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A New Zealand government expert advisory group has said the country should continue to pursue an elimination strategy to COVID-19 even when the majority of its population has been vaccinated. 

The advisory group’s chair, epidemiologist David Skegg, called the Sydney cluster a “disaster,” advising borders stay shut for another six months while New Zealand drives up vaccination rates, which are currently lagging behind Australia’s with just 15% of the adult population fully vaccinated. 

The news has made headlines for its criticism of Australia and drastic approach — but despite Skegg’s criticism, New Zealand’s strategy isn’t all that different from Australia’s.

Australia is taking a very cautious approach

Australia has long pursued an elimination strategy toward COVID-19, despite state and territory premiers labelling it as different things. Lockdowns are often only removed when a region records one or more “doughnut days” of zero locally acquired cases. 

Vaccinations change this: in countries with high levels of vaccination like Israel, the UK and the US, the focus has shifted away from case numbers to hospitalisations and deaths.

This is a little different to Australia, where we’ve been spared from high COVID-19 fatalities, with less natural immunity to the virus as fewer people have been infected. In other countries, the tolerance for high case numbers may be higher. 

The government’s four-phase plan for a vaccinated Australia, based on modelling by the Doherty Institute, lacks a lot of detail. While there are vague references to increasing freedoms for vaccinated Australians and increasing border caps, with limited snap and targeted lockdowns, our strategy isn’t as clear-cut as New Zealand’s. Our current phase of the plan focuses on controlling and suppressing the virus — though again, most regions are pursuing an elimination strategy. 

Still, University of Melbourne epidemiologist Professor Tony Blakley told Crikey that the strategies are pretty similar. 

“New Zealand is a little more risk-averse and they’re talking more openly about maintaining elimination, whereas in Australia the idea seems to be if there’s an incursion you stamp it out,” he said. 

It’s too early to tell whether Australia will maintain this strategy of stamping out COVID-19 cases once more than 80% of the adult population has been vaccinated, as the Doherty modelling only focuses on the first two phases of Australia’s post-vaccination roadmap. The roadmap focuses on keeping case numbers low to ease the burden on health systems and, like New Zealand, estimates border caps will remain low for the next six months.

Blakley said New Zealanders, having lived mostly virus-free for the past 18 months, wouldn’t tolerate even a very low number of hospitalisations or deaths. Their small population, combined with their distance from other Pacific countries, made it easier for them to hold on to an elimination strategy. 

NSW’s approach is a bit more ruthless

NSW Premier Gladys Berejiklian has said the state will have to reach 6 million vaccine doses by the end of August for restrictions to ease — a challenging but possible number going by current vaccination trends. That would bring NSW to an average vaccination rate between 50-60%.

This approach has been questioned. Having just half the population vaccinated isn’t likely to drive down transmission. NSW Health Minister Brad Hazzard has signalled that NSW may pursue a suppression rather than elimination strategy if the virus isn’t brought under control as a “plan B”. 

This could have wide-ranging implications, with states with a more conservative approach to COVID-19 numbers possibly blocking travel to NSW. 

South Korea is currently pursuing a similar approach of suppressing and living with the virus, though reached record-high new daily COVID-19 case numbers this week. The country also has low vaccination rates of just 15%. 

Berejiklian has said along with high vaccination rates, community transmission would also have to drop for restrictions to ease — but didn’t provide further details.