At last, the kind of serious language that we need from people in responsible positions. Swine flu will hit NZ hard.Even so, they are soft pedalling some of the points at issue.
Everyone is being urged to stock up on food and essential medicines to prepare for the disruption of normal life when swine flu hits New Zealand hard.Good start, when it hits, it will be hard, even a mild form of the flu will be hard because of its ability to disrupt the systems on which we depend. The SARS epidemic was not especially infectious or fatal, yet it lead the health system to the verge of collapse. To quote the official report:
It caused untold suffering to its victims and their families, forced thousands into quarantine, brought the health system in the Greater Toronto Area and other parts of the province to its knees and seriously impacted health systems in other parts of the country
Swine flu has infected more than 17,000 people and killed 115 globally. So far in New Zealand, it has been confirmed in just 10 cases and has generally been a mild disease, but health authorities expect it will eventually infect more than half the population.Good. Clear, no messing about. But some of those people will also die, either from the flu itself or complications that can't be treated because medical services will also be affected.
The NZ standard planning model assumes a pandemic wave in which 40% of the NZ population (1.6 million people ) becomes ill over an 8 week period. ... The peak incidence is over weeks 3-5 when about 1.3 million people – about one third of New Zealand's population – would be ill, convalescent or only just recovered.
The model assumes a total case fatality rate of 2% which would see a total of 33,000 deaths over the 8 week period, peaking at about 10,000 in week 4 (compared with around 550 death per week normally)
Even if we cut that in half, this is nasty. No mention is made in the planning documents about the expected effects on the funeral industry when it suffers a 40% absentee rate. An industry that deals with a mere 550 deaths a week stretched over a landscape the size of the United Kingdom. The probability that such an industry will collapse completely is not canvassed, the question of who will handle the dead, where they will be kept, how, and by whom, they will be buried, and who will investigate the possibility that some of those deaths will not be from flu, those questions are not asked, let alone answered.
"It is rapidly spreading internationally, especially in Australia," said Dr Julia Peters, clinical director of the Auckland Regional Public Health Service. "In Australia, the number of cases is doubling every two days. With the amount of transtasman travel, it's almost inevitable we are going to get it in the community in New Zealand.Doubling every day, how many days till it has contacted the whole population of 20 million? Less than you think. Starting with the current 500 you reach 16 million in 17 days. And don't talk about Australia's huge distances, it is the most urbanised nation on earth. Urgent much?
Dr Peters said that based on modelling by the World Health Organisation, it was predicted that 60 per cent of people would become infected with the new virus, A (H1N1).Which is worse than my figures above that were written 2 years ago.
"We are promoting getting prepared, not getting panicky."All for it.
She said that with so many people sick - including workers - services or businesses such as schools, health clinics, banks and supermarkets might not be at full capacity.What's with the MIGHT here? Bite the bullet, they wont. And it wont just be because of sickness itself, some will be because of fear, some will need to be quarantined because a member of the family is sick and needs care. Remember Toronto? A survey a few years ago among medical staff suggested that some 70% of staff would actively consider staying home rather than risk contracting the disease? That will go for any job working close to unknown people.
It was possible the Government would invoke special regulations to prevent the spread of the virus. This would allow officials to close schools, restaurants and other facilities, and to prevent other public gatherings like weddings, funerals and movie sessions.Right there is the paradox. To slow the spread of the flu they will have to cripple the economy overnight. The option is to accept the spread and pour resources into powering down the econiomy under some kind of control. Do we have a plan for that?
Parents needed to plan how they would care for their children if schools or early childhood centres were closed. Businesses needed to decide which essential parts of their operations they wanted to keep running when many staff were at home sick.They also need to think about whether their customers will be there at all. If there is a heightened chance of contact and an option about being there, think about closing up for the duration and keeping your staff safe.
The one thing you don't need to worry about is getting to the supermarket. It may be open but it will be empty.
In 2000, a fuel blockade in the UK emptied some supermarkets within 24 hours because in a just-in-time economy, the warehouse is the supply chain and that is all we have between us and starvation
Thousands of gas stations hung out "no petrol" signs days ago. But by Wednesday evening, the wider effects of the action were becoming evident in many areas. The national health service (NHS), the biggest employer in Europe, was placed on "red alert" for the first time in 11 years. Supermarket chains warned they would run out of essential food within days, and some began rationing bread and milk.
Dr Peters urged people to stock up on three to five days of long-lasting food, and to ensure they had supplies of medicines they needed personally and fever control drugs like paracetamol.Again, a start, but realistically, if everyone tried to stock up simultaneously (and a month at least is needed) the supply chains will break, we don't have that much stuff in the system. And what about those who can't afford to stock up? What exactly are they supposed to do?
People who developed flu-like symptoms should stay at home and call a doctor for advice rather than turning up unannounced at a clinic and risking infecting others.Too late, and how nice of her to tell us HOW we will be informed?
Ngaire Buchanan, a member of the northern regional health emergency group, said that when transmission of the virus was widespread, people would be told of their nearest community-based assessment centre.
Staff at these facilities would check patients and treat them with Tamiflu.Umm. too late. Tamiflu works best when you have the disease but are not seriously symptomatic, by the time you are symptomatic you are pretty much on your own.
Four sites for these centres have been confirmed in Auckland City, five in the Waitemata health district, three in Counties Manukau, and 14 in Northland. In the Auckland region, they will mainly be at accident and medical centres.And what's the big secret? If you tell us now we will already know exactly when we need it. And 12 centres for a population of 1 million plus? That's 100,000 people each and allow for some clustering. That's 1000 people per day for 8 weeks (60% ofthe population). Mhmm. Not counting fights.
The Ministry of Health said it would start an awareness campaign on Saturday about swine flu, advising people what preparations to make and what arriving travellers should do if they had flu-like symptoms.We could quarantine ourselves but the immediate cost would be a collapsed economy and we have a government that is philosophically opposed to taking control. In normal times a good thing, right now, maybe not.