Behaviour: Still the best (and only) tool we have to manage COVID19

Another wave of community transmission in New Zealand is almost certain to happen. Will we be ready to act? Are we acting now?

The good news is that we took swift action before, and we succeeded in controlling the speed of the virus and eliminating community transmission. In fact, the only place is appears to pop up is at the border, where it is managed in isolation facilities. We actually have a good track record. But we need to be aware of the extreme dangers of complacency. It’s critical that we remain vigilant, and behave in ways that protect us all.

For a moment, let’s think of New Zealand as a person, and the borders of New Zealand as its skin. With  a smooth skin, and no cuts or nicks, the border functions well to keep the coronavirus out. But where the skin ends, the nose, the mouth, the eyes, or where the skin gets cut – think of these like when border control breaks down, where people leave quarantine or managed isolation in unauthorised and / or uncontrolled ways – well, that’s when the virus can get into the body of New Zealand

When this happens; if there is a suspected community outbreak, an ‘immune system’ (contact tracing etc) response kicks in to isolate the potential virus carriers, and then tracks back as many possible contacts as possible to determine whether they might also be a potential source of infection. If so, then the immune system quarantines those potential sources until they are either confirmed as a non-case, or they become non-infectious.

In the meantime, we may need to protect the other parts of the ‘body’ of New Zealand by perhaps asking them to wear masks to both protect themselves and others from the of potential transmission, and asking us to circulate less throughout the body of New Zealand, limiting the risk of infected parts coming into contact with non-infected parts, and increasing the risk of spread throughout the body of New Zealand.

So, that would mean using tools like local, regional, or in an extreme case, back to a national level lockdown. Or perhaps limiting movements into high risk areas, like congregating together in numbers more than a few people, or returning to bubbles of safe contact. Nobody wants this, but it must remain part of or tools to change behaviour to limit the spread of the virus.

If we get underneath the skin, and see what’s happening inside the body, then maybe it’s interesting to think of the whole of New Zealand like a person who has recovered from a life-threatening health concern, e.g. a heart attack.

Once someone has been through the rehabilitation programme of watching what they eat, making sure they get appropriate exercise, and all the other things they are asked to do to reduce their risk of having another heart attack, many people manage to establish these as habits and go on to live healthy lives, continuing to manage their risk of further heart issues. They also participate in screening and wellness checks to make sure that all is well within their bodies. However, others find this more difficult and lapse back into old habits, and stop coming to appointments where they have medical tests to see how things are going, increasing their risk of another, possibly fatal, heart attack.

And it’s this reversion to past behaviour that we need to watch out for in terms of protecting ourselves and each other from COVID-19. Adopting new habits to keep checking in on our wellness before we get sick: this is critical. And that’s what using the COVID-19 Tracer App is all about. That’s what taking a test if you fall ill and your health practitioner offers it to you is all about. All this helps us to check on the state of the ‘body’ of New Zealand so we can get an early indication of when things might be going wrong, and so that we can mobilise our ‘immune system’ tools to control the outbreak as early as possible.

When thinking about another outbreak of COVID-19 in New Zealand spread through community transmission of the coronavirus, it’s more a question of when rather than if. And at this point, we would do well to remember that aside from better technologies to detect the virus, the only tools we have are all based on behaviour.

How we behave now, as we work to prevent future outbreaks, and how we behave when these happen will be critical. Indeed, for the foreseeable future until safe, effective and widely accessible vaccines become available, they will most likely be the only tools we have.

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