Photo by Iler Stoe
Photo by Iler Stoe

Bracing for novel coronavirus on NZ shores – Expert Reaction

The New Zealand government is going against World Health Organization recommendations by restricting entry to passengers from mainland China.

The WHO has recommended against restricting travel to China, saying it could cause more harm than good by hindering information sharing, medical supply chains and harming economies.

A flight evacuating New Zealanders from Wuhan is also set to arrive in Auckland on Wednesday afternoon, and the passengers will be quarantined at Whangaparaoa Military Training Facility.

Meanwhile concerns are being raised about coronavirus misinformation running rampant across social media.

The Science Media Centre has gathered expert comment on these topics.

Associate Professor Patricia Priest, Department of Preventive and Social Medicine, University of Otago, comments:

“The WHO recommendation takes into account the potentially significant costs (financial and otherwise) of closing borders, and uncertain benefits in terms of preventing 2019-nCov entering the country.

“While in general following WHO recommendations is the right thing to do, countries do need to make their own decisions given their particular situation. There are a number of unknowns about the new coronavirus which make it difficult to be sure what the best response will be if – or when – there is a case in New Zealand, and so there is an argument that we should err on the side of a more vigorous response to try to ‘keep it out’, as more information becomes available.

“Early identification and isolation of people who are infected is the mainstay of management once it’s clear that the 2019-nCov is in New Zealand. However, if we assume that no one carrying it has yet entered the country, and given the likelihood that border screening would not prevent it from doing so, the most effective way to prevent entry of the virus into the NZ population is to prevent people who might be infected from mixing with the population. This should be achieved by the government’s current strategy, if everyone who is asked to self-quarantine for 14 days does so.

“On the other hand, there are a number of downsides to closing the border to large groups of incoming travellers, and this level of restriction is likely not sustainable – particularly if widespread human-to-human transmission of 2019-nCoV starts happening in other countries. It is appropriate that, if a policy of limiting entry is put in place, it is for a fixed period of time, with regular review, with a view to amending policy as more information about the virus becomes available.”

No conflict of interest.

Dr Sarb Johal, psychologist, comments:

“Central to the goal of keeping people psychologically well during their time in confinement in a quarantine facility will be the fact that social support has been found, over and over again, to be the most important factor when people go through some kind of emergency. So, availability of facilities like wifi, real-time video calls, messaging systems, as well as offering structure and routine to help people occupy themselves usefully, or at least comfortably, during their days and nights become critical to the success of the quarantine period.

“However, if people feel cornered or blamed, then they’re more likely to hide away, and possibly break quarantine to try to get support, or because they feel scared and targeted.

“Training healthcare workers with psychosocial and counselling skills, and/or having native speaker counsellors available will be important too. There is still considerable stigma around mental health services, and this may be especially true for people from Asian communities – so how this is framed and offered becomes critical. More widely, countering stigmatising reports in the media or hearsay and incorrect and mischievous or malicious content on the internet is very challenging but really important in today’s highly networked environment.

“Making sure things like medicines are at hand and not locked away in baggage that is not easy to access or lost needs to be made clear at point of transit to the quarantine facility. Food that is acceptable to the people being quarantined is also important – having control over such a basic item goes a long way in improving wellbeing and sense of comfort, and is a really quick way to reinforce people’s lack of agency if you get this wrong.”

No conflict of interest. Note:  Dr Johal is a clinical psychologist who has been working in the field of Psychosocial Support and Recovery in Disasters since 2006. He was the lead writer for the UK Pandemic Preparedness Plan published in 2011 and led the teams on the NZ plans for pandemic preparedness and psychosocial support & recovery, published in 2007 & 2016.

Professor Michael Baker, Department of Public Health, University of Otago, comments:

“Given the high level of uncertainty around the characteristics of this new disease it is wise for NZ to take a precautionary approach with imposing travel restrictions. This is especially so since NZ is the main gateway to several Pacific Island nations, some of whom have recently been struggling with imported measles epidemics.

“If this new coronavirus continues to spread around the world and starts causing sustained transmission and deaths in multiple countries, then NZ will need to further refine and potentially extend border controls. Such enhancements could buy extra time so that we can learn more about this disease and about treatments for it. Ultimately an effective vaccine may become available in several months’ time.

“We note that like many other countries, NZ’s new travel restrictions do not fit with current World Health Organization advice. This is probably justified as WHO advice is very broad and does not differentiate between types of countries. For example, New Zealand, as an island nation, does not have a problem with people illegally crossing land borders. We are therefore in a much better position than most countries to benefit from travel restrictions and other border control measures. On the other hand, tourism is a key industry for New Zealand so the Government needs to take the economic impact into consideration and be ready to quickly remove travel restrictions if the health risks are clearly shown to justify this.

“The International Health Regulations recognise that states may implement additional health measures such as travel restrictions at borders. These states are obliged to send WHO the public health rationale and justification. WHO can review and challenge such actions and will also share such information with member states.”

No conflicts of interest to declare.

Professor Nick Wilson, Department of Public Health, University of Otago

“It is good that these travel restrictions are reviewed regularly – as the Government is proposing – to determine if they need to be reduced or expanded upon.

“An added benefit of implementing border controls is that it helps test and refine these health protection systems in case a much more serious pandemic arises in the future – for example from a synthetic bioweapon.

“Now is also a good time for the government to invest more in public health messages around the importance of hand washing, coughing into your elbow, and staying away from work if you are sick. These measures can all work to reduce the spread of respiratory viruses including coronavirus and influenza. Even stopping smoking will reduce the risk of such respiratory infections.

“In case this new coronavirus does become established in New Zealand, we should begin preparing now to protect Pacific Island nations with exit screening and even making shared decisions with Pacific Island Governments about cancelling flights. We also need to consider how best to protect and treat vulnerable populations in New Zealand, particularly those in older age groups with chronic diseases.”

No conflicts of interest to declare.

Professor Ekant Veer, Department of Management, Marketing and Entrepreneurship, University of Canterbury

“Social media platforms offer an extremely cost effective means to spread news; however, as we have seen with many cases of medical information, sometimes the information being spread does not have a scientific basis. Fear and concern spreads faster than many infectious diseases, which can make a public health response problematic.

“As a result of the novel coronavirus we have seen instances of racism spreading on social media as incorrect medical advice that may give people a false sense of security. This occurs when the people spreading the information are often trusted (e.g. friends or whānau), there is lots of public support for the information (through likes/shares/positive comments), the people reading the information are not well versed in medical science and there’s a lack of information being spread by medical professionals (especially ones who are not trusted). So, when a prominent and trusted medical professional, like Dr Lance O’Sullivan, sends messages via social media there is a lot of support – however, the same message from the WHO, which has not established the same level of trust and engagement in a community as Dr O’Sullivan, may be ignored.

“Both Facebook and Twitter have been making in-roads in trying to stifle ‘fake-news’ in recent months but this is still difficult to police and by the time a post has been removed there may have been a significant number of people who have been convinced of the mis-information and, when it’s removed, there is a secondary concern that now the social media platform is part of a wider ‘conspiracy’ to silence public voice etc. In reality, they are acting in a responsible manner to ensure information is timely and accurate based on scientific knowledge.”

No known conflicts of interest with the kaupapa of this story.