We are currently heading towards the end of July, which is well through the winter respiratory virus season in the Southern Hemisphere. And still we have not seen any Influenza (or RSV for that matter) circulating in New Zealand. At first I thought it was the lockdown through March and April which was blocking viral transmission through social distancing. However we are now a couple of months post-lockdown… Social distancing has essentially all but disappeared and still there is no Influenza and RSV in New Zealand. This must be now due to the fact we have a closed border and the fact that nobody can currently enter New Zealand without staying in a quarantine facility for 2 weeks on arrival. This seems to be blocking any potential influenza and RSV introductions into NZ*
The winter respiratory virus season still has a couple of months to run here, but things are looking very promising. An average influenza season in NZ causes an average of 400-500 fatalities. There is little doubt that RSV will also cause significant mortality in those with advanced respiratory disease and in the frail elderly. I would suspect that respiratory viruses as a group would count for well over 1000 fatalities per annum in NZ, not to mention several thousand hospital admissions. In contrast the 22 COVID-19 fatalities, although tragic, seems a meagre toll…
Clearly we (NZ) cannot keep our international borders closed indefinitely, because human nature will simply not allow it. We do however have to be very smart about re-opening our borders, using all the risk mitigation tools we can lay our hands on. We have a nation of 5 million COVID-19 virgins to look after, but that is another story.
When the borders do re-open can we still control the winter influenza season? We may not be as successful as we have been this year but I think 2020 has shown that control of seasonal influenza is entirely possible by trying to minimise “introductions” and their subsequent effects. I would suggest the following measures:
- Having a low threshold for testing, treating(oseltamivir) and isolating travellers coming back into New Zealand who have respiratory symptoms
- Influenza & RSV in returning travellers should be notifiable to Public Health so that the appropriate measures can be taken.
- Influenza vaccination should be strongly encouraged for travellers coming into New Zealand, particularly those coming from the Northern Hemisphere
- Routinely vaccinate all children to further reduce the chances of transmission, should any introductions occur
Put quite simply, we set the bar too low for seasonal influenza control in NZ. We regard the winter influenza season as an inevitability. We shouldn’t. We are a small island nation, and our COVID-19 response has shown that we can be united and disciplined when we want to be!
“We set the bar too low for seasonal influenza control in New Zealand”
Let’s make the NZ winter influenza season the exception as opposed to the rule…
Michael
Interestingly rhinoviruses, although much suppressed during the lockdown period, survived and are now flourishing, and possibly filling a niche created by the influenza and RSV vacuum. See this interesting blog post from Australia