Public Health Expert

Lessons learned from a remote blood pressure lowering trial in Aotearoa - Public Health Expert

Sep 16, 2021

Helen Eyles, Jacqui Grey, Elaine Umali, Cliona Ni Mhurchu Technologies such as smartphone apps, Wi-Fi-enabled data collection devices, and web-based data management systems offer the opportunity to deliver and assess the impact of clinical trials remotely, something which researchers are becoming increasingly drawn to.  However, there are drawbacks, and even experienced teams will encounter challenges.  In this blog we share the lessons we learnt during the conduct of SALTS, a remote blood pressure lowering trial in Aotearoa, New Zealand, where a smartphone app was part of the intervention package.  Our aim in sharing these lessons is to help other researchers considering the use of technology in research to be aware of some of the lesser-known challenges they may face.   High blood pressure (BP) is a leading cause of cardiovascular disease, the number one cause of death and disability in … Read More

Intensifying Covid-19 Control Measures: 5 Measures for Faster Elimination and 5 Measures to Prevent Future outbreaks - Public Health Expert

Sep 16, 2021

Prof Nick Wilson, Dr Julie Bennett, Dr Leah Grout, Dr Jin Russell, Dr Jennifer Summers, Prof Michael Baker   Despite some good progress, the persisting Covid-19 outbreak in Auckland still poses risks to health, social wellbeing and the economy. There is a need for accelerated efforts to ensure more rapid elimination of community transmission. In this blog we look at five critical measures to implement immediately, along with a range of other Covid-19 control measures that will help Auckland and the whole country sustain elimination in the medium term.  It is critical that Aotearoa NZ continues with its elimination strategy and successfully ends the current outbreak in Auckland. The impact of failure can be seen in New South Wales and Victoria in Australia where there are mounting cases, hospitalisations and deaths from Covid-19. Furthermore, these Australian states will probably need … Read More

Improving ventilation in schools: a key protection against Covid-19 outbreaks and an enduring legacy for healthier learning - Public Health Expert

Sep 10, 2021

Dr Amanda Kvalsvig, Dr Julie Bennett, Dr Jin Russell, Dr Jennifer Summers, Dr Leah Grout, Prof Michael Baker, and Prof Nick Wilson* As much of the country moves down Alert Levels, children are returning to in-person learning with little or no protection against the potential spread of Covid-19 infection in schools. It is therefore critical that ventilation is improved in schools; it is often as easy as opening windows, but ultimately new standards and improved resourcing are required. Ventilation is a valuable protection that works well in combination with other pandemic control measures such as vaccination and mask use, with additional benefits for improving children’s learning and concentration. The Covid-19 pandemic continues to evolve, with an increasing focus on the impact it is having on child health and wellbeing. Countries across the world are reporting Covid-19 outbreaks with high proportions … Read More

A Smokefree Aotearoa – could taking the nicotine out of smoked tobacco products help us get there? - Public Health Expert

Sep 06, 2021

Nick Wilson, Janet Hoek, Nhung Nghiem, Jennifer Summers, Leah Grout, Richard Edwards* This blog presents key findings from a modelling study where we estimated the impact that denicotinising smoked tobacco products could have on smoking prevalence in Aotearoa New Zealand. A policy requiring that all smoked tobacco products are virtually nicotine free is one of the key proposals included in the Smokefree 2025 Action Plan Discussion Document that was published in April this year. In April 2021, the NZ Government published an Action Plan Discussion Document (APDD) setting out measures that could realise the Smokefree 2025 Goal. The document presents a comprehensive strategy to achieve rapid and equitable reductions in smoking. The APDD includes a proposal to reduce nicotine in smoked tobacco products to very low levels (known as very low nicotine cigarettes or VLNCs). The APDD also proposes … Read More

An Upgraded Alert Level 2 is Urgently Needed to Address the Delta Variant Threat - Public Health Expert

Sep 03, 2021

Dr Leah Grout, Prof Nick Wilson, Dr Jennifer Summers, Dr Amanda Kvalsvig, Prof Michael Baker* Aotearoa New Zealand (NZ’s) Covid-19 Alert Level system worked well in early 2020, but the Covid-19 landscape has changed, and the system must be updated to address the threat of the highly transmissible Delta variant and future variants. The country is using lockdowns (Auckland currently at Alert Level 4, with the rest of the country at Alert Level 3) to eliminate community transmission. As NZ plans moves down the Alert Levels in coming weeks, now is the time to upgrade Alert Level 2 to ensure it is fit for purpose. Key improvements are mask use in all indoor environments, and creating a Level 2+ that keeps the highest risk indoor environments closed while the risk of virus circulation is elevated. On 17 August 2021, a community … Read More

