On reading the official pandemic plan

I’ve been dipping into the official New Zealand Pandemic Action Plan  –  all 193 pages of it –  a bit in the last few days.  The document has evolved over the years and now describes itself as

This edition of the New Zealand Influenza Pandemic Plan reflects the sophistication of a third generation, risk-based plan that promotes collaboration across all levels of government, agencies and organisations when planning for, responding to and recovery form a pandemic event.

and

Pandemics by their nature are unpredictable in terms of timing, severity and the population groups that are most affected. This version of the New Zealand Influenza Pandemic Plan establishes a framework for action that can readily be adopted and applied to any pandemic, irrespective of the nature of the virus and its severity.

It isn’t really clear what status the document has at present.  It was finalised late in the term of the previous government, it was finalised under a different Director-General of Health, and it was designed for an influenza pandemic, and the current virus is not influenza.    As the Ministry of Health notes, in any case it is only a “framework for action”, and has to be adapted for the particular virus –  and presumably for the policy preferences (on how best to respond, what trade-offs to make etc) of the government of the day.   As a document, or even a framework, it seems most likely to be useful the more closely to health the immediate issues are –  but even then, different virus, different issues.

There are various workstreams described in the plan.  One of them in “Economy” –  something I had quite a bit to do with in earlier iterations of the planning almost 15 years ago now – described from page 48 of the plan.  But it really does no more than list the key relevant official agencies (Treasury, MBIE, Inland Revenue, and Reserve Bank) and a brief plain-vanilla description of the sorts of roles and responsibilities those agencies have.  And that’s it.

The plan itself is dealt with in about 35 pages.  But about a quarter of those aren’t about immediate issues, but about longer-term planning and preparation (important of course, but not the uncertainties we now face).   The “Keep it Out” phase –  the one officials and politicians regard us as being in at present –  then takes another seven pages.    I presume it is mostly worthy and sensible stuff, although there is little or nothing about the frameworks or evidence base used to shape official advice to ministers (eg around border restrictions of the sort we have in place now).

The next phase is “Stamp it Out”

Objective
To control and/or eliminate any clusters that are found in New Zealand.

There is a set of key decisions listed

stamp it out

(Many of which won’t be relevant here/now, absent a vaccine)

And there is a detailed listing below that, but it is all lists, and no analytical or policy framework.  One hopes there are more-detailed analytical papers in the Ministry of Health or other agencies, but the Pandemic Action Plan document is what the public has.  The Ministry’s website claims that

The NZIPAP provides information to guide key decision-making.

But really the only information is a listing of issues, agencies, and formal statutory powers. Useful as far it goes, but not that much help –  in particular to the public.

And it is no different in the “Manage It” and “Recovery From It” phases.    Catchy phrases –  useful enough –  and long lists –  again useful enough –  but little substance to guide decisionmaking or public debate/scrutiny of governments plans and actions.

The second half of the document is a little more discursive, and perhaps more useful.   For example, there is a discussion of Public Information Management. But it is limited by the fact that it seems wholly focused on the Ministry of Health, and not on the key role that political leaders (notably the Minister of Health and the Prime Minister) play throughout any pandemic period.    And it is a bit disconcerting when the very first item in the key objectives around public information management

Key objectives are to:
- maintain public confidence in the response and in agencies’ competence and capability

That might be the Ministry’s aim –  pursuing its own interests –  but it isn’t clear it should be what would be most important for the public, who cannot simply assume (need to be shown by transparency, consistency, humility etc) that the response is being well-managed.

The section also seems disturbingly oblivious to both the extent of information available to the public from other countries and public health agencies and to the genuine political choices likely to be faced during the pandemic period.

What first took me to the document was a desire to understand the relevant statutory powers and options.  There is what seems to be quite a good description (p109f).    Here is one summary

legis powers

Do note that reference to the Epidemic Preparedness Act.  It has really far-reaching powers, which appear to allow the government to temporarily waive lots of legislation once the Prime Minister issues an authorising notice. But as the Plan says, it relates “only to give named quarantinable diseases set out in Part 3 of Schedule 1 of the Health Act 1956”.

quarantine

Remarkably, this schedule appears to be able to be updated by regulation, rather than by legislation – itself a little worrying given the scale of the powers given to the executive –  but you might suppose it was about time that the current virus was added to the list.

But to take the Health Act special powers first

special 1

 

special 2

All of which is good to know, but there is no discussion anywhere as to the circumstances, considerations etc that might lead to such powers being exercised.   Now, perhaps one could argue that they would be context-specific, but in a sense that is my point.  In the current context, the Plan itself offers little or guidance to the public, and we have had no guidance, consultation etc specific to the looming event from either the Ministry or (more importantly, since they are the ones we can hold to account) the Minister of Health or the Prime Minister.  (As there was no open discussion of considerations relevant to decisions around border closures, either the initial ones or subsequent decisions.)

