Coronavirus: New Zealand's unique 'elimination' approach is rapidly flattening the curve

It's been less than two weeks since New Zealand imposed a coronavirus lockdown so strict that swimming at the beach and hunting in bushland were banned. They're not essential activities, plus we've been told not to do anything that could divert resources away from the emergency services.

People have been walking and biking strictly in their neighbourhoods, lining up six feet apart while waiting to go one-in-one-out into grocery stores, and joining swathes of the world in discovering the vagaries of home schooling.

It took only 10 days for signs that the approach here - “elimination” rather than the “containment” goal of the United States and other Western countries - is working.

The number of new cases has fallen for two consecutive days, despite a huge increase in testing, with 54 confirmed or probable cases reported on Tuesday. That means the number of people who have recovered, 65, exceeds the number of daily infections.

“The signs are promising,” Ashley Bloomfield, the director-general of health, said on Tuesday.

The speedy results have led to calls to ease the lockdown conditions, even a little, for the four-day Easter holiday, especially as summer lingers on.

But prime minister Jacinda Ardern is adamant that New Zealand will complete four weeks of lockdown - two full 14-day incubation cycles - before letting up. She has, however, given the Easter Bunny special dispensation to work this weekend.

How has New Zealand, a country I still call home after 20 years abroad, controlled its outbreak so quickly?

When I arrived here a month ago, travelling from the epicentre of China via the hotspot of South Korea, I was shocked that officials did not take my temperature at the airport. I was told simply to self-isolate for 14 days (I did).

But with the coronavirus tearing through Italy and spreading in the United States, this heavily tourism-reliant country - it gets about four million international visitors a year, almost as many as its total population - did the previously unthinkable: it shut its borders to foreigners on 19 March.

Two days later, Ms Ardern delivered a televised address from her office - the first time since 1982 that an Oval Office-style speech had been given - announcing a coronavirus response alert plan involving four stages, with full lockdown being Level 4.

A group of influential leaders got on the phone with her the following day to urge moving to Level 4.

“We were hugely worried about what was happening in Italy and Spain,” said one of them, Stephen Tindall, founder of the Warehouse, New Zealand's largest retailer.

“If we didn't shut down quickly enough, the pain was going to go on for a very long time,” he said in a phone interview. “It's inevitable that we will have to shut down anyway, so we would rather it be sharp and short.”

On the Monday, 23 March, Ms Ardern delivered another statement and gave the country 48 hours to prepare for a Level 4 lockdown. “We currently have 102 cases,” she said. “But so did Italy once.”

From that Wednesday night, everyone had to stay at home for four weeks unless they worked in an essential job such as health care, or were going to the supermarket or exercising near their home.

A few hours before midnight, my phone sounded a siren as it delivered a text alert: “Act as if you have Covid-19. This will save lives,” it said. “Let's all do our bit to unite against Covid-19.”

From the earliest stages, Ms Ardern and her team have spoken in simple language: Stay home. Don't have contact without anyone outside your household “bubble”. Be kind. We're all in this together.

She's usually done this from the podium of news conferences where she has discussed everything from the price of cauliflowers to wage subsidies. But she also regularly gives updates and answers questions on Facebook, including one done while sitting at home - possibly on her bed - in a sweatshirt.

There have been critics and rebels. The police have been ordering surfers out of the waves. The health minister was caught - and publicly chastised by Ms Ardern, who said she would have fired him if it weren't disruptive to the crisis response - for mountain biking and taking his family to the beach.

But there has been a sense of collective purpose. The police phone line for non-emergencies has been overwhelmed with people calling to “dob in” others they think are breaching the rules.

The response has been notably apolitical. The centre-right National Party has clearly made a decision not to criticise the government's response, and in fact to help it.

These efforts appear to be paying off.

After peaking at 89 on 2 April, the daily number of new cases ticked down to 67 on Monday and 54 on Tuesday. The vast majority of cases can be linked to international travel, making contact tracing relatively easy, and many are consolidated into identifiable clusters.

Because there is little evidence of community transmission, New Zealand does not have huge numbers of people overwhelming hospitals. Only one person, an elderly woman with existing health problems, has died.

The nascent slowdown reflected “a triumph of science and leadership”, said Michael Baker, a professor of public health at the University of Otago and one of the country's top epidemiologists.

“Jacinda approached this decisively and unequivocally and faced the threat,” said Mr Baker, who had been advocating for an “elimination” approach since reading a World Health Organisation report from China in February.

“Other countries have had a gradual ramp-up, but our approach is exactly the opposite,” he said. While other Western countries have tried to slow the disease and “flatten the curve”, New Zealand has tried to stamp it out entirely.

Some American doctors have urged the Trump administration to pursue the elimination approach.

In New Zealand's case, being a small island nation makes it easy to shut borders. It also helps that the country often feels like a village where everyone knows everyone else, so messages can travel quickly.

New Zealand's next challenge: Once the virus is eliminated, how to keep it that way.

The country won't be able to allow people free entry into New Zealand until the virus has stopped circulating globally or a vaccine has been developed, said Mr Baker. But with strict border control, restrictions could be gradually relaxed and life inside New Zealand could return to almost normal.

Ms Ardern has said her government is considering mandatory quarantine for New Zealanders returning to the country post-lockdown. “I really want a watertight system at our border,” she said this week, “and I think we can do better on that”.

The Washington Post