We expect that knowledge produced and applied in a health emergency will produce information that is protective of health. But it is increasingly apparent that over the last two years New Zealand’s Ardern government has designed policy, regulation, and information to coercively steward citizens to accept a drug under provisional consent.
Strict lockdowns were promised to end when 90% of the population was vaccinated. This was unprecedented: policy endpoints required population-level uptake of novel technology, no matter whether the individual was at risk or not.
In addition, data production was contracted by the department intent on a 90% vaccination rate. For decades governments have promoted ‘evidence-based science’ as the gold standard for public reasoning and risk deliberation. What we saw was internally produced and contracted science that focused on case rates, while (inconvenient) information in the published scientific literature on vaccine risk, waning and breakthrough was ignored.
This produced a tightly controlled scope of knowledge production that then failed to adhere to long-established democratic and public health principles. Responsible risk governance requires that governments must be responsive to data that indicates a technology is not as effective or is possibly more harmful than estimated, – for a democratic government’s primary role is the protection and safety of all citizens. Technology must not be valorized, and uncertainty set aside, in order to achieve policy ends.
Universal Vaccination Assumed from April 2021
New Zealand’s Unite Against Covid-19 ‘elimination’ strategy was confirmed in the first quarter of 2020. Policy, propaganda and legislation predominantly centred around the case, or infection rate, rather than the fatality rate as the measure of risk.
Even though the clinical trials did not demonstrate that the vaccine prevented transmission and infection, the Government promoted ‘the jab’ as a way to protect families in the Unite Against Covid-19 campaign. Persistent reporting of case rates fostered a perpetual state of fear and uncertainty among the population, who perceived infection from the SARS-CoV-2 virus to be something more like Ebola.
The Ardern government’s intention for the entire population to get the mRNA vaccine was declared through the signing of a supply agreement. This intention was then embedded in policy and regulation via the Traffic Light system, designed to nudge the population over 12 into compliance.
It was known by July 2021 that the vaccine waned and was leaky. Breakthrough infections were relatively common and for many. The clinical trials remain incomplete, lacking long-term safety data. The trials did not demonstrate that the vaccine prevented hospitalization and death.
However, in April 2022 in New Zealand, mandatory vaccinations remain compulsory for border workers, and workers in health and disability; corrections; defence; Fire and Emergency New Zealand (FENZ) and Police. These professions must be vaccinated and have received a booster vaccination against COVID-19.
At ‘Traffic Light Orange’ Kiwis ‘must wear a face mask’ in retail businesses, on shared and public transport, in government facilities and when visiting a healthcare service. This is despite the fact that Omicron ripped through New Zealand in February.
In the first week back at school and university after the summer holidays –the obedient mask-wearing young friends of my kids, including my son, from Otago and Canterbury down on the South Island up to the capital Wellington and Auckland – were locked down with Omicron in their first weeks back at university. No evaluation of Omicron and mask efficacy has been provided by the state.
The Risk Modellers
Government policy processes have persistently excluded uncomfortable knowledge that suggested uncertainty or risk. First, the policy accompanying and justifying Covid-19 legislation and Orders, and modelling by the contracted institution Te Pūnaha Matatini (TPM) contained narrow reasoning central to the state’s claims, locking in the narrative that infection was the predicator of risk, modelling wave after wave of infection.
Second, policy supporting the legislation excluded consideration of age-stratified risk and failed to address common principles of infectious disease management embedded in the New Zealand Health Act. Third, reviews of the scientific literature that could publicly identify and communicate risk relating to vaccine-related harm and issues relating to efficacy simply never occurred.
The gaps are considerable. The Government’s Covid-19 Unite campaign failed to communicate age-stratified risk of hospitalization and death as the pandemic evolved. New evidence on infection fatality rates were not reported to the public. In modelling papers, TPM used old infection fatality rate statistics that overestimated death rates.
The potential for the vaccine to wane or for breakthrough infection to occur was ignored in a major policy paper focussed on elimination and by the modellers at TPM. The role of natural infection in producing a broader, and protective structural response, assisting populations to shift to herd immunity status was downplayed. While herd immunity was recognized, testing and data modelling was undertaken to identify naturally derived herd immunity in the population. Later modelling exclusively associated herd immunity with vaccination.
Perhaps the problems addressed here are not surprising, when most modelling was undertaken outside of New Zealand’s public health institutions. Instead, number-crunching was carried out by data analysts, mathematicians affiliated with TPM, with scarce few infectious disease epidemiologists trained in public health ethics participating. And of course, the science and data modelling were directly funded by the government departments and Ministries dedicated to over 90% vaccine compliance.
