The death march of Covid modelling & the biochemist behind Alert Levels

The hyperbolic jumps in the modelling of deaths as the 1st 2020 lockdown grew nearer & how the Alert Levels were created by a biochemist who had then Prime Minister Jacinda Ardern's ear.

The narrative of so much in Covid was so tightly controlled during its height, discourse was not allowed to happen. It occurred in part because of a deferral in many countries to a very small group of un-elected, often academic, experts dominating, advising and lobbying politicians on the Covid response. Reasonable questions were labelled misinformation, and this happened alongside these experts using receptive media outlets who like to safely retreat to hero and villain storylines.

The danger of this is summed up in President Eisenhower’s 1961 farewell address, when he warned of the rise of the military-industrial complex, and added:

Yet, in holding scientific research and discovery in respect, as we should, we must also be alert to the equal and opposite danger that public policy could itself become the captive of a scientific-technological elite.

The early months of the pandemic & the Ministry of Health’s existing pandemic plan

In mid-2020 the NZ Herald did a series called the Pandemic Papers that dealt with the frenetic political pace of the early days surrounding the 2020 lockdown, including interviews with all the key players. While it’s unfortunately behind a paywall, and drops into a breathless, awestruck tone far too often, it does give a lot of insight into what went on in those early weeks. 

But my interest was piqued to find out more when I read the March 2020 minutes of the Covid Technical Advisory Group. The day before Alert Levels were announced and New Zealand entered Alert Level 2, the advisory group were ‘presented’ with the Alert Levels for feedback. That struck me as odd - I would have thought the government’s public health advisory group would have created the Alert Levels? 

Flipping through some early documents to find who did create the Alert Levels, led to additional proactive releases that weren’t available in 2020 (I’ve noticed when people do OIAs it can prompt further document releases) and to also look back at the alarmist voices modelling doom that drove lockdowns.

Which were mostly, but not exclusively, a group of ‘public health experts’ from Otago University. Their then-called ‘public health expert’ blog had a post from them at the end of January 2020 rather reservedly talking about what was known about Covid. Academic Michael Baker reassuringly wrote New Zealand had an “established pandemic plan” and experience using it during a 2009 influenza pandemic.

The reserve didn’t last. A 5th of February post from Baker and his colleague Nick Wilson broke down into hand-wringing that New Zealand was now facing a “severe” threat and that the case fatality rate of Covid was a “few percent.” By this time, Baker had joined the Ministry of Health’s Covid-19 Technical Advisory Group.

A few percent was quickly found to be be an exaggeration but in fairness it was being bandied about. Tedros Adhanom Ghebreyesus, the head of the World Health Organisation (WHO) gave a speech on the 23rd of February 2020 claiming a joint WHO-China team found the fatality rate in Wuhan was between 2% and 4% but dropped to 0.7% outside of Wuhan.

In mid-February 2020 the Ministry of Health commissioned Covid modelling from Baker, Wilson and their Otago University colleagues. 

Their 27th of February modelling references those WHO estimates, claiming between 67,000 and 79,000 people would need ICU care and deaths could range from 12,600 to 33,600 in New Zealand. They also used parameters from a Covid outbreak on the Diamond Princess cruise ship, noting the close quarters meant both more transmission and among a much older cohort than the average age of the New Zealand population. However using the parameters of this outbreak, resulted in modelling 6,230 or 6,510 deaths.

The day after this modelling, the 28th of February, was the day the 1st case of Covid was confirmed in New Zealand.

Within government things moved rapidly over the following month. 

By early March border restrictions from a growing list of countries were in place. A 10th of March paper proactively released by then Prime Minister Jacinda Ardern, claimed doom was coming but acknowledged the UK’s Chief Medical Advisor was confident there was an upper limit of a 1% death rate. This paper was more aligned with the existing Ministry of Health pandemic plan, focussing on measures to mitigate the spread. It noted that when there was sustained community transmission it could be “considered” to advise older people to stay at home, prioritise health care services, and to end any border restrictions as they would no longer be useful.

