This year the ADEPT autumn conference heard of a masterclass in scientific and political management - New Zealand did not just minimise COVID deaths it eliminated excess mortality; it actually gained lives during a pandemic.
True, the nation is far-flung with a small and mostly sparse population, but the achievements of its strategy are incredible.
Wellington, April 2020
Professor Michael Baker, Department of Public Health, the University of Otago in New Zealand, is an expert in epidemics and pandemics, having experience managing such threats since the AIDS epidemic in the 1980s.
He told UK local government directors that 'all-cause mortality in New Zeland has declined by 5%' largely due to its stringent lockdown approach not only eliminating COVID but also seasonal influenza.
'Through the GP system for tracking influenza, we had no [influenza] cases at all. There was the odd virus still detected, but it was a 99.9% reduction. Our excess winter mortality vanished,' he said.
'We actually saw a decrease in mortality. There was no increase in suicides, although we do expect an impact on mental health. Overall, 1,500 fewer deaths occurred this year as a result of the reduction in respiratory infections.'
He added that New Zeland has the lowest COVID mortality rate in the OECD at around five per million.
One of its key elements was 'highly functioning local agencies, which are essential to test and trace', prof Baker said.
New Zealand was only at 100 cases on no deaths on 23 March when it went into intense lockdown.
Rather than mitigation or suppression, New Zealand went straight for an elimination plan based on three approaches.
This involved excluding cases by managing the border; managing outbreaks with test and trace, isolation and quarantine, and reducing transfer at population level using masks, reducing travel and social distancing.
While the borders were never completely closed, travel into New Zealand went down to about 1% of the pre-elimination period, and on two days there were no arrivals or departures at all.
After five weeks at its top lockdown level (four) and two weeks on the level just below, the nation emerged into a virus-free country.
'For 100 days, we eliminated the virus. We had a resurgence from imported cases, but that has been stamped out within a few weeks,' prof Baker said.
Dr Jeanelle de Gruchy, president of the Association of Directors of Public Health (ADPH), said the New Zealand example, as well as nations in Asia that successfully managed the virus, showed that health and economy had to be linked rather than set against each other.
She also compared the success of local agencies in New Zealand, with the more centralised approach in the UK.
'We are in a tricky position where decision making is still held nationally. Locally we want to pick things up locally, but it is still controlled nationally.
'Policy needs to be more local by default, and local authorities need to influence national policy more.'