Public Health Expert

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

Is Euthanasia a health priority for New Zealand at present? - Public Health Expert

Sep 09, 2020

Dr Ben Gray* This blog discusses what will be needed to operationalise the End of Life Choice Act in the event that it is approved at referendum. It argues that this will take significant resources. Judging by the experience in Oregon it is likely that this may only benefit a small number of older educated white people. The health system is currently significantly stretched by the extra demands and changes required because of Covid-19. There is also an urgent need to implement some of the findings of the Simpson review on health system reform. Arguably more suffering would be relieved if the resource required to implement a system for assisted dying were put into palliative care funding.   At the next election voters will be asked to answer the referendum question “Do you support the End of Life Choice … Read More

Tax policy as a key health determinant: Reform for the Covid-19 reset - Public Health Expert

Sep 07, 2020

Louise Delany,* Assoc Prof George Thomson Tax provides revenue for the collective societal services that are critical for the prevention and management of Covid-19. Tax is the way we all share our resources in contributing to a healthy, decent and just society. Tax reform options should be included in pre-election party proposals. More importantly, we need to continue to talk about tax reform.   Our tax system has glaring holes. It relies too much on taxing wages and on GST. New Zealand income tax rates have become less progressive than they were in the 1980s.1 As a flat tax, GST takes a bigger chunk out of the incomes of the poor and thus does nothing to reduce inequalities. Covid-19 has emphasised the gravity of these issues. Those with fewer resources are the most adversely affected by Covid-19, for reasons ranging … Read More

Upgrade of NZ’s COVID-19 Alert Levels Needed to Help Regain NZ’s Elimination Status - Public Health Expert

Sep 03, 2020

Prof Nick Wilson, Dr Amanda Kvalsvig, Prof Michael Baker In this blog we comment on the current COVID-19 situation globally and in NZ. We focus on potential revisions to NZ’s Alert Level system that involve improved use of mass masking, targeted internal travel restrictions, and gathering/event limits. These interventions could all help accelerate rapid progress back to elimination status for NZ while minimising disruption of economic activity and education.   The global situation It is clear that the COVID-19 pandemic virus is highly infectious and is causing major health and economic damage in most countries around the world. Nevertheless, a number of jurisdictions appear to have eliminated community transmission of the virus (eg, China, Taiwan, Fiji and 5 Australian States/Territories – including the island of Tasmania). Other jurisdictions appear to be getting recent outbreaks under control and might … Read More

Children and young people and COVID-19: The urgent need for improved guidance in NZ - Public Health Expert

Aug 27, 2020

Dr Amanda Kvalsvig, Prof Nick Wilson, Dr Amanda D’Souza, Prof Michael Baker In this blog we consider the ‘Auckland August cluster’ in the light of the changing landscape of international evidence about COVID-19 risk for children and young people. The high proportion of Pasifika children and young people in the Auckland outbreak may be a preview of what an uncontrolled COVID-19 pandemic would look like in Aotearoa New Zealand. There is an urgent need to improve coordination of child-centred policy in the COVID-19 response with better Māori and Pasifika representation in decision-making at all levels. Immediate actions include mandating mask use for secondary-age children at Alert Levels 2 and 3 and encouraging primary-age children to make and use masks.   The SARS-CoV-2 virus is a new pathogen, requiring pandemic response strategies to be built on evidence that has uncertain … Read More