Annual Review Debate — COVID-19 Response

OK. If members are ready, we have the Minister for COVID-19 Response in the Chair.

Thank you, Mr Chair. It’s a real pleasure, as chair of the Health Committee, to lead off the annual review debate on the COVID-19 response. This year, the Health Committee reviewed the Ministry of Health and DHBs, and we looked at the overall health sector response to COVID-19. Some of the issues that we discussed were around the care-in-the-community model, hospital capacity during Omicron, and equity in the vaccine roll-out. But I’m just also noting that the Economic Development, Science and Innovation Committee also looked at the response, in relation to managed isolation and quarantine.

So from the Health Committee perspective, though, we reviewed, this year, the Ministry of Health, and we also reviewed nine DHBs in depth. We started each of our hearings by just acknowledging the complexity that COVID had brought to the health sector, but also thanking the workforces, the people that have been at the coalface and keeping us all safe from COVID—really important to do that at the beginning and the end of each of those hearings. And just noting that our first hearing was with the Ministry of Health, and it was on 8 December, and at that point we had just moved into the COVID protection framework. But it was before the first case of Omicron had actually entered the community. But by the end, when we were reviewing our DHBs, often, in mid-March, we were actually talking to them about how they were managing because Omicron was at its peak.

I just wanted to talk through some of the themes that we discussed. With that review, in December, with the Ministry of Health, one of the things we did discuss was the advice that they had provided as we entered the COVID protection framework, and the various settings that, say, Auckland versus the South Island would have been at during that time. We also talked about the care-in-the-community model, because, at that point, this had just been introduced, and I think the discussion was around the capacity—because up until then, most cases had been managed in quarantine facilities, whereas now we were planning to manage most cases out in the community—and talking about the resources that would involve. We also talked about the equity of the vaccine roll-out and some of the lessons learnt. I think what the ministry was saying at that time was the equity team was working closely with local providers and iwi because they were getting ready to think about how they were going to roll out vaccine to five-to-11-year-olds and wanted to make sure that all the learnings that had been gained could be used in that process, even at that point when the roll-out hadn’t begun.

When we started to talk through to our DHBs, most of them—because their hearings were in sort of February and March, we were actually at the peak of the Omicron outbreak. And so a lot of the questions initially focused around hospital-bed capacity. And I think, in general, DHBs were managing and they’d put in place ways of assessing patient flow. What they were saying is that, you know, they did have—all the DHBs we reviewed in depth in the hearings—spare beds available, even though we were at the peak of the outbreak. But what they said was that the workforce was very stretched. You know, there had been illness within staff, and other issues. And so what some DHBs were having to do was just redeploy workforces from other areas, so that they could make sure that front-line services were still being delivered, and some had deferred some elective services.

We also talked to them about the equity in the vaccine roll-out, and thinking about some of the lessons that they’d learnt. The DHBs we talked to, they were all very positive about their achievement in terms of the vaccination coverage, and of those that we had hearings with, all of them were 90 percent or above, which was encouraging. And I think, just thinking through some of those lessons learnt, one was about regional collaboration. So the Auckland DHBs and Northland were talking about how they’d worked together to pool resources and coordinate their response. We also talked about the need for close working relationships with iwi and Māori and Pacific providers, and also some DHBs talking about their work with the disabled community and making sure that their vaccination sites were accessible, but also if people weren’t able to get to vaccination sites, how they could deliver vaccination in people’s homes or in some of their residential facilities. And also thinking through how the learnings from the adult roll-out had applied for the children aged five-to-11, and, in particular, the focus on equity for Māori tamariki.

So I think it’s been another busy year, in terms of the COVID response, and, again, I’d just like to thank all of those that have been working at the coalface to keep us safe over the past year. Thank you.

Thank you very much, Mr Chair. And can I start by echoing the words of the chair of the Health Committee in saying thank you to all of our managed isolation and quarantine (MIQ), Defence, police workers, nurses—everyone out there at the front line of the health response—for a really tough two years. And we do thank them as a Parliament for all the work they’ve done.

I have a series of questions for the Minister. Perhaps I’ll start with one, and then, if he’d like me to read more out and take them in sum, happy to. But maybe start with a question that I know affects a small group of people out there, but a not insignificant minority of people, which is unvaccinated permanent residents of New Zealand who wish to return.

