New Zealand

Pandemic Plan
A framework for action

(Interim update – July 2024)

Released 2024 health.govt.nz

Acknowledgements
The Ministry of Health would particularly like to acknowledge the health care workers
for their response and the people of New Zealand for their resilience during the COVID-
19 pandemic.

Comments
The Ministry of Health – Manatū Hauora first published the New Zealand Influenza
Pandemic Action Plan in 2002, and last updated it in 2017. In the years since the plan
was first published, it has undergone substantial revision, due to lessons learnt from the
influenza A (H1N1) 2009 pandemic, the evolving and ongoing potential threat from
H5N1 influenza and more recently the COVID-19 pandemic, which started in 2020.
This plan will continue to evolve. In particular, we will review it again following the
completion of the Royal Commission of Inquiry into COVID-19 Lessons Learned -
Te Tira Ārai Urutā. Further changes to the New Zealand health system announced by the
government may also result in changes to this plan.
If you have any comments, please send them to the Ministry of Health:

by post to: Ministry of Health – Manatū Hauora

133 Molesworth Street
PO Box 5013
Wellington 6145

or by email to: [email protected]

Version
Date: July 2024
Key revisions since last version: Changes have been made to reflect changes
in terminology, legislation, agencies’ names, population-based calculations
and references to publications and websites.

Citation: Ministry of Health. 2024. New Zealand Pandemic Plan: A framework

for action. Wellington: Ministry of Health.

Published in July 2024 by the Ministry of Health

PO Box 5013, Wellington 6140, New Zealand

ISBN 978-1-991075-81-9 (online)

HP 9082

This document is available at health.govt.nz

This work is licensed under the Creative Commons Attribution 4.0 International licence.
In essence, you are free to: share ie, copy and redistribute the material in any medium or
format; adapt ie, remix, transform and build upon the material. You must give
appropriate credit, provide a link to the licence and indicate if changes were made.
Foreword
The New Zealand Pandemic Plan: A framework for action sets out the all-of-
government measures to be taken to prepare for and respond to a pandemic. It
updates the New Zealand Influenza Pandemic Plan: A framework for action 2017.

The Ministry of Health leads the health system’s response and informs the wider
government’s response to a pandemic. It is the responsibility of other agencies to plan
for and respond to a pandemic in their respective sectors and settings, based on the
direction set out by the Ministry of Health.

Pandemics by their nature are unpredictable in terms of timing, severity and the
population groups that are most affected. While written with influenza and
coronaviruses primarily in mind, this version is broadly applicable to other respiratory
illnesses, and, as long as pathogen-specific considerations are accounted for, also has
potential application to other diseases with pandemic potential.

This plan updates the 2017 version to reflect the health system reforms of 2022. It also
incorporates some of the lessons identified during the COVID-19 pandemic response.
The key decisions, public health interventions and phases of the plan remain valid.

The COVID-19 pandemic has demonstrated the impacts that a pandemic can have
across all aspects of society. The risk of another global pandemic remains and the
severity of its impact, especially on those most vulnerable, can be reduced through
implementing lessons learned from COVID-19 through planning and preparedness. In
addition to COVID-19, since the first version of this plan the New Zealand national
security system has been codified and the health sector has responded effectively as a
support agency to a range of hazards and threats, including the Canterbury, Seddon
and Kaikōura earthquake sequences, flooding events, volcanic eruptions and terrorism,
as well as numerous local and regional events.

This version of the New Zealand Pandemic Plan reflects a risk-based approach that
promotes collaboration across the wider health system, all levels of government,
agencies and organisations when planning for, responding to and recovering from a
pandemic event.

Dr Diana Sarfati
Director-General of Health

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION iii

 Kōrero Takamua
Ko tā te Mahere Mate Urutā o Aotearoa: He anga hei whai he whakatakoto i ngā mahi katoa
ā-te kāwanatanga me mahi kia whakarite mai me te urupare mai ki tētahi mate urutā. Ko
tāna anō he whakahou i te Mahere Rewharewha o Aotearoa: He anga hei whai 2017.

Kei te ārahi Te Manatū Hauora i tā te pūnaha hauora urupare me te whakamōhio atu i tā te

kāwanatanga urupare whānui ki tētahi mate urutā. Kei ērā atu pokapū te kawenga ki te
whakarite mahere hei urupare atu ki tētahi mate urutā i roto mai i ā rātou ake rāngai me ō
rātou wāhi, i runga anō i te ahunga i whakaritea ai e Te Manatū Hauora.

Whanokē ana ngā mate urutā mō āhea e puta mai ai, mō te taikaha me ngā rōpū taupori ka
kaha pāngia mai. Ahakoa kua tuhia noatia tēnei whakaputanga mō te rewharewha me ngā
kowheori, ka hāngai hoki ki ētahi atu mate arahau, ā, ina whakaarohia ngā momo tukumate,
ka taea hoki te hāngai atu ki ētahi atu mate ka huri hei mate urutā.

Ka whakahoungia tēnei mahere i tō te 2017 whakaputanga kia whakaata mai i ngā

hanganga hou o te pūnaha hauora o 2022. Ka kōkuhu mai hoki i ētahi akoranga i tautohua
mai ai i te wā o te urupare ki a KOWHEORI-19. Ka whaimana tonu ngā tino whakataunga,
ngā wawao o te hauora tūmatanui me ngā wāhanga o te mahere.

Kua whakaatu mai a KOWHEORI-19 i ngā pāpātanga o tētahi mate urutā ki ngā āhuatanga
katoa, huri noa i te pāpori. Ka noho tonu te tūraru o tētahi atu mate urutā ā-ao, ka mutu, ko
te kaha o tōna pānga mai, inā hoki ki te hunga tino whakaraerae ka taea te whakaiti iho mā
te whai i ngā akoranga i ākona mai ai i a KOWHEORI-19 mā te whakamahere me te ata
whakarite. Tāpiri atu i te KOWHEORI-19, mai i te whakaputanga tuatahi o tēnei mahere kua
whakaritea te pūnaha haumaru ā-motu o Aotearoa, ā, kua urupare pai hoki te rāngai hauora
hei rāngai tautoko i te whānuitanga o ngā pūmate me ngā mahi tūpato, tae atu ki ngā
raupapa rūwhenua o Waitaha, o Seddon me o Kaikōura, ngā waipuke, ngā hūnga me te
whakatuatea, waihoki ko ngā raru o te kāinga, o te motu hoki.

Ko tā tēnei whakaputanga o te Mahere Mate Urutā o Aotearoa he whakaata mai i tētahi

tukanga ā-tūraru e whakatairanga ake ana i te mahi tahi huri noa i te pūnaha hauora
whānui, i ngā wāhanga katoa o te kāwanatanga, i ngā pokapū me ngā rōpū whakahaere e
whakamahere ana, e urupare ana, e whakaora ake ana hoki i tētahi mate urutā.

Tākuta Diana Sarfati

Te Tumu Whakarae mō te Hauora

iv NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Contents
Foreword iii

Kōrero Takamua iv

Part A: Setting the scene 1

Introduction 2
Purpose of the New Zealand Pandemic Plan 2
Structure of this document 3
New in this version 4
Audience for this document 4
Exercising plans 5

What is a pandemic? 6
Definition of ‘pandemic’ 6
Characteristics of pandemics 6
Coronaviruses and influenza viruses 7
The COVID-19 pandemic 8
Influenza pandemics 9
Impacts of the COVID-19 and 1918 pandemics on New Zealand 10
Pandemic scenarios for preparedness and planning 12
Phases of a pandemic: the World Health Organization and New Zealand 13

New Zealand pandemic framework 14

Managing health-related emergencies 14
Pandemic planning and preparedness strategy 15
Legislation 17

Pandemic planning and preparedness 19

Overview of pandemic planning 19
Intelligence between pandemics 19
Ministry of Health pandemic planning 19
Health New Zealand – Te Whatu Ora pandemic planning 21
Te Aka Whai Ora - Māori Health Authority pandemic planning 21
All-of-government pandemic planning 22
Key issues to consider in pandemic planning and preparedness 22

Summary of roles 32

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION v

 Resources must be dedicated as the emergency escalates 32
All-of-government response 32
Coordination arrangements nationally and locally 35
Intersectoral response 39

Part B: The Action Framework 41

How to use the Action Framework 42

Context of the Action Framework 42
Key to the Action Framework 42
New Zealand phases drive the pandemic response in New Zealand 42
Interpretation of actions and key decisions for each phase 43
Key factors to consider when deciding whether to scale up or down
response measures at each phase 45

New Zealand Pandemic Plan 58

Plan For It 59
Keep It Out 69
Stamp It Out 77
Manage It 85
Manage It: Post-Peak 91
Recover From It 96

Appendices 99

Appendix A: Public Information Management Strategy 100

Introduction 100
Key messages framework 100
Key messages prompts 101
Sequence of communication planning 105
Communication initiatives to reach target audiences 107

Appendix B: Explanatory material 113

Ethical considerations 113
Public Information Management Strategy 114
Communications objectives 116
Sequence of communication planning and key messages 116
Intelligence 116
Legislation 122
Disease containment measures 130
Manage It 141
Manage It: Post-Peak 157

vi NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

 Recover From It 161

Appendix C: Intersectoral Pandemic Group work streams 167

Health work stream 167
Biosecurity work stream 171
Law and order and emergency services work stream 173
Civil defence emergency management work stream 176
Welfare work stream 178
Education work stream 182
Border work stream 183
External work stream 186
Economy work stream 189
Infrastructure work stream 191
Workplaces work stream 192

Appendix D: Recovery 195

Cornerstones of recovery 195
National recovery management structure 196

Appendix E: Glossary 199

References 206

List of Figures
Figure 1: New Zealand strategic approach to a pandemic 16
Figure 2: New Zealand pandemic planning actors 20
Figure 3: COVID-19 average daily case numbers in New Zealand, 2020 to 2023
160
Figure 4: COVID-19 average daily case numbers in New Zealand, 2020 to 2021
160
Figure 5: Integrated and holistic recovery 196
Figure 6: Possible national recovery management structure in a pandemic 198

List of Tables
Table 1: Areas of interest to audiences of the New Zealand Pandemic Plan: A
framework for action 4
Table 2: Six-phase strategy of New Zealand pandemic planning 17
Table 3: Intersectoral Pandemic Group work streams and lead agencies 39
Table 4: Calibrating the response according to the potential impact of the event
44

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION vii

 Table 5: Key factors that inform risk assessments and the actions to be taken in a
pandemic response 46
Table 6: Additional factors to consider when mounting a response 49
Table 7: Summary of phases in the New Zealand Pandemic Plan 58
Table 8: Health sector surveillance objectives 119
Table 9: Summary of specific legislative provisions 130
Table 10: Overview of possible border management actions, responsibilities and
relevant legislation 135
Table 11: Infection hazards from bodies of people who have died from pandemic
151

viii NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Part A:
Setting the scene

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 1

 Introduction
Purpose of the New Zealand
Pandemic Plan
The New Zealand Pandemic Plan: A framework for action is based on an established
strategy to deal with outbreaks of infectious disease, and forms part of the National
Health Emergency Plan1 (Ministry of Health 2015).

The purpose of this plan is to outline the health system and wider all-of-government
measures that relevant agencies will consider in response to a pandemic caused by a
respiratory pathogen and to provide an overview of the activities they undertake to
ensure New Zealand is adequately prepared for a pandemic or events with pandemic
potential.

This plan provides an overarching framework for possible actions before, during and
after a pandemic. Actions in any pandemic will depend on a range of factors (eg, the
population susceptibility, transmissibility and severity associated with the particular
disease). Part B of the plan sets out relevant actions.

An enduring feature of all the actions we take will be a strong focus on pae ora, Te
Tiriti o Waitangi, proportionality, equity and advice that is grounded in science.

Agencies (including Health New Zealand - Te Whatu Ora, individual hospitals, regional
emergency management agencies and the National Public Health Service) have their
own legislative and functional responsibilities, and work to their own response plans,
manuals, handbooks and standard operating procedures based on the New Zealand
Pandemic Plan. Each of those documents provides information in addition to that
contained in this plan.

This version of the New Zealand Pandemic Plan provides a framework for action that
can readily be adopted and applied to any pandemic of respiratory infection
characterised primarily by airborne transmission, irrespective of the aetiological
pathogen and its severity. We have developed this plan with influenza and
coronaviruses primarily in mind, but it is broadly applicable to other respiratory
illnesses, and, as long as pathogen-specific considerations are accounted for, may also
apply to other diseases with pandemic potential.

The New Zealand Pandemic Plan is of less relevance to pandemics in which spread is
predominantly by the faecal-oral route, sexual contact, blood-borne transmission or
disease vectors such as mosquitoes, although some components may be applicable.

1
The National Health Emergency Plan is currently under review; the updated plan will be considered in the
second stage of the Pandemic Plan review.

2 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

 The New Zealand Pandemic Plan is a living document. We will update it from
time to time as new evidence becomes available. Agencies should refer to the
version of the plan that appears on the Ministry of Health website, which will
always be the most up to date.

The New Zealand Pandemic Plan is the foundation for our preparedness for and
responses to future pandemics. The Ministry of Health and Health New Zealand - Te
Whatu Ora (Health New Zealand) will use it to inform and customise their responses to
pandemics. The overall response strategy will likely be determined by Ministers and
Cabinet.

Key objective
The key objective of this plan is to minimise deaths, serious illness and significant
disruption to communities, the health system and the economy arising from a
pandemic associated with a respiratory pathogen.

The New Zealand Pandemic Plan is primarily a central government planning and
response framework. It will inform, but not prescribe, the structure of operational plans.

Structure of this document

This plan has three parts (Part A, Part B and Appendices) and concludes with a list of
references.

Part A: Setting the scene outlines the approach the Ministry of Health, Health New
Zealand, and all-of government take to pandemic planning and preparation, and the
coordination arrangements and response functions they would put in place in the
event of a pandemic.

Part B: The Action Framework categorises the phases of a pandemic and provides
guidance on potential actions that may be relevant to each phase, the individuals or
agencies responsible for those actions, and the authority under which actions can be
taken. These factors will always depend on the nature of the particular pandemic. The
Action Framework provides information to guide key decision-making.

The Appendices contain the Public Information Management Strategy (Appendix A),
explanatory material concerning the specific measures identified in Part B (Appendix B),
information on Intersectoral Pandemic Group work streams (Appendix C), some further
information on recovery (Appendix D) and a glossary of key terms and abbreviations
(Appendix E).

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 3

 New in this version
This version of the New Zealand Pandemic Plan updates the New Zealand Influenza
Pandemic Plan: A framework for action (Ministry of Health 2017). It represents the first
part of a two-stage review process. This version follows a limited interim review
undertaken during 2023 and early 2024. Changes here reflect the health system
reforms of 2022, some aspects of the COVID-19 pandemic response and also changes
in terminology, legislation, agencies’ names, population-based calculations and
references to publications and websites.

This version does not address the full range of lessons identified during the COVID-19
pandemic and has not updated the roles of other agencies outside the health sector.
Much content has therefore been retained from the 2017 plan and predates COVID-19.

We plan to undertake a further, more substantive review, including of the roles of other
government agencies, in 2024 /25. This timeline will allow for consideration of findings
from the Royal Commission of Inquiry into COVID-19 - Te Tira Ārai Urutā and other
relevant work, such as the development of a strategy for the national quarantine
capability, reviews of New Zealand pandemic-related legislation, review of the New
Zealand COVID-19 Strategic Framework and amendments to the International Health
Regulations 2005 (WHO 2006) amendments to the IHR were adopted at the World
Health Assembly in May 2024 and in due course New Zealand may choose to accept
them).

Audience for this document

The New Zealand Pandemic Plan is for anyone involved in planning, preparing for or
responding to a pandemic. It also provides general information on pandemics and
government planning for the New Zealand public.

The New Zealand Pandemic Plan summarises many issues. Where possible, it also gives
references to websites and key documents that provide further information.

Table 1: Areas of interest to audiences of the New Zealand Pandemic Plan: A

framework for action

Audience Relevant section of Supporting information

document

Public Part A: Setting the scene Further guidance and resources on the following
Appendix B: Explanatory websites’:
material www.health.govt.nz/our-work/emergency-
management/pandemics/health-sector-pandemic-
influenza-guidance
info.health.nz/conditions-treatments/infectious-
diseases/flu-influenza/

4 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

 Audience Relevant section of Supporting information
document

Health Entire document National Health Emergency Plan (Ministry of Health

professionals 2015)
Guidance documents available from the Ministry of
Health’s web page ‘Health sector pandemic influenza
guidance’: www.health.govt.nz/your-
health/healthy-living/emergency-
management/pandemic-planning-and-
response/health-sector-pandemic-influenza-
guidance-0

Health and Entire document National Health Emergency Plan (Ministry of Health
other sector 2015)
decision-makers Guide to the National Civil Defence Emergency
Management Plan 2015 (Ministry of Civil Defence and
Emergency Management (MCDEM) 2015b)
Guidance documents available from the Ministry of
Health’s web pages ‘Health sector pandemic influenza
guidance’ and ‘Workplace pandemic influenza
guidance’:
www.health.govt.nz/your-health/healthy-
living/emergency-management/pandemic-
planning-and-response/health-sector-pandemic-
influenza-guidance
www.health.govt.nz/your-health/healthy-
living/emergency-management/pandemic-
planning-and-response/workplace-pandemic-
influenza-guidance

Exercising plans
As the National Health Emergency Plan (Ministry of Health 2015) states, to be effective,
all health emergency plans require ongoing testing through exercises.

The education and training of key staff likely to be involved in the activation of a health
emergency plan is essential; this will ensure they will function effectively in what is
likely to be a highly stressful and unusual event. The exercising of emergency plans will
increase the pool of appropriately trained people with competencies in emergency
management.

This plan will be exercised under the National Exercise Programme, which is chaired by
the National Emergency Management Agency. Its main objective is to build capability
across government through a coordinated series of interagency readiness activities,
measured against a set of national objectives. A developed programme of exercises
covers all the risks on the National Risk Register, of which communicable diseases
(pandemics) is one.

All health and emergency plans should be evaluated and reviewed after each exercise.
This may necessitate further training and exercising.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 5

 What is a pandemic?
Definition of ‘pandemic’
Pandemic: An epidemic occurring worldwide, or over a very wide area, crossing
international boundaries and usually affecting a large number of people (Porta
2014).

A pandemic caused by a respiratory pathogen – in particular, a virus – is the most likely

event to cause a large-scale health emergency. Coronaviruses have caused multiple
outbreaks this century: for example, severe acute respiratory syndrome (SARS) in
2002/03, Middle East respiratory syndrome (MERS) in 2013 and 2015 and the COVID-
19 pandemic starting in 2019 (which has moved to being endemic at the time of
publication). As of 6 August 2023, over 769 million confirmed cases of COVID-19 and
over 6.9 million deaths have been reported globally (World Health Organization (WHO)
2023a). In Aotearoa New Zealand, as of 15 October 2023, cumulatively, 3,407 deaths
had been recorded for which COVID-19 was the underlying cause or contributed to the
person’s death (Health New Zealand 2023a). Three major influenza pandemics
occurred in the 20th century, reaching New Zealand in 1918, 1957 and 1968. Estimates
put mortality from the 1918 pandemic at between 50 million and 100 million
worldwide. In New Zealand, the 1918 pandemic is estimated to have infected between
one-third and one-half of the entire population, causing about 8,000 deaths, of which
at least 2,160 were Māori. However, the pandemic of influenza A (H1N1) in 2009
reminds us that some pandemics have only a small impact on death rates. We have
designed the New Zealand Pandemic Plan to ensure it can be readily adapted for mild,
moderate or severe pandemics.

Characteristics of pandemics2
Pandemics entail the global spread of a novel pathogen, usually a virus, which evades
existing immunity, spreads readily (usually from person to person) and can cause
unusually high morbidity and/or mortality for an extended period. Global population
mobility through air, sea and land travel is a key contributor to the rapidity of the
spread of pandemics in recent years.

Viruses that have pandemic potential are those that can undergo antigenic changes –
for example, influenza viruses and coronaviruses. These viruses undergo regular small

2
Pandemics should not be named by their association with countries or animals, as this can lead to
stigmatisation, racism, incorrect assumptions and the misdirection of resources. (For example,
consumers may avoid produce from a named animal, even though there may be no risk of infection
from it, and this avoidance can lead to health, social and economic consequences.) The Ministry of
Health uses the nomenclature recommended by WHO; for example, pandemic influenza A (H1N1) 2009.
The Ministry notes that the way the media refer to pandemics is outside the control of international or
national agencies.

6 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

changes (or mutations) in their genes that alter their surface proteins (or antigens).
The antigenic changes mean that a person may be susceptible to the virus even if they
have been previously exposed, as their existing antibodies will not effectively recognise
and neutralise the antigenically different viruses, or because the virus’s fitness to infect
and reproduce increases. The evolution of the SARS-CoV-2 virus over the course of the
recent COVID-19 pandemic and the evolution of the influenza virus between seasons,
are examples of antigenic drift. Sometimes a virus may undergo a major change in its
genetic profile. This results in a new virus sub-type to which humans have no immunity.
This new sub-type may be a virus with pandemic potential.

New influenza virus strains tend to arise from genetic mutation or a recombination of
viruses in humans or species like pigs and birds. New coronavirus strains have emerged
from zoonotic spread, when humans have come into closer contact with bats (in the
case of SARS-CoV) or dromedary camels (in the case of MERS-CoV) but may also arise
through genetic changes during person to person spread. If new sub-types are able to
spread efficiently within human populations and cause significant human illness, a
pandemic can occur. There is an increasing risk of zoonotic disease spill over into
people as a result of climate change-associated habitat loss, agricultural intensification,
food insecurity and increasing deforestation driving wild animals out of their natural
habitats and closer to human populations. The consumption or keeping of certain
species of wild animals is another risk factor.

Internationally, health agencies including the WHO undertake surveillance of viruses

with pandemic potential.

For further consideration of the generic properties of pandemic scenarios and agents,
see chapter 3 of the Te Niwha report Likely Future Pandemic Agents and Scenarios (Te
Niwha 2023).

Coronaviruses and influenza viruses

Coronaviruses (CoV) are a large family of viruses that cause a range of respiratory
infections, including the common cold and more severe diseases such as Middle East
Respiratory Syndrome (caused by MERS-CoV) and Severe Acute Respiratory Syndrome
(SARS-CoV).

Coronaviruses are zoonotic, meaning they are transmitted between animals and
people. Common signs of infection include respiratory symptoms, fever, cough,
shortness of breath and breathing difficulties. In more severe cases, infection can cause
pneumonia, severe acute respiratory syndrome, kidney failure and death.

Influenza is a contagious viral disease of the respiratory tract. It is a major threat to

public health worldwide because of its ability to spread rapidly and cause widespread
illness and severe complications. Relatively minor epidemics of influenza typically occur
annually in New Zealand during winter, often affecting all age groups and causing
many complications, including viral or bacterial pneumonia.

Influenza is a significant cause of mortality in New Zealand; in many cases, influenza

contributes to an elderly or chronically ill person’s death. Population groups at the

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 7

 highest risk of developing severe outcomes from influenza are typically young children;
people aged over 65 years; people with underlying conditions like heart, lung and
immunosuppressive conditions; pregnant people; and Māori and Pacific peoples over
55 years of age. However, otherwise healthy adults can also be severely affected.

Influenza is characterised by the rapid onset of respiratory and generalised signs and
symptoms, including fever, chills, sore throat, headache, dry cough, fatigue and muscle
/ body aching. Influenza is easily spread through droplets from an infected person
(suspended in the air through coughing or sneezing) being inhaled by another person,
or through contact with contaminated objects. The incubation period can range from
one to seven days, but is commonly one to three days. There is limited evidence that
adults are infectious for half a day to one day before most symptoms start, and until
about day five of the illness. Children generally remain infectious for up to seven days
after symptoms start, but may be infectious for up to 21 days.

The COVID-19 pandemic

Following the first confirmed detection of human-to-human transmission of SARS-
CoV-2 in December 2019, COVID-19, as the disease caused by the virus was
subsequently named, rapidly spread around the world in early 2020. In January 2020
the WHO determined the event to be a public health emergency of international
concern under the International Health Regulations 2005 and in March 2020 the WHO
characterised it as a pandemic.

As of May 2024, the WHO has received reports of over 775 million confirmed cases of
COVID-19 and more than 7 million deaths. These numbers most certainly under-report
the true burden of disease; the WHO has estimated all-cause excess mortality
associated with the COVID-19 pandemic to be in the order of 15 million deaths.

Since its initial detection, the virus has exhibited a remarkable ability to spread within
communities, leading to widespread outbreaks and regional surges. Its transmission
primarily occurs through respiratory droplets and close contact, including with
asymptomatic and pre-symptomatic individuals. Variants of COVID-19, such as Delta
and Omicron, have raised concerns due to their increased transmissibility and potential
to partially evade immunity. These factors have challenged public health systems
worldwide.

Clinically, COVID-19 exhibits a diverse spectrum of severity, ranging from mild or

asymptomatic cases to severe acute respiratory distress syndrome and death. The virus
predominantly acutely affects the respiratory system, but its impact can extend to
various organs, leading to complications like myocarditis and long COVID. Age and
underlying health conditions significantly contribute to disease severity; older adults
and individuals with comorbidities face elevated risks. The demand for medical
resources during surges has strained health care systems, highlighting the need for
adequate infrastructure and resources to manage critical cases.

A significant challenge throughout the pandemic was the rapid development and
uneven distribution of vaccines. Multiple effective vaccines were developed in record
time, but their global availability was highly inequitable. High-income countries

8 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

secured a substantial portion of vaccine supplies, leaving low- and middle-income
countries with limited access. This imbalance not only perpetuated health disparities
but also hampered the global effort to achieve widespread immunity and reduce the
chances of new more virulent variants emerging. Initiatives like COVAX aimed to
address this disparity by facilitating equitable vaccine distribution, but challenges such
as supply chain disruptions and vaccine hesitancy continued to impede progress.

Vulnerable population groups bore a disproportionate burden throughout the

pandemic. Socioeconomic factors, limited access to health care and crowded living
conditions heightened the virus's impact on marginalised communities. Essential
workers, including health care personnel, grocery store employees and public
transportation staff, faced increased exposure risks. Additionally, the pandemic
exacerbated existing health disparities, affecting racial and ethnic minorities at higher
rates. Addressing these disparities requires targeted interventions, equitable access to
resources and inclusive public health policies.

Influenza pandemics
During the 20th and 21st centuries to date, the emergence of influenza A virus
subtypes has caused four pandemics, all of which spread around the world within a
year of being clinically recognised. These were:
• the 1918/19 pandemic influenza A (H1N1)
• the 1957/58 pandemic influenza A (H2N2)
• the 1968/69 pandemic influenza A (H3N2)
• the 2009/10 pandemic influenza A (H1N1) 2009.

