Friday, May 1, 2009

Porirua On Tenterhooks As Criminal Released Back Into The Community

A potentially dangerous criminal has been released into the Porirua community after the parole board failed in its efforts to keep him imprisoned.

According to the Domion Post "The Parole Board exhausted all legal avenues to keep him in prison after deeming him likely to reoffend upon release. He is not considered sick enough to be held under the Mental Health Act."

The unnamed man was imprisoned for 10 years for kidnapping, indecent assault, aggravated robbery and arson.

Armed with a knife, he invaded a family home, tied up a couple and robbed their house while their two young children slept upstairs. He then severed a gas line and set fire to their home.

"The man had written to a judge threatening to kill a child for every year he was in prison, but said yesterday he had been sick when he wrote it."

Porirua's Deputy Mayor Litea Ah Hoi said

"He has a very violent criminal history but he has done his time. After 10 years everybody needs to be given a second chance."

Yes, but who wants to take the risk when even a parole board tried their best to keep him under lock and key. Now a whole community is to be imprisoned behind locked doors.

Should the rights of one individual outweigh the right of the many to feel safe in their own homes?

And what if Mr X were to forget to take his medication but remember his threat to kill 10 children. Who is going to take responsibility for keeping him under proper medical surveillance for the next 50 years?

Time for a change in the law.

Taranaki Backs Down on Tamiflu Restrictions

Taranaki DHB board has now lifted its restrictions.

From today Tamiflu may be sold over the counter by pharmacists to individuals displaying symptoms of influenza.

Thursday, April 30, 2009

Taranaki Locks Down Tamiflu Supplies

New Plymouth's medical officer of health Dr Penny Hutchinson, has restricted supplies of Tamiflu within the Taranaki DHB area.

The move was thought to be independent of the MOH's directives and none of the other 20 DHBs are thought to have followed Taranki's example.

There are only 200 doses currently available in the region and another 800 on order.

Ever since Monday NO prescriptions OR counter sales of the drug have been permitted unless the request carries an authorisation number from Dr Hutchinson.

Dr Hutchinson's action seems to have added another unnecessary layer of bureaucracy and could potentially slow down the speed at which infected people access the anti-viral drug whilst in the early stages of illness, therefore increasing the risk of further transmission. Her action also prevents people from accessing preventative doses of the drug prior to travel to infected countries.

Pharmacies were first informed of the action when their stock was requisitioned under the Civil Defence Emergency Act 2002 on Monday.

Taranaki has 17 people in isolation and 3 suspected cases.

Some DHB's Ignored MOH Advice to Stockpile Anti-Virals

November 2005 the NZ Ministry of Health issued advice to District Health Boards to source and build up supplies of Tamiflu for the treatment of H5N1/Bird flu

Some DHBs decided not to do so, citing concern over the shelf life of the drug and no doubt were concerned about the cost of buying something that could expire before it was needed.

(Recent information is that shelf life of Tamiflu can be extended from 5 to 7 years if it is stored correctly and tests confirm that it has remained stable)

In March 2006 Bay of Plenty District Health Board chairwoman Mary Hackett told the Bay of Plenty Times

"One of the problems is that Tamiflu has an expiry date. If we do stockpile antibiotics, we are turning them over because we use a lot of antibiotics. But the Tamiflu we are not using for anything else,"

The board said it was counting on the Ministry of Health to distribute its stockpile of Tamiflu should a pandemic hit.

At the time news reports stated that Wellington, Hawke's Bay, Hutt Valley and Taranaki had extra supplies of Tamiflu, and that 4 others were ordering supplies.

In 2008 The MOH issued "National Health Emergency Plan, National Reserve Supplies and Usage Policies" in which it said that each DHB board only holds 200 courses of the national reserve of Tamiflu, authorised for immediate use.

It went on to state
"DHBs generally do not hold significant additional stocks of Tamiflu beyond the 200 course allocation. Accordingly national reserve stocks will be mobilised and made available as first response supplies in case of a pandemic or threatened pandemic"

Which raises the following questions:

* Why Taranaki DHB still only had 200 courses of Tamiflu?

