ESR has developed an interactive dashboard that displays national and regional surveillance data on COVID in wastewater samples. This allows users to track COVID risk in specific areas of the country. In most regions there is currently a marked discrepancy between reported cases and wastewater results. Click here.

Health professionals can subscribe to an email newsletter that covers key health messages about the COVID-19 response. A list of other Manatū Hauora (Ministry of Health) newsletters that health professionals can subscribe to is available here.

Āwhina is a Ministry of Health app that provides COVID-19 information for people working in the health sector, e.g. case numbers, updated guidance for the aged care sector; it is available for free download here.

N.B. We note that recent clinical changes, e.g. changes to eligibility criteria for antivirals and vaccine boosters, were not announced first via the methods of communication above.

Many people recover from the acute phase of COVID-19 without any notable health problems. However, for a small number of patients more serious health impacts can be experienced, including breathing disorders, post-viral fatigue syndrome, renal and hepatic injury, cognitive impairment, impaired swallowing and malnutrition. Social impacts may include fear of accessing healthcare (or difficulty in doing so), increased anxiety and loss of income.

This living guidance document sets out a framework for addressing these specific health and social impacts in people experiencing ongoing issues in recovery from COVID-19.

Definitions of clinical phases of COVID-19:

The service

• The framework for delivery of the service is based on the Standard of Care, available here, and Clinical Guideline (only available to practitioners directly involved in the service)
• Te Apārangi: Māori Partnership Alliance provides governance and strategic oversight to the service
• There are two hospital pharmacies in New Zealand contracted to provide medicines for assisted dying
• Funding is available for practitioners to travel to provide services so people can receive care regardless of their location; this also allows people choice of practitioner
• As of 31 March, 2022 there were 130 practitioners registered with the service (91 as attending medical practitioners)
• All reports on completed assisted deaths are reviewed by the End of Life Review Committee, which is comprised of a medical ethicist, a doctor specialising in end-of-life care and one other health practitioner; one member is Māori

Applicants

• Between 7 November, 2021 and 31 March, 2022, there were 206 applications for assisted dying
• 66 people had an assisted death
• 59 people were still in the process of assessment (25) or preparation (34) for assisted death
• 81 people did not continue the process due to ineligibility (40), withdrawal (11) or death due to their condition (30)
• Ethnicity: Of the 206 applicants, 79% were NZ European, 6% were Māori, 2% were Asian and 13% were other ethnicities (none were Pacific)
• Age and sex: Of the 206 applicants, 55% were female, 74% were aged ≥ 65 years
• Health status: Of the 206 applicants, 65% had a cancer diagnosis, 10% had a neurological condition, 80% were receiving palliative care at the time of application
• Location of death: 73% of assisted deaths occurred at the persons home or other private residence and 17% in aged care facilities

• The physiological and behavioural responses that occur in response to fever cause metabolic stress and increased oxygen demand, in severe cases leading to seizure and organ failure, therefore the clinical rationale is that reducing fever will improve patient outcomes
• However, fever also induces cellular and immunological changes that are part of the inflammatory response against infection, and some studies have found that antipyretics increase the duration of some infections
• The authors conducted a systematic review with meta-analyses and trial sequential analyses of 42 randomised clinical trials including 5140 participants
• The trials assessed antipyretic medicines (mainly paracetamol and ibuprofen), physical cooling and combination treatment v.s. no fever treatment or placebo, in patients with fever who were critically ill, non-critically ill, with and without infectious illness
• There was no evidence that fever therapy reduced the risk of death (risk ratio 1.04 [0.9 – 1.19]) or the risk of serious adverse events (risk ratio 1.02 [0.89 – 1.17]); conversely there is no evidence that fever therapy increases these risks
• The authors concluded that: Fever therapy does not seem to affect the risk of death and serious adverse events.
• There was insufficient evidence to determine whether fever therapy influences quality of life or non-serious adverse events – we can’t even say for certain that at least it will make the patient feel better