Latest / The SME Stream / The impact of winter illnesses on our health system, and how you can avoid getti

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The impact of winter illnesses on our health system, and how you can avoid getti · The SME Stream

• 0:05
  Speaker 1: Kyoda. I'm Georgina Campbell in for Chelsea Daniels and this
• 0:09
  Speaker 1: is the Front Page, a daily podcast presented by the
• 0:13
  Speaker 1: New Zealand Herald. Does it seem like people are a
• 0:19
  Speaker 1: bit sicker than usual this winter? It's been the talk
• 0:22
  Speaker 1: of offices around the country as people seem to be
• 0:26
  Speaker 1: falling sick and staying sick for longer than usual. And
• 0:30
  Speaker 1: it's not just COVID that is continuing to claim lives,
• 0:34
  Speaker 1: with The Herald reporting on two cases in the past
• 0:37
  Speaker 1: months of people dying suddenly after developing flu symptoms. So
• 0:45
  Speaker 1: how bad are the bugs and diseases going around our
• 0:48
  Speaker 1: TETO this winter and what do we need to know
• 0:51
  Speaker 1: to be vigilant about our health today? On the Front Page,
• 0:56
  Speaker 1: we're joined by doctor Lucy Talfa Barnett, an epidemiology with
• 1:00
  Speaker 1: the University of Otago's Department of Public Health, and doctor
• 1:04
  Speaker 1: Brian Betty, Chair of General Practice New Zealand. I just
• 1:12
  Speaker 1: want to start by acknowledging two deaths that The Herald
• 1:16
  Speaker 1: has reported on recently. William Jones, a sixteen year old
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  Speaker 1: from Rolliston, died a few days after developing a sore
• 1:24
  Speaker 1: throat and cough and willing to nurse. Maria pack Lennard
• 1:28
  Speaker 1: died after catching influenza type A. Both really tragic cases. Brian,
• 1:34
  Speaker 1: How does the flu become fatal and how common is
• 1:37
  Speaker 1: it that it does?
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  Speaker 2: Look, I mean, I think one of the things I
• 1:40
  Speaker 2: see in that in my clinic is people underestimate, I think,
• 1:44
  Speaker 2: the potential for the influenza or the flu to cause
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  Speaker 2: harm the confuser with things like the common cold, where
• 1:50
  Speaker 2: the symptoms are a lot often a lot less, but
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  Speaker 2: the flu can be severe, especially for the elderly, especially
• 1:57
  Speaker 2: for those with underlying conditions, and as you've just described, younger, fit,
• 2:02
  Speaker 2: healthy people. In fact, University of Tago Michael Baker, in
• 2:06
  Speaker 2: the study they did estimated about possibly five hundred people
• 2:09
  Speaker 2: a season of flu season could actually die from the flu. So, look,
• 2:14
  Speaker 2: it's a potentially dangerous virus, and I think it's very
• 2:19
  Speaker 2: much underestimated in terms of people's perceptions of its potential
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  Speaker 2: for harm.
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  Speaker 1: And what symptoms separate the flu from say a could Look.
• 2:30
  Speaker 2: I think there's a couple of things here, but one
• 2:33
  Speaker 2: in particular is probably the speed of onset. That's certainly
• 2:36
  Speaker 2: a differentiator. So often with a cold it will come
• 2:39
  Speaker 2: on gradually, over a couple of days, you know, you'll
• 2:41
  Speaker 2: get this slight sore throat, the bit of a cough,
• 2:44
  Speaker 2: the runny nose, those sort of cluster of symptoms start
• 2:47
  Speaker 2: to happen. Often what people describe with the influenza is
• 2:51
  Speaker 2: the will be okay in the morning, in the afternoon,
• 2:53
  Speaker 2: very suddenly over a few hours they'll get you a
• 2:57
  Speaker 2: very severe Often muscle ache is one of the things
• 2:59
  Speaker 2: people describe, headache, dry cough and temperature and start to
• 3:05
  Speaker 2: feel miserable. But it's the speed with which it comes
• 3:08
  Speaker 2: on is probably a key differentiator in terms of what happens.
• 3:13
  Speaker 2: And also the body ache or the must lake is
• 3:15
  Speaker 2: another thing that we often see, so that differentiator is
• 3:18
  Speaker 2: probably the key too. Things that I think we start
• 3:20
  Speaker 2: to see.
• 3:21
  Speaker 1: And Lucy, what sort of winter illnesses are we seeing
• 3:25
  Speaker 1: spread around the country this season? Is there anything in
• 3:28
  Speaker 1: particular we should be keeping an eye on.