The 1918/19 pandemic caused the highest number of known influenza deaths. Many
people died within the first few days after infection, and others died of secondary
complications; nearly half of those who died were young, otherwise healthy adults.

Emergent influenza viruses are of particular concern with regards to their pandemic
potential, due to a lack of prior exposure and underlying immunity in the population.
Influenza viruses circulating in animal species can spill over into humans, causing
severe disease and high mortality. Several strains of influenza are currently of potential
concern and are being monitored globally.

Emergent influenza virus H5N1

Of current concern is high pathogenicity avian influenza H5N1, which primarily causes
severe disease in avian populations. H5N1 rarely infects humans but has a case-fatality
rate of approximately 50% in those that become infected. However, the true case-
fatality rate could be lower, due to the lack of detecting or reporting of asymptomatic
and mild cases (Li et al 2008). To date, cases of H5N1 in humans have been sporadic
(associated with those who have had exposure to live or dead poultry or contaminated
environments such as live bird markets). There has not been any detected human-to-
human transmission of H5N1 in humans; thus the current likelihood of a pandemic due
to H5N1 is low.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 9

 It is still unclear how easily H5N1 can acquire the mutations required to readily infect
humans or cause human-to-human transmission. It is unknown whether changes to the
transmissibility of the virus would also affect its mortality rate. Risk assessments from
agencies such as the WHO, the United Kingdom Health Security Agency and the United
States Centers for Disease Control and Prevention differ in detail, but broadly speaking
the current threat from H5N1 is characterised as ‘low risk/high impact’. The Ministry of
Health considers it important to put plans and strategies in place to manage and
mitigate the impacts of a potential H5N1 pandemic in New Zealand.

Impacts of the COVID-19 and 1918

pandemics on New Zealand
The COVID-19 pandemic was the most severe pandemic New Zealand had experienced
since 1918 and caused significant mortality, morbidity and disruption to health
services. Adverse health outcomes were disproportionately experienced by Māori,
Pacific peoples, the elderly and those with pre-existing or long-term conditions and
disabilities. Like many other countries, New Zealand adopted unprecedented response
measures, including national and regional travel restrictions, physical distancing
(including through school closures), mask wearing and vaccination. The country
effectively closed the border to all but returning citizens and certain essential workers.
The capacity limits at managed isolation and quarantine facilities meant that many
travellers could not travel when they wished to do so; High Court decisions criticised
processes involved in the allocation of these facilities. The Government quickly enacted
bespoke legislation to implement far-reaching, tailored and targeted measures, and
rapidly revised this legislation as circumstances changed.

While the direct and indirect health impacts of the pandemic were significant, the
response measures implemented to save lives and preserve health system functionality
themselves caused major disruption to almost every sphere of social and economic
activity in New Zealand. The provision of financial support to adversely affected
individuals and businesses proved crucial to supporting adherence with public health
and social measures. However, in some segments of society, over time, misinformation
and disinformation contributed to distrust in public health measures. The importance
of measures to build and maintain public trust and confidence cannot be
overestimated.

The 1918/19 pandemic also had a profound effect on New Zealand, which took years
to recover. Because it came at the end of World War I, the extent of the trauma
suffered is less clear than it would otherwise have been. Little was known about the
cause of the disease or how it spread, and a variety of ineffective treatments (such as
throat-sprays) that were available at public facilities might have been additional
sources of infection. Public health knowledge was limited at that time, and in each
community health care workers were overwhelmed and able to do little to halt the
course of influenza in those infected. Because there was no effective treatment, many
people died from secondary infections. Communities formed groups and committees
to look after those most in need with food or home help. It seems that without this
basic care even more could have died.

10 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Impact of pandemics on Māori and Pacific peoples
in New Zealand
The 1918/19 pandemic had a severe impact on Māori, whose death rate of 4.2% was
approximately five to seven times higher than the non-Māori death rate. One study
suggests that the Māori mortality rate was 7.3 times the European rate (Verrall et al
2010). However, there may have been a significant undercount of Māori influenza
mortality rates as a result of undocumented Māori deaths. There were also unusual
mortality patterns between Māori and non-Māori, and between males and females.
Potential explanations of the increased rates for Māori included the higher rates of
chronic respiratory burden experienced by Māori men and women (eg, because of
smoking prevalence and tuberculosis), higher rates of household crowding among Māori
communities and poorer access to health care in those communities (Summers et al
2018). The 1918/19 pandemic was also devasting for our Pacific neighbours. In Samoa
during the 1918/19 pandemic 80% of the population was considered infected, and 20%
died (ibid).

Māori and Pacific peoples in New Zealand had higher rates of morbidity for the influenza
A (H1N1) 2009 pandemic than other ethnic groups. During the 2009 pandemic, Māori
and Pacific were found to have higher influenza notification rates, higher hospitalisation
rates and higher mortality rates and were significantly more likely to require intensive
care unit-level admission. The mortality rates were 2.6 times and 5.8 times higher for
Māori and Pacific peoples respectively when compared with rates for non-Māori, non-
Pacific. Factors associated with higher mortality rates included obesity, morbid obesity
and underlying respiratory conditions. Additionally, a significant proportion of those
who died (39%) were living in the most deprived quintile (Wilson et al 2012).

More recently, a report into COVID-19 mortality in New Zealand shows that the mortality
risk was higher for Māori and Pacific peoples (2.0 and 2.5 times respectively) than the
risk for those in the European and other groups after accounting for age differences
(Ministry of Health 2022b).

There may be multiple contributing factors for the disproportionate impacts of

pandemics on populations. These factors span inequities in the determinants of health,
including experience of crowding, systemic racism and discrimination, as well as
components of communicable disease preparedness and planning, from surveillance to
access to health care.

Evidence suggests that socioeconomic disadvantage and inadequate health system

design, coupled with underlying health conditions and risks, increase the potentially
devastating impact of pandemics on Māori and Pacific communities. Future pandemic
planning needs to take account of these risk factors, which have been clearly and
consistently identified in systematic reviews and epidemiological studies, to ensure
appropriate consideration and planning is undertaken to address the disproportionate
risks for these communities in particular.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 11

 Pandemic scenarios for
preparedness and planning
The New Zealand Pandemic Plan is flexible enough to enable a response to be tailored
to the level of severity of a pandemic. Key actions outlined here reflect the more
serious end of the scale of national health emergencies, but can readily be customised
for less severe pandemics. The 1918/19 influenza pandemic and the COVID-19
pandemic represent the severe to moderate end of the spectrum.

Previous versions of this plan have used the New Zealand standard planning model for
planning assumptions. This plan continues to refer to this model but begins to
transition from it, in that it now accommodates a range of pandemic ‘typologies’ (see
below).

The standard planning model was developed prior to the COVID-19 pandemic and
assumed a severe pandemic wave in which 40% of the New Zealand population (more
than 2 million people) became ill over an eight-week period. The model assumed a
‘stamp it out’ phase followed quickly by a ‘manage it’ phase. The peak incidence in the
model occurred in weeks three to five, when about 1.7 million people – a third of New
Zealand’s population − would be ill, convalescing or just recovered. (These figures are
based on the New Zealand population calculated by Stats NZ in 2023; that is, 5,199,100
people.)

The standard planning model assumed a total case fatality rate of 2%. Thus, about
41,000 deaths occur in the model over the eight-week period, peaking at about 26,500
in week four (New Zealand’s normal weekly death rate is around 623). It is important to
note that this is not a prediction – it is not possible to make any such forecast before a
pandemic develops.

The model’s purpose was to provide a structure around which the health sector, the
Government and New Zealand as a whole could plan for a very large event having
severe impacts on all aspects of society. Because the 1918/19 pandemic in New
Zealand is relatively well understood, for the purposes of the interim review of this plan
it provided the basis for the standard planning model, while recognising that future
pandemics might be more severe or mild in their impact. The interim review also
considered early lessons identified from the COVID-19 pandemic response.

Recently, New Zealand researchers have provided a range of potential pandemic

scenarios based upon knowledge of past events, allowing for pandemic preparedness
and assessment during the early response phases (Baker 2016). These scenarios can be
refined as the pandemic progresses. The scenarios allow planning by predicting the
physical, psychological and socioeconomic harm that might be caused and guiding the
development and implementation of appropriate responses.

Typologies can be based on the type of scenario, informed by features of previous

pandemics and on the characteristics of the pathogen. Important typology
characteristics include transmissibility, clinical severity, visibility, controllability and
certainty of knowledge. Consideration of pandemic typology can inform an assessment

12 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

of the potential impact on the population. We expect that the planned second phase
review of the New Zealand Pandemic Plan will consider the application of a pandemic
typologies approach.

Although our planning is based on a severe pandemic, we have modified the

New Zealand Pandemic Plan so that we can customise the mix of actions at
different phases to apply to a mild or moderate pandemic.

Phases of a pandemic: the World

Health Organization and New
Zealand
Based on experience gained during the COVID-19 pandemic and other recent public
health emergencies, the WHO is developing and disseminating resources to support
member states to respond effectively to future health emergencies. Its Health
Emergency Preparedness, Response and Resilience framework focuses on a strategic
shift towards strengthening five intersecting sub-systems of health security, primary
health care and health promotion: (1) collaborative surveillance; (2) community
protection; (3) safe and scalable care; (4) access to medical countermeasures; and (5)
emergency coordination. The WHO has published the first of a series of transmission-
specific modules, Preparedness and Resilience for Emerging Threats (WHO 2023a) in
draft form. PRET’s Module One focuses on respiratory pathogens such as coronaviruses,
influenza and paramyxoviruses (such as respiratory syncytial virus). The PRET resources:
• outline relevant principles, such as equity, inclusiveness, evidence-informed decision-
making and continuous learning
• recognise the interdependencies between different government and non-
government sectors and resilient communities
• describe different operational stages to inform planning, including prevent and
prepare, respond, recover and the return to prevent and prepare.

We have not modified this version of the New Zealand Pandemic Plan to give full effect
to the draft PRET framework, but we are likely to modify subsequent versions to this end.
This version, while not incompatible with PRET, continues to be structured on pandemic
phases (See Part B for details).

The plan acknowledges that pandemic activity may come in waves, that response and
recovery actions need to recognise this and that different parts of the country may be in
different phases at the same time.

The time between onset and widespread outbreak is unlikely to be predictable, and may
be compressed. If a pandemic has a particularly rapid onset, some phases might
progress quickly or be skipped. For this reason, it is very important to prepare
emergency responses in the inter-pandemic period, the ‘Plan For It’ phase (which
corresponds to PRET’s ‘Prevent & Prepare’ stage).

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 13

 New Zealand pandemic
framework
Managing health-related
emergencies
The New Zealand Pandemic Plan is one part of the wider New Zealand emergency
management framework, which is governed by several Acts and Regulations. The
relationship between health emergency planning and planning in the wider emergency
management sector is detailed in the National Health Emergency Plan (Ministry of
Health 2015), which provides overarching direction for the health and disability sector
and all of government.

The National Health Emergency Plan:

• creates the strategic framework to guide the health and disability sector in its
approach to planning for, responding to and recovering from the health-related
risks and consequences of significant hazards in New Zealand
• clarifies how the health and disability sector fits within the context of New Zealand
emergency management
• specifies roles and responsibilities that health and disability agencies and providers
must provide and carry out in the areas of emergency planning, risk reduction,
readiness, response and recovery
• supports government agencies and other organisations with contextual information
on the health and disability sector’s emergency management strategic framework
and response structure.

The New Zealand Pandemic Plan is an all-of-government document that details

arrangements to be made and specific actions to be undertaken in the management of
a pandemic of respiratory illness.

Cross-references and supporting material

The latest versions of all plans under the National Health Emergency Plan and
associated documents are available on the Ministry of Health’s Emergency
Management web page ‘National Health Emergency Plan’:
www.health.govt.nz/our-work/emergency-management/national-health-
emergency-plan

14 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Pandemic planning and
preparedness strategy
The Government has taken a strategic approach to preparing for, reducing the impact
of, responding to and recovering from a pandemic. Central to this approach are three
overarching goals and a six-phase planning strategy. A series of key functions then
gives effect to the goals and the strategy. This plan describes all these components;
Figure 1 illustrates them.

The three overarching goals are:

• to minimise the impact of the disease on human health and disruption to health
services without increasing health inequities
• to enable society to continue to function as normally as possible during and after a
pandemic
• to minimise and mitigate the economic consequences of a pandemic on New
Zealand.

The key functions giving effect to these goals are of an all-of-government nature,
although they maintain a health focus in line with the nature of a pandemic
emergency.

The six phases are:

1. Plan For It (planning and preparedness)

2. Keep It Out (border management)

3. Stamp It Out (cluster control)

4. Manage It (pandemic management)

5. Manage It: Post-Peak (post-peak management)

6. Recover From It (recovery).

Experience in the COVID-19 pandemic demonstrated the critical importance of regular

risk assessment to inform decision-making on the most appropriate response
strategies as evidence and information evolves and the event changes overtime. The
six-phase pandemic model allows the Government to tailor and adjust a suite of
response measures to ensure they remain appropriate and proportionate to the event.

Table 2 outlines the six phases along with their potential triggers and specific
objectives. The Keep It Out and Stamp It Out phases focus on containing the spread of
the virus and are often jointly described as ‘containment’. Several phases may be in
play at one time (to illustrate, the COVID-19 Elimination Strategy may be seen as a
combination of Keep it Out and Stamp it Out), and different parts of the country may
be in different phases at any one time.

The specific objectives of each phase are not exclusive to each phase. For example,
planning is a continuous process through all phases, but is the primary focus of the

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 15

 inter-pandemic Plan For It phase; border management activities occur in several
phases, but enhanced measures are the focus of the Keep It Out phase.

The six-phase strategy focuses attention on the main objectives and tasks at any
particular time, and represents a simple way to structure plans and activities.

Figure 1: New Zealand strategic approach to a pandemic

16 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Table 2: Six-phase strategy of New Zealand pandemic planning

Phase Potential trigger Specific objectives

Plan For It Level of respiratory illness at Plan and prepare to reduce the health,
Planning and normal seasonal levels social and economic impact of a
preparedness Sporadic cases of novel or non- pandemic on New Zealand
seasonal respiratory illnesses Deal with disease in animals, if required
reported globally Closely monitor overseas reports of
novel or non-seasonal respiratory
illness

Keep It Out Sustained human-to-human Prevent, reduce or delay, to the

Border management transmission of a novel greatest extent possible, the arrival of
respiratory virus overseas in one the pandemic virus in New Zealand
or more countries Border management may also include
exit measures (eg, to prevent or reduce
risk of spread into the Pacific)

Stamp It Out Novel respiratory virus or Control or eliminate any clusters found
Cluster control pandemic virus detected in in New Zealand
case(s) in New Zealand (When combined with Keep it Out, the
Stamp It Out phase can potentially
provide an ‘elimination strategy’)

Manage It Multiple clusters at separate Reduce the impact of the pandemic on

Pandemic management locations or clusters spreading New Zealand’s population, disruption
out of control to health services and the economy

Manage It: Post-Peak New Zealand wave decreasing Expedite recovery and prepare for a
Post-peak management re-escalation of response

Recover From It Population protected by Expedite the recovery of population

Recovery vaccination or pandemic abated health, communities and society where
in New Zealand affected by the pandemic, pandemic
management measures or disruption to
normal services

How changes in strategy are decided in New

Zealand
Part B sets out high-level triggers for transitioning between phases. Risk assessments
should be undertaken regularly; in particular, when new information emerges or
circumstances change. Ministers and Cabinet make final decisions (see ‘All-of-
government response’ in Part A).

Legislation
The New Zealand Pandemic Plan refers to actions authorised by statute. These statutes
include the Health Act 1956, the Civil Defence Emergency Management Act 2002 and
the Epidemic Preparedness Act 2006.

The Health Act is the primary statute focused on the need to contain communicable
diseases, within the country and at the border, and works alongside the more general

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 17

 Civil Defence Emergency Management Act. The Epidemic Preparedness Act provides
additional legislative provisions prompted in part by emerging diseases such as SARS
and influenza A (H5N1) and by the limitations of existing law.

In a pandemic response, the Government will use legislative provisions in a way that is
proportionate and appropriate to the circumstances. In some cases, this may require
the development, enactment and use of event-specific legislation. The COVID-19
Public Health Response Act 2020 is an example of such legislation. It provided a legal
framework to implement public health measures across different classes of people or
regions in New Zealand. As New Zealand moved out of the emergency phases of the
response, The COVID-19 Public Health Response (Extension of Act and Reduction of
Powers) Amendment Act 2022 scaled back the Government’s previous powers.

The Government may only use provisions under the Epidemic Preparedness Act when
the Prime Minister is satisfied that the effects of an outbreak of a quarantinable disease
(as listed in Part 3 of Schedule 1 of the Health Act) are likely to disrupt, or continue to
disrupt, essential governmental and business activity in New Zealand (or parts of New
Zealand) significantly. This standard is high; agencies must therefore not rely on the
activation of these provisions in mounting a response.

If necessary to support a response, Cabinet can agree to amend the schedules of

infections and quarantinable diseases provided for in the Health Act.

Likewise, agencies must not rely on the provisions in the Civil Defence Emergency
Management Act to mount a response.

Appendix B provides greater detail on relevant legislation.

18 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Pandemic planning and
preparedness
Overview of pandemic planning
Sudden surges in the number of people seeking health care, either from mass-casualty
events or from outbreaks of infectious disease, are difficult to manage, so all hospitals
and health agencies have established emergency plans to deal with such events. Within
the Ministry of Health and Health New Zealand, these plans have been coordinated
through the National Health Emergency Plan (Ministry of Health 2015).

New Zealand demonstrated the advantages of comparatively easily managed borders,

an effective government structure and a strong sense of community during the COVID-
19 pandemic. Those factors allowed New Zealand to prevent transmission of COVID-19
during initial waves, enabled high vaccination coverage and consequently kept
morbidity and mortality rates low in comparison to other countries.

Intelligence between pandemics

A nationally consistent monitoring and surveillance system during the period between
pandemics (the ‘inter-pandemic’ period) is an essential component of preparedness. As
such, surveillance and laboratory capabilities in the context of human and animal
health are among the core capacities countries should maintain under the International
Health Regulations 2005 (WHO 2006) to support pandemic prevention and response.
Overseas trends must be monitored and analysed, and surveillance systems in New
Zealand maintained, to enable the early detection of an emerging threat. These
systems must be capable of detecting and tracking the progress of a pandemic illness
in New Zealand. Information from the intelligence system will play a key role in guiding
actions throughout all the phases of a pandemic.

Ministry of Health pandemic

planning
The Ministry of Health began pandemic planning in 2005 because of increased national
and international concern about the risk posed by pandemic influenza. This concern
was reinforced by experience with SARS in 2002–2004, the ongoing threat of influenza
A (H5N1), influenza A (H1N1) in 2009 and most recently the COVID-19 pandemic.

Figure 2 sets out the main actors in pandemic planning.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 19

 Figure 2: New Zealand pandemic planning actors

During a pandemic, expert groups are convened as required to provide expert clinical,
virological, epidemiological, infection control and ethical advice to inform the Ministry
of Health’s pandemic response planning. These groups will inform the Ministry’s policy
on communications, key messages, public health interventions and a range of
associated issues, and help address specific operational issues as the need arises. They
may also provide technical advice to the Director of Public Health.

The Ministry of Health’s pandemic planning aims to ensure a coordinated approach

that avoids duplication of effort or communication across the large number of groups
and organisations within the wider health and disability sectors involved in pandemic
planning. One mechanism to achieve this is the Intersectoral Pandemic Group,
comprised of central government agencies convened by the Ministry of Health.

The Ministry of Health recognises the importance of an effective flow of information

between health agencies (including Health New Zealand) and to regional, district and
local health providers (including hospitals, ambulance services and the primary health
care sector). Providers of primary health care in the community (eg, general
practitioners, pharmacists and primary health care nurses) and ambulance services will
be under great pressure in the context of a pandemic, and will need ongoing

20 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

information, advice and assistance. Other providers of community health care, such as
those working with people with disabilities and in aged care, will need similar help. The
Ministry has issued several pandemic-related guidelines to help those involved in
pandemic planning and response, including for the management of national reserve
supplies, H5N1 pre-pandemic vaccine use and laboratory guidelines.

Health New Zealand – Te Whatu Ora

pandemic planning
Health New Zealand is the lead agency for co-ordinating local and regional reduction
readiness planning, ensuring health services function to the fullest possible extent
during and after a pandemic (and other health emergencies) and ensuring the
coordination of all health service providers. Further emergency responsibilities are set
out in the New Zealand Health Plan, established under the Pae Ora (Healthy Futures)
Act 2022.

Relevant documents and legislation noted in the New Zealand Health Plan include:
• the Health Act 1956
• the Epidemic Preparedness Act 2006
• the Civil Defence Emergency Management Act 2002
• clauses 47–51 and 71 in the Schedule to the National Civil Defence Emergency
Management Plan Order 2015
• the National Health Emergency Plan (Ministry of Health 2015)
• National Health Emergency Plan: Hazardous substances incident hospital guidelines
2005 (Ministry of Health 2005b)
• Communicable Disease Control Manual (Health New Zealand).

Te Aka Whai Ora - Māori Health

Authority pandemic planning3
As originally set out in the Pae Ora (Healthy Futures) Act 2022, the role of Te Aka Whai
Ora was to lead and monitor transformational change in the way the entire health
system understands and responds to the health and wellbeing needs of whānau Māori.
Te Aka Whai Ora’s foundational mahi was to:
• lead change in the way the health system understands and responds to Māori
health needs
• develop strategy and policy which will drive better health outcomes for Māori
• commission te ao Māori solutions and other services for Māori communities

3
With effect from 30 June 2024 Te Aka Whai Ora has been disestablished. As a result, the functions of Te
Aka Whai Ora were transferred to either the Ministry of Health or Health New Zealand – Te Whatu Ora.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 21

 • co-commission other services alongside Health New Zealand and other agencies
• monitor the overall performance of the system and reduce health inequities for
Māori
• manifest the aspirations, objectives and imperatives of iwi, hapū and Māori
communities.

The Pae Ora (Disestablishment of Māori Health Authority) Amendment Act 2024 came
into effect on 30 June 2024. As a result, the above functions transferred to either
Hauora Māori Services within Health New Zealand or the Ministry of Health. Functions
include working in collaboration with partners and other stakeholders, including iwi
Māori partnership boards, Māori health partners and professionals, iwi, hapū and Māori
communities. Partnership with Māori and integrating Māori voices into health planning
and service delivery remain a priority.

Iwi Māori partnership boards are the primary source of whānau voice and influence
regional strategies. Māori health partners and professionals provide services grounded
in te ao Māori and are more responsive to Māori needs.

The COVID-19 pandemic highlighted the strength of New Zealand’s kaimahi workforce,
the innovation and agility of Māori providers and the effectiveness of those providers
in improving the hauora of their communities. The importance of resilient communities
and the benefit of a health promotion approach in emergency planning and response
is increasingly recognised internationally (Public Health Agency of Canada 2023) and
was a notable feature of the COVID-19 response in New Zealand.

All-of-government pandemic
planning
Planning and preparedness for an event of the scale, scope, complexity and potential
impact of a pandemic require expertise from a range of fields across government
agencies. The Ministry of Health takes a lead role in strategy and planning for a health-
related emergency; Health New Zealand leads operational response planning.

The New Zealand Pandemic Plan is the core document agencies should use to
inform their pandemic planning.

Key issues to consider in pandemic

planning and preparedness
The National Health Emergency Plan (Ministry of Health 2015) outlines generic
considerations for health emergency planning. The New Zealand Pandemic Plan

22 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

highlights the issues specifically related to respiratory pandemics. Planning needs to be
accompanied by preparedness programmes, including training and exercising.

Ethical issues in pandemic planning

The National Ethics Advisory Committee is an independent advisor to the Minister of
Health on ethical issues of national significance concerning health and disability
matters. Its guidance Finding Balance: Ethical guidance for epidemics and pandemics
20234 sets out a number of principles to guide decision-making. It highlights ethical
considerations in a pandemic relating to priority populations, those in higher-risk
settings (eg, hospitals, residential services and correctional facilities) and occupations
and other vulnerable groups (including people over 65, people experiencing
homelessness, rainbow community members, former refugees and recent migrants,
and children in poverty). These considerations must underpin planning to ensure
inequities are not increased as a result of a pandemic intervention. The committee
recommends co-designing epidemic and pandemic plans with relevant population
groups to better ensure equal outcomes and connecting with local communities before
a pandemic to enable the rapid stand-up of community-led responses, which can
significantly reduce or eliminate the risks.

None of the principles should be read as being more important than another. Rather,
they are all important, and the appropriate emphasis to give each one depends on the
context, and may shift during a pandemic. The six principles are:
• manaakitanga – implementing measures that are intentioned and respectful, and
demonstrate caring for others. Establishing mutually beneficial communication and
collaboration pathways.
• tika – implementing measures that are ‘right’ and ‘good’ for a particular situation, in
a way that is open and transparent. Cultivating trust between decision-makers and
the people their decisions affect.
• liberty – implementing measures that uphold human rights, including liberties and
privacy.
• equity – implementing measures that eliminate or reduce unjust inequities in health
outcomes for different groups of people and achieve healthy futures for all.
• kotahitanga – implementing measures that strengthen social cohesion through
empowering local government, leaders and communities to be active participants in
planning and response.
• promoting health and wellbeing – implementing measures that protect and uplift
the four cornerstones of the Te Whare Tapa Whā health model: whānau health,
mental health, physical health and spiritual health. Healthy individuals and whānau
turn into healthy communities and a healthy population.

Cross-references and supporting material

Finding Balance: Ethical guidance for Epidemics and Pandemics (forthcoming).

4
This document is yet to be published at the time of the interim review. Its name may change.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 23

 Ethics and Equity: Resource Allocation and COVID-19 (National Ethics Advisory
Committee 2021)

Māori as tāngata whenua, Te Tiriti o Waitangi and

the strategic direction for hauora Māori
Pae Tū: Hauora Māori Strategy (Pae Tū: Ministry of Health 2023b) sets the direction for
improving the health and wellbeing of Māori towards pae ora – healthy futures for
Māori. It is a key element of the Government’s health system reforms required by the
Pae Ora (Healthy Futures) Act 2022 and drives the health system to realise new
opportunities to accelerate and enhance progress for hauora Māori. The development
of Pae Tū was a joint initiative between the Ministry and Te Aka Whai Ora (prior to its
disestablishment).

