Medical centres in the Western Bay of Plenty are experiencing a spike in the number of people who are presenting at their clinics with influenza and Covid-19 infections.

Last week, Bethlehem Family Doctors sent a text out to their patients that read:

“We are currently seeing a significant rise in both flu and Covid-19 infections. To ensure safety for both patients & staff, if you have respiratory symptoms and require medical assistance, please let the team know prior to your appointment. You may be asked to remain in your car until a GP can see you & mask up prior to coming into the building. Masks are available at the front door. Regards, The team @ Bethlehem Family Doctors.”

Bethlehem Family Doctors is one of 37 medical practices in the Western Bay of Plenty Primary Health Organisation (WBOP PHO).

“We’re seeing the expected seasonal rise in winter colds and flus,” said WBOP PHO clinical director and general practitioner Dr Clare Isham.

“These can range from mild infections to more serious flu-like illness.”

Dr Isham said at this time of year, general practices, urgent care and emergency departments often experience high demand.

“We encourage everyone who is eligible to consider immunisation against both influenza and Covid-19, especially those with existing health conditions who may be at increased risk.

“For free health advice 24/7, call Healthline on 0800 611 116. Their clinicians can help you manage symptoms and guide you on whether to see a doctor, visit urgent care, or go to hospital. You can also find tips for managing winter illnesses on Healthify.

“If you need to see a doctor, contact your general practice, many offer same-day acute clinics.”

Dr Isham said people may be asked to wear a mask or wait in their car before being seen, to help protect clinic staff and other patients.

“You can also ask about phone or video consult options if that suits you.”

Hospitalisations for severe respiratory infections are trending upward, as are calls to Healthline about influenza-like illnesses, according to ESR surveillance.

Health New Zealand Te Whatu Ora does not hold data on flu infections because it is not a notifiable disease, however, it does provide regular updates on current cases of Covid-19 in New Zealand.

Covid-19

In the week up to June 16, there were 942 new cases of Covid-19 reported in New Zealand, of which 610 were reinfections. Six people have died during the last week, within 28 days of testing positive for Covid-19.

Of the six people whose deaths Te Whatu Ora reported on Monday, two were from Auckland region, one was from Bay of Plenty, two were from Wellington region and one was from Southern.

One was aged between 10 and 19 years, one was in their 70s, two were in their 80s and two were aged over 90. Of these people, three were women and three were men.

Of the 942 new cases, 34 are in the Bay of Plenty and 19 in the Lakes area. Southern has the greatest number of new active cases with 145, Canterbury 147, Waitematā 115, Counties Manukau 75, Auckland 77, Capital and Coast 68, Waikato 60, Nelson Marlborough 50, Northland 35, Hutt Valley 29, Taranaki 20, MidCentral 16, Wairarapa 15, Hawke’s Bay 17, Tairāwhiti 6, South Canterbury 7, Whanganui 5 and West Coast 2.

In the week prior, five people died with Covid, 94 people were reported to be in hospital and three in ICU.

In the week up to June 23, there were 869 new cases reported, of which 565 were reinfections. There were 22 deaths with Covid-19, with two from Northland, four from Auckland region, five from Waikato, one from Bay of Plenty, two from Lakes, one from Nelson Marlborough, two from Canterbury and five from Southern.

Two were less than 10 years old, one was in their 60s, four were in their 70s, 13 were in their 80s and two were aged over 90.

Of the 869 new cases, 31 are in the Bay of Plenty and 13 in the Lakes area. Canterbury has the greatest number of new active cases with 140, Southern 110, Waitematā 98, Counties Manukau 95, Waikato 68, Capital and Coast 59, Auckland 58, Nelson Marlborough 35, Hutt Valley 35, MidCentral 31, South Canterbury 25, Taranaki 20, Northland 15, Hawke’s Bay 14, Wairarapa 12, Tairāwhiti 5, Whanganui 4, West Coast 0.

Winter peaks and waning immunity

“We used to think that winter peaks in respiratory infection are inevitable, until we saw them largely disappear for two years in 2020-21 because of Aotearoa New Zealand’s highly effective Covid-19 response,” said Professor Michael Baker of the Department of Public Health, University of Otago, Wellington.

“Border closures not only stopped Covid-19; they also prevented the arrival of the usual global ‘pandemics’ of new influenza, RSV and other viruses that wash over us each year and make hundreds of thousands of us sick.

“We certainly don’t want to go back to the Covid-19 elimination period, but it was a powerful reminder that respiratory infections are preventable. And also, that most are spread in the same way by aerosols in indoor settings.”

Baker said while we talk about the “flu season” running for six months from May to October each year, most of the infections are not influenza.

“Prior to Covid-19, influenza was by far the most serious respiratory infection in New Zealand, with an estimated impact of 500 deaths a year, and 2500 hospitalisations,” Baker said.

“It still needs to be a major focus of prevention. Annual vaccination is recommended for people of all ages, and is state-funded for high-risk groups, notably those 65 years of age and over, those with serious chronic illnesses, pregnant women, and children under 4 with history of severe respiratory illness.”

Baker said Covid-19 is not a seasonal respiratory infection.

“Most waves of infection in New Zealand have occurred in the warmer half of the year. These waves appear to be mostly driven by viral evolution producing new variants that are better at evading our existing immunity, as well as waning immunity.”

Baker said NZ needs a comprehensive respiratory infectious disease strategy to reduce the largely preventable burden from these diseases.

“This strategy would include a strong focus on raising coverage with influenza and Covid-19 vaccines. We need a major co-ordinated effort to improve the safety of indoor air in our main shared environments such as schools, workplaces and healthcare facilities. And selective use of masks in crowded indoor settings such as public transport over winter or when we are experiencing a Covid-19 wave.”

Rosalie Liddle Crawford is a multimedia journalist with a background in medical science, holding New Zealand qualifications in immunohaematology and medical microbiology. A former lecturer in immunohaematology, she now writes on topics related to Covid-19 and the immune system, bringing scientific insight to public health reporting.