Post-Cabinet Press Conference on the Flu Outbreak

 

Prime Minister: Good afternoon. The process today will be that I’m going to make some comments in relation to the influenza A outbreak that we have, then I’m going to pass over to the Minister and ask him to make some comments and then we will answer any questions you have in relation to that. Then we will take all other questions on other things that we are going to answer. Let me just start with that.

 

Firstly, we are doing what we can to manage the situation, and the response to date of our services has been swift, thorough, and appropriate for the level of risk.

The second point we would make is that this is a risk that we have been preparing for. We have done a lot of planning in the past 4 years. We have in place the arrangements and resources, and have exercised for this eventuality.

The third thing is that while the situation could change, so far we have been fortunate only a few people who have travelled in the affected areas have displayed symptoms, and to date they have been very mild, which is the same as the pattern that we’ve seen in the United States.

Fourthly, we also need to remember that the only thing we in New Zealand have identified so far is a form of influenza. Swine flu A, which is H1N1, has yet to be confirmed. We are awaiting the completion of tests in Australia, as you know, for whether people actually do have swine flu A H1N1, but we are taking exactly the same measures as we would if someone had swine flu.

The only other comment I would make is just really a personal health comment, which is we would encourage people to have a flu vaccination anyway. That’s an important measure that they can take to try to protect themselves against the flu. Secondly, the fastest way to break the cycle of this is for people to wash their hands regularly. And the third thing is for them to refer quickly if they are displaying symptoms of the flu. It is important to understand that if and when we administer someone Tamiflu, that helps them if they are in contact with someone, but they are only covered in terms of any protection they get from Tamiflu while they are taking it. So there is no point in issuing Tamiflu to someone today. The moment that you stop taking Tamiflu, then you stop being immunised for a potential outbreak. They are the only comments I want to make. I’ll pass it to the Minister, and then we can go from there.

Minister Ryall: Thank you, Prime Minister. The public health messages at this time still remain the messages that the ministry has been giving for the last day or so. Anyone who has travelled to the United States or Mexico in the last 2 weeks and who is displaying flu-like symptoms should be in touch with their general practice or a health professional. The Ministry of Health has asked me to thank the New Zealand media for their reporting of this public health message in order to get that through. I can also advise you that Healthline is reporting a 60 percent increase in calls. They’ve been receiving calls from passengers, other people who have travelled overseas, and other interested people, and they’re dealing with that at the moment. Further, contacting NZ1 passengers—more than two-thirds of those passengers have been contacted or have presented. We’ve got a team of 25 people phoning, and that’s being taken as a precautionary step.

Media: What about NZ5?

Minister Ryall: Ministry of Health officials and regional public health in Auckland will start phoning NZ5 when they’ve completed NZ1, as a precautionary step. The next piece of key information that we look to receive, probably later this evening, is the results of the tests on the three Northcote College kids who came in on NZ5 and have reported flu-like symptoms, and when we get that information we’ll share that with you. But we are proceeding on the basis that they probably have swine flu, and that is why we have moved to make those contacts with NZ5.

Media: Can you also clarify, please, about the groups with Pinehurst and Westlake the countries that they had been in and what implications that has now for the state of affairs?

Minister Ryall: The latest information we have is that the Westlake Girls group were, in fact, in Spain, and the Pinehaven group were in Argentina. So neither of those groups are within the scope of concern at this time.

Media: Prime Minister, what’s your advice to New Zealanders who may be travelling to Mexico?

Prime Minister: While there isn’t a travel ban to Mexico, my advice would be that I think people should think very cautiously about whether they have urgent travel. In the end it’s for them to assess the merits of their trip. It is our understanding that if someone presents as unwell it is possible that the Mexican authorities could actually discourage them or, in fact, stop them from leaving Mexico, and on that basis I think New Zealanders should think very carefully before they embark on any travel.

Media: Do you think if these children or these young kids turn out to have it that that sort of advice should be issued against travel to New Zealand?

Prime Minister: No I don’t. The reality is that we are treating anybody who is displaying symptoms of influenza A as professionally as any other country in the world would. My guess is that you’ve had worldwide travel in and out of Mexico. There is nothing particularly unique about New Zealand. I think we’ve done a good job of identifying very quickly, along with the United States and Mexico, that there is a problem, but I don’t think anyone would be at more risk coming to New Zealand than to any other country.

Media: Are we treating or looking at treating anyone in New Zealand presently who hasn’t been to Mexico—i.e. is there any evidence that those who have been have passed it on to others when they’ve got back?

Minister Ryall: We have got no information on that at the moment. We are making Tamiflu available to those people who were on NZ1 who may not have been to Mexico, but in terms of are there people who’ve received anything that’s been passed on we’ve got no information that I can share with you at that time. When we do have we will make sure we are in touch with you.

Media: No evidence about the families of the kids—you know—

Minister Ryall: None that I have received.

