Most people welcomed the opportunity to get vaccinated against covid-19, yet a non-trivial minority did not. Vaccine-resistant people tend to hold strong views and assertively reject conventional medical or public health recommendations.

This is puzzling to many, and the issue has become a flashpoint in several countries.

It has resulted in strained relationships, even within families, and at a macro-level has threatened social cohesion, such as during the month-long protest on Parliament grounds in Wellington, New Zealand.

This raises the question: where do these strong, often visceral anti-vaccination sentiments spring from? As lifecourse researchers we know that many adult attitudes, traits and behaviours have their roots in childhood.

This insight prompted us to enquire about vaccine resistance among members of the long-running Dunedin Study, which marks 50 years this month.

Specifically, we surveyed study members about their vaccination intentions between April and July 2021, just prior to the national vaccine roll out which began in New Zealand in August 2021. Our findings support the idea that anti-vaccination views stem from childhood experiences.

The Dunedin Study, which has followed a 1972-73 birth cohort, has amassed a wealth of information on many aspects of the lives of its 1037 participants, including their physical health and personal experiences as well as long-standing values, motives, lifestyles, information-processing capacities and emotional tendencies, going right back to childhood.

Almost 90 percent of the Dunedin Study members responded to our 2021 survey about vaccination intent. We found 13 pecent of our cohort did not plan to be vaccinated (with similar numbers of men and women).

When we compared the early life histories of those who were vaccine resistant to those who were not we found many vaccine-resistant adults had histories of adverse experiences during childhood, including abuse, maltreatment, deprivation or neglect, or having an alcoholic parent.

These experiences would have made their childhood unpredictable and contributed to a lifelong legacy of mistrust in authorities, as well as seeding the belief that “when the proverbial hits the fan you’re on your own”.

Our findings are summarised in this figure.

Personality tests at age 18 showed people in the vaccine-resistant group were vulnerable to frequent extreme emotions of fear and anger. They tended to shut down mentally when under stress.

They also felt fatalistic about health matters, reporting at age 15 on a scale called “health locus of control” that there is nothing people can do to improve their health. As teens they often misinterpreted situations by unnecessarily jumping to the conclusion they were being threatened.

The resistant group also described themselves as non-conformists who valued personal freedom and self-reliance over following social norms. As they grew older, many experienced mental health problems characterised by apathy, faulty decision-making and susceptibility to conspiracy theories.

Negative emotions combine with cognitive difficulties
To compound matters further, some vaccine-resistant study members had cognitive difficulties since childhood, along with their early-life adversities and emotional vulnerabilities. They had been poor readers in high school and scored low on the study’s tests of verbal comprehension and processing speed.

These tests measure the amount of effort and time a person requires to decode incoming information.

Such longstanding cognitive difficulties would certainly make it difficult for anyone to comprehend complicated health information under the calmest of conditions. But when comprehension difficulties combine with the extreme negative emotions more common among vaccine-resistant people, this can lead to vaccination decisions that seem inexplicable to health professionals.

Today, New Zealand has achieved a very high vaccination rate (95 percent of those eligible above the age of 12), which is approximately 10 percent higher than in England, Wales, Scotland or Ireland and 20 percent higher than in the US.

More starkly, the New Zealand death rate per million population is currently 71. This compares favourably to other democracies such as the US with 2,949 deaths per million (40 times New Zealand’s rate), UK at 2,423 per million (34 times) and Canada at 991 per million (14 times).

How to overcome vaccine resistance
How then do we reconcile our finding that 13 percent of our cohort were vaccine resistant and the national vaccination rate now sits at 95 percent? There are a number of factors that helped drive the rate this high.

They include:

• Good leadership and clear communication from both the prime minster and director-general of health
• leveraging initial fear about the arrival of new variants, delta and omicron
• widespread implementation of vaccine mandates and border closure, both of which have become increasingly controversial
• the devolution by government of vaccination responsibilities to community groups, particularly those at highest risk such as Māori, Pasifika and those with mental health challenges.

A distinct advantage of the community-driven approach is that it harnesses more intimate knowledge about people and their needs, thereby creating high(er) trust for decision-making about vaccination.

This is consistent with our findings which highlight the importance of understanding individual life histories and different ways of thinking about the world – which are both attributable to adversities experienced by some people early in life. This has the added benefit of encouraging a more compassionate view towards vaccine resistance, which might ultimately translate into higher rates of vaccine preparedness.

For many, the move from a one-size-fits-all approach occurred too slowly and this is an important lesson for the future. Another lesson is that achieving high vaccination rates has not been free of “cost” to individuals, families and communities. It has been a struggle to persuade many citizens to get vaccinated and it would be unrealistic not to expect some residual resentment or anger among those most heavily affected by these decisions.

Preparing for the next pandemic
Covid-19 is unlikely to be the last pandemic. Recommendations about how governments should prepare for future pandemics often involve medical technology solutions such as improvements in testing, vaccine delivery and treatments, as well as better-prepared hospitals.