On the 11th of March WHO announced a pandemic. 

On the 12th of March a paper to Ministers invoved in the Covid response recommended restricting large events. That same day advertising agency Clemenger BBDO were hired under emergency procurement to develop a mass public health campaign within the week - to encourage behavior like hand washing, coughing into your elbow, isolating if sick and limiting travel.

Also on the 12th of March, the Prime Minister’s Chief Science Advisor, Juliet Gerrard wrote a letter to Ardern noting that while there were, "…infectious disease experts who support border closure…” WHO did not support border closures and doing so would only delay rather than prevent an epidemic. Gerrard ended with, “The merit of this idea hinges on whether the health system capacity could be significantly improved during the time the border was shut.”

On the 16th of March those ‘public health experts’ produced another round of modelling which had far lower case fatality rates and used some estimates supplied by the Ministry of Health. With absolutely no public health interventions, their modelling showed 8,190 deaths, or a worse case scenario of 10,983 deaths.

A visual of their modelling for the worse case scenario from their paper.

An 17th of March paper, on how to scale up the health system to respond, included a 1 page graph called ‘mitigation vs suppression’ which didn’t show deaths, but peaks of Covid infections against a flat line of existing hospital capacity:

The green line representing suppression was noted at the bottom with ‘hold out until vaccine’ if used. It surely drew a visual for politicians that total infections were directly linked to overwhelming health care. But the word lockdown or complete elimination doesn’t seem to have been used yet, it was more about managing widespread outbreaks and only noted there could be “possible closures” of schools or workplaces.

But from the NZ Herald Pandemic Papers, ”After seeing that graph, Ardern went into a Covid Cabinet meeting and said: "I think we need an alert system. How else do you communicate this constant cycle of response to New Zealanders? That day she tasked officials to move fast and make things. Just three days after requesting the creation of an alert level system, she gave a speech live from her office unveiling it to the public.”

Ardern didn’t just come up with the idea of Alert Levels randomly in the Cabinet meeting - it had already been floated to her by her science advisor. Gerrard had shown her Singapore’s Disease Outbreak Response System Condition (DORSTAN) - a system with color-coded stages.

On Singapore’s system Gerrard said in an April 2020 interview with Forbes that, “When I showed that to the PM, she was very, very passionate about using it as a useful communication tool.” And, “The Prime Minister herself had a big hand in how those alert levels actually looked.” 

Did she just.

Ardern said that Gerrard, "…played a bigger role than anyone will ever know…" in Covid policy. I’m definitely starting to get the hint on her role.

The Prime Minister’s Chief Science Advisor & her influence 

Juliet Gerrard is a biochemist whose focus was fundamental and applied protein science prior to 2018 when she was invited to apply to be the 2nd Prime Minister’s Chief Science Advisor (PMCSA). Until Covid her work in this independent advisor role was largely on managing plastics in the environment. 

Gerrard heard about Covid from the UK Government’s Chief Scientific Adviser, Sir Patrick Ballance on the 4th of January 2020. Soon afterwards Ballance organised a call among 5 of their equivalents in different countries (Gerrard doesn’t state this but I assume this was among the 5 eyes nations of the UK, Australia, the US, Canada and NZ). 

Through January and February she says it started as largely informal contact, then became weekly teleconference calls coordinated through the White House. Gerrard says, “We stuck very much to the science…and avoided politics where we could.” Gerrard observed that countries that had SARS plans such as Singapore, Taiwan and Hong Kong appeared better prepared than Western countries whose plans were based on influenza outbreaks, such as Italy and the UK. 

Initial advice appeared largely verbal, and frequently changing - she relied on Ian Town, the Chief Science Advisor at the Ministry of Health, to split things up and they would both talk together before briefing Ardern. 

While she clearly states she’s “not a health expert” she felt her biochemistry background helped her understand how a virus replicates.

Gerrard presented Ardern with the idea for Alert Levels from Singapore, and later recommended she put New Zealand into Alert Level 2, but her influence didn’t end there.