Public health response to report on potential risk of nitrate from drinking water - Public Health Expert

Sep 03, 2021

Dr Tim Chambers and Professor Simon Hales This week a report, co-funded by Fonterra and MBIE, investigated the relative contributions of nitrate in our diet from water and food. The report comes in response to emerging epidemiological evidence observing nitrate in drinking water as a risk factor for colorectal cancer. In separate public statements, the authors concluded “it is highly unlikely that nitrates in drinking water or the diet present an increased risk of cancer.” In this blog, we explain why the evidence in this report is not sufficient to draw these conclusions by highlighting some key limitations. A recent report co-funded by Fonterra and MBIE and commissioned by the New Zealand Food Safety Science & Research Centre aimed to investigate the relative contributions of water and food to New Zealanders’ overall … Read More

The end game should not be just Smokefree 2025 but also Vapefree - Public Health Expert

Sep 02, 2021

Jenni Stephenson* Aotearoa New Zealand has been a world leader in the smokefree arena and is doubling down on its efforts to reach the 2025 goal. This blog asks if is enough to aim just for smokefree or whether Te Tiriti o Waitangi demands we aim higher and eliminate vaping also. Under the Te Tiriti o Waitangi the Government is obliged to protect the health and wellbeing of Māori. It is further obligated under both the United Nations (UN) Declaration on the Rights of Indigenous Peoples (UNDRIP) and the WHO Framework Convention on Tobacco Control. But despite smoking rates falling since the adoption of the Smokefree 2025 target, disparities in smoking rates still exist with the largest gap evident for women aged 15 to 24 years. In the 2015/16 NZ Health Survey 34% of Māori in this group smoke compared … Read More

Lessons from jurisdictions that are battling their own Delta variant outbreaks - Public Health Expert

Aug 31, 2021

Dr Jennifer Summers, Prof Nick Wilson, Dr Leah Grout, Dr Amanda Kvalsvig, Prof Michael Baker * The first Delta-variant outbreak in the community brings a new challenge to Aotearoa New Zealand’s COVID-19 response. A Delta outbreak was in some respects a likely scenario given the high infectiousness of this variant and the emerging evidence that vaccines may be less effective at preventing Delta transmission compared with the original strain of the pandemic virus. In this blog we discuss public health responses employed in other jurisdictions in response to the Delta variant that may be beneficial in controlling the current Delta outbreak in NZ and strengthening NZ’s COVID-19 response in future. We have written several blogs about different ways that NZ could improve its COVID-19 response, such as increasing wastewater testing, wider mask use, more targeted vaccinations, a revised … Read More

Throwing Open the Windows: The Need for Ventilation Improvements as Part of Covid-19 Outbreak Control in Aotearoa - Public Health Expert

Aug 30, 2021

Dr Leah Grout, Prof Nick Wilson, Dr Julie Bennett, Dr Jennifer Summers, Dr Amanda Kvalsvig, Prof Michael Baker * The importance of indoor aerosol transmission of the virus that causes COVID-19 is increasingly recognised. In addition to public health measures such as masking and physical distancing, further protections are needed to prevent the spread of the virus. Interventions to improve ventilation and filtration are needed for indoor settings in Aotearoa NZ. In this blog we address the particular need to improve ventilation in three settings: (i) homes with contacts who are self-isolating; (ii) indoor workplaces that have essential workers; and (iii) MIQ facilities. Introduction Airborne transmission of the pandemic virus causing COVID-19 has been recognised by the World Health Organization, which states that it can spread in “poorly ventilated and/or crowded indoor settings” [1]. This is also the view of the … Read More

More Wastewater Testing Could Guide Optimal Covid-19 Control on the Path Back to Elimination - Public Health Expert

Aug 26, 2021

Prof Nick Wilson, Dr Matthew Parry, Dr Leah Grout, Prof Michael Baker This blog briefly considers the issue of wastewater testing as part of Covid-19 control in Aotearoa NZ. Our analysis suggests that wastewater testing is much more effective in determining if a population is very likely to be Covid-19 free, when compared to typical levels of community testing. It also achieves these better results at perhaps only 1% of the cost of community testing. Even though there are large benefits in maximising the use of wastewater testing, community testing does still have a critical role to play, especially if cases are actually present. On 26 August, ESR was reported to be testing wastewater for the pandemic virus (SARS-CoV-2) at 97 sites across the country, with this covering cities and towns with around 3.8 million New Zealanders (Prime Minister’s … Read More