The decaying advice of the Covid advisory group
A very short history of the influential (and then not) Covid advisory group whose members used the media to lobby government.
Most countries had a quasi-governmental advisory group on Covid, there was SAGE in the UK, Italy had the Comitato Tecnino Scientifico and New Zealand had the Covid-19 Technical Advisory Group - set up in January 2020. Mainstream media wrote up profiles of the original 11 members and heavily relied on them for commentary and quotes. They were celebrated too - a June 2020 article included 1 member, Michael Baker, as part of a group of “magnificent” Covid science heroes.
Their group minutes show as the pandemic wore on the heady initial influence they enjoyed decayed and became...cantankerous and firmly stuck in the past.
The group’s 1st meeting was held on the 24th of January 2020 but no minutes were taken. The 2nd meeting on the 29th of January had them grappling to understand the evolving context of Sars-Cov-2. Before the border was completely closed the advisory group were involved in the classification of high risk countries that would be more likely to have someone infectious arrive in New Zealand.
In February University of Otago advisory group members and their colleagues (a la the ‘public health expert’ blog I’ve mentioned) were commissioned by the Ministry of Health for alarmist modelling. By March the group were assuming it was a pandemic but waiting for WHO to call it. WHO declared a pandemic on the 11th of March 2020.
Their early meetings debated what a likely Covid patient was going to present with, so they could provide guidance to health care. Was it “fever and respiratory illness” or “fever or respiratory illness”? Later meetings saw them go with simply “a range of common respiratory symptoms” and people presenting to health care with those symptoms were to be treated as suspected cases until proven otherwise.
At their 20th of March meeting, PCR testing was noted to be at almost capacity and it had been shared with Ministers that New Zealand was on the “cusp” of a community outbreak. Alert Levels were also presented to the group by Ministry of Health staff in Unite Against Covid-19 branding for feedback (they were announced by the Prime Minister the following day).
Even at that early stage the group were recommending:
By the 31st of March they agreed as a group the current strategy was definitely elimination (the 1st lockdown in New Zealand had kicked off at 11.59pm on the 25th of March 2020).
A 2nd of February 2020 aide memoir to then Prime Minister Jacinda Ardern from the Ministry of Health noted vaccine development was underway but would take, “some months at a minimum.” On the 1st of May, the Chair of the group Ian Town, the Ministry of Health’s Chief Science Advisor, gave an update on a vaccination strategy Cabinet paper that was in progress. On the 8th of May the group thought the success of the elimination strategy, “is based on assumption of vaccine development within 24 months.”
This was the only accepted strategy within the advisory group’s minutes, if they discussed other strategies or even disagreed - it wasn’t minuted.
Later in 2020, some of the advisory group members like Chair Ian Town and Michael Baker were included in special pre-briefings on vaccine purchasing to ensure their public comments aligned with the government’s interests (well…c’mon, what else was it?). Despite the group discussions at the start of the year, and the fact the elimination strategy completely hinged on it - officials waited a month after being directly approached by Pfizer. Negotiations only started in mid-August 2020, with the contract signed in October (and announced in time for the election).
A 15th of May meeting was preoccupied with testing issues - particularly as some people had been in isolation for almost 2 months! They appear to have been still testing positive so unbelievably DHBs were requiring them to isolate until they were negative. (On that note - a few OIA requestors got responses asking for cycle threshold values in use and people would have probably tested positive for alien DNA at the incredible cycles that were used at the time.)
Elimination only worked as a strategy if testing was both bountiful and controlled and it preoccupied their meetings: not enough testing, the wrong people being tested, high testing volumes not being sustainable (although they weren’t referring to the cost - each PCR test cost $70 plus the fee for the person administering it), people were reluctant to test, saliva testing, RATs not sensitive enough, then an about turn when RATs were okay, wastewater testing and so on. Later in 2022, a Covid specific testing advisory group was set up. So far almost 8 million PCR tests have been done for Covid, with 2.88% returning positive. What’s the cost to find those positive results?!
Worrying about case definition also continued to crop up through the minutes as it meant patients in healthcare could be treated as a suspected Covid case rather than for the actual reason they were seeking healthcare.
