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Speaker 1: Kyoda. I'm Georgina Campbell in for Chelsea Daniels and this

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Speaker 1: is the Front Page, a daily podcast presented by.

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Speaker 2: The New Zealand Herald.

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Speaker 1: Does it seem like people are a bit sicker than

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Speaker 1: usual this winter? It's been the talk of offices around

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Speaker 1: the country as people seem to be falling sick and

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Speaker 1: staying sick for longer than usual. And it's not just

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Speaker 1: COVID that is continuing to claim lives, with The Herald

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Speaker 1: reporting on two cases in the past months of people

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Speaker 1: dying suddenly after developing flu symptoms. So how bad are

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Speaker 1: the bugs and diseases going around our TETO this winter

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Speaker 1: and what do we need to know to be vigilant

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Speaker 1: about our health today? On the Front Page, we're joined

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Speaker 1: by doctor Lucy Talfa Barnett, an epidemiologist with the University

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Speaker 1: of Otago's Department of Public Health, and doctor Brian Betty,

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Speaker 1: Chair of General Practice New Zealand. I just want to

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Speaker 1: start by acknowledging two deaths that The Herald has reported

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Speaker 1: on recently. William Jones, a sixteen year old from Rolliston,

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Speaker 1: died a few days after developing a sore throat and

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Speaker 1: cough and willing to nurse. Maria pack Lennard died after

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Speaker 1: catching influenza type A. Both really tragic cases. Brian, How

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Speaker 1: does the flu become fatal and how common is it

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Speaker 1: that it does?

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Speaker 3: Look, I mean, I think one of the things I

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Speaker 3: see in that in my clinic is people underestimate, I think,

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Speaker 3: the potential for the influenza or the flu to cause

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Speaker 3: harm the confuser with things like the common cold, where

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Speaker 3: the symptoms are a lot often a lot less, but

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Speaker 3: the flu can be severe, especially for the elderly, especially

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Speaker 3: for those with underlying conditions, and as you've just described, younger, fit,

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Speaker 3: healthy people. In fact, University of Otago Michael Baker, in

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Speaker 3: the study they did estimated about possibly five hundred people

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Speaker 3: a season of flu season could actually die from the flu. So, look,

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Speaker 3: it's a potentially dangerous virus, and I think it's very

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Speaker 3: much underestimated in terms of people's perceptions of its potential

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Speaker 3: for harm.

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Speaker 1: And what symptoms separate the flu from say a could Look.

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Speaker 3: I think there's a couple of things here, but one

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Speaker 3: in particular is probably the speed of onset. That's certainly

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Speaker 3: a differentiator. So often with a cold it will come

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Speaker 3: on gradually, over a couple of days, you know, you'll

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Speaker 3: get this slight sore throat, the bit of a cough,

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Speaker 3: the runny nose, those sort of cluster of symptoms start

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Speaker 3: to happen. Often what people describe with the influenza is

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Speaker 3: they'll be okay in the morning, in the afternoon, very suddenly,

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Speaker 3: over a few hours they'll get you a very severe

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Speaker 3: Often muscle ache is one of the things people ascribe headache,

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Speaker 3: dry cough and temperature and start to feel miserable. But

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Speaker 3: it's the speed with which it comes on is probably

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Speaker 3: a key differentiator in terms of what happens. And also

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Speaker 3: the body ache or the must lake is another thing

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Speaker 3: that we often see, so that differentiator is probably the

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Speaker 3: key too. Things that I think we start to see.

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Speaker 1: And Lucy, what sort of winter illnesses are we seeing

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Speaker 1: spread around the country this season? Is there anything in

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Speaker 1: particular we should be keeping an eye on.

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Speaker 2: So the distribution of the respiratory illnesses this year, it's

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Speaker 2: really the same viruses that we see every winter. With

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Speaker 2: the new edition of COVID in the mix as well,

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Speaker 2: we're seeing a fair amount of the influenza A as

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Speaker 2: you mentioned earlier, particularly the H one N one strain

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Speaker 2: came through earlier in the season, and now we're seeing

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Speaker 2: the H three N two strain has started to come through.

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Speaker 2: All these better numbers, but also some RSV was coming

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Speaker 2: through in July to though that might be petering off

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Speaker 2: now and Brian might be able to comment more on

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Speaker 2: the differences between RSV and flu.

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Speaker 1: Yeah, what are those differences, Brian?

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Speaker 2: Look.

