Public Health Expert

Professor Tony Blakely is an epidemiologist at the University of Otago, Wellington. He has an extensive portfolio of research. Tony initiated and implemented the New Zealand Census-Mortality Study (NZCMS) in the late 1990s, a pioneering study linking the national censuses with mortality data to allow monitoring and research on ethnic and socio-economic inequalities and the contribution of smoking to mortality (the NZ census periodically includes smoking). He has also led the parallel study, CancerTrends, that links census and cancer registration data to allow cancer incidence and survival studies.

Why eliminating Covid-19 is critical: Since more waves of infection, hospitalisations and deaths are inevitable for other countries until a vaccine arrives - Public Health Expert

Apr 19, 2020

Prof Rod Jackson (Epidemiologist, Auckland University) There are really only three ways that a population can beat Covid-19. 1. Eliminate the virus and keep infected people out (the approach NZ is taking) 2. Allow a sufficient proportion of the population to get infected and become immune to re-infection so there are no longer enough non-immune people to allow the virus to spread (this is called herd immunity and is estimated to be at least half of any population for Covid-19), or 3. Develop an effective vaccine, which is the ideal way of achieving herd immunity. Given a vaccine might still be a long way off, NZ’s elimination strategy (if successful) is likely to avoid high numbers of deaths and the need for long periods of restrictions to suppress or mitigate the spread of Covid-19. One of the key pieces of … Read More

We need rapid progress on digital solutions to help eliminate COVID-19 from New Zealand - Public Health Expert

Apr 15, 2020

Dr Tim Chambers, Prof Nick Wilson, Prof Michael Baker In this blog, we discuss some of the emerging technologies New Zealand could adopt to support the country’s COVID-19 elimination strategy. We argue for the prioritisation of technologies to assist with contact tracing, border controls, early diagnosis and surveillance. These technologies present major benefits for the collective effort against COVID-19 and can also strengthen our preparedness for future pandemics. Nevertheless, they also present major challenges related to privacy, public acceptability and coordination that must be overcome if these innovations are to make substantial contributions to the pandemic response. The scale of the COVID-19 pandemic has quickly overwhelmed existing health systems in affected countries. Most countries are working hard to refine and implement an effective response. On 2 April, the World Health Organization hosted a high-level meeting between technology and health … Read More

COVID-19 and Māori health – when equity is more than a word - Public Health Expert

Apr 14, 2020

Dr Paula King,1 Dr Donna Cormack,2,1 Dr Melissa McLeod,3 Associate Professor Ricci Harris,1 Dr Jason Gurney,3 (1Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago; 2Te Kupenga Hauora Māori, The University of Auckland; 3Department of Public Health, University of Otago). As Māori academics, researchers and health professionals, we are extremely concerned about the impacts of the COVID-19 pandemic on our whānau and communities. We are also worried by the inadequate focus on Māori health equity in pandemic planning within the health and disability system, and in the whole-of-government ‘one-size-fits-all’ approach. And we are troubled by the local proliferation of commentaries on COVID-19 within multiple fora that either intentionally ignore the existence of health inequities within our society, frame equity as an add-on to a substantial list of other ‘equally’ important principles, or demonstrate “nonperformativity”1 in reference to equity. Saying, … Read More

Testing for COVID-19 in NZ to Achieve the Elimination Goal - Public Health Expert

Apr 06, 2020

Nick Wilson,1 Ayesha Verrall,1,2 Len Cook,3 Alistair Gray,3 Amanda Kvalsvig,1 Michael Baker,1 (1epidemiologists, 2infectious disease physician, 3statisticians) In this blog, we raise ideas for how New Zealand might optimise testing to both identify cases in the community as part of the COVID-19 elimination strategy, and to confirm when the virus has been completely eliminated from the country. These are urgent issues to clarify in order to minimise time spent under lockdown conditions and allow the economy and health system to return to more normal functioning. The priority is to continue testing symptomatic people, with the sensitivity of case detection expanded by steadily broadening the case definition and ensuring wide geographic and demographic coverage. After that, testing to assess the elimination goal could involve testing of higher-risk exposed groups, potentially using pooled specimens and serology, along with sewage testing. Along … Read More

Might a ‘Coasean’ social contract mitigate overall societal harm from COVID-19? - Public Health Expert

