Guest Post: The Covid-19 Royal Commission

A guest post by Tom Hunter:

I doubt that the Labour government will be willing to do it but there must be a Royal Commission on this subject. Perhaps it’s best delayed until 2024 anyway; as time removes us from this situation there will be fewer concerns about criticising poor decisions by both government and its bureaucracy. People will feel able to speak up and be heard.

As Lord Sumption, a British historian and former Supreme Court judge, said about instilling fear back in April while Britain was still in the grips of another lockdown:

What we have got at the moment is a desire to instil fear in people… It’s not been a total clampdown, but there has clearly been a serious reduction in the space for debate. I get many, many emails, some of them from people in senior positions in politics and the health service, who say that they agree entirely with what I’m saying, but they don’t dare say it themselves. I hear from hospital registrars and consultants, pointing out things that are happening in their hospitals, about the misclassification of deaths or the long-term effects of lockdown on cancer diagnoses and other illnesses.

So what should the topics be and what are the key questions in each case? Here’s my list.

Lockdowns

I already looked specifically at this in posts last year here, here, here, and this one that focused on the fight by epidemiologists against the concept when the Bush Administration introduced it in 2006. But since then there have been studies done of the current situation, including 2021 data. The following article looks at a group of them, Covid-19 Lockdown Cost/Benefits: A Critical Assessment of the Literature:

An examination of over 100 Covid-19 studies reveals that many relied on false assumptions that over-estimated the benefits and under-estimated the costs of lockdown. The most recent research has shown that lockdowns have had, at best, a marginal effect on the number of Covid-19 deaths. Generally speaking, the ineffectiveness stemmed from individual changes in behavior: either non-compliance or behavior that mimicked lockdowns. The limited effectiveness of lockdowns explains why, after more than one year, the unconditional cumulative Covid-19 deaths per million is not negatively correlated with the stringency of lockdown across countries.

There’s also the open letter to the UK government signed by a large number of doctors that makes several key points, of which this is just one:

It is for this reason that lockdown policies were never part of any pandemic preparedness plans prior to 2020. In fact, they were expressly not recommended in WHO documents, even for severe respiratory viral pathogens and for that matter neither were border closures, face coverings, and testing of asymptomatic individuals.

Aside from weighing the costs and benefits it was nice to see some experts who, unlike Baker, Bloomfield and Wiles, were not autistic fanatics or publicity hounds and thus had a grasp of the non-medical side of nationwide lockdowns.

South Korea is a democratic republic, we feel a lockdown is not a reasonable choice,” says Kim Woo-Joo, an infectious disease specialist at Korea University.

New Zealand was no exception to that rule, as shown by the New Zealand Influenza Pandemic Plan, last updated by the MOH in 2017. In its 193 pages you will search in vain for the word “lockdown”, or any suggestion that standard practices such as quarantining infected and exposed people could be translated into such.

KEY QUESTIONS:

1. What were the decision criteria that basically dumped that plan in favour of the national lockdown strategy in 2020.
2. Assuming that one of the key decision criteria was the epidemiological computer modelling used to make forecasts of cases, hospitalisations and deaths under different scenarios, are those models being revised for future use and how can we determine that they are fit for purpose, given the huge variations in their forecasts?
3. What were the decision criteria for the the 2021 lockdown, when it was already well understood by mid-2021 from overseas experience that the Delta variant was more infectious than the Alpha and unlikely to be stopped by a lockdown? Did the MOH and government think it would work a second time?
4. Was there any single decision criteria for the second lockdown that overrode all others, a likely candidate being the very low vaccination rates?
5. Was the traditional “Focused Protection” approach ever considered and if so, why was it rejected?
6. When the extreme L4 lockdown approach was abandoned in September 2021 what were the decision criteria? Was there any beyond the simple fact that, unlike 2020, the L4 had failed to “crush” the Delta variant and that therefore Covid-Zero had failed?
7. A complete assessment of the benefits and costs of the New Zealand lockdowns is required, given the need to move beyond a simple death count in assessing any public health strategy.

Masks and Virus Transmission(inc. fomite transmission)

In this post I looked at the lack of medical experimental data supporting the wearing of masks, citing multiple studies as well as the CDC (early on) and other medical experts, plus the complete lack of correlation between mask mandates and case numbers across nations, also here and in particular the problem of pro-maskers citing observational studies rather than Randomised Control Trials. At best the N-95 masks showed some effect but their expense and lack of availability made them a non-option.

Including the hypocrisy of experts and politicians who clearly did not believe their own bullshit about masks, there was clearly a startling lack of evidence for wearing masks and much evidence that they were useless (hence the Fauci comments & CDC recommendations of early 2020).

KEY QUESTIONS:

1. What medical experimental evidence did our NZ experts use in recommending cloth masks?
2. What evidence existed that they should also be worn outdoors?
3. What medical evidence existed that the virus was transmitted by surface contact, requiring “deep cleaning” of hotels and warehouses?
4. When it became clear through 2020 that no cases of SARS-CoV-2 transmission could be traced to fomite transmission why did deep cleaning continue into 2021? Why did the MOH not advise in at least 2021, if not 2020, that this was unnecessary.

Vaccination programme

I’m not going to delve into the well-known problems with the government roll-out of this programme in 2021 as they are raised by the questions that need answering.