Other recommendations emphasise economic solutions such as a world pandemic fund, more resilient supply chains and global coordination of vaccine distribution. The contribution of our research is the appreciation that citizens’ vaccine resistance is a lifelong psychological style of misinterpreting information during crisis situations that is laid down before high school age.

We recommend that national preparation for future pandemics should include preventive education to teach school children about virus epidemiology, mechanisms of infection, infection-mitigating behaviours and vaccines. Early education can prepare the public to appreciate the need for hand-washing, mask-wearing, social distancing and vaccination.

Early education about viruses and vaccines could provide citizens with a pre-existing knowledge framework, reduce citizens’ level of uncertainty in a future pandemic, prevent emotional stress reactions and enhance openness to health messaging. Technology and money are two key tools in a pandemic-preparedness strategy, but the third vital tool should be a prepared citizenry.

The takeaway messages are twofold. First, do not scorn or belittle vaccine-resistant people, but rather attempt to glean a deeper understanding on “where they’re coming from” and try to address their concerns without judgement. This is best achieved by empowering the local communities that vaccine resisters are most likely to trust.

The second key insight points to a longer-term strategy that involves education about pandemics and the value of vaccinations in protecting the community. This needs to begin when children are young, and of course it must be delivered in an age-appropriate way. This would be wise simply because, when it comes to future pandemics, it’s not a matter of if, but when.

Dr Richie Poulton, CNZM FRSNZ, director of the Dunedin Multidisciplinary Health & Development Research Unit (DMHDRU), University of Otago; Dr Avshalom Caspi, professor, Duke University, and Dr Terrie Moffitt, Nannerl O. Keohane University Professor of Psychology, Duke University. This article is republished from The Conversation under a Creative Commons licence. Read the original article.

Article by AsiaPacificReport.nz

The first two charts show official case numbers and deaths, for all countries, including the little countries that tend to dominate in the peak of the northern summer holiday season.

Chart 1 shows the countries with the highest case numbers per person – from French Polynesia (Tahiti) to Greece, plus four other countries for reference. Chart 2 shows cases in order of deaths per person.

The three top ‘countries’ are all French overseas territories, as are Saint Martin, French Guiana, and St Barth. Also listed are Sint Maartin and Aruba (and Curaçao on Chart 2 only), overseas territories of the Netherlands. Also shown in these charts are six Caribbean destinations in the British Commonwealth (the ‘West Indies’ as we know them, plus the Bahamas). Then there’s Cuba, now a popular holiday destination for Europeans. And Suriname is a former Dutch colony – and a holiday destination – in the Caribbean.

What we are seeing is a ‘colonisation’ problem, rich vaccinated people from rich European countries (a number of which are shown in grey, and the United Kingdom and United States, which have substantial case numbers but few deaths by 2020 standards. Covid19 has always been a condition of the rich which they have then passed on to the poor, especially the relatively poor people who provide services to those rich people. What is happening now is that ‘healthy’ vaccinated Europeans are infecting (with Delta) and killing the local service sector employees (and their families) in these mainly Caribbean destinations. These territories and countries are open because they are understood to be dependent on tourism from Europe (and, except for Cuba, from USA), and because this class of rich tourists is uncaring – entitled – in their lack of care towards the people whom they are killing. We look the other way, because these death zones are very small territories and countries.

In French Polynesia, 450 deaths per million people is equivalent to 2,250 covid deaths in New Zealand in just one week.

Another small tourist country to mention here is Seychelles, still among the top infection/death sites, and has been since April. In this case, as I understand it, Seychelles has become a tourism bolt hole for rich Indians, especially in the summer monsoon season.

And another small country is Iceland. This fully vaccinated country has, at present, a delta outbreak far worse than New Zealand’s, and in the last week has had its first deaths in this outbreak. Per capita, it is the worst affected in Scandinavia, although Norway and Denmark also have very high case numbers at present. (We should note that, since the start of the pandemic, and according to ourworldindata.org/excess-mortality-covid, all three of these Scandinavian countries have fewer excess deaths per person than does Aotearoa New Zealand.) These countries affirm that Covid19 remains highly infectious, that immunisation substantially lowers deaths, and that international travel by people from highly immunised countries is more dangerous than ever to people with low levels of immunity to Covid19.

It is important to note that the immunity in western Europe to severe illness from Covid19 is due to both a mix of vaccination and viral circulation. Even when New Zealand is as immunised through vaccination as are Europeans, New Zealand will remain substantially vulnerable to an opening up to tourism from Europe, USA, India, South Africa, and South America.

The second two charts are restricted to countries with more than 900,000 people.

Looking at death rates at the end of August, regions that show up are the Caucasian countries (Georgia, Armenia, Azerbaijan) and neighbours Russia, Kazakhstan and Iran.

Reunion, another far flung French territory, with a population (like Fiji) of 900,000, also shows up. (I visited Reunion in 1978; it’s a truly spectacular piece of real estate.)

