Summary Report

6 - All-of-gove­rnment preparation­s and response Ngā whakaritenga me te urupare a te kāwanatanga whānui

Summary report

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Introduction | Kupu whakataki

At the start of 2020, the scale of the threat presented by COVID-19 and its possible implications for Aotearoa New Zealand were becoming apparent. This chapter is focused on the plans, systems, governance mechanisms, decision-making structures and strategiesiii that were central to the Government’s pandemic response over the next two years, and how they were communicated to the public.

National and international preparedness for pandemics has been a high-profile public health issue in recent decades as potent infectious diseases (such as Ebola, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and various influenza viruses) have emerged or re-emerged with increasing frequency.

Across the world, numerous pandemic strategies and plans have been drafted, enhanced surveillance and testing regimes adopted, and simulation exercises conducted.6

Yet the Director-General of the World Health Organization, Tedros Adhanom Ghebreyesus, was frank in his appraisal of what the ’preparedness project’ had achieved by 2020:7

“Over the years we have had many reports, reviews and recommendations all saying the same thing: the world is not prepared for a pandemic. COVID-19 has laid bare the truth: when the time came, the world was still not ready.”8

Tedros Adhanom Ghebreyesus,
Director-General, World Health Organization

Faced with a pandemic of this scale and a virus about which so little was known, it was impossible for any country to have made infallible preparations. Quite simply, as the World Bank noted, ’there are limits to preparedness’.9 Any assessment of Aotearoa New Zealand’s readiness to respond to the COVID-19 pandemic needs to place it in this global context.

Before COVID-19, Aotearoa New Zealand had in fact scored well relative to other countries in a World Health Organization assessment of its capacity to respond to health security threats.10 Another assessment of international pandemic preparedness, the Global Health Security Index, had scored Aotearoa New Zealand slightly above the average for high-income countries.11 But that assessment also revealed that, collectively, international preparedness was weak.iv

Before COVID-19, a range of existing systems, legislation, plans, structures and capabilities were available to support a pandemic response in Aotearoa New Zealand. This put the country in a good position when COVID-19 first emerged. However, there were areas of weakness. For example, the Civil Defence Emergency Management System was primarily geared towards natural hazard emergencies, the New Zealand Influenza Pandemic Plan (last updated in 2017), while useful in the first few weeks, was inadequate for a pandemic like COVID-19, and the risk management system did not work as well as it could have.

Note: detailed information about these topics and what occurred during Aotearoa New Zealand’s response to COVID-19, along with our complete assessment, can be found in the corresponding Looking Back chapter in our main report.

The Inquiry evaluated the state of pandemic preparedness and emergency management arrangements across government at the point COVID-19 emerged. This was the base from which the Government’s COVID-19 response began.

We describe the evolution of key aspects of the response over the course of the pandemic, including governance and decision-making structures, national pandemic strategies and tools, and finally the use of public information and communications tools to mobilise support for the pandemic response.

In the main report, the Chapter also includes short case studies (spotlights) on the Alert Level System; traffic lights – the COVID-19 Protection Framework; and the rise of misinformation and disinformation.

We heard a range of experiences and perspectives in relation to the overall pandemic response.

Through the Inquiry’s public submissions process, we heard a range of experiences and perspectives in relation to the overall pandemic response. Some praised Aotearoa New Zealand’s response to the pandemic as being world-leading and effective in achieving one of its main purposes – saving lives. People told us they felt the Government clearly communicated the rules and policies, and appropriately engaged with public health experts to explain the scientific information sitting behind the evidence-based decisions being made. We heard that personal protective equipment (PPE) and tests were accessible during the pandemic, and communities were supported to plan and organise their own responses.

Public feedback about the economic and social supports implemented during the pandemic response is provided in Chapter 10.

On the other hand, people told us they felt that Aotearoa New Zealand’s pandemic response was too controlling and based on fear. Some felt that the negative impacts of the response outweighed the risk of COVID-19, and that people’s personal rights and freedoms were breached. People told the Inquiry they felt certain measures were ineffective or harmful, and the reasons behind them weren’t always clear. Some told us that PPE and rapid antigen tests (RATs) weren’t always easily available, and that a ’one size fits all’ approach to engage with the public doesn’t work. Many people said they supported the overall response up to a turning point, when certain restrictions became viewed as being too severe, or lasting too long.

For future pandemics, people suggested:

  • the Government should do more to stop the spread of misinformation and take actions to rebuild trust in Aotearoa New Zealand’s public institutions
  • stockpiling or manufacturing PPE and testing kits locally to increase future pandemic preparedness
  • using a cross-government approach to involve non-political groups throughout the response
  • targeting future pandemic restrictions toward the most ’at risk’ members of the community
  • a future pandemic plan should be prepared, including lessons from other countries and increased funding and resources for the health system.

 

“I believe the Government’s response during the pandemic saved many lives.”

“It was hugely important to me in order to feel safe that we had leadership in government that valued lives over money. Health and wellbeing over commerce. While still making provision to keep the economy going as best as possible.”

“The ’why’ could have been explained better sometimes. Without that, a vacuum forms which people are great at filling with frustration and anger.”

“The pandemic was handled badly by the government – in a very draconian and authoritarian manner and New Zealanders’ human rights were massively violated.”

“…people started to question what we were being told, and what we were being told we had to do. And as this questioning and concern increased, and people queried the health regulations, then we started to move into the era of coercion, control, mandates and the whole labelling of people who wouldn’t ’comply’….”

“Isolate the sick and elderly. Only the sick should isolate, not the fit and healthy.”

Note: this material is taken from the Inquiry’s Experiences Report, which is a summary of the public feedback submitted to Phase One of the Inquiry during early 2024.

