COVID-19 has now reached New Zealand. How prepared is it to deal with a pandemic?


Michael Baker, University of Otago and Nick Wilson, University of Otago

New Zealand joined 48 other countries affected by the novel coronavirus last week when health authorities confirmed the first COVID-19 case. The news prompted panic buying of supplies in some places, but it had long been expected.

The management of the case seemed exemplary. Shortly after arriving in New Zealand from Iran, the person became unwell, rang the national health information service (Healthline) and was directed to a hospital where they were placed in isolation. Family members and fellow passengers on the flight were tracked and placed into home quarantine.

As yet, there is no evidence of transmission to others and New Zealand remains at the “keep it out” stage of its pandemic plan.

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Preventing a pandemic

Like many countries, New Zealand has two broad phases in responding to an emerging pandemic: the containment phase followed by the management phase.

The containment phase aims to prevent, or more likely delay, the arrival of a pandemic. New Zealand is managing this by excluding some travellers entirely (currently from China and Iran, except New Zealand residents and their families). It also requires those arriving from a growing list of countries to “self-isolate” for 14 days to reduce the risk of infecting others if they develop disease. Such quarantine is unsupervised, but travellers are encouraged to register with Healthline.

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Border controls make intuitive sense for limiting the movement of infectious diseases between countries. There is evidence they delay the entry of pandemic diseases, and they have sometimes prevented the spread of pandemics to islands. Travel restrictions are not generally supported by the World Health Organization, but it offers no advice specific to islands or for extremely severe pandemics.

If a case of COVID-19 is detected during this containment phase, efforts are made to “stamp it out” by isolating the person and placing their contacts under quarantine. Such measures were effective in ending the SARS epidemic, but are probably unlikely to do more than delay the more infectious COVID-19.

A COVID-19 pandemic could potentially become one of the greatest public health disaster threats in New Zealand since the 1918 influenza pandemic when 9,000 New Zealanders died.

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Managing a pandemic

The detection of cases that have no known connection to travel typically marks the beginning of community transmission and a shift in focus from eliminating an infection to managing it.

With COVID-19, this stage may arrive quite suddenly. Because most cases are mild, the virus may be transmitted through several generations before being detected, perhaps only when someone develops more severe symptoms and is admitted to hospital. This pattern is called silent transmission. It has been reported in a number of locations for COVID-19, including in the US.

In the management phase, interventions focus on dampening down transmission by encouraging hand washing and cough etiquette, which can be poor even during pandemics. Social distancing (working from home, closing schools etc) is also effective at slowing transmission, at least for influenza pandemics.

During this phase, the focus is also on ensuring health-care services are organised to manage increased demand, particularly for scarce resources such as intensive care, and health-care workers are protected from infection.

Health services are critical for reducing the risk of death during a pandemic. Unfortunately, COVID-19 has a relatively high case fatality risk. Nearly 1% of the infected people on board the Diamond Princess cruise ship have died.

What New Zealand needs to do

New Zealand has many natural and institutional advantages in managing the health and economic threats of a pandemic. Like Australia, New Zealand’s island status and ability to control its borders may buy time to continue pandemic planning. Given the seasonality of other known coronaviruses, the summer timing may provide further protection.

But the pandemic has hit New Zealand at a challenging time for public health. Capacity has been reduced by erosion and fragmentation of responsibilities across several agencies over the past decade or more. New Zealand is emerging from a severe national measles epidemic that had its roots in neglected public health infrastructure that failed to raise immunisation coverage sufficiently to prevent it.

New Zealand has a relatively low score, coming in far behind Australia, on the Global Health Security Index, which assesses pandemic capacity. We hope that an upcoming review of the health and disability sector will propose a major upgrade of public health in New Zealand.

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New Zealand’s response to COVID-19 is driven by the 2017 edition of the influenza pandemic plan. But we should also learn from the experience of other countries.

COVID-19 disease risk is highest for older people and those living with chronic health conditions such as diabetes, chronic respiratory disease and heart disorders. Unfortunately, a pandemic is likely to magnify social and ethnic inequalities through multiple pathways linked to poverty, poorer access to health care and a higher prevalence of chronic health problems.

We should learn from China’s apparent success in containing the pandemic, while at the same time balancing all interventions with a strong focus on human rights.

Here are other measures New Zealand could consider to prepare for this pandemic:

  • Start talking about a pandemic, rather than using euphemisms, to make it more real.

  • Form a parliamentary group to ensure multi-party engagement with the response. During an election year, it would be distracting for the response to become politicised.

  • Follow Australia’s lead and other developed countries and rapidly develop a specific COVID-19 emergency plan.

  • Consider measures to protect the most vulnerable populations. One option is “protective sequestration” to prevent spread to certain islands or regions as was achieved in the 1918 flu pandemic. This approach is being rolled out at a country level by Pacific nations, notably Samoa which now has some of the tightest border controls in the world.