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Speaker 3: RSV can cause certainly severe disease, especially with young children,

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Speaker 3: that's what we tend to see, and with the elderly again,

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Speaker 3: but again it's those key things that I sort of

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Speaker 3: mentioned that often the severity of the symptoms that muscleate,

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Speaker 3: the headache, the temperature with that very rapid onset, and

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Speaker 3: people feel really unwell with it RSB. Sometimes not. It

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Speaker 3: can cause a cough. It can be quite severe obviously

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Speaker 3: in terms of lower respiratory tract infections, which is the lungs.

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Speaker 3: But the flu. I mean, you know the conversation I

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Speaker 3: have with patients when I offer them the flu bags

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Speaker 3: and they say, well, oh, look, I've never had the flu.

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Speaker 3: I just get a mild cold and it's all okay.

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Speaker 3: Often they have actually experienced a full blown influenza infection,

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Speaker 3: and once you've had it, you don't want it again.

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Speaker 3: It can go on for seven to fourteen days. It

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Speaker 3: can really lay you low down in bed, you can't

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Speaker 3: do much, would feel miserable. It really is full on.

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Speaker 3: So it is not something you really want to catch.

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Speaker 3: If it's going to be in that severe end of

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Speaker 3: the speak. You know, for the oldly, some younger people,

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Speaker 3: it can end up in hospitalization ICU, and an extreme examples, tragically,

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Speaker 3: it can end in death with those very severe lung

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Speaker 3: infections at a company.

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Speaker 4: It she's contracted the flu virus and effectively something else

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Speaker 4: has then been added to that issue, so then she

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Speaker 4: has got very very sick, very quickly, and unfortunately passed

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Speaker 4: away at her house. Basically, what I would like people

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Speaker 4: to know is that these two people were very fit people.

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Speaker 4: They both went into health declined 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 geta I think if there's

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Speaker 4: any doubt, there is no doubt. So if they think

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Speaker 4: they need to go to hospital, they need to be

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Speaker 4: there quickly.

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Speaker 2: The other thing that I just mentioned there also with

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Speaker 2: the flu, is with that paper where we talked about

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Speaker 2: the five hundred deaths a year attributable to the influenza virus.

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Speaker 2: A number of those deaths weren't necessarily from obvious flu infections,

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Speaker 2: although the person clearly had come into contact with the virus.

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Speaker 2: But they were dying of things related to the circulatary system,

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Speaker 2: so dying from heart attacks or other things in that space,

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Speaker 2: 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 3: Yeah, that's a good question. I look for the most part, again,

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Speaker 3: there's a range of ways this presents in the spairing

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Speaker 3: we've talked about. I think for most people it can

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Speaker 3: be managed very effectively at home. Big first message is

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Speaker 3: to stay at home, not to go out and spread it.

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Speaker 3: That's really really important something we learned in COVID. It's

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Speaker 3: something we should continue to do. Don't go to work

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Speaker 3: and spread it. I think it can be managed with

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Speaker 3: simple analges like paracetamol, of rufin. Plenty of fluids is

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Speaker 3: really really important in rest. I suppose where advice should

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Speaker 3: be sought is if there's a particularly severe headache that

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Speaker 3: isn't responding to those simple analges is a very high

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Speaker 3: temperature that isn't responding to things like paracetamol, rufin or

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Speaker 3: in particular especially with younger or older patients, where they're

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Speaker 3: not drinking or not taking on fluids, that's often a

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Speaker 3: pretty key sign. And the other thing is any type

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Speaker 3: of really severe headache with drowsiness or anything like that.

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Speaker 3: A rash is the other thing. If I rash develops,

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Speaker 3: then definitely medical attention. But really, if the simple treatments

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Speaker 3: are not settling things down, it's getting worse. There's any

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Speaker 3: sort of respiratory distress that is with breathing or not

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Speaker 3: taking in fluids, then definitely you should be bringing health

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Speaker 3: life or bringing your general practice to give advice or

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Speaker 3: obviously in very severe cases than after ours, or ed

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Speaker 3: in extreme cases. But I mean, those are probably the

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Speaker 3: 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 3: Look, I'm quite happy to make a couple of comments

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Speaker 3: and perhaps throw to Lucy, but certainly general practice around

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Speaker 3: the country has seen a lot of respiratory illness at

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Speaker 3: the moment. Our Clinic in Eastporror runs a respiratory clinic

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Speaker 3: that is invariably full throughout the day. We have overflow,

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Speaker 3: We give advice on the phone, but still a number

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Speaker 3: of people end up at after ours, which puts pressure

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Speaker 3: on after ours and we've seen that around the country

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Speaker 3: and often emergency departments and hospital admissions, and we've seen

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Speaker 3: that up in Auckland where there's been a high rate

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Speaker 3: of hospital admissions due to influenza or flu like illness.