Other important regions showing up in these two charts are southern Africa, the Balkans (southeast Europe), Sri Lanka and Southeast Asia, and Central America. And we note Greece, the Eurozone country with the highest covid death rate, and a country for whom the vast majority of recent deaths precede Delta. And South America – also non-Delta – still shows up strongly in the fatality data.

In Chart 3 above, we note the presence of Israel and Palestine. Many anxious eyes are looking in that direction, and the news at present is not good. Almost certainly the inequity between Israelis and Palestinians is an important part of the problem there. And, while Israel will resolve its problem, this month, through booster vaccination, it is likely that Israeli tourists are among the most dangerous for other countries to host. Lebanon, though no longer present on this chart, almost certainly continues to be ravaged by Covid19. Its economy is in a state of collapse, including three-digit inflation. We should be hearing much more about Lebanon in our mainstream news media.

Of countries with high infection rates though low death rates, the places that show up most are the British Isles (UK, Ireland, Isle of Man), and Switzerland. We also note the Baltic States (Estonia, Lithuania) and Portugal (with better holiday weather this year than Greece) getting new delta outbreaks, though with indications – see Lithuania – that deaths will soon follow. Interestingly, Poland, Lithuania’s neighbour, is much less affect at present (see final section below).

Australia and New Zealand remain well below the international radar, at least in the data if not in the global news cycle. (On Al Jazeera we continue to get frequent Covid19 reports from Australasia that are mainly of novelty interest to global audiences.) Canada broadly falls in between the experiences of the United States and Australia.

India now has low rates of Covid19, with the exception of Kerala. While the statistics there understate the true picture, that understatement is almost certainly less now than it was in the peak of India’s epidemic, and is probably no more understated than many other countries. India today is like Northern Europe, highly immunised, yet dangerous to people in countries with low immunity to Covid19 and comparable viruses.

Japan is interesting, given the Olympic and Paralympic Games. Its profile is very much like that of a typical northwestern European country.

This final chart shows historical (for the pandemic) excess deaths of people aged 65-74, in a range of countries all severely affected by Covid19. (A similar chart showing England and Spain, was on this site last week.) None of what features in this chart has anything to do with Delta. France was surprisingly little impacted; eg much less than England. Portugal just had the one peak, of Alpha, which strongly coincided with England’s peak.

In the Americas, Chile and the United States feature prominently. As a region, the Americas have suffered most of all this pandemic; ironic perhaps given that Brazil is the antipodes of the source country, China (whereas China has suffered the least mortality of any large country). Chile suffered severely from the Gamma strain of Covid19, and it really shows; and despite Chile’s high and early vaccination rates, which focussed especially on people aged over 75.

Finally, we note the severity of the pandemic in northeastern Europe, shown here through Czechia and Poland. Their deaths resulted from the non-variant Wuhan strain of Covid19; and they almost certainly occurred in large part because of (rather than ‘despite’) earlier restrictive policies to keep Covid19 out of their countries. (See the timing of France’s peak mortality.)

Poland is particularly interesting here, because I included it in the third chart above, and because it borders Lithuania and Germany, both much more infected. Poland even ‘lent’ Australia much of its excess stock of Pfizer vaccine. Through herd immunity, a mix of vaccination and calamitous infection last northern autumn and winter, Poland is, for now at least, able to have normal domestic freedoms. The same basically applies to Czechia, Slovakia and Hungary. No country would want to go through Poland’s experience to get to their present position. It is important, nevertheless, that we in little Aotearoa New Zealand do understand Poland’s situation, in these ‘Delta Days’.

Keith Rankin (keith at rankin dot nz), trained as an economic historian, is a retired lecturer in Economics and Statistics. He lives in Auckland, New Zealand.

It’s a known known that the late Donald Rumsfeld’s principal legacy to the world is the following quote:

“As we know, there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns—the ones we don’t know we don’t know.”

I might say that there are also unknown knowns, nuggets of truth buried in archives and barely read books and articles.

When it comes to known unknowns, there are two basic types. The first are questions posed for which we do not yet have any plausible answers. This could be due to technical (eg measurement) difficulties, or economic difficulties (the expected cost of finding answers being too high). The other type is because at least some people don’t want the questions answered (and may even place embargos on finding answers), or because the possible answers simply do not fit the prevailing filter through which the questions are framed in public discourse.

Re unknown unknowns there are also multiple categories. First there are cases where questions have never had reason to be posed, cases beyond the prevailing human imagination. These are genuine unknown unknowns; things that are true but that none of us had the capacity to imagine. I can offer no present examples. A past example is the electric light bulb, which could not have been imagined even by Julius Caesar. (Although the light bulb could have been imagined well before it happened; for example, after the scientific work of Michael Faraday.)