  • Also consider a “safe haven” policy to protect vulnerable groups such as older people with chronic conditions by temporarily moving them to carefully managed locations (such as high quality aged care facilities or even protected islands) for the duration of the pandemic.The Conversation

Michael Baker, Professor of Public Health, University of Otago and Nick Wilson, Professor of Public Health, University of Otago

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Christians in Vietnam Hold Another Historic Celebration

Largest-ever event in northern part of country encourages house churches.

HANOI, December 21 (CDN) — For the second time in 10 days, Protestant history was made in Vietnam yesterday when 12,000 people gathered for a Christmas rally here.

The event, which took place in the large square in front of the entrance to My Dinh National Stadium in the heart of Hanoi, was said to be 10 times larger than any prior Protestant gathering in history in northern Vietnam. On Dec. 11 in southern Vietnam, an estimated 40,000 people attended a Christmas celebration in Ho Chi Minh City (see “Unprecedented Christmas Gathering Held in Vietnam”).

Local sources said long-requested written permission for the event, entitled “Praise Jesus Together,” never came in spite of several reminders. But four days before the event was to take place, Hanoi authorities and police told organizers – in words as close as they would get to granting permission – that they would “not interfere.”

“One can hardly overestimate the importance of such an event in the lives of northern house church Christians,” said one long-time Compass source. “For many, this will have been the first time to join in a large crowd with other Christians, to feel the growing power of their movement, to hear, see and participate in the high quality, and deeply spiritual mass worship.”

The day before the event, Christians gathered near the stadium for final prayer and to help with preparations. Witnesses said the huge public square at the entrance to the stadium was arrayed with thousands of stools rather than chairs – plastic, backless, and bright blue and red. In 10-foot tall letters, “JESUS’ was emblazoned on the backdrop to the stage.

Invitations had been sent through house church networks even as official permission for the event was still pending. When church leaders decided to move ahead only days before, Christians were asked to send out mass invitations by text-message, leading some to speculate whether this may have been the largest ever such messaging for a Christian event.

Nearby Christians as well as those bussed from more distant areas began to fill the venue hours before the event. They were not dissuaded by a Hanoi cool spell of 12 Celsius (56 Fahrenheit) with a chill wind. Bundled in thick jackets, their heads wrapped in scarves, they waited expectantly without complaint.

They were not disappointed. Witnesses said the throng deeply appreciated a program of outstanding music and dance, a powerful personal narrative followed by a gospel message and an extended time for prayer for the nation. As at the previous event in Ho Chi Minh City on Dec. 11 that house church Christians had long worked and prayed for, the program featured music from Jackson Family Ministries of the United States.

In a world of globalized gospel and praise choruses, songs included hymns such as “How Great Thou Art” as well as classic praise songs such as “Sing Hallelujah to the Lord.” Witnesses said the music was accompanied by tasteful, emotionally engaging dance. Top Vietnamese artists performed, including news songs by Vietnamese songwriters, and a Vietnamese choir of 80 sang, as did a Korean choir.

A young man in his 30s who now pastors two house churches told the crowd how an encounter with Jesus proved more powerful than the grip of drug addiction. His story, simply and humbly told, proved an effective bridge to a Christmas evangelistic message by Pastor Pham Tuan Nhuong of the Word of Life house church. Then the winsome Pastor Pham Dinh Nhan, a top southern house church leader, gave a disarming but strong invitation to follow Jesus, witnesses said.

Organizers said approximately 2,000 people then poured forward in response, packing the large area in front of the stage.

The final portion of the program included a time of intense prayer for the nation, with pastors confessing and praying for righteousness for Vietnam’s leaders, as well as for God’s protection and blessing on their land. In their prayers they claimed Vietnam for Christ, witnesses said.

A high point for the throng was the superimposing of a large white cross on a yellow map of Vietnam on the backdrop. As the Korean choir sang a spirited revival hymn, the crowd raised thousands of hands and exploded in sound.

“The sound of crying, of praise, of prayer were blended as one, beseeching Almighty God for spiritual revival in Vietnam,” said one participant.

The event was streamed live at for Vietnamese and others around the world to see.

Until recently – and still in some places – most Vietnamese meet in small groups in homes knowing at any time there could be a hostile knock on the door, a source said.

“None of these groups is registered or recognized by the government,” the source said of the crowd at yesterday’s event. “What you see is Christians standing up!” 

In addition to this event and the Dec. 11 event in Ho Chi Minh City, a large public Christmas rally was held by the Evangelical Church of Vietnam (North) at the Hoang Nhi church in Nam Dinh Province on Saturday (Dec. 19). Some 2,500 people gathered in the church’s large courtyard, with sources saying 200 responded to an invitation to follow Christ. 

In Tuy Hoa, on the coast of central Vietnam, a Christmas program is planned for Saturday (Dec. 26) in a 4,000- seat theater. Many smaller events are also planned in other areas, part of an unprecedented public display by Vietnam’s Protestants.

