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2.
International Journal of Disaster Risk Reduction ; : 102779, 2022.
Article in English | ScienceDirect | ID: covidwho-1593714

ABSTRACT

Hotel-based Managed Isolation and Quarantine (MIQ) is a key public health intervention in Aotearoa New Zealand's (NZ) COVID-19 border control strategy for returning citizens and permanent residents. We aimed to investigate the experience of transiting through MIQ in NZ, to inform future refinements of this type of system. A qualitative thematic analysis method was utilised to explore experiences in depth with seventy-five individuals who had undergone MIQ in NZ between April 2020 and July 2021. Participants were interviewed by telephone or Zoom or completed an online qualitative questionnaire. Interviews were audio recorded, transcribed and coded;questionnaire responses were sorted and coded. All data were subjected to thematic analysis. Three main themes described the key elements of the participants' experience of MIQ that influenced their overall experiences: 1) The MIQ process, 2) MIQ Hotels, and 3) Individual experience. The variation in participants' overall experience of MIQ was strongly influenced by their perceptions of how well the MIQ process was managed (including communication, flexibility, and compliance with disease prevention and control measures);and the quality of the hotels they were allocated to (in particular hotel staff, meals and information). This valuable insight into the experience of individuals in NZ MIQ hotels can inform better planning, management and implementation of the MIQ process for NZ and adds to the literature of countries utilising such strategies to minimise the transmission of COVID-19, whilst protecting the wellbeing of those using the system.

3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-296772

ABSTRACT

Key messages Risk assessment for children has been a polarising issue during the Covid-19 pandemic. Governments around the world are preparing to ‘open up’ before risks to children are fully quantified, with unknown implications for their long-term health.Applying the Precautionary Principle to child health requires decision makers to 1) take preventive action until risks are better understood;2) ensure that the burden of proof rests with proponents of risk;3) explore alternatives to the risk;and 4) use participatory approaches to decision-making.Policies relating to children must be centred on the rights and wellbeing of children. We provide a framework for comprehensive Health Impact Assessments to ensure that direct and indirect impacts upon children are taken into account in major policy decisions.Elimination strategies offer an integrated approach to the protection of children’s wellbeing, the wellbeing of the population as a whole, and health equity. Where countries are transitioning away from elimination, a tight suppression approach is preferable to loose suppression or mitigation.

4.
The New Zealand Medical Journal (Online) ; 134(1546):8-16, 2021.
Article in English | ProQuest Central | ID: covidwho-1543338

ABSTRACT

Accumulating evidence suggests that elimination is probably the optimal initial response to an emerging pandemic disease of moderate or greater severity, at least until vaccines and disease-modifying agents are available.6 The elimination strategy has performed exceptionally well for New Zealand, giving us the lowest COVID-19 mortality in the OECD, a significant increase in life expectancy,7 a relatively high degree of personal freedom for much of the pandemic period and relatively good economic performance.8 The first major upgrade of the elimination strategy was the Reconnecting New Zealanders to the World strategy released on 12 August 2021,9 which proposed a carefully managed increase in inbound travel to New Zealand while continuing with elimination. [...]some of us have argued for continuing with suppression in Auckland while maintaining an elimination strategy for the rest New Zealand, which would require maintaining strong boundary controls around Auckland.13 Principles to guide the ongoing pandemic response There is a series of key principles that can help inform Aotearoa New Zealand's pandemic response, some of which have been articulated in government plans.14 Science-informed strategic leadership One of the strongest lessons from the pandemic response comes from the demonstrated benefits of combining effective political and scientific leadership. Given the ongoing need to meet new challenges in the pandemic response, it would be timely to institutionalise an improved set of processes for decision-making that foster use of evidence, innovation, consensus decision-making, continuous quality improvement and transparency.15'16 These processes could include: convening a cross-party parliamentary group along the lines of the Epidemic Response Committee;17 forming a high-level science strategy ropū (council) to provide the multidisciplinary expertise needed for complex emergencies;and developing a well-resourced COVID-19 research and development strategy. The post-acute effects of SARS-CoV-2 infection (so called "long-COVID") appear to be far more common and severe than for influenza.24 For example, there is the possibility of life-course impacts in the child population through effects on the developing brain.25 If that is found to be the case, then this pathogen may belong in the same category as measles and polio, which create such a burden of illness that they justify efforts for progressive elimination.26 27 One of the biggest unknowns is about the future evolution of SARS-CoV-2 "variants of concern," which may be more vaccine resistant, more infectious and even more lethal.28 The best way to stem SARS-CoV-2 evolution is to rapidly suppress transmission of this virus to very low levels across the globe, which is technically feasible but difficult to implement given inequities with vaccine supply, public health infrastructure and coordination.