Apr 03, 2020

Brian Williamson1, Prof Nick Wilson2 (1Economic consultant, UK; 2University of Otago Wellington) In this blog, we outline how a win-win social contract could be forged to address the major dimensions of response to the COVID-19 pandemic when using a mitigation strategy: the particular need to protect older people from high death rates and the desirability of maximising freedom from lock-downs and economic wellbeing for nearly everyone else. The social contract could take a range of forms, but one approach could be for a government to offer a period of extra payments to older age-groups to commit to home quarantine, with the option of opt out either with no payment or an insurance surcharge reflecting risk until either a vaccine arrived or until protective immunity arose in the population. In response to the COVID-19 pandemic, most countries have adopted a ‘flattening … Read More

Avoidable hospitalisations: Helping our health system get through COVID-19 - Public Health Expert

Mar 25, 2020

Associate Prof George Thomson, Louise Delany, Prof Nick Wilson While it is possible that New Zealand can use intense public health controls to eradicate COVID-19 from the country – we must also plan for other scenarios where thousands of New Zealanders are sick – including many urgently hospitalised.1 Better resilience for our health system in the face of COVID-19 must include reducing current avoidable pressures that are not COVID-related. Emergency policies should include the reduction of preventable injuries that currently take a toll on hospital and health resources. These include those caused by alcohol, avoidable home accidents and road crashes. Increased alcohol prices, reduced sales hours, and reduced or banned advertising of alcohol would make significant and valuable differences for hospital staff, medical centres and patients. Even with reduced private road traffic, two immediate policies to help are (1) … Read More

The maths and ethics of minimising COVID-19 deaths in NZ - Public Health Expert

Mar 23, 2020

Prof Tony Blakely, Prof Michael Baker, and Prof Nick Wilson The NZ Government must do more to clearly articulate its COVID-19 strategy: eradication or ‘flattening the curve’ mitigation. But to do so means understanding the maths and ethics of both these strategies. In this blog, we adapt our work for Australia (just published in this blog) to the NZ setting. The NZ Government is rapidly ratcheting up its control measures to deal with the threat of the COVID-19 pandemic. But in our view at least, there is still insufficient clarity about what strategy it is taking. Is it going for eradication (as was the successful goal for the SARS pandemic and seems to have been achieved in China for COVID-19), or is it going for ‘flattening the curve’ (mitigation) as per the traditional approach with influenza pandemics? Similarly, in … Read More

Proposed Vaping Regulations for NZ: Strengths and Limitations - Public Health Expert

Feb 25, 2020

Janet Hoek, Richard Edwards, Andrew Waa, Nick Wilson, George Thomson Minister Jenny Salesa announced the Government’s long-awaited Smokefree Environments and Regulated Products (Vaping) Amendment Bill on Sunday 23 February.  The Bill contains some important provisions as it works to strike a balance between ensuring regulated products are available to smokers wishing to quit, while at the same time minimising uptake by young people. Its proposed extension of prohibitions on advertising and sponsorship from tobacco products to all vaping and smokeless tobacco products, including e-liquids, are important steps.  However, there are also opportunities for the Bill to go further to protect young people from vaping uptake. In this blog, we discuss the provisions, as summarised in the Ministry of Health’s Factsheet, and outline important questions that we argue the final Act should address. The Bill brings the prospect … Read More

Updating the role of the state: the case of housing in New Zealand - Public Health Expert

Feb 17, 2020

Prof Philippa Howden-Chapman Housing policy is building up to be the key election issue again. In this blog I reflect on the importance of the role of the New Zealand Government in improving access to affordable housing. I look at what the Government has been doing to increase quality public housing and to reduce homelessness and why the public housing waiting list is getting longer. The challenge Healthy, safe, affordable housing is a critical foundation of population health and wellbeing. Shortages in many OECD countries, including New Zealand and Australia, have led to increasing homelessness. This is not a new phenomenon. It has been recognised by numerous academics and commentators for more than a decade. However, prevailing neo-liberal policies largely over the last decade, led to little investment in public housing. By 2016, the lack of affordable housing was … Read More

Getting Through Together: Ethical Values for a Pandemic - Public Health Expert

Feb 14, 2020

Ruth Cunningham, Charlotte Paul, Andrew Moore Public health responses to infectious diseases such as COVID-19 require us to draw on our common humanity and be explicit about our values. Recognising this will help us make good decisions in difficult situations so that, for example, the need to impose restrictive measures and to protect ourselves does not conflict with fairness, respect, and neighbourliness.  In Aotearoa/NZ, Getting Through Together already provides a statement of shared values which can be used to guide a wide range of responses. In response to Wilson and Baker’s timely piece on preparing for a potentially severe novel coronavirus (COVID-19) pandemic, Shanthi Ameratunga raises the spectre that ‘keeping it out’ could morph into ‘keeping them out’. Her observation is a proper reminder that epidemics require us to draw on our common humanity as … Read More