Public Health Expert

Weekly deaths declined in NZ’s lockdown – but we still don’t know exactly why - Public Health Expert

Jul 10, 2020

Prof Nick Wilson, Dr Anja Mizdrak, Dr Jennifer Summers, Prof Michael Baker The pandemic-related lockdown is possibly the most dramatic public health intervention in NZ history. It helped achieve the elimination of community transmission of the COVID-19 virus in NZ. But it was also associated with 548 fewer total deaths than for the same period in 2019. Death rates (per 100,000 population) were also lower in 2020 than the three preceding years. There are a range of plausible reasons for this reduction (eg, fewer road crashes, fewer circulating respiratory infections) but we still need precise cause of death data (available in the future) to make more informed assessments. We examined weekly death data for NZ up to 8 June 2020 (the first 23 weeks into the year) and made comparisons with the three previous years. Preliminary data on weekly … Read More

COVID-19 and the law in Aotearoa NZ - Public Health Expert

Jul 06, 2020

Louise Delany (public health lawyer) Health and emergency laws have played a critical role in this country’s successful elimination of community transmission of the COVID-19 pandemic. This blog details key aspects of the legislation and comments on issues around testing, payments by incoming travellers for quarantine costs, and mask use. The implementation of law relating to COVID-19 has meant that public health law has become real in daily life in Aotearoa New Zealand (NZ). But not all of us are quite sure what the law allows, and what it doesn’t. NZ’s legal framework for infectious disease management and public health emergencies has existed for over 150 years, with various modifications over this time. The Health Act passed in 1956 did not radically change this framework but largely continued previous health law provisions, including amendments made in response to the … Read More

Kiwi public health doc reporting back from Victoria (Australia): “Do quarantine well!” - Public Health Expert

Jul 03, 2020

A bit like a letter home. I have now been full-time at the University of Melbourne since 2019. Before that, I was 20 years at the University of Otago, Wellington. Indeed, I set up this very Public Health Expert Blog with Nick Wilson ten years ago. Now I am your Australian correspondent.   Life as an epidemiologist and public health medicine specialist in Victoria, as a person who is new to the State, and not part of the formal apparatus, has been an interesting outside-in experience. But it has resulted in me becoming a ‘go to’ commentator for the media, given I have an outside perspective. So what follows is my perspective – without privilege to the inner workings on COVID-19 management. Australia now has a conundrum. By pretty good design (we did not lockdown as hard as in NZ) … Read More

Eliminate the pandemic virus causing COVID-19 or risk an animal reservoir - Public Health Expert

Jul 01, 2020

Prof John Potter* Elimination has been an effective strategy for New Zealand in the management of the COVID-19 pandemic virus (SARS-CoV-2). Most other countries have not pursued this goal and are ignoring the opportunity even now. SARS-CoV-2 is not manageable by the influenza playbook; its longer incubation period makes tracing and isolation more practicable and puts elimination within reach. There is one additional argument in favour of elimination: the longer the highly infectious SARS-CoV-2 virus circulates in the human population, the greater is the likelihood that it will find a host among other animal species and that these will become a reservoir capable of transmission back to humans.   Elimination has been an effective strategy in the management of the COVID-19 pandemic virus (SARS-CoV-2) in Aotearoa/New Zealand. The COVID-19 pandemic began in Wuhan, China late in 2019. The first case … Read More

Pandemic terminology: getting it right matters for effective risk communication and management - Public Health Expert

Jun 30, 2020

Prof Nick Wilson, Dr Amanda Kvalsvig, Prof Michael Baker Compared with other OECD countries NZ is a stand-out success story by ending community transmission of COVID-19. While there have been some well-publicised recent deficiencies (eg, quarantine organisation), there has still been no evidence of community transmission for many weeks. Nevertheless, further improvements in NZ’s response are possible and in this blog we detail how pandemic terminology could be upgraded. Consistent, accurate terminology could assist effective communication between political leaders, officials, scientists, international collaborators and the NZ public on key COVID-19 risk management issues. Clear communication with the public is critical for managing the COVID-19 pandemic. Indeed, it appears to have been a major strength to date by NZ political leaders and officials (eg, Prime Minister Jacinda Ardern and Director General Ashley Bloomfield). Nevertheless, there is further scope for improvement. In … Read More

Preventing Outbreaks of COVID-19 in NZ Associated with Air Travel from Australia: New Modelling Study of Alternatives to Quarantine - Public Health Expert