People out there listening will know that unvaccinated citizens have been allowed to return to New Zealand for the last three or so weeks. That was announced sort of late at night one Friday without any Government announcement, sort of surreptitiously—well, that’s a little bit unfair, but sort of without much public prominence placed on the COVID website. But that privilege of returning to New Zealand does not extend to unvaccinated permanent residents, and it has actually caused quite a degree of confusion out there. Now, I’m aware of, for example, a couple of people who have turned up to the airport and have got differing instructions from Immigration New Zealand, the airline staff, the MIQ people, and the various COVID officials about whether or not they’re actually able to enter New Zealand. And so, my question to the Minister is: what is the current status of unvaccinated permanent residents? Why is there a distinction between unvaccinated permanent residents and unvaccinated New Zealand citizens? And can we expect to see some change to that situation in the future?

I’m very happy to answer that for the member. At the moment, the legal situation is that the New Zealand Government cannot discriminate against New Zealand citizens on the status of vaccination and, therefore, they have been allowed in. We’ve not yet made decisions around the ongoing status of vaccination requirements at the border. It is something that we do keep under review and therefore, you know, we will look at what the ongoing—well, not look at; we’ve been looking at it all along. But we’ll make further decisions around what the ongoing requirements for people coming into the country around vaccination are in due course. I note that a lot of countries still have requirements in place, but—like the testing requirements—the international sands are shifting quite rapidly on that, and we continue to review all of the evidence around that and all of the international experience.

Thank you, Mr Chair. I’m pleased the Minister mentioned testing, because that was going to be my next question. I was in Australia on the weekend. I took advantage of the reopening of the border, and I duly got my pre-departure rapid antigen test (RAT) 24 hours before I left, and I duly got my pre-departure RAT in Australia to come back to New Zealand. I did find myself sitting there saying, “Is there much utility in this process?” I don’t want to say, “Woe is me” too much, but it was quite a hassle, and Australia is actually getting rid of pre-departure testing from 18 April.

I suppose a couple of questions go to that: when will Cabinet consider pre-departure testing next for New Zealand; is the issue of whether or not we actually need it at the border under consideration; and is there any health benefit now in a world in which Omicron is on both sides of the Tasman—in particular, for Australia? So what’s the latest on pre-departure testing?

Again, I don’t want the member to feel I’m fobbing him off here, but we haven’t made specific decisions on this at this stage. Do I envisage that we will have the current pre-departure testing requirements for all countries on an ongoing basis for ever? No; I don’t. I think we will reach the point at some stage—maybe at some stage soon—where it becomes more targeted. So it may well be, for example, that there continues to be a pre-departure testing requirement for those countries where there is a significant escalation in COVID-19 cases—significant outbreaks, new variants, etc. So it is one of the tools that will remain in the tool kit for some time yet to come, I think, but will it be right the way across the board indefinitely? No; I don’t think it will. But we haven’t made specific decisions around the timing for when we might shift up the requirements.

In a similar vein, can the Minister perhaps advise the House as to whether or not the Government is giving consideration to the bringing forward of the—I think it’s step 5 of the reconnecting pathway, which is non - visa waiver countries. People from non - visa waiver countries are allowed in from October. There’s no specific date, but from October is the current understanding and, of course, many people who wish to travel to New Zealand are from non - visa waiver countries. I think the Minister signalled previously that the Government would look to bring that time line forward. Does he have an update for the House on whether or not that’s still the plan and, if so, what that time line might look like?

Again, there are two Ministers with the responsibility for what happens at the border: me, in the sense of—well, there’s multiple Ministers but in terms of this particular topic, there’s me in terms of the public health considerations and then there’s the Minister of Immigration. Actually now at the border, the primary driver of decisions around timing now are immigration decisions not public health ones, in the sense that a visa waiver country visitor versus a non - visa waiver country visitor, the risk profile for them is more or less the same from a COVID-19 perspective. The public health profile is more or less the same; therefore, the considerations there now largely become ones about immigration, about immigration processing, and so on, rather than public health considerations.

Turning away from the border for a little bit: a couple of questions in relation to the actual health response. The first is: does he have any more advice on when Paxlovid or molnupiravir—but particularly Paxlovid, because that seems to be the more effective of the two—will become available for use in New Zealand?

I note that Australia is now rolling it out, and other countries are well ahead of us. It’s clearly not a substitute for vaccination, and no one would suggest that it is. But it’s clearly a treatment that we would want to have access to, so do we have any further update as to when that will become available in New Zealand?

