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Culture Shock: Why New Zealand's Response to COVID-19 Worked

— A first-hand account from a doctor from the U.S. who lives in New Zealand

MedpageToday
A graphic displaying the current COVID-19 cases from the New Zealand government Unite against COVID-19 Twitter page

"How was school today?" I asked.

"Chill," came the reply.

I have two daughters in a public high school here in New Zealand. I've found that this is a standard response when we ask them how school is going. Whether they're reporting on tests or reports or assessments, it seems that everything is "chill." They are allowed to work at their own pace, and aren't graded in a system where one kid can "blow the curve" to earn the classroom's only A. Instead, each kid is competing only with himself or herself, as guided by the teacher. Their academic success or failure will never rest on a single test or assessment. There are many opportunities to redeem yourself, catch up with your peers, and succeed. It seems to me, as a newly-arrived parent of two happy and academically-fulfilled teenagers, that the educational system here emphasizes cooperation, interpersonal skills, and communication, rather than classroom competition and a strict adherence to numerical grading systems.

The collaborative element of Kiwi culture doesn't stay locked behind the schoolhouse doors, either. A few weeks ago, I attended a and got a first-hand view into why their COVID-19 response has been so successful. At the very start of the outbreak, their national government invested a huge amount of money in a "go hard, go early" strategy to combat the spread of the virus.

The Ministry of Health had the task of conveying these new public health protocols to the country's twenty District Health Boards (DHBs), which they did quickly and effectively. The DHBs then turned to their own local infectious disease experts to implement policies that worked for each individual clinic or hospital department, with an emphasis placed on coordination and communication, both between each other and upstream to management.

The hard-and-early New Zealand strategy was able to work as effectively as it did only because government administrative managers asked public health scientists what they needed, and then supplied and funded it. Then they let the scientists make their own schedules and policies to distribute the resources they had -- personnel, medication, personal protective equipment (PPE), laboratory supplies, everything -- in an ethical and equitable way. Doctors who participated in this plan of attack told me that nobody they knew had suffered burnout, even at the height of the pandemic. Everybody was invested in the process, and communication flowed from the top to the bottom and right back up.

New Zealand's leadership has won the credit for the life-preserving success of this approach, and they deserve it. As an outsider now working inside this system, though, I believe that there is something to the culture here that has also played a significant role in that success. New Zealand's academic, political, and scientific institutions all emphasize communication, empathy, and cooperation.

Competition as a driver for high achievement and societal success might work when you have unlimited resources and an even playing field, but it will fail in the face of a pandemic -- and when it fails, disadvantaged groups will suffer disproportionately. We saw this and are still seeing it in the U.S., where states were forced by the apathetic inadequacy of federal leadership to compete with one another for COVID-fighting resources. PPE went into the black market and laboratories ran out of reagents. More than a quarter-million Americans are dead, and the deaths will likely double before the new year arrives. Market-based health care and its competition for limited resources has brought us the worst peacetime catastrophe we have ever faced as a nation.

This catastrophe was avoidable, and its perpetuation is not inevitable. Vaccines are on the near horizon. How will we produce them, procure them, distribute them? The United States would be wise to study the New Zealand model of empathy, cooperation, and communication, in order to ensure an equitable allocation of vaccines in the spring. While the tragic consequences of holiday get-togethers won't peak until after the new year, the new federal administration will hopefully rise to the challenge to unite the country to defeat COVID-19.

, is a forensic pathologist and CEO of PathologyExpert Inc. She is currently working as a contract pathologist in Wellington, New Zealand. Her New York Times bestselling memoir, co-authored with her husband, writer T.J. Mitchell, is . They've also embarked on a medical-examiner detective novel series with , available from Hanover Square Press.