The worried well

Doctors used to talk about “the worried well”, people who were healthy, but who nevertheless worried about something happening to their bodies or health. The clear implication of the phrase was that such worry was irrational, but what happens when the world changes so much because of a raging global pandemic that healthy people worrying about their health isn’t merely rational, but even necessary? That’s now life as we know it.

There’s something very different about Covid in New Zealand now, and not just the obvious, namely, that the techniques that worked so awesomely well last year are, by themselves, no longer capable of stopping the spread of the virus. People now seem to fully understand the implications of an unstoppable virus spreading widely through a population with little or no resistance to it. We know that one infected person can infect six others unless there are things to slow that down—widespread vaccination, constant mask-wearing, social distancing, and good ventilation.

Vaccination rates are still the country’s Achilles Heel. As of 1pm on October 6, 2021 (the most recent stats available as I write this), a mere 51% of New Zealand’s eligible population is fully vaccinated, and only 80% of the population has had one dose. But that’s only the eligible population (currently those 12 and over). The vaccinated rates among the total population are an abysmal 43% fully vaccinated, and 68% with one jab. [In the interest of full transparency, 83% of the eligible population has either had their first jab or is booked in for it, and 73% are either fully vaccinated or booked in for their second jab).]

A large percentage of that 80% of eligible people who have had a first jab are now eligible for their second one, mainly because the government reduced the time between jabs to a minimum of three weeks (it was raised to six weeks a couple months back, apparently to manage the supply of vaccine to make sure as many people as possible could get one jab until new shipments of vaccines could arrive). The government is also ramping up the vaccination campaign.

Saturday, October 16 has been designated “Super Saturday”, a nationwide campaign to get as many people as possible vaccinated as quickly as possible. Roughly a million people eligible for the vaccine haven’t yet had even one jab, and that’s a lot of people to get motivated to do the right thing. There will be some carrot-stick things going on, too.

This week the prime minister confirmed that proof of full Covid vaccination will be available before summer using a new App, or a code people can download on paper for scanning on site (and they’re going to arrange sites where people who don’t have computers or smartphones can get free print-outs of the proof). The existing Covid Tracer App can’t be used because that has the option of enabling Bluetooth to allow anonymous information sharing when we’re out and about (making contact tracing far faster and easier), and neither Apple nor Google allow private data (like vaccine records) to be accessed in Bluetooth-enabled Apps due to the probably remote chance of data breaches). [See also: “Covid-19 vaccine certificates: How they might work and what questions remain” – RNZ]

This matters because, the prime minster announced, proof of full vaccination will be required for anyone attending large public events, like the music festivals this summer and, I’d guess, large concerts and sports events. They’re also looking at what they have to do to make sure any venue (including potentially bars and restaurants) can restrict entry to only those who are fully vaccinated (there’s some question at the moment about whether that would be legal). There will be more details provided later, probably next month when the App is rolled out. [See also: “The three possible ways vaccine certificates could be legally enforced” and also “EMA (NZ business lobby group) says vaccine passports should be mandatory in the workplace”]

The fact that full vaccination will be mandatory to do some things is an incentive for people who simply haven’t gotten around to getting vaccinated. I saw an example of that very thing yesterday evening when TVNZ’s One News showed a young man who’d just had his first jab saying he did it because he wants to go to music festivals this summer. In other words, he had a reason that was important to him personally, and that’s a common enough reason to get the jab.

An additional problem with the old system is that it relied on people obeying the rules—and law—and doing the right thing. The Waikato (and, as of last night, points south) are now under Level 3 Lockdown because of two men who are gang members, one of whom illegally crossed the Auckland border, became infected, and brought the disease back to the Waikato (seems to me that there are legitimate questions about why police patrols of rural roads crossing the border weren’t far more frequent). So far, all the people infected in the Waikato have been connected to each other, meaning there’s not yet any evidence of wider community transmission, but it’ll take a couple weeks to be sure—if even then. The Auckland outbreak keeps showing new infections, and even though they’re connected to each other one way or another, it still means that infectious people could, potentially, infect others in the community.

All of which makes this outbreak feel different than last year’s. In the first one in early 2020, it was all scary because there so much we didn’t know, but now? We may know a lot more now, but we face a far more infectious variant of the virus, and it just doesn’t go away—we keep getting new cases. We—the vast majority of Kiwis—know that vaccination is our only hope for ever getting anything like the freedoms we had before Delta, but 20% of the population still hasn’t had even one jab. That’s a lot of people who aren’t pulling their weight, regardless of why that may be (and, it must be noted, so far the main reasons seem to be lack of access to vaccines, like in rural communities for example, cultural/language barriers, or simple lethargy; there’s still no evidence of any widespread deliberate, willful, arrogant avoidance like in some other countries, even though our tiny fringe is as extremely noisy as it can be in order to try to fool the rational majority of people into thinking there’s more than a tiny number of the loons about).

This outbreak feels much closer, possibly because Covid was brought to the Waikato just last week (though illegal activity…), and because the “locations of interest” (places an infected person went to) are often close by. The fact that the cases in Auckland just keep growing, and also that vaccination is so very slow, makes it seem like it’s more probable than possible that we’ll come in contact with the virus if we go out in public.

I take this very personally. I have people in my life who cannot be vaccinated, including young children, but even among those of us who are fully vaccinated, there are still several of us who are vulnerable if we have a breakthrough infection. I got to get my first jab ahead of my age cohort because of my heart condition and hypertension, both of which put me at higher risk of severe disease. But I’ve had lung infections throughout my life, especially in childhood, and my dad often did, too. All of which means that if I do become infected, the odds of me being one of the rare cases that becomes serious or even life-threatening is greater than if I didn’t have that health history. I’ve done pretty much all I can do to protect myself, from following all guidance and rules and laws when I’m out and about, and also including staying home as much as possible to reduce the possibility of being exposed to the virus and becoming infected.

Many of us, including me, are well and worried, and we have every right to be. In fact, I’d argue it’d be irrational to NOT be worried. Until we get our vaccination rates dramatically higher, we’re all vulnerable to widespread infection that could claim us, too. At the very least, until vaccination rates are dramatically higher, we cannot even contemplate a return to anything approaching the freedoms we had eight weeks ago.

The way forward is clear: We all have to do our part to protected everyone else by getting vaccinated and following all the other rules and laws. I just hope we can all rise to meet the challenge and do our duty. The consequences of failing to do so are too severe and horrible to even contemplate.