KEY QUESTIONS:

1. Why was the programme so slow after promises had been made about NZ being first in the queue turned into us being almost last in the developed world, with a very low vaccination rate?
2. Was the rollout slowed by the lack of Covid-19 in the community through late 2020 and early 2021 – as the government publically rationalised?
3. Did the government officially decline a speeded up delivery because it felt other nations were in more need – as the government publically rationalised?
4. The supply contracts with Pfizer must be revealed to the Commission so it can be determine that the government’s negotiators did not come “late to the party, did a poor job and got a raw deal“.
5. Why was Pfizer the only vaccine chosen and was this decision re-visited as other nations such as Israel discovered in 2021 that its efficacy waned in just a few months?
6. As the understanding of waning efficacy grew through 2021, what discussion took place in the MOH and government as to the need for booster shots? Also, when were orders placed for booster shots and what was the government’s desired timetable on these?
7. Was any modelling done on the parallel development of immunity in the NZ population via vaccine and via acquired natural immunity, which is the typical track for reaching herd immunity for transmissible diseases or was vaccine immunity considered to be the only option here?
8. Was any discussion held with any of the vaccine makers regarding the possibility of evolutionary pressure on the virus resulting from a mass vaccination programme, as raised by Andrew Pollard, one of the developers of the AstraZeneca vaccine,
9. What studies of the vaccine for children aged 18 or less were looked at, or did we simply rely on FDA approval in the USA? What level of attention was paid to the near-zero incidence of Covid-19 sickness and death in this demographic? What were the decision criteria here for a large-scale vaccination programme to be enforced with this age group, particularly those aged 5-11 (I am assuming the government will do this in 2022)

Testing, Tracing and Quarantine

A key argument for the need to lockdown in early 2020 was that New Zealand lacked the sophisticated track and trace capability of nations like Taiwan that would have enabled a traditional track, trace and quarantine approach of infected and exposed people.

KEY QUESTIONS:

1. What steps need to be taken to provide such a system so that in future the recommendations of the New Zealand Influenza Pandemic Plan can be followed rather than the lockdown approach?
2. Will the WHO definition of Covid-19 deaths – that people who died WITH the virus must be counted along those who died FROM the virus – be followed for future pandemics, including seasonal flu? Does this increase the possibility of making poor public health decisions in the future by overstating the risks of sickness and death from some future virus?
3. Why was the PCR test the only one used for detecting the virus, especially given that its own inventor recommended against non-laboratory use given its well-known extreme sensitivity and high rate of false positives? Related to this is a detailed breakdown of how decisions were made about the PCR test cycle rates used.
4. Why was the saliva testing of Rako, available by January 2021, rejected by the MOH? What lessons can be learned from this to prevent similar MOH mistakes in the future?
5. Why were antibody testing kits not purchased from overseas and made available in 2020 or at least 2021 so that people could privately test themselves for exposure to the SARS-CoV-2 virus and subsequent natural immunity?
6. Why was the decision made that MIQ facilities would be used for positive cases rather than home isolation, especially given the tendency of respiratory viruses to spread more easily in AC-reliant indoor spaces like hotels?
7. What efforts were made to expand MIQ spaces when it became clear that the system was being swamped by New Zealanders attempting to get home? Was self-isolation considered as an option in this scenario and if so, when?

Therapeutic Treatments and Hospitalisation

KEY QUESTIONS:

1. Why was the ICU capacity of hospitals not expanded throughout 2020 and especially in 2021 when the Delta variant emerged overseas? Could this have been done with temporary facilities as Singapore has done over the years?
2. Was the actual constraint the number of ICU doctors and nurses? How many such people were trapped in the MIQ or immigration systems and could they have been given priority?
3. By mid 2020, monoclonal antibody infusion was demonstrated as an FDA-approved, safe, practical and highly effective means of treating patients with Covid-19. Were any efforts made to obtain these treatments, in sufficient numbers for the forecast numbers of cases, and if so, what became of these efforts?
4. What, if any, other therapeutic treatments for Covid-19 patients were proposed and/or studied by the MOH or other government bodies?

An examination of past flu pandemics

This would perhaps form more of a footnote for the Royal Commission but any studies of the pandemics of 1918 (Spanish), 1957 (Asian), and 1968-69 (Hong Kong) should be included. In particular I’d like to hear from Professor Geoffrey W Rice, whose study of the 1918 pandemic in New Zealand was deemed by the MOH “invaluable to our planning”.

A detailed study of excess mortality in the last two years would also be useful, so that in future we’re not guided by the politically useful but simple-minded counting of deaths or cases. Certainly the excess mortality of the nearest thing the world has to a control nation – Sweden – puts that criteria in perspective:

Assuming the excess mortality in 2019–2020 “fully balanced” the mortality deficit in the previous flu year, the true excess mortality in Sweden was less than 1% (about 700 deaths). And if we assume, absurdly, that the mortality in 2019–2020 was not affected at all by the mortality deficit in the previous flu year, then the excess mortality in Sweden did not exceed 4.1% (about 3,800 deaths).

To remind us, the hysterical response to the pandemic was not due to fear of an excess annual mortality of 4% or even 10%. The apocalyptic forecasts, which caused the world to shut down, predicted about 90,000 deaths from the coronavirus in Sweden by the summer of 2020: 100% excess mortality! No wonder policy makers around the world prefer to forget those predictions.

Eyal Shahar – Professor Emeritus of Public Health (University of Arizona); MD (Tel-Aviv University, Israel); MPH, Epidemiology (University of Minnesota) Readers are welcome to suggest other questions that might reasonably fall under the sway of such a Royal Commission.