A top public health academic says Aotearoa will need to change tack over its Covid-19 elimination strategy when our borders open to more high-risk countries.
On Thursday Prime Minister Jacinda Ardern outlined expectations around border restrictions over the coming months.
Immunisation Advisory Centre medical advisor Professor Peter McIntyre told Checkpoint the big question, once there is high vaccine coverage across the country, is 'what happens next?'.
"What about countries where there's been a lot higher levels of Covid-19 activity than there has been in New Zealand? Is it going to be a continued restriction or an expansion, what is that going to look like?"
In her speech, Ardern said there could be travel arrangements made with nationals that have a similar risk profile to New Zealand.
"Another one that's been talked about, also in Australia, is Singapore, given the economic and international student ties, and the high quality of control.
"Beyond that you could even look to China, in the not too distant future, if you were thinking about other countries in Southeast Asia that also have very tight control of Covid-19 as you then are progressing towards what happens with countries that aren't in that fortunate situation."
Director General of Health Dr Ashley Bloomfield has suggested as the border opens New Zealand might need to exist at something like alert level 2.5.
"I think for most of the world there's been an acceptance that it's very unlikely that zero Covid-19 is where the landing is going to be, because there's such widespread circulation," Professor McIntyre told Checkpoint.
"So I think most countries are now talking about good control of Covid-19, which means that you're in a situation where it's more like flu or perhaps, given how well the vaccines are performing… potentially you end up in a better situation than you are with ordinary flu.
"And of course with ordinary flu we've never seen nightly announcements of flu cases or discussion about how many tests are being done for influenza. It's just not been part of the environment.
"I think the expectation is that once Covid-19 is no longer threatening to close intensive care units in hospitals… you start to look at it more like flu.
"That's I think a common perspective in the world out there that's not in zero Covid-19 environment. For countries like Australia and New Zealand who are in that environment I think there's that big decision to make.
"Is there a willingness to ultimately be treating Covid-19 like flu because we've got really good protection? Or do we want to keep a situation where there's just no Covid-19? Because that will be a very, very difficult long-term goal."
Professor McIntyre said if New Zealand is going to open borders completely then it would need to accept an amount of Covid-19 would be in the country.
"But we need to reassure people that in the post-vaccine environment it's not the scary thing that it was.
"And I think everyone accepts that the elimination strategy has worked brilliantly up till now. But looking forward to a hopefully vaccine-protected world, could we end up with something else that's not zero? Because zero is very hard to maintain."
He said vaccinations can never provide 100 percent protection from the virus, but what has been seen is those who are vaccinated and still get infected tend to have less virus, and are therefore less infectious.
"I think the really good news about the variants … is that all vaccines that are currently approved, even if they let through more infections with variants… they all seem to perform well at stopping severe infections.
"So even though there might be more infections getting through with some variants, it seems that you don't get severe infections causing hospitalisation or death. You are protected against that more severe disease."
