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