Improving New Zealand's preparations for the next pandemic

Scott, Julia; Wilson, Nick; Baker, Michael G

The national public health institute of Germany, the Robert Koch Institute, has selected 127 pathogens notifiable by German law, reportable within the European Union or to WHO, with potential for deliberate release or with dedicated chapters in a manual of infectious diseases. 32 It then used previous research and expert scoring to determine pathogen importance as a risk to population health. 32 Some pathogens that scored highly had already been identified as priorities, such as HIV and influenza, but the potential importance of others (such as Hantavirus) was newly recognised through this process. 32 Similarly, the National Expert Panel on New and Emerging Infections of the United Kingdom (UK) developed a two-algorithm risk assessment process for emerging infectious diseases, considering the likelihood a pathogen will infect the population and its potential impact on human health. 33 This tool has been used to assess the threat of a range of infections in the UK and communicate information to government departments and other agencies. 33 Many authors state that one of the most effective ways to test and improve pandemic preparedness is by conducting exercises. 34 Reports from exercises undertaken around the world detail their benefits. They give stakeholders the opportunity to deepen their understanding of crisis issues, clarify policies and processes, and build up trust and familiarity that can lead to faster decision making during a crisis. 35, 36 New Zealand public health professionals also emphasise the importance of exercises in building capacity, 37 and simulation exercises will form part of the new IHR core capacity monitoring and evaluation framework. 23 A New Zealand-based workshop and series of interviews with public health professionals (undertaken by one of us in 2015), 37 assessed utility of ranking pandemic 'scenarios' to inform planning. These were thought to be a useful way to consider threats for training and testing capacity. Other key components of emerging infectious disease preparedness identified during these discussions were retention of institutional knowledge, exercising responses, national public health leadership and consideration of potential impact on vulnerable populations. Surveillance outside notifiable diseases and laboratory capacity for highly pathogenic organisms were identified as major gaps in current New Zealand preparedness.