A pair of Covid experts on either side of the Tasman compare and contrast the two nations’ approaches.
New Zealand, Australia and many countries are experiencing a new omicron wave driven by the latest BA.4/BA.5 sub-variants. Our response to this threat is remarkably laissez-faire compared to past approaches, as society turned to “living with the virus”.
But in New Zealand and Australia, there is a real risk that current policy settings will be insufficient to prevent health services from being overwhelmed – and more will need to be done in the weeks to come.
We could get through the current political parameters if many more of us got vaccinated, wore masks and isolated well when sick.
So how do New Zealand and Australia compare on key policy metrics?
Free masks? And what kind?
New Zealand: Free masks for everyone in Aotearoa – available at testing centres, marae and community centres, and provided directly to schools. Some 16 million surgical masks have been distributed in the past two months, along with 3 million N95 masks (the latter to high-risk and vulnerable people).
Australia: Free masks are sometimes distributed to certain groups (for example, certain schools may have them). But access is extremely variable. (Also, one of us – Tony Blakely – has been in Australia and New Zealand for the past 10 days and can report that mask-wearing is much higher in New Zealand.)
Free rapid antigen tests (RAT)?
New Zealand: Access is similar to masks. Approximately 10.4 million free RATs have been distributed in the past two months.
Australia: The federal government will not extend free rapid antigen testing for concession cardholders after July 31. Victoria makes RATs available free of charge to some under certain circumstances. But nationally, access to free RATs is variable and limited. (One of us – Tony Blakely – got four free RATs when he arrived in New Zealand and zero when he arrived in Australia.)
Access antivirals (and do you need to go to the GP)?
There are two oral antivirals available in both countries: Paxlovid and Lagevrio.
Both are effective in preventing disease progression (for example, keeping you from ending up in hospital) if taken within five days of the onset of symptoms.
New Zealand: Available for high-risk groups – access has been extended from 2% to 10% of cases. Available on prescription from the general practitioner and directly from the pharmacist. No charge if you are eligible.
Australia: Available for certain high-risk groups. Prescription required from the general practitioner. Co-payment of A$42.50 ($6.80 with discount card).
Both countries are gradually expanding access. Differences at one time may not be present in a few weeks. That said, as of mid-July 2022:
New Zealand: Primary course (i.e. the first two vaccines) available to everyone aged five and over. First booster available for all ages 16 and up. Second booster (i.e. fourth dose) available to all 50+ (but more targeted to 65+, except Maori or Pasifika, in which case all 50+ take priority) . Free. Compulsory vaccinations for workers in the health and disability sector.
Australia: Eligibility for primary course and first recall as in New Zealand. However, second booster encouraged for immunocompromised and all 50+, and available for 30-49 year olds if they wish. Free. Compulsory vaccinations for certain workers in certain settings.
Income support for people who test positive?
New Zealand: Several forms of assistance, including the Covid-19 Leave Support Scheme for people who need to self-isolate.
Australia: Very limited availability.
New Zealand: Mandatory for public transport, retail, healthcare and aged care facilities and public places.
Australia: Mandatory in aged care and health care facilities, on public transport and in some other settings (but compliance is low).
Actual mask wearing is higher in indoor settings in New Zealand, based on direct observation in New Zealand and Victoria by one of us – Tony Blakely – in July.
New Zealand: Mandatory seven-day self-isolation after a positive test result. Household contacts must also self-isolate for seven days, unless they have had Covid-19 in the past three months.
Australia: if you test positive for Covid-19, you must immediately isolate yourself. However, the circumstances under which you can leave isolation may depend on the state you are in. In many places, household members do not have to self-isolate, as long as they have no symptoms.
Are either countries successful?
Based on the criteria above, New Zealand is a clear ‘winner’. But getting the policy parameters right over the long term is not just about having the most favorable assessment on some selected (but important) criteria.
If the goal is to minimize hospitalizations, deaths, and long-term illnesses, there is an argument for minimizing infections by moving from a mitigation strategy to a suppression strategy.
Longitudinal studies increasingly show high rates of reinfection, which lead to many of the same health consequences as the initial infection.
As the pandemic continues (and continues), we increasingly need to consider cost-effectiveness.
Giving free RATs to everyone is a cost to governments and has sustainability implications. These interventions must be effective and compared to other approaches.
These are complex decisions – and difficult to quantify. We don’t have a good enough crystal ball to know what is “right now”; Unfortunately, we will only know with hindsight.
Tony Blakely is Professor of Epidemiology at the Melbourne School of Population and Global Health at the University of Melbourne and Michael Baker is Professor of Public Health at the University of Otago.
This article is republished from The Conversation under a Creative Commons license. Read the original article.