Pathways and obstacles to social recovery following the elimination of SARS-CoV-2 from Aotearoa New Zealand: a qualitative cross-sectional study

Abstract

Background Many public health experts have claimed that elimination strategies of pandemic response allow ‘normal social life’ to resume. Recognizing that social connections and feelings of normality are important for public health, this study examines whether, and for whom, that goal is realized, and identifies obstacles that may inhibit its achievement. Methods Thematic analysis of narratives obtained via a qualitative cross-sectional survey of a community cohort in Aotearoa | New Zealand. Results A majority of participants reported that life after elimination was ‘more or less the same’ as before the pandemic. Some became more social. Nevertheless, a sizeable minority reported being less social, even many months after elimination. Key obstacles to social recovery included fears that the virus was circulating undetected and the enduring impact of lockdowns upon social relationships, personal habits and mental health. Within our sample, old age and underlying health conditions were both associated with a propensity to become less social. Conclusions Elimination strategies can successfully allow ‘normal social life’ to resume. However, this outcome is not guaranteed. People may encounter difficulties with re-establishing social connections in Zero-COVID settings. Measures designed to overcome such obstacles should be an integral part of elimination strategies.

Community healthcare workers' experiences during and after COVID‐19 lockdown: A qualitative study from Aotearoa New Zealand

“…Kay, a Pākehā personal care assistant from Christchurch, described having drifted apart from her best friend, who lived on the other side of town and had become preoccupied with their own bubble. While not unique to essential workers (see Long et al., 2022), such dynamics of estrangement often affected them acutely. As Rowena, a Pākehā midwife from Nelson, explained, work was so stressful that many had ‘no mental or emotional energy left once off work’ to interact with friends.…”

“…Other participants indicated long‐term impacts of the stigma they carried as suspected vectors of COVID‐19, either because loved ones remained anxious that they might transmit the virus or because damage to their relationships proved difficult to heal (see also Long et al., 2022). In some cases, experiences of lockdown even led participants to question whether they wanted to continue in their current roles:

I think it has reinforced how little nurses are valued in NZ, especially primary health care nurses.

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“…Opportunities to expand bubbles at Level 3 could, in principle, have provided relief. In practice, however, few participants took up this option, either facing stigma from prospective bubblemates or worrying they might be vectors of infection (Long et al, 2020;Long et al, forthcoming;Trnka et al, 2021). Such findings highlight how 'social distancing'-often framed as an ethical endeavour undertaken to ease pressure on health systems and healthcare workers (Jackson et al, 2020;Marchesi, 2020)-can actually generate distinct pressures for certain groups of the latter.…”

“…The requirement that people other than essential workers spend the 7 weeks of Level 4 and Level 3 within a single 'bubble'-a small, exclusive social network, usually coterminous with a single household (see Long et al, 2020)-disrupted the flows of inter-household care that would usually support patients living in the community (Long, 2020a). The deep relationships that many carers had developed with their patients prior to COVID-19 were thus heavily leaned upon during lockdown-a development which could take a toll on workers at the coalface of community service delivery, who were left to absorb the risks.…”