Public Health Expert

How to best prioritise Covid-19 Vaccination in Aotearoa/New Zealand - Public Health Expert

Mar 02, 2021

Dr Ben Gray* New Zealand has begun to roll out its Covid-19 vaccination programme, starting with those working at the border, including in the Managed Isolation and Quarantine (MIQ) facilities. There have been calls for prioritising other groups such as those in South Auckland [1] and meat industry workers [2]. The National Ethics Advisory Committee has released a final report [3] on Resource Allocation and Covid-19 that includes a section on vaccine prioritisation. The NZ Government has also developed a Covid-19 Vaccine Strategy [4] but without any detailed prioritisation. Broadly speaking, there are two benefits to vaccination; protection of the individual and protection of the community (by reducing the risk of transmission and of reducing the risk of outbreaks that overload the health system). Prioritisation for vaccination is not the same for all settings. The UK approached this with … Read More

How best to classify and count NZ’s border control failures in the COVID-19 pandemic? - Public Health Expert

Feb 12, 2021

Prof Nick Wilson, Dr Leah Grout, Prof Michael Baker In taking a systems approach to pandemic control, it is helpful to define what is meant by a “border control failure” so that such events can be used to guide performance improvement. This blog proposes specific definitions for the current context in Aotearoa NZ. It concludes that since July 2020, NZ has had at least 10 border control failures (9 via MIQ facilities and one via a port), and at least 5 “internal MIQ facility failures” involving spread between returnees.   Aotearoa NZ has done very well overall with its COVID-19 pandemic response – as acknowledged recently by a first place in a world ranking by the Lowy Institute in Australia [1]. NZ’s economic indicators also compare favourably to countries using a “suppression” strategy, as opposed to NZ’s elimination strategy [2]. Read More

Five Strategic Approaches to Achieving the Smokefree Aotearoa 2025 Goal - Public Health Expert

Jan 28, 2021

Richard Edwards, Nick Wilson, Janet Hoek, Anaru Waa, George Thomson, Tony Blakely The new NZ Government is to be congratulated for working on an Action Plan towards achieving the Smokefree Aotearoa 2025 Goal. To inform this process, we briefly set out five potential strategies for achieving this important health and equity goal and discuss their implementation.   Smokefree Aotearoa 2025 has been described as “a world-leading, bold ‘endgame’ goal” [1]. The goal’s origins were in Māori led advocacy to address the harms that tobacco smoking and the tobacco industry cause Māori, led by Māori leaders including Shane … Read More

Staying Safe from COVID-19 over Summer and Beyond: The Need for More NZ Government Action - Public Health Expert

Dec 21, 2020

Prof Nick Wilson, Prof Michael Baker Aotearoa/NZ has responded very successfully to the COVID-19 pandemic by achieving elimination and the lowest death rate in the OECD. But there are ongoing risks – which may even be increasing with larger numbers of infected returnees in border facilities. In this final blog of the year we detail the critical actions needed to lower the risk further, with these measures being largely the responsibility of the NZ Government. We also highlight the importance of ensuring the huge investment in the COVID-19 response generates lasting benefits for NZ. Aotearoa/NZ has achieved elimination of community transmission of COVID-19 with the lowest death rate in the OECD [1, 2]. The massive economic rebound at a 14% rise in GDP for the third quarter [3], is also highly favourable. Indeed, a preliminary analysis of IMF data suggests … Read More

Regulation of alcohol marketing is needed to meet health, wellbeing and equity goals - Public Health Expert

Dec 16, 2020

Prof Jennie Connor,* Prof Sally Casswell   The Advertising Standards Authority (ASA) has just released the report on its review of their Code for Advertising and Promotion of Alcohol. The ASA is an industry body which develops the voluntary codes that set the standard for advertising of alcohol, and also adjudicates on complaints made by the public when advertisers breach the code. The ASA exemplifies both an ineffective approach to protection of the population from harm, and an explicit commercial conflict of interest. In this blog, the case for regulation of alcohol marketing and the need for urgency is … Read More

What does the 2019/20 NZ Health Survey tell us about progress towards a Smokefree Aotearoa? - Public Health Expert

