Ministerial Statements — Swine Flu—New Zealand Response

I wish to make a ministerial statement under Standing Order 347 in relation to the global influenza situation and the responses here in New Zealand. As has been said, this is a time for concern and caution, not alarm.

On Saturday morning Air New Zealand flight NZ1 arrived in Auckland from Los Angeles at 5 a.m. On board was a school group from Rangitoto College travelling home from a trip to Mexico. Several of the students had flu symptoms. Their teacher insisted they see their doctors. Just a few hours later, at 12.30 p.m., one of those general practitioners contacted the Auckland Regional Public Health Service. The Auckland public health response centre was activated by 3 p.m., and by 6 p.m. a team of nurses had been assembled, equipped, and were out assessing the Rangitoto group. All were treated with Tamiflu and isolated with their families by 10 o’clock that night.

The Ministry of Health activated its coordination centre on that same day in accordance with the emergency Influenza Pandemic Action Plan, and the national Tamiflu stock at Middlemore Hospital was made available. On Sunday night, testing revealed that 10 of the Rangitoto College group had influenza A; swine flu is a subset of influenza A. Because of their recent travel to Mexico and a greater sense of caution, ministry officials decided that the group should be treated as probable cases of swine flu. Our health services’ response was rapid, thorough, and appropriate for the level of risk apparent at that time. The work of the past 4 years, preparing for a situation such as this, needs to be acknowledged. It is important to be clear that there are no confirmed cases of swine flu in New Zealand, but I am advised that at this point health authorities are operating as though there are.

The Rangitoto College samples are now being tested for H1N1 swine flu at the World Health Organization laboratory in Melbourne. To date, the Rangitoto College group’s flu symptoms have been mild, and all 10 are on the road to recovery. This is consistent with the pattern experienced so far in other countries outside of Mexico. Public health officials tell me that they have contact-traced almost all of the passengers on flight NZ1 who disembarked in Auckland. They have all been medically assessed, offered Tamiflu as a precaution, and asked to stay at home. Three students from Northcote College with flu-like symptoms, who also visited Mexico and returned home later that Saturday morning, have tested negative for influenza A. Public health officials were able to tell them and their families late last night that they are no longer at risk.

Since Sunday night, there have been doctors and nurses at Auckland Airport meeting all international flights arriving from North America, and passengers are being assessed. I am advised that as a result of the increasing international spread of swine flu, the Ministry of Health has asked that a statement providing information and advice on swine flu should be read on all incoming flights into New Zealand. In addition, the ministry has requested a travel health notice is given to all incoming passengers on arrival. Regional public health services around the country are supporting this effort. At last count, in addition to the 10 Rangitoto College students, 56 people are being monitored around New Zealand. Those suspected cases are being tested to see whether they too have influenza A.

The key public health message is this: people who have been in Mexico or the United States in the past fortnight and have flu-like symptoms should contact their general practitioner or a health professional. The Ministry of Health says that if people have flu-like symptoms and they have not been to Mexico or the United States in the past fortnight, then they should treat any flu symptoms as normal seasonal influenza—they should do what they would normally do. I have been advised in the past few minutes that later today the Ministry of Foreign Affairs and Trade will be upgrading its travel advisory to suggest that people defer non-essential travel to Mexico. The existing health measures are fully justified. Officials are ready for any escalation in the domestic or international swine flu situation. As this rapidly changing situation evolves, updates are being issued and press briefings are being held. This is a matter that the Government and officials are treating with the utmost caution and concern. This is a threat that New Zealand has planned for, and many of the best people in the New Zealand health services are working night and day to protect the health of our country.

I begin by assuring the Minister and the House that this is not a time for any political point-scoring when we have such an important issue facing our nation. I wish all speed to those who work in the health sector, and, of course, a return to full health for all those who are potentially affected. Those who work in the health sector are vital, and should be valued at all times.

