In the absence of more detailed recent data on deaths in New Zealand, the Smithometer acts as a good proxy for older New Zealanders’ mortality. The Smithometer includes all New Zealand deaths where the persons’ surnames are Smith, including women with birth surnames of Smith. So, the Smithometer most reflects the mortality of older women. The historical data-source only gives access today to the deaths of people born on or before 10 January 1944.

In the above chart, the seven-week moving total is the most informative, as it better smooths out random variations.

The chart clearly shows the three Covid19 peaks of 2022: February/March, June/July, and December.

2023 is different. The usual seasonal peaks are missing. Deaths for this demographic have been consistently high from April to November, with recent peaks in early September and late October.

The new pattern is partly because Covid19 is a ‘seasonal’ illness that’s proving to be far less seasonal than we originally expected. The second reason is likely to be related to a more general deficit in immunity to a whole range of conditions, but especially conditions like Covid19 for which immunity tapers off relatively quickly. Put another way, there are likely to be more problems of tissue ‘inflammation’ in the community in our populations, and that is almost certainly partly due to decreased exposures to the regular minor bugs which used to keep topping up our general immunity.

Prolonged facemask mandates have almost certainly been part of the problem. Facemask mandates should only apply to exponential growth phases of a new respiratory virus. We need to discard the facemasks as soon as possible to bring ourselves back to a normal environmental interaction between humans and microbes.

An important point to note about 2022 is the death peak in June/July of that year was almost certainly due to many older vulnerable people being refused second booster vaccinations, on account of there having been ‘only’ five months between the well-predicted June wave of Covid19 and their first boosters in January and February. This finding is reinforced by the relatively small mortality peak for this demographic in March 2022, the month of peak infections in New Zealand. In March 2022, the vulnerable population had been recently vaccinated.

Younger New Zealanders

My suspicion is that younger demographics – for which good data is harder to find – will be showing greater increases (compared to the over-80s) in mortality relative to their 2010s’ norms. While younger people are more ‘vigorous’, their immune systems are generally less-well trained. Indeed, that’s probably why younger people are more likely than older people to get ‘long-coronavirus’ symptoms. In saying this, I am putting out the hypothesis that many pre-Covid19 cases of chronic fatigue syndrome may have been lagging symptoms of the other four circulating human ‘common cold’ coronaviruses.

*******

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.

The above chart looks rather noisy, and so it should. Life and death are messy, and subject to random variations. But this chart, for females, and those that follow, are important charts. It’s worth looking through the ‘random noise’. These charts suggest that the cliché ‘we are all living longer’ is incorrect. Also, this representation of New Zealand’s mortality data highlights the experience of younger people, something hidden by most death and life expectancy data.

First, some technical information. Triennial death increases are three-yearly percentage increases in the actual number of deaths; in this case, the numbers of deaths for an age-cohort (aka. for a generation). These are 11-year age-cohorts; eg the 1970s’ age cohort here is made up of people born from 1969 to 1979. Hence it is listed as 1974±5 (where ± means ‘plus or minus’).

Consider the plot for people in the 1974±5 cohort who died aged 21. The number shown is 23%. Essentially, that means there were 23% more deaths of females in this 1970s’ birth cohort who died aged 21 compared to the number from that birth cohort who died aged 18. (This is equivalent to an annual increase in deaths of 7%. We note that the incidence of death among 18-21 year-olds remains very low, even if the numbers of deaths are increasing.)

The data has been ‘smoothed’ in the following way. The deaths of those aged 21 have been compared with the annual average of deaths for those people when they were aged 16 to 20. The reason for this smoothing is to remove distortion arising from random single-year impacts on comparison populations.

We note that, in the absence of immigration and emigration, each year the population of a birth cohort falls; the fall is slow when the birth cohort is young, and accelerates from middle-age. Certainly, from about age 30, the likelihood of death from natural causes increases, as the cohort population falls. Again ignoring net immigration for the time being, death increases with age should be positive (ie above zero percent); and approximately stable as the increased likelihood of death offsets the reduced cohort population size.