Dec 14, 2020

Richard Edwards, Janet Hoek, Nick Wilson, Andrew Waa [Department of Public Heath, University of Otago, Wellington] The latest NZ Health Survey data continues to show encouraging reductions in smoking prevalence. However, progress remains inadequate to achieve the Smokefree Aotearoa 2025 goal with persisting disparities in smoking, particularly for Māori and Pacific peoples. The Government urgently needs to introduce a comprehensive action plan, including measures to reduce the continued marked disparities in smoking. E-cigarette use and vaping has increased over the last three to four years, though its contribution to … Read More

Health and Economic Impacts of the COVID-19 Response: NZ Compared to OECD Countries - Unsorted

Dec 04, 2020

Prof Nick Wilson, Dr Leah Grout, Dr Jennifer Summers, Dr Nhung Nghiem, Prof Michael Baker (author details*) Aotearoa/NZ has achieved the lowest death rate in the OECD from the COVID-19 pandemic, equivalent to around 2000 lives saved compared to the OECD average. With regard to economic harm, NZ appears to be close to the OECD average, with the IMF predictions for GDP in 2020 overall being -6.1% for NZ and -6.3% for the OECD. Nevertheless, a fuller accounting of health, economic and equity impacts probably needs to wait until vaccination is sufficiently available and border restrictions are lifted. Despite NZ’s health success there is still a need to improve border controls (eg, with a “traffic light” system), until the population is protected by vaccination.   As with a number of other jurisdictions in the East Asia and Pacific region, New … Read More

Bioethicists, Scientists and Politicians; Decision Making in a Pandemic - Unsorted

Dec 01, 2020

Dr Ben Gray* To date New Zealand has come through the pandemic well. The role of political leadership and scientific input has been well covered. Part of this success was built upon having a clear ethical framework for managing a pandemic that had been developed in advance following the SARS outbreak. This blog considers the interaction between the science the ethics and the decision makers. In their blog post in February Cunningham et al1 drew our attention to the 2007 document “Getting through together: ethical values for a pandemic.”2 This document was the result of wide consultation in Aotearoa/New Zealand following the SARS epidemic and is a good example of applied practical ethics. The norm in bioethical discussion is to debate what is normatively the right thing to do. This document tried to answer the question what we, in … Read More

The COVID-19 pandemic in Aotearoa/NZ: A brief photo-essay with 10 photos - Public Health Expert

Nov 25, 2020

Luke Pilkinton-Ching, Prof Michael Baker, Prof Nick Wilson In this photo-essay of the COVID-19 pandemic in Aotearoa/NZ, each photo is accompanied by a brief comment on the pandemic impact or response. In some instances these images reflect success factors such as the relatively early introduction of border controls and the stringent nature of the “lockdown”. But we also consider some weaknesses: the slow adoption of mandated mass mask use and the recent run of eight border control failures.   Figure 1: Decisive science-informed government action. The distinguishing feature of the NZ response to COVID-19 was that the Government listened to science input and changed direction from the mitigation approach of its pandemic influenza plan to an elimination strategy.1 The goal of eliminating COVID-19 transmission in the community has driven subsequent interventions to keep it out at the borders and stamp … Read More

Time to Stop Dodging Bullets? NZ’s Eight Recent Border Control Failures - Public Health Expert

Nov 17, 2020

Prof Nick Wilson, Dr Leah Grout, Dr Amanda Kvalsvig, Prof Michael Baker There have been eight distinct border control failures in Aotearoa/NZ relating to the pandemic virus that causes COVID-19, since early August 2020, equivalent to one every two weeks. In this blog we briefly detail these failures and argue the case for an urgent review and upgrading of the country’s defences against this highly infectious pandemic virus, including: shifting to a risk-based approach to border management (a traffic light system), fine-tuning the Alert Level system to incorporate mask use, and enhancing contact tracing. Overall, Aotearoa/NZ has done extremely well by international standards by adopting and pursuing a goal of eliminating community transmission of the pandemic virus that causes COVID-19.1 It has sustained the lowest COVID-19 mortality rate in the OECD.2 However, since early August there have been reports … Read More