Although in a podcast interview she says the science was saying “maybe” on mask efficacy, in August 2020 Gerrard followed up Town’s uncertain mask review at the Ministry of Health with her own mask review which was confidently titled ‘Masks prevent the spread of Covid-19’. The same month Gerrard released her mask review, the Ministry of Health did an u-turn on masks. And there was her briefing to Ardern in June 2021 which saw the end of the elimination strategy through copying Israel’s traffic light system - which was announced without consulting any of the go-to public health advisory groups or experts. 

In 2023, she gave an interview noting what she called her ‘bat phone’ (whose number is held by senior officials as well as the Prime Minister) hadn’t rung in a long time. Presumably it rang alot when Ardern was Prime Minister, who Gerrard called “keen” to get details from her.

The attention that Covid garnered her in the media, like so many other dreary academics, appears to have been a touch intoxicating. The press release page on the PMCSA website re-published her interviews and more, from being called a “magnificent” science hero, to her personal self-congratulatory Instagram posts on the success of lockdown. The page also had several podcast interviews as well as a fawning documentary with her which is where I got a lot of this information. 

Back to the forming of the elimination strategy & the idea of lockdowns

The Cabinet minute from the 18th of March meeting notes Ministers agreed to the suppression strategy and it, “…will require border restrictions, intense testing, aggressive contact tracing, and stringent self-isolation and quarantine.”

The next day, on the 19th of March a news media article confirmed Imperial College modelling, that predicted hundreds of thousands of deaths within the UK, had already altered government policy making (estimates used in that modelling pop up as estimates used in New Zealand modelling). 

Also on the 19th, a Cabinet briefing recommended all countries now be added to Category 1A - cannot travel to New Zealand. By the time of this briefing the US and Canada has stopped all but essential travel across the border and Australia was issuing a ‘do not travel’ advisory.

On the 20th of March, Baker and his ‘public health expert’ colleagues (including Ayesha Verrall who in 2022 would replace Chris Hipkins as the Covid-19 Response Minister) submitted a wordy report to the Ministry of Health. The report lists all potential interventions from hand washing to a 4 day working week to lockdowns that were either in the existing Ministry of Health pandemic plan or in use internationally. 

These included China’s restrictive measures as well as looking back to 1918 (although Covid is different than influenza - flu kept being the sole reference point) and grasping for interventions, like whether traffic blocks limited the spread of influenza in Iceland 102 years ago. The 3 pages of references that end the report are also predominantly influenza references. 

The report strongly pushed elimination, influenced by China’s lockdowns and thinking total elimination was both possible and desirable:

Because influenza has a short incubation period, contact tracing and lockdowns wouldn’t be effective to stop the flu but could work for Covid.

Health and well-being is multi-faceted, yet they also didn’t concern themselves with the impacts of these interventions, whether they be economic or ethical costs or even non-Covid health impacts, instead baldly stating they would leave that to policy-makers. 

The 20th of March was a busy day. A letter was sent to Prime Minister Ardern and a group of Ministers on the Covid response from her advisor Gerrard, as well as then Director-General of Health Ashley Bloomfield from the Ministry of Health and the head of the Department of the Prime Minister and Cabinet and the All-of-Government Comptroller. It stated, “If community transmission becomes widespread we will have lost the opportunity gained by closing the border.” Discussing the new Alert Levels, which were attached to their letter, they recommended New Zealand enter Alert Level 2 for at least 30 days and move upcoming school holidays forward by a week.

The same day as this 20th of March report and letter - there was a 3 hour meeting of the Covid-19 Technical Advisory Group, which was the meeting whose minutes note they were “presented” the Alert Levels by a Ministry of Health staff member for feedback. 

Early Saturday morning on the 21st of March Clemenger BBDO pivoted to a mass media campaign on the rules of Alert Levels. They were sent the table of the proposed Alert Levels, that was attached to Gerrard’s letter to Ardern, to furiously design. The Alert Levels replaced Singapore’s color-coded stages with numbered levels from 1 to 4 - lockdown being level 4. 