Then there are questions of wilful blindness, questions which verge on the final category of known unknowns. Third are the black swans, events that happen ‘out of the blue’ or ‘out of left-field’; but which were predictable ‘with hindsight’! Black swans represent something akin to wilful blindness; they are events that were genuinely unexpected, and for which the precise form of their manifestation could never have been predicted. Covid19 is a black swan. (Note that ‘black swan’ is an unfortunately ironic term. It was either first coined – as a metaphor – by someone who did not know that black swan birds exist, and are the normal type of swan in some parts of the world, including ours. Or it was coined because the ‘coiner’ believed that, for almost everybody except themself, actual black swans were unknown. In reality, black swans are not black swans, and they have been known in Europe since the seventeenth century. Nor are the black-white swans I saw on the island of Chiloe; I was not expecting to see them, but one reason people travel is to discover things that other people already know.)

(That the Taliban would rule over the whole of Afghanistan as soon as July 2021 was a black swan as recently as June 2021. It was not conceived of as even a possibility, except – maybe – by the Taliban themselves.)

Related to these unknowns are the unseen – or ignored – red flags. It is missed red flags that create black swans, such as Covid19. And – I would argue – our failure to adopt joined-up-scientific thinking re the known facts about Covid19 and related viral diseases, means that there are more black swans lurking. The most important red flag that I would mention in this case, is the present apparent loss of natural immunity to respiratory viruses; loss of what I will call ‘community respiratory viral immunity’ (CRVI). CRVI is not a binary concept; it’s a level of community immunity that, like the economy, has for the most part grown over time. Natural variation of immunity rises (or diminishes) through the changes in the pathogenic environment, rather than through interventions such as vaccination. (The economic growth analogy of a temporary loss of community immunity is a recession.)

The problem in New Zealand at present is epitomised by the way we report about ‘Delta’, a highly transmissible variant of the SARS-COV2 virus that causes Covid19; this ‘comms’ problem is perpetrated in particular by our technocrats, our bureaucrats, our ‘policrats’ (narrative-framing politicians), and our mediacrats.

Before discussing this further, I need to emphasise that New Zealand’s present ‘Level 4 lockdown’ is absolutely the correct emergency policy measure for the present outbreak in New Zealand of Covid19.

The Delta-Bogey and the Missing Science and CW2 (Covid-War 2)

The dominant narrative in Aotearoa New Zealand is that Covid19 – which we (the New Zealand ‘team of five million’) defeated in battle in 2020 – has morphed, like some demon – into Delta. And that Delta is a seriously mean beast. In creating Demon Delta, we implicitly treat its predecessors as comparatively harmless. Yet by far the majority of Covid19 deaths in the world have been caused by non-Delta variants. (If this latest outbreak had been identified as non-Delta, we should have been more – not less – alarmed; it would probably have come from South America, where Covid19 has most affected, and where Delta has been least present.) In this narrative, populations have four weapons at their disposal: macro barrier methods (lockdowns and quarantines), micro barrier methods (hygiene practices, including facemask wearing), contact tracing, and ‘silver bullet’ vaccinations. (By ‘silver bullet’ vaccinations, we mean that – after a course of vaccinations – a person may be classified as ‘immunised’; this is how we understand, for example, measles vaccinations.)

In this narrative, the implicit counterfactual is that the adverse consequences of a Delta outbreak are much greater than of an outbreak of the South American versions of Covid19, or of the original Wuhan version. While we have heard much about the greater transmissibility of Delta, I have heard of no scientific studies that compare Delta and non-Delta strains in fully comparable populations. (All scientific pharmaceutical trials require that drugs be tested alongside ‘control’ treatments.)

This predominant narrative may be called Hypothesis One.

There is a second obvious hypothesis (Hypothesis Two): that (i) Delta is substantially the same as previous versions of Covid19, though just enough more transmissible to displace other variants in circulation in the same environments (like grey squirrels displacing red squirrels), and (ii) from late 2020 – and especially in 2021 – populations have reduced CRVI (community respiratory viral immunity). (There is another possibility, an in-between hypothesis, that Delta is significantly more harmful than other variants, and that its impact is exacerbated through many current host populations having reduced CRVI.)

An extension of Hypothesis Two is that immunisation by vaccination may not be permanent. (It is a known known that measles immunisation is permanent, but that immunisation against influenza is temporary.)

In summary, Hypothesis One is that the major problem leading to ongoing mortality and morbidity is the more aggressive behaviour of the enemy (of Delta). Hypothesis Two is that the major problem leading to ongoing mortality and morbidity is the reduced CRVI of the population.

The counterfactual to the first hypothesis is that the Covid19 pandemic would be in its endgame, were it not for Delta. The counterfactual to the second hypothesis is that the outcome of New Zealand’s August 2021 outbreak of Covid19 (and recent Asian outbreaks) would be much the same – serious – whether or not this was the Delta strain. Both hypotheses predict that – without appropriate policy responses – there will be problematic levels of mortality and illness.