5.
Med J Aust ; 215(7): 320-324, 2021 10 04.
Article in English | MEDLINE | ID: covidwho-1389701

ABSTRACT

OBJECTIVES: To identify COVID-19 quarantine system failures in Australia and New Zealand. DESIGN, SETTING, PARTICIPANTS: Observational epidemiological study of travellers in managed quarantine in Australia and New Zealand, to 15 June 2021. MAIN OUTCOME MEASURES: Number of quarantine system failures, and failure with respect to numbers of travellers and SARS-CoV-2-positive travellers. RESULTS: We identified 22 quarantine system failures in Australia and ten in New Zealand to 15 June 2021. One failure initiated a COVID-19 outbreak that caused more than 800 deaths (the Victorian "second wave"); nine lockdowns were linked with quarantine system failures. The failure risk was estimated to be 5.0 failures per 100 000 travellers passing through quarantine and 6.1 (95% CI, 4.0-8.3) failures per 1000 SARS-CoV-2-positive travellers. The risk per 1000 SARS-CoV-2-positive travellers was higher in New Zealand than Australia (relative risk, 2.0; 95% CI, 1.0-4.2). CONCLUSIONS: Quarantine system failures can be costly in terms of lives and economic impact, including lockdowns. Our findings indicate that infection control in quarantine systems in Australia and New Zealand should be improved, including vaccination of quarantine workers and incoming travellers, or that alternatives to hotel-based quarantine should be developed.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Disease Outbreaks/prevention & control , Quarantine/organization & administration , Travel , Australia/epidemiology , COVID-19/diagnosis , Humans , New Zealand/epidemiology
8.
Journal of the Royal Society of New Zealand ; : 1-24, 2021.
Article in English | Taylor & Francis | ID: covidwho-1124415
10.
J Prim Health Care ; 12(3): 199-206, 2020 09.
Article in English | MEDLINE | ID: covidwho-1042176

ABSTRACT

INTRODUCTION Mass masking is emerging as a key non-pharmaceutical intervention for reducing community spread of COVID-19. However, although hand washing, social distancing and bubble living have been widely adopted by the 'team of 5 million', mass masking has not been socialised to the general population. AIM To identify factors associated with face masking in New Zealand during COVID-19 Alert Level 4 lockdown to inform strategies to socialise and support mass masking. METHODS A quantitative online survey conducted in New Zealand during April 2020 invited residents aged ≥18 years to complete a questionnaire. Questions about face masking were included in the survey. The sample was drawn from a commissioned research panel survey, with boosted sampling for Maori and Pacific participants. Responses were weighted to reflect the New Zealand population for all analyses. RESULTS A total of 1015 individuals participated. Self-reported beliefs were strongly related to behaviours, with respondents viewing face masking measures as 'somewhat' or 'very' effective in preventing them from contracting COVID-19 more likely to report having worn a face mask than respondents who viewed them as 'not at all' effective. The strongest barriers to face mask use included beliefs that there was a mask shortage and that the needs of others were greater than their own. DISCUSSION Highlighting the efficacy of and dispelling myths about the relative efficacy of mask types and socialising people to the purpose of mass masking will contribute to community protective actions of mask wearing in the New Zealand response to COVID-19.


Subject(s)
COVID-19/prevention & control , Coronavirus Infections/prevention & control , Health Knowledge, Attitudes, Practice , Masks , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Adult , Betacoronavirus , COVID-19/epidemiology , Coronavirus Infections/epidemiology , Female , Humans , Male , New Zealand/epidemiology , Physical Distancing , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Self Report , Surveys and Questionnaires
12.
Lancet Reg Health West Pac ; 4: 100044, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-885373

ABSTRACT

Approaches to preventing or mitigating the impact of the COVID-19 pandemic have varied markedly between nations. We examined the approach up to August 2020 taken by two jurisdictions which had successfully eliminated COVID-19 by this time: Taiwan and New Zealand. Taiwan reported a lower COVID-19 incidence rate (20.7 cases per million) compared with NZ (278.0 per million). Extensive public health infrastructure established in Taiwan pre-COVID-19 enabled a fast coordinated response, particularly in the domains of early screening, effective methods for isolation/quarantine, digital technologies for identifying potential cases and mass mask use. This timely and vigorous response allowed Taiwan to avoid the national lockdown used by New Zealand. Many of Taiwan's pandemic control components could potentially be adopted by other jurisdictions.

15.
Emerg Infect Dis ; 26(6): 1339-1441, 2020 06.
Article in English | MEDLINE | ID: covidwho-8521

ABSTRACT

We estimated the case-fatality risk for coronavirus disease cases in China (3.5%); China, excluding Hubei Province (0.8%); 82 countries, territories, and areas (4.2%); and on a cruise ship (0.6%). Lower estimates might be closest to the true value, but a broad range of 0.25%-3.0% probably should be considered.


Subject(s)
Coronavirus Infections/mortality , Pneumonia, Viral/mortality , Betacoronavirus , COVID-19 , China/epidemiology , Humans , Pandemics , Risk Assessment , SARS-CoV-2 , Survival Rate
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