At the same time, the freedom for Christians tolerated in large cities has not reached some more remote parts of the country, where ethnic minority Christians live. In Dien Bien Dong district of Dien Bien Province, authorities on Tuesday (Dec. 15) orchestrated immense ethnic social pressure on a new Christian couple to recant. The couple told Compass that police added their own pressure. 

“The police said they would beat me to death, and take away all my possessions, leaving my wife a widow, and my children orphans with no place to live,” the husband told Compass. “I folded. I signed promising that I would no longer follow God. I really want to, but it is very, very hard to be a believer where we live, as the officials will not allow us.”

Report from Compass Direct News 

Unprecedented Christmas Gathering Held in Vietnam

With permission little and late, organizers work by faith to accommodate crowds.

HO CHI MINH CITY, December 14 (CDN) — On Friday evening (Dec. 11), history was made in communist Vietnam.

Christian sources reported that some 40,000 people gathered in a hastily constructed venue in Ho Chi Minh City to worship God, celebrate Christmas, and hear a gospel message – an event of unprecedented magnitude in Vietnam.

A popular Vietnamese Christian website and other reports indicated up to 8,000 people responded to the gospel message indicating a desire to follow Christ.

For the last two years, authorities surprisingly granted permission to unregistered house churches in Ho Chi Minh City to hold public Christmas rallies, and last year more than 10,000 people participated in one in Tao Dan Stadium.

This year visionary house church leaders approached the government in October and asked for a sports stadium seating 30,000; they were refused. Authorities offered a sports venue holding only 3,000, located 13 kilometers (eight miles) out of the city. This was unacceptable to the organizers. They pressed for another stadium in the city holding about 15,000, and officials gave them a verbal promise that they could have it.

The verbal promise did not translate into the written permission that is critical in the country – church leaders say such promises are empty until “we have the permission paper in our hand.” Christian leaders believed event planning had to proceed without permission and sent out invitations far and wide – only to have authorities deny the stadium they had promised.

Led by Pastor Ho Tan Khoa, chairman of a large fellowship of house church organizations, organizers were forced to look for alternatives. They found a large open field in the Go Vap district of the city. When permission was still not granted five days before the planned event, several church leaders literally camped for three days outside city hall, pressing for an answer.

Authorities, who often work to sabotage united action among Christians, tried urgently to find ways to talk the leaders out of going ahead, promising future concessions if they would cancel the event. Organizers stood firm. Ultimately they told the deputy mayor that refusal to grant permission at that point would have far-ranging, negative ramifications in Vietnam as well as internationally.

Finally, at the close of business on Dec. 9, just 48 hours before the scheduled event, officials granted permission that required clearance all the way to Hanoi. But the permission was only for 3,000 people, and many more had been invited.

Organizers had less than two days to turn a vacant field into something that would accommodate a stadium-size crowd. They had to bring in ample electricity, construct a giant stage, rent 20,000 chairs, and set up the sound and lighting. The extremely short time frame caused contractors to double the prices they would have charged with ample time.

Organizers also rented hundreds of busses to bring Christians and their non-Christian friends from provinces near the city. Thousands of students sacrificed classes to help with last-minute preparations and to join the celebration.

Just after noon on Friday (Dec. 11), word came that police had stopped busses carrying 300 Steing minority people from the west to the event scheduled for that day. Organizers, fearing all busses would be stopped, put out an emergency worldwide prayer request.

Christian sources said that authorities either did not or could not stop busses from other directions, and that by evening the venue became the biggest “bus station” in all of Vietnam. By 6 p.m. the venue was full to capacity, and at least 2,000 had to be turned away.

Christians described the event, entitled, “With Our Whole Hearts,” in superlative terms. For house churches, large gatherings are both very rare and very special, and for many this was their first glimpse of the strength of Vietnam’s growing Christian movement. Thousands of Christians joined a choir of more 1,000 singers in loud and joyful praise.

Sources said that the main speaker, the Rev. Duong Thanh Lam, head of the Assemblies of God house churches “preached with anointing” and people responding to his gospel invitation poured to the front of the stage “like a waterfall.” With space in front of the stage insufficient, the sources said, many others in their seats also indicated their desire to receive Christ.

Organizers along with many participants were overwhelmed with emotion and gratitude as the event closed. People spontaneously hugged each other and cried, “Lord, bring revival to all of Vietnam!” Other comments included, “Beyond our fondest imagination,” and, “Nothing could stop the hand of the Lord.”

The event raised more than 60 million dong (US$3,280) for a charity helping needy children. People were quite surprised to read a positive article on the event in the state-controlled press, which often vilifies Christians.

House churches in the north were hopeful that they could hold a similar event. Organizers in Hanoi have heard encouraging reports that they will get permission to use the national My Dinh sports stadium for a Christmas celebration, though they do not have it in hand. Sources said they have sent out invitations across a broad area to an event scheduled for Dec. 20.

Friday’s event also made history in that it was streamed live on the Vietnamese website and viewed by thousands more in Vietnam and by Vietnamese people around the world.

Report from Compass Direct News