New Zealand Pandemic Planning

New Zealand Pandemic Plan Key issues

Potential Scale of a Pandemic

The Ministry of Health has taken a 'maximum credible event' approach using the 1918 pandemic influenza wave in New Zealand as a basis ie this is planning for a more severe end of the spectrum in what may be possible.

This model assumes a pandemic wave affecting 40% of the population (1.6 million people) over an 8 week period with peak incidence in weeks 3-5. Case fatality rate of 2%, about 33,000 deaths over an 8 week period. used in modelling.

Preparation: Inter-pandemic period

• Promote influenza vaccination and awareness, thereby providing the first line of defence against infection in the workforce and general population. While routine vaccination will not protect against a new pandemic strain, the immunisation programme has the advantage of raising general awareness of influenza and capacity to deliver immunization.
  • Development of national and DHB plans
  • Focus on an effective national surveillance system for all influenza strains.
• Current system:
  • GP sentinel disease and virological surveillance system currently in place involves over 90 practices operating during the winter months recording daily consultations of influenza-like illnesses
  • Ongoing virological surveillance via designated laboratories and the ESR. Specimens collected from hospitalised patients with influenza-like illnesses
  • Intersectoral Response - in recognition that a pandemic will affect all levels of society the government has set up an Intersectoral Pandemic Planning Group.

Pandemic Strategy:

New Zealand pandemic planning is based around a sequential five-stage strategy:

New Zealand has developed an action plan based around the WHO pandemic phases:

Refer Table 2: Summary of New Zealand pandemic phases in this plan

Channels of communication that the government will consider using:

• Fact sheets and FAQs
• Video presentation for broadcast via electronic media
• Establishment of a pandemic national free phone line and website
• National advertisements
• Regular media briefings

Keep It Out:

This phase is all about how to stop or delay pandemic influenza entering NZ and is focused on intensive border management, and quarantine measures.

The Ministry of Health have developed illustrative scenarios to consider these issues:
Scenario One from the plan (PDF)
Scenario Two from the plan (PDF)

Stamp It Out:

Pandemic influenza has crossed into New Zealand and is either identified at the border, or from community surveillance but is either still an isolated case or small clusters. The key issues in this phase are rapid identification of cases with good surveillance and public health responses of isolation and contact tracing, and (potentially) the closure of schools, restriction of public gatherings and restriction of movement.
Phase 3, Scenario 3, Code Yellow (PDF)
Phase 3, Scenario 4, Code Yellow (PDF)
Phase 4 , Scenario 2, Code Red (PDF)

Manage It:

Here the pandemic has spread through the community.
Action Response (PDF)

Table: Code White/Yellow/Red and some possible responses at each phase:
NB B2H = bird to human H2H = human to human

Impact on Society:

There is likely to be a high level of absenteeism in the workforce. Essential services such as police, fire, transportation and critical infrastructure such as communications, water and electricity supply need to be maintained during a pandemic.

The Ministry of Health is working with the Officials' Committee for Domestic and External Security Co-ordination (ODESC) to consider these key issues and how to minimise social disruption and economic impact.

Impact on communities :

Due to the high rates of infection possible, the majority of cases will need to be cared for at home. Most cases of influenza will remain self-limiting and only require management of symptoms. Primary Health Care needs to participate locally in planning needs focused on how to manage substantial numbers of sick people within the community. Given the fact that most people will neither benefit from, nor need medical intervention, it is important to have appropriate advice on when people need to seek medical care, and how to provide self care in he home environment.

There will be additional problems if the pandemic virus that emerges turns out to have a high rate of complications and deaths.

This would need to include considerations around large numbers of deceased through the peak weeks. Particularly consideration needs to be given to the very vulnerable - those in poor health, the elderly, those living alone, solo parents, people in poverty, Maori and Pacific communities particularly carry a disproportionately heavier burden of infectious disease and this may continue to be the case in pandemic influenza.

Examples of steps that could be taken to reduce the rate of spread:

• Strongly recommending that sick people stay at home; and that if they must leave home, they should wear a surgical mask or other barrier
• Advising the public against unnecessary travel and any activities that will bring them into close contact with others
• Utilising the powers of medical offers of health to cancel public events and institute other interventions under the Health Act 1956
• Closing childcare facilities, schools and tertiary institutions