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  Speaker 3: So the distribution of the respiratory illnesses this year, it's
• 3:34
  Speaker 3: really the same viruses that we see every winter. With
• 3:38
  Speaker 3: the new edition of COVID in the mix as well,
• 3:42
  Speaker 3: we're seeing a fair amount of the influenza A as
• 3:46
  Speaker 3: you mentioned earlier, particularly the H one N one strain
• 3:50
  Speaker 3: came through earlier in the season, and now we're seeing
• 3:52
  Speaker 3: the H three N two strain has started to come through.
• 3:55
  Speaker 3: All these better numbers, but also some RSV was coming
• 3:59
  Speaker 3: through July two, though that might be petering off now
• 4:02
  Speaker 3: and Brian might be able to comment more on the
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  Speaker 3: differences between RSV and flu.
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  Speaker 1: Yeah, what are those differences, Brian?
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  Speaker 2: Look. RSV can cause certainly severe disease, especially with young children,
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  Speaker 2: that's what we tend to see, and with the elderly again,
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  Speaker 2: but again it's those key things that I sort of
• 4:19
  Speaker 2: mentioned that often the severity of the symptoms that muscleate,
• 4:22
  Speaker 2: the headache, the temperature with that very rapid onset, and
• 4:26
  Speaker 2: people feel really unwell with it RSB. Sometimes not. It
• 4:30
  Speaker 2: can cause a cough. It can be quite severe obviously
• 4:33
  Speaker 2: in terms of lower respiratory tract infections, which is the lungs.
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  Speaker 2: But the flu. I mean, you know the conversation I
• 4:39
  Speaker 2: have with patients when I offer them the flu bags
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  Speaker 2: and they say, well, oh, look, I've never had the flu.
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  Speaker 2: I just get a mild cold and it's all okay.
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  Speaker 2: Often they have actually experienced a full blown influenza infection,
• 4:51
  Speaker 2: and once you've had it, you don't want it again.
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  Speaker 2: It can go on for seven to fourteen days. It
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  Speaker 2: can really lay you low down in bed, you can't
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  Speaker 2: do much, would feel miserable. It really is full on.
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  Speaker 2: So it is not something you really want to catch.
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  Speaker 2: If it's going to be in that severe end of
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  Speaker 2: the speak you know, for the oldly, some younger people,
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  Speaker 2: it can end up in hospitalization ICU, and an extreme examples, tragically,
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  Speaker 2: it can end in death with those very severe lung
• 5:22
  Speaker 2: infections that accompany it.
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  Speaker 4: She's contracted the flu virus and effectively something else has
• 5:33
  Speaker 4: then been added to that issue. So then she has
• 5:36
  Speaker 4: got very very sick, very quickly, and unfortunately passed away
• 5:42
  Speaker 4: at her house. Basically, what I would like people to
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  Speaker 4: know is that these two people were very fit people.
• 5:48
  Speaker 4: They both went into health decline very quickly. So what
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  Speaker 4: I would suggest for people to do if they get
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  Speaker 4: the symptoms of flus to get checked out by health professional,
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  Speaker 4: and I think don't second. I think if there's any doubt,
• 6:02
  Speaker 4: there is no doubt. So if they think they need
• 6:04
  Speaker 4: to go to hospital, they need to be there quickly.
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  Speaker 3: The other thing that I just mentioned there also with
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  Speaker 3: the flu is with that paper where we talked about
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  Speaker 3: the five hundred deaths a year attributable to the influenza virus.
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  Speaker 3: A number of those deaths weren't necessarily from obvious flu infections,
• 6:24
  Speaker 3: although the person clearly had come into contact with the virus.
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  Speaker 3: But they were dying of things related to the circulatory system,
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  Speaker 3: so dying from heart attacks or other things in that space,
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  Speaker 3: and not necessarily attributed to flu when they died.
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  Speaker 1: So when should people seek medical attention in terms of
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  Speaker 1: preventing the worst from happening if they are sick.
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  Speaker 2: Yeah, that's a good question. I look for the most part, again,
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  Speaker 2: there's a range of ways this presents in the spairing
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  Speaker 2: we've talked about. I think for most people it can
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  Speaker 2: be managed very effectively at home. The big first message
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  Speaker 2: is to stay at home, not to go out and
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  Speaker 2: spread it. That's really really important something we learned in COVID.
