Would you want a flu warning system for your region?

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1. 0:06Speaker 1: Kiota.
2. 0:06Speaker 2: I'm Chelsea Daniels and this is the Front Page, a daily podcast presented by The New Zealand Herald. Severe respiratory
3. 0:17Speaker 2: illness rates are now the highest they've been in the last.
4. 0:21Speaker 3: Decade, mostly because of the flu.
5. 0:24Speaker 2: It comes as ambulance services struggle to meet demand and Health New Zealand urging people to save emergency departments for emergencies.
6. 0:34Speaker 2: Aran Z reported this week that hospitals have even created dedicated flu wards and some elective surgery is being canceled
7. 0:42Speaker 2: as influenza A hits the health system hard. So why has this flu season been so late, so sharp and so severe, and what does it mean for our hospitals
8. 0:54Speaker 2: are most vulnerable and the rest of winter. Today on the Front Page, University of Otago epidemiologist Professor Michael Baker is with us to break down what's driving this surge
9. 1:05Speaker 2: and what all of us can do to stay well and keep pressure off the health system. So, Michael, we're
10. 1:14Speaker 2: seeing severe acute respiratory illness hospitalizations at their highest in a decade. From a public health perspective, how unusual is
11. 1:25Speaker 2: this late season spike that we're seeing.
12. 1:28Speaker 4: Well, this is a feature of influenza and actually the other respiratory illnesses that drive the flu season. So we
13. 1:38Speaker 4: see this big peak over the coldest six months of the year basically every year, and it is higher or lower, So it's within the range of what these biases can do.
14. 1:50Speaker 4: But yes, it is very unpleasant when we see a peak like this from influenza. And typically we see maybe
15. 1:58Speaker 4: one and a half thousand extra dear every year in winter in New Zealand. That's on average, but there's a big range from one year to the other.
16. 2:07Speaker 2: People in the office have been going down like fliers left, right and center, and it is because of this influenza,
17. 2:14Speaker 2: and it sounds pretty terrific. It sounds a lot more severe than I guess your usual flu that we're used to hearing about.
18. 2:21Speaker 3: Is that right?
19. 2:22Speaker 2: That those anecdotal the anecdotal evidence that I'm bringing from the people in the office, Well.
20. 2:28Speaker 4: I think this flu will be very similar in severity for individuals. It's just that we're seeing a lot more people infected in this period of time. But the flu
21. 2:40Speaker 4: is a very serious illness. I mean, it's our single biggest infectious disease killer in New Zealand over many decades.
22. 2:49Speaker 4: It's responsible for more than one percent of total deaths in New Zealand. So people forget they say, oh, it's just the flu, But what they're often saying is they're
23. 3:01Speaker 4: mixing it in with all the other respiratory infections that come around in winter. But all of us have, most adults have experienced the flu at some stage, and it
24. 3:09Speaker 4: is not like other things. It is very unpleasant and it is responsible for several thousand hospitalizations a year as well.
25. 3:19Speaker 4: So we need to make a distinction between just the flu and actually influenza, and not everyone makes that distinction.
26. 3:28Speaker 4: But that said, of course, some other respiratory viruses also make you feel very miserable and do hospitalize you as well.
27. 3:34Speaker 3: I've noticed that.
28. 3:35Speaker 2: So during COVID we all got used to swabbing our noses and doing the tests and things, and somebody in the office actually said to me that there are tests available that you can get from the pharmacy to detect
29. 3:46Speaker 2: whether it's you know, influenza A or B. I mean, first of all, I guess that's a good thing that we're used to being able to do these tests now, and those tests are available, But what are the benefits
30. 3:58Speaker 2: of actually knowing what you has well.
31. 4:01Speaker 1: I think it is useful for several reasons. But you're right.
32. 4:05Speaker 4: You know that the rapid antigen testing has really advanced because of the pandemic, and that full component test you're describing tells you about influenza A and B and RSV
33. 4:17Speaker 4: and COVID nineteen. So that's very helpful because certainly if you know you have one of those more serious infections
34. 4:25Speaker 4: among other things, hopefully you get more sympathy from other people.
35. 4:30Speaker 4: But also you know that if you could deteriorate quite rapidly, particularly if you have any underlying illnesses or you're a bit older, so really being having people who are caring
36. 4:41Speaker 4: for you and making sure that you're going to get good care if you should deteriorate. But the other big benefit is that you know really to stay put and
37. 4:52Speaker 4: not go and socialize with other people for until you're feeling better, ideally for five to seven days, but it's some times hard to manage that. But don't go back
38. 5:02Speaker 4: to work or school or socializing.
39. 5:05Speaker 2: We've also got higher activity from other viruses, Like you said, you're RSV rhinovirus on top of the influenza. Is this a kind of triple threat scenario and how does that
40. 5:16Speaker 2: change the pressure on our hospitals and gps.