Adding emigration and immigration to the picture, for New Zealand at least, is likely to reduce the numbers of deaths of people aged in their early twenties (an age which typically features net emigration) and to raise the numbers of deaths of people in their thirties (an age which features net immigration).

A further point of interpretation. Where there are ‘spikes’ in the chart, it does not necessarily mean that death rates are falling in subsequent years. The spikes essentially show acceleration of death incidence. If death rates are high, then zero percent increases indicate that death rates are still high.

So, what does this first chart tell us?

First, we see that from age 30 onwards, each birth-cohort (ie each generation) has experienced about 20% more deaths every three years; this amounts to about a 6% annual increase in death numbers. The greater variability for women aged 30 to 50 most likely reflects variations in the rate of immigrant arrivals; and we should bear in mind that immigration in this age group includes large numbers of returnees, immigrants to New Zealand who were born in New Zealand.

There is no obvious sense that more-recently-born women are living longer or shorter than their elders. Though women born in the 1930s do seem to have been more likely to die age 35 to 45 than their daughters and granddaughters; probably a mix of aftereffects of childhood poverty in the Depression years, and of the high rates of smoking amongst that generation.

Second, all generation show at least one age from 20 to 25 where there were fewer deaths than three years previously. Emigration – in particular, extended ‘overseas experience’ – will have been one reason, though probably not the only reason.

Third, and perhaps most worrying, are the high increases in teenage death rates showing for people born after 1980. This will be partly due to falling death rates for people aged around ten. But is also likely to reflect the emergence of a growing underclass; child/teenage poverty in times in which underclass births have become a larger proportion of total births. While this data is for females, we’ll look at males shortly.

This second chart shows the same data as the first chart, though it’s plotted by year-of-death rather than age-at-death. This chart shows particular high-death or low-death years. 1957 and 1968 were influenza pandemic years, and it shows, especially for the 1930s-born age cohort. We can also see death peaks in 1977, 1980, 1987, 1995, 2003/04, 2011, 2017, and 2022.

We note the big fall in the late 1990s in deaths of the 1970s’ born. This will be due to particularly heavy emigration of young people in the 1990s; emigration resulting from the record-high unemployment levels in the early 1990s.

The other feature prominent in this chart is the experience of teenagers born from 1979 to 2009. These are most likely to be due to increased mental health issues faced by teenagers born from the 1980s, perhaps combined with other issues around childhood immunity to pathogens. Anecdotally, we do hear about increasing incidences of conditions such as asthma and allergies; conditions possibly due more to over-cleanliness than to exposure to pathogens.

Comparing males with females, we see that the ‘teenage issue’ is substantially more prominent with males, and more clearly extends back to older generations. In the case of teenage males, we note a greater propensity to risky behaviours, and also the greater likelihood of death by suicide. On the matter of risky behaviours, the most prominent feature of risk-taking was vehicle crashes.

(A particular note re my own memories. 1973 was the worst year ever for road deaths in New Zealand, and one group overrepresented were motorcyclists aged around 18 to 20. Look at the green 1950s’ birth cohort. While I neither died nor got injured from such a crash, that was me; born in 1953, and an active student motorcyclist. I knew a number of people who did have serious crashes. And I attended two funerals in 1973; both born in 1952, one in a mountaineering accident and one suicide.)

In the final chart, we again see no evidence that the younger generations are healthier – or more likely to be long-lived – than their parents’ generations. Further, those born in the 1990s are not showing the decline in deaths in their early 20s which characterised previous generations. Though this may be due to less emigration; ie to changes in the culture of ‘overseas experience’ with more young people taking short trips rather than an extended or indefinite period of absence from New Zealand.