Media: What about the two-thirds from NZ1 that have been rung? Are any of them reporting similar flu-like symptoms?

Minister Ryall: I don’t have that information with me; we were hoping to have that to give to you with the full set of information when we get the Northcote College tests this evening.

Media: If Swine flu is confirmed in New Zealand are you satisfied that the action taken so far has been enough to stop the spread around the rest of the country?

Minister Ryall: Look, I think the action taken has been completely appropriate. People who have been to Mexico or the United States in the last 2 weeks with flu-like symptoms should be reporting. We want to get a better picture of how things are developing around the country. People are reporting to public health units; their GPs. We’re bringing that information together and we will report that to you as soon as we can.

Media: Are there any signs that—I know you’ve mentioned a few case—it has spread further than, say, Auckland. What’s the latest on the information?

Minister Ryall: Regional public health authorities are reporting that there are suspected cases, of which they are monitoring, in Hamilton, Nelson and in Otago at this stage. We will provide you with the full set of information that we can obtain from those various agencies when we report to you later this evening.

Media: What is the basis for them saying they suspect it? Is it just flu-like symptoms or—

Minister Ryall: Yes, flu-like symptoms and have been to the affected areas or are people who have been to Mexico and the United States within the last 2 weeks.

Media: The ones on NZ1, do you know how many were New Zealanders coming back and how many were tourists?

Minister Ryall: No I can’t give you that information, but it’s a very good point that you raised. There will be people on that flight, tourists, whom we will not be able to contact because they won’t have left any contact details or they’re out in their campervan. That is why public health messages through the mainstream media are very important, so that those people become aware of the fact that if they display flu-like symptoms they need to be in touch with a health professional here in New Zealand.

Media: Will there be checks put on at the airport for those people if they are leaving again?

Minister Ryall: There is going to be a much higher visibility of this issue throughout airports in New Zealand.

Media: How long will this last for in terms of the people at the airports and that sort of thing? Minister Ryall: We can’t give you a timeline on that, but I would advise that it will be as long as it is necessary.

Media: Presumably if people on the flights coming into New Zealand are affected or possibly affected and you’re calling them, there must be a whole range of other people who have been affected? Someone has already mentioned the families, but what about the plane that took people from Auckland to Otago, for instance? I mean, are you tracking all of those things through?

Minister Ryall: Yes, the ministry is taking all these things into account and they are working with all the authorities to make sure that we can manage this well. I think we’ve got some of the very best people in health working on this, and we’ll keep reporting to you on the information that we get and the steps that are being taken.

Media: Does it go beyond those flights that are coming into New Zealand in terms of tracking the contacts of those people?

Minister Ryall: At the current time we’re putting out the public health message that anyone who has been to Mexico, the United States in the last 2 weeks with flu-like symptoms should come forward. We are contact tracing the NZ1 passengers, and that obviously includes those people who’ve travelled to their homes on another airline.

Media: I know you say that the response has been swift, but when you consider that CDC in Atlanta has been itemising and detailing at great length on its website since April 21st the details of this outbreak, and advice—there are pages of it on there—and the Ministry of Health has never released anything here, even to the media, until it became known about the students, that they could have nipped this in the bud at the airport, and at least told the airport authorities at least what has been distributed in the United States about this disease.

Minister Ryall: Well, the advice I’ve received is that the Ministry of Health received notification from the World Health Organization at around about midday on Saturday, New Zealand time, and within two and a half hours they had established a national coordination centre. One of the excellent pieces of work that have happened here is the way that the Auckland Regional Public Health authorities managed to get the information together so that they could get these kids into isolation at home as quickly as they did. So, I think the Ministry of health, once they got the World Health Organization response, did act as you would expect, and the regional public health authorities have acted quite quickly to get those kids into isolation.

Media: What measures are in place at airports at the moment to keep tabs on people who may be coming back into the country, having visited Mexico or the US, particularly people who aren’t New Zealanders and perhaps their English isn’t that good, and they’re not being aware of what they’re being asked? Now are we asking people specifically if they’ve been to Mexico or the US?

Minister Ryall: The public health messages are clear about those people who have been to Mexico and the United States, but we’ve also introduced, particularly at Auckland, a screening whereby health professionals are monitoring those people who are coming off the planes. Of the thousand or so passengers who arrived this morning from North American flights, the ministry has been advised that two presented to cabin crew or ground staff as having flu-like symptoms. They were checked and have been moved on because they didn’t believe that they were at all in difficulty, and authorities also watched many of those passengers and observed them and didn’t think there were any cases of concern there, at this time. That sort of checking will carry on.

Media: So there’s no sort of specific checking to see whether or not people have actually been to Mexico, because, for example, a lot would go down through South America and then come to New Zealand?

Minister Ryall: Well, all of those flights from the Americas are getting the public health messages, and one of the flights this morning was, I understand, a flight from Santiago.

Media: Has there been any discussion about implementing some of the measures that were passed in 2006?

