Epidemiologist in the Department of Public Health, University of Otago Wellington @OtagoWellington Aotearoa New Zealand, all views my own, she/her.
Dec 13, 2024 • 4 tweets • 1 min read
It will take time and resources to make every indoor space safe - so how to prioritise?
For rapid seasonal and pandemic preparedness we need to focus first on settings that enable superspreading. There's good evidence about which settings those are, and how to make them safe. 1/
Schools, for example, are v effective propagators of outbreaks:
- Large numbers of contacts
- Indoor air quality often poor
- Long duration of exposure
- Universal attendance
- Children don't live alone: they live in households with other age groups -> community spread.
2/
Dec 13, 2024 • 4 tweets • 2 min read
Aotearoa New Zealand's Covid Inquiry has produced a high-quality, insightful report with a huge scope and range.
See the linked article for a summary of key findings (and some gaps).
1/4
via @ConversationEDUtheconversation.com/the-covid-inqu…
NZ's capacity to implement the findings from its own Inquiry is threatened by massive cuts to public health, in stark contrast with Aus, where the release of their report coincided with an announcement of a A$251 million investment in a national centre for disease control.
2/4
Sep 8, 2024 • 7 tweets • 2 min read
Globally, economists are estimating the productivity costs of Long Covid. LC is common & affects working-age adults. Costs add up fast to large numbers (9 countries -> 0.5-2.3% of GDP).
What are the costs to New Zealand? No-one appears to be counting. 1/ phcc.org.nz/briefing/long-…
In our Briefing out today, we review some international evidence on the economic impacts of Long Covid, consider the potential effects in the NZ context, and outline actions that the NZ Government can take to mitigate these costs.
@PaulaLorgelly
2/
May 26, 2024 • 5 tweets • 2 min read
Excellent points here from @jacktame. Protecting the health of school communities has to come first.
Making attendance the #1 goal is manifestly self-defeating.
Sick kids in school -> teachers sick -> families sick -> no-one is learning.
We need an action plan for schools: 1/5
We wrote about this policy gap in 2022 and then again in 2023, calling for an Action Plan for NZ schools and describing what needed to be done. Long Covid adds urgency to the need for safe schools.
Here's a new Briefing about implications of our new major mask review for Aotearoa New Zealand.
Winter is on the way, respiratory infection rates are up, & there's a potential new pandemic on the horizon.
Mask work & New Zealanders are missing out.
phcc.org.nz/briefing/scien…
The NZ Government needs act on the review, upgrading its outdated mask policies so we can benefit from effective and versatile protection against seasonal, epidemic, and pandemic infections.
Anyone who is thinking that if you get Long Covid the system will support you, please understand: the system will not support you.
Anyone thinking that this wouldn't happen to you: for many previously healthy people, it already has.
An ounce of prevention is worth a pound of... well, that's the problem, there isn't a cure.
So @DrAnnaNZ and her colleagues need funding for the vital research they are doing.
In the meantime prevention is what we have, and there's plenty we can do. 2/4 phcc.org.nz/briefing/long-…
Mar 29, 2024 • 4 tweets • 2 min read
It's time to shift the burden of proof.
If someone wants to claim that Covid-19 or Long Covid will be less harmful in future, they must provide evidence showing why multiple infections are better for you than one or zero.
You can't choose to have only a 3rd infection. 1/4
The cumulative infections are what matter and around the world they are ticking up.
The evidence is compelling. It shows multiple longer-term harms to individuals, sectors, & societies from this virus.
This week we called for a country-level response:
For those interested in the source for our statement that teaching is a high-risk occupation for Covid-19 and Long Covid in Aotearoa New Zealand, a short 🧵
1/5 rnz.co.nz/news/national/…
In 2022 when NZ was experiencing widespread Covid-19 cases for the first time, an internal NZ Government memo (later OIA'd) included a graph of Covid-19 case rates by occupation. Teaching was at the top of the ranking.
If some propose that children's immune systems were harmed in 2020 by spending time in minimal/no contact with others, they should apply testable hypotheses and data in support.
eg, Children have always lived on remote islands & farms, isolated for weeks/months at a time. 1/5
1. What types of immune dysfunction are they at risk of and how do these effects manifest in health data? The list from AlKhater shows what you would measure.
And ask the flying doctors. Are country children known for being particularly sickly?
This analogy isn't just incorrect, it’s actively harmful. The immune system is nothing like a muscle.
Immunity isn't the goal: health is the goal. There's no net benefit to health post infection, & ++ potential harms. Aiming for immunity at the expense of health is indefensible.
Alongside infection-generated immunity to pathogens, well-described health impacts include death, multiple organ damage, autoimmunity, cancers, lower immunity to other infections, birth defects, disruption of microbiome and gut barrier, viral persistence/reactivation and more.
Sep 25, 2022 • 4 tweets • 1 min read
It's hard to wrap one's brain around the idea of a new, serious, common disease.
One reaction is to see plain statements of risk as fear-mongering. Another is not to see yourself in statements of risk, because after all, you've never lost anyone or died from a pandemic before.
You can see this brain wrinkle in statements intended to reassure, eg "Most children will be fine". The statement is true, but is it grounds for permitting infection to spread? Only if you subconsciously assume that the children you care about will always be in that "most" group.
Aug 6, 2022 • 16 tweets • 3 min read
This article is a v good explanation about Covid-19 immunity. It’s also (inadvertently) a v good explanation of why it’s vital to pick the right strategic goals. If you make immunity your strategic goal instead of population health, logic will walk you to some strange places. 1/
NZ no longer has a well-defined pandemic strategy - a key policy gap. I’ve put down some ideas about why it’s critical to choose the right goal - & why hybrid immunity doesn’t make the grade.
(I’m certain the author and commentators are all clearly aware of this fact, btw).
2/
Apr 2, 2022 • 5 tweets • 1 min read
It's an interesting question, how you assess potential harms from a new pathogen. My own approach with Covid and children has been: 1. All major childhood infections have potential for post-acute impacts so the question was 'what and how much' not 'whether' there would be impacts
2. Rule 1, 2, and 3 in paeds is 'listen to parents'; lived experience is a very important early signal. New health problems may go under the health system radar for a long time because they sit outside usual disease frameworks and the health system is v busy with acute illness.