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  Speaker 2: It's something we should continue to do. Don't go to
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  Speaker 2: work and spread it. I think it can be managed
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  Speaker 2: with simple analges like paracetamol, of rufin. Plenty of fluids
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  Speaker 2: is really really important in rest. I suppose where advice
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  Speaker 2: should be sought is if there's a particularly severe headache,
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  Speaker 2: that isn't responding to those simple analges is a very
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  Speaker 2: high temperature that isn't responding to things like paracetamol, rufin
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  Speaker 2: or in particular, especially with younger or older patients, where
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  Speaker 2: they're not drinking or not taking on fluids, that's often
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  Speaker 2: a pretty key sign. And the other thing is any
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  Speaker 2: type of really severe headache with drowsiness or anything like that.
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  Speaker 2: A rash is the other thing. If I rash develops,
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  Speaker 2: then definitely medical attention. But really, if the simple treatments
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  Speaker 2: are not settling things down, it's getting worse. There's any
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  Speaker 2: sort of respiratory distress that is with breathing or not
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  Speaker 2: taking in fluids, then definitely you should be bringing health
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  Speaker 2: Life or bringing your general practice to give advice or
• 8:04
  Speaker 2: obviously in very severe cases than after ours or ed
• 8:08
  Speaker 2: in extreme cases. But I mean, those are probably the
• 8:10
  Speaker 2: critical things to start to look for.
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  Speaker 1: Unfortunately, just because our health system is under such strain
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  Speaker 1: at the moment, it's not necessarily easy getting an appointment
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  Speaker 1: with your GP. I wonder if either of you could
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  Speaker 1: talk about the broader impact of winter illnesses at the
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  Speaker 1: moment on our health system.
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  Speaker 2: Look, I'm quite happy to make a couple of comments
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  Speaker 2: and perhaps throw to Lucy, but certainly general practice around
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  Speaker 2: the country has seen a lot of respiratory illness at
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  Speaker 2: the moment. Our Clinic in Eastporror runs a respiratory clinic
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  Speaker 2: that is invariably full throughout the day. We have overflow,
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  Speaker 2: We give advice on the phone, but still a number
• 9:00
  Speaker 2: of people end up at after ours, which puts pressure
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  Speaker 2: on after ours and we've seen that around the country
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  Speaker 2: and often emergency departments and hospital admissions, and we've seen
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  Speaker 2: that up in Auckland where there's been a high rate
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  Speaker 2: of hospital admissions due to influenza or flu like illness.
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  Speaker 2: So it does put a large burden on both general
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  Speaker 2: practice and on the hospital system itself and produces quite
• 9:23
  Speaker 2: a bit of strain. Again, I'll make the point that
• 9:26
  Speaker 2: if you cannot get through to your general practice or
• 9:29
  Speaker 2: get an appointment and you're concerned, then actually Healthline NOO
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  Speaker 2: eight one hundred national number is a good place to ring.
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  Speaker 2: There will always be a nurse on the phone to
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  Speaker 2: talk you through what's happening and to see whether you
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  Speaker 2: do need to seek urgent medical attention.
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  Speaker 3: Yeah, and I'd add in there that yes, you know
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  Speaker 3: the hospitals are seeing a peak possibly about a week ago.
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  Speaker 3: Hopefully it might have peaked me coming down again, but
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  Speaker 3: there was a real bump in those flu hospitalizations around
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  Speaker 3: that time, and it does put a real pressure on
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  Speaker 3: the hospital systems, and you know, you see other services
• 10:01
  Speaker 3: being delayed or canceled because they're needing to make room
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  Speaker 3: for those respiratory cases coming in.
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  Speaker 1: And ESR data released a few weeks ago, as you say,
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  Speaker 1: showed the biggest single week spike in hospitalizations in Auckland
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  Speaker 1: for serious acute respiratory illness since twenty.
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  Speaker 5: Fifteen winter illnesses and COVID nineteen of filling up our hospitals.
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  Speaker 5: Otago University Brovisa of Public Health Michael Baker says, it's
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  Speaker 5: been caused by a perfect storm of disease behavior.
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  Speaker 4: It's happened to be a very bad for a year.
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  Speaker 4: We've got the usual RSD and O list between infections,
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  Speaker 4: but we're also seeing this is a new phenomenon. We're
• 10:41
  Speaker 4: seeing COVID nineteen also peaking at the same time.
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  Speaker 1: That aligns with what people I think are hearing anecdotally
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  Speaker 1: about a lot of people getting sick and staying sick
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  Speaker 1: for quite a long time. My producer knows a few
• 10:58
  Speaker 1: people who've been sick for a month and it seemed
• 11:00
  Speaker 1: to be getting better. Lucy, is this usual or are
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  Speaker 1: things worse than normal?