* Why it felt the need to place restrictions of the prescription and sale of Tamiflu when national reserve stocks will be released in the event of a threatened pandemic? There is no mention in the MOH plan of district health boards needing to use the Civil Defence Emergency Act 2002 (CDEA) to requisition stock from pharmacies.

* Has the national reserve stock been released or not?

* Who is the national reserve stock being reserved for?

* Is Taranaki DHB holding back its 200 doses for its own staff?

Racial Discrimination in the Workplace: Complaints to the Human Rights Commission

The recent news reports of student nurse Linda Tang taking UNITEC to the HRC shows that not much has changed in New Zealand since the HRC issued a media release in March of 2007, the text of which is reproduced in parenthesis below.

Indigenous people as well as migrants were discriminated against and the issue of foreign accents was just as much of a problem then as it is now.

Complaints about racial discrimination in the workplace remain of concern

Complaints about racial discrimination in employment made up almost one third of the 190 race related complaints dealt with by the Human Rights Commission last year. The figures have been published in the Commission's annual review of race relations released today.

Workplace complaints made up 20 per cent of race related complaints in 2005 up from 16 per cent in 2004. In one case a Russian teacher of English was refused a job on the grounds that she lacked local experience. A number of overseas trained doctors complained about the difficulty of obtaining New Zealand registration.

The number of complaints about racial harassment continues to grow. In 2006 they constituted 24 per cent of race related complaints compared to 19 per cent in 2005 and 15 per cent in 2004. One case of harassment involved a religious minister who mimicked a recent migrant's accent during an incident involving a parking space.

Accommodation continues to be an area where discrimination persists. In one case a Korean landlord said he would only accept Korean tenants. In another a landlord agreed to rent a property over the phone but rescinded the offer when he discovered the person was Maori.

There were few complaints about comments made in the media. The Press Council considered only one complaint based on race, the BSA considered two complaints. No complaint was upheld.

In all the Human Rights Commission received 491 race related complaints last year. Of these 301 were resolved in the early stages, many by the provision of information and advice from the Commission.

Wednesday, April 29, 2009

Tamiflu Rush Expected Friday

Pharmacists are gearing up for an expected rush on Tamiflu this coming Friday as prescription only restrictions on the drug are eased for the coming NZ influenza season.

Normally Tamiflu is only available on a doctor's prescription except during the flu season.

However, between the dates of 1 May and 30 September it can be obtained over the counter by a person exhibiting flu symptoms and after consultation with a pharmacist. The cost is around $65 for a 5 day course of treatment and may well be out of the reach of many low income families.

New Zealand is thought to be the only country in the world that will sell the drug to the general public without a doctor's prescription. Some pharmacists have already expressed concerns that sick people seeking out sources of the drug will ignore Ministry of Health guidance to stay at home and run the risk of spreading the disease into the community.

NZ is thought to have enough supplies to treat only 30% of the population with a single course of treatment, usually 5 days worth. Prophylactic (preventative) doses would be twice that at 10 days per course of treatment.

Pregnant Women and Babies

Pregnant women should be particularly diligent in preventing their own exposure to the virus because, according to the USA's Centres for Disease Control and Prevention (CDC), no clinical studies have been conducted to assess the safety of this type of medication for pregnant women.
Neither have there been any clinical trials on children under the age of 1, therefore Tamiflu is not licensed for that age group either and its supply in both cases falls to the judgement of the doctor who must be expected to weigh up the risks on a case by case basis.


Meanwhile, the WHO has issued new figures which have scaled down significantly the number of confirmed cases of Swine Flu in Mexico to 26 confirmed human cases of infection, including 7 deaths but paradoxically upgraded its threat awareness level of a pandemic from 4 to 5.

WHO figures are for reported laboratory confirmed cases with no deaths - Canada (6), New Zealand (3), the United Kingdom (2), Israel (2) and Spain (2). Since then a 2 year old child with links to Mexico has died in the USA.