The last year of data is 2022, the year of high Covid19 mortality in New Zealand. New Zealanders born in the 1970s appear to have been hard-hit by Covid19, whether by the infection itself, or as a result of other circumstances associated with the pandemic. A 40% triennial increase in deaths in 2022 cannot be explained entirely by immigration.

Finally, in terms of the charts, we see that for older people, cohort death increases have been less for males than for females. This is because there are fewer older men than older women; meaning that more ‘past deaths’ of older men means relatively fewer ‘present deaths’ of older men.

Explanatory Context

Finally, I should mention the work of prominent (and still living) twentieth-century demographer Richard Easterlin (b.1926). His central insights were that baby-bust generations have more successful life-outcomes, on average, than baby-boom generations. (This may be modified, by the conclusion that ‘trailing baby-boomers’ – eg Gen X – would do less well in life than ‘leading baby-boomers’.)

And that the advantages/disadvantages of each age-cohort would show up in death rates, and would persevere throughout their cohorts’ lives.

The recent data that I have shown here modifies the first insight. Young people born in the 1980s – a baby bust period – have higher teenage death rates than those born in the 1960s and 1970s. My modification to Easterlin’s conclusion is that increasing inequality and poverty within a nation-state will also have an adverse impact on the life outcomes of a generation; especially given that, for today’s younger generations, children are overrepresented in the poorest households.

On Easterlin’s second insight, it’s too early to tell if unusually high teenage death rates for recent birth cohorts will also translate to unusually high death rates for these generations when they reach middle-age and old-age. But it’s looking likely that triennial death toll increases for people born in New Zealand after (say) 1970 will continue higher than for people born in the 1940s, 1950s, and 1960s.

This means that I am questioning current official life-expectancy projections as too optimistic, given that they are biassed by the experiences of people born before 1970. Not only are we not all living longer, as the purveyors of retirement savings’ schemes claim, but my prediction is that true life-expectancy (an average) for people born after 1970 is actually lower than it is for people born between 1940 and 1970. Indeed, some United States data already shows this for that American country. I can see every reason to believe that New Zealand will follow this turning trend already apparent in official United States’ mortality data.

*******

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.

National Party leader Christopher Luxon made claims about health outcomes that were clearly false. Why was he left unchallenged?

In the TVNZ leaders’ debate last night, Luxon and Labour’s Chris Hipkins had a testy exchange over Māori healthcare.

Hipkins held firm on the creation of a Māori Health Authority, established last year, arguing strongly that the persistent gaps in health outcomes and care justified it.

Luxon was equally clear in opposition to it. He framed his critique of the authority around an alleged complete lack of progress on Māori health outcomes. He was very specific.

“Every single health outcome has gone backwards under Chris’s government,” Luxon said.

“Six years, not one has improved for Māori or for non-Māori.”

While sweeping in nature, Luxon’s claim did not get a direct response from Hipkins.

Luxon repeated a similar line later in the debate.

“Gone backwards. Chris, under your government, every single health outcome for Māori or non-Māori [has gone backwards]. You can’t have that.”

Hipkins did push back on this occasion, citing the ongoing reduction in rates of smoking.

Luxon’s claim was far from true — there are a number of areas where health outcomes for Māori and non-Māori have improved while Labour has been in charge.

But it is perhaps understandable that Hipkins was not quick to correct Luxon because the data — even though it’s better in many respects — is still grim. Maybe Hipkins did not wish to dwell on this.

Improved health outcomes
There are a number of health outcomes where, for Māori, statistics have improved.

Perhaps Labour’s biggest boast is their track record on bringing down lung cancer and smoking rates for Māori.

Lung cancer is the second leading cause of death for Māori in Aotearoa. But according to the Ministry of Health, rates of lung disease for Māori have come down.

In 2017, the rate per 100,000 people was 79.9 for Māori. By 2019, it was down to 68.4. This also aligns with smoking rates among Māori dropping.

Pre-colonisation, Māori did not smoke. However, when tobacco was introduced to Aotearoa in the 18th century that quickly changed.