Pae Tū sets out five strategic priorities that build on the reforms and will accelerate
action through innovation, collaboration and learning. Pae Tū also drives action across
four other population-specific strategies: for Pacific peoples, disabled people, women
and rural populations respectively. It acknowledges the diversity of Māori communities
and reinforces the whole-of-system approach needed to improve hauora Māori. Health
entities must have regard to this strategy when exercising their powers or performing
their functions.

Whakamaua: Māori Health Action Plan 2020–2025 (Whakamaua: Ministry of Health

2020c) is the implementation plan for Pae Tū and provides clear direction for health
planners and funders, whānau, hapū, iwi and other stakeholders to give effect to our
strategic direction for hauora Māori. Whakamaua has played an important role in
guiding the Māori health response to COVID-19 as well as the recent health reforms.

Meeting our obligations under Te Tiriti o Waitangi is critical to achieving the

aspirations and priorities outlined in Pae Tū and Whakamaua. These obligations are
outlined in the Ministry of Health’s Te Tiriti o Waitangi framework. They include five
Tiriti principles, defined as follows:
• tino rangatiratanga: provides for Māori self-determination and mana motuhake in
the design, delivery and monitoring of health and disability services
• equity: requires the Crown to commit to achieving equitable health outcomes for
Māori
• active protection: requires the Crown to act, to the fullest extent practicable, to
achieve equitable health outcomes for Māori. This includes ensuring that it, its
agents and its Treaty partner are well informed on the extent and nature of both
Māori health outcomes and efforts to achieve Māori health equity
• options: requires the Crown to provide for and properly resource kaupapa Māori
health and disability services and to ensure that all health and disability services are
provided in a culturally appropriate way that recognises and supports the
expression of hauora Māori models of care

24 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

• partnership: requires the Crown and Māori to work in partnership in the
governance, design, delivery and monitoring of health and disability services. Māori
must be co-designers, with the Crown, of the primary health system for Māori.

Agencies must give practical effect to these Tiriti obligations in line with our strategic
direction for hauora Māori. These responsibilities should be addressed early in the
pandemic planning and response process. They could involve:
• using and establishing Māori governance structures to inform decision-making,
making use of devolved decision-making authority where appropriate
• investing in Māori communities and hauora Māori providers to ensure they have
appropriate resources to lead their own response
• developing tailored Māori communications and using channels that provide a far
reach across Māori communities to ensure those communities are kept informed
• ensuring any public health measures have a strong equity approach.

Cross-references and supporting material

New Zealand Pandemic Plan: Appendix A: Public Information Management
Strategy
New Zealand Pandemic Plan: Appendix B: Explanatory material
He Korowai Oranga: Māori Health Strategy (Minister of Health, Associate Minister
of Health 2014)
Pae Tū: Hauora Māori Strategy (Ministry of Health 2023b)
Whakamaua: Māori Health Action Plan 2020–2025 (Ministry of Health 2020b)
Te Tiriti o Waitangi (Ministry of Health 2020b)
Including Culturally and Linguistically Diverse (CALD) Communities (MCDEM
2013)
Likely Future Pandemic Agents and Scenarios: An epidemiological and public
health framework (Te Niwha 2023) – Section 4.2

Other priority populations and equity considerations

Under the Pae Ora (Healthy Futures), Act we are committed to achieve equity in health
outcomes for all under an equitable, accessible, cohesive and people-centred system.
Specific strategies now set the direction for certain populations that experience
inequities in health and wellbeing outcomes:
• Māori
• Pacific peoples
• disabled people
• rural populations
• women.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 25

 Policymakers have a duty to identify and anticipate the population groups likely to be
disproportionately affected by disease outbreaks (eg, wāhine Māori) and take steps
that build on the strengths of those groups and mitigate predictable harms. They
should take an intersectional approach, and apply an analytical framework to
understand how a person’s various social and politic identities (eg, in terms of gender,
age and ethnicity) create compounding disadvantage or privilege.

In the context of disease outbreaks, inequitable health and wellbeing outcomes may be
associated with poorer access to health services or the increased impact of public
health measures (eg, economic impact of quarantine). Some groups may have a higher
risk of exposure, acquisition, transmission or severe clinical disease. To address
inequities, we can apply our defined Tiriti principles, build on lessons learnt in the past
(eg, in the context of community-led responses to COVID-19), undertake better data
collection and disaggregation, and address the current gaps in health data sets.

Pacific peoples in New Zealand

‘Pacific peoples’ is a collective term for diverse ethnic groups who whakapapa (have
ancestry) to Pacific Island countries. The seven largest Pacific groups in New Zealand
are Samoan, Tongan, Cook Island, Niuean, Fijian, Tokelauan and Tuvaluan. An
understanding of this diversity is essential for pandemic planning and preparedness;
for example, effective communication of public health messages and health promotion
needs to be provided by trusted members of these communities in appropriate
languages. Translating health messages into the range of Pacific languages during the
COVID-19 response was important to ensure Pacific communities were kept informed).
The age structure of the Pacific population is younger than it is for New Zealand’s total
population. Pacific populations are concentrated in Auckland, Wellington and the
Waikato; there are smaller populations throughout New Zealand, including in rural
areas.

Pacific peoples were disproportionately affected in the influenza A (H1N1) 2009

pandemic and the COVID-19 pandemic; there is evidence of delayed care and a slow
public health response for those at highest risk (Sonder et al 2020). However, COVID-
19 also illustrated the resilience of Pacific peoples and the natural support systems
among Pacific communities that contribute to collective wellbeing. Pacific providers
and communities formed a cornerstone of the response to COVID-19, responding to
the evolving needs of whānau and households. The success of this response depended
on the strength and resilience of Pacific peoples and the value of tautua (service).

Priority areas within Te Mana Ola: The Pacific Health Strategy (Ministry of Health 2023c)
can inform actions aiming to achieve better performance of the health system for
Pacific people during a pandemic. Those priority areas are:
• autonomy and determination:
– maintaining and nurturing Pacific decision-making and leadership
– engaging and involving Pacific leaders and communities (eg, through churches,
councils or sports groups) to identify issues, raisie awareness and maximise the
delivery of key messages
• access: increasing access to culturally safe health services, including to Pacific-led
options

26 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

• workforce: strengthening Pacific pandemic and emergency capacity and capability,
and involving more Pacific people in leadership and decision-making
• disease prevention, health promotion and management for good health:
improving the prevention and management of chronic diseases
• population health: improving environments including housing and considering
these determinants/environmental factors in responses (eg, ensuring safe and
effective options for isolation and quarantine where needed and providing wrap-
around services such as integrated social supports).

Cross-references and supporting material

New Zealand Pandemic Plan: Appendix A: Public Information Management
Strategy
New Zealand Pandemic Plan: Appendix B: Explanatory material
Te Mana Ola: The Pacific Health Strategy (Ministry of Health 2023c)
Being Prepared (Ministry of Health 2013b)
Including Culturally and Linguistically Diverse (CALD) Communities (MCDEM
2013)
Likely Future Pandemic Agents and Scenarios: An epidemiological and public
health framework (Te Niwha 2023) – Section 4.3

Tokelau, Niue and the Cook Islands

New Zealand has constitutional relationships with Tokelau, Niue and the Cook Islands.
Tokelau is a dependent territory of New Zealand, and Niue and the Cook Islands are
self-governing states in free association with New Zealand. Because of these linkages,
and the fact people from Tokelau, Niue and the Cook Islands are New Zealand citizens,
the New Zealand Government needs to consider the situation of these states and
territory when planning for, and responding to, a pandemic.

The New Zealand Government works closely with the governments of Tokelau, Niue
and the Cook Islands to determine how best to help them with their preparedness and
response to a pandemic.

There is a need to support South Pacific island nations in general to strengthen

regional pandemic control measures and infectious disease surveillance. New Zealand
has very specific obligations to these Pacific Realm countries, including in terms of
providing access to health care. This has important considerations for the prevention
and control of infectious diseases, including legal obligations, the management of
borders and the delivery of health care and immunisations.

Cross-references and supporting material

Likely Future Pandemic Agents and Scenarios: An epidemiological and public
health framework (Te Niwha 2023) – Section 4.3

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 27

 Other ethnic communities in New Zealand
It is important to consider the needs, experiences and realities of ethnic communities
other than Māori and Pacific peoples. In the COVID-19 pandemic, there was no
systematic approach to funding initiatives for ethnic communities. However, specific
actions were initiated after needs were identified: for example, translating key
information into a variety of languages and establishing the Ethnic Communities
COVID-19 Vaccine Uptake Fund.

Cross-references and supporting material

New Zealand Pandemic Plan: Appendix A: Public Information Management
Strategy
New Zealand Pandemic Plan: Appendix B: Explanatory material

Disabled people
Disabled people are a vulnerable population, and are more susceptible to secondary
health conditions and environmental hazards, including infectious diseases. They are at
higher risk of infection and poorer outcomes from pandemics. The COVID-19
pandemic highlighted that public health responses are critical to reducing the
disproportionate impacts of pandemics on disabled people, including tāngata
whaikaha Māori and Pacific disabled peoples. There is a fundamental need to enable
the self-determination of disabled people and ensure their voices are heard, including
by engaging disability sector leaders and stakeholders in the co-design of strategies
and solutions. Other important goals are:
• learning from pandemic-related disability issues and the disability community’s
experiences and concerns
• providing clear, consistent public health communications in accessible formats,
tailored through disability networks addressing concerns specific to the disability
community
• partnering with disabled people in the design of public health measures such as
testing strategies and infection prevention and control (IPC) measures.

Cross-references and supporting material

Provisional Health of Disabled People Strategy (Ministry of Health 2023)
Inquiry into the Support of Disabled People and Whānau During Omicron (Human
Rights Commission 2022)
Making Disability Rights Real in a Pandemic (Ombudsman 2021)

28 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Women
The COVID-19 pandemic showed that women are disproportionately impacted by
public health emergencies like pandemics. One of the priorities of the Women’s Health
Strategy (Minister of Health 2023c) is a ‘health system that works for women’. It is
essential that pandemic preparedness and response enable participation by diverse
groups of women in response planning, decision-making and coordination. A
gendered lens should be applied to all policy related to pandemic preparedness and
response, and to collecting and analysing gender data that is disaggregated by age,
ethnicity and so on.

Cross-references and supporting material

Women’s Health Strategy (Minister of Health 2023c)

Rural populations
The COVID-19 pandemic showed the strong social networks and sense of responsibility
for collective wellbeing that characterise rural communities. Rural Māori make up
almost a quarter of the rural population. In the COVID-19 response, iwi, hapū and
marae offered support to help rural people to stay safe and connected and access
essential needs.

Future pandemic planning must enable rural Māori to meaningfully participate and
direct pandemic efforts from the base of their iwi and hapū, guided by tikanga and
kawa. ‘Rural-proofing’ of future pandemic planning is required to ensure that
government action will work for rural communities.

Cross-references and supporting material

Rural Health Strategy (Minister of Health 2023b)

Community issues
Action at a community level will be fundamental to an effective national response to a
future pandemic. During the height of a moderate to severe pandemic, people within
communities will not be able to rely solely on the health and disability sector or other
government agencies for support; they will need to support each other. Health services
are likely to be reconfigured and use different models of care, but are still unlikely to
be able to provide business-as-usual levels of health care beyond the early stages of a
severe pandemic. Families need to be prepared to care for each other at home. Non-
governmental organisations, charities and community groups all have an important
role to play in assisting their communities to respond to a pandemic. The importance
of building resilient communities prior to emergencies and adopting health promotion
approaches is increasingly recognised internationally (Public Health Agency of Canada
2023).

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 29

 One particular community issue that government agencies and other service providers
must consider in a pandemic is that people who are dependent on others may be left
without their caregivers. At the community level, neighbourhoods should prepare for
the possibility that they will need to assist each other in this respect. Local community
networks of support will be particularly important for people living on their own.

Pandemics are stressful, and there is often considerable uncertainty about the threat
and how to deal with it. Under these circumstances, mis- and disinformation can
flourish. As part of the response, there is a need to monitor and address harmful mis-
and disinformation, to consult and engage with communities and community leaders,
and to build and maintain public trust and confidence.

Other groups that are at higher risk of infection or

poor outcomes
Other groups that are at a higher risk of infection or poor outcomes in the context of a
pandemic include:
• people who are immunosuppressed
• people with high-risk medical conditions or chronic conditions
• the elderly
• children
• pregnant people
• health care workers
• other essential workers.

The impact of a pandemic on different population groups may vary. People living in
institutions such as rest homes or barracks, and schoolchildren, are at higher risk of
infection than other groups because they are living or working closely to each other.

Programmes at all phases, therefore, must focus intensively on groups at higher risk,
particularly when resources are stretched: for example, during the response phase(s).

During a moderate to severe pandemic, there are likely to be substantial numbers of

people whose usual caregivers are unable to provide assistance. This could include
children whose parents are sick, older people, people with a chronic illness or disability
and people with mental illness. As a matter of priority, services need to be targeted to
provide support to such people.

During the COVID-19 pandemic, health care workers globally faced particular risks of
exposure in the course of their work. Shortages of personal protective equipment and
uncertainty about the mode of transmission contributed to very high mortality rates
among health care workers in the early stages of the outbreak. Pandemic planning
must pay particular attention to keeping health care workforces safe.

30 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

High-risk settings
During preparedness and response, particular attention should be given to certain
settings where individuals may be at higher risk of adverse outcomes. These may include:
• aged residential care facilities
• disability care facilities
• corrections facilities
• educational facilities
• Scott Base in Antarctica and other remote scientific stations.

Cross-references and supporting material

New Zealand Aotearoa Pandemic Response Policy for Aged Residential Care
(Ministry of Health 2020a)
Six Principles for Safe Visiting and Social Activities in Aged Residential Care
(Ministry of Health 2022a)

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 31

 Summary of roles
Resources must be dedicated as the
emergency escalates
New Zealand’s strategic response to a pandemic will use the framework detailed in the
Action Framework (Part B). As a pandemic emergency escalates, more resources will
need to be dedicated to the response. As a result, agencies must understand, and in
fact expect, that business as usual will be affected (see ‘Business continuity’ in
Appendix B). In particular, agencies are likely to be affected by high levels of illness
among staff, and disruptions to supply and distribution processes. This chapter outlines
the responses required.

All-of-government response
An emergency such as a pandemic that potentially affects the whole of society requires
national coordination and decision-making to protect and reduce the impact of the
emergency on New Zealand as a whole. In such an event, strategic decisions will be
made centrally through established processes and systems.

Recent events such as the Canterbury earthquakes (2010/11), the Port Hills Fire (2017),
the Whakaari volcanic eruption (2019), the measles outbreak (2019), COVID-19 and
Cyclone Gabrielle (2023) have demonstrated the need for effective coordination,
cooperation and leadership in managing emergency responses. This section outlines
current organisational arrangements to ensure effective coordination, cooperation and
leadership in a pandemic emergency.

Governance and decision-making

The Officials Committee for Domestic and External Security
Coordination system
The Officials Committee for Domestic and External Security Coordination (ODESC) is
the all-of-government strategic crisis management mechanism in the case of events
such as a pandemic. The Department of Prime Minister and Cabinet will activate the
ODESC system following confirmation of a sustained and efficient human-to-human
transmission of a pathogen with pandemic potential overseas (ie, at the Keep It Out
phase).

The ODESC system has been used as the all-hazards, all-risks strategic crisis response
governance mechanism for a wide range of threat- and hazard-caused crises since
2001.

32 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

In responding to a crisis, government seeks to:
• ensure public safety, protect human life and alleviate suffering
• preserve sovereignty and minimise impacts on society, the economy and the
environment
• support the continuity of everyday activity and the early restoration of disrupted
services (including non-pandemic-related health services)
• uphold the rule of law, democratic institutions and national values.

The ODESC system focuses on strategic matters and provides for a coordinated
government response in which:
• strategic risks are identified and managed
• the response is timely and appropriate
• national resources are applied effectively
• adverse outcomes are minimised
• multiple objectives are dealt with together
• agencies’ activities are coordinated.

The ODESC system is based on the expectation that a lead agency for a particular
hazard, threat or risk will coordinate appropriate all-of-government operational activity
in response. Lead agencies have a mandate for this responsibility through legislation or
agreed authority. A lead agency monitors and assesses the situation, coordinates
national support, reports to ODESC and provides policy advice. In the case of a
pandemic, the lead agency is the Ministry of Health.

The Prime Minister is the lead decision-maker in the ODESC system, which operates
across three levels:
• ministers
• chief executives
• senior officials.

The Department of Prime Minister and Cabinet leads the National Resilience System.
This includes the National Risk Framework, which generates advice and drives decision-
making. The Hazard Risk Board, made up of relevant public sector chief executives, has
a strategic governance role in this system across national hazard risks (including
communicable diseases). The Department of Prime Minister and Cabinet convenes
meetings to consider issues, identify risks and ensure decisions are being taken at the
right level and escalated as needed. Officials will receive a situation update from the
lead agency and other agencies as relevant, discuss key risks and issues, and identify
communications requirements (public-facing and to ministers). Decision-making
relevant to the situation is elevated from the lead agency through the same three
levels described above: from watch groups of senior officials through ODESC chief
executives to ministers, as warranted by the situation.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 33

 The Ministry of Health as lead agency
The Ministry of Health is the lead agency for national level planning for pandemics
(and other health emergencies). Health New Zealand leads the planning and response
at a local and regional level. The Ministry’s stewardship and oversight role includes
collaboration with Health New Zealand. The Ministry’s assurance function requires
confidence that the other entities are giving full effect to their operational roles. The
points below list activities and the associated agencies with responsibilities for them.
Where a certain activity does not have a clear owner, in the first instance, the Ministry
will take responsibility for identifying the appropriate entity to take ownership.

This list allocates one or more lead entities to each activity. Other entities may still be
involved in a supporting capacity:
• initiating, activating, escalating and standing down co-ordination of regional
emergency responses through the Health New Zealand National Coordination
Centre (NCC) and as required for coordination of a national emergency response,
through the National Health Coordination Centre (Ministry of Health). The National
Health Co-ordination Centre will be initiated, activated, escalated and stood down
as required by the Ministry of Health in the event that the National Crisis
Management Centre is activated by NEMA
• maintaining standard operating procedures for the National Health Coordination
Centre that clearly identify roles and responsibilities consistent with the Coordinated
Incident Management System (CIMS) organisational strategy identified in the
National Health Emergency Plan (Ministry of Health 2015). Standard operating
procedures are in place for certain functions under the International Health
Regulations 2005, risk assessment procedures and interaction with ODESC, which
are led by the Ministry of Health and Health New Zealand
• ensuring sufficient staff are trained and exercised to participate in the National
Health Coordination Centre at short notice and maintaining a knowledge base on
pandemic planning and response (Ministry of Health and Health New Zealand)
• undertaking national intelligence and planning, including liaising with the WHO and
other international bodies responsible for providing high-level advice and
recommendations to national authorities (Ministry of Health and Health New
Zealand)
• providing information and advice to ministers (Ministry of Health and Health New
Zealand)
• liaising nationally with, and advising, other government agencies (Ministry of Health
and Health New Zealand)
• advising the ODESC system to activate the National Crisis Management Centre
when necessary (Ministry of Health)
• convening advisory groups and collating information (Ministry of Health and Health
New Zealand)
• providing clinical and public health information and advice nationally, including
through 0800 advice lines and digital channels, and providing access to travel
advisories that border control agencies produce (Ministry of Health and Health New
Zealand)

34 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

• overseeing and monitoring the health sector response nationally (Ministry of
Health)
• instigating and leading public health risk assessments (Ministry of Health and
Health New Zealand)
• commissioning and delivering services for hauora Māori (Health New Zealand).

Ministry for Primary Industries as lead agency

For an animal disease, whether epizootic or panzootic (the animal health equivalents of
epidemics and pandemics respectively), the Ministry for Primary Industries will be the
lead agency.

If a human contracted the disease as a result of handling affected animals or working

in a contaminated environment, the Ministry for Primary Industries would continue as
lead agency, working closely with the Ministry of Health and Health New Zealand on
the risks associated with the human case or cases and possible human-to-human
transmission. In particular, the Ministry for Primary Industries would be responsible for:
• notifying the Ministry of Health and Health New Zealand
• determining the particular strain of the disease in infected animals
• notifying the World Organisation for Animal Health
• implementing technical response policies and plans in accordance with the
Biosecurity Act 1993
• monitoring the infection in animal populations
• liaising with the Ministry of Health and Health New Zealand in relation to human
cases or suspected cases.

Where human-to-human transmission of an animal disease occurs in New Zealand or

overseas and there is an indication of possible pandemic spread, the Ministry of Health
becomes the lead agency for managing the pandemic. The Ministry for Primary
Industries would, however, continue undertaking incursion response activities.
Additional roles the Ministry for Primary Industries would have in a pandemic situation
include assisting with welfare recovery, assisting with legal and border issues with other
agencies and assisting the Ministry of Health with laboratory testing.

Coordination arrangements
nationally and locally
One of the critical components of an effective pandemic response is the relationship
between the Ministry of Health, as lead agency, and other government and local
organisations involved in emergency management. The National Emergency
Management Agency and designated local and group controllers have certain
responsibilities for the management of emergencies in the community.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 35

 Government agencies are responsible for leading their own responses and those
of the sectors they serve, using the New Zealand Pandemic Plan and generic
material the Ministry of Health has produced to help them develop and
disseminate information.

Roles and accountabilities of local agencies

Health New Zealand, in accordance with national policy, will involve regional and
district emergency planners or health coordinators,5 public health services and, where
statutory public health measures are called for, local or national medical officers of
health in planning for and responding to a pandemic.

The Minister of Health can authorise the use of special powers under sections 70−72 of
the Health Act 1956 to assist with the management of health or disease-related
interventions in response to a pandemic. Alternatively, those powers can apply when a
state of emergency has been declared under emergency legislation or while an
epidemic notice is in force under the Epidemic Preparedness Act 2006. In the absence
of such conditions, a medical officer of health may exercise general health protection
powers, including under Parts 3A and 4 of the Health Act.

While the Ministry of Health is accountable for implementing the New Zealand
Pandemic Plan, civil defence emergency management structures and resources will be
available to support management of the pandemic in the community. Other
government agencies will continue to operate under their own legislation as they meet
their responsibilities under the New Zealand Pandemic Plan.

A state of local or national emergency will only be declared under the Civil
Defence and Emergency Management Act in extreme circumstances. A
declaration is not necessary for civil defence emergency management resources
to be made available. The National Civil Defence Emergency Management Plan
Order 2015 provides for such arrangements. Appendix B of this plan provides
further information on civil defence emergency management declarations.

In practice, the Government expects the local (or regional) Health New Zealand health
coordinator, the local (or regional) medical officer of health and the corresponding civil
defence emergency management controller to work in partnership, jointly considering
decisions and their consequences as far as possible, with the following accountabilities
and responsibilities.

5
‘Health coordinator’ is the generic term this plan uses to denote the person with overall accountability for
the local Health New Zealand response. Individual districts of Health New Zealand use different
terminology for this role (eg, ‘incident controller’ or ‘response coordinator’).

36 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

• The health coordinator is accountable for the local pandemic response and for
providing the command and control necessary to deliver health response measures
under the New Zealand Pandemic Plan.
• The medical officer of health has statutory powers and is accountable for the
exercise of those powers to the Director-General of Health. They are also the lead
for delivering clinical public health services such as contact tracing, whether or not
those powers are exercised.
• The civil defence emergency management controller is accountable for coordinating
and directing community and civil defence responses, resources and functions
under civil defence emergency management plans.

In terms of health imperatives, the decisions of the health coordinator will prevail
because the coordinator is the representative of the lead agency, the Ministry of
Health, which has overall accountability for implementing the New Zealand Pandemic
Plan.

It is not necessary for agencies to rely on emergency legislation to mount a response in

a timely fashion.

An important consideration in managing a pandemic response is the use of

established organisational structures and accountabilities.

The detail for delivery operations will be determined at the local level, to reflect local
and regional circumstances, but should conform to the accountabilities outlined above.

Cross-references and supporting material

New Zealand Pandemic Plan: Appendix B: Explanatory material, ‘Legislation’

The Coordinated Incident Management System

The Coordinated Incident Management System (CIMS) is New Zealand’s model for the
systematic management of all emergency responses. It is designed primarily to
improve management of the response to emergency incidents through effective
coordination between major emergency services. All emergency services in New
Zealand use a CIMS organisational structure to staff their emergency operations
centres.

Further information on CIMS can be found in the Coordinated Incident Management

System third edition (National Emergency Management Agency 2020).

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 37

 The Coordinated Incident Management System in
the health and disability sectors
The organisational structures, roles and processes used by the health and disability
sector in its response to a national health-related emergency or to manage health
aspects of any emergency are based on the CIMS, tailored for use within the health
context. The CIMS provides a structure to allow and support the multiple agencies or
units involved in an emergency to work effectively together. The national COVID-19
response was initially structured on the CIMS, but over time, the response framework
was adapted and replaced with a more enduring, purpose-built functionality that
included policy, strategy and an ad hoc all-of-government coordination mechanism. In
some areas, local/regional CIMS structures persisted for the majority of the duration of
the national response.

The application of the CIMS does not detract from or replace the day-to-day vertical
management and service delivery and horizontal dependencies and collaboration
between Health New Zealand and other health agencies. Rather, it incorporates
management, dependencies and collaboration into a coordination model that goes
beyond normal processes. Normal clinical, managerial and other relationships are
maintained within units and agencies involved in a response. The CIMS, as such, has no
impact on the identity of individual services or the way they carry out their statutory
responsibilities, although emergency management requirements may have implications
for priorities and reporting lines.

Cross-references and supporting material

National Security System Handbook (Department of the Prime Minister and
Cabinet 2016)
National Health Emergency Plan (Ministry of Health 2015)
New Zealand Coordinated Incident Management System third edition (National
Emergency Management Agency 2020)

National Crisis Management Centre

The National Crisis Management Centre is a secure, centralised facility for information
gathering and management, strategic-level oversight, decision-making and the
coordination of national responses. In an emergency the centre facilitates an all-of-
government response by supporting government crisis management arrangements.

The ODESC will activate the National Crisis Management Centre on the
recommendation of the lead agency during an emergency requiring an all-of-
government response.