Global vaccination policies ignored the fact that infection-related risk always centered on the aged and infirm and those with complex multimorbid conditions. Disconcertingly, the clinical trial data had conceded that vaccine efficacy remained uncertain for the most at-risk of harm from Covid-19 – the immunocompromised, autoimmune and people who were frail, and those with inflammatory conditions (see p.115). In addition, as coronaviruses readily mutate, it was highly probable the vaccine would have a short shelf life.
Early Treatments Sidelined
Governments are entrusted with an overarching obligation to protect health – this includes putting populations directly at risk through bad policy. There was always a role for safe, established drugs with a long history of safe use that had undergone complete testing before launching onto the market.
Early treatments could have been integrated as a major tool to prevent hospitalisation and death. Early treatments avoid the dilemma of mutating variants while acting to protect at-risk groups whose immune systems might not be as responsive to a vaccine.
Conventionally doctors are at liberty to repurpose drugs for their patients, such as antivirals with a long history of safe use. However, in July 2021, the government locked in approved drugs for treatment.
From at least October, New Zealand doctors were instructed to ‘not use any other antiviral outside of a clinical trial’ while Medsafe warned against use of the safe antiviral Ivermectin for a respiratory virus. Yet the clinical guidelines were intended as last resort medicine for the hospitalized, rather than designed as protective nor preventative at home therapies.
These directives have fractured the practice of informed consent, which forms the basis of trust in the doctor-patient relationships. Even the New Zealand Medical Council, the organisation that grants licences to practice medicine, declared that there was ‘no place for anti-vaccination messages in professional practice.’ These actions may unwittingly undermine trust in vaccines and the doctor-patient relationship for years to come.
The implications of silencing doctors, some who have had their medical licenses suspended, when observed alongside the above-mentioned data gaps, are extraordinary.
Ethical questions continue to be sidelined. The principle of proportionality, embedded in the 1956 Health Act, has been effectively dropped. Proportionality, which allows for individual risk, is a core consideration in public health. Medicine is a technology, and the space where biology meets technology – including medicine – is never constant, and requires value-based judgement. Risk management of a medical intervention for a pregnant woman, young person or child requires significantly different deliberation to a 75-year-old.
Democratically Unaccountable Legislation
Since January 2020, a tsunami of rights-limiting has been rolled out purposefully and consistently. There was scant citizen consultation with public input limited to a few short days in most cases. The unprecedented barrage of rules and orders released by the Ardern government entrenched requirements for almost everybody to get the mRNA vaccine.
By mid-2021 – before most mandates – the scientific literature was revealing that the vaccine waned; that breakthrough infection occurred and that there was extensive evidence that it produced a wide range of side effects, and even death. This knowledge should have invalidated any workforce vaccine mandate, but instead by October, the state doubled down and locked in mandates and regulations that would legally and socially coerce most of the population over 12 into accepting the shot.
It’s probable that the mountain of legislation produced over the last two years never fulfilled democratic norms of accountability and transparency. For science in a pandemic to be harnessed to serve the public interest, the institutions that set those terms of reference must be guided by principles that protect health.
The failure of government agencies to draw on peer-reviewed scientific literature while prioritizing internal modelling is clear from tracking the literature stored online with the relevant agencies. Most compellingly, it is documented in the policy supplied in support of the unprecedented quantity of law-making.
It appears that from late 2019, institutional interests anticipated that there would be hesitancy around vaccine safety. Yet there was no public forum. Instead, groups who sought to question the safety of the novel mRNA vaccine remained outside ‘accredited’ media, possibly due to the chilling effect of unprecedented Covid-19 funding and advertising boosts which effectively captured mainstream media.
That the New Zealand state mandated not-at-risk people accept a novel technology, creating rules (as nudge policies) that limited economic and social life for the non-vaccinated when there was early evidence the vaccine was leaky and potentially harmful, will take years to unpick. As mandates continue, injured groups continue to face barriers to justice following vaccine injury and death.
Ultimately, practices such as this raise nagging doubts concerning the state’s capacity to honor broader obligations to protect health and the public interest in future emergency situations. New Zealand’s response to the Covid-19 pandemic serves as a case study – a precedent, for future health emergencies.
A deeper dive on this discussion can be found in the paper, Covid-19 Emergency Powers and on Rumble. The paper is offered to assist academic and legal experts, citizens and communities to consider use of policy and science by the Ardern Government from 2020-2022. I question the potential for the New Zealand state to navigate future pandemics, and future techno-controversies, in the public interest.