Smoking has been particularly harmful for Māori who have higher smoking rates than non-Māori and experience greater rates of death and tobacco-related illness.

In 2017/18, the smoking rate for Māori adults was 35.3 percent. By 2021/22, it was down to 20.9 percent (approximately 127,000 people).

Rates were falling under National but they have continued to drop under Labour, which has rolled out a number of initiatives in an effort to reduce nation-wide smoking rates.

As part of the Smokefree 2025 Action Plan, historic and world-leading legislation mandated an annually rising smoking age that will mean that anyone born on or after 1 January, 2009, will never be able to purchase tobacco products.

Other cancers
Overall, cancer registrations rates among Māori fell from 416 per 100,000 people in 2017 to 405.7 in 2019.

Breast cancer registration rates for Māori women fell from 140.7 per 100,000 people in 2010 to 122.5 per 100,000 in 2019. Prostate cancer registration rates for Māori fell from 105.5 for Māori in 2017 to 103.5 in 2019.

For non-Māori, overall cancer registration rates increased slightly from 323.2 (2017) to 332.4 (2019).

Life expectancy
The life expectancy gap between Māori and non-Māori may be the most telling indicator of all when it comes to inequities.

According to the latest available data from 2019, life expectancy at birth for Māori men in 2017-2019 was 73.4 years, up 3.1 years from 2005-2007 data.

The life expectancy for non-Māori men is 80.9 years. For Māori women, it was 77.1 years, up 2 years from 2005-2007. Non-Māori women are expected to live to 84.4 years.

While Māori life expectancy has increased over time, the gap to non-Māori persists.

At the current rate of progress it will be more than a century before Māori and non-Māori have equal life expectancy, a study by the Association of Salaried Medical Specialists found in 2021.

Child immunisation
In the debate, after Hipkins raised smoking as an area of improvement, Luxon said child immunisation was a concern. On this, he was correct.

Over the past six years, child immunisation rates have steadily fallen.

In 2017, 86.2 percent of eligible Māori five year olds had completed all of their age-appropriate immunisations. As of last year, the rate had shrunk to only 71.8 percent. That is an alarming 16 point drop in the period Labour has been in power.

In April of this year a report commissioned by Te Whatu Ora’s Immunisation Taskforce found that immunisation failed to achieve “adequate on-time immunisation rates in young tamariki” and to immunise Māori, meaning those who were most susceptible to “vaccine-preventable disease” had the lowest immunisation coverage.

The report highlighted the worst rate in the country — just 34 percent of Māori children in South Auckland were fully vaccinated. It attributed part of the problem to vaccinators being diverted to the country’s covid-19 pandemic response.

“This caused childhood immunisation rates to plummet. These rates are now the lowest they have ever been and ethnic disparities have further expanded,” it said.

The report outlined 54 recommendations covering funding, delivery, technology, communications and governance across the programme.

In the debate, Hipkins suggested the anti-vaccine movement was part of the problem, which he sought to link with National.

National has proposed an immunisation incentive payment scheme. The plan would see GP clinics paid a lump sum for achieving immunisation targets, including full immunisation for two-year-olds, MMR vaccines for ages 1-17, and influenza vaccines for ages 65+.

The clinics would have to either achieve 95 percent coverage for their childhood patients, and 75 percent for the flu shots, or achieve a five percentage point increase for each of those target groups, by 30 June 2024 to receive the payment.

Labour’s Dr Ayesha Verrall said a similar scheme already existed.

Labour has also failed to halt type 2 diabetes, the country’s biggest and fastest growing health condition.

Ministry of Health figures show that in 2021 there were 302,778 people with diabetes, predominantly type 2. Since the Labour government came into power in 2017, the estimated rates of the number of Māori with diabetes per 1000 has risen from 66.4 to 70.1 in 2021.

