Thursday 11 May 2023

How quickly they forget

So we're three and a bit years into the pandemic. We have a decent vaccine that prevents most mortality, but there were 250 Covid cases in hospital as of midnight Saturday, we're getting about 12000 cases a week, and who knows what the long-term Long-Covid cost is going to run to.

The Government has resurrected a Public Health Advisory Committee that'll get to take on one big project a year.

There are lots of great options to choose from.

  • Cost-effectiveness of tighter ventilation standards in reducing the burden of transmissible disease would be great. It's possible that it's extremely cost-effective. But it might not be! And how does it compare to UV light? The latter has looked really promising. And how should that kind of cost-effectiveness evaluation weigh the insurance aspect? This kind of intervention would also reduce the transmission risk of other stuff we haven't yet hit. Even just running improved ventilation in schools to reduce run-of-the-mill sickness would reduce days out of school.
    • This would be a big project. I don't think anyone in government is tracking what Covid/long-Covid has done to labour force availability. If the number is big, then potential benefits of avoiding more long-Covid could be big. If it's trivial, then they're smaller. 
  • Are our regulatory standards up to spec for these kinds of emergency scenarios. Crampton keeps arguing that we should just approve anything that's been approved by two other agencies, so we can get access to drugs in a hurry in scenarios where it matters. Is he nuts? What would be the downside he's missed?
  • Can we build a better MIQ plan in case we ever have to do this again? The last one kinda sucked. It was fragile and would not scale. 
  • Vaccination rates have fallen off a cliff and measles is back. What does a robust and equitable vaccination programme look like? We used to have by-DHB targets for vaccination. It's all been downhill since those were abandoned. 
  • Public health starts with the local GP's office, but we're very short of GPs and few are coming through the pipeline. Every part of the system blames the others. No point in scaling up in the med schools as there aren't enough registrar positions. No point allowing foreign doctors to come in; there won't be registrar positions for them and they might not even stay. Why not expand the number of registrar positions? Not enough doctors who want to supervise 'em. Great big fun problem. How about easing back requirements for doctors from places like Canada so they can easily practice here? What about expanded scope-of-practice nurse-practitioners? 
Anyway. Lots of potential options.

The resurrected Public Health Advisory Committee will tackle access to healthy food and other factors that shape our eating habits as its first major project, Marc Daalder reports

Is New Zealand fulfilling people's right to healthy food?

That's one of the questions a new public health committee is striving to answer in its first major project.


Minutes from the committee's first meetings show it hopes to tackle big issues like climate change and rural health. However, Health Minister Ayesha Verrall asked it to investigate food environments as its first main topic of work. Under the terms of reference, the committee has to complete at least one major piece of work each year.

"This was a topic where expert advice on solutions would be beneficial. It was acknowledged that the topic was broad and complex, but there were factors in the food environment space causing harm to New Zealanders’ health. Food security issues were heightened through the Covid-19 pandemic and continue to cause pressure due to cost of living. The PHAC would need to think creatively," Verrall said, according to the minutes.

"Minister Verrall asked the PHAC to consider the food regulatory system, including food labelling and composition, acknowledging New Zealand’s regulatory system is joint with Australia through Food Standards Australia New Zealand (FSANZ)."

So I'll continue to be the only one wearing a mask at public sector events, and the Public Health Advisory Committee will be working on my right to healthy food and protecting people against the evils of ads for unhealthy foods. 

It's like the last three years didn't happen, and we're back in the spot where MoH is more interested in making sure DHBs can ban soda from the cafeteria than in ensuring there are vaccinated hospital staff during a measles outbreak

1 comment:

  1. Do you know why NZ and Australia decided not to combine their medicine regulatory authorities in 2014? NZ must be the smallest developed market with its own regulatory body.