That same Saturday afternoon, Ardern announced the Alert Level system where she also placed the country into Alert Level 2. Gerrard said in a podcast interview she found it “fascinating” to watch Ardern deliver it. New Zealand had 52 cases at the time of her announcement. 

Either Ardern was always planning that lockdowns were inevitable and needed to ease into them, or perhaps she mulled the 20th of March report calling for complete elimination over the weekend. Gerrard implied in an interview that “across all sectors” people wanted the Alert Levels to raise right after they were announced.

Ardern had a teleconference with business leaders on the 22nd of March where they promised Ardern they would support her to mobilise like a ‘war effort’ and to ‘shock’ people into following her advice. Their email of notes back to her implies she’d already briefed them that she planned to enact Level 4 quickly.

On Monday the 23rd of March a frenzied Cabinet paper discussed when and how to move to Alert Level 3 and 4 as further modelling from those ‘public health experts’ also dated the 23rd of March found more alarming numbers depending on what estimate you put in. In the worst case scenario, 36,600 people would need ICU care and 27,600 would die. Or perhaps it was 8,560 to 14,400 would die in a less shrill scenario?

At 1.30pm that same day, Ardern announced New Zealand would enter Alert Level 4 - a full country-wide lockdown - at 11:59pm on Tuesday the 25th of March. 

At a 3pm press conference on the 25th of March, Ardern called the approaching lockdown “unprecedented” but necessary to stop the virus, “…that left unchecked would have [an] unacceptable toll on New Zealanders.”

In mid-March academic Shaun Hendy’s research think tank, Te Pünaha Matatini (TPM) hosted by the University of Auckland, also came on board to do modelling for science advisor Gerrard. That same day, on the 25th of March, their modelling was released that claimed without a lockdown 80,000 people would now die. If I was being cynical I’d say the sudden jump in numbers are incredibly convenient to ensure the public’s support of the lockdown. This TPM modelling used estimates from the ‘public health experts’ modelling from the 16th of March, as well as the Imperial College modelling.

A radio interview in support of that night’s lockdown had Gerrard call the TPM modelling a reasonable “worst case” scenario and “alarm bells” for decision-makers to act, while also saying the death rate is likely under 1%. Gerrard credited Denmark with being successfully with these measures while admitting there is a “slim evidence base” for lockdowns. On the 25th of March there were 205 confirmed and probable cases (including people who had recovered) with no deaths and no-one in ICU yet.

Some reflections on context to these decisions

The Ministry of Health’s Ian Town said the early modelling “galvanised” decision making. Gerrard noted that, "If we hadn't been watching Italy on TV, it could have been very different." I’m not sure if she’s referring to politicians who were scared by overseas images (which she alluded to in another interview) or the public’s buy-in for lockdowns.

Modeller Hendy from TPM, also in the documentary with Gerrard, spoke on the importance of supporting decisions using models, and said that the worst case scenario is always the most unlikely to happen (as people will change their behavior when faced with a threat). The ‘public health expert’ modellers put at the top of their reports that their modelling, “can only represent potential future scenarios rather than predictions.”

Gerrard also publicly discussed that the degree of consensus when these large decisions were made was surprising to her - as science works by people disagreeing. There were a handful of people who tried to speak up, like University of Auckland epidemiologist Simon Thornley, who in April 2020 was quoted as saying discussion on lockdowns had been “one-sided.” He went on to speak about using the Diamond Princess cruise ship Covid outbreak parameters, as well as dryly pointing out, “people in their 80s have a very high mortality rate, with or without COVID-19.” 

But I don’t think Gerrard’s point on consensus is surprising. I think this group of ‘experts’ was very small and New Zealand culture values consensus as a proxy for outcomes. If everyone is already accustomed in a culture to agree and not stand up and speak differently - it doesn’t surprise me that within this small group everyone converged (conformed?) to largely agree.

A later May 2021 Stuff hit-piece on that contrarian to their consensus, Simon Thornley, had Hendy repeat, “That early modelling was very much the worst case scenario – unmitigated without the public taking any measures.” And, “We weren’t making that as a prediction, it was really just something you could benchmark against when you do actually take actions.”