1. Pockets of pandemic preparedness existed at the start of 2020 which helped the initial response. However, all-of-government readiness proved insufficient for an event of the scale, impact and duration of the COVID-19 pandemic.

  • Before COVID-19, a range of existing systems, legislation, plans, structures and capabilities were available to support the response. However, many turned out to be insufficient for a pandemic on the scale of COVID-19, which required a prolonged response and had widespread and complex national impacts. Many other countries found themselves in a similar position.

  • The New Zealand Influenza Pandemic Plan, last updated in 2017, provided much useful support to the health response in the initial weeks. But, as often happens with plans, it was soon overtaken by events – in this case by factors specific to COVID-19 and the development of the elimination strategy.

  • While the pre-pandemic system of risk management was useful in identifying national risks – including pandemics – there was scope for stronger oversight and accountability mechanisms to ensure those risks were adequately prepared for across government.

  • As happened in other countries such as Australia and the United Kingdom, Aotearoa New Zealand found the response to the COVID-19 pandemic required more integrated all-of-government coordination than the lead agency model was able to deliver. Governance changes were quickly made to recognise this, although the Inquiry was told that this took longer than was desirable. Having an all-of-government model ready to go would have avoided having to develop such a structure during the busy initial response.

2. Government made hard decisions quickly under pressure but, over time, some shortcomings emerged which were not adequately addressed.

  • The all-of-government structures set up in the early stages of the COVID-19 response had a clear focus on elimination. They supported the rapid delivery of this strategy which formed the basis of Aotearoa New Zealand’s response. Unfortunately, a separate long-term strategy function – that could sit above the fray of the day-to-day response, allow future scenarios to be considered, and deliver integrated long-term planning supporting a smooth transition across later stages of the pandemic – did not evolve.

  • In the early stages of the pandemic response, it was appropriate for decisions to be made quickly with a particular focus on technical public health expertise. However, over time, the process by which advice was provided (in order to incorporate the most up-to-date health information) meant fewer opportunities for non-health matters to be considered. Opportunities to consider proportionality across health, social and economic objectives were also limited.

  • The emergency nature of the pandemic meant some standard policy practices were (appropriately) suspended during the early stages of the response. This included adequate opportunities for stakeholder and agency consultation, and transparent and thorough assessment of regulatory impacts. It took longer than desirable to adequately re-establish all aspects of standard policy practice.

3. Enormous efforts by public servants (supported by individuals from across communities, iwi, academia and the private sector) and the flexibility and adaptability of Aotearoa New Zealand’s public service enabled the rapid setup and delivery of an effective response to COVID–19.

4. Aotearoa New Zealand’s elimination strategy, and the use of public health and social measures to support it, were highly effective at stamping out pre-Delta chains of transmission when they arose and giving the country long periods without transmission.

  • The initial Alert Level System was a world-leading and innovative communication and policy tool that proved highly effective in supporting widespread compliance with public health restrictions.

  • The success of the elimination strategy relied on the coordinated effort of thousands of people around the country who supported the deployment of public health and social measures.

5. However, a determined focus to keep pursuing an elimination strategy, and a lack of strategic planning for the longer term, affected the Government’s ability to prepare for and respond to new developments and shift direction soon enough.

  • Once the elimination strategy was established and demonstrated to be effective, its success resulted in less emphasis on all-of-government, long-term, strategic planning – work that could test options and scenarios on how and when to adjust or move beyond elimination, what would replace the elimination goal, and that could integrate health and social, economic and wellbeing goals.

  • This reduced focus on evolving the long-term, strategic focus to guide forward direction added pressure to how the Government navigated the complexities and impacts arising from new events (such as the emergence of new variants); adapting tactics (moving from PCR to RAT testing, removing vaccine mandates and so on); and moving beyond, and ultimately exiting elimination (for example, the shift to caring for those with COVID-19 in the community).

6. In the early stages of the pandemic, the public communications response was highly effective and contributed to the success of the elimination response. But communications became more challenging as the pandemic wore on.

  • Government messaging was initially very effective, but it became more challenging to convey messages as new settings were announced and Government objectives shifted.

  • Greater engagement with communities during the response could have improved the effectiveness of communications by ensuring individuals, families and communities better understood how to comply with Government directives.

  • The transition out of the elimination strategy was not well signalled or communicated ahead of time. This had an unsettling impact on people, which was compounded by a rise of misinformation and disinformation (both about the virus itself and the Government response).

iii A more detailed description of the legislation, emergency plans, systems and structures supporting the COVID-19 response is provided in Appendix A of the Inquiry's main report.

iv To assess overall preparedness, the Global Health Security Index 2019 studied 195 countries’ pandemic readiness across six dimensions/categories – prevention of the emergence of pathogens, early detection, rapid response and mitigation, sufficiency and robustness of the health system, commitment to improving national capacity and financing and a country’s overall risk environment and vulnerability to biological threats. However, a major gap has been identified between countries’ preparedness levels – as measured in the Index – and COVID-19 death rates. For example, the top-ranked country in the Index was the United States of America whose death rate as at March 2023 was 341 per 100,000 people (according to Johns Hopkins University: see https://coronavirus.jhu.edu/data/mortality). Health researchers say this suggests more accurate ways to measure countries’ pandemic preparedness and response capabilities are needed: see Crosby, S, Dieleman, JL, Kiernan, S and Bollyky TJ (2020), All Bets Are Off for Measuring Pandemic Preparedness, Think Global Health, 30 June 2020, https://www.thinkglobalhealth.org/article/all-bets-are-measuring-pandemic-preparedness

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