Rhys Lewis, a participant in the pandemic forum held in Wellington 4th July 2006 involving church, civil defence, and health representatives, offered two personal updates in July 2007.

Part 2 - Bird flu update

Planning for Pandemic

Fundamentals
It remains the solid view that a flu pandemic is a matter of ‘when not if'. The severity of the virus is not predictable; planning is being modelled on the basis of the 1918 outbreak, which was a severe one. The Sars outbreak showed the potential for society to be affected by severe new diseases.

Preparation can also be made on the basis of the certainty of more general social disasters caused by weather, seismic or man made emergency events.

Government planning has proceeded on the basis of certain simple predicates

Government goals are

To get society through the pandemic

To get the economy through pandemic

Government strategy is

Stage 1             get a central government strategy in place

Stage 2             get local communities prepared to respond to pandemic - "community engagement"

On the ground
There will be no intermediate level of planning or action. The initial top down approach has seen an enormous amount of work done at government level but has also meant there is little  joined up planning at local level.

But the battle will be won or lost in local communities. The nature of the emergency and of our national resources is such that there is nothing available between the top down government framework and the bottom up local community responses.

Some people plan to ‘hole up' for the duration of the emergency. While there is some validity in this we should not forget that the nest long term outcomes will come for supportive and well organized communities.

At a local level there are three relevant organs   DHBs; Local Councils; Civil Defence. How these relate to other local organisations, networks, businesses, institutions, and the churches is completely defined by local conditions. DHBs are the lead organization but welfare is regarded I understand as a Civil Defence responsibility

Much as it might seem desirable to have national blueprint to follow, basic fact about society in a pandemic will be that effective response will depend on individual self reliance, and local community self- reliance. Recent experience (eg South Islan snowfall) gives us a good examples of the breakdown of systems above the local level.

What might the pandemic look like?
The majority of people in the community will get an extremely debilitating disease lasting a week to ten days. The whole community will be impacted. The course of the epidemic may involve three waves of 8 weeks with two 8 week interludes.

The 1919 pandemic is well described in the book Black November. It seems that there was one particularly large and devastating wave where there was considerable social dislocation. Very large numbers had the flu and very large numbers were involved in nursing them. This intense but in fact short period may be what we really have above all to bear I mind - the other waves, while difficult will perhaps be rather more manageable provided social panic is contained.

In such a period schools and public places will be closed. There will be periods when front line services (police, fire, electricity, services,) have 50% absenteeism - perhaps more. There will possibly be uncertainties about supermarkets opening. Will care givers for highly dependent people continue to go to work. The dependent, the very poor, and floating populations (students etc) will be badly placed.

The pandemic will be international and there is no likelihood of external aid to NZ when it hits. There should be some lead in time. It is almost impossible that it will begin in NZ. It is not thought to be imminent. The next danger period will be the northern hemisphere flu season and it is hoped we have a few years up our sleeves.

There will be a very large economic impact - maybe 10-15% effect on GDP. It will not be a normal situation. We will have to have a community philosophy - market philosophy will not do the job.

99% of the population ought to survive on the basis of the severe 1919 pandemic. The Black Death took one third of the European population - its hard to imagine it could be as bad as that.

Surviving a pandemic. This is a very open question! However, if no vaccination is available and anti virals are ineffective it will come back to basic nursing and hygiene. Some communities had very low death rates in 1919 because of the excellence of the nursing care. Various pilot schemes are in operation concerning community education should a pandemic develop

Personal responsibility in a pandemic
Personal preparedness and self reliance, as in all emergency situations, will be a key factor. The lead that Civil Defense is giving about being prepared is an important priority for all, and any local response will need to support the Civil Defence lead.

People will be differently placed as regards responsibilities. Some with young families or dependent elderly will feel their basic call is to be with their family. Others will feel freer to continue an active if cautious involvement in essential work and welfare.

Community preparedness. Well set up communities will be better placed.

Civil Defence. This is a small administrative unit which co-ordinates the general response to emergencies. It has no resources of its own beyond the small administrative leadership if offers. It helps co-ordinate two kinds of response

Infrastructure  Restoration/maintenance of basic services - roads, law and order, electricity etc. Here it works with council.

Welfare            Each area has a small welfare group whose task is to set up emergency welfare centres. These groups have a good plan but their basic remit is to maintain communities in flood/earthquake conditions - ie limited numbers of people for a limited time. Our local group is staffed by older volunteers from Te Aroha and Morrinsville.

DHB                Some preparations are being made (eg community education as outlined above). It is planned to open local reception units for flu cases separate to medical centres (in Matamata at the St John's Hall). We wait more information.

Mutual community support. Here is a major resource and a major conundrum. In 1918 the helping one's neighbor was strong. Today it is weaker. Then there will be the fear of either contracting the disease, or also reasonably of giving the disease to others. Nevertheless one can imagine scenarios where one's neighbours are all terribly sick with maybe only a ten year old in the house looking after the others. Surely we will want to be able to help. How will we engage with this dimension.

Volunteers. Volunteers are a bit of a menace unless they are well led. However well led volunteers will be of huge help. There will be those who have recovered from the illness. There will be older people, especially with relevant skills, who are willing to take risks. It may be that there will be people willing to volunteer into situations where they do not need to contact the public.

Local citizens committees were highly significant in the 1919 pandemic

A MUST READ

Black November by Geoffrey W Rice - outstanding history of NZ in 1918

Final comforts

NZ is the best place in the world to be

We are held up as world leaders in preparation

Knowledge brings steadiness

Final caution

This is my account of what other people said - treat it with due caution, be careful what you quote.

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