“Flatten the curve” strategy to Omicron variant in New Zealand—public health experts

New Zealand might respond to an approaching Omicron variant outbreak by returning to the “flatten the curve” strategy that it used when the pandemic began two years ago, according to public health experts.

Professor Michael Baker, Dr. Jennifer Summers, Dr. Amanda Kvalsvig, Dr. Matire Harwood, and Professor Nick Wilson of Otago University have written a new opinion outlining actions the government should take before and after the fast-spreading strain gained root here.

Explosive outbreaks due to Omicron variant

According to public health specialists, while the Omicron variant normally caused less severe illness than Delta, it was generating explosive outbreaks and might infect half of Europe within two months.

“Therefore, a poorly controlled Omicron outbreak in New Zealand risks overwhelming the health care system, increasing inequities, and disrupting essential services as is being seen overseas,” they said. 

“The experience of Australia probably provides the best example of what New Zealand can expect to see, given that its population immunity has largely come from vaccination rather than previous uncontrolled waves of infection and vaccination coverage is similarly high to New Zealand.” 

Their pandemic waves, fueled mostly by the Omicron variant, looked to be reaching a climax in New South Wales and Victoria.

They also reveal that Covid-19 hospitalizations and fatalities were mostly unrelated to these massive outbreaks of illness, but were still happening in quite significant numbers, putting a considerable strain on Australia’s health care capacity and other important services.

They went on to say that the good news was that several nations were now emerging from Omicron pandemic, which had resulted in significantly fewer deaths than prior outbreak waves.

Experts call to delay Omicron variant’s entry into New Zealand

The researchers reiterated past suggestions to postpone the arrival of the Omicron variant in New Zealand, which they said would need a reduction in the number of sick travellers and expats entering.

“The number one priority should be taking rapid action to turn down the tap on the number of infected cases arriving in New Zealand, as this country has done before,” they said. 

“That means doing a risk analysis of where the cases are coming from, and if we’re getting more than a certain proportion from some source countries, limiting travel from them until conditions change.” 

New Zealand also required to strengthen pre-departure testing standards as soon as possible, maybe by demanding quick antigen tests at international airports right before departure, in addition to the present PCR testing within 48 hours before boarding.

Meanwhile, they suggested that health officials focus on eradicating Delta in New Zealand, which would put the country in a better position to deal with the Omicron variant.

Achieving that aim may necessitate making greater use of MIQ facilities to isolate Delta individuals and providing improved assistance to those people remaining quarantined at home.

Another rationale for trying to postpone the Omicron variant was to provide more time to roll out booster vaccinations that still gave pretty decent protection against the new variety, as well as to have as many young children vaccinated as possible.

“Vaccination is particularly important in New Zealand because there has been minimal exposure to widespread circulating virus,” they noted. 

“By contrast, in the UK which has high vaccine coverage, high booster uptake, and almost two years of exposure to circulating virus, about 97 to 98 per cent of adults test positive for SARS-CoV-2 antibodies.” 

They stated that the roll-out of boosters and vaccinations for children was an especially critical chance to prioritize delivery to Mori, Pasifika, those with underlying diseases, and other at-risk groups such as those in aged-care residential homes.

Strategy should shift from suppression to mitigation—experts

While the Omicron variant did come, they proposed that the government adjust its strategy from suppression to mitigation, exactly as it did when dealing with Delta.

“This would be an explicit recognition that Omicron outbreaks are extremely hard to eliminate or substantially suppress, and so the best that can be feasibly achieved in the New Zealand setting at present is to mitigate spread so as to minimise harm in the most vulnerable, to prevent the health system being overwhelmed, and to reduce social and economic disruption.” 

“As a result, the primary focus moves from minimising the number of infections to a ‘flatten the curve’ goal.” 

They highlighted that the transition may necessitate a limited period of controls that were analogous to components of the alert level system used previously

“The traffic light system is largely orientated towards achieving an indoor vaccine mandate. This system is now less effective since the vaccine passes are based on people being double vaccinated rather than having a booster as well,” they said. 

“This limitation could be fixed in time but ultimately the traffic light system lacks an adequate range of tools.” 

Because contact tracing might be quickly swamped and proven useless in an Omicron outbreak, measures such as masks, stay-at-home orders for non-essential personnel, and people limitations in pubs and clubs could become the primary instruments for flattening the curve.

Other urgent steps to stop COVID-19

Four other essential and urgent steps were identified by the experts: establishing a new national mask policy; better preparing educational institutions and workplaces; increasing testing capacity, notably by delivering quick antigen testing; and safeguarding the health system, in part by treating patients from their homes.

New Zealand has to plan for the prospect of a never-ending stream of new variants in the longer term.

“As evolutionary biologists remind us, there is no guarantee that this process will produce further variants that are less virulent, or that Covid-19 will become endemic,” experts said. 

“New Zealand, like other jurisdictions, needs to continue building its capacity for high-quality risk assessment and management so that it can adapt its response strategy to changes in the pandemic.”