The rates for non-Māori have also climbed from 27.8 in 2017 to 30.1 in 2021. It is also important to note that the rate of diabetes in Aotearoa has been steadily rising over the past 50 years.

Type 2 diabetes can also lead to devastating health conditions and complications, including heart failure, kidney failure, strokes and limb amputation.

According to Ministry of Health data obtained by RNZ under the Official Information Act, since 2011 there has been a 39 percent increase in diabetic limb amputations across the whole population.

For Māori, the number has more than doubled in the past decade from 130 in 2011 to 211 in 2021. Under Labour, the number of Māori diabetic limb amputations rose by 15 percent.

Māori are still 2.8 times more likely to have renal failure, another complication of diabetes.

Mental health
According to Te Whatu Ora, the rate of suspected suicide per 100,000 Māori population in 2021/22 was 16.1. This is not a statistically significant change from the average of the past 13 years.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

National Party leader Christopher Luxon made claims about health outcomes that were clearly false. Why was he left unchallenged?

In the TVNZ leaders’ debate last night, Luxon and Labour’s Chris Hipkins had a testy exchange over Māori healthcare.

Hipkins held firm on the creation of a Māori Health Authority, established last year, arguing strongly that the persistent gaps in health outcomes and care justified it.

Luxon was equally clear in opposition to it. He framed his critique of the authority around an alleged complete lack of progress on Māori health outcomes. He was very specific.

“Every single health outcome has gone backwards under Chris’s government,” Luxon said.

“Six years, not one has improved for Māori or for non-Māori.”

While sweeping in nature, Luxon’s claim did not get a direct response from Hipkins.

Luxon repeated a similar line later in the debate.

“Gone backwards. Chris, under your government, every single health outcome for Māori or non-Māori [has gone backwards]. You can’t have that.”

Hipkins did push back on this occasion, citing the ongoing reduction in rates of smoking.

Luxon’s claim was far from true — there are a number of areas where health outcomes for Māori and non-Māori have improved while Labour has been in charge.

But it is perhaps understandable that Hipkins was not quick to correct Luxon because the data — even though it’s better in many respects — is still grim. Maybe Hipkins did not wish to dwell on this.

Improved health outcomes
There are a number of health outcomes where, for Māori, statistics have improved.

Perhaps Labour’s biggest boast is their track record on bringing down lung cancer and smoking rates for Māori.

Lung cancer is the second leading cause of death for Māori in Aotearoa. But according to the Ministry of Health, rates of lung disease for Māori have come down.

In 2017, the rate per 100,000 people was 79.9 for Māori. By 2019, it was down to 68.4. This also aligns with smoking rates among Māori dropping.

Pre-colonisation, Māori did not smoke. However, when tobacco was introduced to Aotearoa in the 18th century that quickly changed.

Smoking has been particularly harmful for Māori who have higher smoking rates than non-Māori and experience greater rates of death and tobacco-related illness.

In 2017/18, the smoking rate for Māori adults was 35.3 percent. By 2021/22, it was down to 20.9 percent (approximately 127,000 people).

Rates were falling under National but they have continued to drop under Labour, which has rolled out a number of initiatives in an effort to reduce nation-wide smoking rates.

As part of the Smokefree 2025 Action Plan, historic and world-leading legislation mandated an annually rising smoking age that will mean that anyone born on or after 1 January, 2009, will never be able to purchase tobacco products.

Other cancers
Overall, cancer registrations rates among Māori fell from 416 per 100,000 people in 2017 to 405.7 in 2019.

Breast cancer registration rates for Māori women fell from 140.7 per 100,000 people in 2010 to 122.5 per 100,000 in 2019. Prostate cancer registration rates for Māori fell from 105.5 for Māori in 2017 to 103.5 in 2019.

For non-Māori, overall cancer registration rates increased slightly from 323.2 (2017) to 332.4 (2019).

Life expectancy
The life expectancy gap between Māori and non-Māori may be the most telling indicator of all when it comes to inequities.

