Public Health Expert

Monitoring CO2 indoors for improving ventilation as a Covid-19 control tool - Public Health Expert

Oct 27, 2021

Dr Ian Longley and Dr Julie Bennett* Poor ventilation in indoor settings is widely recognised as a risk factor for the airborne transmission of the virus (SARS-CoV-2) that causes Covid-19. Virus-laden aerosols can remain airborne for hours in indoor spaces with low levels of ventilation. In this blog, we discuss how to use carbon dioxide (CO2) measures as a proxy for estimating the level of ventilation in a building and to guide ventilation improvements in schools and workplaces. Airborne transmission of the virus (SARS-CoV-2) causing Covid-19 has been recognised by the World Health Organization, which states that the virus can spread in “poorly ventilated and/or crowded indoor settings”. This is also the case with the US Centers for Disease Control and Prevention (CDC), which recommends: “adequate ventilation and avoidance of crowded indoor spaces”. Airborne transmission differs from the traditional view that … Read More

Reducing the risk of Covid-19 transmission through the use of air purifiers - Public Health Expert

Oct 26, 2021

Prof Mark Jermy, Dr Julie Bennett, Dr Jason Chen, Phoebe Taptiklis and Dr Caroline Shorter* Indoor environments increase the risk of transmission for the virus that causes Covid-19 (SARS-CoV-2) by containment and concentration of the airborne virus. However, to reduce such transmission, the particles that carry the virus can be diluted by bringing in as much outdoor air as possible. When good ventilation is not possible, air purifiers can be used as an additional preventative measure to reduce the number of virus-laden particles. Ventilation and purification of indoor air needs to be used alongside public health measures, such as vaccination, staying home when unwell and mask use. This blog outlines some basic principles of using air purifiers to reduce the risk of Covid-19 transmission. Indoor spaces with low levels of ventilation are high-risk settings for Covid-19 transmission, as an infected … Read More

Is Funding Euthanasia a Health Priority for Aotearoa New Zealand: Part 2? - Public Health Expert

Oct 22, 2021

Dr Ben Gray* Providing equity of access for assisted dying without equity of access to palliative care is to completely undermine the goals of the End of Life Choice Act. The choice is distorted towards aid in dying and away from palliative care. In this blog I will describe the detail in the Gazette Notice documenting the funding mechanism for provision of services under the Act. I will argue that the focus in this policy on equity is misplaced and that the effect of not allowing practitioners to charge a co-payment will significantly undermine provision of aid in dying. In a blog last year (Gray, 2020) I argued that it is very likely, based on experience from Oregon USA, that assisted dying would be predominantly taken up by a small number of mostly educated white people. The recently announced … Read More

COVID-19 in Aotearoa: what does public health do now? - Public Health Expert

Oct 18, 2021

Dr Belinda Loring, Dr Ruth Cunningham, Dr Polly Atatoa Carr* Public health activities have collectively made an incredible contribution to minimising the impact of COVID-19 in Aotearoa. But the work for public health is not over. As the situation in Auckland heralds a transition point in our approach to the pandemic, the challenge now is to be bold and clear about how we prioritise our public health resources and effort going forwards to the activities that will make the greatest impact on protecting and improving population health.   Through Aotearoa’s elimination strategy, an estimated 10,000-20,000 deaths have been averted by keeping COVID-19 largely out of our communities until now. Critical to this success has been the intensive efforts of the public health community – providing policy advice on which control measures offer the biggest impact, the vaccination strategy, and intensive … Read More

Urgent measures needed to allow the safe re-opening of Auckland schools - Public Health Expert

Oct 11, 2021

Dr Rachel Webb, Dr Jin Russell, Dr Pip Anderson, Dr Emma Best, Dr Alison Leversha and Dr Subha Rajanaidu* In this blog we describe the range of urgent measures that are needed to facilitate a safe return to schools in Auckland and other regions of the country where there is ongoing community transmission of COVID-19. These include very high vaccination coverage of staff and eligible students, improved ventilation in schools, mask guidance and physical distancing. A premature return to on-site learning in schools, particularly in areas of Auckland with low vaccination uptake, and current community cases, may contribute to further transmission of COVID-19, with devastating health and wellbeing outcomes for children, young people and their families. The Auckland region of New Zealand is experiencing ongoing community transmission of SARS-CoV-2 B.1.617.2 (Delta variant). Since the beginning of the Delta outbreak in … Read More

The Need for an Updated Strategic Approach to Covid-19 Control in Aotearoa NZ - Public Health Expert

