Michael Baker, the doctor who devised New Zealand’s aggressive coronavirus response, explains what inspired his successful strategy.
Health
23 June 2020
By Alice Klein
Marty Melville/AFP via Getty Images
New Zealand has been widely praised for its aggressive response to covid-19. At the time of writing, the country had just 10 active cases. But Michael Baker, the doctor who formulated New Zealand’s elimination strategy, says that even some of his colleagues initially thought it was too radical a plan and resisted its implementation. “Some likened it to using a sledgehammer to kill a flea,” he says.
The first case of covid-19 in New Zealand was recorded on 28 February. Like most countries, it initially planned to gradually tighten its control measures as the virus gained momentum. But Baker, a public health expert at the University of Otago who is on the government’s covid-19 advisory panel, believed that this was the wrong approach. “I thought we should do it in the reverse order and throw everything at the pandemic at the start,” he says.
Baker was inspired by the World Health Organization’s report from its joint mission to China in February, which documented how the country largely contained covid-19 when it was already in full flight. This convinced Baker that New Zealand could also stop the virus from spreading and even wipe it out entirely if it implemented a strict lockdown as soon as possible.
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Other experts, however, argued that New Zealand should take a lighter approach like Sweden, which never fully locked down. Many believed the spread of covid-19 was inevitable and that an elimination strategy would “never work”, says Baker. Others thought that locking down the country would lead to mass unemployment, poverty and suicide, which would outweigh the benefits of containing the virus.
The government ultimately decided to go with Baker’s advice, possibly because of his public health track record. In the 1980s, for example, he helped establish the world’s first national needle exchange programme, which has meant that rates of HIV among injecting drug users in New Zealand are some of the lowest globally.
“I thought we should do it in the reverse order and throw everything at the pandemic at the start”
On 25 March, when New Zealand had only 205 covid-19 cases and no deaths, the government implemented one of the strictest lockdowns in the world, only permitting people to leave their homes for essential reasons like buying food and going to the doctor. This followed the closure of New Zealand’s borders to
non-nationals on 19 March.
Baker felt “very moved” by the government’s decision, but also anxious, because he didn’t know if it would work. “As a scientist, you feel very worried if you’re giving advice when the evidence base isn’t totally there yet, particularly when it’s something that could be harmful to people,” he says.
However, putting the entire country into home quarantine early on extinguished community transmission and gave authorities time to strengthen testing and contact tracing capacities, which were initially “really quite woeful”, says Baker.
The country has recorded only 1515 covid-19 cases and 22 deaths to date, and hasn’t had any new, locally acquired cases since 22 May. The current active cases are all citizens in supervised quarantine after returning from overseas. On 8 June, New Zealand lifted all its restrictions except for its border control measures. “There was this amazing sense of relief,” says Baker.
He is proud of New Zealand’s success, but says it is important not to become complacent or smug. Baker warns that other countries that have seemingly got on top of the virus, such as China and South Korea, have experienced subsequent outbreaks.
Last week, New Zealand was shaken by the news that two women had tested positive for covid-19 after returning from the UK and being allowed to leave quarantine early to visit a dying relative. Extensive contact tracing is now under way.
To guard against a second wave in New Zealand, Baker thinks masks should be worn on public transport, aircraft and at border control and quarantine facilities. For him, one positive thing to come out of the pandemic is that it has shown how proactive government measures can protect the public from avoidable hazards. Baker hopes this will inspire more ambitious action on climate change and biodiversity loss.
“People are saying, ‘I can’t wait to get back to business as usual’, but there are a whole lot of things that we must do better,” he says. “I hope that is the lesson we learn from this terrible event.”
Michael Baker is a professor of public health at the University of Otago, New Zealand, and an adviser to the government of New Zealand.
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