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Since the start of the pandemic, Aotearoa New Zealand has spent tens of billions of dollars on responding to Covid-19.
The World Health Organisation declared an end to the public health emergency in May, 2023, but emphasised the pandemic wasn't over. Instead, it's entered an endemic phase, meaning the virus will continue to circulate indefinitely.
Budget 2024, announced on 30 May, allocated more than $230 million over four years to Covid and pandemic preparedness. According to Budget documents, this covers Covid vaccines and therapeutics, while retaining "critical public health surveillance infrastructure, supporting system preparedness to identify and respond to future disease outbreaks".
Since then, Health Minister Shane Reti and Health New Zealand Te Whatu Ora have provided more details.
Health New Zealand Te Whatu Ora will purchase an additional 9 million rapid antigen tests (RATs), extending the deadline of freely available tests by three months.
Nearly $200m of the funding will go towards delivery of vaccines and polymerase chain reaction (PCR) test processing, Reti announced on Thursday.
Separately, under new government commitments, $14m will go towards expanding the terms of reference of the Covid-19 inquiry, Internal Affairs Minister Brooke van Velden confirmed.
Funding for Covid tests
First, it's important to note the last mandatory Covid measures were removed last year. Meaning it's no longer a legal requirement to self-isolate after a positive Covid test - although it's recommended. Vaccine mandates are also long gone.
Initially, Covid vaccines and treatments were paid for from a separate fund provided by the government. From mid-2023, the budget for them was added to the combined pharmaceutical budget; a pot of more than $1.5 billion.
Meaning Covid vaccines and treatments needed to be prioritised against all the other medicines, medical devices, vaccines, and related products funded for New Zealanders. (While the Covid vaccines do not necessarily stop someone becoming infected, they remain good protection against severe illness and death from the disease.)
Minister Reti told reporters on Thursday: "RAT testing is still an important method to support eligible people to access antiviral medications and reduce the impact of Covid-19 on hospital admission rates."
Free RATs would be available to the public until 30 September, Previously, the date was 30 June.
"Many other countries have ceased the distribution of free RATs, however this approach ensures New Zealand has a good supply of tests available through to the end of winter."
Despite some pharmacies being out of stock, Te Whatu Ora told RNZ "there is currently no shortage of free RATs, which remain available for providers across the country to order from Health New Zealand as normal".
A network of healthcare providers and pharmacies had opted to become distributors of free RATs to the public. (A list of them was available online and Te Whatu Ora said it was working on making sure it was kept up to date.)
"These providers will contact us when they need to top up their stocks and we can confirm that we have sufficient stocks currently to meet all orders for distribution.
"It is up to individual providers to choose whether to supply RATs, and there is no cost to access RATs by becoming a participating provider. This means that in some areas, availability of RATs will be subject to the number of participating providers who have chosen to supply them in that particular location."
PCR tests are used in some situations by health professionals. Results are generally more accurate than for RATs but take two to five days. They are an important part of infection control in hospitals and Covid remains a notifiable disease.
Vaccines and treatments
Of the $230m, $192.9m was for delivery of vaccines and PCR processing, Reti said.
Covid vaccination was free for everyone aged 5 and over, while additional doses or boosters were free for people over the age of 30. (Some younger people can be vaccinated and have additional doses, but eligibility criteria apply).
"Our government is committed to ensuring on-going timely access to Covid-19 vaccines and therapeutics for people who are at greater risk of serious illness," Reti said.
When asked whether there would be any change to vaccine eligibility, Reti said "it would remain as it is at the moment".
Covid antiviral medicines, that can help reduce the amount of virus in your body so you don't get as sick, remain freely available to people with certain risk factors relating to age, ethnicity, vaccination status, and underlying health conditions.
Pandemic surveillance
The remaining amount, about $30m, will help maintain pandemic surveillance, Reti said, "such as wastewater testing and whole genome sequencing".
A Ministry of Health document published last year outlined the country's long-term Covid strategy.
Based on the behaviour of the virus to date, we could expect new variants to favour "increased immune evasion", and/or transmissibility, it said.
"In combination with waning immunity, these will lead to a consistent base level of new Covid-19 infections with several outbreaks or waves each year."
Expanding the inquiry
The Royal Commission of Inquiry into Covid-19 Lessons Learned was set up by the previous government in December, 2022, to look at the lessons learnt from the country's response to the pandemic, to help prepare for any future pandemic. Its approach is forward-looking and non-adversarial.
Under its original terms of reference, it was expected to cost about $15m and required to deliver a report by 30 September, 2024.
But both the National-Act and National-NZ First coalition agreements committed to expanding the inquiry's terms of reference.
The NZ First agreement went further and promised an inquiry covering "use of multiple lockdowns, vaccine procurement and efficacy, the social and economic impacts on both regional and national levels, and whether the decisions made, and steps taken, were justified".
Budget 2024 set aside $14 million until 2026 to expand the inquiry's terms of reference.
Minister van Velden in a statement provided to RNZ said: "In February and March of this year, we consulted on the expanded terms of reference and last month, I received the summary of the submissions.
"The submissions covered a wide range of issues including the use of multiple lockdowns, the impact on social wellbeing and business, and vaccine efficacy."
The government would decide "on the path forward for the inquiry" by the end of June.
The $14m would support "the future of the inquiry going forward with expanded terms of reference", she said.
The National-NZ First coalition agreement also promised to end all Covid-19 vaccine mandates. The coalition was still working through what that would require, an NZ First spokesperson told RNZ last month. Vaccine mandates ended in 2022, when the Covid-19 Public Health Response (Vaccinations) Order 2021 was revoked.
However, employers could still require workers to be vaccinated as a condition of employment.
The ongoing threat of Covid
While Covid wasn't considered a seasonal infection, the country appeared to be experiencing an increase in case numbers as the country entered its flu season.
A new subset of variants, referred to as "FLiRT", was thought to be contributing to the increase, while replacing JN.1 as the dominant strain.
In March, JN.1, from the Omicron lineage, accounted for 98 percent of sequenced cases, according to the Institute of Environmental Science and Research.
ESR started tracking FLiRT subvariants in April. The latest surveillance data showed three named variants, JN.1.16, KP.2, and KP.3 comprised more than 50 percent of all Covid viruses sequenced from wastewater.
Hospital admissions have also increased, with about 45 people a day going in with Covid, according to Te Whatu Ora.