Contributors: Melissa Adamski, Eleanor Beck, Jennifer Crowley, Breanna Lepre, Rachael McLean & Alyce N Wilson
Since January 2020, countries worldwide started recording cases of novel coronavirus disease (COVID-19). Now six months later we have witnessed different strategies of tackling the virus with varied effectiveness. With Australia and New Zealand both considered to have successfully flattened the curve, we thought we would give you an overview of our experiences from down under.
At the time of publication, New Zealand has not recorded any new cases of local transmission of COVID19 for several weeks and has been basically declared ‘covid free’, even though there have been a number of cases caught at the border. Across the ditch in Australia, the number of new cases identified has rapidly decreased, with the majority of new cases being from returning travellers and detected whilst in quarantine. However, recently the state of Victoria in Australia has demonstrated just how precarious the situation is, with several local outbreaks across metropolitan Melbourne.
New Zealand is in the fortunate position of being able to remove almost all lockdown restrictions, whilst restrictions continue to be eased considerably across most of Australia. Both Australia and New Zealand still maintain strict border controls that include limiting all overseas visitors, and strict quarantine for citizens returning home. New Zealand has had, at the time of writing, just over 1500 cases, with 22 deaths whilst Australia has had 7,920 cases and 104 deaths.
Australia had its first case of COVID-19 on the 19th January whilst New Zealand didn’t have one until over a month later on the 28th February. Over the next few weeks, several COVID-19 clusters developed throughout both countries. Australia introduced initial travel restrictions on the 1st February, with a federal ban on the entry of foreign nationals from mainland China. Over coming weeks, these bans were increasingly widened with similar restrictions implemented in both countries. In mid-March, both Australia and New Zealand implemented policies which required all incoming passengers to self-isolate for 14 days. This was followed by full border closures to all incoming non-citizens and residents - the most rigid border controls ever experienced in both countries.
On the 26th March, New Zealand went into a 4-week strict ‘stage 4’ lockdown: schools and other educational institutions, restaurants, bars, shops and malls were closed. Only supermarkets and other ‘essential services’ remained open under strict conditions that ensured physical distancing of customers. Similar restrictions were implemented across Australia but the extent varied by state and territory. None were as strict as NZ. Hospitals and health services cancelled elective surgery and procedures to clear beds for the anticipated surge in cases, whilst public health departments prepared for huge swells in contact tracing activities. The COVID-19 response has highlighted the importance of public health and exposed a long-standing under-investment in the public health workforce and system, as national health ministries/departments have scrambled to increase capacity.
So how have New Zealanders and Australians responded to the situation? In general, New Zealanders have been remarkably compliant with the COVID-19 restrictions. Police have taken an educative rather than a punitive approach, although there have been a number of prosecutions. Support for the Prime Minister and the Director General of Health has been high. The popularity for the Director General is so high that there has been a production of T shirts, tote bags and tea-towels featuring his face! Primary, secondary and tertiary students moved online. Universities have tried to consider the impact of online learning, with two of New Zealand’s leading Universities announcing a 5% increase in marks for all Semester 1 courses.
These unparalleled times have also meant a rapid shift to novel approaches to teaching, with the need for innovative ways to teach clinical skills and practical elements online. The use of telehealth clinics in the University of Auckland Nutrition and Dietetic training programme has enabled the ongoing development of some core clinical and communication competencies during the pandemic, and exposed students to a varied case-mix. It has also provided opportunities for the development of new techniques for educating patients in the online environment. Food Science and Nutrition Laboratories have also been taught online. Dedicated teaching staff have been using their kitchens to demonstrate science. For example, a disperse system was demonstrated by making mayonnaise!