Policy Implications

Both hypotheses require policies of ’emergency lockdown’ and, if available, ‘vaccination’. (Fortunately, we do have available effective vaccinations which target the SARS-COV2 virus; had these vaccinations proven to be ineffective, then we would further emphasise ’emergency immunity management’ policies such as lockdowns.

There are two important policy differences, however, depending on which hypothesis is more true. The first policy difference relates to how populations should behave outside of periods of emergency lockdown. The second is about the ongoing vaccination programme.

In Hypothesis One, Delta is the problem, and success is the ‘elimination’ of SARS-COV2 (whereby SARS-COV2 goes to the same place that SARS-COV1 – in 2003 – went to), aided by the immunisation by vaccination of the population.

In Hypothesis Two, reduced CRVI is the problem, and success is a level of community immunity that would tolerate SARS-COV2 circulating in future as another seasonal ‘common cold’ coronavirus. And success means adopting practices – including regular vaccinations – that extend CRVI levels in the population. (The good news here is that regular Covid19 vaccinations should reduce illness from other endemic viruses by facilitating high CRVI levels. Good for labour productivity as well as for general wellness.)

CRVI

What exactly is community respiratory viral immunity? It’s probably not quantifiable as a precise metric, but is a real-world parameter that rises or falls under different conditions; and it’s a community attribute that, ideally, should be optimised but not necessarily maximised.

The key idea is that it is a measure of general immunity to an important class of pathogenic diseases, and not immunity to a specific respiratory virus. And it should be understood as a population measure, rather than a measure of an individual person’s immunity.

CRVI increases with exposure to respiratory viruses in aggressive or attenuated form. It relates to what might be called the ‘common’ classes of community viruses: influenzas, coronaviruses, rhinoviruses, and other similar viruses such as respiratory syncytial virus (RSV).

Novel viruses (such as coronavirus SARS-COV2) can be classed as ‘aggressive’ (mainly because they are unknown to our immune systems), though some may be more aggressive than others (eg SARS-COV1 was more lethal than SARS-COV2). Attenuated viruses can be classed as those which have evolved to be less aggressive, forming equilibriums with populations with given levels of community immunity. And the label ‘attenuated’ can be used to describe the deactivated viral sequences that constitute the active ingredients of our vaccines. Vaccination against community viruses is a relatively recent episode in the wider history of vaccination; until 2020, only influenza vaccinations were in place for this viral class, and even they are comparatively recent (ie, in practice, influenza vaccinations are twentyfirst century interventions).

Over the history of humanity, CRVI has increased, and necessarily so. As more community viruses circulate within human populations (ie become endemic to humans) – typically viruses passed to humans from other species for which they were already endemic – then CRVI levels increase due to accumulated exposure to ever-greater-numbers of these virus species. Thus, in 2019, CRVI levels in human populations throughout the world were probably at the highest level that they had ever been in human history. Indeed, the main driver of rising CRVI levels in recent decades has been the decreasing cost and increasing convenience of international air travel. Another important driver has been the introduction of annual influenza vaccinations.

CRVI levels are generally higher in urban populations, and highest of all in the world’s metropolitan cities; cities which are both densely populated and within close reach to international airports. One of the most important unknown knowns (or at least ‘little known’ knowns) in this regard is the difference in community immunity levels between different homeplaces of young men called into the United States’ military in 1917, the year that a new H1N1 influenza virus started to circulate in the United States. The weaker – indeed ‘weedier’ – city boys proved to be significantly more resistant to the virus than the muscular young men from the farms and the provincial towns. (Refer to The Pandemic Century (2019), by Mark Honigsbaum.)

An important feature of CRVI is that it wanes when not fortified by ongoing exposure to community viruses. CRVI is nuanced, in that if fortified mainly by rhinoviruses in one year, then populations become a little more susceptible to serious illnesses from influenza viruses in the following year. Nevertheless, exposure to one class of community viruses probably gives some degree of resistance to other classes of community viruses.

So, under Hypothesis Two, in early 2020, global population CRVI levels were very high. The result was that Covid19 illness – caused by the then novel coronavirus SARS-COV2 – was resisted by the younger infected population, including the middle-aged-populations which represented the majority of airline passengers. Thus the major health consequences were faced by the older and comorbid populations who were less able to mount the requisite immunity responses.

However – and under Hypothesis Two – the important but not understood story of 2020 was the unusually rapid waning of CRVI levels in (now largely physically disconnected) human populations. This waning was a result of restrictive behaviours, mandated and unmandated. Restrictive behaviours include both mandated isolations, and personal barrier restrictions (such as physical distancing and the widespread use of facemasks).

Under emergency conditions, a loss of CRVI is the necessary price we must pay in order to minimise – if not eliminate – a dangerous pathogen. This elimination was achieved with SARS-COV1. The under-recognised challenge is to – as best as possible – start to restore CRVI levels as soon as emergency conditions are lifted (and, as part of this, to fully lift domestic emergency mandates as soon as a novel virus has been suppressed).