According to the latest available data from 2019, life expectancy at birth for Māori men in 2017-2019 was 73.4 years, up 3.1 years from 2005-2007 data.

The life expectancy for non-Māori men is 80.9 years. For Māori women, it was 77.1 years, up 2 years from 2005-2007. Non-Māori women are expected to live to 84.4 years.

While Māori life expectancy has increased over time, the gap to non-Māori persists.

At the current rate of progress it will be more than a century before Māori and non-Māori have equal life expectancy, a study by the Association of Salaried Medical Specialists found in 2021.

Child immunisation
In the debate, after Hipkins raised smoking as an area of improvement, Luxon said child immunisation was a concern. On this, he was correct.

Over the past six years, child immunisation rates have steadily fallen.

In 2017, 86.2 percent of eligible Māori five year olds had completed all of their age-appropriate immunisations. As of last year, the rate had shrunk to only 71.8 percent. That is an alarming 16 point drop in the period Labour has been in power.

In April of this year a report commissioned by Te Whatu Ora’s Immunisation Taskforce found that immunisation failed to achieve “adequate on-time immunisation rates in young tamariki” and to immunise Māori, meaning those who were most susceptible to “vaccine-preventable disease” had the lowest immunisation coverage.

The report highlighted the worst rate in the country — just 34 percent of Māori children in South Auckland were fully vaccinated. It attributed part of the problem to vaccinators being diverted to the country’s covid-19 pandemic response.

“This caused childhood immunisation rates to plummet. These rates are now the lowest they have ever been and ethnic disparities have further expanded,” it said.

The report outlined 54 recommendations covering funding, delivery, technology, communications and governance across the programme.

In the debate, Hipkins suggested the anti-vaccine movement was part of the problem, which he sought to link with National.

National has proposed an immunisation incentive payment scheme. The plan would see GP clinics paid a lump sum for achieving immunisation targets, including full immunisation for two-year-olds, MMR vaccines for ages 1-17, and influenza vaccines for ages 65+.

The clinics would have to either achieve 95 percent coverage for their childhood patients, and 75 percent for the flu shots, or achieve a five percentage point increase for each of those target groups, by 30 June 2024 to receive the payment.

Labour’s Dr Ayesha Verrall said a similar scheme already existed.

Labour has also failed to halt type 2 diabetes, the country’s biggest and fastest growing health condition.

Ministry of Health figures show that in 2021 there were 302,778 people with diabetes, predominantly type 2. Since the Labour government came into power in 2017, the estimated rates of the number of Māori with diabetes per 1000 has risen from 66.4 to 70.1 in 2021.

The rates for non-Māori have also climbed from 27.8 in 2017 to 30.1 in 2021. It is also important to note that the rate of diabetes in Aotearoa has been steadily rising over the past 50 years.

Type 2 diabetes can also lead to devastating health conditions and complications, including heart failure, kidney failure, strokes and limb amputation.

According to Ministry of Health data obtained by RNZ under the Official Information Act, since 2011 there has been a 39 percent increase in diabetic limb amputations across the whole population.

For Māori, the number has more than doubled in the past decade from 130 in 2011 to 211 in 2021. Under Labour, the number of Māori diabetic limb amputations rose by 15 percent.

Māori are still 2.8 times more likely to have renal failure, another complication of diabetes.

Mental health
According to Te Whatu Ora, the rate of suspected suicide per 100,000 Māori population in 2021/22 was 16.1. This is not a statistically significant change from the average of the past 13 years.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

In a recent article (Weekend Herald, April 16) John Roughan wrote that the covid-19 pandemic has been an anticlimax in Aotearoa New Zealand.

Surprisingly, he acknowledges covid-19 has killed about 25 million people worldwide, so hopefully he was referring to New Zealand’s 600 deaths. He goes on to ask how many lives we in New Zealand have saved and states that it’s “not the 80,000 based on modelling from the Imperial College London that panicked governments everywhere in March 2020”.

