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Why New Zealand’s Coronavirus Elimination Strategy Is Unlikely to Work in Most Other Places

As countries around the world work to “flatten the curve” of coronavirus infections, one has set itself a far more ambitious target. New Zealand plans to wipe out COVID-19 completely.

“We have the opportunity to do something no other country has achieved—elimination of the virus,” Jacinda Ardern, the country’s Prime Minister, said Apr. 16.

 

The strategy appears to be working. Fewer than 1,500 people have been infected with the virus in the country of almost 5 million. Only 17 have died. On April 24, just five new cases were confirmed. (By comparison, Colorado, which is roughly the same geographic size as New Zealand, with a population of 5.8 million, has more than 11,000 cases confirmed and more than 550 people have died.)

 

New Zealand’s bold plan has drawn admiration from all over the world. But it is a small, wealthy island nation, far from other major countries, with a population that is spread out. Experts say its success will be difficult to replicate elsewhere—especially in places like the U.S. They also caution that the costs of maintaining such a strategy are higher than most other nations are willing to bear.

“New Zealand has an advantage of a relatively isolated location, which meant fewer early travelers from China and other infected areas and a longer time before cases started to appear. New Zealand saw its first cases on Feb. 28, at a time when the U.S. already had community spread and likely thousands of unreported cases,” says Thomas J. Bollyky, the director of the global health program at the Council on Foreign Relations.

One of the world’s strictest lockdowns

On Mar. 23, New Zealand announced harsh lockdown measures. At the time, only about 100 people in the country had tested positive for the virus and no one had yet died. “We must go hard and we must go early,” Ardern said some days prior, when announcing what she described as world’s toughest border restrictions.

Citizens are required to stay at home unless it is absolutely necessary to go out. People are allowed to exercise in their own neighborhoods, but swimming at the beach is banned. Borders are shut, except to citizens and residents, who are required to quarantine or self-isolate for 14 days upon entry. And almost all businesses are shuttered. “Only the businesses absolutely essential to ensure the necessities of life, like supermarkets and pharmacies, can stay open,” is the official position. “If in doubt, the business premises should be closed.”

The lockdown measures have been paired with isolation, quarantines, widespread testing for anyone who is suspected of being exposed and contact tracing. Once a case is identified, that person’s close contacts are tracked down and required to self-isolate.

New Zealand has administered more than 100,000 coronavirus tests—a rate of 2,190 per 100,000 people. By comparison, South Korea—which had a much larger outbreak and made testing widely available using innovative approaches like mass drive-thru test centers—has a rate of 1,140 per 100,000 people. The U.S. has tested 1,420 people per 100,000, according to data from the COVID Project.

Why New Zealand is unique

Geography has helped New Zealand’s success. The island nation has more control over who can come in than a country with large, porous land borders. Michael Baker, a professor at the University of Otago’s Department of Public Health who advises the government on its COVID-19 response, tells TIME that “an ability to control entry points” is a key feature of the elimination strategy.

The country is also relatively isolated. It is 2,500 miles east of Australia and its nearest neighbor is the tiny island chain of New Caledonia, 1,200 miles to the north.

New Zealand’s low population density also means it may be harder for the virus—which is transmitted via close contact and airborne respiratory droplets—to spread. Only 1.66 million people live in Auckland, New Zealand’s biggest city, and its population density is less than one twentieth of America’s biggest urban center, New York City.

Outside of the country’s handful of big cities, “you have a population that is already pretty socially distant,” says J. Stephen Morrison, the director of Global Health Policy Center at the Washington-D.C.-based think tank the Center for Strategic and International Studies.

And the citizens of New Zealand place a high level of trust in their government—according to one poll, 88% of Kiwis trust their government to make the right decisions about COVID-19.

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