38 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

 Cross-references and supporting material
Guide to the National Civil Defence Emergency Management Plan (MCDEM
2015b)
National Health Emergency Plan (Ministry of Health 2015)

Intersectoral response
Intersectoral Pandemic Group work streams
Each government agency, informed and directed by the Ministry of Health as lead
agency, is responsible for leading planning, preparedness and response in the sectors it
serves. Agencies also play an important role in intelligence: for example, by tracking
workforce or student absence, movements at the border and impacts on the economy
and critical infrastructure. For the purposes of emergency management, it is important
that agencies carry out these responsibilities in a coordinated fashion.
The Ministry of Health will engage with the wider government sector through the
Intersectoral Pandemic Group, which coordinates 11 work streams established to plan
for and respond to a pandemic. These work streams address critical areas of the
national pandemic response. Lead agencies have responsibility for particular work
streams, within which agencies with operational roles in a pandemic response will work
together (or will establish new work streams where appropriate) to ensure an
integrated and coordinated interagency response (see Table 3). For example, the New
Zealand Customs Service leads the ‘Border’ work stream. This work stream also involves
the Aviation Security Service, the Civil Aviation Authority, Maritime New Zealand, port
and airport agencies, the Ministry for Primary Industries and other border management
agencies.

The Ministry of Health may convene the Intersectoral Pandemic Group at any time, to
support preparedness and response activities.

These are the default arrangements. The work stream descriptions set out in
Appendix C are included primarily for reference. In the event of an emerging pandemic
threat, the Ministry of Health would rapidly update these descriptions in conjunction
with the relevant agencies.

Table 3: Intersectoral Pandemic Group work streams and lead agencies

Work stream Lead agency

Health Ministry of Health

Health New Zealand

Biosecurity Ministry for Primary Industries

Law and order and emergency services New Zealand Police

Civil defence emergency National Emergency Management Agency

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 39

 Welfare National Emergency Management Agency

Education Ministry of Education

Border New Zealand Customs Service

External Ministry of Foreign Affairs and Trade

Economy The Treasury

Infrastructure Ministry of Business, Innovation and Employment

Workplaces Ministry of Business, Innovation and Employment /

WorkSafe New Zealand

During a pandemic, multi-agency groups will also address all-of-government

communications (led by the Ministry of Health), legislation issues (led by the Ministry
of Health) and coordination (led by the Department of the Prime Minister and Cabinet).
As part of a major response, Cabinet may alter the allocation of roles and
responsibilities.

40 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Part B:
The Action
Framework

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 41

 How to use the Action
Framework
Context of the Action Framework
The Action Framework is the core of the New Zealand Pandemic Plan. It outlines the
phases of a potential pandemic in New Zealand, and provides guidance on high-level
actions that need to be considered and/or adapted for each phase, who is responsible
for these actions and by what authority actions can be taken.

Key to the Action Framework

Table 7 summarises the different phases of a pandemic in New Zealand and describes
the likely international context as well as New Zealand-specific escalation/de-escalation
points to guide the transition between phases.

The formulation of New Zealand phases and their associated actions is not designed to
be predictive or prescriptive: the phases are not always going to proceed in order, not
all actions will always be appropriate and some may need to be adapted. Rather, the
system provides a framework for planning and for customising a response to a future
pandemic according to the nature of the event as it unfolds, the virus/pathogen
involved and the changing domestic and international situation. Table 5 sets out key
factors that will help inform the course of action to be taken during a particular phase.

This approach is consistent with the WHO advice that planning needs to reflect the
local situation as well as circumstances globally.

New Zealand phases drive the

pandemic response in New Zealand
The applicable New Zealand phase will be announced by the national
coordinator (or equivalent), Director-General, Minister or other senior decision-
maker.

42 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Health alert codes provide a simple system of indicative, generic actions to be taken in
emergency situations. The National Health Emergency Plan (Ministry of Health 2015)
provides further information on alert codes.

Health agencies should always be prepared to escalate the response to a higher level if
the situation deteriorates.

Withdrawal of actions may take place incrementally or in stages as determined by

national and local circumstances. After a mild pandemic, there may be no need for a
recovery phase.

Actions within this Action Framework are cumulative and build on actions detailed in
previous phases, but moving between phases and health alert codes is not necessarily
a consecutive or chronological process. For example, two phases may be in play
simultaneously (eg, Keep It Out and Stamp It Out), or a rapid-onset severe and
uncontrollable pandemic may necessitate an immediate move to Manage It.

Interpretation of actions and key

decisions for each phase
This Action Framework is flexible, to ensure that agencies consider a range of actions
and apply them where appropriate and customise response measures to the particular
situation, adapting them as necessary. The actions described under various response
phases do not dictate the overall response strategy. The overall response strategy,
which will evolve over time, will be informed by many variables, including all-of-
government consideration of wider social and economic factors.

The tables within this Action Framework set out actions that can be considered in each
phase, who has the responsibility for those actions and under what authority (where
necessary) the actions may be taken. The tables identify actions under headings (eg,
‘planning’ and ‘public health interventions’) that apply in any pandemic, whether mild,
moderate or severe, and in all phases.

Actions marked with the ‘key decision’ symbol, ‘KD’, may also be implemented, depending
on the situation. These actions require consideration and a decision at the time.

Because actions are cumulative, it is important to review decisions made in previous

phases at regular intervals.

Different parts of the country may experience different phases at different times,
depending on local circumstances.

Actions to prevent or slow the progress of a pandemic often have potentially far-
reaching implications for individuals, whānau, communities, society and the economy.
In some cases, individual people (eg, certain statutory officers or Ministers) have the
power to decide to proceed with a particular action. However, in the interests of

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 43

 national consistency the default setting is that these decisions are made within the
ODESC system (as described in Part A). However, event-specific decision-making
arrangements may also be implemented. All decisions are expected to be made in
consultation with relevant agencies. Rapid, all-of-government decision-making is
crucial to ensure a coordinated and flexible response.

Most interventions (in particular, in the Keep It Out and Stamp It Out phases) rely
on timely risk assessments and rapid implementation of response measures for
their efficacy. Decision-makers can expect to have to make critical decisions with
potentially significant consequences in real time, in a situation of considerable
uncertainty and where reliable information may be lacking. The timely
communication of such decisions to those responsible for implementing them,
and to those affected by them, requires intensive coordination in terms of
content (which can change rapidly) and sequencing.

Table 4 illustrates how the response may vary according to the level of potential impact
expected. It sets out a range of possible response actions. Decisions on
implementation of such action will be based on the unmitigated impacts; that is, what
impacts are expected if no response measures are applied.

Table 4: Calibrating the response according to the potential impact of the event

Response actions Level of impacts expected

Low Medium High

Virus characteristics Modest transmission Moderate level of Moderate transmission

and epidemiology and low realised realised severity or and realised severity, or
severity moderate high transmission or
transmission realised severity

Public health measures Mostly guidance Mandatory measures Mandatory measures

possible likely

Border measures Business as usual Some additional Restrictive requirements

requirements likely appropriate
appropriate

Welfare and financial Low level of Medium level of High level of

support for individuals, investment investment investment
communities and Narrow eligibility for Moderate level of Broad eligibility for
businesses support eligibility for support support

Enablers (surveillance, Minimum dedicated Activate some Activate most capacity

science, risk capacity, capacity Services scale-up high
communications, preparedness for Services scale-up
funding, workforce etc) surge capacity medium

Emergency legal Generally not needed May be needed Most likely needed
powers

Decision-makers Government agencies Generally, ministers Cabinet

/ statutory officers

Source: Aotearoa New Zealand Strategic Framework for Managing COVID-19 (Ministry of Health 2023a)

44 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

The Te Niwha report Likely Future Pandemic Agents and Scenarios (Te Niwha 2023) also
provides information on response and control options.

The Ministry of Health expects that relevant agencies will review key decisions and
actions throughout a pandemic to ensure they remain proportionate and not unduly
rights-limiting. Agencies need to be forward-looking in their decision-making and
preparations.

Key factors to consider when

deciding whether to scale up or
down response measures at each
phase
The national coordinator or equivalent will announce the applicable New Zealand
phase. Decision-makers need to consider a suite of factors when deciding the most
appropriate measures at a given time.

Table 5 sets out some of the key factors that will inform the nature and level of
response, indicating escalation or de-escalation points that will inform the transition
between phases and key decisions to be made over the course of the pandemic. It is
important to consider the interaction and interdependence of these key factors when
making decisions, rather than considering each in isolation.

Table 6 lists other factors to be considered in the assessment of risk and proposed
response.

The set of actions undertaken in response to a pandemic needs to be reviewed as the

nature, impacts and our understanding of the pandemic change. It is important that a
similarly systematic approach is also undertaken for scaling down a response, to ensure
that measures remain in place only for as long as necessary.

The New Zealand response is likely to be guided initially by international

epidemiological and clinical data and other relevant information, but will be
increasingly informed by New Zealand data and experience once the pathogen reaches
our shores. At all phases, priority should be given to continuous learning from the
evolving situation. This includes mid- and after-action reviews, programme evaluation
and other assessments of the effectiveness of response measures and capabilities.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 45

 Table 5: Key factors that inform risk assessments and the actions to be taken in a pandemic response

Key factor Impact Comment Especially informs

Characteristics of the Ease of transmission influences the Ease of transmission must be considered • exclusion and containment measures at the
pathogen: eg, number of cases and the shape of the alongside severity when making key border and internally, for cluster detection and
transmissibility, epidemic curve: high transmissibility decisions. control. For example, Stamp it Out may not be
reproduction number, and/or short incubation periods increase These are important factors in possible with a high reproduction number
mode of transmission, the number of cases and speed of determining the potential efficacy and • the application of social / physical distancing
incubation period, transmission. sustainability of containment measures. measures and IPC measures (eg, personal
immune evasion, Severity influences the proportion of protective equipment)
Higher rates of transmission may mean
clinical severity, cases who become more seriously ill or agencies need to be prepared for a swift • which settings may present a higher risk of
duration of infection die. transition to the Manage It phase. transmission or result in poorer health
and illness,
Ease of transmission and severity High rates of transmission and severity outcomes
asymptomatic
combined determine demand for will mean that greater efforts will need to • the readiness and response capacities of public
transmission, longer-
ambulance, primary health care and be put into containment measures to health services, primary care services,
term morbidity, and
hospital (including intensive care unit) flatten the pandemic curve, delay the ambulance services and hospitals, including
populations at higher
services. If the pandemic is moderate to peak, reduce the volume of cases and intensive care units. It may be necessary to
risk of poor outcomes
severe, there is an increased risk of health spread the impact on health services and consider:
services being overwhelmed. society. – scaling up (or down) of contact tracing
The proportion of people who are Transmission and severity among capacity
asymptomatic, and whether they are different population groups and the total – welfare support for the management of
capable of transmitting the pathogen, are population must be considered. For cases and contacts, including additional
important factors. example, a higher rate of fatality or rate support where warranted for equity
of transmission in certain population purposes
groups may necessitate the introduction
– the establishment of community-based
of either broad interventions to prevent
assessment centres (CBACs) and
harm to a particular group or specially
customising their purposes
targeted interventions, where feasible.
This requires early and ongoing – cross-training staff to perform duties they
assessment of potentially do not usually perform in hospital settings
disproportionate impacts on groups that under pressure
experience inequity. Te Tiriti obligations – reprioritisation of services (eg, cancellation
also require active protection of Māori. of planned care, including electives)

46 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Key factor Impact Comment Especially informs
Severity and attack rates in different – support for patients to recover at home
population groups may affect society in – standing up regional emergency operations
different ways, for example: centres
• higher rates in younger adults or their – whether non-mandatory measures are
children will affect workforce sufficient or regulatory/legislative tools are
productivity needed
• higher rates in some population
groups may increase existing health
inequalities.

Testing efficacy and Testing can have four main purposes, The decision to test, and which method • purchase and distribution decisions for test kits
availability each of which has a specific aim and to use, will be influenced by a number of • whether ‘Stamp It Out’ through the isolation /
method: factors: quarantine of cases / contacts can be achieved
1. diagnosis of symptomatic people to • the likelihood of the person being • commissioning of laboratory capacity
inform clinical care positive (presence of symptoms
• whether ad hoc testing centres are needed
2. identification of cases for isolation and/or risk of exposure)
• changes in testing and surveillance strategies
and contact tracing • the purpose for testing (eg, clinical
over time
3. surveillance / intelligence to inform care, prevention of onward
public health action (population or transmission or public health
sub-population level) intelligence)

4. screening of asymptomatic infection • current community transmission rates

to inform clinical and public health • the settings the person
management. • resides or works in
The recommended type of test to be • the availability and performance of
performed and the breadth of testing testing methods
undertaken for each purpose will vary,
• the capacity and capability of the
dependent on the overall context and
laboratory workforce.
public health measures in place at the
time.
Surveillance data needs to include good
demographic information, including
ethnicity.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 47

 Key factor Impact Comment Especially informs

Vaccine efficacy, safety The nature and timing of a vaccination A mass vaccination programme is unlikely • length and intensity of containment measures
and availability programme have implications for other to start for six months or more after a and measures in the subsequent Manage It
aspects of the response strategy. For WHO declaration of a public health phase
example, late delivery of a vaccine in a emergency of international concern • speed of transition to the recovery phase
moderate to severe pandemic may mean /pandemic and production of a vaccine.
• immunisation programmes, including priority
greater efforts need to be made within Decisions on the purchase of a vaccine (if groups and eligibility
the Keep It Out and Stamp It Out phases available) need to be made by the
to flatten the pandemic curve and spread Government/Pharmac, taking into
the impact more evenly over time. account the costs, timeliness,
Consideration needs to be given to the effectiveness and benefits to society of
effectiveness of the vaccine and the reducing the impact of the pandemic.
stability of the vector (eg, the pace of
Plan for equipment requirements, surge
mutation)
workforce, training and media campaigns.

Efficacy of treatment on Depending on the pathogen, therapeutic It is important to monitor treatment • clinical guidance
morbidity and mortality medicines such as antivirals may play a resistance before and during a pandemic, • contact tracing and other containment
significant role in containment and so containment and response measures measures
response measures. can be modified accordingly.
• laboratory capacity and capability
If antivirals are not effective (or cost- Decisions on access to, and clinical
• demand on primary and hospital services
effective) against new virus strains, then practices for, medicines need to assess
more intensive efforts may need to be and address equity issues.
made in the Keep It Out and Stamp It Out
phases, and to treat and support patients.

Wider social economic Evaluation of response measures needs These considerations have a bearing on • the framing, detail, communication, duration
and legislative to include the direct and indirect impacts the likely effectiveness of and adherence and review mechanism of public health and
considerations on individuals, whānau and communities; to proposed response measures with social measures.
financial and economic implications; and disruptive societal implications.
engagement of key legislative Communication to and engagement with
requirements, particularly the New affected and priority population groups
Zealand Bill of Rights Act 1990 are important to inform decision-making
on response measures.

48 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Table 6: Additional factors to consider when mounting a response

Key factor Impact Comment Especially informs

Global trends and These help to inform the degree of action that could Global epidemiological trends, modelling and • public health risk assessment
experience or should be implemented in New Zealand at any international experience provide a context for the • level and type of measures,
given point. potential impact in New Zealand to inform New including border controls
Zealand’s response strategy.
• readiness plans and response
capacity
• dissemination of public
information
• level and types of domestic
surveillance and modelling
required

Advice of the WHO The existence of a WHO determined public health The WHO recommendations should be interpreted • public health risk assessment
emergency of international concern, and standing or in light of the New Zealand situation at the time • level and type of measures
temporary recommendations under the International and New Zealand’s obligations under the
• readiness plans and response
Health Regulations 2005 (WHO 2006), should be International Health Regulations 2005.
capacity
used to help guide New Zealand’s public health risk
assessment and response, • dissemination of public
information
• response measures of other
countries

Responses of other The responses of other countries may have Decision-makers need to consider the situations in • public health risk assessment
countries implications for New Zealand’s assessment of risk and responses of comparable countries (eg, • mix of actions at different
and response. Australia) and ‘close neighbours’ (eg, Pacific phases
countries) ’while ensuring actions are based on the
• surveillance and reporting
New Zealand situation.
• dissemination of public
New Zealand needs to consider requests by other
information
countries (eg, Pacific Island countries and
territories) in undertaking measures for exiting
travellers.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 49

 Key factor Impact Comment Especially informs

Characteristics of This assists with understanding of the potential Decision-makers need to consider factors such as: • public health risk assessment
the pathogen and burden of disease, mortality and impact, and which • mode of transmission • level and type of measures,
population health suite of response measures will be required. including border controls
• transmissibility
risk
• reproductive rate • readiness plans and response
capacity
• virulence (clinical severity)
• dissemination of public
• immune evasion
information
• availability of a safe and effective vaccine
• level and types of domestic
• availability of safe and effective treatments surveillance and modelling
• availability of effective tests to diagnose cases required
• current level of protection in the population
(eg, population immunity, protection against
severe outcomes)
• populations most at risk of infection and
transmission or at greater risk of poor
outcomes
• mutation – whether characteristics change as
the pathogen mutates (eg, increased or
decreased virulence, immune evasion)

Potential for health Extent, type and pace at which response measures Decision-makers need to monitor demand and • readiness and response plans
services to be need to be activated assess projected demand and put plans in place / for essential health services
overwhelmed Ability to provide normal levels of health care, and activate plans to manage instances where • dissemination of public
in particular essential health services, for all demand might exceed capacity; for example, in: information and availability of
patients, not just pandemic patients • hospitals tele-health services
Impact on planned care and ambulatory services • intensive care units • dissemination of clinical
Establishment of community- based assessment • emergency departments guidance (eg, diagnosis,
centres, including functions, workforce, logistics, treatment, use of antivirals,
• primary and community care services
and information to the public and other health IPC)
• ambulance services
service providers
• maternity services

50 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Key factor Impact Comment Especially informs
Reconfiguration of services and redeployment of • home care services • surveillance, including
staff to meet priority requirements • public health services reporting and review of
Dissemination of information to the public on deaths
• mental health and addition services
expectations of the services health providers can or • regional emergency
• medical supply services
will deliver operations centre escalation
• pharmacy services
Demand for additional welfare and other services to
support people taking care of themselves and/or • laboratory services.
dependants at home Plans should be in place to manage deferred care
(eg, screening, immunisation, specialist outpatient
appointments, dental care).

Likely effectiveness The type, extent and mix of response measures to be Decision-makers need to consider: • public health risk assessment
of response put in place. • whether legislation or regulation is required, • level and type of measures
measure(s) including enforceability and alternatives to • dissemination of public
regulation/mandates information
• the expected level of health gain, costs and
cost-effectiveness associated with the
measures
• whether the public will understand, accept
and adhere to the measures
• whether exemptions may be needed for the
measures (including the ability to resource
and implement exemptions regime)
• how each measure interacts with other
measures to achieve the objective

Proportionality The extent and type of possible response measures Decision-makers need to consider: • public health risk assessment
to put in place • the nature and level of risk to public health • level and type of measures
• the expected efficacy / public health benefits
of different response measures
• equivalence with the way other health risks
are managed

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 51

 Key factor Impact Comment Especially informs
• risk appetite and trade-offs, such as the
direct and indirect adverse impacts on
individuals, communities, businesses,
education
• human rights and New Zealand Bill of Rights
Act 1990 impacts

The need for The extent, type, mix and duration of response When possible and appropriate, restrictions • public health risk assessment
restrictive or measures to put in place should be voluntary rather than compulsory.
mandated measures Measures that promote voluntary compliance will
reduce the need for mandatory restrictions.
Restrictive measures should restrict only those
rights it is necessary to restrict. Special attention
may be needed for people who are subject to
restrictions (eg, to their freedom of movement) to
ensure their other rights are protected.
Restrictive measures should only be used when
there are no less intrusive and restrictive means
available to reach the same objective.
Restrictive measures should be regularly reviewed
and when the risk has abated, restrictive
measures should be removed as soon as possible.
Matters for which consideration should be
documented include:
• New Zealand Bill of Rights Act 1990
• Associated arrangements for exemptions
and/or appeals (including criteria, workforce,
other resources required for receiving,
processing and issuing them etc)
• Relevant international obligations
• The legislative powers available to implement /
enforce mandates

52 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Key factor Impact Comment Especially informs
• for international travel / border restrictions,
article 43 of the International Health
Regulations 2005 (WHO 2006)

Equity The extent, type and mix of response measures to Decision-makers need to consider the measure’s • public health risk assessment
put in place and mitigations needed to reduce actual or potential impacts on individuals, groups • level and type of response
inequities. or communities at the greatest risk of poor measures
outcomes.
• level and type of mitigation
measures

Te Tiriti o Waitangi The extent and type of response measures to put in Decision-makers need to ensure consistency with • level and type of response
place. the Crown’s obligations under Te Tiriti o • level and type of mitigation
Waitangi, including the principles of equity, measures
partnership, tino rangatiratanga, active protection
• engagement with iwi Māori
and options.

Operational The extent, type, pace and duration of response Decision-makers need to consider: • Level. type, pace and duration
implications of measures that can be put in place. • cost and feasibility to implement of response measures
standing up the
• the extent to which the measure will be easily
response measure(s)
understood and complied with
• the enforceability of legal requirements
(mandates)
• the direct and indirect implications for the
implementing workforce.

Explaining the Explaining the science, including basic terms being There needs to be a focus on a diversity official • The content, timing,
science of used, the rationale for response measures, the voices in the public debate and on protecting spokespeople used, delivery
pandemics uncertainties, changing knowledge etc. These can those voices. channels etc of public
prove critical in relation to restrictive response Note there were more than 300 media briefings communication
measures and the eligibility for, safety and during the COVID-19 response; explaining the
effectiveness of vaccine(s) to counter the pandemic. science was a critical part of these events.
Along with the pandemic, there will also be
misinformation and disinformation, which may be
voluminous and significant in its consequences.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 53

 Key factor Impact Comment Especially informs

Sustainability of the Sustainability may affect the timing of a shift in The sustainability of the response will be • personnel resources
response (in all phase, the extent and mix of different measures in influenced by the interaction of a number of • use of supplies
phases, across all place, the prioritisation of services and resources factors.
• prioritisation of services
sectors) etc. In a moderate to severe pandemic, greater
• regional emergency
The impact on the workforce involved in the reprioritisation of normal services will be required
operations centre escalation
response is a critical factor. The sustainability of a to sustain a response.
response will be influenced by the number of staff Many actions are interdependent; for example:
and/or volunteers who are able to perform duties
• quarantining arriving passengers from affected
outside their normal duties / scope of practice, and
areas may be only a short-term option by itself,
by the amount of support they receive to avoid
unless programmes are put in place to reduce
burn-out.
arrivals from affected areas
• extensive cluster control operations may be
feasible only in the medium term if health
workers and staff from other agencies are
seconded to response activities.

Social licence and The level of support for and compliance with public Public sentiment in regard to and compliance • dissemination of public
public sentiment health measures may change over time and with mandated and non-mandated response information
influence perceptions and the acceptability of measures should be monitored as part of • the mix of measures at
response measures. ongoing assessment on the pandemic response different phases
and modified as required.
• attitude and behavioural
surveys

Economic impacts The likely mix and impact of actions within New Economic impacts may result from: • dissemination of public
nationally and Zealand must take potential economic impacts into • restrictions on non-essential businesses information
internationally account, including: • mix of actions at different
• restrictions on movement
• positive benefits (eg, saving lives, flattening the phases
• cancellation or restrictions on mass gatherings
pandemic curve, delaying or reducing the impact • community support
on business and services) • staff absence
• government supports
• negative impacts (eg, impact, including • disruption to national and international supply
chains • data and intelligence to
differential impacts, of movement restrictions on
monitor and measure impacts
commerce and trade, supply chains, transport, • rationing of critical supplies

54 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Key factor Impact Comment Especially informs
maintenance of core infrastructure, business • disruption to commerce and trade • business subsidies and
sustainability) • disruption to tourism worker compensation
schemes
• widespread defaulting on debt
• foreclosure of affected businesses
• adverse impacts on the exchange rate
• reduction of the tax take.
Some of these factors will be influenced by the
mix of actions implemented in New Zealand, but
many are outside New Zealand’s direct control.

Social impacts There may be multiple possible social impacts, Resources that can be used to ameliorate social • dissemination of public
depending on the severity of the pandemic and the impacts include: information
efficacy and nature of response actions, potentially • the National Welfare Advisory Group, which • community support
including: can catalyse a nationally consistent approach to • intelligence and surveillance
• a psychosocial impact on individuals, families, welfare (see ‘Welfare work stream’ in Appendix to measure social impacts
response staff and communities affected C: Intersectoral Pandemic Group work streams) • assessments of the
• interruption of core public service provision • NGOs, Maori and Pacific groups to help to proportionality of response
• impacts on law and order coordinate local resources and deliver measures
community support • the need for community
• educational impacts
• the Framework for Psychosocial Support in engagement
• a need for a higher degree of welfare and other
Emergencies (Ministry of Health 2016b) and
support for sick people and their families at
Getting Through Together: Ethical values for a
home
pandemic (National Ethics Advisory Committee
• an increased need to take care of people who 2007).
have lost support (eg, orphaned children)
• an increase or decrease in social cohesion (eg,
increased solidarity and altruism or a loss of trust
resulting from mis- or disinformation).
Impacts of response measures may include:
• a reduction in adverse social effects, if the impact
of the pandemic is reduced by containment
actions (eg, border management, cluster

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 55

 Key factor Impact Comment Especially informs
control,), early establishment of community-
based assessment centres and support of
response staff
• an increase in some adverse social effects (eg,
family violence and sexual violence, as seen in
the COVID-19 lockdown)
• social disruption caused by certain measures (eg,
if movement into an affected area is restricted,
people may lose their ability to care for
dependants; school closures will affect
educational outcomes)

International New Zealand’s response may have a positive or • Intelligence functions

relations negative impact on countries with which New • international reporting and
Zealand has close relationships (eg, Australia and information sharing (for
Pacific Islands) and vice versa. example, during COVID-19,
New Zealand and Australia
shared national health
SitReps)

International New Zealand’s responses should be aligned with Advice to decision-makers needs to consider the • intelligence and reporting
commitments our international obligations potential impact of New Zealand’s response on
our international commitments, such as:
• the International Health Regulations 2005
(WHO 2006) (especially article 43)
• the United Nations Convention on the Rights of
Persons with Disabilities
• the United Nations Convention on the Rights of
the Child
• the United Nations Convention on the
Elimination of All Forms of Discrimination
Against Women

56 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Key factor Impact Comment Especially informs
• the United Nations Convention on the Rights of
Indigenous Persons
• the United Nations Declaration of Human
Rights
• the International Covenant on Economic, Social
and Cultural Rights.

Resources
Getting Through Together: Ethical values for a pandemic (National Ethics Advisory Committee 2007)

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 57

 New Zealand Pandemic
Plan
Table 7 summarises the phases in the New Zealand Pandemic Plan, relating them to
potential transition factors for moving between phases and also the international
situation.

Table 7: Summary of phases in the New Zealand Pandemic Plan

New Zealand New Zealand situation and International situation

phase transition factors

Plan For It No human cases in New No viruses/pathogens among animals have

Zealand been known to cause human infections.

An animal pathogen is known to cause

infection in humans and is a specific pandemic
threat.

