What’s in a cover?

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There are two answers to this question: To intrigue you so that you pick up the magazine and buy it, or to make a statement about what’s important in this country.

I’ve learned that if we put a bird on the cover, or a tiny house, or a tramping track, it’s much more appealing to buyers than if we feature a social issue, such as climate change, ocean pollution, or P addiction. But we would be neglecting our mandate not to feature the human world as well our wildlife.

We thought about putting a tree on the cover: an awe-inspiring, thousand-year-old forest giant. We thought about putting a historic bach on the cover: something that speaks of idyllic childhood summers and simpler lives. But the most important challenge facing New Zealand right now is a virus, and how we build our defences to it.

As I write this, COVID-19 has killed 2.4 million people around the world. Some scientists now believe SARS-CoV-2 won’t ever be eradicated, but that humanity will build enough immunity to the virus that it will circulate harmlessly among us—like the four coronaviruses that cause common colds.

The question is how many people will die, or become permanently harmed, before that happens. How much will it alter our economy, our relationship with our neighbours in the Pacific, our lives and environment?

This is a challenge we’ve faced before, points out Dave Hansford on page 40. New Zealand experienced polio epidemics about once a decade throughout the 20th century, until the polio vaccine ended them. As with COVID-19, most people who caught polio were asymptomatic; a small number required help breathing with a ventilator, and some found themselves permanently paralysed or had lifelong health issues as a result.

Our victory had a price: polio vaccines were poorly tested, and bad batches harmed innocent people. While vaccine development has improved immensely, public trust has not recovered.

Vaccination is one of the most important technologies humans have developed. A recent study found that 37 million deaths were prevented between 2000 and 2019 by vaccinations. Those lives saved were estimated to be mostly those of children under the age of five, and particularly from measles.

Yet New Zealand has never attained the World Health Organization’s measles vaccination coverage target of 95 per cent—the level required to achieve herd immunity from measles. This has had devastating consequences. In August 2019, a person infected with measles travelled from Auckland to Samoa, causing an outbreak of the disease; 5707 people were infected, and 83 died. The majority of deaths were children aged under four.

Which is worse: not having a treatment for a disease, or having a treatment and failing to use it?

Dangerous public doubt swirls around this technology, and more now than existed half a century ago. The COVID-19 vaccines enter a world filled with suspicion.

In this issue we’ve attempted to address some of the things you may be wondering about them: how they were tested, how they work, what their limitations are and what they might achieve. The answers to these questions may be some of the most important messages our mercifully isolated society needs to hear.

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