Public Health and Health Promotion
The coronavirus disease (COVID-19) underscores the long-standing flaws of healthcare systems across the world. Since the initial outbreak in Wuhan China in late 2020, the COVID-19 pandemic continuous to subject healthcare systems to their limits. The pandemic has triggered a series of reactions across the world, with composite transnational implications. Yet, contingency policies at the national level have led to divergent outcomes, often with immense human and socioeconomic costs. Some countries like New Zealand were quick to react to the pandemic, which has since proved effective in containing COVID-19 transmission. However, indecisiveness, policy errors, and discordance have adversely strained healthcare resources in other nations like the United Kingdom. The sheer scale of the COVID-19 crisis constitutes an imperative precedent for evaluating potential opportunities to improve population health. Lessons from the COVID-19 pandemic offers exclusive insights and opportunities to strengthen public health infrastructures, cope with a future health crisis, and other global health issues.
Global Health Trends and Governance
Epidemic contingencies against infectious diseases often constitute curbing transmission through either partial or complete quarantine. As a result, most nations across the world took isolationist measures against the pandemic by restricting cross-border movement to contain viral transmission (Gostin, Moon, and Meier 2020). Today, globalisation entrenches transnational interdependence and social mobility as nations pursue economic prosperity (Labonté, Mohindra, and Schrecker 2011). The downside to globalised interconnectivity emanates from the rapid transportation of pathogens, as evident from the COVID-19 outbreak and subsequent spreading across the world. Thus, strict restrictions on human mobility and social behaviour seemed rationale to curb the rapid transmission of the disease.
As the de facto authority, the World Health Organisation (WHO) provides global leadership on diverse health issues facing international health communities, through the International Health Regulations (IHRs) (Gostin, Moon, and Meier 2020). This policy encapsulates transnational guidelines on how to manage pandemic threats through epidemic surveillance, containment, and mitigation. According to Lal et al. (2020), the IHRs guidelines have proved effective in dealing with some of the most recent pandemics such as Ebola and Influenza epidemics. Emphasis on surveillance, coordination, and threat communication empowers nations to develop strategic response plans based on contextual factors. However, Gostin, Moon, and Meier (2020) postulate that hesitancy and inadequate commitment by national governments have limited WHO's mandate to coordinate multilateral global governance during the COVID-19 crisis. Legge (2020) observes that most countries abandoned IHRs guidelines in favour of local-led intervention. The outcome of such challenges has been fragmented priorities and overburdened national health systems.
For instance, the United Nations took nearly six months to agree on a collective resolution on the COVID-19 humanitarian response (Gostin et al. 2020). China’s failure to alert the WHO about the true extent of the COVID-19 endemic also hindered prompt international containment, allowing the virus to proliferate quietly across the world (Lal et al. 2020). However, the WHO’s inaction might have partly been attributable to the novelty of the COVID-19. The lack of COVID-19 medical data hampered early containment. At the national level, policymakers have had to deal with competing priorities. The dilemma of balancing decision-making trade-offs between health, social, and economic difficulties further engenders policy uncertainties (Tarricone and Rognoni 2020). Given the lack of precedent and defective global health governance, the COVID-19 crisis has been marred with pervasive uncertainties as each nation seek to minimise health, economic and social devastation. These trends have partly contributed to significant COVID-19 response deviations of contingency measures taken by each country.
Patterns of Incidence Management in the U.K. and New Zealand
The COVID-19 epidemic encapsulates overlapping tripartite effects due to social, health, and economic devastation. In the policymaking domain, these tripartite consequences create inescapable tension between public health protection and economic priorities (Legge 2020). With more than four million COVID-19 cases and 127,000 fatalities, the U.K.’s response strategy ranks poorly compared to other nations like New Zealand (Geddes 2021). Ham (2021) attributes the U.K.'s failures to governance weaknesses and inadequate data-driven policy actions, leading to avoidable human and socioeconomic costs. According to Costello (2020), the British government ignored scientific counsel to pursue complete suppression of the COVID-19 disease through a radical approach. Instead, British authorities failed to act quickly, allowing the infection to spread within its population.