An animal or human–animal pathogen has

caused sporadic cases or small clusters of
disease in people, but has not resulted in
sustained human-to-human transmission
sufficient to cause community-level outbreaks.

Keep It Out No or few human cases in Human-to-human transmission of an animal or

New Zealand human–animal pathogen able to sustain
community-level outbreaks has been verified
(depending on the circumstances,
precautionary measures may be initiated prior
to confirmation).

The same pathogen has caused sustained

community-level outbreaks in two or more
countries in one WHO region.

Stamp It Out First case identified in New Not applicable

Zealand

Clusters of cases in New

Zealand

Manage It Increased and substantial Not applicable

transmission in the general
population (containment is
no longer feasible or
otherwise appropriate)

58 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

 New Zealand New Zealand situation and International situation
phase transition factors

Manage It: Post- Wave decreasing; possibility Levels of infection in most neighbouring
Peak of a resurgence or new wave; countries with adequate surveillance have
any changes in pathogen dropped below peak levels.
transmissibility or severity

Recover From It Pandemic over and/or Levels of infection have reduced (eg, returned
population largely protected to levels seen for seasonal influenza) in most
by vaccine or infection- countries with adequate surveillance.
induced immunity, and/or
pathogen no longer resulting
in severe outcomes

Plan For It
Planning and preparedness
Objective
To reduce the health, social and economic impacts of a potential pandemic on New
Zealand during the inter-pandemic period.

Key issues to be addressed in planning

We seek to:
• strengthen pandemic preparedness at national, regional and local levels
• minimise risk of transmission to humans, and rapidly detect cases and transmission.
• avoid increasing inequities

We will achieve our aims through:

• addressing the underlying modifiable determinants of health that increase risk of
morbidity and mortality during a pandemic
• planning, coordination and reporting (among all agencies), including appropriate
oversight
• multisource surveillance and intelligence, both domestic (including mātauranga)
and overseas, including, where appropriate, through the activation of an incident
assessment team to monitor evolving events, even if offshore
• strengthening public health laboratory capabilities and identifying and addressing
gaps or weaknesses in surveillance capabilities, including identifying potential
opportunities to introduce new / innovative surveillance methods such as
monitoring social media and trends in school absence rates
• consider setting up an incident assessment team to monitor evolving events even if
offshore
• maintenance, planning for and coordination of public health functions, including
containment, routine immunisation programmes and border controls

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 59

 • health care and emergency response planning
• communications and public engagement planning
• training
• simulation exercises
• preparation in all sectors at local, regional and national levels
• incorporating pandemic response issues into business continuity planning.

In the planning phase we will:

• develop and exercise relationships, plans and procedures
• strengthen / maintain IPC, diagnostic and contact tracing capabilities
• build generic capability and capacity in Māori and Pacific health providers
• establish capability and capacity through training and exercising, and maintain
systems and structures for responding to a pandemic and other emergencies
• ensure pandemic-related issues are incorporated into business continuity plans
• alongside the Ministry for Primary Industries, maintain intelligence of animal
pathogens that may present a threat to human health
• maintain an appropriate level of engagement within and across communities and
agencies during low-risk or low-activity times
• establish likely priorities for a national response.

Plan For It phase

There are no human cases in New Zealand.

60 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Action Responsibility Authority
Planning, coordination Strengthen pandemic preparedness nationally, regionally and locally, including: All agencies No powers required
and reporting • Incorporate pandemic response issues into business continuity planning.
• Develop and implement action plans that allow the organisation or sector to
address lessons identified in response to the COVID-19 pandemic (2020–
ongoing).
• Maintain sector-specific guidelines and protocols for planning, response and
communications, including a contingency plan to address any disruption to
employment and other economic activities associated with restricted public
health and social measures.
• Establish, revise and exercise pandemic plans locally, regionally and nationally.
• Maintain a legal framework for pandemic interventions.
• Train staff and exercise agency and intersectoral plans.
• Prepare to implement pandemic plans at short notice should circumstances
change.

• Maintain a communication plan and resources (addressing, for example, public Ministry of Health,
information, dis- and misinformation, health systems’ disease assessment and Health New Zealand
management tools and information for other authorities) at national, regional
and local levels.
• Maintain and regularly review stockpiles of critical pandemic supplies (eg,
personal protective equipment and pharmaceuticals) and mechanisms to
access vaccines.
• Maintain (and be prepared to revise) plans and policies for the use of vaccines,
including priority groups in anticipation of vaccine availability.
• Plan for laboratory services (public and private), assessment facilities and
antiviral and vaccine delivery mechanisms (including registers of individuals
who have received each).
• Plan local isolation and/or quarantine facilities, including in terms of linkages to
the proposed national quarantine capability, care in the community welfare
support and physical distancing measures.
• Promote the uptake of inter-pandemic influenza and other funded
vaccinations.
• Maintain and strengthen IPC functions, including personal hygiene.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 61

 Function Action Responsibility Authority

• Plan to minimise the risk of animal zoonotic virus transmission from animals to Ministry for Primary Biosecurity Act 1993
humans and to rapidly detect transmission. Industries, Ministry of Health Act 1956
Health, Health New
• Assess the likelihood of animal or bird infection being the vector to New
Zealand
Zealand.

• Assess animal response options and maintain response plans. Biosecurity New Zealand Biosecurity Act 1993, sections
43, 109, 114 and 121

• As required, provide public advice on limiting the risk of transmission from Biosecurity New Zealand Health and Safety at Work Act
animals. 2015

• Ensure appropriate workplace guidelines, protection and training for animal Ministry of Business, Health and Safety at Work Act
workers and exposed humans to reflect WHO guidelines and New Zealand Innovation and 2015
guidelines and legislation. Employment / WorkSafe
New Zealand,
Biosecurity New Zealand

Public health • Ensure national and local multi-sectoral plans are in place. All stakeholders active in No powers required
interventions: border • Ensure plans are nationally consistent, so stakeholders are aware of their border operations
responsibilities and roles irrespective of their location. nationally and at each
international port of
• Assess and review International Health Regulations (WHO 2006) core capacity
entry
requirements regularly.
• Ensure national and local border emergency management groups meet
regularly and that all relevant stakeholders for relevant locations (eg,
international airports) meet regularly and update plans.
• Review assessment policies and procedures at the border.
• Maintain or enhance digital border certification (eg, the New Zealand Traveller
Declaration and, potentially, international certificates of vaccination and recent
negative test results)
• Maintain appropriate capability for scalable quarantine and isolation.
• Review and, where appropriate, amend relevant legislation.

62 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

 Function Action Responsibility Authority

Public health • Maintain the capability, preparedness, training and surge capacity to mount Health New Zealand Health Act 1956
interventions border control and cluster control operations when required. (National Public Health
• Identify sources of additional staffing locally from health or non-health Service (NPHS)) and
agencies, to enable an intensive cluster control operation to be sustained if border agencies
required.
• Use training material to develop a local orientation package for these
additional staff.

Surveillance and • Monitor the situation overseas. Ministry of Health, No powers required
intelligence Ministry of Foreign
Affairs and Trade

• Monitor intelligence and build the knowledge base on pathogen Ministry of Health,
characteristics, disease presentation, diagnosis, treatment, case and contact Biosecurity New Zealand
management, One Health considerations6.
• Ensure human surveillance systems can identify a novel virus and a developing
pandemic within New Zealand following an alert from the WHO.

• Maintain the capability to track and monitor the impact of a pandemic in New Ministry of Health,
Zealand to inform actions at different phases (eg, whether the illness Health New Zealand,
associated with the pathogen should be notifiable under the Health Act 1956). Whaikaha, Biosecurity
New Zealand

• Maintain and potentially increase animal surveillance as required. Ministry for Primary
• Maintain a response evaluation framework focusing on outcome, output, Industries, Department
impact on priority populations and process evaluation. of Conservation
All agencies

6
One Health is an integrated, unifying approach that aims to sustainably balance and optimise the health of people, animals and ecosystems. It recognises that the health of
humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and interdependent.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 63

 Function Action Responsibility Authority

Health care and • Review, update and exercise plans for managing a pandemic. Health New Zealand No powers required
emergency response • Prepare for an expansion in demand for key services and consumables
including intensive care, community and primary care, ambulance services,
laboratory services, 0800 helplines/digital channels, iwi Māori partnership
boards, other Māori stakeholders, Pacific leaders and communities, the NPHS
and other hospital services.

Communications and At all times: Ministry of Health, No powers required

community • maintain inter-agency reporting, communications and consultation, including Health New Zealand and
engagement liaison with the WHO and the Australian Department of Health and Aged Care all agencies
• build public trust and awareness about pandemics and the potential for
pandemic through routine media engagement
• reinforce health and disability sector awareness and preparedness
• promulgate pandemic key messages (eg, ‘be aware’, ‘know that we are
preparing for a pandemic at some time’) available in different languages and
formats
• reiterate key public health messages (eg, the importance of hand-washing,
cough and sneeze etiquette) available in different languages and formats

• ensure media planning and monitoring Ministry of Health,

Health New Zealand

• develop and prepare to adapt the Public Information Management Strategy Ministry of Health
(Appendix A) as required

• maintain active and meaningful relationships with national Māori agencies and Health New Zealand
advisory groups maintain active and meaningful relationships with iwi (NPHS)
partnership boards, local iwi/Māori providers and organisations and local Ministry of Health,
marae Health New Zealand
• maintain active and meaningful relationships with Pacific communities and (NPHS)
providers, other ethnic communities, disabled people’s organisations and other
key stakeholders.

64 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Action Responsibility Authority

If a new strain emerges overseas, or there is a resurgence of an existing strainNPHS in coordination

overseas, undertake a risk assessment and, as required: with Ministry of Health,
• inform key stakeholders Biosecurity New Zealand
and other agencies as
• promulgate key messages (eg, personal protection and preparedness, where to
required
go for help (eg, 0800 helplines, websites)) and likely impacts
• inform the public about current and proposed actions (where appropriate)
• provide travel advice relevant to the threat
• review and update key messages and communication channels
• coordinate communications across and within sectors
• create web-based information sources, such as frequently asked question
sheets and guides (available in different languages and formats)
• initiate background briefings for spokespeople.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 65

 If there is an outbreak of a pathogen with pandemic potential among animals in New Zealand posing a risk of human disease, then the following
additional actions will be considered in all phases.

Function Additional action Responsibility Authority

Planning, • Update human detection and clinical care guidelines. Health New Zealand (NPHS, with
coordination and • Develop/revise a case definition. advice from the Institute of
reporting Environmental Science and
Research Ltd (ESR))

• Develop and implement surveillance of animal workers. Health New Zealand (NPHS), Potential application of Health
Biosecurity New Zealand, Ministry Act 1956, section 77 (power of
of Business, Innovation and medical officer of health to
Employment / WorkSafe New enter any premises and examine
Zealand persons)

• Investigate rapidly any reported suspected human cases. Health New Zealand (NPHS), public
health services, Ministry of Business,
Innovation and Employment /
WorkSafe New Zealand

• Enhance laboratory diagnostic capacity for a novel strain. Health New Zealand (NPHS)

• Prepare for possible release of a pre-pandemic vaccine if available. Ministry of Health, Health New
Zealand (NPHS)

• Implement (pandemic) response plans. Biosecurity New Zealand Biosecurity Act 1993

• Ensure appropriate protection and training for animal workers and Biosecurity New Zealand, Ministry Health and Safety at Work Act
other exposed humans (those who work with poultry and pigs are of Business, Innovation and 2015
most at risk) to reflect the WHO guidelines and New Zealand health Employment / WorkSafe New
and safety at work guidelines and legislation. Zealand

• Restrict the movement of animals or any at-risk goods from affected Biosecurity New Zealand Biosecurity Act 1993, sections
areas in New Zealand as required. 130 and 131 and Part 7

Health care and • Prepare for possible cases of zoonotic illness by activating enhanced Health New Zealand
emergency response infection control, laboratory procedures, clinical guidelines and
isolation facilities, among other measures.

66 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Additional action Responsibility Authority

Intelligence • Target the surveillance of humans in areas where animals are Ministry of Health, Health New Biosecurity Act 1993, sections
affected, and place primary health care providers on enhanced alert Zealand (NPHS) and Biosecurity 43, 109, 114 and 121 and Part 7,
for the detection and notification of the first zoonotic cases. New Zealand Health Act 1956

Communications • Inform key stakeholders of the increased risk regarding infection in Biosecurity New Zealand, Ministry No powers required
and community animals. of Business, Innovation and
engagement • Disseminate guidance materials and key messages for employers, Employment / WorkSafe New
employees and other workplace participants to help them plan, Zealand
prepare for and respond to a pandemic.

• Review, update and increase the frequency of communications for all Biosecurity New Zealand, with the No powers required
audiences. support of other agencies as
required

• Initiate web and media monitoring. Initiate wide distribution of short Biosecurity New Zealand, with the No powers required
videos and secure their broadcast. support of other agencies as
• Regularly brief government stakeholders for media interviews, and required
increase the frequency of media updates.
• Initiate the production of new materials for paid media advertising in
next and ensuing phases (and arrange for an ‘authority figure’
presenter to regularly present key messages).

• Initiate a buying plan for advertising in national media for the next Biosecurity New Zealand
phase.

• Carry out ongoing liaison with the WHO and the Australian Ministry of Health
Department of Health and Aged Care.

• Communicate with foreign governments and travellers about the Ministry of Foreign Affairs and
New Zealand situation. Trade

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 67

 Function Additional action Responsibility Authority

Other cross-sectoral • Ensure appropriate engagement with Biosecurity New Zealand as the All agencies No powers required
actions lead agency.
• Ensure each agency’s single point of contact details are disseminated
to other agencies.
• Maintain a contact list of other agencies.
• Keep relevant staff and sectors updated as the situation evolves.
• Revisit, review and revise plans and prepare to activate them if the
situation escalates.

68 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Keep It Out
Border management
Potential escalation factors
Several factors may have to be rapidly considered, such as community-level outbreaks
overseas through verified human-to-human transmission, significant increase in the
risk of a pandemic, evidence of airborne transmission, early indicators of severity, other
international actions taken and guidance and formal recommendations from the WHO.

Objective
• To prevent, delay or reduce the arrival of the pandemic into New Zealand by
implementing international border management controls, and to allow time to
prepare for the next phases.
• To prevent the exporting of cases from New Zealand to countries that are not yet
affected (eg, Pacific nations) or, in the event of an epidemic starting in New Zealand,
to the international community.

Key decisions
The extent and level of (sea and air) border controls to be implemented will be
determined by the actual and potential impact of the pandemic and its ongoing
development overseas. This phase will also involve iterative consideration of:
• health advice and alerts and travel advisories
• scaling up surveillance and intelligence
• whether the disease needs to be added to one or more schedules of the Health Act
1956
• a potential move to positive pratique (health status reporting required from all
incoming ships and aircraft)
• travel restrictions at air and maritime borders; screening inbound travellers; or
requiring recent travel history, evidence of vaccination or a negative pre-departure
test (including systems to check/verify measures to manage symptomatic or
exposed travellers)
• potentially enhanced travel restrictions up to and including border closure and
managed isolation and quarantine
• implementing exit measures (particularly to protect neighbouring Pacific countries)
• authorising special powers or infectious disease management powers under the
Health Act 1956, authorising powers under other existing legislation (such as the
Epidemic Preparedness Act 2006 or the Civil Defence Emergency Management Act
2002) or creating new powers under bespoke legislation
• putting in place event-specific legal orders/regulations for any mandatory
requirements, including pre-departure testing; vaccination certificates; and systems
for enforcement, infringement and exemptions
• preparing for a possible release of a pre-pandemic vaccine, if available

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 69

 • preparing for a possible release of antivirals for use according to policy
• developing and activating an appropriate vaccination strategy (including ordering
vaccine supplies or making an advance purchase agreement)
• activating an appropriate testing strategy
• activating antiviral/therapeutic policies
• briefing the Minister of Health and Cabinet on options for an elevated response in
advance (eg, by limiting arrivals, managing visa applications, issuing a Notice to
Airmen7 or implementing enhanced quarantine) and seeking agreement for prompt
implementation
• developing protocols for case investigation, contact tracing and case and contact
management
• consulting with Pacific Realm countries to ascertain actions needed to support their
response measures.

Refer also to Responding to Public Health Threats at New Zealand Air- and Seaports:
Guidelines for the public health and border sectors (Health New Zealand 2023b).

Keep It Out phase

There are no or few human cases in New Zealand.

7
A Notice to Airmen (NOTAM) also known as Notice to Air Mission, is a notice issued by government
agencies and airport operators containing information concerning the establishment, condition or
change in any aeronautical facility, service, procedure or hazard, the timely knowledge of which is
essential to personnel concerned with flight operations.

70 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Additional action Responsibility Authority
Planning, • Activate or prepare to activate pandemic plans at short notice when notified by All agencies No powers required
coordination and the Ministry of Health.
reporting
• Activate the National Health Coordination Centre. Ministry of Health, Health New No powers required
Zealand

• Regularly monitor, evaluate and report on the actual and anticipated impact of All agencies
the pandemic and response activities in individual sectors and through the
Intersectoral Pandemic Group work streams. Report on these activities to the
National Health Coordination Centre.

• Activate emergency management organisational structures as required. Ministry of Health and Health No powers required
New Zealand

• Activate the Intersectoral Pandemic Group, border agencies and border industry Ministry of Health No powers required
stakeholder groups and other pandemic work groups as required.

• Plan for an escalation to the Stamp It Out and Manage It phases and review All agencies No powers required
recovery plans.

• Prepare for a possible release of pre-pandemic vaccine (if available) under the Ministry of Health, Health New No powers required
Pre-Pandemic Vaccine Usage Policy. Zealand, public health services

• Order the pandemic vaccine, if available, following a pandemic declaration by the Ministry of Health, Pharmac
WHO.

• Release national reserve volumes of antivirals and consider pre-positioning bulk Ministry of Health, Health New
supplies for use according to policy in border management operations. Monitor Zealand
antiviral usage.

• Prepare to activate contingency plans in anticipation of supply chains being All agencies
disrupted due to border restrictions

Testing, surveillance • Develop and issue a case definition and provide technical advice to inform action Health New Zealand (NPHS, No powers required
and intelligence in health and other settings. with advice from ESR)
• Carry out intensive testing and surveillance through primary health care service
providers, Healthline calls, accident and medical centres, hospital emergency
departments, infectious disease physicians and laboratories to detect possible
imported cases and secondary cases.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 71

 Function Additional action Responsibility Authority
• Develop and implement a pathogen-specific multisource surveillance and testing
plan
• Introduce enhanced staff surveillance and sickness reporting – address any
influenza-like illness consistent with the respiratory virus.

• Review recent surveillance of influenza-like and severe acute respiratory illness.

• Consider enhancing surveillance capabilities (eg, community wastewater testing)
and sentinel surveillance, both from health sites and essential workers (such as the
border workforce).

• Refer to and share sequencing data and other surveillance information with No powers required
relevant international partners.

• Monitor the situation overseas and perform risk assessments as new information Ministry of Health (lead), No powers required
emerges. Biosecurity New Zealand and
• Create intelligence summaries. Ministry of Foreign Affairs and
Trade

• Carry out testing and surveillance at air and sea borders. Public health services and No powers required
border agencies at local and
national levels

• Advise WHO of any border measures implemented, as required under the Ministry of Health No powers required
International Health Regulations 2005 (WHO 2006), and provide WHO with the
rationale for and relevant scientific information concerning their implementation.

• Continuously monitor, improve and assess the appropriateness of response All agencies, informed by No powers required
measures. Ministry of Health and Health
New Zealand

• Undertake modelling of case and deaths Health New Zealand, Ministry of No powers required
Health with support from ESR

Public health • Activate coordination mechanisms between border agencies at local levels to Health New Zealand No powers required
interventions: border ensure planning and programmes are well coordinated.
management
• Issue travel advisories as appropriate. Ministry of Health, Ministry of No powers required
Foreign Affairs and Trade

• Define area(s) of concern from which arriving travellers might be subject to risk- Ministry of Health, Health New No powers required
based border controls. Zealand

72 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Additional action Responsibility Authority

• Provide information to incoming and outgoing travellers NPHS, other border agencies, No powers required
Ministry of Foreign Affairs and
Trade

• Monitor and report on border measures being used in other countries. Ministry of Foreign Affairs and
Trade

• Alert agencies managing facilities that are to be used for quarantine/isolation and NPHS No powers required
consider activation.

• Require additional declarations from masters of maritime vessels. Compliance Maritime operators and Health (Quarantine)
with national protocols is required. shipping agents Regulations 1983

• Assist with measures for recreational maritime vessel arrivals and arrivals of non- Biosecurity New Zealand, New No powers required
commercial flights that land at airports served by the New Zealand Customs Zealand Customs Service and
Service. NPHS

• Identify aircraft from areas of concern and passengers on other aircraft who are New Zealand Customs Service Customs and Excise Act
from areas of concern, using advanced passenger notification systems and direct 1996
questioning.

• Implement IPC procedures for aircraft and maritime vessels as required. Airlines, Maritime New Zealand
and shipping agents, with
advice on procedures from
NPHS

• Consider moving to positive pratique (100% health status reporting required from Ministry of Health No powers required
all incoming aircraft). If Australia takes this step it would be prudent for New
Zealand to do so, as the measure will be more effective if actioned in all countries
in which an aircraft lands.

• Establish public health presence at points of entry and implement processes for NPHS Health Act 1956
screening, assessment referral and management of travellers.

• Require and collect contact-tracing information from travellers arriving from areas Airlines, New Zealand Customs Customs and Excise Act
of concern. Service, Health New Zealand 1996, section 282A
• Introduce pre-departure test requirements and verification at port of departure, if Health Act 1956,
applicable. section 70 as an interim
• Introduce post-arrival testing requirements, if applicable. measure (would require
new legislation)

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 73

 Function Additional action Responsibility Authority
• Introduce post-arrival quarantine/isolation for all inbound arrivals, if applicable Health Act 1956,
(and consider appropriate requirements for airline staff and maritime section 70 as an interim
workers). measure (would require
new legislation)

• Request the Minister of Health’s conditional authorisation for the use of special Ministry of Health Health Act 1956; Health
powers by the medical officer of health under section 70 of the Health Act 1956. (Infectious and
Brief the Minister on options for an elevated response in preparation for Notifiable Diseases)
escalation of the situation. Regulations 1966

• Seek ministerial agreement to New Zealand’s coordinated response to the Ministry of Health, in Health Act 1956
pandemic situation; for example: consultation with border
– in limiting or refusing arrivals of craft or individuals from areas of concern agencies and the ODESC

– in issuing Notices to Airmen

– in managing visa applications
– in implementing enhanced quarantine measures.

• Implement the above interventions approved by ministers. Ministry of Health, Health New Health Act 1956
Zealand, NPHS, New Zealand
Customs Service, Ministry of
Business, Innovation and
Employment/Immigration New
Zealand, Ministry of Foreign
Affairs and Trade

Public health • Implement or prepare to implement case investigation, contact tracing, and case Health New Zealand, NPHS No powers required
interventions: other and contact management capabilities in support of cluster control activities.
• Promote vaccination to appropriate population groups, including health care and
border workers.
• Consider establishing regional emergency operations centres.

Health care and • Assess suspected cases at the border using WHO case definitions and travel Medical officer of health, NPHS, Health Act 1956, Parts
emergency response history, as advised by the Ministry of Health. Health New Zealand 4 and 3A, section 70(f)
(if applicable)

74 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Additional action Responsibility Authority

• If a suspect case is reported, arrange for the person to be met and assessed at an NPHS, ambulance services, Health Act 1956, Part
appropriate location. Ensure the emergency department (or facility) is advised if Health New Zealand (regional) 3A, sections 97B and 1
the case is being transported and that appropriate laboratory testing is Health New Zealand (NPHS) 01
undertaken. Apply IPC policy.
• Quarantine/isolate people whose symptoms do not require hospitalisation in
either managed facilities or elsewhere.

• If a case is confirmed, manage other symptomatic people (and other suspected Health New Zealand (regional) Health Act 1956,
cases and contacts) according to set management procedures for suspected section 92I
cases.

• Prepare and disseminate clinical guidelines, including for the use of personal Health New Zealand No powers required
protective equipment, testing, treatment, isolation/quarantine and vaccination
procedures (if applicable).

• Commence targeted immunisation once a vaccine is available. Ministry of Health, Health New No powers required
Zealand

Communications and • Review and update materials for education services, employers, employees and Ministry of Business, Innovation No powers required
community other workplace participants containing key messages for workplaces to help and Employment / WorkSafe
engagement them plan for, prepare for and respond to a pandemic. New Zealand, Ministry of
Education

• Establish authoritative channels (eg, a website or web page) to provide key Health New Zealand, Ministry No powers required
information for the public and agencies to guide their planning and response. of Health, with support from
• Review key messages and promulgate new messages reflecting health action (eg, other agencies as required
border controls).
• Review and increase the frequency of media conference updates.
• Continuously review and update public information in conjunction with all key
agencies.
• Engage with Māori, Pacific peoples, people with disabilities and other
communities to develop information and key messages that are appropriate,
useful and targeted.
• Continuously liaise with the WHO, the Australian Department of Health and Aged
Care (ongoing) and other Australian state agencies as required.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 75

 Function Additional action Responsibility Authority

• Regularly review the Public Information Management Strategy (Appendix A), Ministry of Health and Health No powers required
incorporating feedback from talkback monitoring, media monitoring, call centre New Zealand with support from
reports, web monitoring, sector intelligence and other agency intelligence. other agencies as required

• Issue information to all travellers to New Zealand by air or sea of the escalating Ministry of Business, Innovation No powers required
situation and the public health measures they may need to follow (eg, pre-alert and Employment, Ministry of
airlines to symptoms of concern). Health, Tourism New Zealand
and the Tourism Industry
Association, Maritime New
Zealand, shipping agents

• Continuously evaluate and refresh paid media campaigns. Ministry of Health, Health New
Zealand

• Expand services through the national Healthline number and other channels to Health New Zealand
provide information and clinical advice to the public, and use regular monitoring
of calls to refresh scripts and provide data on the pandemic to inform national
policy.

• Coordinate communications to foreign governments on the situation in New Ministry of Foreign Affairs and No powers required
Zealand and advise New Zealanders overseas. Trade

• Distribute situation reports and intelligence summaries. Ministry of Health, Health New
Zealand

• Review planning documents and information, with special reference to border All agencies
control, the tourism and travel sectors and education (international).

Other cross-sectoral • Brief staff and key decision-makers. All agencies No powers required
actions • Keep up to date with national policy and advice issued by the Ministry of Health.
• Lead communications, planning and response within the agency and with the
sector the agency serves.
• Answer queries from the relevant sector.
• Maintain coordination with other agencies through established national and
district mechanisms.
• Ensure each agency’s single point of contact details are maintained and
disseminated to other agencies.
• Ensure response staff are given the opportunity for rest and recuperation.