It wasn’t until the 5th of June meeting they discussed any possible treatments for Covid. And again, eventually a specific therapeutics advisory group was set up - if you want the history of why a first order of 60,000 Paxlovid treatment courses arrived in March 2022, yet hardly any doses were being prescribed - their minutes have it.
Issues with adherence to physical distancing requirements were raised too. Which struck me as curious as a later September 2021 blog post from the ‘public health experts’ who contributed to this advisory group - called for more indoor masking mandates because the use of social distancing was based on “antiquated” studies from the 1930’s.
In a review of border settings they noted existing MIQ facilities aka hotels were not really up to snuff for infection prevention control (IPC) and it needed, “Clear communication that once vaccines become available and while it may be possible for some to be vaccinated prior to departure, it will not indicate opening of the borders.” The hubris in that sentence amazes me.
In a November 2020 meeting, “Pfizer vaccine data has been reported 90% efficacy and protection in the vaccine group relative to the control group. New Zealand has secured 750k double doses.” It also said:
I couldn’t resist looking it up, but disappointingly I think they mean this study which referred to religious establishments, not rubbish bins.
2021 dawned and their 1st meeting of the year in early February began with a discussion on elimination and that, “NZs high numbers of arrivals makes us vulnerable.” But thank goodness the, “Group was reassured that a very wide range of options/suggestions for improving border controls was being explored at pace.” The group’s “aspirational goal” of having zero cases arrive in New Zealand was also discussed, an idea was floated that people quarantine for 14 days before boarding the plane - then arrive to a further 14 days of quarantine!
During their 2 month break from meetings there were clearly some hurt feelings as the ‘other business’ part of the minutes, had a member raising they had not been consulted for feedback. The minutes note the group was, “…reassured that their feedback is very much appreciated and work highly trusted.”
They moved on to discuss the new vaccine program which had purchased 18 million doses. A December 2022 OIA confirmed that number -18.58 million doses had been purchased with 1.95 million still to be received - leading to a surplus to be disposed of. I’ll let you do the math if they were all purchased at the alleged $36.50 per dose.
Their February minutes also note the, “…impact of vaccines on transmission is unknown.” The following month Ministry of Justice officials were questioning the policy proposal to mandate vaccination to groups of workers. A late March meeting added, “Information from overseas on the extent to which vaccinations provide protection from transmission is being monitored as vaccination rollout continues.” By their 16th of April meeting they commented that mandatory vaccination of border workers was being considered and on the 20th of April, based on the public health justification that it reduced transmission, Ministers agreed that border workers would be mandated.
Although the group acknowledged there was a specific vaccination advisory group, they had a few ideas to impart, “Suggestion for some better communications about reactogenicity with this vaccine (e.g. headache, fatigue, and fever are common). This may help everyone take this in their stride rather than generate mistruths.”
In an early March 2021 meeting they reviewed an Alert Level options paper to basically make us suffer under more levels and, “It was argued there is minimal evidence on the effectiveness of putting numbers on gatherings, with studies finding little in the way difference related to absolute size, and therefore focus should be on making sure environments are managed sufficiently with ventilation, or by being outdoors.”
Uh then like social distancing, why were numbers put on gatherings during the Alert Levels and then Traffic Light System? It was this meeting which had the comment leading me to how the 90% vaccination target was completely made up:
A mid-April meeting suggested that side effects shouldn’t be presented as numbers because, ”Presenting absolute numbers is more alarming than presenting rates per million or percentages (i.e., no denominators are being given) Although it is possible that there will be some complications identified with the Pfizer vaccine, it would be difficult to provide this information proactively without causing public concern.”
Yes, changing how you communicate something will certainly solve it. Marketing 101.
Their last meeting in April strangely contained only a discussion of the elimination strategy - and is completely redacted.
As the vaccine rollout gathered momentum after mid-2021, this group’s advice remained stuck in believing (wishing?) stringent Covid restrictions would continue indefinitely.
In October 2021 advisory group members ran to media (a strategy that had worked previously to lobby government) to complain they hadn’t been consulted on an announcement to move away from the elimination strategy they still clung to. They weren’t alone, other ‘experts’ who were allowed to speak, also shrilly warned the end of elimination meant, “…death and disability at a persistently higher level than we have known - probably for decades.”