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  Speaker 3: Well, we have had a few years where it's been
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  Speaker 3: less severe the particularly around twenty twenty twenty twenty one,
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  Speaker 3: the flu went away, and I think it was easy
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  Speaker 3: for us to kind of think that was the new normal.
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  Speaker 3: It is normal to have peaks in the winter and
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  Speaker 3: respiratory illness, but we have seen a particularly sharp rise
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  Speaker 3: and rather than kind of creeping up slowly, it's going
• 11:27
  Speaker 3: to come on all at once, and that may be
• 11:28
  Speaker 3: part of the shock that we're experiencing. But Brian might
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  Speaker 3: like to comment on whether there's any sort of sign
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  Speaker 3: that the flu that's around this year is lingering longer
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  Speaker 3: than usual.
• 11:37
  Speaker 2: Yeah, Look, it's a good question, and certainly what you've
• 11:40
  Speaker 2: described about people being unwell with cough and persistent symptoms
• 11:46
  Speaker 2: over three to four weeks, we've actually seen that in
• 11:48
  Speaker 2: our practice that occurring.
• 11:50
  Speaker 3: Now.
• 11:51
  Speaker 2: I suppose the point I'd make it may not be
• 11:53
  Speaker 2: due to the influenza virus itself, which usually runs for
• 11:55
  Speaker 2: about fourteen days, but there is a mix of other
• 11:58
  Speaker 2: viruses that are running around. You've still got your covid,
• 12:01
  Speaker 2: you've still got your RSP, you've still got your adinoviruses,
• 12:04
  Speaker 2: and hooping cough is actually out there as well. We've
• 12:06
  Speaker 2: sent a couple of cases of hooping cough where you
• 12:08
  Speaker 2: get this persistent cough which does go on for weeks.
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  Speaker 2: So there's this real mix that's going on. And often
• 12:14
  Speaker 2: we don't do a definitive diagnosis in terms of swabs
• 12:18
  Speaker 2: and things, so we don't know exactly what's causing the
• 12:20
  Speaker 2: cluster of symptoms. But certainly we have seen some cases
• 12:24
  Speaker 2: of people just you know, just with these persistent symptoms
• 12:27
  Speaker 2: or getting better and then developing more sort of respiratory
• 12:31
  Speaker 2: flu like symptoms, and that has been a feature this year.
• 12:35
  Speaker 1: And Lucy, the other thing that I wanted to talk
• 12:38
  Speaker 1: to you about was whether covid in our closed borders
• 12:42
  Speaker 1: has had any impact on our immune systems.
• 12:46
  Speaker 3: So no, no is the short answer. The more complicated
• 12:51
  Speaker 3: answer is that we had a couple of years where
• 12:54
  Speaker 3: we didn't have any flu at all, which was quite impressive,
• 12:58
  Speaker 3: and so when the flu came back again, as it
• 13:01
  Speaker 3: inevitably does, it, it meant that we hadn't been exposed
• 13:06
  Speaker 3: to it as recently, so we were potentially able to
• 13:10
  Speaker 3: catch it again. So normally, when if you catch flu,
• 13:13
  Speaker 3: if you maybe get a mild dose or a severe dose,
• 13:17
  Speaker 3: then that gives you some immunity for the next few
• 13:19
  Speaker 3: years and then you become a bit more susceptible again.
• 13:23
  Speaker 3: So none of us had flu for those two years,
• 13:25
  Speaker 3: and so that susceptibility built up, but our immune systems
• 13:28
  Speaker 3: are still functioning just as well as they were before.
• 13:32
  Speaker 1: From you both, what would your key advice be to
• 13:36
  Speaker 1: people listening who are concerned about, you know, just getting sick,
• 13:41
  Speaker 1: or who aren't sure what to do to shake the
• 13:43
  Speaker 1: bugs they already have.
• 13:45
  Speaker 2: For me, quite simply get a flu vaccination every year,
• 13:50
  Speaker 2: and in fact you still can get one again. It's
• 13:52
  Speaker 2: this thing with patients often or people see who underestimate
• 13:56
  Speaker 2: potential for flue and say, oh, look, I don't need
• 13:58
  Speaker 2: a flue vaccination. I never get it. Look. I think
• 14:01
  Speaker 2: vaccination is incredibly important in two areas, one flu and
• 14:04
  Speaker 2: the other one with COVID and with children their routine
• 14:08
  Speaker 2: childhood immunizations are really really important. I think for those
• 14:12
  Speaker 2: people that can't shake residual symptoms, you know, whether it
• 14:16
  Speaker 2: be a cough or just feeling slightly unwell or fatigued
• 14:19
  Speaker 2: or run down post and infection. Generally speaking, those will
• 14:24
  Speaker 2: just improve over time, and it can be very, very frustrating.