Part of the CRVI restoration process is of course vaccination, and it is probable that booster influenza vaccinations did to some extent increase our abilities to resist new outbreaks of Covid19. Of course vaccines that specifically target coronaviruses – and SARS-COV2 in particular – would have much more impact during a coronavirus pandemic; and the beneficial side-effect of coronavirus vaccines is that they most likely reduce populations’ susceptibility to the other community viruses that give us colds and influenzas.

It is now possible to talk of the ‘benefits of complacency’. ‘Complacent’ barrier behaviour – though not so much complacency towards contact tracing – helps to restore CRVI, and prepares populations for the next (or next wave of) community viral infection.

Hypothesis Two states that the major single factor in the severity of outbreaks of Covid19 since the middle of 2020 has been the loss of CRVI, and not the increased virulence of the evolving viral agents.

1917-19 Influenza Pandemic

It is worth digressing here to note the epidemiology of the H1N1 influenza pandemic of 1917-19; the pandemic best called the ‘black flu’, though more commonly (and inappropriately) called the ‘Spanish flu’.

This pandemic essentially hit the world in three waves, with the second wave being the most severe. In New Zealand the probable fatality rate was about 0.8% of the population, though ‘officially’ it was more like 0.4%. (We note that the present official fatality rate of Covid19 in the United States state of New Jersey has, just this month, surpassed 0.3%.)

The first wave of this pandemic appears to have begun in the United States, and its spread was almost certainly facilitated by the mobilisation of conscipted troops, as the United States entered World War One (WW1). However, another variant of H1N1 influenza had been emerging in China, and it seems that, on the Western Front, the two versions fused into a new super H1N1 variant, the ‘second-wave’ variant that was brought to New Zealand by returning soldiers. (The best source for New Zealand epidemiological information is the second edition of Geoffrey Rice’s book Black November. And we should note that evolution – of viruses as well as larger creatures – is about hybridisation [fusion] as well as through descendant mutation [fission].)

The earlier variant had however circulated in New Zealand in the late winter of 1918, with some severe health outcomes, but also raising the effective CRVI in those parts of New Zealand that were affected. When the big second wave hit in November 1918, two groups suffered least. First were those – such as Ngāti Porou – who implemented local quarantines. Second, were those in the places most affected by the first wave. After the short emergency period (essentially the month of November 1918) people reverted to normal life – or as near to normal life as possible in the month that WW1 ended. CRVI levels were clearly very high by New Year 1919, so when the slightly attenuated third wave hit in 1919, New Zealand was barely affected. Australia – which had imposed a full quarantine in November 1918 – suffered much worse in 1919 than New Zealand, though not as badly as New Zealand had done in 1918. Clearly, New Zealand had – for that time in history – very high levels of CRVI in 1919; ‘herd immunity’ to influenza, and most likely a higher than normal immunity to other community respiratory infections.

The ‘black flu’ pandemic was an event that featured both a more virulent muted version of the H1N1 influenza virus, and significantly varying levels of community immunity to respiratory viruses.

We note that in the present pandemic, both Hypothesis One (a very lethal variant of the virus) and Hypothesis Two (waning CRVI levels) may contribute to the story. In 2021, however, the Hypothesis One story (the ‘delta’ story) seems less convincing; I suspect, because the newer more aggressive variant is a descendant (fission) variant, not a fusion of two already aggressive variants (as was the case in 1918).

Hypotheses One and Two: the Evidence

To start with, we need to look at the big European second wave of Covid19, in the northern autumn of 2020. By then, there was increased knowledge of Covid19, improved testing and contact tracing, and renewed use of barrier interventions to viral circulation; all of these should have reduced the impact of the second wave if the virulence of the virus was the main determinant of the level of deaths and serious illnesses. But none of the new ‘more transmissible’ variants were present at that time; Covid19 was not more virulent then. (‘Alpha’ was the ‘Kent variant’ that surfaced in England in about December 2020.)

Instead, what happened was that, in late 2020 in most West European countries, the death rates were similar to those of the preceding spring wave. Spain was different; its fatality rates were significantly lower. Of most importance for this analysis was East Europe, within the European Union. There, where, in the spring, barrier methods had largely kept Covid19 out, fatality rates soared in the autumn to levels much higher than in West Europe. It was the same virus in both parts of the European Union. This picture negates Hypothesis One, and strongly supports Hypothesis Two. The major determinants of Covid19 death in Europe in late 2020 would have been varying CRVI levels, lowest in the east due to its successful earlier precautions, highest in Spain. Whereas summer complacency in the Czech Republic (where CRVI had become dangerously low) undoubtedly contributed to the problem, summer complacency in Spain most likely contributed to the solution, by boosting CRVI there. We also note that, for the most part, younger people were more likely to die from Covid19 in East Europe. This is consistent with lower CRVI levels there and then, rather than greater levels of complacency (unlikely) being the problem in East Europe. By September 2020, Covid19 was a known known, no longer a ‘black swan’.