If the move was a surprise, perhaps it was because it was the Prime Minister’s Chief Science Advisor Juliet Gerrard who had briefed Ardern in June on Israel’s success at vaccination, including their ‘green pass’ as part of their own traffic light model.
The briefing between them shows New Zealand copied Israel’s system despite the fact Israel had already canned their domestic passes (the pass hadn’t stopped infections and Gerrard didn’t note that down but rather referred to them as ‘incentivising’ vaccination). Gerrard also included a summary of a 4 month study estimating the effect of vaccination on transmission at, “…around 95% effective at preventing SARS-CoV-2 infection.” Later briefings from Gerrard did have graphs showing Australia’s high vaccination rates weren’t curbing infections.
Days after the announcement, Gerrard led a workshop ‘under urgency’ with the group and other ‘experts’ to discuss the proposed Traffic Light System.
The group requested that instead Ardern institute a further lockdown for Auckland, and maintain the ability to use lockdowns as needed - suggesting the real issue was to decide if lockdown decisions were done nationally or locally. Regardless of risk, they wanted everyone vaccinated before they encountered the virus and that any strategy should have the “…explicit goal to save Māori lives” - who were more at risk statistically of poor outcomes.
Yet, they seem disconnected from the consequences of their advice. Despite the equity focus, the workshop also discussed lockdown’s adverse effects on people and that lockdowns were not working in the current community outbreak (of largely Māori and Pacific communities in Auckland) - but they still thought they should be in use! Regardless, their advice wasn’t heeded and rather than hang the future of the country on Māori vaccination rates - iwi providers were given further funding to support upping the rates.
Back at a mid-November 2021 advisory group meeting shows how isolated New Zealand was during the pandemic, “Even some health professionals are surprised to learn that literally every person will have to encounter the virus at some point.”
By June 2022, the end of elimination was a painful reality to the group as well, ”We can no longer keep new variants out, but more focus is needed on how the spread can be delayed” and worried that 2% of arrivals into the country self-recorded a positive RAT after arrival.
I never understood the obsession with delaying the ‘spread’ and by mid-2022 it seemed poor advice. What is the point of being vaccinated - with a waning vaccine -if you need to delay, as long as possible, encountering the virus? And I’ll add, 1 of the reasons Covid isn’t such a big deal for the last 18 months is because people…were exposed.
Their July 2022 meeting included the revelation to the group, “The Chair noted that ICU admission rate is low, more people are in hospital with influenza than with COVID-19.”
Unlike Italy’s Covid advisory committee, which dissolved in March 2022, this group are still listed as an active group. I’m surprised they still meet - what would be left to talk about and more importantly - who is listening?
End of post bonus: Here are the available minutes from OIAs:
The leaky sieve exposed!
Something worth deep investigation is the role of the New Zealand Microbiology Network, a closed and very exclusive group of representatives of medical laboratories which had contracts to supply the old DHBs (but which, tellingly, did not admit representatives of laboratories which acquired contracts to the Ministry and Te Whatu Ora during the epidemic, nor any medical microbiologists not employed by provider organisations). The NZMN was the Ministry's source of advice on all Covid testing. There are a number of aspects in which in my opinion the interests of this group, and in particular those of the dominant member of the group, a commercial laboratory which provides over 80% of community laboratory testing in NZ, had priority over those of the country:
1. Advocacy of mass testing, rather than targeted on the very ill, and, for epidemiological purposes, comprehensive testing in surveillance practices strategically placed around the country: just as much information, of better quality, and at a fraction of the cost.
2. Resistance to implementation of serological testing, which would have given a measure of the extent of asymptomatic infection.
3. Slowing of the uptake of saliva based PCR testing, which though marginally less sensitive, is much less invasive. This, in my opinion, was purely about keeping out the competition.
4. Very substantially slowing the introduction of RAT tests. Again, in my opinion a purely self interested commercial issue - the RATs when they came, caused a collapse of volumes of PCR tests. [Just as pointless, but the massive profits were going to the makers of the RATs rather than to the member laboratories of the NZMN]
A hard look at conflicts of interest, and even of cartel-like behaviour may be justified.