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Speaker 3: So it does put a large burden on both general

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Speaker 3: practice and on the hospital system itself and produces quite

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Speaker 3: a bit of strain. Again, I'll make the point that

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Speaker 3: if you cannot get through to your general practice or

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Speaker 3: get an appointment and you're concerned, then actually HEALTHLINEYO eight

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Speaker 3: one hundred national number is a good place to ring.

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Speaker 3: There will always be a nurse on the phone to

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Speaker 3: talk you through what's happening and to see whether you

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Speaker 3: do need to seek urgent medical attention.

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Speaker 2: Yeah, and I'd add in there that yes, you know

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Speaker 2: the hospitals are seeing a peak, possibly about a week ago.

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Speaker 2: Hopefully it might have peaked me coming down again, but

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Speaker 2: there was a real bump in those flu hospitalizations around

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Speaker 2: that time, and it does put a real pressure on

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Speaker 2: the hospital systems, and you know, you see other services

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Speaker 2: being delayed or canceled because they're needing to make room

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Speaker 2: 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.

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Speaker 3: We're 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

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Speaker 1: people who've been sick for a month and it seemed

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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 2: Well, we have had a few years where it's been

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Speaker 2: less severe the particularly around twenty twenty twenty twenty one,

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Speaker 2: the flu went away, and I think it was easy

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Speaker 2: for us to kind of think that was the new normal.

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Speaker 2: It is normal to have peaks in the winter and

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Speaker 2: respiratory illness, but we have seen a particularly sharp rise

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Speaker 2: and rather than kind of creeping up slowly, it's going

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Speaker 2: to come on all at once, and that may be

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Speaker 2: part of the shock that we're experiencing. But Brian might

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Speaker 2: like to comment on whether there's any sort of sign

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Speaker 2: that the flu that's around this year is lingering longer

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Speaker 2: than usual.

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Speaker 3: Yeah, Look, it's a good question, and certainly what you've

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Speaker 3: described about people being unwell with cough and persistent symptoms

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Speaker 3: over three to four weeks, we've actually seen that in

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Speaker 3: our practice that occurring. Now. I suppose the point I'd

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Speaker 3: make it may not be due to the influenza virus itself,

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Speaker 3: which usually runs for about fourteen days, but there is

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Speaker 3: a mix of other viruses that are running around you.

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Speaker 3: You've still got your COVID, you've still got your RSP,

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Speaker 3: you've still got your adinoviruses, and hooping cough is actually

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Speaker 3: out there as well. We've sent a couple of cases

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Speaker 3: of hooping cough where you get this persistent cough which

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Speaker 3: does go on for weeks. So there's this real mix

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Speaker 3: that's going on. And often we don't do a definitive

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Speaker 3: diagnosis in terms of swabs and things, so we don't

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Speaker 3: know exactly what's causing the cluster of symptoms. But certainly

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Speaker 3: we have seen some cases of people just you know,

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Speaker 3: just with these persistent symptoms or getting better and then

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Speaker 3: developing more sort of respiratory flu like symptoms, and that

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Speaker 3: has been a feature this year.

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Speaker 1: And Lucy, the other thing that I wanted to talk

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Speaker 1: to you about was whether covid in our closed borders

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Speaker 1: has had any impact on our immune systems.

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Speaker 2: So no, no is the short answer. The more complicated

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Speaker 2: answer is that we had a couple of years where

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Speaker 2: we didn't have any flu at all, which was quite impressive,

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Speaker 2: and so when the flu came back again, as it

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Speaker 2: inevitably does, it, it meant that we hadn't been exposed

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Speaker 2: to it as recently, so we were potentially able to

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Speaker 2: catch it again. So normally, when if you catch flu,

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Speaker 2: if you maybe get a mild dose or a severe dose,

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Speaker 2: then that gives you some immunity for the next few years,

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Speaker 2: and then you become a bit more susceptible again. So

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Speaker 2: none of us had flu for those two years, and

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Speaker 2: so that susceptibility built up, but our immune systems are

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Speaker 2: still functioning just as well as they were before.

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Speaker 1: From you both, what would your key advice be to

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Speaker 1: people listening who are concerned about, you know, just getting sick,

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Speaker 1: or who aren't sure what to do to shake the

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Speaker 1: bugs they already have.