I’m happy to get a breakdown for the member of the various antiviral and various therapeutic treatments that are available for COVID-19 in New Zealand, and the number increases regularly. In terms of Paxlovid, it is available in New Zealand now. What I would say, though, is that our technical advisory group have been giving us some relatively frank advice that some of those early treatments that showed early promise aren’t showing so much promise now.

So is he saying that health practitioners can prescribe Paxlovid right now? Because, I mean, I think that would be news to people. Is that the Minister’s position? Because I accept that, in the case of molnupiravir, for example, I think the Minister is right to say did show really big promise but has proven to be, I think, less effective against Omicron than people perhaps thought it was. But my understanding—and I’m happy to be advised, wrongly—is that Paxlovid was not yet available, where I think we were expecting it in April, but we’re now in April. So I suppose it’s a question of whether or not it’s available yet.

The Minister is looking at his notes, so maybe I’ll just ask another question, which is the issue of vaccine mandates. Some of the heat in this debate has obviously been taken out by the decision of the Government to phase out mandates—well it’s a misused word, “mandate”, but phase out the requirement to have a vaccine pass and therefore a requirement to be vaccinated in order to work in a place like a cafe, for example. But there are still mandates in place for border workers, prisoners, and health and care workers. Is it the Government position that those mandates will be phased out in time? And if it is the Government position that they will also be phased out, what is the timeline for that?

In terms of the therapeutic treatments, sorry, I didn’t bring the list with me—you know, what’s here and what’s not. But I’m certainly happy to come back to the member specifically on Paxlovid as to whether or not it is here or not. I’ll get a more specific answer on that.

In terms of the ongoing vaccination requirements, we haven’t made decisions about those three remaining workforces that the member mentioned, as to whether or not those requirements will continue until we’re past the COVID-19 peak or, you know, past the COVID-19 pandemic stage, or whether there might be vaccination requirements there on a longer term basis. We haven’t made that decision yet. We’ll get good, robust public health advice before making any further calls there.

What is the point of the COVID-19 protection framework or traffic light system today? It used to be a combination of vaccine pass requirements, which are gone; crowd size restrictions, which now exist only in one restriction of 200 people at red; it used to have masking requirements which now exists only in the difference between green and orange; and it used to be about record-keeping, which we no longer require. So if there’s no vaccine pass, there’s no record-keeping, there’s only one crowd size restriction, and there’s only one masking rule in the entire traffic light system, then it’s become a husk, and we’d be better just to say that you can’t have a crowd over 200, and you have to wear masks in some circumstances, because that’s, effectively, all it’s become.

Now, the Government has said we’ve got to keep it around in case we need to bring it back, but, by keeping it in place without any of its features, it’s been distorted beyond recognition, and meanwhile, we have the question of—regardless of whether we call it the traffic light system—what possible benefit are we getting from knee-capping hospitality events with a 200-person limit inside, when the reality of Omicron is there are so many different transmission sites that one super-spreader event will make far less, or any, difference, in comparison with elimination, when one super-spreader event really could decide whether an outbreak got under control or not? So if the Minister could explain: why do we still have the traffic light system? How can we claim that we’re keeping it around for the future when it’s been completely denuded? Wouldn’t it be simpler just to say there’s a maximum crowd size of 200 and you have to wear masks inside, which is, effectively, all it adds up to now? And, if there is a rationale for a crowd size of 200, what is it and can the Minister explain why it’s worth the enormous cost and impacts it’s having, not only in not being able to have events but the uncertainty of whether events can be had, by restricting indoor meetings to 200 or more?

I think the member somewhat contradicts his own argument when he says that we shouldn’t have the traffic light system any more, we should just take the rules that we have under the traffic light system and call it something else. Ultimately, we have the traffic light system in place at the moment because we’re still dealing with a global pandemic, and we’re trying to reduce the number of people that get COVID-19.

I would also point out to the member that I get two pieces of very strong feedback from the business community: one is opposition to restrictions. That’s true. There’s no question there is a strong opposition among some sections of the business community to any form of COVID-19 restrictions. And then we also get quite strong feedback from businesses at the moment that they are struggling with the number of their staff who are sick because they’ve got COVID-19, and removing restrictions potentially increases the number of people out of the workforce because they are at home, in bed, because they are sick. Those are the difficult balancing decisions that we make on a daily basis.