• 14:27
  Speaker 2: You can use those symptomatic treatments from the chemist, like
• 14:30
  Speaker 2: cough mixture and as I've mentioned, parasitamal and things and
• 14:33
  Speaker 2: plenty of fluids, and often it's just rest and time
• 14:36
  Speaker 2: to get through them. Often by the time you get
• 14:38
  Speaker 2: to week three or four, if you have got those
• 14:40
  Speaker 2: type of symptoms, you're certainly not infectious at that stage,
• 14:44
  Speaker 2: but it does become a time issue, and generally you
• 14:46
  Speaker 2: see people just slowly improve over time.
• 14:49
  Speaker 3: You know, I'd absolutely reiterate the endorsement for vaccinations. There's
• 14:53
  Speaker 3: a really good match this year between the strains of
• 14:57
  Speaker 3: flu that are protected against in the vaccine nation and
• 15:00
  Speaker 3: the strains of flu that are in the community, so
• 15:03
  Speaker 3: that vaccination really will reduce your chances of getting flu
• 15:08
  Speaker 3: or getting a severe case of flu. So definitely worthwhile.
• 15:13
  Speaker 3: Staying home when sick has been mentioned so that you're
• 15:15
  Speaker 3: not spreading it to other people. And then the other
• 15:18
  Speaker 3: thing that you can think about doing, particularly if you're
• 15:21
  Speaker 3: catching public transport to work, think about wearing a mask.
• 15:24
  Speaker 3: It works for the flu and for other respiratory viruses
• 15:27
  Speaker 3: just as well as it does for COVID. So if
• 15:30
  Speaker 3: you're in those spaces where there's not necessarily great ventilation
• 15:34
  Speaker 3: and you're with a bunch of people who you wouldn't
• 15:36
  Speaker 3: necessarily spend a lot of time with, those are spaces
• 15:38
  Speaker 3: where you're going to come into contact with virus that
• 15:41
  Speaker 3: you wouldn't necessarily come into contact with otherwise. So if
• 15:45
  Speaker 3: you make the choice to mask up in those spaces,
• 15:48
  Speaker 3: you are reducing your risk of catching whatever's going around.
• 15:52
  Speaker 3: And apart from that, the things that we do to
• 15:56
  Speaker 3: prevent flu are the same as what we need to
• 16:00
  Speaker 3: do to prevent respiratory viruses in general. It's staying warm,
• 16:04
  Speaker 3: which doesn't obviously, you know, it's not that getting cold
• 16:07
  Speaker 3: makes you sick. It's just that when you're warm, you're
• 16:10
  Speaker 3: less likely to be susceptible to those viruses that you
• 16:13
  Speaker 3: come into contact with, and staying dry for the same reason,
• 16:17
  Speaker 3: and ventilating the spaces that you're in so that the
• 16:20
  Speaker 3: viruses that are floating around in the air are ventilated
• 16:24
  Speaker 3: out into the outdoors where they won't do so much harm. Look,
• 16:30
  Speaker 3: you know. I mean, I could go into the weeds
• 16:32
  Speaker 3: of it and say we need a national respiratory strategy
• 16:35
  Speaker 3: so that we're better prepared for future pandemics. Back before COVID,
• 16:40
  Speaker 3: we all thought that the next pandemic that was coming
• 16:42
  Speaker 3: would be a flu pandemic and things would pop up
• 16:45
  Speaker 3: from time to time that we thought or it like
• 16:47
  Speaker 3: the swine flu. If you remember that, it still could
• 16:51
  Speaker 3: happen at any time, and we need a strategy with
• 16:54
  Speaker 3: that in mind, and also just for managing respiratory illness
• 16:57
  Speaker 3: on a year to year basis. There's other things you
• 17:00
  Speaker 3: can get into as well. We would love to see
• 17:03
  Speaker 3: all schools having air filters in their spaces because schools
• 17:07
  Speaker 3: are just breeding growths through respiratory virus going and they
• 17:10
  Speaker 3: really do contribution to spread and virus in the community
• 17:13
  Speaker 3: as well. But the interest in doing that seems fairly low,
• 17:16
  Speaker 3: So we'll see what happens.
• 17:18
  Speaker 1: Lucy and Brian, thanks for joining us. That's it for
• 17:26
  Speaker 1: this episode of the Front Page. You can read more
• 17:29
  Speaker 1: about today's stories and extensive news coverage at zidherld dot
• 17:34
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• 17:38
  Speaker 1: Sills and sound engineer Patti Fox. I'm Georgina Campbell. Subscribe
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