Public Health Expert

Smokefree outdoor areas: A missing part of Government’s new Smokefree 2025 proposals - Public Health Expert

Apr 22, 2021

George Thomson, Nick Wilson (ASPIRE2025) Smokefree outdoor areas are not ‘business-as-usual’ for New Zealand. Current efforts for such areas are rarely backed by law. Smokers trying to quit need places where being smokefree is normal, and in particular, they need smokefree outdoor hospitality areas. Aotearoa is far behind many jurisdictions in helping smokers in this way. There is strong public support for major changes, including for smokefree building entrances and outdoor dining. Queensland State Government 2008 smokefree campaign logo Great NZ Government Smokefree 2025 proposals, but needing a vital addition The NZ Government is to be congratulated with its recent proposals for achieving the Smokefree 2025 Goal,1 especially with those for markedly reducing retail outlets and removing nicotine to make cigarettes non-addictive.2 If effectively implemented, these proposals could lead to major health gains, health system cost savings and reducing … Read More

Progress towards a Smokefree Aotearoa 2025 Action Plan: Congratulations to the Government - Public Health Expert

Apr 16, 2021

Richard Edwards, Janet Hoek, Anaru Waa, George Thomson, Nick Wilson (author details*) We congratulate the NZ Government on its proposed Action Plan for the Smokefree Aotearoa 2025 goal. Here we examine the evidence for three key ideas outlined in the plan: permitting tobacco products to be sold in only a small number of stores; reducing the nicotine in tobacco products to very low levels; and restricting the legal sale of tobacco products to people born before a certain fixed year (the “smokefree generation” idea). Given sufficient political and public support, and effective implementation, New Zealand is poised to lead the world in tobacco control. The Government’s “Proposals for a Smokefree Aotearoa 2025 Action Plan: Discussion Document” represents a bold and innovative approach informed by sound logic and research findings from Aotearoa and internationally. If adopted and implemented … Read More

More Evidence that Elimination is the Best COVID-19 Control Strategy for Health and the Economy - Public Health Expert

Apr 12, 2021

Prof Nick Wilson, Dr Jennifer Summers, Prof Michael Baker In this blog we briefly consider a new Report from a European think tank that aims to identify an optimal COVID-19 response strategy. It considers mortality data, GDP impacts, and mobility data and suggests that COVID-19 elimination appears to be superior to mitigation/suppression strategies in health and economic terms. Nevertheless, more data and a longer-term perspective is needed, before we can be really certain about the relative benefits and costs of different COVID-19 control strategies. The likely health and economic benefits of using an elimination strategy (as NZ has done), relative to mitigation/suppression strategies have previously been reported on by some of us in a blog [1] and in the British Medical Journal [2]. The ability of Australia and NZ to resume quarantine-free travel in mid-April is another sign of the … Read More

Charting our way back to normal - Public Health Expert

Apr 08, 2021

By Professor Tony Blakely, Dr Tim Wilson, Luke Thorburn and Professor Nathan Grills, University of Melbourne A new web tool, COVID-19 Pandemic Trade-offs, allows people to weigh the costs and benefits of different policy responses as Australia rolls out vaccines and considers opening borders. See here for an associated explanatory video. Article reproduced with permission from Pursuit  The burning COVID-19 question this year is – “When can we get back to normal?” Or more pessimistically, “Will we ever get back to normal?” The honest answer is we do not know, and only time will tell. Moreover, we are privileged in Australasia to have little-to-zero community transmission, giving us some space to learn from other countries as they aggressively roll out emergency vaccination programs. However, keeping our borders closed to the world indefinitely is not feasible and we need … Read More

To ensure success of the trans-Tasman travel “green zone”, we need to reduce system failures at the NZ border - Public Health Expert

Mar 30, 2021

Dr Leah Grout, Dr Jennifer Summers, Dr Amanda Kvalsvig, Prof Michael Baker, Prof Nick Wilson While succeeding very well with its elimination strategy, NZ still does not have optimal border control. We find since July 2020 there have been 13 identified border failures and at least 6 internal MIQ facility failures. The forthcoming quarantine-free “green zone” between NZ and Australia provides an opportunity for NZ to benchmark its MIQ/border management policies and practices with Australian States and Territories to identify improvements in both countries. Overall, Aotearoa NZ has done very well with its COVID-19 pandemic response. NZ is ranked first in the world by the Lowy Institute in Australia [1] and its economic indicators, such as GDP impacts, also compare favourably to countries using a “suppression” strategy against the pandemic [2]. A recent favourable development has been the roll-out of … Read More