I beg to differ. It is because governments panicked everywhere that the number of deaths so far is “only” about 25 million.

A recent comprehensive assessment of the covid-19 infection fatality proportion — the proportion of people infected with covid-19 who die from the infection — found that in April 2020, before most governments had “panicked”, the infection fatality proportion was 1.5 percent or more in numerous high-income countries. Included were Japan, Belgium, Denmark, Germany, Greece, Italy, Portugal, Spain, Switzerland and the UK.

Without stringent public health measures, covid-19 is likely to have spread through the entire population, and an infection fatality proportion of 1.5 percent multiplied by 5 million (New Zealanders) equals 75,000.

That’s close to the estimated 80,000 New Zealand lives likely to have been saved because our “panicking” government, like many others, introduced restrictive public health measures.

Public health successes are invisible
What Roughan fails to appreciate is that public health successes are invisible. Unlike deaths, you cannot see people not dying.

Without the initial public health measures and then the rapid development and deployment of highly effective vaccines (unconscionably largely to high-income countries) there would have been far more deaths.

Roughan asks “is this a pandemic?” He states that 25 million covid deaths are only 0.3 percent of the world’s population (“only” 16,000 New Zealand deaths).

How many deaths make a pandemic? In 2020, covid-19 was the number one killer in the UK, responsible for causing about one in 10 deaths in every age group, with each person who died losing on average about 10 years of life expectancy.

In the US, more than 150,000 children have lost a primary or secondary caregiver to covid-19.

So, has our pandemic response been proportionate?

Stringent public health measures were highly effective pre-omicron, but are unsustainable long term.

New Zealand is incredibly fortunate
We are incredibly fortunate that highly effective vaccines were developed so rapidly.

Even the less severe omicron variant is a major killer of unvaccinated people, as demonstrated in Hong Kong, where the equivalent of 6000 New Zealanders have been killed by omicron in the past couple of months, due to low vaccination rates.

Unfortunately, despite our high vaccination rates, we are unlikely to be out of the woods, and it is likely a new covid-19 variant will be back to bite us. The only certainty is that the next variant will need to be even more contagious to overtake omicron.

As long as covid-19 passes to a new host before killing you, there is no selection advantage to a less fatal variant. We are just lucky that omicron was less virulent than delta.

Pandemics over the centuries have often taken several generations to change from being mass killers to causing the equivalent of a common cold.

What response will we accept as proportionate to shorten this process with covid-19 without millions of additional deaths?

As immunity from vaccination or infection wanes, we will need updated vaccines to prevent regular major disruptions to society.

A sustainable proportionate response
Unlike the flu, which has a natural R-value of less than two (one person on average infects fewer than two others), omicron appears to have an R-value of at least 10. That means in the time it takes flu to go from infecting one person to two, to four, to eight people, omicron (without a proportionate response) could go from infecting one to 10 to 100 to 1000 people.

There is no way that endemic covid will be as manageable as endemic flu.

The only sustainable proportionate response to covid-19 is for New Zealanders to embrace universal vaccination.

It is likely that vaccine passes will be required again if we want to live more normally and for society to thrive. It cannot be difficult to make the use of vaccine passes more seamless.

Almost every financial transaction today is electronic and it must be possible to link transactions to valid vaccine passes when required.

Almost 1 million eligible New Zealanders haven’t had their third vaccine dose, yet few are anti-vaccination.

Rather, thanks to vaccination and other public health measures, the pandemic has been an anticlimax for many New Zealanders and the third dose has not been a priority.

As already demonstrated, for the vast majority of New Zealanders, a vaccine pass is sufficient to make vaccination a priority.

Professor Rod Jackson is an epidemiologist with the University of Auckland. This article was originally published by The New Zealand Herald. Republished with the author’s permission.

Article by AsiaPacificReport.nz