I am very pleased to hear the Minister acknowledge the work that the previous Government started on pandemic planning in 2002, with Operation McGill in 2007 involving the whole emergency management health sector. We increased the public Tamiflu stocks from around 800,000 to 1.2 million in March 2007, from coverage of 20 percent of the population to 30 percent—a fact that I recall the current Minister of Health criticising at the time. He now understands the importance of that point.

I am concerned about the vulnerability of the entire spectrum of the health services under the current proceedings. Pandemic modelling and the rehearsal have shown time after time that hospital-based services can quickly become overwhelmed if we do not ensure that community-based and home-based services are supported and are in place. We know, from the district health boards’ latest plans, that those are the very services that are being cut. The services that make the delivery of a pandemic response possible are the ones under threat.

I also remind the Minister of Health of the comments from Ian Powell, the executive director of the Association of Salaried Medical Specialists, when he talked about the range of staff who are critical in the health sector. He said: “It is one of the major concerns of our members, who would rather be underpaid specialists than overpaid secretaries.”

To all the health workers, I say the focus and intensity of this work is significant and will be supported, I am sure, by every party in Parliament. I thank the Minister for the acknowledgment of the work over the last 6 years. I also thank him for his generous offer of a briefing on this issue. That is appreciated by me, as well. I recommend respectfully that he reflect now on how critical the support workers in the health system, who are otherwise often known as backroom workers, are to the delivery of health services for all New Zealanders and ensure that they continue to be valued for the critical role that they play in delivering health services in our nation.

I wish to begin by joining the Minister and the Hon Ruth Dyson in conveying the Green Party’s very best wishes to the health professionals, and to those who have been affected by this infection to date, for a speedy recovery, and for all possible strength to their arm for those fighting to combat the epidemic. At this time it is uncertain what the course of this global pandemic will be. Its spread is uncertain, but it already appears to be extensive, suggesting that containment will be difficult. The nature of the virus is also uncertain. It is clear that it has significant ability to develop or strengthen particular characteristics through mutation, and that means there are particular risks associated with this virus that we need to prepare for.

It is at a time like this that we indeed must be grateful for the pandemic planning that has been undertaken over the past several years, and I pay tribute to the previous Government. I also bring to the House’s attention the Green Party’s contribution towards that pandemic preparedness. I had some personal part to play in some of the pandemic preparedness exercises and I can assure the House that district health boards have taken this process extremely seriously.

It is critical that we maintain a sense of perspective. It is inevitable that at some point there will be a further influenza pandemic that will cause very substantial illness and death. It is possible that this could be it, or that it could develop into such a pandemic. But it is crucial that all New Zealanders understand that in fact influenza causes illness and death at a substantial level around the world every day. It is essential that our response takes seriously the risk that this poses, while at the same time not fuelling a sense of panic about that risk.

I am aware that there will be questions about the timeliness of response; I am sure that those will be addressed at some point in the future. But, for now, our focus must be on the process going forward, and on minimising the impact of this epidemic for New Zealand. For my own part, I know a number of the officials involved in this process. I have a great deal of trust in their judgment, and I believe that New Zealanders can be confident in their work. What is most required now is a commitment from all political parties to act together to minimise the impact of this epidemic, and in that spirit I offer the Green Party’s cooperation to the Government, in any way that we can be helpful in minimising the impact of this epidemic. Thank you.

I respond on behalf of the ACT Party to the ministerial statement. The Minister of Health is quite right when he says that balance is important; this is a time for caution but not alarm. I would like to congratulate the health professionals involved, who to date have so swiftly, efficiently, and appropriately dealt with this threat to the New Zealand population. Pandemic planning, in fact, is very important, and we find ourselves well-prepared because of the 4 years of work that has gone on in relation to, firstly, the perceived threat of bird flu in 2005.

