The BFD | ‘Elimination’ Nation

Chris Penk

First published by The BFD 27th June 2020

The BFD is serialising National MP Chris Penk’s book Flattening the Country by publishing an extract every day.

“Elimination” nation

No word sums up the government’s misplaced sense of self-congratulation as much as “elimination”.

Let’s start with this perfectly reasonable observation about a certain unqualified usage of the word:

[Jacinda Ardern]and her head health honcho Ashley Bloomfield kept telling us at the beginning of the week that Covid-19 had been “eliminated”, which seemed strange considering they were standing alongside each other still reporting new cases.

Clearly their spin doctors were sounding like humming tops overnight because the pair emerged the next day and set about reinventing the word.

In fairness, New Zealand’s situation at the time did meet the technical epidemiological meaning of the word “elimination”, which is something like “a small number of cases, a knowledge of where those cases are coming from and an ability to identify cases early, stamp them out and maintain strict border restrictions so we’re not importing new cases”, in the words of Dr Bloomfield.

Technically correct is the best kind of correct (in the words of the meme) so that’s fair enough as far as it goes.

As any good communicator knows, however, ordinary people tend to assume the ordinary meanings of words like elimination. In this case, the result was “even more praise being heaped on Ardern, setting her aside from all the others as being the leader among leaders at a time like this” (as described in that same item by Soper), on the basis of a misunderstanding about which meaning of “elimination” was intended.

What got really strange, however, was when the Prime Minister elevated rhetoric over reality a step further, with yet another definition of the “elimination”.

Peter Dunne noted, in an excellent piece about the (contrived) difference between “elimination” and “eradication”, that:

the Prime Minister later told Radio New Zealand that “when I talk about elimination it does not mean zero cases, it means zero tolerance for cases.” She further explained that “the idea of Covid being completely gone, that is eradication – so there are important differences there.” (The Concise Oxford Dictionary does not think so – it applies the same “get rid of” definition to eradication, as it does to elimination.)

So, just to be clear: any time that we have “zero tolerance” for a thing we have eliminated it?

If only we’d known that years ago, we could have eliminated family violence merely by saying that we have zero tolerance for it. Imagine the positive international press!

Elsewhere we’ve already discussed the illusory worth of “eliminating” the virus (or even “eliminating” it). But it’s worth re-producing at length from an excellent online article at The Emperor’s Robes (“the observations of Alex Davis”), viewed over 125,000 times apparently:

In short it is almost inconceivable that New Zealand can eliminate Covid19 without maintaining a permanent lock down. Which begs the question: if [we] weren’t flattening the curve and we can’t eliminate it why did we go into an economy crippling, poverty inducing, long term public health damaging lock down?

But, just for the sake of argument, let’s pretend that somehow New Zealand achieves the impossible and we do eliminate Covid19 – what then? What happens when the dog chasing the car actually catches the car?

The rest of the world will still have Covid19. As mentioned, no one, anywhere else in the world is even considering this strategy. New Zealand will become a de facto prison for its 4.9M “citizens.”

Large scale in-bound travel to New Zealand will be effectively eliminated, and with it the tourism sector, our largest export earner, contributing $45 billion to GDP annually. Without offshore tourism Air New Zealand will become a domestic only airline, so expect few flights to or from our fair shores (great news if you are a hard-green environmentalist, curtains for tens of thousands of employees).

Testing times

The government was woefully slow to get underway with any reasonable volume of testing, hence the headline in late March that read, “Calls for more COVID-19 testing as Marist College becomes ‘cluster site’ and its associated story:

An Auckland GP is now calling for all New Zealanders who have symptoms to be eligible for a test.

Newshub has learned of multiple cases of people getting referrals from doctors for a swab only to then be denied the crucial check at dedicated COVID-19 sites.

For weeks after this once-novel coronavirus had become known to the world (and even the Minister of Health in this country), our government was touting that a key criterion for testing eligibility was whether a prospective patient was showing signs of having the disease.

To describe this logic as incomplete would be kind.

As Sir Peter Gluckman explained:

An increasing amount of research was showing about 50 percent of transmission occurred before the individual was symptomatic […]

Obviously, the longer a person is wandering around potentially spreading the virus … the more people they are potentially going to infect. The more people we infect the more likely we are to not get the pandemic under control.

Was it really the case that people wanting to be tested were turned away? Not according to the Labour-led government, who earnestly emphasised that testing was a clinical decision. Meanwhile, medical professionals (including some who approached me) were making it very clear to anyone unpatriotic enough to listen that they simply had not been given testing capacity to match that mandate.

As luck would have it (bad luck, for him), one of those turned away was Stuff.co.nz reporter Tom Kitchin. The testimony he provided about his “battle to get tested” made for a fascinating read:

I almost wasn’t tested. I didn’t meet the criteria and was nearly sent home from the clinic. A day later, I was diagnosed with Covid-19.