Right, but the worse the modelling grew, the more it “galvanised” decisions (Town’s words) for "unprecedented” lockdowns (Ardern’s words) on a “slim evidence base” (Gerrard’s words). 

Sir David Skegg, another government go-to public health expert when questioned in an August 2021, Covid-19 Response Health Select Committee, cautioned against putting too much faith in modelling, quoting, “All models are wrong; some are useful.” 

For some reason (again in the same documentary as Gerrard) doom modeller Hendy from TPM chose to even intone that when faced with an emergency, “…you can’t necessarily go with democratic choices…”

If he went there, I will too: Hendy is a physicist and perhaps has never reflected that democracies were created on the basis that power is dangerous and as such must be limited, and it’s very important (in Aldous Huxley’s words) to never let any 1 person or group have that power for too long. Surely it’s when you are in an emergency - that democratic values are worth the most?

But lockdowns had been sweeping the world by the time they were implemented in New Zealand. 

Ardern and her Cabinet, and her various experts/advisors, were also conforming to the international situation when she made these decisions. If Ardern hadn’t considered or chosen that path - she would have been heavily criticised, and I think it’s fair to say that Ardern appeared to struggle to take on criticism or alternative views. 

These government-affiliated ‘experts’ I cover here were also being heavily promoted in the media and the media thrives on pumping out fear and click bait headlines - which these ‘experts’ were gleefully providing. And to me they appeared to bask in the attention it brought them - a self-fulfilling loop. While Covid lockdowns were completely un-precedented with incredible unknowns - Ardern also took the easiest path on offer. 

Despite New Zealand’s differences between geographically smaller and denser countries, the lockdowns that were implemented under Alert Level 4 were rated the toughest in the world on the Oxford University’s Stringency Index. 

After the lockdown

Michael Baker, in a 2021 puff piece that showcased him grinning through rooms in his upper-class Wellington home, boasted he recommended elimination in March 2020 based on how China had “contained” Covid through Wuhan’s lockdown. Which he said resulted in saving 10,000 lives in New Zealand.

In mid-November 2021 news media uncritically reported a government funded paper authored by Baker, Hendy and others that claimed further modelling now showed that politicians couldn’t have locked down any earlier or later than they did in March 2020. Like Goldilocks they got it just right and in the process that 2020 lockdown now saved 32,000 lives.

In early 2022 after the elimination strategy had failed and the government pivoted, the original ‘public health expert’ modelling duo, Baker and Wilson, in their newly re-branded blog ‘Public Health Communications Centre’ offered up a (preemptive?) defence of that strategy.

They continue to baldly never address any other impacts or costs of the elimination strategy and what it meant for other health, societal or economic outcomes. But they warned against looking back and questioning the elimination strategy that they lobbied for because - wait for it - they now claimed due to the elimination strategy that 2,750 lives had been saved if excess deaths was the parameter. They go on to baseline other countries and extrapolating those out could mean New Zealand avoided, “..deaths of 19,900 (USA experience), 13,700 (UK experience), 9,470 (Swedish experience), and 5,530 (Danish experience)…”

And the biochemist with Ardern’s ear, Gerrard? She was renewed in her advisor role, but while her phone is silent since Ardern resigned, she has been travelling internationally in 2023 (virtuously noting her team are “fully vaccinated!”) and continues to provide her specialist advice, now to Prime Minister Chris Hipkins.

In June 2023 she released a report into gangs. The leader of the opposition, Christopher Luxon, has publicly rejected the report’s recommendations. In August 2023 Gerrard announced that she is now looking into AI with Chief Science Advisor at the Ministry of Health, Ian Town.

*Note for readers: I now have many posts of referenced documentation on such a wide range in the archives like dosing interval advice mistruths and vaccine pass dishonesty, made up vaccination targets, sly behavioral nudging, social cohesion, and consultants who benefited from the creation of Covid misinformation.