Oct 09, 2021

Prof Nick Wilson, Dr Jennifer Summers, Prof Michael Baker* The NZ Government appears to have drifted into an unclear strategic approach to Covid-19 control. In this blog we outline one potential way forward: a regional strategic approach that considers “regional suppression” and “regional elimination”. To maximise the success of this strategy, NZ would need to ensure tighter internal borders. Fortunately, there are examples from five Australian states and territories that show that successful internal border control of Covid-19 is possible.  Until very recently, Aotearoa NZ was clearly using an elimination strategy for Covid-19 control. Also, the Government had released (in August 2021) a fairly clear approach to Reconnecting New Zealanders to the World. The latter was also based on continuing the elimination strategy (for at least the short-term), while achieving high vaccine coverage; and increasing connections with the … Read More

Using Rapid Antigen Tests to Improve COVID-19 Control in Aotearoa NZ - Public Health Expert

Oct 07, 2021

Figure 1: Rapid Antigen Test kit given out freely from the NHS in the UK Dr Jennifer Summers, Assoc Prof James Ussher, Assoc Prof Nikki Moreland, Dr Leah Grout, Prof Nick Wilson, Prof Michael Baker* Most COVID-19 testing aims to identify infected people. To date, Aotearoa NZ has relied almost exclusively on Nucleic Acid Amplification Tests (NAATs) for this purpose. However, Rapid Antigen Tests (RATs) have a complementary role, particularly if COVID-19 infection becomes widespread. In this blog we briefly describe RATs, their performance, and how they could be used to further improve Aotearoa NZ’s COVID-19 response. Throughout the COVID-19 pandemic, Aotearoa New Zealand (NZ) has largely relied on nasopharyngeal swabs to collect specimens to test for the presence of SARS-CoV-2 (the virus which causes COVID-19). These COVID-19 tests became available in NZ in January 2020[1] and use RT-PCR (reverse … Read More

Five actions to support New Zealand’s Covid-19 response, with a focus on Auckland - Public Health Expert

Oct 03, 2021

Prof Michael Baker, Prof Sue Crengle, Assoc Prof Collin Tukuitonga, Sarah Helm, Dr Amanda Kvalsvig, Prof Nick Wilson* Regardless of whether Auckland returns to Covid-19 elimination or transitions to a suppression approach, there are critical actions that can be taken to strengthen pandemic control measures, including: (1) Enhancing Covid-19 control in groups who experience deprivation and marginalisation; this is key and requires a dedicated strategy, leadership by trusted members of those communities, an expanded role for Māori and Pacific providers, and models of care that are equity focussed and culturally safe across all providers; (2) Enhancing surveillance and screening to detect infectious people and areas; (3) Expanding vaccine access and mandates to protect key groups and slow transmission; (4) Upgrading the Alert Level system to provide more nuanced options for controlling Covid-19; (5) Strengthening regional boundaries to limit national spread … Read More

In May 2022 the COVID-19 Public Health Response Act 2020 expires: what then? - Public Health Expert

Sep 30, 2021

Louise Delany* The COVID-19 Public Health Response Act 2020 (‘Covid Act’) expires on 13 May 2022. A further time-limited legal framework will be needed to support Covid policy. A new Bill will require public submissions and thorough consideration by a parliamentary select committee. The Government should begin discussions now with relevant groups, so that the new Bill is ready for introduction in February 2022. Background The COVID-19 Public Health Response Act 2020 (‘Covid Act’) was enacted on 13 May 2020 as a tailor-made, ‘bespoke’ legal response to the then unfolding Covid pandemic [1]. The Covid Act now provides the principal means for making Orders, similar to regulations, that give effect to alert levels. The Act also authorises rules for those arriving in New Zealand, and those working at the border. Although other statutes such as the Health Act 1956 remain … Read More

Making the Most of Masks - Public Health Expert

Sep 17, 2021

Dr Nitasha Rimar, Dr Lucy Telfar Barnard, Dr Amanda Kvalsvig, Lesley Gray, Prof Michael Baker  Masks and vaccination have a central role in minimising the health and economic impact of COVID-19, regardless of the long-term strategy we use against the pandemic. These interventions depend on both good performance and high population coverage.  Here we update evidence on mask effectiveness and make the case that mask use needs to be universal in all indoor environments at Alert Level 2, including workplaces, schools, and high risk settings such as gyms. As New Zealand’s outbreak of the COVID-19 Delta variant continues, and the public becomes eager to move out of lockdown, the need to prevent new outbreaks in the community remains imperative. One of the most effective ways we can quickly accomplish a safe move down Alert Levels is through universal masking by … Read More