And what about that Epidemic Preparedness Act?  Here is what the Plan says

epidemic preparedness act

That is quite a mouthful.  The Act itself isn’t long, and if anything I found it a little clearer.  Here is the purpose statement

epidemic act

Such legislative overrides can themselves be disallowed by Parliament, which has to be called together pretty quickly if the Act is invoked –  unless, potentially an issue this year, the House has been dissolved for the election.

My point isn’t to debate whether or not these powers should exist –  although it does seem strange that the criteria relate to “essential government and business activity in New Zealand” (a term itself not defined anywhere, and you have to wonder how the Director-General of Health is qualified to judge what is “essential business activity”) not to human health, societal functioning etc (as well).   My point is that there is nothing in the Plan, and nothing we’ve heard from the officials or politicians on (a) what grounds they would look to invoke this Act, and (b) what statutory requirements they would look to suspend, in what circumstances (for those particularly worried, there are some core Acts they can’t touch).

Perhaps that might be unavoidable if there was a sudden outbreak of some disease with no real warning at all.  But we’ve had time –  now weeks and weeks of it – and there is nothing.  Ministers and officials act in ways that look as though they think “there, there, don’t worry your silly little heads about it, we’ll tell you what you need to know when you need to know it”.   But that is no standard for an open and democratic society.  It doesn’t even really seem consistent with the “public information management” themes, which talk about transparecy, building and maintaining trust.  You do that best by (a) being excellent, (b) being humble, but (c) being open and letting the public in on your thinking and planning, and being responsive to feedback.

As a good example, there is some discussion in the Plan of the possible closure of schools (and similar entities) –  pages 125 and 126 –  but it offers almost nothing.  And, as they note, much will depend on the circumstances of the virus.  In the current episode globally, we’ve seen many countries move to close schools, but one highly-regarded example of management (Singapore) where schools etc have been open throughout.  What is our government’s view on the matter at present, when New Zealand experiences community outbreak?  Surely it matters to the sort of planning individuals etc can/should be doing now.   If universities might end up closed quite soon, might that be relevant to questions around reopening borders to foreign students?   More generally, what is the government’s thinking on the movement restrictions etc being adopted in other democratic countries, notably Italy and South Korea.  Both ministers and officials seem missing in action –  no doubt talking among themselves, but not talking with citizens.

In an Appendix to the document there is a longer Public Information Management Strategy.  Much of it appears sensible enough.  There is even a specific extended section on

Key messages
It looks like a flu pandemic is about to start

Again, a lot of it seems sensible and seems consonant with what we are hearing from health authorities in various other countries. For example

plan

But we aren’t hearing any of this from our officials and ministers, even though –  as we’ve in the last week –  countries have gone from thinking they have no major immediate problem to full-bore crisis in a matter of days.  If anything, the Director-General of Health on RNZ this morning sounded rather Trump-like still talking of low risks of community outbreak in New Zealand  (when plenty of international experts talk in terms of having got well beyond that point everywhere, even if some still think Stamp It Out strategies can work –  viz encouraging signs from Singapore).    They still seem more interested in playing things down –  don’t worry your heads about it –  than in helping guide the public to realistic preparations and precautions, or even to offering substantive answers to specific reasonable questions about how the health system –  under pressure at the best of times –  would be able to step up, add capacity in short order etc when/if significant community outbreak becomes established here.  Perhaps there is a good case for such a choice, but we don’t see the Prime Minister or the Minister of Health even trying to make that case.

And since this blog is still primarily economics-focused, much the same point could be made about economic issues.  The Minister of Finance’s speech the other day seemed okay as far as it went, but it stopped well short of taking seriously the sort of disruption, risks and economic losses, if we see widespread closures (from regulation or fear) when the virus hits here.  There might not be much governments can do in the very short-term if those losses happen, but there are important specific issues, including those around how things like the food distribution system keeps working (if, say, one main city is largely locked-down and movement in and out restricted).

We really deserve and need more pro-active leadership and preparation from key ministers, and perhaps from officials too –  but they mainly work for and to the ministers, whose handling of these event may yet feature significantly in this year’s election campaign.

 

 

4 thoughts on “On reading the official pandemic plan

  1. All the best laid plans – A billion words – and it isn’t working

    On February 2, the New Zealand government announced it would refuse entry to “any foreign travellers who leave or transit through mainland China.”

    Meanwhile on 29 February 2020 65 Chinese Students are currently being isolated by Otago University”

    So in spite of the ban how did these students get in. If they arrived prior to 2 February there wouldn’t be any need to isolate being outside the 14 day stand-down containment period

    “Otago University emergency and business continuity co-ordinator Andrew Ferguson said about 65 students from mainland China, or who had visited or travelled through China before coming to the Dunedin campus, had self-isolated so far.”

    https://www.odt.co.nz/news/dunedin/campus/university-of-otago/65-university-placed-isolation

    Like

  2. Reblogged this on The Inquiring Mind and commented:
    An interesting look at the NZ Pandemic Plan, but as Mr Riddell concludes
    We really deserve and need more pro-active leadership and preparation from key ministers, and perhaps from officials too – but they mainly work for and to the ministers, whose handling of these event may yet feature significantly in this year’s election campaign.

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s