This has made me realise the criteria for deciding if people are tested or not needs to be changed.

Sitting on the edge of a seat in the testing centre, the clinician in front of me said taking a swab would be “tenuous”.

This was going to be the third time I was put off. It was a no from Healthline on Tuesday. On Wednesday my GP said I needed a test but his referral was also refused. […]

But, once there, the clinician told me I didn’t meet the case definition for a test; I hadn’t travelled overseas recently and I wasn’t a close or casual contact of someone with the virus.

Others also sought reassurance or at least some kind of certainty through testing, also to be denied repeatedly:

A mother and full-time carer for her disabled son is hiding away in a room above her garage as she fights to get tested for coronavirus.

Davena Shields fits all the criteria, but on Thursday she was turned away from the testing station near Christchurch Hospital, despite the announcement on Wednesday testing conditions would be relaxed. […]

But knew she was in isolation for 14 days due to returning from overseas.

When Shields’ flight landed she had her temperature taken, registered her details and was told someone would be in touch to monitor her.

She did not hear from anyone.

“I could’ve been galloping around the countryside.

As a side-note: so much for the stringency of self-isolation, albeit that this poor woman clearly did play by the voluntary rules.

Back to the subject of (non-)testing, though:

Shields rang Healthline about three days ago, but no-one called back. When she finally got a nurse on the phone, she was told she met all the criteria so should go straight to the testing station near the hospital.

She wore a mask and gloves, which they already had because of her son’s high medical needs, but “the lady refused, saying she needed a GP letter”.

“I was doing what I was told to do and I was sent away quite rudely.”

Then a nurse at her health clinic said it was not their problem.

In desperation, Shields stopped at the clinic on her way home, and from a distance got a nurse who agreed to have a doctor call her. […]

“I’m up here, and I have tried and tried to get tested, but it’s not happening”, she said.

“If they’re not giving them to people who fit the criteria, how do they know how many people are out there who have it?”

And even in the eye of the storm – the “Marist cluster” – official inattention was the order of the day:

A teacher at the Catholic girls’ college at the leafy Auckland suburb of Mt Albert was off work sick, and her symptoms seemed similar to the emerging coronavirus.

At that point, there were only a handful of cases in the country, and all were linked to overseas travel. But the teacher hadn’t been overseas, or in contact with anyone who’d recently returned home.

But to satisfy themselves the school was safe, leadership supported the teacher to get the test. Her doctor had to do the referral. It was a bit of a push back then, two weeks and a lifetime ago. Clinicians weren’t testing people without the overseas criteria – and eventually the teacher was swabbed on Thursday, March 19. […]

Other parents reported they were struggling to get tested for the virus even if they said they were from Marist. One mother of a Year 10 student told the Herald that although she had symptoms, she was turned away by officials.

With so little testing going on, relative to the need, was the government suitably embarrassed about its lack of foresight or even insight?

Of course not.

The situation on the front line– as reported by those who would know (ie those actually on the front line) – was continually challenged from the rarefied air of the Ninth Floor of the Beehive.

As Thomas Manch and Michael Hayward reported at the time, “[h]ealthcare workers [are saying that] coronavirus tests are being withheld because of limited supply, despite the prime minister’s insistence clinicians have both the resources and permission to test.”

But what would those doctors and nurses know, right?

As Massey University academic Paul Elers explained with excellent clarity, the Prime Minister blithely continued to claim that we were leading the field:

At the same briefing, the prime minister said: “Our testing has scaled up and we have now tested over 85,000 New Zealanders, one of the highest testing rates per capita in the world.” Wrong. At that time we were 31st in the world for testing rates per capita. I don’t think 31st can be considered “one of the highest” in the world, unless, of course, we have turned into a society where we believe everyone is a winner.

And as Steven Joyce pointed out in a typically astute analysis, in the early days there was a dearth of information about how much testing was actually being done:

One of the more curious approaches the government is taking to this emergency is their shyness about releasing daily Covid-19 test numbers since they started testing.

They are now releasing rolling weekly averages but that just makes it more curious. If you can calculate weekly averages you must have the daily numbers. […]

We all need to be able to graph that trend against the daily increase in the number of tests taken; to help determine how much of the increase in cases (the curve) is caused by increased transmission, and how much could be courtesy of increased testing (seek and you shall find). […]

It is important the government release all the relevant data to enable the public to have confidence in the momentous decisions being taken in their name

As something of a postscript to the period in which there was a serious lack of clarity about testing – and lack of testing itself – in May 2020 the government introduced to Parliament an interesting amendment to the Coroners Act 2006. Swabs to test for covid-19 are to be conducted on deceased persons, under this law change, meaning that some time after the virus had been “eliminated” from this country, dead people available to the state are to be tested more for the coronavirus at greater rates than living people at the height of the pandemic here.

Better late than never, I suppose.

Sources: