Cases of respiratory illnesses like Covid-19 and influenza have been creeping up as the days get colder.
Hospitalisations for severe respiratory infections are trending upward, as are calls to Healthline about influenza-like illnesses, according to ESR surveillance.
The SMC asked experts for comment.
Dr Janine Paynter, Senior Research Fellow, General Practice and Primary Healthcare, University of Auckland, comments:
“The trends look reasonably consistent with the seasons in years pre-covid (slightly higher). There is marked inequality in rates with Māori and Pacific Peoples bearing the brunt of illness.
“Influenza looks to be the strongest contributor to the increasing trend in hospitalisations rather than Covid-19.
“Vaccination uptake for those aged over 65 years of age is suboptimal and below the 75% target – with significant inequities. This is disappointing given this is one of the best ways to protect people from serious illness due to the influenza virus including more serious consequences of respiratory illness such as heart attacks.”
Conflict of interest statement: “I work on research projects funded by GSK. Have given a seminar on behalf of CSL Seqirus. Have attended advisory board meetings for CSL Seqirus and Novavax. Funds for these were paid to my employer, The University of Auckland.”
Professor Michael Plank, School of Mathematics and Statistics, University of Canterbury, comments:
“It’s winter and the three biggest respiratory viruses – Covid-19, influenza and RSV – have all increased in recent weeks. According to ESR data, overall respiratory disease levels appear to be around normal for the time of year. Although Covid-19 has increased, hospitalisation and death rates are currently much lower than last winter.
“Nevertheless, it’s a good reminder that the season for winter bugs is in full swing. if you have respiratory symptoms, it’s a good idea to stay at home rather than soldiering on and spreading bugs around at school or work.
“It’s also a good time to check if you’re up to date with vaccines for flu and Covid-19. Over 65s and people in specified risk groups are eligible for a free flu vaccine (otherwise you can get one for $25-$45). Everyone over 30 is eligible for a Covid-19 booster. Vaccines are the best way to reduce the risk of a nasty round of flu or Covid-19 this winter.”
No conflicts of interest.
Dr Sarah Jefferies, Public Health Physician, ESR, comments:
“Overall, ESR’s surveillance systems are showing winter seasonal illness activity has been continuing to increase in the community and hospital settings over recent weeks in keeping with expected levels for this time of year. This is being driven mostly by the spread of seasonal influenza viruses. Respiratory Syncytial Virus (RSV), COVID-19 and common cold viruses like rhinovirus are circulating too.
“Indicators of seasonal respiratory illness activity in the community have been relatively stable in the last few weeks but continue to be elevated at expected levels for this time of year. Influenza A(H1N1) and B viruses are currently both spreading among the community. Rhinovirus, human metapneumovirus and RSV are also among the most common viruses detected at GPs.
“The weekly Severe Acute Respiratory Infection hospitalisation rate in the Auckland region has increased and is now at moderate seasonal activity. These hospitalisations are currently mostly associated with influenza, rhinovirus, and RSV.
“The influenza-positive hospitalisation rate increased in the week ending 22 June and is now in the medium activity level.
“The annual influenza season in New Zealand usually happens during May to October and we are not yet near the usual peak of illness which is expected in July or August. So it is still recommended for people to access the seasonal influenza vaccine to protect themselves and loved ones. It is free for older people, pregnant people and those with certain medical conditions. The Health New Zealand website is a good source of information for further advice on preventing the spread of influenza, self-care if you’re sick, and for preventing RSV and COVID-19.
“ESR’s wastewater dashboard indicates there has been increasing community COVID-19 in New Zealand, with ESR genomic surveillance showing this is being driven by the spread of a globally recognised more transmissible variant called Nimbus, NB.1.8.1.
“ESR’s Health Intelligence and Surveillance team monitors influenza-like illness activity on behalf of the Public Health Agency using several surveillance systems, including monitoring viruses detected at GP consultations for influenza-like illness through a network of sentinel practices across New Zealand, and monitoring the number of people hospitalised with Severe Acute Respiratory Infections in the Auckland region associated with influenza and other viruses. If you’d like to keep an eye on trends through the season, the national acute respiratory illness surveillance dashboard is updated weekly on a Thursday. Click on the tabs at the top of the dashboard to see the information from health practitioners and community members around the country coming in through these systems, as well as information on trends overseas.”
No conflicts of interest.
Professor Michael Baker, Department of Public Health, University of Otago, Wellington, comments:
“We used to think that winter peaks in respiratory infection are inevitable. Until we saw them largely disappear for two years in 2020-21 because of Aotearoa New Zealand’s highly effective Covid-19 response. Border closures not only stopped Covid-19, they also prevented the arrival of the usual global ‘pandemics’ of new influenza, RSV and other viruses that wash over us each year and make hundreds of thousands of us sick. We certainly don’t want to go back to the Covid-19 elimination period, but it was a powerful reminder that respiratory infections are preventable. And also that most are spread in the same way by aerosols in indoor settings.
“While we talk about the ‘flu season’ running for six months from May to October each year, most of the infections are not influenza. Prior to Covid-19, influenza was by far the most serious respiratory infection in NZ, with an estimated impact of 500 deaths a year, and 2,500 hospitalisations. It still needs to be a major focus of prevention. Annual vaccination is recommended for people of all ages, and is state funded for high-risk groups, notably those 65 years of age and over, those will serious chronic illnesses, pregnant women, and children under 4 with history of severe respiratory illness.
“Covid-19 is not a seasonal respiratory infection. Most waves of infection in NZ have occurred in the warmer half of the year. These waves appear to be mostly driven by viral evolution producing new variants that are better at evading our existing immunity, as well as waning immunity.
“NZ needs a comprehensive respiratory infectious disease strategy to reduce the largely preventable burden from these diseases. This strategy would include a strong focus on raising coverage with influenza and Covid-19 vaccines. We need a major coordinated effort to improve the safety of indoor air in our main shared environments such as schools, workplaces, and healthcare facilities. And selective use of masks in crowded indoor settings such as public transport over winter or when we are experiencing a Covid-19 wave.”
No conflicts of interest.
Associate Professor Mark Thomas, Molecular Medicine and Pathology, University of Auckland, comments:
“The increase in illnesses that occurs every winter is very largely due to virus infections of the nose, sinuses, throat and the airways that carry air to and from the lungs. Colds, sinusitis, pharyngitis and bronchitis are mostly caused by viruses and almost always recover without any specific treatment. While some more severe viral infections such as HIV, hepatitis B and C, and Covid-19 do respond to anti-viral medicines, there are no similar antiviral drugs for the treatment of coughs and colds. Antibiotics work against bacteria, but not against the viruses that cause winter coughs and colds.
“Home remedies, such as a teaspoon of honey two or three times a day and at bedtime can reduce coughing, pine and menthol ointment rubbed on the chest can provide benefit as can nasal decongestant sprays.
“Most people are well aware that coughs and colds are an annoying but unavoidable fact of life, and despite being more severe or more prolonged than usual, or occurring at a very inconvenient time, they are not a reason for a visit to a doctor. Stay home, rest, drink plenty of fluids and wait for your immune system to clear up the infection. And be aware that these illnesses almost never recover in a few days, one to two weeks is common, and many people still have a cough three weeks after the start of the illness. Antibiotic treatments will not shorten these illnesses, and may cause adverse effects such as a rash, diarrhoea, or thrush.”
No conflicts of interest.
Dr Mikael Boulic, Senior Lecturer, School of Built Environment, Massey University, comments:
“With winter here, it’s important to keep your family warm (around 20°C). Low inside temperatures kill about 1,450 extra people each year in Aotearoa.
“During winter, we often keep our windows closed. Make sure to open your windows for about 20 minutes daily to allow fresh air in and reduce pollutants and moisture. Cold outside winter air is usually dry, so letting it in can lower the humidity in your home and help prevent mould growth.
“Mould feeds on materials like fabrics, paper, and wood. To stop mould, you need to reduce moisture at home by:
- Remove the source: Avoid drying clothes indoors and do not use an unflued gas heater, as it releases moisture and pollutants.
- Ventilate: Open windows and doors, use the rangehood when cooking, and turn on the extractor fan when showering.
- Insulate: Well-insulated homes avoid cold surfaces that can lead to condensation.
“If you find mould, clean it with a solution of 70% white vinegar and 30% water instead of harsh chemicals. Mould will return if there is moisture, so it’s crucial to eliminate dampness to solve the mould problem.
“Keep your home healthy in winter!”
No conflict of interest declared.