41. 5:20Speaker 4: Yeah, it's very hard to know if those other viruses are adding a great deal to the surge we're seeing because influenza is very high. RSV has been on a
42. 5:30Speaker 4: plateau for a few weeks, it seems. But all those other respiratory viruses, many of them are capable of giving you pneumonia and making you very ill. So we do
43. 5:41Speaker 4: have reasonable surveillance of serious illness that puts people into hospital.
44. 5:46Speaker 4: That's just in hospitals in the Aukran region. We could do better with saveillance. I think it's still got a few gaps, but yes, if for a range of reasons.
45. 5:56Speaker 4: I mean, obviously cold weather means people indoors more often, but we get that every winter, so it's hard to put it entirely down to that. But one thing I
46. 6:06Speaker 4: think is a driver of the influenza component is the one of the subclades K, which caused a lot of harm in the Northern Hemisphere at the end of last year.
47. 6:17Speaker 4: It's arrived in New Zealand and that may be contributing to this very high surge and influenza we're seeing. But it doesn't appear to be more severe necessarily, It's just
48. 6:28Speaker 4: that because we have less immunity to it, it seems more people get infected at once, and that gives the impression that we're getting well, we are being overwhelmed in
49. 6:38Speaker 4: the health system, but people may be starting to fail.
50. 6:40Speaker 1: Yes, it's everywhere, which is partially true.
51. 6:43Speaker 2: You've said that covid era in science should be applied to seasonal respiratory infections.
52. 6:49Speaker 3: Now, where do you see biggest gaps?
53. 6:53Speaker 4: Well, one of the big gaps is that I think we need a systematic way of looking at the level of risk because we've got enough data to do that,
54. 7:02Speaker 4: and then communicating to the public and to healthcare workers what's about to hit them. Because we can see the
55. 7:10Speaker 4: rises days or ideally a week or two before it's really hitting the system. We're just not acting on that information, even though we spend a great deal on collecting it.
56. 7:20Speaker 4: I think it's a real gap. I think the public would like a simple system the way we communicate weather forecast risk or fire risk that says, well, look we've
57. 7:31Speaker 4: got different bands of risk. We can do that quite easily.
58. 7:34Speaker 4: And that's what it means if we're moving into this high risk territory. These are things you can do to protect yourself and people around you. And if we get on top of that we're more proactive, then we can
59. 7:45Speaker 4: reduce circulation of these viruses and avoid overwhelming our health services. Instead, we just seem to be sitting back and waiting for it to hit us. And I think we should be
60. 7:55Speaker 4: past that stage. We've had so much experience from the pandemic.
61. 8:02Speaker 4: We've got the huge Royal Commission report over a thousand pages across the two phases, over forty recommendations. We need to act on this information. We can do much better.
62. 8:14Speaker 4: And if you think about simple measures to reduce circulation, two of the obvious ones are mask wearing in healthcare
63. 8:23Speaker 4: settings and doctors are saying yes, they are getting onto that, but we should start much sooner with that. And the other is mask use on public transport, because we know
64. 8:34Speaker 4: from all of our other research that's a major environment for transmitting these viruses. People spend hours in a fairly confined environment with other people. We know that the CO
65. 8:46Speaker 4: two levels are very high. They're showing a lot of rebreathing of people's other air. We really should act on that information.
66. 8:53Speaker 5: Well.
67. 8:53Speaker 2: The issue with that though, is as soon as we start talking about making things mandatory, people get you know, PTSD something and start yelling at each other about free rights.
68. 9:03Speaker 3: I mean, is there any way of encouraging.
69. 9:06Speaker 2: People to wear masks on public transport without infringing on their human rights and things?
70. 9:12Speaker 4: Well, I think at the very least a strong recommendation from health authorities and transport operators saying this is highly recommended.
71. 9:21Speaker 4: After all, there's the word pro sociality, which came out of the pandemic period, and that is the idea of caring for those around us, particularly if you have maybe
72. 9:32Speaker 4: the beginning of a respiratory infection, but you feel you're going to go to work or whatever. Anyway, wearing a mask in those confined environments seems like a good precaution
73. 9:44Speaker 4: and encouraging anyone who has underlying health issues to wear a mask in those situations, because if you're the only person on the bus or the pain of a mask,
74. 9:52Speaker 4: you don't feel very supported by those around you. So I think that would be the very least we could do, and then we might be become a bit more like
75. 10:02Speaker 4: many Asian societies who are renowned for mask using as a form of consideration for other people in those settings.
76. 10:16Speaker 5: Public service announcement late season surge in the flu here in New Zealand, with record demands on ambulance and hospital services for flu related illness.
77. 10:24Speaker 1: What does that mean? We're probably going to.
78. 10:25Speaker 5: See the flu going into the spring. It is not too late to get vaccinated now you still have benefit for yourself and for those around you if you get vaccinated.
79. 10:33Speaker 1: How do I prevent the spread of the flu?