Jun 17, 2020

Prof Nick Wilson, Prof Michael Baker, Prof Martin Eichner (*author details) In this new study, we estimated the risk of COVID-19 outbreaks associated with air travel from Australia (with a low prevalence of COVID-19 infection) to NZ. We found that the combined use of exit and entry screening, two PCR tests (on days 3 and 12 in NZ), mask use and contact tracing, reduced the risk from one outbreak every 1.7 years (no interventions) to every 29.8 years (95% uncertainty interval: 0.8 to 110). This risk is similar to that achieved by the current system of 14 days quarantine, at one outbreak every 34.1 years (0.06 to 125). In conclusion, multi-layered interventions can markedly reduce the risk of importing the pandemic virus into a COVID-19-free nation like NZ. Whatever approach is chosen, careful management and evaluation will be needed. Read More

After the new law for smokefree cars for Kiwi kids, what next? - Public Health Expert

Jun 04, 2020

George Thomson, Nick Wilson, Richard Edwards This blog discusses the passing of the Smoke-free Environments (Prohibiting Smoking in Motor Vehicles Carrying Children) Amendment Act last week. We briefly review some lessons from this legislation’s long journey and explore future smokefree possibilities in Aotearoa / New Zealand.   A law providing smokefree cars for children is a matter for delight. Many have worked hard and long for this, community workers, advocates, researchers, officials and policymakers. As we celebrate the passing of legislation which will require cars carrying those under 18 years to be smokefree, what can we learn from the process for smokefree and wider health matters? Why was the policy process for the law so long? It is over 45 years since the first smokefree places law in the world,1 over 35 years after there was clear evidence … Read More

When can COVID-19 be Declared Eliminated from NZ? New Modelling Study - Public Health Expert

May 25, 2020

Prof Nick Wilson, Dr Matthew Parry, Dr Ayesha Verrall, Prof Michael Baker, Prof Martin Eichner (author details*) This blog details a recent modelling study we conducted. In it, we estimated that it would take between 27 and 33 days of no new detected cases of COVID-19 for there to be a 95% probability of epidemic extinction in NZ (at around current testing levels). For a 99% probability of epidemic extinction, the equivalent time-period was 37 to 44 days. So now the country urgently needs the Ministry of Health to provide an official definition of elimination and to upgrade the data on its website so that the public, the media and researchers can monitor progress towards achieving the goal. NZ is a rare example of a country to clearly articulate an elimination goal for the SARS-CoV-2 pandemic virus that causes … Read More

Monitoring and Forecasting the COVID-19 Pandemic in New Zealand Including the Successful Impact of the Lockdown - Public Health Expert

May 22, 2020

Dr Jaijus Pallippadan-Johny1, Dr John McDermott2, Rodney Jones1 and Michael Duddin1 (1 Wigram Capital Advisors, Auckland; 2Motu Economic and Policy Research, Wellington) In this blog, we introduce our modelling approach to estimating the transmissibility of the SARS-CoV-2 virus, the cause of the COVID-19 pandemic. We demonstrate the usefulness of the Wallinga model for the calculation of the effective reproduction number and show the major impact of the lockdown on containing the pandemic in New Zealand. The global COVID-19 pandemic represents an unprecedented public health and economic crisis. As the SARS-CoV-2 virus spread across the globe in early 2020, there was a clear need to find a modelling approach that could be used by policymakers and non-specialists to monitor the spread of the virus, and allow timely risk assessments to be made at critical times. The reproduction number (R0) is an … Read More

Why a “mouth and nose” lockdown with masks might help avoid a “full body” lockdown at home - Public Health Expert

May 20, 2020

Prof Nick Wilson, Dr Sophie Febery, Dr Ling Chan, Dr Jennifer Summers, Prof Michael Baker The concepts of an Alert Level system, household “bubbles”, and social event size limits are all valuable pandemic control measures. Nevertheless, better “source control” of COVID-19 at various Alert Levels by requiring masks in public indoor spaces could reduce the risk of outbreaks (should there be border control failures) and reduce the likelihood that we would need to move back to tighter restrictions and lockdowns with the associated adverse economic, social and mental health effects.   Typical street/shopping scene in Hong Kong with everyone wearing a mask (photo from author [LC] personal collection) The spread of the SARS-CoV-2 virus appears to be mainly through conversational contact, at home and at social events. Both internationally and in New Zealand, large clusters are usually initiated by … Read More