For further information see WHO Swine influenza - update 4

Student Nurse Linda Tang Alleges Racial Discrimination

A student nurse in the final stages of her nursing degree has dropped out of her course and is taking her college to the Human Rights Commission.

Linda Tang, a 42 years old student at UNITEC, left her course because she said her tutors were making it impossible for her to pass.

Tang's tutors complaint is that her accent made it difficult for her patients to understand her.

Tang who holds a degree in English, has taught English at a Chinese university and passed an English language test says the complaint is just an excuse and that she is being penalised just for the way she talks.

More than a third of UNITEC's student nurses are Asian and New Zealand has a broad range of different cultures and ethnic diversities.

19% of the population of Auckland identifies itself as belong to the Asian ethnic group.

The case has again raised the issue of racial discrimination towards migrants in New Zealand and drawn comment from bloggers and posters all over the net. One comment on the forum is particularly pertinent:

"I applaud her for taking up the case. I hope it gets a good hearing and we shall know what is the truth.

English is spoken with all kinds of accents. I cannot understand my British colleague who speaks with a strong Yorkshire accent? And I have been using English my entire working career!

We just need to be tolerant with each other. Language is more than the spoken form.

It's a good point and well made. Why should Chinese people be singled out when English is spoken with a variety of accents in multi-racial New Zealand, including the strong Kiwi accent.

Can the overstretched and understaffed health service afford to lose valuable nurses because of the way they talk?

Monday, April 27, 2009

Two Possible Swine Flu Cases in Waikato

A media release from Waikato District Health Board, made on Monday 27 April

"Waikato District Health Board is investigating two possible cases of Swine Flu today.

These people and their household contacts (people they have been in regular contact with) are being tested to determine whether they have Influenza A (Swine Flu is a sub-set of A).

Both cases, Waikato DHB residents, are being isolated within their homes until the test results come back within the next 24 hours.

Both possible cases fit the case definition for Swine Flu, and have returned from the United States within the past two weeks.

"Currently, as per Ministry of Health guidelines, Tamiflu will be prescribed for probable and confirmed cases and their household contacts (as appropriate)," said Waikato DHB medical officer of health Dr Anita Bell.

"So if these two test results come back as being positive, they will then be administered with the medication."

"Dealing with influenza and pandemic is our business. It is what we do and something we have been prepared for, for at least two years now," said Population Health Service group manager Barbara Garbutt.

"We are comfortable with our previous pandemic planning and are keeping in regular contact with the Ministry of Health on this event."

If anyone is suffering influenza-like illness and has travelled to either Mexico or America within the past two weeks, or been in contact with someone who has, they should call their general practitioner immediately, said Dr Bell."

NZ's Roads Described as "Killing Fields"

The death toll on New Zealand's roads over the Anzac weekend reached 14, prompting National Road Policing manager, Superintendent Paula Rose to describe the roads as "killing fields".

The accidents happened at a number of locations throughout the country which included Oruanui near Taupo, Tangimoana Rd, south of Bulls, Nelson, Whenuapai, SH1 north of Wellsford, Taupaki, Albany Village, Kelston, Meremere and Te Awamutu.

The worst accident was at Oruanui where a collision with a Chrysler shunted a BMW into a head on collision with a van which then burst into flames, killing the 4 people inside. The driver of the of the Chrysler also died and his daughter was seriously injured.

Two young children were pulled alive from the burning wreckage of the van by a passing motorist and taken to hospital.

Foreign Visitors to New Zealand
Visitors to New Zealand should take care on its roads. The high death toll has caused the
UK's Foreign and Commonwealth Office to make this statement in it's travel advice for New Zealand.

"Whilst road conditions are generally good in New Zealand, it takes a little while to get used to local driving conditions.

In 2007 there were 422 road deaths in New Zealand. This equates to 10.0 road deaths per 100,000 of population and compares to the UK average of 5.0 road deaths per 100,000 of population in 2007.