80. 10:35Speaker 5: Wash your hands, cover your costs, keep things well ventilated, Avoid really crowded places when you can, especially if you're a vulnerable person. Avoid people that are sick. Obviously, please stay home if you're sick. You don't get extra points
81. 10:46Speaker 5: going to work, going to school, going to the gym.
82. 10:48Speaker 5: When you're sick, all you're doing is spreading illness to other people. Stay safe and stay healthy.
83. 10:55Speaker 2: Do you think that there should be more onus on companies when it comes to these kind of illness because a lot of employees do feel guilty about taking a
84. 11:04Speaker 2: sick day when they're not on death's door. Kind of thing, like if you've got a bit of a cough, a bit of a sniffle, you kind of think that you do need to come into the office.
85. 11:12Speaker 4: Yes, of course, I think employers should take this risk seriously afterwards, in the interests they don't want to have infected people coming to work and infecting lots of other
86. 11:23Speaker 4: staff members. So I think making it the norm to shift to or working from home staying home if you
87. 11:32Speaker 4: think you are a potentially in fictires to other people.
88. 11:35Speaker 4: I mean, I think many employers probably do that anyway, but I think having that is a new norm, and many of us, of course are fortunate to be able to work remotely if we have to, and I think
89. 11:47Speaker 4: obviously taking advantage of that in these situations.
90. 11:50Speaker 1: There are other things that employers can do.
91. 11:52Speaker 4: Is, for example, make the four component RAP tests available for staff members so they can easily confirm if they
92. 12:01Speaker 4: have one of these particularly serious respiratory infections. And after all that they're quite good at picking up infection when
93. 12:10Speaker 4: people are actually infectious to those around them. They're not particularly expensive if they're bought in bulk, so I think that would be the kind of measure they could implement.
94. 12:21Speaker 1: And also the same thing with mask use.
95. 12:23Speaker 4: I mean, high quality in ninety five type masks can be used many times. They're not a one use product, and again making those available to staff members I think
96. 12:35Speaker 4: would also be useful.
97. 12:37Speaker 2: How long should we expect this current season to stretch out? Like, could we be seeing these incredibly high numbers of hospitalizations, for example, well into spring?
98. 12:48Speaker 1: Oh very much so.
99. 12:49Speaker 4: I mean the typical winter respiratory season dares last right through September, So if it's peaking now with influenza, I
100. 12:58Speaker 4: think we can expect several weeks more of that pattern before we get back to a more baseline late spring level.
101. 13:07Speaker 2: What lessons should we be taking notice of during this flu seasons for perhaps next year?
102. 13:13Speaker 4: The number one thing I would like to see is for us to have a decent way of describing risk and communicating it to the public and the health sector,
103. 13:25Speaker 4: with very clear recommendations for actions that people should take over and above the normal actions. I think that's well within the capabilities we have at the moment with our
104. 13:36Speaker 4: surveillance systems and our highly developed health communication system in New Zealand. I think many people in New Zealand, particularly
105. 13:46Speaker 4: those who are more vulnerable, those in aged care facilities and in the health system, would really congratulate our health authorities if they implemented something like that.
106. 13:58Speaker 3: Why don't we have a national frame work like that, I.
107. 14:01Speaker 4: Think you described earlier on in the interview, because as we know, revisiting any COVID era measures is seen, as
108. 14:13Speaker 4: I know, it is associated with probably quite a bit of negativity for many people, and it's not a topic that I think our political leaders want to talk about.
109. 14:22Speaker 4: But there are many threats in our society that are unpleasant, and I think it's important that we do confront them
110. 14:30Speaker 4: in a a simple, clear, evidence based way and try and avoid some of the emotional baggage. I mean, there
111. 14:40Speaker 4: are a lot of problems that we I think have you know, as a mature society, we do confront regularly.
112. 14:47Speaker 4: I think this is just should be added to the list.
113. 14:50Speaker 4: And I think New Zealanders generally are very pragmatic and I think they would like honesty and good public discourse around these kind of issues.
114. 14:59Speaker 2: If you had your w what would this framework look like.
115. 15:04Speaker 3: Could a region, for instance, go into like a red.
116. 15:07Speaker 2: Warning like we do with the weather, like a red red rain warning. We've got a red influenza warning in the month or two.
117. 15:14Speaker 1: Yeah, I think it can work regionally.
118. 15:16Speaker 4: I mean, one thing is influenza does is such a good it's so good at spreading very rapidly. We often see very similar levels of risk across the country. But yes,
119. 15:26Speaker 4: I think it can certainly be used regionally, and some regions do pick before others, so I think that's a sensible way to go.
120. 15:33Speaker 3: Maybe we just shouldn't call them alert levels.
121. 15:38Speaker 1: That's right. Yes, we may have to come up with a new name. I agree.
122. 15:42Speaker 3: Thanks for joining us, Michael.
123. 15:43Speaker 1: Great to talk, Chelsea.
124. 15:48Speaker 2: That's it for this episode of the Front Page. You can read more about today's stories and extensive news coverage at Enzidhrald dot co dot nz. The Front Page is
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