Minister Ryall: Well, I’ve been in touch with the ministry, as we’ve talked throughout the day, about what further steps need to be considered, and we are looking at those options of what needs to happen if there’s an escalation. But, at this stage, the ministry and the health authorities are taking the appropriate and justified steps, in their view, and the public health message remains very strong.

Media: How many doses of Tamiflu are currently kept in reserve?

Minister Ryall: 1.25 million. We’ve got one of the highest stocks on a per head of population basis in the world.

Media: And if we do move to a second phase with this, what role does that stock envisage to play as the events unfold?

Ryall: Well, the national pandemic plan makes it clear that Tamiflu stock is used to manage the scale and scope of any outbreaks around the country. There’s quite a lot of detail in that, and we would share that with you when we have our next media update.

Media: Just how concerned should the general public be about this situation? If we go back several years to SARS, one of the criticisms that was made was the coverage was over blown. Just how worried should Joe Public be?

Minister Ryall: Oh look, the Government is concerned. We’re taking a precautionary approach, and we are working closely with health authorities to make sure that things are well managed. My view is that we do need to be precautionary and concerned. And also we’re all very concerned for the worry that the families must have had, but I’m told that the illness has been mild, and those young people are on the road to recovery.

Media: So to the otherwise fit and old person, how dangerous is this?

Minister Ryall: Well, it’s enough that we should be concerned, and people should be aware of the public health messages about this. It’s a reminder for people to have their winter flu jab, and also the importance of hand-washing and hygiene in order to help protect ourselves.

Media: Will the winter flu jab do anything, though, to this particular strain of the virus?

Minister Ryall: Well, the advice is that it may assist. That certainly was the view during the discussion on the bird flu a few years ago.

Media: Are either of you taking Tamiflu as a precaution?

PM and Ryall: No, no.

Media: Have you anymore information about how long those Melbourne tests might take to come back?

Minister Ryall: I have no further information on that. We know that we would like it done as a matter of urgency. We will inform you on a timeline, when we get it.

Media: In relation to the Tamiflu, 1.25 million. That’s 1.25 million doses that are able to be used; there’s no expiry date on any of those? Minister

Ryall: There is an expiry date on them. A smaller number expires at the end of this year, but the vast majority of those are still current.

Media: Is there a concern, Prime Minister, about the impact on the economy? I read somewhere that a pandemic would cost the world economy trillions at a very delicate time, obviously, with the recession.

Prime Minister: Well, I think we’d be jumping to conclusions at this point. We are obviously taking a precautionary approach and taking the sensible steps, and that’s to be recommended. But, we are a long way away from a situation that we’re completely closed down, either our economy or the global economy, I would’ve thought.

Media: If the US disease centre was detailing these cases on 21 April, do you think the WHO should’ve let New Zealand know before Saturday?

Minister Ryall: Look, I would have to ask our Ministry of Health officials to advise you that, and we will be having a press conference as soon as we get some information on the Northcote tests that we can share with you.

Media: Has the Ministry of Health briefed you at all about this issue if it was on overseas websites on 21 April? Were they reading those websites and passing that on to you?

Minister Ryall: The information I’ve received—I can’t give you a full detail on that. I would be prepared to give you that information when we next meet on this.

Media: But they obviously weren’t telling you about it?

Ryall: I became aware of the specific case with respect to these young people on Sunday. That’s when the ministry already had its national centres in place, at that time.

Media: Shouldn’t they have told you when they became aware on midday on Saturday?

Minister Ryall: Look, I’m comfortable with the way things have happened, and the ministry have kept us informed.

Media: Why do we have to send samples to Australia to be tested? Wouldn’t it be prudent to be able to test them here; or can’t we?

Minister Ryall: Well, that’s where the World Health Organization laboratory for this sort of testing is. It’s in Melbourne, it’s quite specialised, and, for our part of the world, that’s where it is, in Melbourne.

Media: As of this afternoon, they hadn’t actually received the samples there. Does that concern you?

Ryall: I think the samples are on their way there now.

Media: Is there a vaccine at all for this?

Ryall: Not that I’m aware, though there has, I think, been reports that there is one organisation that thinks they have a vaccine, but at this stage we’re dealing with it with the stocks of Tamiflu that we have in the way that we’re dealing with it.

Media: Do you know why, or have you had any advice as to why they are dying in Mexico and not in the US or anywhere else?

Ryall: Well, the advice that we’ve received is that the issue in Mexico of their deaths could in fact be as a result of a secondary condition coming from the swine flu. So, for example, people have caught pneumonia or some sort of other infection as a result, and that may be, in fact, causing the deaths. But that is speculation at this time.

Media: The 1.25 million—presumably that is doses—how many people would that be able to treat? Is there any way of working that out?

Ryall: It’s courses, and it’s sufficient to treat, I think, about a third of the population.

Media: So that is a full course? So at some point where it wouldn’t be a threat any more?

Prime Minister: Seven days, two tablets.