In the Americas, throughout the pandemic, piecemeal barrier protection almost certainly reduced the peaks of the outbreaks, but also brought about depressed CRVI levels. We see that, in the United States, the timing of outbreaks in the ‘blue’ (Democratic) states (where barrier controls were most followed) and the ‘red’ (Republican) states (where barrier controls were most resisted). In general, the new outbreaks started in ‘blue’ states (with less CRVI), and eventually moved on to red states (with higher CRVI than blue states, but less CRVI than in 2019). In the very latest outbreak, though, the blue states were saved through higher CRVI arising from much higher vaccination rates; the present outbreak is accentuated in the red states.

Hypothesis Two predicted that, in 2021, Asia (which had imposed the most effective barriers in 2020) would be very vulnerable. That has come to pass. And – as in Indonesia today – the age profile of fatalities has been coming down, suggesting that levels of CRVI in Asia in 2021 are even lower than in Eastern Europe in late 2020 and early 2021. The tragedy of Indonesia is that even very young children are dying.

Further, in Asia in 2021, those countries unable to implement sufficient barrier protections (such as India), have seen short (but severe) outbreaks of Covid19, this time with the Delta variant of SARS-COV2 featuring as a circulating virus. An extreme case of this is Afghanistan, already in political turmoil when Covid19 hit in June this year. Briefly, Afghanistan in June – as Nepal in May – was amongst the worst affected countries in the world. But now, in August and with even greater political turmoil, Covid19 seems to have largely disappeared. It looks like Afghanistan has experienced a dramatic boost to its CRVI status.

The present outbreaks in Australia are proceeding differently from those of 2020. The popular narrative is that of Hypothesis One – that the people are now up against a more vicious foe, a devil called Delta. But the manner of the more lethal spread of Covid19 in the young population is more suggestive of low CRVI levels, as in East Europe late in 2020. The (counterfactual) control here is the United Kingdom, and West Europe. In these places CRVI has largely been restored (though, as in Israel, may be waning due to the earliness of its jabs). There, Delta has behaved more like a pussy cat than a devil, infectious but not lethal. In the United Kingdom, CRVI was largely restored by vaccination, but the removal of mandated barrier protections will be ensuring that vaccination-induced CRVI is being enhanced by renewed community circulation of seasonal (non-novel) respiratory viruses. Australia – especially young Australians – have substantially less CRVI protection from serious illness.

Eastern Europe is an interesting test case; it seems to have been immune from Delta so far. However, waning community immunity may see it vulnerable this coming northern winter.

Here in Aotearoa New Zealand, the rapidly imposed emergency measures should – after a few weeks – repel the current outbreak. The challenge will be for us to substantially restore CRVI levels, in time for the southern winter of 2022. While vaccinations this year – and 2022 booster vaccinations for the more vulnerable – will represent the main part of meeting this challenge, a high dose of Level 1 barrier-complacency this summer (but not QI-code complacency, for contact tracing) should help to keep the unvaccinated somewhat safe, the rest of us safe from them, and should help the vaccinated to hold on to raised CRVI levels through next autumn. It means that, once back to Level 1 (no community presence of Covid19), we should be encouraged to remove our masks – and to enjoy mixing and mingling – at least until another border-infringement outbreak occurs. And, when international travel is once again opened up, our priority should be to maintain – and extend – high levels of CRVI (community respiratory viral immunity). Low CRVI means lots of infections, many serious, and not all Delta Covid19.

Conclusion

The evidence, at least as I have presented it, comes closer to disproving Hypothesis One (the aggressive Delta hypothesis) than to disproving Hypothesis Two (the deficient CRVI hypothesis). I would like to see, in the media, a proper scrutiny of both hypotheses. Until this happens, the attention that community respiratory viral immunity requires will be negligently missed. The likely truth that is Hypothesis Two will remain a known unknown.

Barrier methods – macro and micro – work in emergency contexts, much as cortisol reduces stress and anxiety in these contexts. But, out of these acute situations, excess cortisol becomes a source of ill health. Barrier infection blocks all of the community viruses that support CRVI levels, making us over time more vulnerable to community infections, and making those infections more dangerous. On the other hand, annual vaccinations for influenza and coronavirus will substantially extend CRVI levels, making us generally more healthy with respect to both influenza and common cold viruses. In the United Kingdom and West Europe, Delta Covid19 shows all the signs of becoming – in a few years – another common cold coronavirus.

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Keith Rankin, trained as an economic historian, is a retired lecturer in Economics and Statistics. He lives in Auckland, New Zealand.

contact: keith at rankin dot nz

Academics who made allegations of racism at the University of Waikato are welcoming the outcome of an independent review.

While individual claims have been dismissed as “inaccurate”, “incorrect” and “reflective of differing perspectives”, it is hoped the findings could lead to nationwide action on racism at tertiary institutions.

Six academics wrote to the Ministry of Education last month, expressing concerns about casual and structural racism at the University of Waikato – prompting the review.

