Coronavirus: Sceptics say Singapore is proof Shaun Hendy's COVID-19 modelling is wrong; but is it really?

Disease modelling expert Shaun Hendy's projection that thousands of Kiwis could die of COVID-19 in the year after dropping lockdowns has been met scepticism in some quarters.

Dr Hendy presented the figures on Thursday at a press conference with Prime Minister Jacinda Ardern and Director-General of Health Ashley Bloomfield. He and others at research centre Te Pūnaha Matatini looked at how many Kiwis might end up in hospital or dead from the Delta variant of COVID-19 at different levels of vaccination coverage. 

At 80 percent of those currently eligible - which appears to be about where many other nations are topping out - the modelling suggests around 58,000 would be hospitalised and 7000 would die in 12 months. That's with "a moderate suite of measures" such as vaccine passports, rapid-testing, improvements to ventilation (or where that's not possible, mandatory mask use or capacity restrictions) are in place, as well as a "full  test-trace-isolate-quarantine" system. 

Without a full quarantine system the estimated death toll rises to 8886. Under worst-case scenarios - if the vaccine turns out to be not as good as we thought, or only 70 percent get vaccinated, deaths could reach 20,000; or they could stay in the single figures, if things go well. 

Wigram Capital's Rodney Jones, whose modelling the Government has also looked at, told RNZ the mid-range figure of about 7000 wasn't matched by what's happening overseas in countries with a similar population to New Zealand - such as Singapore - with high vaccine coverage. 

"When you see 7000 deaths it's frightening, that's 140 a week in a country like New Zealand - there is no way New Zealand would experience anything like that."

He called Dr Hendy's presentation a "side-show".

Immunologist Graham Le Gros told The AM Show on Friday it was "just a model" and "doesn't take into account a lockdown being put on top of that, or if we do booster vaccinations mid-next year, which could really change the game as well". He too pointed to Singapore.

And while Newstalk ZB's Heather du Plessis-Allan might not have any qualifications in epidemiology, she used her massive platform to rubbish Te Pūnaha Matatini's work, calling it "not in the slightest bit plausible" - also citing Singapore as proof. 

So what's actually going on in Singapore, population 5.7 million, and is it evidence Kiwis have little to fear? 

Like New Zealand, Singapore managed to squash the initial outbreak of COVID-19. Its first wave of Delta appeared to be heading the same way - peaking at 195 in one day in mid-July and falling to just a few dozen daily a month ago.

But in the past week, it's lost control of the outbreak - almost every day has brought a new record-high daily figure not just for this outbreak, but the entire pandemic. Thursday's figure was 1504. Almost half the nation's 70 deaths to COVID-19 have happened since the start of August. New Zealand's had only 27 deaths in the entire pandemic, and just one to Delta. 

Singapore's fully vaccinated 82 percent of its entire population, even though children aren't eligible. New Zealand is at 34 percent

Shaun Hendy.
Shaun Hendy. Photo credit: Getty Images

It's hard to say how many people will die as a result of Singapore's rapidly growing outbreak - the mortality rate for COVID-19 depends heavily on the burden placed on the health system. If the health system gets overwhelmed - like it has been in some states in the US - not only do some COVID-19 patients miss out on high quality care, but others requiring treatment for other maladies. 

Singapore has for most of the pandemic had tougher restrictions in place than New Zealand. On the Oxford University Stringency Index - which tracks response measures such as "school closures, workplace closures, and travel bans",  Singapore is currently at 53 out of a possible 100; before the recent lockdown, New Zealand was at 22, where it's spent most of the pandemic. 

Te Pūnaha Matatini's modelling for New Zealand assumes a lower level of restrictions currently in place in Singapore. In Singapore, there are still strict capacity limits on places like cafes, cinemas, shows, cruise ships, hotels, workplaces and gyms. Vaccinated people are in some cases allowed to congregate in bigger groups than the unvaccinated. Some  patients at hospitals are presently banned from having visitors.

Despite all these restrictions and one of the best vaccination rates in the world, last week the nation's Health Minister warned they feared running out of hospital capacity if the outbreak couldn't be contained. Singapore reportedly has the capacity to surge to 1000 ICU beds - New Zealand has 326 and can surge to 550, Health Minister Andrew Little recently said

NZ vs Singapore restrictions.
NZ vs Singapore restrictions. Photo credit: Oxford University / Our World in Data

Comparisons to Singapore also ignore the countries' very different demographics. Singapore is a very wealthy nation, GDP per capita 50 percent higher than New Zealand's. They also have a more ingrained mask-wearing culture, after suffering 238 cases and 33 deaths in the deadly SARS epidemic of the early 2000s. 

The Canadian province of Alberta has a similar population to New Zealand, and first-dose vaccine coverage of 82 percent of those 12-plus. Yet they are experiencing a massive wave of infection - there are 20,180 active cases at present - and 2611 people have died to date

Alberta's present seven-day rolling average of deaths is 14, equating to an annual toll of more than 5000, and it's fast rising. There are currently 226 COVID patients in the province's ICUs - 89 percent of capacity, with rationing likely to start soon

Dr Hendy took to Twitter on Friday to say he's been accused of "fear-mongering".

"What I think is actually going on is that the modelling is undermining hopes for when things can return to normal and that makes some people despairing and angry. I get that - it was incredibly disheartening when we ran the numbers for Delta back in June," he said, referring to modelling which suggested 97 percent coverage of those eligible would be needed to achieve herd immunity. 

"This new report actually offers a way forward, but it is going to take more work than perhaps many had bargained for. It’s ok to feel angry about that (perhaps just not take it out on my inbox). It is also fine to remain optimistic that new data will change these conclusions.

"But we do need to think hard over the coming months about our strategy and ignoring what the best data we have right now is telling us is not going to help us put together a good plan."

He said it was unlikely even the mid-range projection of 7000 people would die, telling RNZ the Government would step in with tighter restrictions before that could happen.