One of the most important things to do, I think, in this sort of situation is to educate people about the threats, and to tell them what they need to do to keep themselves and those around them safe in situations like this. I think there is a lot of confusion about how viruses that are usually confined to animal populations can suddenly find themselves operating in human populations. The swine influenza virus is usually endemic, obviously, to pig populations, but it can mutate into a form that allows it to pass from human to human. The United States Centers for Disease Control and Prevention report that the symptoms of swine flu are much like those of any seasonal flu—commonly, fever, lethargy, lack of appetite, and coughing. Some people with swine flu have also reported runny noses, sore throats, nausea, vomiting, and diarrhoea. As has already been pointed out, it is important when someone has influenza to treat those symptoms sensibly, and those education messages should be put out amongst the general population. Affected people are most contagious during the first 5 days.

It is also important that people do not panic and suddenly worry about the food supply. Swine flu cannot be spread by pork products, because the virus is not transmitted through food. These viruses—bird flu and swine flu—seem to be descendants of the 1918 influenza outbreak. I think it is important to take a sensible approach to these things, to monitor the situation carefully—as we are doing here in New Zealand—and to take advice from organisations like the World Health Organization. Thank you.

The Māori Party expresses its concern for those who have been affected by the swine flu virus. Long before our lifetimes, but part of the legacy left by the generation of our parents and grandparents, was a period of time referred to as Black November. That was when 8,573 New Zealanders lost their lives in the 1918 influenza epidemic. So we need to be cautious and we need to be careful. I understand that history, because every time we go to Parewanui we see in one of the urupā the tragic shape of the very small coffins that carried our children to their final resting place.

We must not alarm the general public unnecessarily, but we have every reason to be cautious. I guess the most important thing is that people have good access to information, and I believe that the Ministry of Health is providing that. The two biggest factors for vulnerability to swine flu are, of course, having recently visited Mexico, and exposure to somebody with swine flu. There is an added concern around the similarity of the symptoms and effects of swine flu and those of the traditional flu, which hits hard in winter. So we must be careful, we must be vigilant, and all of us must execute caution.

The announcement of the precautions that are being taken by the students and staff who returned from Mexico at the weekend could have provoked undue alarm. I recognise the important role that being prepared with pandemic planning has played in New Zealand’s response. The fact that we had a plan already in place meant that the action could immediately take place, as announced earlier by the Minister of Health. We are not out of the woods by any means, but if there is one message that we should take from this situation, it is the vital importance of being prepared. I finish off by saying that we should not use this issue as an opportunity to play politics.

I want to make a very brief comment on the Minister’s statement. Firstly, I share with colleagues the sense of support and anguish for the health workers and the people who are at risk at the moment. This is a very stressful time for all. Our thoughts must be with them, and we wish those who are at risk a speedy recovery. Secondly, I acknowledge the preparedness that has been put in place over the last 4 years, which means that New Zealand is in a position to respond strongly if, in fact, a pandemic is confirmed.

Thirdly, and perhaps finally, I make this point: a number of the contributions this afternoon have, quite properly, stressed the need to move prudently and soberly with regard to this issue. We cannot be in a mode of causing undue alarm or panic, but we do need to be vigilant about its potential implications. In this regard, the news media have a very powerful role to play. I would urge the media to think very carefully about how they handle this situation. I do not think that, for instance, the sensationalism of Television New Zealand’s approach on Sunday evening, and again last night, is actually helpful in terms of conveying accurate public information, or also in downplaying an element of public fear and anxiety. I urge our broadcasters and our news media to take very seriously their responsibilities to inform people accurately about what is happening, and to not take this as an opportunity to ramp up the way in which they make good television or write exciting newspaper articles. This issue is far too serious for that. We serve our people well when we do the best by them, not when we try to make a dangerous situation more serious.

I acknowledge the contributions of all members on this quite serious issue, and the offers of further contribution from the Opposition parties.

To pick up on the point from Mr Dunne—without commenting on any specific cases—I say that the New Zealand media actually have been doing their level best to assist us in providing clear and consistent public health messages to New Zealanders. Their role is important because it is quite clear that we cannot trace everybody who may have an issue here. Although there may be some criticism about individual cases, the messages that the media are providing are still fundamental and important to the public health message.

I also acknowledge members’ recognition of our front-line health staff and the work that they are doing. Thank you.