4 May 2020

Dr Mark Jacobs compares Swine Flu and Covid-19

From Checkpoint, 6:11 pm on 4 May 2020

Despite zero new cases of Covid-19 today a former public health boss who was at the centre of New Zealand's battle against swine flu says the coronavirus is going to be with us for years to come.

Dr Mark Jacobs was the Director of Public Health during the 2009 outbreak in New Zealand, in which at least 20 people died and more than a 1,100 people were hospitalised, with 119 in intensive care.

Dr Jacobs, who now works with the World Health Organisation, told Checkpoint any urge to celebrate is premature.

"It's obviously good news that it's down to zero new confirmed cases but that's one day. There's a long way to go yet, it's still a long haul in New Zealand, it's a long haul right around the world.

"It's good news but we would hope that there'd be a lot more good news that's quite consistent for quite some time yet before we start feeling confident. 

"But the problem fundamentally is not really just what's happening in New Zealand, it's what's happening in the world.

"Covid-19 is going to be with us for a long time yet. We are far, far away from it stopping spreading in other countries around the world. Really it's going to be with us at least until there's a very good vaccine and that vaccine is available, widely right around the world.

"I think we still need to be very cautious in New Zealand and actively looking out for it, actively responding to cases and thinking about how we can minimise the risk at the border, I think for years," Dr Jacobs said.

What are the differences between Covid-19 and Swine Flu?

Dr Jacobs told Checkpoint Covid-19 is proving to be more severe and more deadly than the A/H1N1 Swine Flu was. 

"I think there were 3,500 or so confirmed cases in New Zealand and about 20 deaths. But in fact, studies that ESR [Institute of Environmental Science and Research] did looking at whether people were infected with Swine Flu found that actually was about 29 percent of New Zealanders ended up with immunity.

"And of those, probably about 780,000 or so were actually infected during that pandemic, so it did actually infect a lot of people.

"I think there's no evidence that so far Covid-19 is anywhere near that in New Zealand."

In dealing with Covid-19, New Zealand health officials had been following the plan that was created to deal with the Swine Flu pandemic in 2009. 

On Monday Director-General of Health Ashley Bloomfield said they have had to tweak that plan as Covid-19 is proving to behave quite differently. 

Dr Jacobs said one difference is a vaccine was more quickly accessible for Swine Flu in 2009, and New Zealand also had stockpiles of antivirals that worked against the virus. 

"We don't yet have medication that we know is going to be helpful for Covid-19." 

Another difference with the new coronavirus is it tends to spread easily in clusters.

"What that means, actually, is that it is easier to stamp it out. The Swine Flu plan and response talked about keeping it out and stamping it out. But that was actually about buying time.

"With Covid it is actually possible to stamp it out. That's what has led to the approach in New Zealand to try to eliminate that sort of local spread. So that is a fundamental difference.

"One of the other things is that because we found out quite a lot about Covid through the response in China, we knew that strong social distancing measures actually make a very big difference.

"That then I think has influenced governments around the world and their decision-making... The lockdowns ... weren't thought about in terms of swine flu, they  were thought about for a very, very severe flu, like if it was like Spanish flu, but not for what Swine Flu turned out to be.

"So a lot of the basics are the same, a lot of the language is the same, and the planning that was done before Swine Flu ... I'm sure has been very helpful for really turning on the Covid response."

One thing he said they found with Swine Flue was it did not affect the elderly as much. 

"It was actually much more affecting young children, so about a third of all children in New Zealand got Swine Flu, whereas the elderly were relatively spared, and we think that's because they were exposed to a similar strain of influenza years before and so they still have some immunity.

"Because this new coronavirus is a very new virus, we're assuming that everybody is at risk of catching it.

"So we don't think there's really much in the way of immunity that anybody has already got. What we are seeing though is that there are very small numbers of young people getting getting seriously ill with it.

"It's much more badly affecting older people. Younger people are catching it but the people who are generally ending up in hospital are older people or people with other health issues."

He said it is not known yet if younger people are carrying Covid-19 without showing symptoms, but could pass it on. 

"There's lots of different estimates and different studies around the world with wildly different answers so far.

"There's no doubt there'll be some people in the community who've been infected already, and who potentially could have passed it on to other people who have no idea they're infected, which is why the approach of having a big emphasis on everybody doing social distancing now and lockdown is quite important.

"Because it's possible, quite likely some people will be getting infected and not getting sick, everybody needs to be aware of the importance of these sort of lockdown measures."