Coronavirus: Expert fears just 'one or two people' will ruin self-isolation plan for everyone

A public health expert fears self-isolation instead of managed isolation (MIQ) will be tough to enforce, because "there will always be one or two people" who can't be trusted. 

The Government on Thursday morning revealed plans to test ways to slowly reopen the border, including letting some Kiwis self-isolate at home rather than taking up space in MIQ facilities. A trial will be held later this year, open to people returning from short overseas trips for work. 

Business leaders have welcomed the trial, saying it will help Kiwi firms establish their connections overseas while ensuring we keep COVID-19 out, and protect the booming economy we've got going even with the borders shut. 

"It's really important that it works, that it's successful, because it will point the way to allowing travellers from overseas to come into New Zealand in 2022," Tourism Industry Aotearoa (TIA) chief executive Chris Roberts told Newshub. "We're as keen as anyone for that trial to be successful."

"The blueprint is cautious but balanced," added Kirk Hope, chief executive of BusinessNZ. "They've got to balance the really strong amount of economic activity that we have in the country with the risks that come with opening the border.

"I think the pathway that we've laid out is pretty reasonable... It's really useful to have all the steps they've laid out, pretty clear, pretty transparent." 

He said it was a "fool's errand" to put a definite timeline on reopening, given the unpredictability of the pandemic and potential future variants. 

Why self-isolation is being trialled 

Rooms in MIQ have been difficult to secure, with new spots being snapped quickly whenever they're released, leading to frustration from Kiwis stranded in countries where COVID-19 is a real threat. 

Letting some people self-isolate will free up space for those who can't, for example if they're not vaccinated or coming from a high-risk country. It's also cheaper than staying two weeks in MIQ, which can cost up to $3100.

But there are concerns it won't work. Sir David Skegg, who headed the group that advised the Government on its opening up plans, said the "kind of home isolation we had before just won't cut the mustard". 

In March 2020, before the borders were shut and MIQ facilities were set up, Kiwis arriving from overseas were told to self-isolate and register with Healthline. Many didn't, and later that month the country went into lockdown, with dozens of cases in the community being reported every day. MIQ opened up in April, requiring every arriving person to stay for 14 days. Anyone who tests positive is sent to a quarantine facility, without exemption. 

University of Otago senior health lecturer Lesley Grey planned to do research last year into why some people breached the self-isolation orders, but was unable to track them down. 

"We weren't able to access those people, but some of our theoretical research is around depending on what people's beliefs and attitudes are, that will inform how well they self-isolate at home,"she told Newshub.

Dr Grey said relying on people to stay isolated for 14 days won't work without a pretty heavy stick.

"For most people trust will be good enough. However there will always be one or two people for whom trust cannot guarantee that good-enough self-isolation will happen. 

"There are lots of people who are trying desperately get into MIQ at the moment and they will gladly wear things like ankle bracelets, they will happily be GIS tracked, they will be more than happy for people to ring them every day."

She said she recently went to the UK and was required to self-isolate - but it wasn't enforced.

"I fully expected to be called every day by the UK government - I didn't get one call. Nobody ever checked up on me to see if I had had my tests, if my tests were negative or where I was."

The Delta threat

The Delta variant is highly infectious - about twice as contagious as the original strain, at least. It can also infect vaccinated people who can then spread it onwards (though they're far less likely to fall ill or die than the unvaccinated).

New Zealand so far has vaccinated 21 percent of everyone 16 or over. 

"What we need to do is put in place a system where everybody is treated equally and everybody has the opportunity to know that they will be checked up on in some way shape or form, and the expectation is on them to stay where they're at," said Dr Grey.

"What we don't want is a situation as Australia."

In Australia, people with asymptomatic or mild COVID-19 can isolate at home - but not everyone does, with even some air crew being fined for breaching the rules

Immunisation Advisory Centre boss Nikki Turner.
Immunisation Advisory Centre boss Nikki Turner. Photo credit: The AM Show

Prime Minister Jacinda Ardern says people will only isolate by themselves or with others they were travelling with. She told The Project on Thursday ankle bracelets might be used to ensure people comply. 

Dr Grey said with all the experts the Government has access to, they should make the right calls.

"There is no reason why the Government cannot do the right thing if they listen to their experts." 

Vaccination is more important than ever

If the virus does get out, having as many people vaccinated as possible will be crucial. While vaccinated people can be infected with the Delta variant, it's believed they're not as infectious for as long as the unvaccinated, so are less likely to pass it along

"The Delta variant will come into New Zealand - it's of huge benefit to us that it hasn't while we're getting as many people vaccinated as possible," Nikki Turner, director of the Immunisation and Advisory Centre told The AM Show on Friday. 

"So I think we need to prepare for a lot of different eventualities. But right now, the huge focus for every one of us is the best protection for our whole country is to have as many people vaccinated as possible, and then we've got options. If we don't get vaccinated, we're really in trouble." 

TIA boss Roberts agrees.

"None of this works if we have low vaccination rates. Get yourself vaccinated, encourage your staff to get vaccinated, your family, your friends. We need to do all of this together."