76 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Stamp It Out
Cluster control
Potential escalation factor
Human cases infected with the pathogen are detected in New Zealand.

Objective
• To contain, control and/or eliminate any cases or clusters that are found in New
Zealand, as well as to decrease the impact on certain population groups at higher
risk of severe outcomes.
• Depending on the circumstances, to enable a return to the Keep It Out phase.

Key decisions
• Assess whether protocols for case investigation, contact tracing and case and
contact management can be implemented, and if so at what volumes and for how
long.
• Prepare authorisation for use of special powers and an epidemic notice, or bespoke
legislation for mandatory requirements if needed.
• Consider declaring a state of local or national emergency under the Civil Defence
Emergency Management Act 2002.
• Consider national, regional or location-specific stay-at-home (isolation and
quarantine) notices, movement restrictions and other physical distancing measures.
• Put in place regulations for any mandatory requirements, including enforcement,
infringement and exemptions.
• Close or restrict the use of educational facilities in affected areas.
• Scale up IPC measures at settings that present a higher risk of poor outcomes (eg,
aged residential care facilities).
• Escalate contact tracing systems (including case investigation and management).
• Implement advice or mandates to restrict public gatherings, as appropriate.
• Release antivirals for use according to policy and monitor their usage.
• Order the pandemic vaccine, if available, after a pandemic declaration by the WHO.
• Commence vaccination when the vaccine becomes available.
• Release the pre-pandemic vaccine, if available, under the pre-pandemic vaccine
usage policy, noting that the policy may need to be reviewed regularly.
• Stand up testing plans.
• Consider whether air and sea border entry restrictions/requirements are required,
including in terms of IPC measures.
• Consider the need for exit-assessment procedures, depending on the domestic and
international situation and the risk of exporting the disease (particularly to
neighbouring Pacific countries).

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 77

 • Issue domestic and/or international ‘don’t travel’ notices, as appropriate.
• If not already activated, activate CBACs and establish regional response structures.

Stamp It Out phase

Two situations are covered by this phase. The extent of implementation of

control measures will depend on the particular characteristics of the pandemic,
and the measures will need to be reviewed continuously to ensure that they
remain appropriate to the nature of the threat and capability and capacity of
response resources. Additionally, the nature and extent of the control measures
necessary may vary from one district to another and change over time.
Situation one: The first laboratory-confirmed human case in New Zealand has
been identified, whether imported, locally acquired or of source unknown, with a
risk of community transmission.
Situation two: There are one or more clusters of cases in New Zealand. These
may be in one or more locations (and of different sizes), but containment
remains feasible.

78 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Action Responsibility Authority
(If arising from • Implement actions detailed in the Keep It Out phase in addition to actions noted Biosecurity New Zealand,
contact with New below. Ministry of Health, Health New
Zealand animals) Zealand (NPHS), Ministry of
Business, Innovation and
Employment / WorkSafe New
Zealand, New Zealand Customs
Service, Department of Prime
Minister and Cabinet

Planning, • Review actions and decisions in the context of information provided by the All agencies No powers required
coordination and Ministry of Health and Health New Zealand, and increase the response as
reporting necessary and in accordance with agency response plans.

• Ensure ongoing surveillance information informs policy and operational Ministry of Health, Health New No powers required
decisions on implementing the CIMS and regional response plans and Zealand
preparation for an escalated response.

• Prepare to activate business continuity plans, in anticipation of staff or supply All agencies No powers required
chains being disrupted by the pandemic internationally or within New Zealand.

• Prepare for the Manage It phase and review Recover From it plans. All agencies No powers required

• Activate emergency operation centres using CIMS, including the National Health Ministry of Health, Health New No powers required
Coordination Centre, if not already activated. Zealand

• Consider risk assessment criteria and transition factors for a shift to the Manage Health New Zealand, Ministry of No powers required
It phase (eg, increasing transmissibility, increasing case numbers, containment Health
measures failing or at risk of failing or particular risk to specific populations).

• Release therapeutics/antivirals for use according to policy and monitor their Ministry of Health, Health New No powers required
usage, if applicable. Zealand

• If available and appropriate, release pre-pandemic vaccine under the pre- Ministry of Health, Health New No powers required
pandemic vaccine usage policy Zealand

• Prepare authorisation for use of emergency powers and an epidemic notice, if Ministry of Health Health Act 1956, section
required. 70

• Order vaccine, if available. Ministry of Health No powers required

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 79

 Function Action Responsibility Authority

Testing, surveillance • Actions on the identification of a first case will depend on case investigation. Health New Zealand (NPHS, Notification requirements
and intelligence Factors to consider include the following: with advice from ESR), Ministry (to medical officer of
– Implement a surveillance and testing strategy, which may include the of Health, Biosecurity New health): Health Act 1956,
following: Zealand sections 74 (health
practitioners) and 76
– If the case has travelled overseas recently, increase monitoring and
(quarantine); Health
surveillance at the border.
(Quarantine) Regulations
– Exposure to animal sources of infection 1983, regulations 3 (pilots)
– If the case has not travelled overseas recently and there has been no animal and 10 (masters of ships)
exposure, assume human-to-human transmission within New Zealand.
• Ensure contact-tracing and case investigation information informs policy and
programmes.
• Conduct intensive surveillance to detect other cases, possible secondary cases
and contacts, including through source investigation.

• Carry out surveillance through border management. Health New Zealand (NPHS) No powers required

• Carry out intensive surveillance (locally, regionally or nationally as appropriate) Health New Zealand (with
through primary care, Healthline and accident and medical and hospital advice from ESR), Ministry of
emergency departments to detect possible cases and clusters, and notify cases Health
to a medical officer of health for cluster control measures.
• Enhance laboratory surveillance.

• Monitor the demand and capacity of the health and disability sector. Health New Zealand No powers required

• Enhance existing processes for monitoring staff absences through sentinel Health New Zealand, Public No powers required
surveillance in district and regional Health New Zealand facilities, schools and Service Commission, Ministry of
other workplaces. Education, Ministry of Health

• Ensure surveillance information informs policy and operational decisions on Ministry of Health, Health New No powers required
implementing the CIMS and regional response plans and preparation for a full Zealand
response.

• Monitor the situation overseas. Ministry of Health (lead), No powers required

• Create intelligence summaries. Biosecurity New Zealand,
Ministry of Foreign Affairs and
Trade

80 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Action Responsibility Authority

• Ensure laboratories have sufficient supplies and capacity as well as surge capacity Health New Zealand No powers required
and establish criteria for prioritised testing.
• Manage the procurement, supply and distribution of self-testing kits, if available.

• Carry out national and international reporting, including to the WHO. Ministry of Health International Health
• Advise the WHO of the first and subsequent cases identified in New Zealand. Regulations 2005 (WHO
2006)

• Review the surveillance of animals in the area or areas where humans are Biosecurity New Zealand Biosecurity Act 1993,
affected, as appropriate. sections 43, 109, 114 and
• Continuously monitor, improve and assess the appropriateness of response 121
measures

Public health • Review Keep It Out phase actions and consider exit assessment procedures, Border agencies (lead), Health Special powers may be
interventions: initially on a voluntary basis, depending on the New Zealand situation, WHO New Zealand (NPHS), airport required under the Health
border management advice and the risk of exporting disease. authorities Act 1956, section 71

• Consider and implement measures or restrictions on people leaving New Border agencies, ODESC system Health Act 1956; Epidemic
Zealand to prevent spread of the disease internationally (with specific reference Preparedness Act 2006
to Pacific Island countries and territories).

• Implement Keep It Out phase actions, exit assessment and other procedures as Border agencies
agreed above.

• Carry out contact tracing, voluntary quarantine and the dissemination of advice Health New Zealand Health Act 1956
to contacts on IPC measures and disease symptoms.

• Ensure those in voluntary quarantine can access food, medications and Health New Zealand (NPHS)
treatment for existing conditions and are referred to welfare agencies for income (lead), local authorities
support needs.

• Activate a national contact-tracing system and plan for surge capacity. Health New Zealand (NPHS) No powers required

• Monitor contacts’ health while they are in home quarantine and, if applicable, on Health New Zealand (and
antiviral prophylaxis. primary health services if
applicable)

• Promote relevant public health IPC measures (eg, cough and sneeze etiquette, Ministry of Health, Health New No powers required
advice that people should stay home if sick and physical distancing). Zealand

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 81

 Function Action Responsibility Authority

• Issue domestic or international ‘don’t travel’ advisories, as appropriate. Ministry of Health, Ministry of No powers required
Foreign Affairs and Trade

• Prepare authorisation for use of emergency powers or bespoke legislation as Ministry of Health Health Act 1956, section
required. 70

• Consider declaring a state of local emergency under the Civil Defence Emergency Local government, National Civil Defence Emergency
Management Act 2002 if this is not already in force. Emergency Management Management Act 2002,
Agency, ODESC system Part 4

• If authorised, consider national, regional or location-specific stay-at-home Ministry of Education, medical Epidemic Preparedness
(isolation and quarantine) notices and domestic movement restrictions (eg, local, officer of health Act 2006; Civil Defence
regional or national lockdown). Emergency Management
• If authorised, close educational facilities in affected areas. Act 2002; Health Act 1956,
sections 70(1)(la) and (m)

• If authorised, consider closures or limits within premises of a stated kind, and/or Ministry of Education, medical Epidemic Preparedness
forbid or limit people to congregate in outdoor places of amusement or officer of health Act 2006, Civil Defence
recreation. Emergency Management
Act 2002, Health Act 1956,
section 70(1)(m)

• If authorised, consider isolating or quarantining patients. Medical officer of health, Health Health Act 1956, Part 3A;
New Zealand (NPHS) Epidemic Preparedness
Act 2006; Civil Defence
Emergency Management
Act 2002; Health Act 1956,
section 70(1)(f) and (fa)

• Isolate affected areas in New Zealand or limit travel between regions, if New Zealand Police, New Epidemic Preparedness
appropriate and possible and if agreed by Cabinet (through the ODESC system). Zealand Defence Force Act 2006; Civil Defence
Emergency Management
Act 2002; Health Act 1956,
sections 70(1)(g) and (h),
Part 3A

• Identify potentially higher-risk groups and institutional settings in the Ministry of Health, Health New No powers required
community to inform communications and enable the targeting of control Zealand, with support from
interventions, as required. Whaikaha

82 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Action Responsibility Authority

• Implement intensive, targeted cluster control activities and other programmes in Health New Zealand No powers required
higher-risk populations and settings.

• Protect unaffected islands, or easily isolated regions, if authorised by the Minister Ministry of Health, New Zealand Epidemic Preparedness
of Health, if an epidemic notice is in force or if an emergency has been declared Police, New Zealand Defence Act 2006; Civil Defence
under the Civil Defence Emergency Management Act 2002 (that is, forbid people Force Emergency Management
or things from an infected place entering a healthy district; forbid people from Act 2002; Health Act 1956,
leaving a healthy district or a place within it; and consider detaining people sections 70(1)(g) and (h),
attempting to leave or enter an affected area). 79

• Commence immunisation once a vaccine is available. Health New Zealand No powers required

Health care and • Isolate cases and treat according to clinical advice and antiviral policies. Medical officer of health Health Act 1956
emergency
• Update human resource guidelines and policies prepared by Health New Health New Zealand No powers required
response
Zealand for major emergencies as required.

• Track all staff contacts of cases, review their health status and redeploy staff as Health New Zealand Health Act 1956, Part 3A,
required. sections 92P and 92ZQ

• Implement contact-tracing, case investigation and testing systems. Health New Zealand No powers required
• Scale up laboratory capacity as required.

• Liaise with ambulance services to provide updated information on IPC and Health New Zealand No powers required
service requirements.

• Consider activating CBACs to support cluster control responses. Health New Zealand No powers required

• Consider activating regional response structures. Health New Zealand No powers required

Communications • Coordinate communications to foreign governments and New Zealanders Ministry of Foreign Affairs and No powers required
and community overseas about the situation in New Zealand. Trade, Ministry of Health,
engagement Health New Zealand, with the
support of other agencies as
required

• Implement a multi-media campaign fronted by a trusted authority figures Ministry of Health, Health New No powers required
covering: Zealand, with the support of
– hygiene other agencies as required

– social distancing
– self-care and caring for others

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 83

 Function Action Responsibility Authority
– staying safe
– limiting spread
– control interventions
– accessing advice and help
– vaccination
– therapeutics.

• Distribute information to staff, the sector and clients through normal channels at All agencies
national, regional and local levels.

• Ensure tailored materials for populations at increased risk of infection or severe Ministry of Health, Health New
outcomes, such as: Zealand, Whaikaha, with the
– Māori support of other agencies as
required
– Pacific peoples
– non-English-speaking communities
– higher-risk groups, as informed by epidemiological data.

• Expand the capacity of telephone helplines to meet an increase in demand from Health New Zealand No powers required
the public and health professionals. Ministry of Health, Health New
• Distribute situation reports and intelligence summaries. Zealand

• Provide customised information to overseas visitors in New Zealand. Ministry of Business, Innovation No powers required
and Employment, Health New
Zealand, Tourism New Zealand,
Tourism Industry Association

Other cross-sectoral • Focus on ensuring and maintaining appropriate engagement with the Ministry of All agencies No powers required
actions Health as the lead agency to inform action.
• Ensure contact details for each agency are up to date.
• Keep staff and sectors updated on the evolving situation.
• Ensure response staff are given the opportunity for rest and recuperation.

84 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Manage It
Pandemic management
Potential escalation factors
• There are multiple clusters in New Zealand at separate locations or clusters
spreading out of control.
• It is logistically impossible to maintain widespread cluster control activities.
• There is sustained and substantial transmission in the population.

Objective
• To reduce the impact of the pandemic on New Zealand’s population, including
inequities of outcomes for specific population groups.
• To minimise serious illness and deaths.
• To slow the spread of the pathogen.
• To reduce pressure on primary and secondary care services.

Key decisions
• Consider whether to focus on suppression (to minimise the burden of disease) or
mitigation (to protect the health system from being overwhelmed).
• Release therapeutics for use according to policy and monitor antiviral usage.
• Order the pandemic vaccine, if available, following a pandemic declaration by the
WHO.
• Consider the need for an epidemic notice, if one is not already in force; consider
declaring a state of local or national emergency under the Civil Defence Emergency
Management Act 2002; and review both on an ongoing basis.
• Review the need for containment measures, and implement as necessary.
• Consider setting national prioritisation criteria for the distribution and use of critical
goods and services that may be in short supply.
• Review border entry/exit/closure requirements.
• Identify mitigating measures for gatherings.
• Consider the use of telehealth appointments in health care settings.
• Consider the provision of support services available to support cases/contacts to
safely isolate/quarantine.
• Identify required and/or already available data and digital tools (eg, for contact
tracing) to support the response.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 85

 Manage It phase

There is increased and substantial transmission in the general New Zealand

population.

The application of Manage It phase actions will depend on the epidemiology of the
pandemic; the severity of outcomes from infection on population groups (including
longer term sequalae); the availability, effectiveness, acceptability, cost and impact of
the response measures and its geographical spread; and the availability and coverage
of therapeutics and vaccines.

Some districts or regions may remain at the Stamp It Out phase, while others move to
the Manage It Phase. Movement from the Manage It phase into the Manage It: Post-
Peak phase may also vary. Targeted Stamp It Out programmes may be maintained
during later phases to protect populations at greater risk.

86 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Action Responsibility Authority
Planning, coordination • Review actions and decisions and adjust to the current situation. All agencies No powers required
and reporting • Implement new actions and change/remove previous actions as the evolving
situation demands.

• Ensure the National Health Coordination Centre is adequately resourced for Ministry of Health No powers required
the increase in demand, and consider possible activation of the National Crisis
Management Centre.

• Consider the need for an epidemic notice and/or other bespoke legislative Ministry of Health, Minister Epidemic Preparedness Act
tools. of Health, Prime Minister 2006

• Consider declaring a state of local or national emergency under the Civil Local government, Ministry Civil Defence Emergency
Defence Emergency Management Act 2002 if this is not already in force. of Civil Defence and Management Act 2002, Part 4
Emergency Management,
ODESC system

• Order the pandemic vaccine, if available, following a pandemic declaration by Ministry of Health No powers required
the WHO.

• Release therapeutics for use according to policy and monitor their usage. Ministry of Health No powers required

• Activate recovery arrangements. All agencies No powers required

• Consider setting national prioritisation criteria for the distribution and use of All agencies Civil Defence Emergency
critical goods and services that may be in short supply. Management Act 2002, Part
4; Health Act 1956; other
sector-specific legislation

Testing, surveillance • Change the overall emphasis in surveillance activities from nationwide Ministry of Health, Health No powers required
and intelligence detection of cases and clusters to extensive assessment of the general spread, New Zealand, NPHS,
the health and social impacts of the pandemic and the efficacy of control agencies focused on social
measures. and economic impact

• Target containment surveillance programmes in higher-risk settings and in Health New Zealand, No powers required
groups with a higher risk of acquisition and/or severe outcomes. Ministry of Health, ESR
• Monitor Healthline calls.
• Monitor information from CBACs, primary care services and hospitals on
patients seen; clinical status; capacity of critical services such as emergency
departments, laboratory services and intensive care units; and usage of
national reserve supplies.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 87

 Function Action Responsibility Authority
• Monitor data on mortality and illness caused by the pathogen.
• Monitor workforce absence at sentinel sites.
• Monitor antiviral resistance and vaccine effectiveness.
• Monitor pathogen molecular epidemiology (eg, genome sequencing
surveillance).
• Monitor the load on, and capacity of, the health and disability sector.
• Monitor laboratory capacity and prioritise services, if required.

• Review surveillance of animals in areas where humans are affected, as Biosecurity New Zealand Biosecurity Act 1993, sections
appropriate. 43, 109, 114 and 121

• Monitor the situation overseas. Ministry of Health, No powers required

Biosecurity New Zealand,
Ministry of Foreign Affairs
and Trade

• Distribute situation reports and intelligence summaries. Ministry of Health, Health

New Zealand

Public health • Re-evaluate border measures and ensure a nationally consistent approach. Border agencies No powers required
interventions: border
• Implement exit assessment if required. Health Act 1956, section 71
management
• Re-evaluate actions and critical decisions implemented in the Stamp It Out Ministry of Health (lead), No powers required
phase. Consider the value of maintaining, increasing, targeting or reducing Health New Zealand, other
interventions such as measures to slow the spread of the pandemic, including government agencies
closures or restrictions in the education sector, social distancing, advice on
staying home, focusing on hygiene, reduction or restriction of travel,
restrictions on public gatherings and venues, and voluntary quarantine of
contacts.
• Tailor programmes to high-risk populations or settings.
• Review and update case and contact management.
• Consider support for cases and close contacts in quarantine/isolation.

Health care and • Consider adjustments to scopes of practice and/or registration requirements Health New Zealand No powers required
emergency response to enhance health care workforce flexibility.
• Action regional plans locally and/or regionally as necessary or directed,
including for primary care, CBACs, hospital services (including emergency

88 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Action Responsibility Authority
departments and intensive care units) and therapeutics distribution to
prioritise the maintenance of essential health services while considering
deferrals of other health services where appropriate.
• Increase and support national, regional and local telephone triage as
necessary, and monitor demand.
• Provide relevant and accessible information to higher-risk populations and
settings.
• Review the core competencies required to deliver critical services under
pressure (eg, in an intensive care unit or primary health care) to inform any
necessary reprioritisation of health resources locally, regionally or nationally.
• Monitor the impact on critical hospital services; postpone electives if required
and liaise with other district/regional Health New Zealand administrative units
to make best use of available regional and national resources.

• Report to the Ministry of Health on service capacity, as required. Health New Zealand No powers required
• Comply with any national service or resource priority criteria the Ministry of
Health establishes.
• Liaise with ambulance providers to prioritise the use of this service, if required.

• Monitor the use of personal protective equipment. Ministry of Health No powers required
• Respond to local/regional Health New Zealand requests for use or distribution
of personal protective equipment from the national reserve supply.

Communications and • Implement measures applicable to the Stamp It Out phase, and additionally: Health New Zealand, with No powers required
community – continuously review the communications strategy, with special reference to support from other
engagement audiences and key messages, incorporating feedback from media agencies as required
monitoring and other agencies’ channels and intelligence
– continuously evaluate and refresh paid media campaigns and inter-agency
communications and consultation
– ensure messaging is in appropriate languages and formats to support
affected populations.
• Continuously liaise with the WHO and appropriate Australian agencies and Ministry of Health No powers required
departments on all issues, and Pacific Realm and other Pacific countries as
appropriate.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 89

 Function Action Responsibility Authority

• Coordinate communications to foreign governments about the situation in Ministry of Foreign Affairs No powers required
New Zealand and advise New Zealanders overseas. and Trade

• Create and distribute situation reports and intelligence summaries. Ministry of Health

Other cross-sectoral • Implement measures applicable to the Stamp It Out phase, and in particular: All agencies No powers required
actions – focus on ensuring and maintaining appropriate engagement with the
Ministry of Health as the lead agency
– keep contact details for each agency up to date
– keep staff and sectors of each agency updated on the evolving situation
– monitor staff absences
– undertake preparatory actions for the Manage It: Post-Peak and Recover
From It phases
– ensure response staff are given the opportunity for rest and recuperation
– use Framework for Psychosocial Support in Emergencies (Ministry of Health
2016b) to inform recovery planning.

90 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Manage It: Post-Peak
Potential de-escalation factors
• The wave is decreasing and the likelihood of significant resurgence is low or
manageable.
• The severity and/or health impact of the infection has decreased.
• The associated risk is considered manageable within business-as-usual settings.

Objective
To move towards the restoration of normal services, expediting recovery, while
preparing for a potential re-escalation of the response.

Key decisions
• reviewing with consideration of removing or easing any mandatory requirements, or
the use of other special powers (eg, border and travel restrictions, restrictions on
public gatherings)
• reviewing and modifying non-mandatory public health advice and guidance (eg, the
extent of necessary IPC measures such as use of personal protective equipment
/face-masks), the frequency of testing, the settings at which specific advice applies
(eg, visitors to farms or aged residential care facilities)
• reviewing any other specific public health measures for specific settings, such as
workplaces, education facilities and health services settings
• reviewing and modifying vaccination programmes
• reviewing contact tracing and testing programmes
• reviewing surveillance needs
• reviewing the communication strategy
• determining the ongoing response and any scaling back of services and activities
• preparing to re-introduce interventions from earlier phases at short notice, if
required, should there be a resurgence or a new wave.

Manage It: Post-Peak phase

The initial wave of the pandemic is decreasing, but there is the possibility of a
resurgence or a new wave.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 91

 It is likely that actions applied in the Manage It phase will be slowly stood down during
this phase, and that actions for the Recovery From It phase will be introduced and
strengthened. This phase may occur at different times across the country, reflecting
local circumstances. At this stage, maintenance of surveillance and intelligence
activities is particularly important, to ensure early warning of any change in
circumstances that requires action. Should there be a resurgence of the pandemic, the
actions implemented in previous phases may need to be re-introduced at short notice.

92 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Action Responsibility Authority
Planning, • Inform agencies of the change in phase. Ministry of Health
coordination and
• Review actions and decisions; in particular, actions relating to key decisions made All agencies No powers required
reporting
in earlier phases. Stand down controls and programmes when feasible, noting that
they may need to be re-introduced quickly if there is a resurgence.

• Debrief staff and agencies, and collate lessons identified to better inform planning All agencies No powers required
and future responses.

• Evaluate the effectiveness of measures used and update plans, guidelines, All agencies No powers required
protocols and algorithms accordingly.

• Collate report on lessons identified in the New Zealand health and intersectoral Ministry of Health No powers required
response to inform planning and future responses, using an evaluation framework.

• Collate resources and store material developed in the response for use in future All agencies No powers required
pandemics.

• Review activation of the National Health Coordination Centre and National Crisis Ministry of Health No powers required
Management Centre, and prepare to transition to the Recover From It phase
coordination mechanism.

• Review the ongoing need for an epidemic notice or the use of special legislative Ministry of Health, Minister Epidemic Preparedness
powers, and revoke or stand these down if appropriate. of Health, Prime Minister Act 2006

• Review the ongoing need for a declaration of a state of local or national Local government, Ministry Civil Defence Emergency
emergency under the Civil Defence Emergency Management Act 2002, and revoke of Civil Defence and Management Act 2002,
or stand this down if appropriate. Emergency Management, Part 4
ODESC System

• Review usage of national reserve supplies and consider re-ordering. Ministry of Health No powers required

• Implement activation of recovery arrangements as required. All agencies May require Civil Defence
Emergency Management
Act 2002, Part 4

• Prepare to re-introduce interventions from earlier phases at short notice, should All agencies No powers required
there be a resurgence.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 93

 Function Action Responsibility Authority

Testing, surveillance • Review surveillance programmes applied in earlier phases to focus activities on Ministry of Health, Health No powers required
and intelligence early detection of any resurgence. New Zealand, ESR
• Continue to distribute situation reports and intelligence summaries.
• Monitor the load on, and capacity of, the health system
• Continue molecular epidemiology and pathogen treatment resistance monitoring.
• Analyse molecular and epidemiological data to inform programmes to be re-
introduced in a resurgence.

• Review the surveillance of animals in areas where humans are affected. Biosecurity New Zealand Biosecurity Act 1993,
sections 43, 109, 114 and
121

• Monitor the situation overseas to identify any changes in frequency and severity of Ministry of Health, No powers required
the pandemic, and in management plans and guidance from critical international Biosecurity New Zealand,
bodies (such as the WHO). Ministry of Foreign Affairs
and Trade

Public health • Re-evaluate measures that have been put in place and return, in a staged manner if All border agencies, NPHS Refer previous phases
interventions appropriate, to business as usual when appropriate.

• Continue or commence a pandemic vaccination programme, as required. NPHS No powers required

• Consider an incremental return to business as usual for educational institutions Ministry of Education, Health Act 1956; Civil
and childcare facilities. Ministry of Health, NPHS Defence Emergency
Management Act 2002

• Remove mandatory requirements when appropriate. Ministry of Health, NPHS Health Act 1956; Civil
Defence Emergency
Management Act 2002,
bespoke legislation

Health care and • Review actions and decisions and stand down controls and pandemic programmes Health New Zealand, No powers required
emergency response when feasible, noting that they may need to be introduced quickly if there is a Ministry of Health
resurgence.
• Prepare to return to business as usual.

