Best flu help close to home
The next flu pandemic to hit New Zealand will be fought in neighbourhoods and in the home, says Christchurch historian Geoffrey Rice.
Hospitals and the public health system would be quickly overwhelmed, he said.
Rice, a professor of history at Canterbury University and author of Black November the 1918 Influenza Epidemic in New Zealand, said: "The main lesson is that in a major pandemic you can't rely on health boards and hospitals. It comes back to home nursing and neighbourhood support.
"That's the key lesson: getting to know your neighbours, or at least get their phone numbers the people on either side and two or three opposite. That's all you need to do. If people get sick, they should ring someone and tell them."
Rice was involved with the preparation of the national pandemic plan.
"One of the big lessons was the community response," he said. "Hospitals would be snowed under, so it falls back on home nursing."
Three influenza pandemics in the 20th century killed tens of millions of people. The Spanish flu of 1918-20 killed so many people worldwide that an accurate death toll is unknown. Between 50 million and 100 million people died in what has been called "the greatest medical holocaust in history".
Most deaths were from bacterial pneumonia, a secondary infection caused by the virus.
In New Zealand, the Spanish flu arrived in October 1918 with the return of troops at the end of World War I. Poor quarantine measures allowed the virus onshore and by 1919 more than 8500 Kiwis had died.
The Asian flu pandemic of 1956-58 killed about two million people, 70,000 of them in the United States. It originated in China from the mutation of a virus in wild ducks combining with a human strain.
The Hong Kong flu pandemic of 1968-69 killed an estimated one million people worldwide.
It first appeared in Hong Kong in July 1968 and within a fortnight spread to Vietnam and Singapore. Two months later it was in India, the Philippines, northern Australia and Europe, and then entered the US with returning Vietnam War troops. The virus reached Japan, Africa and South America the following year.
Rice said air travel had made quarantine difficult, but that was offset by better planning and communications.
"We are so much better prepared now than they were in 1918," he said. "They didn't even know what was causing it in 1918."
Rice was impressed by the "amazingly quick response to the new virus."
"The authorities jumped into action and were screening passengers coming into Auckland Airport, and that's precisely how it should work. The Government's response has been excellent."
New Zealand's pandemic plan was the first and best developed of many countries, Rice said.