Public Health Expert

Bioethicists, Scientists and Politicians; Decision Making in a Pandemic - Public Health Expert

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

How to Systematically Reduce the Border Failure Risk for COVID-19 in Aotearoa/NZ - Public Health Expert

Oct 28, 2020

Prof Nick Wilson*, Dr Jennifer Summers, Dr Amanda Kvalsvig, Prof Michael Baker With the 2020 election over and with a newly elected government, it is an excellent time for a systematic review by NZ health authorities to identify optimal methods for reducing the risk of future COVID-19 outbreaks in Aotearoa/NZ. The persisting occurrence of cross-border incursions of the pandemic virus (five since 1 August, including a large outbreak in Auckland) highlights the need for such a review. In this blog we provide a framework for this systematic assessment and specific ideas for further risk reduction.   Aotearoa/NZ is a top performing nation internationally when it comes to eliminating community transmission of the COVID-19 pandemic.1-3 The response to COVID-19 also appears to have eliminated seasonal influenza and has reduced overall weekly deaths for NZ in 2020.4 5 The economic damage from … Read More

Covid-19: A planetary disease - Public Health Expert

Oct 14, 2020

Louise Delany* This blog focuses on the underlying environmental causes of Covid-19 (Covid) and the role of international law in tackling both Covid and other planetary crises. I argue that major changes to our relationship with our planet and its creatures are needed and these changes must be supported by new international law.   What caused Covid? Covid-19 is a planetary disease and we humans are its cause: ‘The animals who infected us did not come to us; we went to seek them out.’1 Human beings have suffered from diseases arising from contact with animals since time immemorial; most infectious illnesses were, at one stage, of animal origin. The rate of emergence of new diseases has increased over the last century. Transmission of biological material between species is needed in order to transmit and develop zoonotic disease, and thus some … Read More

Preventing diabetes: What does the latest modelling evidence tell us about health gains and cost savings? - Public Health Expert

Oct 07, 2020

Dr Cristina Cleghorn, Dr Leah Grout, Dr Anja Mizdrak, Prof Nick Wilson Approximately 5.5% of NZ adults have been diagnosed with diabetes. In this blog we summarise our recent modelling work that suggests that further investment in interventions of proven effectiveness to prevent type 2 diabetes could substantially benefit health, reduce health inequalities, and save billions in health sector costs for NZ.   In 2013-2014, it was estimated that around 5.5% of NZ adults (those aged 15 years and over) had diagnosed diabetes [1]. However, men are more likely than women to have diabetes, Māori and Asian New Zealanders are twice as likely as non-Māori or non-Asian New Zealanders (respectively) to be diagnosed with diabetes, and Pasifika in NZ are almost three times as likely as other New Zealanders to have been diagnosed with diabetes [1]. Furthermore, people living … Read More

Getting the Marketing Mix Right: A Commentary on NZ’s Forthcoming Vaping Regulations - Public Health Expert

Oct 01, 2020

Janet Hoek, Lindsay Robertson, Jude Ball, Richard Edwards, Anaru Waa On August 11 2020, the NZ Parliament passed legislation that extends existing regulation of tobacco and herbal smoking products to vaping products (or electronic nicotine delivery systems [ENDS] and heated tobacco products (HTPs]. The new Act represents an important step in managing access to ENDS and HTPs, and regulating how these are marketed.  In this blog, we summarise some of the Act’s key provisions before exploring how the regulations, still to be made available for consultation, could further strengthen the Act’s ability to protect young people. We also consider how other countries considering similar legislation could extend the approach taken in NZ.   For several years, public health researchers, parents and school principals have expressed concerns that young people are experimenting with ENDS,1 2 attracted by the novel flavours,3-5 expressive … Read More

The long-term health burden of COVID-19: further justification for NZ’s elimination strategy - Public Health Expert

Sep 24, 2020

Prof John D. Potter* This blog briefly surveys the emerging scientific evidence on the longer-term burden of symptoms and disease in survivors of the COVID-19 pandemic. Many of these symptoms point to damage in the brain and heart. These long-term harms add to the wide range of other reasons for Aotearoa/New Zealand to persist with its successful COVID-19 elimination strategy.   Following clear and focused scientific advice, New Zealand chose to meet the current COVID-19 pandemic with an elimination strategy. As we have discussed on multiple occasions in the scientific literature and public media, this strategy seeks to reduce the community transmission of the pandemic virus, SARS-CoV-2, to zero by a series of public-health interventions and rapid responses to any outbreak. Borders remain tightly controlled, incoming travellers are isolated or quarantined as appropriate, hygiene and behavioural guidelines have been promulgated … Read More

The smokefree policies of political parties: Do they care about people who smoke? - Public Health Expert

Sep 24, 2020

George Thomson*, Nick Wilson, Janet Hoek, Andrew Waa, Richard Edwards In this time of Covid-19, helping people who smoke to quit their addiction has an even greater importance. Smokers are more vulnerable to many harmful health effects, including severe effects from the virus. Policies that support people who smoke to be smokefree would also increase the discretionary income of many of those most affected by the Covid-driven recession. We looked at the policies of seven New Zealand political parties and found that they are largely ignoring the strategies that would help smokers to become free of their nicotine addiction.   Most New Zealanders who smoke regret starting smoking and most want to quit.1 Being an ex-smoker decreases a huge range of respiratory, cardiovascular and other health conditions and is also likely to make people less vulnerable to severe Covid-19 infection.2-5 … Read More

Shifting all Isolation/Quarantine Facilities to a Single Air Force Base: The Need for a Critical Analysis - Public Health Expert

Sep 14, 2020

Prof Nick Wilson*, Prof Michael Baker In this blog the arguments for and against shifting all COVID-19 related isolation/quarantine facilities to a single air force base at Ōhakea are considered. The main advantage would be a reduction in the risk of border control failures, which can potentially involve outbreaks in NZ’s largest cities with large health and economic impacts. The main disadvantage would be reduced numbers of returnees that could be allowed back into NZ, with these returnees assisting with economic recovery. There is therefore a need for an integrated health and economic analysis with the NZ Government being explicit about its decision-making.   In this blog the assumption is made that the current Auckland outbreak of COVID-19 will be successfully controlled and NZ will regain its COVID-19 elimination status for community transmission in the coming months. This … Read More