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Speaker 3: For me, quite simply get a flu vaccination every year,

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Speaker 3: and I think you still can get one again. It's

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Speaker 3: this thing with patients often or people see who underestimate

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Speaker 3: potential for flue and say, oh, look, I don't need

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Speaker 3: a flue vaccination. I never get it. Look. I think

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Speaker 3: vaccination is incredibly important in two areas, one flu and

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Speaker 3: the other one with COVID and with children their routine

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Speaker 3: childhood immunizations are really really important. I think for those

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Speaker 3: people that can't shake residual symptoms, you know, whether it

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Speaker 3: be a cough or just feeling slightly unwell or fatigued

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Speaker 3: or run down post and infection. Generally speaking, those will

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Speaker 3: just improve over time, and it can be very, very frustrating.

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Speaker 3: You can use those symptomatic treatments from the chemist, like

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Speaker 3: cough mixture and as I've mentioned, parasitamal and things and

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Speaker 3: plenty of fluids, and often it's just rest and time

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Speaker 3: to get through them. Often by the time you get

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Speaker 3: to week three or four, if you have got those

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Speaker 3: type of symptoms, you're certainly not infectious at that stage,

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Speaker 3: but it does become a time issue, and generally you

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Speaker 3: see people just slowly improve over time.

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Speaker 2: You know, I'd absolutely reiterate the endorsement for vaccinations. There's

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Speaker 2: a really good match this year between the strains of

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Speaker 2: flu that are protected against in the vaccine and the

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Speaker 2: strains of flu that are in the community, so that

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Speaker 2: vaccination really will reduce your chances of getting flu or

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Speaker 2: getting a severe case of flu. So definitely worthwhile. Staying

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Speaker 2: home when sick has been mentioned so that you're not

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Speaker 2: spreading it to other people. And then the other thing

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Speaker 2: that you can think about doing, particularly if you're catching

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Speaker 2: public transport to work. Think about wearing a mask. It

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Speaker 2: works for the flu and for other respiratory viruses just

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Speaker 2: as well as it does for COVID. So if you're

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Speaker 2: in those spaces where there's not necessarily great ventilation and

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Speaker 2: you're with a bunch of people who you wouldn't necessarily

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Speaker 2: spend a lot of time with, those are spaces where

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Speaker 2: you're going to come into contact with virus that you

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Speaker 2: wouldn't necessarily come into contact with otherwise. So if you

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Speaker 2: make the choice to mask up in those spaces, you

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Speaker 2: are reducing your risk of catching whatever's going around. And

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Speaker 2: apart from that, the things that we do to prevent

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Speaker 2: flu are the same as what we need to do

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Speaker 2: to prevent respiratory viruses in general. It's staying warm, which

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Speaker 2: doesn't obviously, you know, it's not that getting cold makes

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Speaker 2: you sick. It's just that when you're warm, you're less

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Speaker 2: likely to be susceptible to those viruses that you come

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Speaker 2: into contact with, and staying dry for the same reason,

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Speaker 2: and ventilating the spaces that you're in so that the

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Speaker 2: viruses that are floating around in the air are ventilated

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Speaker 2: out into the outdoors where they won't do so much harm. Look,

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Speaker 2: you know, I mean, I could go into the weeds

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Speaker 2: of it and say we need a national respiratory strategy

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Speaker 2: so that we're better prepared for future pandemics. Back before COVID,

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Speaker 2: we all thought that the next pandemic that was coming

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Speaker 2: would be a flu pandemic and things would pop up

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Speaker 2: from time to time that we thought or it like

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Speaker 2: the swine flu. If you remember that, it still could

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Speaker 2: happen at any time, and we need a strategy with

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Speaker 2: that in mind, and also just for managing respiratory illness

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Speaker 2: on a year to year basis. There's other things you

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Speaker 2: can get into as well, like we would love to

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Speaker 2: see all schools having air filters in their spaces because

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Speaker 2: schools are just breeding growths three respiratory virus going and

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Speaker 2: they really do contribution to spread and virus in the

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Speaker 2: community as well. But the interest in doing that seems

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Speaker 2: fairly low, So we'll see what happens.

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Speaker 1: Lucy and Brian, thanks for joining us. That's it for

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Speaker 1: this episode of the Front Page. You can read more

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Speaker 1: about today's stories and extensive news coverage at NZDHRALD, dot

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Speaker 1: co dot NZED. The Front Page is produced by Ethan

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Speaker 1: Sills and Sound engineer Patti Fox. I'm Georgina Campbell. Subscribe

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Speaker 1: to the front page on iHeartRadio or wherever you get

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Speaker 1: your podcasts, and tune in tomorrow for another look behind

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Speaker 1: the headlines.