A long-awaited report into New Zealand's COVID-19 testing systems and the border response concluded stamping out the August outbreak was a "major achievement", considering the numerous flaws investigators found in our systems.
The report, compiled by Heather Simpson and Sir Brian Roche, was delivered at the end of September, but only released by COVID-19 Response Minister Chris Hipkins on Friday.
Hipkins said a number of recommendations made in the report had already been implemented or were underway, as had recommendations in a separate report by Sir Brian on contact tracing.
The Simpson-Roche report found a "number of key themes" in New Zealand's response:
- consistency and quality of communication, and consultation with relevant stakeholders was suboptimal
- inappropriate accountability for various aspects of the strategies and their implementation
- border control directives have been difficult to understand and implement
- lack of clarity in the testing framework
- lack of good forward planning from the perspective of an end-to-end system
- underutilisation of health expertise outside the Ministry of Health leading to suboptimal analysis and planning documents
- lack of confidence in data being reported to key decision makers.
- The report says "exhausted" officials weren't ready for the August outbreak, which sent Auckland back to alert level 3 after 102 days of no community transmission.
"The immediate goal had been achieved and much focus rightly turned to supporting economic recovery. In hindsight, however, better use could have been made in the 102 days to prepare for the inevitable outbreak.
"This is important, not as a criticism of the actions in the past, but because it is essential, we learn that lesson now."
The patchwork of agencies and ministries involved in the response had done well, the report said, but the arrangement wasn't sustainable in the long-term fight against COVID-19.
"We don't have a status quo model which is well understood and could serve effectively for the next 24 to 36 months," Sir Brian and Simpson said. "While the model is improving it is not yet fit for purpose."
The contact tracing report by Sir Brian noted while lockdowns work to stop outbreaks from spiralling out of control, they are very expensive - costing in the billions - while the Auckland Regional Public Health Service, tasked with tracing all possible contacts so the August lockdown could end, only has $24 million a year to work with.
"There is a strong argument to be made that the ability to rapidly deploy trained resources will be a critical success factor for any future outbreak and avoiding a lockdown... the working assumption of being able to redeploy staff from other roles has proven to be inadequate and places unnecessary early risk into any response."
Sir Brian also cast doubt on the capacity of our tracing systems, saying it was likely far short of the 1000 cases a day the Government was previously advised it would need.
Hipkins said by the time the reports were written, "the required improvements, including border testing, were underway".
"The ministry has all year been at the heart of a massive response to a global pandemic that a year ago no-one could have foreseen. It has continued to improve and adapt its response to COVID-19, while delivering on its many other obligations.
"New Zealanders should have confidence in the containment of recent community cases to date as a result of a stronger ministry response and the hard work of public health units."
New funding, governance structure
The Government is prepared to fund efforts to keep the coronavirus out of New Zealand "for as long as it takes", Hipkins said.
To that end, on Friday he announced another 18 months of funding for the Ministry of Health, district health boards, the border response and managed isolation and quarantine (MIQ) facilities.
Another $1.12 billion has been set aside for health activities, including:
- 7000 tests a day, including swabbing and laboratory services
- contact tracing, supplies of PPE and "supporting technology"
- more funding on an as-needed basis.
The MIQ system has had another $1.74 billion allocated to keep running until June 2022, "including the costs of accommodation, transport, food, security and health and wellbeing services".
"These are significant investments that are critical to keeping our defences strong," said Hipkins.
"Keeping COVID-19 out and quickly managing any incursions that do occur is an expensive business but it's the best investment we can make for our health and our economy."
The funding will also go towards "a greater role in research, more capacity to undertake infection, prevention and control audits and a beefed up policy and strategy unit".
He also said by March next year, "strategic leadership and central coordination" would be handled by "a COVID-19 Response unit, building on existing all-of-government functions in the Department of Prime Minister and Cabinet".
The Ministry of Health would continue to handle the public health response, while the border and MIQ system would be "led by a Border executive board of interdepartmental chief executives".
"The system of multiple interconnected agencies and portfolios is complex but has stood up well overall. Continual improvements have and continue to be made, but making substantial changes at the same time as focusing on keeping COVID-19 out has been a challenge.
"With much-improved testing, contact tracing and border control now in place however, the Government is in a position to consolidate and strengthen administration and governance of the response."