Pandemic: What NZ should do
number, which is the number of people typically infected by each case.
Early figures reported by the World Health Organisation (WHO) suggest a reproduction number of between 1.4 and 2.5 – which suggests that every case detected is typically infecting two other people.
The biggest unknown is how controllable it will be. There is currently no vaccine and no specific treatment for coronaviruses so interventions are not available.
So far this coronavirus has continued to spread despite initial control efforts in China. It therefore ticks all the boxes for being a potential pandemic threat.
The whole world is now watching to see if the massive effort now being taken by China is enough to control this epidemic.
The world has come a long way since the severe acute respiratory syndrome (SARS) coronavirus pandemic in 2002-03.
China delayed reporting this emerging infection for several months, hindering an effective response and resulting in severe negative economic consequences for the country.
That pandemic was a major stimulus to acceptance of the International Health Regulations which in 2005 were adopted by all 193 member states of WHO.
The regulations require all WHO members to rapidly report potential emerging health threats, particularly where they pose a risk of international spread. China was quick to report this emerging disease and has been reasonably transparent in reporting its progression and disseminating scientific data about it.
After a country reports a new event, the WHO then assesses the potential for an international public health emergency.
WHO convened Emergency Committee meetings last week to consider the need for internationally coordinated control measures. They concluded that it had not yet reached the threshold to declare an international emergency but they will meet again as new information becomes available.
This epidemic is already having an impact on New Zealand that is likely to grow over time. There is grief and worry for those at the centre of the epidemic in China. There is the risk of imported and sustained disease in this country. And also the economic impact, which is already being felt financial markets and may affect tourist flows to New Zealand.
Of these concerns, the threat of importing disease to New Zealand is probably receiving most attention, as it is one risk that we have the ability to manage. It is stating the obvious to say that we live in a highly connected world with most countries just one or two flights away from China. If the spread continues we are likely to see imported coronavirus cases in New Zealand, just as such cases are being detected in Australia and a growing number of other countries.
Virus reaches Australia as China’s celebrations overshadowed WORLD
The future course of this epidemic is unpredictable. New Zealand is fortunate in having a number of advantages in combating this threat. Because of China’s greater openness in sharing information, we have the most important defence of all, which is knowledge about the nature of this threat.
There is a laboratory test that can confirm cases. We know it’s a coronavirus and, if it behaves like SARS, it can be controlled with basic public health measures.
Another protective factor for New Zealand is timing. Respiratory viruses of all sorts are highly seasonal and conditions in summer (e.g. people spending less time indoors) reduce their transmission.
New Zealand has a welldeveloped pandemic plan and experience with rolling this out during the last influenza pandemic in 2009.
One limitation is that the ‘‘keep it out’’ component of our pandemic plan remains underdeveloped. Our very small national and regional public health capacity could be easily swamped if a coronavirus epidemic became established here.
PHARMACIES across the country are selling out of surgical face masks as the deadly coronavirus continues to spread throughout China.
So far, there have been no reported cases of the virus within New Zealand, but this hasn’t stopped Kiwis from stocking up on the masks just in case, pharmacy staff have said.
One worker at Life Pharmacy in Remuera, Auckland, said the store had sold out of the masks three days ago and were unable to get any more straight away.
‘‘Our wholesaler, Pro Pharma, is out at the moment too so we’re having to tell people we’re out,’’ she said.
‘‘We’re getting around 15 people a day coming in and asking for masks, whereas, before last week, we’d maybe sell a box a day or less.’’
Invercargill pharmacist Donna Kerr said masks were selling out faster than her shop could restock them.
‘‘We got in six boxes of masks on Saturday morning, by midday, they were all gone.’’
Kerr said the masks were being bought in bulk, mainly by the local Asian communities.
Lisa Chamussy, a New Zealander who had just arrived in Auckland from Thailand, said she heard about the outbreak four days ago and decided to buy a mask before heading home.
‘‘We’ve been wearing masks at the airports and on the planes – being cautious, just in case.’’
Chamussy said many other tourists in Thailand had also been wearing them, as did nearly everyone on her flight.
The Ministry of Health said the risk of coronavirus in New Zealand was currently low but it was taking the outbreak ‘‘very seriously’’.
sustained transmission should be preventable with a vigorous public health response.
Based on current knowledge, and the potential for harm, we need to respond vigorously and effectively to minimise the impact on New Zealand and our Pacific neighbours.
This might require following those countries outside of China which have enhanced risk-based entry screening at airports (eg, asking travellers about their travel history and any symptoms and providing them with information).
If this new coronavirus does become established in New Zealand we should work with Pacific nations to consider exit screening or even suspending flights from New Zealand to give
them more time to prepare for this epidemic.
Throughout this response, we should also take the opportunity to refine our pandemic response systems, identify improvements to our public health infrastructure, and enhance scientific knowledge.
The global environment is arguably becoming more dangerous, with climate change, ecological collapse, and the increased availability of synthetic biology potentially increasing the risk of pandemic diseases. All the more need to strengthen our public health institutions at the regional, national and international levels.
Michael Baker is a Professor of Public Health at Otago University.