The review was led by Harawira Gardiner and Hekia Parata, who held individual and group meetings with 80 people and received 96 submissions, and the findings were released yesterday.

Instead of upholding specific claims, it concluded that New Zealand’s public institutions, including universities, adhere to Western university traditions and cultures – so there was a case for structural, systemic, and casual discrimination.

“Today, in 2020, in this post-settlement world, it is not acceptable for places of teaching and learning, of research, scholarship and debate, of nation building, to continue this selectively accommodating patronage, of Māori, tāngata whenua, their mana, tikanga and mātauranga,” it said.

Delighted with outcome
Professor of Māori Education at Victoria University of Wellington Joanna Kidman – who has publically supported the six academics – says she was delighted with that outcome, and confirmation from the University of Waikato that it would set up a taskforce to “open up the dialogues” and tackle the issues.

“I think this will be a positive step forward… we will look towards the university to lead what could be a model for other universities in times to come,” she said.

However, she said the findings could also be put on a “national footing”.

“We’ve seen recently, a group of Māori professors have put an open letter to Education Minister Chris Hipkins saying that they would like an independent review of New Zealand universities. I think this is an excellent way forward.”

The report also recommended the university engaged in a future-focused process to determine how to apply the 1840 Treaty of Waitangi, and to refresh its relationships with iwi.

The University of Waikato declined to comment further on the report or speak to RNZ, but Vice-Chancellor Professor Neil Quigley posted a video statement saying the university council unanimously accepted the recommendations.

He said the taskforce would create an action plan over the next few months.

“This is an opportunity for the University of Waikato to provide leadership both here, and nationally, for the development of ideas that will address structural and systemic discrimination and racism in the university system,” he said.

“It’s going to be a difficult journey, a challenging journey, but we are committed to making it work.”

This article is republished by the Pacific Media Centre under a partnership agreement with RNZ.

Article by AsiaPacificReport.nz

The covid-19 coronavirus pandemic and subsequent lockdown has been tough on the mental wellbeing of Asian New Zealanders, according to new research.

The New Zealand Asian Mental Health and Well-being report, commissioned by charity Asian Family Services, found high levels of anxiety and nervousness, as well as racism.

The research surveyed 580 Asian New Zealanders across the country and found almost 44 percent of them experienced some form of mental distress since level 4 lockdown.

READ MORE: Al Jazeera coronavirus live updates – Global death toll passes half a million

Nervousness and anxiety are the most widely experienced (57 percent), followed by little interest or pleasure in doing things (55.2 percent), uncontrollable worrying (47.4 percent) and feeling down and hopeless (44 percent).

Asian Family Services director Kelly Feng said isolation, lack of support, family issues, academic or work pressure, new migrants adjusting to a new environment can all cause mental stress.

She said the findings correlate to what they were seeing on the ground.

“That’s quite true when over the lockdown, our service has also experienced high demand about emotional support and counselling services.”

Help primarily from friends
The report also finds that Asians primarily seek help from friends (44.1 percent) and family (42.6 percent), with just over a quarter (28.3 percent) saying they would see their doctor, comparing with the national figure of 69 percent according to the Health Promotion Agency.

A small portion (13.8 percent) did not seek any support at all, and Feng said it was concerning.

“That gives me an indication that we really need to promote or even do a campaign about mental wellbeing and addiction issues and raise awareness among Asian communities so people can seek help in the early stage and get a bit of early intervention rather than at the bottom of the cliff,” she said.

Just over 16 percent of respondents reported experiencing racial discrimination during the pandemic, and those who faced discrimination were also more likely to have mental health concerns.

Race Relations Commissioner Meng Foon said the findings were alarming.

“I feel gutted and sad that people are receiving discrimination and racism. It doesn’t matter what the numbers are. It’s really important that we continue to try and implement progress in systems and education to eliminate racism,” he said.

“It’s good to have an analysis report on mental health and discrimination. I think there’s a lot of work to do ahead of us. It’s good to know where we can actually target our resources to support mental health.”

Kindness message helped
The study said the overall messaging of being kind to one another during the pandemic has likely contributed to the relatively low percentage of discrimination.

But Dr Andrew Zhu, director of Trace Research which carried out the study, said it was still serious.

“On a percentage base, it’s relatively small which means we’re on the way to achieving racial harmony, however if you translate this number into a population-based number, that’s around 84,000 adult population of Asian ethnicity which could still be counted as serious,” he said.

Koreans reported to have experienced discrimination the most, with 30 percent of those surveyed saying they’ve been discriminated against, followed by Chinese at just over 22 percent.

However, Chinese accounted for nearly half of the overall discrimination cases as it has the largest population base among all Asian ethnicities.

Data for this study was collected online between May 22 and June 3, and quota sampling was used to ensure representativeness of all Asian ethnic groups according to the 2018 census of Asian adult population distribution.

This article is republished by the Pacific Media Centre under a partnership agreement with RNZ.

Article by AsiaPacificReport.nz