We all want to get to the point where restrictions are removed and there is a much greater degree of freedom; life returns much back to normal. We are on the pathway towards that. Things are looking very promising at the moment. Our case numbers have turned down steeply—that’s great—but we have been very cautious to not move so fast that the case numbers turn back up again. We’re on the downward trajectory; we want to stay on the downward trajectory.

Thank you, Mr Chair. My questions follow on from that as well. I was wondering, in terms of the traffic light system, about what sort of mechanisms you’ve got in play just in case there is a stronger wave, a post-Omicron wave as well? There’s a lot of talk about loosening up stuff; what about if we actually need to tighten things up—so what you’ve got in place there as well. And if you could tell us that from the context of the capacity of front-line staff to actually deal with any potential new variants or a new outbreak as well. I echo the thanks to our front-line staff from folks around the Chamber as well. But it’s also very important that we had that planning in mind. So I want to hear a little bit about your plans about that as well.

And on the back of that, what’s being planned in terms of long COVID, the impacts on our vulnerable communities, you know, compromised whānau, and Māori and Pasifika as well? Thanks.

Just to clarify, the Minister seems to have misunderstood, and I hope not deliberately, my last question. The problem with what he’s done to the traffic light framework is that by taking out all of its features, it no longer makes sense to have three traffic light colours. He should just say there are two rules, and then, if there was another outbreak or new variant, he’d still have the traffic light system intact, fully understood, and able to be brought back. He’s actually created the worst of all worlds by destroying the traffic light system and yet keeping in place rules that are devastating businesses in certain cities.

Now, the Minister said, “Don’t worry. By having a limit of 200 people indoors, we are helping solve the problem of people being absent from work because they’re sick.” Can the Minister stand up here and tell us what cost-benefit analysis the Government’s done? How much has the amount of cases that we face each day been restricted and the absenteeism from work been restricted by a crowd size limit of 200? And how much does he think it’s going to cost events and hospitality, and do the costs outweigh the benefit? Because my sense is this Government doesn’t do any cost-benefit analysis. They don’t weigh up the impacts on people’s lives against their mission of reducing COVID cases.

Here’s another question related to something another member just asked that the Minister kind of dodged. Can he honestly tell us: what is the cost-benefit analysis of allowing only 5,000 international students, only some horticultural workers, only some people from certain countries? Can he honestly tell us that if we let people who weren’t from non - visa waiver countries come in today, alongside people that have visa waivers, COVID-19 understands the visa waiver programme and would get around it and we’d have more COVID cases if we let people from non - visa waiver countries be reunited with their families? Because my electorate office—and I’m sure many people’s electorate offices—is filled up with people being separated by things like that. The human costs are real.

And if the Minister believes that he has a done cost-benefit analysis on only allowing people from visa waiver countries into the country right now, then can he explain what those costs and benefits are? Because he keeps saying he’s weighing it up and down, but he can never tell us that he’s done the work. Meanwhile, the costs people pay are deep, personal, and expensive.

In answer to that last question, as I indicated to the member before, the primary drivers around the sequencing at the border are around immigration issues, not around COVID-19 public health issues. So one of the things that the Government has been trying to balance here is that not all visas are equal, and not all visas produce equal value to New Zealand. We want to make sure that those that are the most critical and those that are the most valuable are actually getting in when we need them. So we don’t want to have someone who’s applying for a visa to come here for a couple of days getting their visa processed ahead of someone who’s coming here to work to fill a critical job that the employers are desperate to get people in to fill. So the Government has been balancing that up, and that is—you know, we’ve got to acknowledge that we’ve got two years of built-up demand at the New Zealand border, and we’ve been working to deal with that.

In terms of the cost-benefit analysis, the Government does always look at the impact of keeping any restrictions in place. We look at what that does in terms of spending—consumer spending patterns. We look at what that does in terms of the number of people in or out of the workforce. So we do get that analysis, and that is something that we do weigh up.

Teanau Tuiono asked about our plan around new variants. I can say that there is a lot of work that has been done over the last 18 months or so to continue to update and refine what we might do in response to new variants of COVID-19 that may emerge. I would say that the major thing that has changed in the last six months is that if a new variant of COVID-19 arrives in the country, in all reality, by the time we find out the potential impact of that new variant, it will already be here. So whereas when we had a closed border, we could learn from other countries’ experience of new variants before deciding how we adapted here in New Zealand, the reality is that for new variants now, with the border relatively open, we won’t have that luxury, so we will need to be ready to adapt as we need to to any new variants that come in, and, of course, we are monitoring new variants on a daily basis.

