18 Aug 2020

Covid-19: Epidemiologists call for new pandemic plan

12:08 pm on 18 August 2020

Epidemiologists say New Zealand needs a new, more generic pandemic plan which caters to worst-case scenarios.

Testing being conducted by health workers at a COVID-19 testing station setup at Eden Park, National Sports Stadium, in Auckland on August 14, 2020.

Covid-19 testing at Eden Park. Photo: AFP

The Ministry of Health's national pandemic plan did not properly account for a non-influenza outbreak, and was not fit for purpose, according to experts.

The ministry first drafted a pandemic plan in 2004, called the National Health Emergency Plan: Infectious Diseases.

An advisory group that helped form the pandemic plan did not feature any epidemiologists.

The plan was tailored to an influenza pandemic, because officials said that was the most likely pandemic to hit.

SARS had struck just one year earlier, a coronavirus pandemic that killed 774 people globally, but was not very contagious.

Since then the plan has only been tweaked, and in depth planning for a response to other diseases has not happened.

Professor Nick Wilson, who works in public health with the University of Otago, said there were two major issues with the current plan.

One, it made assumptions about vaccines that do not fit other diseases, and two, it did not properly consider what is needed at the border if a deadly disease hits.

The plans assumed a vaccine will be available within about six months, which Wilson said was a major flaw.

In turn, the whole plan appeared set out for little more than a six-month period.

Professor Nick Wilson

Professor Nick Wilson Photo: RNZ Insight / John Gerritsen

But he said the bigger issue was how it approaches the border.

"In the extreme situation, you need the capacity to actually block New Zealanders from coming home for some period of time so you can maintain protection of the country," Wilson said.

"It's just not feasilble if there was a terrible bioweapon in one part of the world to say New Zealanders must all come home, and you have to deal with up to a million people wanting to return.

"We just have to have the mechanism to have complete border closure until we assess the situation and gain control."

While a bioweapon may sound like science fiction, Wilson said it was a very real and growing possibility, be it a deliberate act, or through accidental release from a laboratory.

He also warned that smallpox would be a potentially devastating pandemic, far worse than coronavirus or influenza.

Another epidemiologist, Dr Jennifer Summers from the University of Otago and King's College London, said the plan New Zealand had was not designed for anything other than the flu.

"There are definitely lessons to be learnt from Covid-19 in terms of New Zealand's preparations for ongoing outbreaks of Covid-19 and for future disease outbreaks," Summers said.

"One of those lessons is that we need a generic pandemic plan.

"New Zealand now has the opportunity to learn from recent pandemics other than influenza (such as the SARS pandemic in 2003, along with Covid-19), to better prepare us for future pandemics.

"Having a national pandemic plan currently based on just influenza is a weak point in New Zealand's pandemic planning, which impacted our initial response to Covid-19 and this now needs to be addressed."

New Zealand is not the only country that was solely focused on influenza.

The United States also drafted a new pandemic plan after the SARS outbreak, which largely ignored SARS and diseases that were not influenza.

It is a familiar story across the globe.

A country that did learn from SARS was Taiwan.

Taiwan had almost 84 deaths from almost 700 cases of SARS, which was very difficult to transmit.

Fast forward 18 years and a far more infectious coronavirus has hit, but Taiwan has had less than 500 cases and only 7 deaths among a population of almost 24 million.

They have been touted as a world leading example of pandemic preparedness.

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