Expansion of “green zones” may provide a chance for the global eradication of COVID-19 - Public Health Expert

Mar 18, 2021

Nick Wilson, Matt Boyd, Osman D Mansoor, Louise Delany, Michael G Baker With effective vaccines for COVID-19 comes the potential for disease eradication (elimination at the global level). Here we consider the advantages and the challenges, but ultimately suggest consideration of progressive expansion of “green zones” towards a target of COVID-19 eradication. Even if eradication is not achieved, establishing and maintaining “green zones” with no local spread will have many medium term benefits by liberalising travel between “green zone” countries (eg, between NZ and Australia).   The COVID-19 pandemic response led to two unexpected major advances. Perhaps most surprisingly, was that traditional public health and social measures (PHSMs) could stop the spread of a respiratory virus despite about half of spread being from those without symptoms. The virus has been eliminated by these PHSMs in large parts of the globe, … Read More

How to best prioritise Covid-19 Vaccination in Aotearoa/New Zealand - Public Health Expert

Mar 02, 2021

Dr Ben Gray* New Zealand has begun to roll out its Covid-19 vaccination programme, starting with those working at the border, including in the Managed Isolation and Quarantine (MIQ) facilities. There have been calls for prioritising other groups such as those in South Auckland [1] and meat industry workers [2]. The National Ethics Advisory Committee has released a final report [3] on Resource Allocation and Covid-19 that includes a section on vaccine prioritisation. The NZ Government has also developed a Covid-19 Vaccine Strategy [4] but without any detailed prioritisation. Broadly speaking, there are two benefits to vaccination; protection of the individual and protection of the community (by reducing the risk of transmission and of reducing the risk of outbreaks that overload the health system). Prioritisation for vaccination is not the same for all settings. The UK approached this with … Read More

How best to classify and count NZ’s border control failures in the COVID-19 pandemic? - Public Health Expert

Feb 12, 2021

Prof Nick Wilson, Dr Leah Grout, Prof Michael Baker In taking a systems approach to pandemic control, it is helpful to define what is meant by a “border control failure” so that such events can be used to guide performance improvement. This blog proposes specific definitions for the current context in Aotearoa NZ. It concludes that since July 2020, NZ has had at least 10 border control failures (9 via MIQ facilities and one via a port), and at least 5 “internal MIQ facility failures” involving spread between returnees.   Aotearoa NZ has done very well overall with its COVID-19 pandemic response – as acknowledged recently by a first place in a world ranking by the Lowy Institute in Australia [1]. NZ’s economic indicators also compare favourably to countries using a “suppression” strategy, as opposed to NZ’s elimination strategy [2]. Read More

Five Strategic Approaches to Achieving the Smokefree Aotearoa 2025 Goal - Public Health Expert

Jan 28, 2021

Richard Edwards, Nick Wilson, Janet Hoek, Anaru Waa, George Thomson, Tony Blakely The new NZ Government is to be congratulated for working on an Action Plan towards achieving the Smokefree Aotearoa 2025 Goal. To inform this process, we briefly set out five potential strategies for achieving this important health and equity goal and discuss their implementation.   Smokefree Aotearoa 2025 has been described as “a world-leading, bold ‘endgame’ goal” [1]. The goal’s origins were in Māori led advocacy to address the harms that tobacco smoking and the tobacco industry cause Māori, led by Māori leaders including Shane … Read More

Staying Safe from COVID-19 over Summer and Beyond: The Need for More NZ Government Action - Public Health Expert

Dec 21, 2020

Prof Nick Wilson, Prof Michael Baker Aotearoa/NZ has responded very successfully to the COVID-19 pandemic by achieving elimination and the lowest death rate in the OECD. But there are ongoing risks – which may even be increasing with larger numbers of infected returnees in border facilities. In this final blog of the year we detail the critical actions needed to lower the risk further, with these measures being largely the responsibility of the NZ Government. We also highlight the importance of ensuring the huge investment in the COVID-19 response generates lasting benefits for NZ. Aotearoa/NZ has achieved elimination of community transmission of COVID-19 with the lowest death rate in the OECD [1, 2]. The massive economic rebound at a 14% rise in GDP for the third quarter [3], is also highly favourable. Indeed, a preliminary analysis of IMF data suggests … Read More