The pandemic saw Australians and New Zealanders act in unpredictable ways. Across both countries, mass panic buying occurred. In Australia, panic buying and supermarket spending escalated throughout March. Canned and dried foods were particularly popular with sales rising by 180 per cent. Toilet and tissue paper sales doubled whilst there were also huge sales in flour, rice and pasta. In New Zealand, panic buying occurred pre-lockdown and also saw many staple ingredients stripped from supermarket shelves including pasta, rice, bread, soaps and hand sanitisers. With cafes and restaurants closed, people turned to home cooking. In mid-April, the five most searched recipes on google in Australia were banana bread, bread, pancakes, pizza dough and biscuits. Flour, yeast and baking powder were in short supply throughout supermarkets in Australia and New Zealand, as people rediscovered the pleasure of making bread, with ‘kneading’ branded a new form of relaxation.
Fruit and vegetable growers quickly moved to on-line ordering and home delivery as farmers markets and small food suppliers were closed. Calls to support local business and food producers were widely supported. Food banks saw an increase in demand. The Australian Foodbank, Australia’s largest hunger relief charity, noted a 50% increase in demand for food relief. The demand on food banks and charities has not abated as restrictions are gradually lifted which may be due to rising unemployment rates. Across Australia and New Zealand, unemployment has significantly increased and likely amplified the number of food insecure households. Many Australians and New Zealanders are finding themselves in tough financial times despite large support packages announced by both governments. In New Zealand, the end of strict lockdown unfortunately saw a media frenzy over the opening of takeaway and fast food business, that pre-empted long queues of people, some forming from the early hours of the morning, when doors finally opened after four long weeks.
Indigenous communities in both Australia and New Zealand have led initiatives to protect their communities from the threat of COVID19. Māori communities, who were substantially over-represented in impact from the 1918 influenza epidemic and are over-represented in many adverse health outcomes in New Zealand, were particularly concerned. Several isolated Māori communities, in the far North and the East Cape of the North Island, set up road blocks to restrict visitors to their regions and communities. These were largely supported by local police, despite some Conservative Parties’ opposition. Other Māori whanau (extended family) and iwi (tribes) set up community care and response initiatives to support the most vulnerable. The result has been that we haven’t seen the decimation of Māori communities that was seen in 1918. Despite this, some have criticised the lack of Māori representation in the face of the government response to COVID-19, which you can read more about here. There is no doubt that as an economic downturn hits, equity for Māori, minority groups and the socioeconomically disadvantaged must be a primary consideration in the government’s response.
In Australia, First Nations communities have been instrumental in advocating for their communities across all levels of the response. Early involvement of Aboriginal and Torres Strait Islander clinicians, public health practitioners and researchers has been fundamental to effective and successful action, including the design of culturally safe and appropriate pandemic preparedness and response plans for communities. A Government appointed Aboriginal and Torres Strait Islander Advisory Group on COVID-19 prepared and delivered a number of key actions and activities including: legislative changes (to limit non-essential travel by visitors to remote communities), identification of Aboriginal and Torres Strait Islander people as a priority group in the COVID-19 response, health service planning working closely with the Aboriginal community controlled health sector (to scale up COVID-19 testing, staff training and expansion of telehealth services), establishing rapid testing in remote communities and expanding testing sites, infrastructure planning (to provide space for isolate and quarantine in communities where overcrowding exists), improved epidemiological surveillance of cases among First Nations Peoples and a whole suite of targeted health promotion and communication materials for First Nations communities.
Both Australia and New Zealand have been incredibly successful in preparing, managing and responding to the COVID-19 pandemic. In New Zealand, as a general election looms in September, some politicians are agitating for a speedier opening of businesses and borders to stimulate the economy. Whilst others criticise the government’s response as having been too restrictive. We wait with nervousness for a possible ‘second wave’ of cases as restrictions are lifted. Many see the situation in New Zealand and Australia as a triumph of good leadership, science informed decision making and public health practice. We hope many things continue: buying local food and produce, baking and cooking from scratch, strengthening community action, more time with family, breaks from takeaways and fast food, evidence informed policy making, and a focus on equity into the future.