The U.K. government’s failure to stockpile personal protective and pertinent medical equipment, improve testing capacity, and invest in suppression engagement exposed the British National Health System (NHS) to a crisis, further reducing the national capacity to deal suppress the pandemic (Lal et al. 2020). Groups like the Scientific Advisory Group for Emergencies tried to warn against lax strategies as early as 13th March 2020 but the British government continues to prioritise political opinion (Costello 2020; Ham 2021). Wise (2021) reports that the NHS Test and Trace system is under intense pressure due to high infection incidence, inefficient resource allocation, and gross underestimation of the U.K. testing capacity. Had the U.K. government heeded scientific advice and expert medical opinion, the outcome would have been significantly different (Ham 2021). From this perspective, the British epidemic strategy appears to lean more on economic priorities at the public health expenditure.
By contrast, the New Zealand national response was swift, decisive, and coordinated measures to curb the COVID-19 pandemic. As of May 26 2021, New Zealand is among the nations with the lowest COVID-19 cases, with approximately 2,669 infections and 26 fatalities in a population of about 5 million. Unlike the U.K., New Zealand sought a zero COVID-19 strategy by closing its borders as early as February 2 2020, almost immediately after China declared the outbreak (Geddes 2021; Robert 2020). According to Geddes (2021), New Zealand recorded its first case three weeks after the U.K., yet the former closed its borders before Britain considered travel restrictions and non-mandatory self-quarantine in March 2020. Robert (2020 p.569) lauds New Zealand’s border closure policy for its “stringency” and “brevity”. By the end of April, the country managed to halt COVID-19 transmission, reducing new infections to an average of ten cases. There were no new infections within the nation during the first two weeks of the complete shutdown.
The key to New Zealand’s success is attributable to effective control of COVID-19 case importation and proactive border control, allowing curb local infections and transnational risks (Robert 2020). In contrast, the U.K. and other European nations kept their borders open, resulting in a chain of multiple transmission within and across the borders (Geddes 2021). Most experts now agree that February and March were critical periods to control the pandemic as modelled by New Zealand’s strategy (Geddes 2021; Robert 2020). Ham (2021) estimates that delayed border control and restrictions caused 20,000 more COVID-19 fatalities in the U.K. During the same period, sporadic COVID-19 outbreaks in the U.K. and Europe corresponded to an influx of travellers from Spain, Italy, and other high-risk areas (Geddes 2021). Robert (2020) holds that the ingression of travellers in the early phases of cross border COVID-19 transmission could have accelerated the infection rates. This allowed the virus to spread faster than it was anticipated even to remote areas of the country.
While both the U.K. and New Zealand are islands, Britain exudes stronger socioeconomic and political interconnectivity with Europe and other nations than Wellington (Geddes 2021). Ironically, the U.K. is among influential nations in global health governance, putting London in a better policy-making position than Wellington (Gostin et al. 2020; Lal et al. 2020). Multiple sources imply that overconfidence in the NHS could be the reason behind lax border restrictions and subsequent public health failures. Lal et al. (2020) speculate that advanced economies like Britain were susceptible to being “overconfidence in existing health systems,” leading to collective reluctance and political interferences. Some of the most shocking public health behaviours seen across national governments were downright attempting to downplay the pandemic, intergovernmental conflicts, and inadequate solidarity (Legge 2020). This led to policy incoherence, inconsistent coordination, and ultimate containment failures.
In a reproachful Public Accounts Committee’s report, the House of Commons rebukes the British government for “persistent reliance on consultants and temporary staffs” (Wise 2021 p.372). Costello (2020) accuses the U.K. prime minister of leadership failure of refusing to make a stringent decision, thus making Britain a hotspot of COVID-19 infections and fatalities. Ham (2021 p.372) cites British “English exceptionalism” as one of the factors that contributed to the lack of coherent and solid policy interventions. For instance, reports by public accounts watchdogs have since found that the much-hyped NHS Test and Trace programme had no impact on containing the COVID-19 pandemic, despite consuming over £37 billion (Ham 2021; Syal 2021). Such failures expose the NHS to resource constraints, which might limit Britain's ability to recover from the pandemic, limiting the health systems' resilience in the future.