You are advised to read a copy of the Road Code (the official guide to traffic rules and traffic safety) before driving. Particular attention should be given to the section covering the right of way rules, which are different from other countries. UK driving licences are valid for use for a maximum of 12 months.
Motor insurance is not a legal requirement in New Zealand. Therefore, even though the UK has a reciprocal Healthcare Agreement with New Zealand, private accident insurance is recommended. This is because New Zealand law has removed the right of accident victims to sue a third party in the event of an accident. Instead the Accident Compensation Commission (ACC) helps pay for your care if you are injured as the result of an accident. However, the ACC only covers the cost of treatment in New Zealand and delayed travel or loss of income in a third country is not covered.

NZ Students Tested For Swine Flu

A group of students from Rangitoto College returning from Mexico yesterday morning have tested positive for Influenza A.

The students, who were on flight NZ1 from Los Angeles, are awaiting results of further tests to determine if they have contracted the Influenza A H1N1 subtype, also known as Swine Flu.

"Health Minister Tony Ryall said: "Ministry of Health officials advise me there is no guarantee these students have swine influenza, but they consider it likely.

"However, I am also informed none of the affected patients are considered seriously ill, and most in fact seem to be on the road to recovery."

The ten students had tested positive for Influenza A, and their results would be sent to the World Health Organisation laboratory in Australia to ascertain whether it was the H1N1 swine influenza, Mr Ryall said."

A group of students from another Auckland school, Northcote College who also returned home from Mexico that day on flight NZ5 are being monitored by health officials, three of started to develop flu like symptoms but were later cleared.

Pinehurst and Westlake Girls High Schools were reported as presently having students groups visiting Mexico who have yet to return to New Zealand.

Pinehurst School later issued a release saying that Health Minister Tony Ryall's information was wrong and NO students from the school were in Mexico, but were in Argentina which was unaffected by the outbreak

John Key has been reported as saying that "the plan set up since the 2003 bird flu scare meant New Zealand had good stocks of the anitviral drug Tamiflu - about 1.4 million treatments and the single gateway into New Zealand via Auckland meant control was easier."

New Zealand also has international airports at Christchurch (which receives passengers from Australia, Asia and the Middle East) Wellington, Queenstown and Dunedin.

Swine Flu FAQs
The World Health Organisation has published a FAQ on Swine Flu, covering the following questions:

• What is swine influenza?
• What are the implications for human health?
• Where have human cases occurred?
• How do people become infected?
• Is it safe to eat pork meat and products?
• What about the pandemic risk?
• Is there a human vaccine to protect swine influenza?
• What drugs are available for treatment?

With reference to treatment

"Antiviral drugs for seasonal influenza are available in some countries and effectively prevent and treat the illness. There are two classes of such medicines, 1) adamantanes (amantadine and remantadine), and 2) inhibitors of influenza neuraminidase (oseltamivir* and zanamivir).
Most of the previously reported swine influenza cases recovered fully from the disease without requiring medical attention and without antiviral medicines.

Some influenza viruses develop resistance to the antiviral medicines, limiting the effectiveness of chemoprophylaxis and treatment. The viruses obtained from the recent human cases with swine influenza in the United States were sensitive to oselatmivir* and zanamivir but resistant to amantadine and remantadine.

Information is insufficient to make recommendation on the use of the antivirals in prevention and treatment of swine influenza virus infection. Clinicians have to make decisions based on the clinical and epidemiological assessment and harms and benefit of the prophylaxis/treatment of the patient.

For the ongoing outbreak of the swine influenza infection in the United States and Mexico, the
national and the local authorities are recommending to use oseltamivir* or zanamivir for treatment and prevention of the disease based on the virus’s susceptibility profile."

* Oseltamivir is marketed under the trade name of Tamiflu

H1N1 Warning Given a Year Ago
Replikins Ltd released a statement on 8 April 2008 stating that H1N1 was replicating rapidly and may succeed H5N1 as the leading candidate for the next expected pandemic.

Further information about this suspected outbreak can be found on the WHO website, Wikipedia and other news sites


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