And, finally, in terms of Paxlovid, I’ve got the answer that the member is looking for. It has arrived in the country. Pharmac, I think, announced that it arrived in the country on 31 March, so I was right, and it has been available since just after that.

Thank you, Mr Chair. A couple of comments. The first is just in passing, really, which is to ask the Minister to get the officials to look at the traveller declaration form that people are having to fill out to enter New Zealand. In the last 48 hours, I’ve had a number of people contact me. The borders are reopening, obviously. Kiwis are starting to come home. A lot of people were reporting problems with the traveller declaration form—the online form you’ve got to fill out. I personally didn’t have an issue with it. But I think, for those who are maybe a little less computer literate—without blowing my own trumpet too much—people have had issues with it. Particularly, I’m getting reports that people who are in transit—I think from Europe via Dubai, Qatar, and Singapore—the system doesn’t cope well with people who are taking long flights with transit destinations. So that’s the reports I’ve had. I’m happy to send the Minister a couple to his office.

💬 David Seymour: Chris Bishop will help you.

I haven’t been to Singapore or Dubai, Mr Seymour. It won’t be for a while. But I’ll just pass that on.

The second is the Minister made an interesting admission—or at least an interesting comment—around the fact that the reason non - visa waiver people are not allowed to enter New Zealand yet is not a public health issue; it’s an immigration issue. I know the Minister’s not responsible for this, technically, in his COVID-19 capacity, but it does raise the question as to what the Government was doing in the immigration department for the last two years. There haven’t been visas—or there have been very few visas—issued in New Zealand for the last two years. I think it’s well known that the immigration department has longstanding IT and technical issues, and it is a complicated computer system. No one disputes that. Immigration law, as anyone who’s been an MP—particularly electorate MPs—will know, is highly complex. You sometimes think your electorate staff end up becoming immigration lawyers alongside their more pastoral work. But it does raise the question as to what the Government was doing in the last two years to not try and identify and fix some of the issues in the immigration system, such that when the borders did reopen—as they are now starting to—we don’t have this very, very long lag time between early February 2022 and October. It is an extraordinarily long length of time and, as my colleague David Seymour says, is going to put quite a lot of hardship on quite a lot of people. So I think a lot of people will be asking themselves that question, and I hope the Government is too.

Just in terms of the traveller declaration system, thank you for the feedback. I’ll certainly take that one away and have a look at the issues the members raise.

In terms of the immigration issues that the member raised, as I’ve indicated, I would note that that is the responsibility of the Minister of Immigration. But I would also note that we did make a decision in recent times to provide those people who are currently in New Zealand with a pathway in order to be able to stay here, and that has resulted in a significant increase in workload in terms of immigration processing.

Does the Minister think the comments of the Director-General of Health that rapid antigen tests that found themselves somehow from private warehouses to Government possession were “consolidated into the Government’s stock”—does the Minister think that was a good choice of words, or would it be more accurate to say that a Government that spent a year decrying rapid antigen tests didn’t order them, let people order a selected amount, subsequently found itself with none and basically nicked them? And can he offer reassurance to people who have had their rapid antigen tests taken at the border that he will ensure that Customs allows them to be released so that they can, if not be used in New Zealand, then go back to where they came from in order that refunds can be had, particularly by schools that are out of pocket tens of thousands of dollars as a result. Or is that just too bad and we draw a line under the sorry saga of the Government’s rapid antigen test handling?

The member is conflating two issues. One is the people trying to import rapid antigen tests that have not been approved for use in New Zealand, and the other being whether or not the Government has directed for supplies that were destined for businesses and so on to be requisitioned by the Government. In answer to the latter part of the question, absolutely not. In answer to the first issue that the member raised, of course. We continue to have border restrictions around the importation of medical supplies, and that will continue.

I move, That the committee report progress.

Motion agreed to.

House resumed.

Mr Speaker, the committee has considered the Appropriation (2020/21 Confirmation and Validation) Bill and reports progress. I move, That the report be adopted.

Motion agreed to.

Report adopted.

The bill is set down for further consideration in committee next sitting day, and given the proximity to 6 o’clock, I will declare that it is now kai time. The House will resume at 7 o’clock.

Sitting suspended from 5.58 p.m. to 7 p.m.