Lecture 30 Covid 19

Question 1

What are key factors behind the global rise in infections?

Answer 1

• Nature of the virus
• Initial delays in reporting and incomplete information about what had happened at the point of origin
• No changes international travel and trade by many countries
• Inadequate or delayed public health responses initially
• Incorrect assumptions and incomplete information

Question 2

What was the global health security index of New Zealand?

Answer 2

NZ had poor preparedness according to the global health security index

Question 3

What was NZ’s pandemic influenza plan?

Answer 3

1. Plan for it
2. Keep it out
3. Stamp it out
4. Manage it
5. Manage it (post peak)
6. Recover from it

Question 4

Did NZ’s response fit into the pandemic influenza plan

Answer 4

No, lockdowns were not even contemplated, they put that plan to the side as things evolved.

Question 5

What is the control pandemic response choice?

Answer 5

What happens with the most serious and infectious diseases.
Mitigation - reduce to avoid overwhelming the healthcare system
Suppression - reduce to minimize negative health impacts

Question 6

What is elimination pandemic response choice

Answer 6

Reduce to zero in a country or region for prolonged periods –> Eradication - reduce to zero at a global level permanently

Question 7

What were NZ’s objectives during the initial response?

Answer 7

Preventing illness and death for vulnerable populations
Protecting the health care system and health care workers
Protecting the economy
Protecting pacific countries

Question 8

What else shaped New Zealands initial response?

Answer 8

• Modeling of potential scenarios and impact of public health interventions
• Expert technical advice from a range of scientists and researchers
• Constant observation of what was happening elsewhere
• Daily discussions with 5 nation counterparts and Australian colleagues

Question 9

What is the role of surveillance?

Answer 9

The continuous, systematic collection, analysis and interpretation of health related data
- Serves as an early warning system for impending outbreaks that could become public health emergencies
- Enables monitoring and evaluation of the impact of a intervention, helps track progress towards specified goals
- monitors and clarifies the epidemiology of health problems, guiding priority setting and planning and evaluation public health policy and strategies

Question 10

How is the number of people infected determined

Answer 10

• Infectiousness (including pre symptomatic (Reff is the mean number of additional infections caused by an initial infection, if above 1, case numbers increase exponentially)
• Incubation period (time before symptoms shows, which makes it harder to contact and isolate contacts)
• Asymptomatic/mild infections
• How may people are exposed

Question 11

What are the other factors determining the disease impact

Answer 11

How severe the infection is in terms of mortality rates
The availability and effectiveness of vaccines, supportive care and treatments

Question 12

What did we do to address equity during covid 19

Answer 12

• The lockdown was driven by the need to protect vulnerable populations
• Data were collected, reviewed and published by ethnicity to inform ongoing development of response
• Ensuring population wide communications were complemented by communication efforts informed by and channelled to Maori, Pacific, disabled people, refugee and migrant communities, vulnerable groups (segmenting)
• Vaccination program planning and delivery was informed by equity from the outset. Constant feedback: review, learn and adjust

Question 13

What was notable around vaccination?

Answer 13

• Played a key role in immunizing people to reduce likelihood of getting infected , infecting others and getting severe disease or dying from covid 19
• COVID 19 vaccines were developed in record time
• The vaccines were highly effective (95% against severe diseases and 99% protection against dying
• Most of the population needed to be vaccinated twice to achieve herd immunity
• NZ achieved two does coverage for 90% of the population

Question 14

Why was communication so important?

Answer 14

Regular, open and clear communication became a key pillar of NZ’s successful response. Especially important for providing a clarity of purpose and a sense of solidarity. “stay home, save lives, be kind”

Question 15

Channels

Answer 15

Relevant, accessibile, trustworthy

Question 16

Message

Answer 16

Appropriate, co-designed, tested

Question 17

Messenger

Answer 17

Trusted, credible

Question 18

What happened to New Zealand’s trust during covid?

Answer 18

New Zealand was the only European democracy where trust levels increased. Trust in NZ’s public service went up by 10%

Question 19

What was NZ’s excessive mortality?

Answer 19

We had negative excess mortality. Our cumulative excess mortality was less than what it would be pre-pandemic. NZ’s response saved 20,000 lives

Question 20

What are comorbidities?

Answer 20

The existence of one or more pre existing conditions. Led to a much higher risk of infection and death.

Question 21

What can we do to improve our future responses from what we learnt from co-morbidities?

Answer 21

We prevent and treat diabetes, cardiovascular diseases and cancers better than we do now

Question 22

What worked for New Zealand?

Answer 22

• Good people across the public service
• Strong, people focused leadership
• Agility (review, learn and adjusting constantly)
• Clear, honest and consistent communication (including when things don’t go well)
• Being prepared is necessary but not sufficient, great leadership, good decision making and clear communication are essential