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