCR testing was overwhelmed more quickly than the Government expected, despite the warnings of experts. Even our early warning system didn't allow us to respond to Omicron without error.
That early warning system is now gone, though the Government doesn't see it that way. Covid-19 Response Minister Ayesha Verrall made a big deal of ongoing genomic surveillance when she announced the plan. That will give us a good overview of the rise of new variants, which variants are at the border and whether there are some regions harder hit by specific variants than others.
But those on the frontlines of the genome sequencing effort say the lack of border controls and the fact that the vast majority of cases are no longer sequenced means our early warning system is very different from earlier in the pandemic.
"Our genomic surveillance is not what it used to be. We used to know the variant of every single case in New Zealand and now we're doing population-level surveillance like most other places around the world," University of Otago evolutionary virologist Jemma Geoghegan told Newsroom.
"We might not know for a few weeks once a new variant has taken a foothold in New Zealand. We don't have those early warning systems. We knew about Delta, we knew about Omicron before they got here. But it might be that we don't know about a variant until it's already spread here."
That's the experience the rest of the world had with Omicron. It was first reported in a handful of countries in southern Africa in late November. Borders were closed to those countries, but it was already too late - Omicron had spread to the rest of the world and kept ahead of a rolling series of border closures. By mid-December, it was transmitting in almost every country. By January, it was responsible for a majority of cases in most of the world.
When the next variant comes along, New Zealand will undergo that same experience. We may shut our borders to certain places, but that's unlikely to stymie the arrival of new variants.
That's why the lack of detail in the variant plan is so concerning. With Omicron, we had no variant plan but were able to put one together over the course of a couple of months.
For the next variant, we'll have just weeks or even days to launch a new response. If the variant corresponds to the Ministry of Health's worst case scenario, that lack of preparedness would be tragic and deadly.