94 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Action Responsibility Authority

Communications and • Continuously update the public and agencies on any changes to the status of the Health New Zealand, No powers required
community pandemic. Ministry of Health, with
engagement • Advise the public and agencies that it is possible that the pandemic will resurge or support from Whaikaha as
that a second wave will occur, so they remain vigilant. required

• Continuously review and refresh the communications strategy, with special

reference to audiences and key messages, incorporating feedback from
evaluations, media monitoring, behavioural insights and other agencies’ channels
and intelligence.
• Consider initiating development of a recovery campaign with reference to post-
trauma knowledge and best practice.
• Continuously liaise with the WHO and the Australian Department of Health and
Aged Care, Pacific Realm and other Pacific countries as appropriate.

• Disseminate key messages on the post-peak situation, consistent with All agencies No powers required
communications released by the Ministry of Health.

• Update advice on travel, if appropriate. Ministry of Foreign Affairs No powers required

and Trade

• Disseminate information on travel to New Zealand. Ministry of Business, No powers required

Innovation and
Employment, Ministry of
Health, Tourism New
Zealand, Tourism Industry
Association

• Coordinate communications to foreign governments on the situation in New Ministry of Foreign Affairs No powers required
Zealand, and advise New Zealanders overseas. and Trade

Other cross-sectoral • Ensure response staff are given the opportunity for rest and recuperation. All agencies No powers required
actions • Maintain appropriate engagement with the Ministry of Health as the lead agency.
• Ensure each agency’s single point of contact details are disseminated to other
agencies.
• Refer to Framework for Psychosocial Support in Emergencies (Ministry of Health
2016b) to inform recovery planning.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 95

 Recover From It
Recovery
Potential de-escalation factors
• The population is largely protected by vaccination or prior infection.
• The pandemic has abated globally and in New Zealand.
• The pathogen has become endemic but is resulting in more mild illness/less severe
health outcomes.

Objective
To expedite the recovery of population health, communities and society where they
have been affected by the pandemic, response measures or disruption to normal
services and begin to embed lessons identified during the pandemic.

Key decisions
Most decisions listed for this phase are common to all pandemics, whether mild or
severe, and focus on phasing out response measures introduced in earlier phases,
noting that recovery takes time and that some controls and response measures may
need to be retained for a period while society progressively settles on the new normal.
In a mild pandemic, there may be no need for a specific recovery phase. In more severe
pandemics, decisions may need to be made on:
• the establishment of recovery offices
• setting or maintaining national prioritisation criteria for the distribution and usage
of critical goods and services that may be temporarily in short supply
• initiating systematic evaluations of the response.

Recover From It phase

The pandemic is over and/or the population has been protected by vaccination
or prior infection, and/or the pathogen is now resulting in mild illness / less
severe outcomes or has become endemic. During or at the end of this phase,
each function will return to the activities in the Plan For It phase.

96 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Function Action Responsibility Authority
Planning, • Review actions and decisions, and develop phased plans for ceasing response All agencies No powers required
coordination and activities introduced in earlier phases, starting or continuing recovery-specific
reporting programmes, integrating preparedness and response activities across the system
and transitioning to a new business as usual.
• Assess the impacts of the response on Te Tiriti obligations and health equity and
identify further interventions to mitigate adverse or inappropriate impacts
• Give iterative consideration to activating or standing down recovery activities as All agencies No powers required
demanded by the situation.
• Review the ongoing need for an epidemic notice and other regulatory powers, if Ministry of Health, Minister Epidemic Preparedness
still applicable. of Health, Prime Minister Act 2006, other
• Review the ongoing need for a declaration of a state of local or national Local government, Ministry Civil Defence Emergency
emergency under the Civil Defence Emergency Management Act 2002, if still of Civil Defence and Management Act 2002,
applicable. Emergency Management, Part 4
ODESC system
• Review pandemic supplies (vaccines, therapeutics, personal protective equipment) Health New Zealand No powers required
and any other national reserve supply stocks, recall unused supplies to the national
reserve and reassess the need to re-order.
• Deactivate, if still applicable, the National Health Coordination Centre, National All agencies No powers required
Crisis Management Centre and other emergency operations centres.
• Give iterative consideration to the need to establish or de-activate operation All agencies No powers required
recovery offices.
• Consider setting national prioritisation criteria for the distribution and usage of All agencies Civil Defence Emergency
critical goods and services temporarily in short supply. Management Act 2002,
Part 4; Health Act 1956;
other sector-specific
legislation
Surveillance and • Review current surveillance and intelligence activities and maintain those required Ministry of Health No powers required
intelligence during the transition to full recovery (eg, those providing information on health
service impact).
• Monitor the load on and capacity of the health and disability sector. All agencies No powers required
• Return to Plan For It activities when the Recover From It phase is over.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 97

 Function Action Responsibility Authority
Public health • Move to routine measures specified in the Plan For It phase. All border agencies, NPHS No powers required
interventions • Integrate management of the pathogen into the core work of the health and
disability sectors (as applicable).
• Revoke any remaining mandatory measures and replace with guidance if still
needed.
Health care and • Implement a phased stand-down of response activities. All health agencies No powers required
emergency response • Focus on recovery activities.
• Assess priorities for business resumption.
• Resume business-as-usual services gradually.
• Organise debriefings, document lessons identified, and review and revise plans
accordingly.
• Move to routine measures as implemented in the Plan For It phase.
Communications and • Continuously review and refresh the communications strategy, with special Health New Zealand, with the No powers required
community reference to audiences and key messages, incorporating feedback from support of other agencies
engagement behavioural insights, monitoring and information from other agencies.
• Coordinate communications to foreign governments and New Zealanders overseas Ministry of Foreign Affairs No powers required
about the situation in New Zealand. and Trade
Other cross-sectoral • Implement a phased stand-down of response activities. All agencies No powers required
actions • Focus on recovery activities.
• Use Ministry of Civil Defence and Emergency Management and Ministry of Health
resources to inform recovery planning.
• Assess priorities for business resumption.
• Resume business-as-usual services gradually.
• Ensure each agency’s single point of contact details are disseminated to other
agencies.
• Maintain a contact list of other agencies.
• Organise debriefings.
• Review and document lessons identified.
• Revisit, review and revise plans accordingly.
• Move to actions specified in the Plan For It phase.

98 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Appendices

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 99

 Appendix A:
Public Information
Management Strategy
Introduction
The Public Information Management Strategy contains the key message framework
and relevant actions for specific audiences to supplement the objectives and principles
outlined in Appendix B of the New Zealand Pandemic Plan. This appendix should be
read in conjunction with the indicative communications and community engagement
actions outlined in detail in the Action Framework tables in Part B.

Cross-references and supporting material

New Zealand Pandemic Plan: Part B, all phases, ‘Communications and community
engagement’ sections

Key messages framework

The Ministry of Health, in conjunction with its health and disability partner agencies
Health New Zealand and Whaikaha, has identified anticipated information demands for
each phase of a pandemic, and formulated messages to disseminate to communities in
response to those demands.

Much of the information to be communicated will remain constant, although the

emphasis will change as the public health response evolves. The sharing of information
will also vary in frequency, depending on how the pandemic unfolds through its
different phases.

In any pandemic, messaging needs to be appropriately tailored to the situation. The

following section sets out some questions intended to prompt key messages to
support public information management in a pandemic. This section provides some
potential key messages where they are likely to be consistent across events.

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Key messages prompts
It looks like a respiratory-type pandemic is about to
start
• Does the risk to health, and growing public awareness/anxiety, mean health officials
now need to inform/educate the public about this pandemic?
• What is a pandemic?
• What is the risk of this virus/pathogen to health relative to other endemic
respiratory viruses?
• What are the symptoms and duration of infection? How does the virus behave? (eg,
How does it spread? What is its longevity on surfaces?)

There is much about this that we do not know

• What do we know so far?
• What are we doing so far?

The pandemic may be very bad

• What do people need to know about the possible extreme severity of the
pandemic?
• How we are acting to manage that risk?

What matters most is how we prepare

• What can households, communities and organisations do to get ready?
• How should households plan for coping with sickness and absences?
• How should homes and businesses plan for a situation where contact with others is
severely constrained or limited?
• How can we emphasise the importance of business preparedness?

Individual and community preparations should

focus on reducing the chance of getting sick,
helping households cope during a pandemic and
minimising disruption
What steps can people take to stay well and protect others? Key messages could
include:
• Cover coughs and sneezes and keep your distance from anyone who is sick.

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 • Wash and dry your hands (or use a sanitiser).
• If you’re sick, stay home.
• Gather essential supplies.
• Know how to look after yourself at home.
• Organise your work to focus on essential tasks.
• Organise volunteers and help networks.
• Prepare for disruption or restrictions from a pandemic:
– Make plans for any family members travelling overseas to return home promptly.
– Make arrangements to ensure continuity of care for dependants who live in
another location.
– Ensure you have supplies of items needed for protective measures (eg, masks
and hand sanitiser).
– Ensure you have essential supplies (medicines and foods) for a few days (see the
section on possible shortages below).

Immunisations are important

• How will the vaccine enhance people’s protection in a pandemic?
• What do people need to know about the availability of vaccines?
• How and where will vaccines be administered? Will they be free?
• How safe and effective are vaccines?
– On efficacy, how does the vaccine reduce the risk of infection, the risk of
transmission and the risk of severe disease? How does this reduce over time?
– What are the safety risks and potential side effects of the vaccine?
• How do we quantify the risk vs the benefit?
• What was the approval process for the vaccine, and what ongoing safeguards are in
place to ensure adverse reactions are reported?
• What other medicines/treatments are available to protect or treat the effects of the
illness, and how are they safe and effective?

Physical distancing will help us control it

• How is social distancing effective in reducing transmission?
• What public events may be cancelled and why?
• Will people have to work from home? Why? Will business interactions potentially
need to be virtual or online?
• Do people need to try to reduce interactions with other people in their day-to-day
activities?
• How will access to health services be constrained? Will people need to use more
online or virtual consultations?
• Will hospital visitors or family or friends’ support for patients potentially no longer
be permitted? Why?

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• Will any restrictions apply to visiting loved ones in aged care facilities? Why?

School closures will help us control it

• Will schools need to close? Why?
• How do schools need to prepare?
• How do individuals, communities and employers need to prepare for the eventuality
of school closures in terms of managing long-distance learning for school children?

Getting ready is about preparing for possible

shortages
Key messages could include:
• A pandemic could severely disrupt the supply of good and services, including health
care and other government support.
• Being well prepared as a household or an organisation will ensure resources and
services can be prioritised for people with the most urgent needs.
• Health care will be prioritised to meet urgent care needs and the pandemic
response.

Getting ready is about preparing for possible travel

disruptions or border closures here and overseas
What plans do people need to make in terms of possible restrictions to travel which
may remain in place for long periods, including internationally and within New
Zealand?

Think about how to care for loved ones at home

• How will health care be prioritised?
• What, if any, disruption will this cause to health services (planned care, etc)?
• How likely is it that hospitals and other health services will be overwhelmed, and
what steps are being taken to manage this?
• What do people need to do to make sure they have the medicines and essential
supplies they might need?
• What should people do if the health of a sick person in their household
deteriorates?

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 The Government, Health New Zealand and the
Ministry of Health are responding to the pandemic
• How are the Government, Health New Zealand, the Ministry of Health and other
agencies actively planning, coordinating and facilitating a response?
• How do central health agencies use and disseminate information about the
pandemic? Key messages could include:
– We will proactively and frequently share significant new information with the
public to support them to make decisions about their health and the health of
their loved ones.
– We will be honest about the limits of our information and update the
information when we know more.

We will be upfront and honest

Key messages could include:
• Be prepared for news that may be concerning – we will not sugar-coat messages.
• There may be changing or conflicting information; initial information may change as
we receive more detail.
• Pandemics are characterised by uncertainty, and actions in response need to be
taken quickly.

How to get the information you need

• How can people access further information (eg, websites, apps, media releases,
social media)?

Take care with sources of information

• How can people know whether an information source is reliable? Key messages
could include:
– Seek information from reliable and government sources.
– Test any news or information you receive from other sources against trusted and
reliable sources of information as during times of uncertainty there is an increase
in the spread of news from unreliable sources. If in doubt, do not pass it on.

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Sequence of communication
planning
Discrete initiatives and key messages will be developed for specific audiences at
different phases. The following sections list key questions for which the public are likely
to need answers, according to the six phases of a pandemic response.

Plan For It and Keep It Out

• What can I do to prepare?
• How can we reduce the risk of infection and transmission? What will happen at the
borders? Will they be closed? If so, when and where?
• What are the household supplies New Zealanders will need in a pandemic?
• What will happen to travel services?
• Will restrictions affect my day-to-day life (in terms of education, work, home, access
to high-risk locations)? How can I accommodate these restrictions?
• How likely is a pandemic?
• What will happen to me if I get sick?
• Is there a vaccine? How can I access it?
• How will health services cope?
• What are you planning to do to respond?
• Who is in charge?
• Will people be able to ring a free phone number such as Healthline for advice?
• How can antivirals help? Will they cure people?
• Where can I get up-to-date information?

Stamp It Out
• What can I do to help reduce the risk of severe illness or death to myself and my
loved ones?
• Where can I get up-to-date information?
• What are the household supplies I will need?
• What should I do if I think I have the pandemic illness? Who should I call for more
advice? How should I look after myself (specifically)?
• Is it safe to go to work?
• How can I keep myself safe at work?
• Where can I seek local assessment and treatment for the pandemic illness?
• Who is eligible for antivirals or a vaccine?
• How can I get antivirals or a vaccine for myself or my family members?
• What should I do about travel overseas or family members travelling overseas?

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 • What should I do if I have been overseas in an affected area and am feeling unwell
with flu-like symptoms?
• Where should I go for more information or help for health problems other than the
pandemic illness (eg, scheduled surgery)?
• Can the pandemic illness be spread by air-conditioning units?
• Who is in charge of making decisions nationally?
• To what extent should I stay away from infected areas?
• Where should I go for welfare help?
• What are the extended powers of medical officers of health?
• When and how are medical officers of health’s extended powers enacted?
• What should I do and who should I call if someone I am looking after dies?
• How can I volunteer services to help others?

Manage It
• Where can I get up-to-date information?
• How can I reduce the risk to myself and my family? What health and physical
distancing measures (including safety on public transport) should I take?
• What should I do if I think I have the pandemic illness? Who should I call for more
advice? How should I look after myself (specifically)?
• What should I do if someone in my family gets the pandemic illness? How should I
look after them?
• How can I seek assistance if I get sicker?
• What can I expect from health services?
• When, how, where and in what circumstances should I call for medical help? (Note
that the response to this question will essentially give self-triage information – the
‘where’ aspect will be local information.)
• Where can I seek local assessment and treatment for the pandemic illness (eg, are
there local community-based assessment centres that can provide this)?
• Who is eligible for antivirals or a vaccine?
• How can I get antivirals or a vaccine for myself or my family members?
• Which public gatherings, if any, will be cancelled?
• What should I do and who should I call if someone I am looking after dies?
• How can I volunteer my services to help others?
• How can I keep myself safe at work?
• Who is in charge of decision-making nationally?
• To what extent should I stay away from infected areas?
• What are the extended powers of medical officers of health?
• When and how are medical officers of health’s extended powers enacted?

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Recover From It
Recovery messages will be developed in conjunction with relevant agencies at the time
of the event. Key agencies concerned with social issues, health, the economy and
business should take part in developing recovery messages.

Messages will need to take into consideration the scale of the event, existing
community networks, social factors and public expectations.
• What psychosocial recovery activities and support programmes are available for the
public, health personnel and other front-line staff and volunteers?
• Where can I get up-to-date information?
• How can I volunteer my services to help others?
• Who is in charge of decision-making nationally?
• What priority is being given to recovery activities, in terms of:
– reinstating services providing basic necessities
– reopening educational facilities
– identifying services that continue to be disrupted or unavailable?
• How long will it take for services to return to normal?

Take particular care with unofficial sources of

information
During times of uncertainty, we are particularly vulnerable to misinformation or fake
news.

To help decide if information is true, use Netsafe’s tips for spotting disinformation,
‘Tips for spotting fake news’ (https://netsafe.org.nz/wp-
content/uploads/2022/06/Tips-Fake-News_Trifold_0622.pdf). These tips include:
• understanding the context
• comparing other sources
• understanding the subtlety
• checking the facts
• knowing your biases.

Communication initiatives to reach

target audiences
Communication is essential to the management of any pandemic response.
Information must be designed and disseminated in ways that reach all audiences. It
must empower individuals and communities to make informed choices, support
delivery of our response when acting as guidance and ultimately empower New

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 Zealanders to promote and protect the health of their wider community, their whānau
and themselves.

A communications plan should aim to ensure that communications:

• use existing media, communication channels, resources and partnerships (eg, news
media outlets, established communications networks, websites and other digital
platforms, professional bodies and organisations, and faith-based and social
groups)
• are simple (ie, do not over-complicate the message) and achievable, emphasising
what is important and what will work
• are appropriately targeted and use a range of relevant methods to reach and
engage key audiences (ie, that there are specific strategies and plans in place for
specific groups, through established professional bodies and networks).

It is important to regularly monitor the effectiveness of public communications and

adjust the approach as necessary.

News media
Established media channels are one of the primary methods of communication in a
pandemic, and adequate resources need to be provided initially to ensure the
maintenance of an effective and constructive working relationship. Media initiatives
include:
• media conferences – these are helpful for providing information and critical for
providing opportunities for journalists to ask questions and talk to people in key
roles
• media releases and advisories – these draw attention to information and upcoming
events and provide a baseline of credible information, and can take pressure off
busy spokespeople
• briefings for news editors and specialist journalists – these can provide in-depth
background information, on the record
• frequently asked questions sheets and information for file – these can provide a
context and support for specific initiatives
• media interviews (one on one or with another guest or two; live or taped and
edited; in person, on the telephone or via satellite) – these can provide pertinent
information, on the record
• support for partner organisations, particularly those that are better placed to speak
to specific audiences, to make use of media opportunities
• media monitoring of national and international media sites – this can keep the
Ministry of Health abreast of breaking stories and ensure it is ready to respond as
required.

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Digital channels
Digital channels, including social media, provide critical tools for managing
information. They are an efficient way of communicating with large audiences quickly.
Opportunities to use these tools in a pandemic response include:
• implementing a dedicated space an existing website, such as Health New Zealand’s
consumer-facing website(s), supported by broader digital channels, that provides a
consistent branded one-stop shop for public-facing information about the
pandemic, including media conferences, interviews and other video and resources
• establishing a dedicated team with the responsibility and authority to develop and
maintain digital pandemic communication channels and ensure that content is
coordinated, current and aligned to the current level of pandemic response and risk
• ensuring digital communication caters for all discrete groups, including Māori,
Pacific peoples, other ethnic groups and groups with special needs, such as disabled
people (and ensuring it complies with accessibility standards)
• linking the dedicated pandemic response site to other relevant web pages and sites,
local and international, and integrating it tightly with social channels
• being aware of how similar sites present information, and copying formats that
work
• making use of social media platforms including SnapChat, Instagram, Facebook, X
and YouTube to disseminate information in a safe and secured way
• making use of other digital media communication channels (eg, ‘influencers’).

Use of digital media and consideration of digital

exclusion8
All digital media use needs to take into consideration groups that are more likely to be
digitally excluded, such as Māori, Pacific peoples, disabled, rural people and elderly
people. Alternate provisions need to be made accordingly (the COVID-19 response
provides an example of this; there was a high demand for telephone services to order
physical vaccine passes for those who were unable to use digital versions).

Telephone helplines
Helplines are an essential tool for disseminating information and managing large
numbers of enquiries at an operational level. National helplines (such as Healthline)
can disseminate general advice, and local helplines can provide information on
accessing local services. Public information managers need to work closely with
operations teams to ensure the provision of consistent messages and to capture
feedback that can be used to improve and enhance communications. The
establishment of helplines will involve setting up 0800 numbers, creating scripts and
pre-recording messages to be played after hours and during call diversions.

8
‘Digital inclusion’ is defined as an end state in which everyone has equitable opportunities to participate in
society using digital technologies.

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 Public awareness and education
It will be important at different stages of the pandemic response to heighten
awareness and provide educational messages through paid media channels. Planning
for this will involve:
• developing key messages and information
• planning collateral and campaigns to the point of readiness for production
• obtaining pre-approval of a budget for production, considering possible media
mechanisms (eg, print or electronic media, direct mailings or billboards at high-
impact sites) and accordingly obtaining pre-approval of media partners
• where appropriate, establishing a consistent branding approach across multiple
channels (eg web, social, physical assets, video, etc)
• developing public service broadcasts able to be used in national emergencies
• considering a variety of methods to reach communities and agencies.

Māori and Pacific audiences

Teams involved in the public information management function will coordinate with
Māori- and Pacific-focused health teams within the Ministry of Health, Health New
Zealand and networks led by other government agencies to ensure key messages
reach Māori and Pacific audiences effectively. Communication with these audiences can
occur through:
• Māori television
• Māori and Pacific radio stations
• Māori and Pacific language translations on Health New Zealand’s website or other
appropriate dedicated websites.
• the networks and resources of Te Puni Kōkiri, the Ministry for Pacific Peoples and
other government agencies
• Māori health providers and iwi/hāpu-led organisations
• Pacific health providers and community groups.

Ethnic communities
Key information on the pandemic needs to be published online in a variety of
languages other than English, Māori and Pacific languages. Other resources and
channels will need to be considered as the pandemic develops to ensure many ethnic
communities have access to timely and relevant information; for example:
• non-mainstream media outlets, such as the 11-station Access Radio national
network
• the Department of Internal Affairs’ Office of Ethnic Affairs’ translations, database
and regional contact advice, and its current list of the top 15 languages most
commonly spoken by ethnic communities in New Zealand
• ethnic television programmes (eg, in the Auckland area, those in Mandarin and
Cantonese)

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• small Chinese-language newspapers, particularly in Auckland
• locally based refugee services and networks
• religious groups forming centres for ethnic communities (eg, Islamic organisations;
in the influenza A (H1N1) 2009 pandemic, these organisations were willing to
spread health messages through their networks, websites and newsletters).

Disabled communities
Teams involved in the public information management function will coordinate with
focused health teams within the Ministry of Health, Health New Zealand and Whaikaha
to ensure key messages reach disabled communities effectively. These teams will work
in a timely way to disseminate information materials in accessible formats including
New Zealand Sign Language (eg, ensuring media and public briefings involve an
interpreter), Easy Read and Braille and ensure digital media is designed in accordance
with accessibility standards. We will work together to ensure information is accessible
and appropriate for tāngata Whaikaha (Māori disabled people) and Pacific disabled
people.

Other publicity opportunities

An existing network of professional, vocational, community, cultural and special-
interest media provides opportunities for communication with a wide variety of
audiences. Such media include:
• community newspapers
• professional and trades journals (eg, in the health and disability sector, New Zealand
Doctor, Pharmacy Today and nursing journals)
• central agencies’ communication networks (the Ministries of Business, Innovation
and Employment, Education and Welfare all maintain such networks)
• educational supplements and resources
• children’s television, in Māori and English (eg, What Now ran a colouring-in
competition during the influenza A (H1N1) 2009 pandemic, and its programmers
are willing to continue to work closely with the Ministry of Health in the event of a
future pandemic)
• church and social groups
• regional television
• train and bus stations and sidings.

Monitoring and managing false information during

a pandemic
During a pandemic, there will be a heightened public awareness of and sensitivity to
public health threats. This means the public could potentially be more receptive to
authoritative sources of public health information, but it also means there is a greater
risk from the spread of false health information. False information can erode trust in
government and health institutions and reduce people’s receptiveness to public health

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 advice and compliance with public health measures. This can significantly reduce the
effectiveness of any pandemic response. Moreover, belief in false information can lead
people to adopt practices that could actively harm them, rather than protect them.

Given the potential consequences, any public information management approach to a

pandemic needs to address the potential harm of false information. Steps to address
this should include:
• ensuring accurate public health information is widely available and disseminated in
a way that reaches people and makes sense to them. This requires a multi-channel
and multi-audience approach delivered across digital channels, in print and in
person. Careful consideration should be given to meeting a range of formatting,
language and accessibility needs
• partnering with trusted community voices and organisations, who are usually in a
better position to speak to their communities about public health than government
or health agencies
• monitoring and ‘pre-bunking’ false information before it is widely disseminated.
This does not mean directly acknowledging the false information but rather
ensuring that communities that may be vulnerable to the specific false information
have access to accurate information first
• in the medium term, promoting resources that increase people’s ability to critically
assess the reliability of information.

Communications resources
Including Culturally and Linguistically Diverse (CALD) Communities (MCDEM
2013)
Being Prepared (Ministry of Health 2013b)

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Appendix B:
Explanatory material
This section provides additional information to support or supplement matters raised
earlier in the document.

Ethical considerations
The National Ethics Advisory Committee notes that an effective pandemic response will
require a range of interventions, some of which, in the interest of protecting the
collective’s right to health, will limit individual liberties. To find the correct balance
between individual and collective rights, the committee recommends that interventions
should align with the ‘Balance Principles’, be mātauranga Māori and/or evidence-based
and be proportional to the benefit they are trying to achieve or the risk they are trying
to mitigate.

Ethically, restrictive powers and intrusion into people’s lives should be exercised at the
minimum level required to achieve public health objectives. Interventions designed to
slow or eliminate the spread of an epidemic should, when possible and appropriate:
• be agreed rather than imposed. Measures that have been agreed to willingly are, all
other things being equal, better ethically
• aim to minimise any limitation of human rights and carefully describe the
justification for that limitation. Special attention may need to be paid to people who
are subject to restrictions (eg, to their freedom of movement), to ensure their other
rights are protected
• provide reciprocal support for people who, to protect others, have restrictions
imposed upon them
• be evidence-based and proportionate.

People are more likely to accept difficult decisions if decision-making processes are
open and transparent, reasonable, inclusive and responsive, entailing clear lines of
accountability. Decision-making processes are also more likely to be acceptable if they
are based on agreed, core ethical values and are evidence driven.

It is important to note that ethical considerations are broader than the legislation
suggests, and that the law is silent on many issues raised in pandemic planning. In
addition, the law is often slow to follow moral change in the community, so older
legislation may not necessarily reflect a community’s current ethical values.

Some pandemic programmes must be implemented swiftly if they are to be effective,

and some will have ethical components that need to be considered in real time. It will
not always be effective to rely on the usual processes.

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 Public Information Management
Strategy
Overarching principles
Public information management is an integral part of an integrated, wider response
strategy to provide leadership and reassurance for the public, the health and disability
sector and other sectors during a pandemic. It complements the health system’s and
wider sector’s pandemic response.

The Public Information Management Strategy allows central health agencies, including
the Ministry of Health, Health New Zealand and Whaikaha, to explain the public health
response and advise the population on the public health measures they need to take
as the pandemic progresses. It is designed to enhance alignment between agencies;
avoid confusion; and maintain accuracy, clarity and consistency of message. The
overarching principles of the strategy are to:
• build trust and provide reassurance
• announce early
• be transparent
• respect public concerns
• be proactive
• manage risk
• plan in advance
• be responsive.

This strategy recognises that providing accurate, timely and consistent information is
essential to the effective management of a pandemic response, and that in a pandemic
one of the most critical roles of the central health and disability agencies will be to
provide leadership and coordination in communications, to ensure the approach is
locally led, regionally enabled and centrally supported. It also recognises that central
health agencies have a duty to ensure information is accessible and reaches priority
populations in pandemic, including Māori, Pacific peoples, women (the majority of
carers) and disabled people. Specifically, meeting our Te Tiriti of Waitangi obligations
means partnering with Māori to develop ways of communicating with Māori during a
pandemic, ensuring that the information being shared empowers Māori to act and
actively enhances their protection from the impact of the pandemic.

As the public health operational response lead, Health New Zealand runs the Public
Information Management Strategy in the event of a pandemic, including by deciding
the public and sector channels through which pandemic information will be shared.
This will be supported by other health and disability organisations, including Whaikaha,
which will have access to channels and relationships that are more effective at reaching
specific populations.

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The Public Health Agency, within the Ministry of Health, will provide public health
advice to Health New Zealand’s Outbreak Response team to be used in the Public
Information Management Strategy. Health New Zealand will operationalise such public
health advice, working with its supply, contact tracing, and IPC teams to develop advice
and guidance to the public and the sector. This advice will then be reviewed by the
Ministry and Whaikaha before it is finalised.

As part of its oversight of the Public Information Management Strategy, Health New
Zealand will produce materials, as required, which can be customised by relevant
national, regional and local agencies and organisations in their responses. For example,
regional health services can take national resources, add in local details on how the
public can obtain advice and treatment and disseminate this material through local
community networks and media.

Health New Zealand will also use translations services to provide public information in
te reo Māori, Pacific languages and other languages, and in accessible formats.

Different parts of New Zealand may be at different response phases at any given time.
It is therefore important to ensure that national information is adapted and
disseminated by local agencies (such as Health New Zealand districts/regions) to meet
local circumstances. Support is still required to ensure the communications approach
for priority populations works for those communities. It is equally important that the
information being shared by central agencies (nationally or locally) across New Zealand
is consistent with agreed messaging and established best practice principles.

The Public Information Management Strategy is an evolving strategy that is designed

to be revised as more is learnt about a pandemic and its characteristics. New
information will allow central health agencies to better target messages and manage
communications. Throughout the phases of a pandemic, the lead agency will:
• lead all communications on public health, supported by other central health
agencies and key stakeholders as appropriate
• appoint a Public Information Management Strategy manager(s) who has the ability
to carry out the necessary responsibilities, supported by an appropriately resourced
team of communications staff
• ensure the appropriate resourcing and development of public information materials;
awareness campaigns; and website, social media and media content as required to
support the response
• provide expertise, leadership and advice to support the pandemic response
leadership group and other key decision-makers
• provide expertise, leadership and advice to support other government agencies,
ministers and other key stakeholders as required as part of the all-of-government
pandemic response effort
• develop and deliver appropriately targeted audience communications and collateral
to support the operational aspects of the pandemic response.

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 Communications objectives
The provision of information on a pandemic needs to be clear, timely, accurate,
authoritative, planned and sustained, with the aim of establishing and maintaining
mutual understanding and trust between those managing the response and between
agencies and the public. It also needs to reach high-priority populations in need.

Key objectives are to:

• maintain public trust and confidence in the response and in agencies’ competence
and capability
• be proactive and provide information before people know they need it
• be flexible enough to respond to unforeseen or changing circumstances
• ensure those who need information and advice, including external and international
agencies and non-governmental organisations, receive accurate, consistent and
timely information and advice on which to base their own communications and
responses
• ensure that communications are provided in appropriate, culturally safe and
accessible forms, particularly for priority populations
• foster a level of public awareness and a sense of urgency appropriate for the level of
risk, without creating alarm or panic
• be transparent in raising awareness of the potential consequences of a pandemic:
discuss all potential threats and ensure audiences are aware of them
• ensure New Zealanders and overseas visitors have clear and simple information
about how to prepare themselves and their families/whānau for a pandemic, and
where to get help
• ensure the public receives clear and frequent information about the steps they can
take to protect themselves and others (eg, on the importance of hand washing and
mask wearing).

Sequence of communication
planning and key messages
Discrete initiatives and key messages will be developed for specific audiences and
different phases. Appendix A provides an overview of these.

Intelligence
Intelligence functions
Important intelligence activities include:

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• gathering and assessing information on relevant international developments,
actions and advice from reputable sources, including international public health
counterparts, and escalating information that may have an impact on New Zealand
• surveillance of influenza-like illness, viral isolates, testing data and unusual events
• analysis and structured risk assessments that support planning and decision-making
(including modelling)
• behavioural surveillance and monitoring sentiment and social licence for public
health actions; maintaining communications with community groups and front-line
staff (‘soft intel’).
• enhancing surveillance during a pandemic response (including international and
domestic surveillance)
• monitoring response activities and resources (in the health and disability sector and
other sectors)
• evaluating response activities (in the health and disability sector and other sectors)
• assessing impacts on health services, society and the economy
• assessing impacts on non-health services and sectors
• gathering clinical information about illness, severity and management
• gathering and assessing epidemiological information (including on time trends,
geography, impacts on particular population groups and transmission patterns)
• reviewing and assessing virology data
• reviewing mortality data
• undertaking other research.

A number of these functions can also be categorised as ‘surveillance’.

Information gathered by way of these activities should be analysed and used to

produce reports and provide advice to the health and disability sector and other
sectors as needed.

One important function is receiving and providing updates to and from the World
Health Organization through the National Focal Point under the International Health
Regulations 2005 (WHO 2006).

Government agencies are responsible for monitoring the impact of a pandemic;

monitoring, evaluating and reporting on response activities in their own sectors
and through the Intersectoral Pandemic Group work streams; and reporting on
these activities to the National Health Coordination Centre and National Crisis
Management Centre.

Surveillance
Surveillance is the key intelligence function performed by health and other agencies
before, during and after a pandemic, particularly at the national level. Pandemic
surveillance involves the ongoing, systematic collection, analysis, interpretation and

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 117

 dissemination of data to inform planning and response activities, and, ultimately, to
reduce morbidity and mortality.

Table 8 sets out important surveillance objectives for health agencies in a pandemic,
along with national systems and data sources in place as at 2023. Resources and
functions allocated to (and within) health planning and intelligence teams need to take
account of these.

An important priority between pandemics is ensuring that influenza-like illness

surveillance will be enhanced in a pandemic. Throughout all phases, the Ministry of
Health and Health New Zealand will work with other agencies to collect and analyse
data, which will allow early determination of national trends. The Ministry of Health and
Health New Zealand will use their networks to facilitate prompt public health action on
the basis of this data analysis.

The objectives for public health surveillance and the surveillance methods used will
change as a pandemic develops and spreads through the country. In the Plan For It
phase, the priority is to ensure domestic surveillance systems are fit for purpose and
processes are in place to obtain international intelligence to monitor the international
situation. As the country moves through the Keep It Out and Stamp It Out phases, the
early detection of imported and secondary cases and clusters becomes the priority, so
appropriate control measures can be implemented. In the Manage It phase,
characterised by widespread disease in New Zealand, intensive efforts towards the
detection of cases will be replaced by monitoring the progress of the pandemic;
assessing its impact on the population, health and social services, and critical
infrastructure; and assessing the effectiveness of response activities. In the Recover
from It phase, heightened surveillance efforts will be scaled back down, and the data
will be used to support reviews and lessons-learned exercises.

No single surveillance system or information source can provide all the information
needed for pandemic preparedness, control and management. The WHO recommends
multisource systems to ensure resilience and responsiveness. The surveillance system
will be under considerable pressure during a pandemic, and resources are likely to be
limited.

Given the variable incubation and latency periods of a virus (or pathogen) and
potential delays in diagnosis, notification and action, response decisions will need to
anticipate the likely situation in two to three generations of the virus (which may be as
little as four to six days), rather than respond to the immediate situation.

Central and local government, the health and disability sector, social service agencies,
the media and the public have their own information needs. Important common
requirements include:
• coordinating and prioritising surveillance activities to meet well-defined surveillance
objectives
• implementing robust surveillance infrastructure and operations that can operate in
a timely manner
• using simple, existing information sources and surveillance methods where possible

118 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

• considering how enhancing existing systems would compare with creating new
systems (eg, by carrying out costs and benefits analyses) and using different data
sources (eg, point-of-care tests, wastewater surveillance and workplace or school
absentee rates)
• implementing appropriate checks and balances for monitoring the quality of new
surveillance systems
• collecting sufficient demographic information to enable equity analyses
• making multiple use of information – gather once, avoid duplication and use for
many purposes
• ensuring a variety of collection methods, so that the potential collapse of one
source can be compensated for
• integrating and ensuring consistency with other pandemic-related information
management planning and development activities.

Table 8: Health sector surveillance objectives

Objective National strategy or systems Owner Relevant

phase
Identify and monitor International Health Regulations 2005 Ministry of Health All
international events of (WHO 2006) and WHO communication
concern and related channels
advice to inform action
in New Zealand

Detect cases and Notification through public health Public health Keep It Out,
clusters early services and laboratories services, Ministry Stamp It Out
of Health

Detect cases and Monitoring of probable and confirmed Public health All
contacts cases notified to the local medical services, Health
officer of health and through EpiSurv New Zealand
(a database that collates notifiable
disease information) and Notifiable
Disease Management System

Detect community EpiSurv and sentinel surveillance and Ministry of Health, Stamp It Out
transmission genomic surveillance in various Health New
settings Zealand

Monitor virological Virological surveillance (various Health New All

changes domestically methods) and molecular Zealand
epidemiological assessments of viral
transmissibility, disease severity and
impacts, including on prevention (eg,
vaccine effectiveness) and treatment
(eg, antiviral resistance) measures

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 119

 Objective National strategy or systems Owner Relevant
phase

Monitor the level of Monitoring of influenza-like illness Ministry of Health, All

influenza-like illness, consultations in sentinel practices Health New
infection and disease Zealand
activity in the
Influenza-like illness sentinel
community and the
surveillance (including virological
pressure on primary
surveillance)
health care services
influenza-like illness sentinel
surveillance
Monitoring of influenza-like illness-
related calls to Healthline
Flu-tracking citizen science9 influenza-
like illness surveillance
Notifiable disease surveillance as
above (consider a role for over-the-
counter rapid antigen test self-
reporting)
Monitoring of testing and positivity
rates
Possible infection and sero-prevalence
surveys to assess prevalence
Possible Wastewater-based
epidemiology quantitation to monitor
infection trends

Monitor containment Monitoring of, for example: Ministry of Health, Keep It Out,
activities being • volumes of flights Public health Stamp It Out
undertaken services, Health
• levels of contact tracing and
New Zealand
contact tracing performance
metrics
• levels of laboratory testing and
demographic coverage

Monitor pressure and Monitoring of, for example: Health New All
impacts on health • public health services Zealand
services and levels of
• ambulance services
resources
• primary health care use
• hospitalisations
• severe acute respiratory infections
• intensive care unit admissions and
ventilator use
• illness among personnel
• antivirals (national reserve supplies)
• vaccines uptake and equity of
access
• laboratory and testing services
• Healthline calls

9
Citizen science is research conducted with participation from the general public, or amateur/
nonprofessional researchers.

120 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Objective National strategy or systems Owner Relevant
phase

Monitor the impact on Monitoring of data on absences from: Ministry of Health, All
the community and • schools Health New
population groups Zealand, NPHS,
• the workforce in Health New
Whaikaha,
Zealand (including public health
Ministry of
services)
Education, State
• employers in certain industries Services
• the state sector Commission
Monitoring of impacts in certain
settings (eg, aged residential care
services)
Epidemiological analysis and research
on impacts across population groups

Assess the effectiveness Review and evaluation of the Ministry of Health, All
of interventions pandemic response Health New
Zealand,
Whaikaha, other
government
agencies

Detect and monitor EpiSurv and the Office of the Chief Ministry of Health, All
deaths Coroner Health New
The Ministry of Health only reports Zealand
deaths confirmed as being due to the
pandemic virus to the WHO.
Alternative pragmatic definitions of
death may be needed as well.

Detect and monitor Review hospital discharge data, health Ministry of Health,
longer-term morbidity survey and other relevant information Health New
and sequalae associated sources Zealand
with the infection

Track the characteristics Epidemiological reports from the Ministry of Health All
of the virus WHO, other health authorities and
internationally, sources
including information
on incubation and
infectious periods,
severity, transmissibility
and antiviral sensitivity

Anticipate future Modelling that describes potential All All

scenarios (modelling) pandemic scenarios of cases and
hospitalisations and evaluates the
impact of potential public health
actions and policies

Monitor public attitudes Behavioural surveys to assess All All

and behavioural data sentiment, social licence for public
health actions
Methods to track attitudes,
understanding and behavioural trends
over time
Monitoring systems to identify and
track levels of dis- and misinformation

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 121

 Legislation
Mandatory measures are authorised by statute
Any action specified in this plan in relation to individuals, businesses or other entities
that includes the possibility of compulsory measures being taken must be authorised
by statute. The action is otherwise likely to be unlawful and, in particular, might be
contrary to the New Zealand Bill of Rights Act 1990.

Mandated measures may include:

• requirements for people to be tested, screened or vaccinated (may include arrivals
to New Zealand)
• quarantining or isolating people (ie, supporting those potentially exposed and those
with the disease in a quarantine or treatment/isolation facility (or at home) or
prohibiting them from leaving a particular facility/home)
• restricting the movement of people into or out of an area
• restricting travel (within or out of New Zealand)
• imposing a duty to supply information for risk assessment or contact tracing (eg,
future travel plans or past travel history)
• requirements for people to undergo preventive treatment
• requirements for people not to go to work or other public places or to do so only
under certain conditions
• commandeering of resources (eg, land, buildings or vehicles).

Where response measures involve mandated actions, particularly those that restrict
basic freedom of movement and association, a system needs to be developed with
clear criteria and processes to allow for exemptions to be sought and issued in a timely
and transparent manner.

Legislative measures
In a pandemic response, Government and designated officers may use available
legislative powers as appropriate to the particular situation. These include:
• powers provided for in the Health Act 1956 (‘routine’ and ‘special’ powers)
• additional powers available under the Epidemic Preparedness Act 2006 to facilitate
the management of serious epidemics of specified diseases
• additional powers under the Civil Defence Emergency Management Act 2002 (in a
state of emergency declared under that Act) if required in a very severe situation.

The powers in the Health Act 1956 and the Epidemic Preparedness Act 2006 can be
exercised only in relation to specific diseases or categories of disease (notifiable
disease and infectious disease, in the case of the Health Act, and quarantinable disease,
in the case of the Epidemic Preparedness Act). In particular, the Epidemic Preparedness
Act relates to only nine named quarantinable diseases set out in Part 3 of Schedule 1 of
the Health Act. (Quarantinable diseases are specifically dealt with in Part 4 of the

122 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Health Act.) Infectious disease management powers, whether or not applied in an
emergency, were revised in 2017; they are set out in Part 3A of the Health Act. They
apply to all the infectious diseases set out in Schedule 1, including quarantinable
diseases.

Other legislation that contains provisions relevant to managing a pandemic includes:

• the Health (Infectious and Notifiable Diseases) Regulations 2016
• the Health (Burial) Regulations 1946
• the Health (Quarantine) Regulations 1983
• the Cremation Regulations 1983
• the Health Practitioners Competence Assurance Act 2003
• the Medicines Act 1981 (and regulations made under that Act)
• event-specific legislation that may be enacted, such as the COVID-19 Public Health
Response Act 2020
• the Pae Ora (Healthy Futures) Act 2022.

The Medicines Act 1981 provides mechanisms for the approval and classification of
medicines and controls conditions for prescribing, dispensing and selling medicines
(including vaccines). These controls can be changed quickly by notice in the Gazette
and may be relevant in particular pandemic situations. For example, in 2009 a Gazette
notice authorised the supply of prescription medications without a prescription when
supplied from a CBAC.

Table 9 provides a summary of specific legislative provisions.

Health Act 1956

The Health Act 1956 (and its associated regulations) is the core statute for a wide range
of public health functions. It details significant health protection roles for the Minister
of Health, the Director-General of Health, the Director of Public Health, statutory
officers (such as medical officers of health and health protection officers) and local
government officers (such as environmental health officers).

Medical officers of health and health protection officers would rely on two kinds of
primary powers in a pandemic: routine and special, as follows.
• Routine powers are available to the officers, and do not usually need prior approval
by someone else to use (although exercise of the Part 3A powers with regard to
non-notifiable infectious diseases requires the prior approval of the Director of
Public Health under delegation from the Director-General of Health).
• Special powers (for medical officers of health only) need prior authorisation
granted:
– by the Minister of Health
– by virtue of an epidemic notice having been issued by the Prime Minister under
the Epidemic Preparedness Act 2006 in connection with a quarantinable disease
– by virtue of a state of emergency having been declared under the Civil Defence
Emergency Management Act 2002.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 123

 When authorised to do so, medical officers of health can exercise potentially very
significant powers. Such officers are accountable to, and subject to direction from, the
Director-General of Health. During COVID-19, significant powers were exercised at a
national level by the Director-General rather than by local medical officers of health.

Routine and special powers as defined in the legislation relate to specific diseases or
categories of disease.

The term ‘non-seasonal influenza’ (capable of being transmitted between human

beings) applies to any new form of influenza. Non-seasonal influenza is now specified
as a notifiable, infectious disease by its inclusion in Part 1 of Schedule 1 of the Health
Act. As such, medical officers of health may be authorised to use the Health Act’s
special powers to help manage non-seasonal influenza in the event of a pandemic, or
simply use the powers in Part 3A of the Act. However, there are some distinctions
between the two sets of powers, which means advice should be sought at the time
about which set is appropriate. For example, the special powers can be used nationally
and apply to whole communities as well as individuals. In most cases, Part 3A powers
only apply to individual cases and contacts, or suspected cases. An exception is a
direction to close an educational institution or part of it. The police are not expressly
authorised to enforce directions under Part 3A, but have an explicit enforcement role
with regard to the special powers.

Routine powers
Several routine powers are relevant in the pandemic context.

A medical officer of health or health protection officer has the power to enter any
premises, including by boarding an aircraft or ship, at any reasonable time if he or she
‘has reason to believe that there is or recently has been any person suffering from a
notifiable infectious disease or recently exposed to the infection of any such disease’
(section 77 of the Health Act).

The power to examine allows a medical officer of health or health protection officer to
medically examine any person in any premises, including on an aircraft or a ship, to
ascertain whether a person believed to be suffering from a notifiable infectious disease
or recently exposed is suffering or has recently suffered from the disease (section 77).

The power to detain at a specified place of residence for isolation purposes allows a
medical officer of health to issue a written direction to a person or contact whom the
officer believes on reasonable grounds poses a public health risk arising from an
infectious disease under sections 92I to section 92K. These sections outline a variety of
conditions the officer may specify in the direction, including to stay at all or specified
times at a specified place of residence, subject to specified conditions. The direction
must specify its duration. Directions cannot be used to compel a person to seek
treatment under Part 3A. For that to happen, the officer must apply for and be granted
a public health order, order for contacts or medical examination order with a treatment
order component under that Part. A medical officer of health may issue a direction
under section 92K to a person to undergo a medical examination, although several
preconditions must first be met (eg, the person has not complied with a previous
request to seek examination).

124 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

A medical officer of health can also issue directions to the head of an educational
institution where staff or students pose a public health risk because of infectious
disease and the risk is unlikely to be managed effectively by solely giving directions to
individuals (section 92L). A medical officer of health may, after consultation with the
head of the institution, direct them to direct a student or staff member to stay away
from the institution for a specified period, until the infection risk has passed (section
92L). The Communicable Diseases Control Manual (Health New Zealand nd) (currently
under review) sets out disease incubation periods for various infectious diseases, which
will assist in determining how long unimmunised contacts and infectious cases must
stay away from the institution. Alternatively, the head may decide to take action
themselves, under the Education and Training Act 2020. Where it is necessary to close
part or all of the institution, the medical officer of health can issue a direction for
closure to the institution’s head.

Subpart 5 of Part 3A of the Health Act provides for formal contact tracing. This is most
useful in a situation in which voluntary contact tracing is not working, or the case is not
cooperating. A medical officer of health, health protection officer or other person
authorised to contact trace under subpart 5 can require the case to provide specified
information about contacts, including each of their identifying and contact details, in
order for the contact tracer to identify the disease’s source, make contacts aware that
they too may be infected and may require testing and treatment, and limit the
transmission of the disease.

Special powers
Special powers are authorised by the Minister of Health or by an epidemic notice or
apply where an emergency has been declared under the Civil Defence Emergency
Management Act 2002.

The power to detain, isolate or quarantine allows a medical officer of health to ‘require
persons, places, buildings, ships, vehicles, aircraft, animals, or things to be isolated,
quarantined, or disinfected’ (section 70(1)(f)).

The power to prescribe preventive treatment allows a medical officer of health, in

respect of any person who has been isolated or quarantined, to require people to
remain where they are isolated or quarantined until they have been medically
examined and found to be free from infectious disease, and until they have undergone
such preventive treatment as the medical officer of health prescribes (section 70(1)(h)).

The power to requisition premises allows a medical officer of health to requisition

premises and vehicles for the accommodation, treatment and transport of patients
(section 71(1)).

The closure of premises such as schools can be required under sections 70(1)(1a) and
70(1)(m). This can be made by way of written order to the person in charge of the
premises or order published in a newspaper or broadcast by television or radio and
able to be received by most households in the district. If specified in the order,
premises operating certain infection control measures may be exempted from closure.

Section 71A states that a member of the police may do anything reasonably necessary
(including the use of force) to help a medical officer of health or any person authorised

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 125

 by the medical officer of health in the exercise or performance of powers or functions
under sections 70 or 71.

These special powers were used for the first time during the response to COVID-19. In
general terms, they performed well. However, there were some mis-steps in their
application, they lack procedural and human rights safeguards and court judgments
have found that while they can be used as a stop-gap measure in emergency
situations, they are not suitable for sustained, complex responses.

Epidemic Preparedness Act 2006

The Epidemic Preparedness Act 2006 provides for:
• the Prime Minister to issue an epidemic notice and epidemic management notices,
and for statutory changes to then be made through ‘modification orders’
• epidemic modification orders to be made (prospectively or immediately) and
passed by Order in Council.

Epidemic notices
Mechanism for invoking emergency powers
The provisions in the Epidemic Preparedness Act can take effect once an epidemic
notice is issued by the Prime Minister. The Prime Minister may issue an epidemic notice
only when the Director-General of Health recommends taking that step. With the
agreement of the Minister of Health, the Prime Minister must be satisfied that the
effects of an outbreak of a particular quarantinable disease are likely to significantly
disrupt (or continue to disrupt) essential government and business activity in New
Zealand (or parts of New Zealand). The outbreak can be overseas or in New Zealand.
Epidemic notices last for a maximum of three months and are renewable.

Effects of an epidemic notice

When an epidemic notice has been issued, the special powers for medical officers of
health under the Health Act are authorised. While an epidemic notice is in force the
Prime Minister may, with the agreement of the responsible minister, issue an epidemic
management notice. An epidemic management notice may activate, if this is specified
in the notice, action under other statutes (which may refer to an epidemic
management notice (section 8(1) of the Epidemic Preparedness Act)) or a modification
to a specific statute made by a prospective modification order. Immediate modification
orders may also be made; these are designed to allow more flexibility in pandemic
management than envisaged and addressed in any prospective modification orders.
Implementation of a prospective or an immediate modification order must have the
agreement of the minister responsible for administering the relevant statute.

126 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Modification orders
Effects of modification orders
Modification orders:
• can be absolute
• can be subject to conditions
• may be made by stating alternative means for complying with the requirements or
restriction, or by substituting a discretionary power for the requirements or
restriction.

Acts to which a modification cannot be made

A modification cannot be made to the New Zealand Bill of Rights Act 1990, the Bill of
Rights 1688, the Constitution Act 1986, the Electoral Act 1993, the Judicial Review
Procedure Act 2016, the Parliamentary Privilege Act 2014 or the Epidemic Preparedness
Act 2006.

International Health Regulations 2005

The International Health Regulations 2005 (WHO 2006) require WHO member states
to be able to detect, plan for and respond to disease outbreaks of all kinds, including
pandemics. Their scope is broader than just communicable diseases, and includes any
acute or emerging public health event of potential international significance: for
instance, emergencies arising from toxicological, radioactive or other sources.

Under the International Health Regulations, countries must designate a National Focal
Point for coordination and communication with the WHO, to respond to requests from
the WHO for information about public health risks and to notify the WHO within 24
hours of an event that may be a public health emergency of international concern.

A ‘public health emergency of international concern’ is defined in the International

Health Regulations as an extraordinary public health event that requires an
international response. Countries must notify the WHO in accordance with a decision
instrument as set out in Annex 2 of the Regulations. The Public Health Agency within
the Ministry of Health is the National Focal Point in New Zealand.

Under the International Health Regulations, countries must develop and maintain core
public health capacities for maintain surveillance of, investigate, respond to and report
on all potentially significant public health events. These capacities must be in place
locally or regionally, nationally and at the border.

One specific requirement of the International Health Regulations is that countries take
measures to avoid exporting disease. In a pandemic, this means that once cases have
been identified in New Zealand, measures may be needed at the border for departing
travellers (eg, exit assessment).

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 127

 Civil Defence Emergency Management Act 2002
The Civil Defence Emergency Management Act 2002 (currently under review) is the
principal instrument of the civil defence emergency management (CDEM) framework.
Other instruments include the National Disaster Resilience Strategy (MCDEM 2019) and
Guide to the National Civil Defence Emergency Management Plan 2015 (MCDEM
2015b), as well as the National Civil Defence Emergency Management Plan Order 2015,
the Biosecurity Act 1993, the Resource Management Act 1991 and the Health Act 1956
(as outlined above).

The Civil Defence Emergency Management Act provides for (among other things):
• planning for emergencies
• the declaration of a state of local or national emergency: local authority mayors (or
delegated elected representatives) or the Minister of Civil Defence can declare a
state of local emergency, and the Minister of Civil Defence can declare a state of
national emergency
• emergency powers that enable CDEM groups and controllers to:
– close or restrict access to roads and public places
– regulate traffic
– provide rescue, first aid, food, shelter and so on
– conserve essential supplies
– undertake emergency measures for the disposal of dead people and animals
– provide equipment
– enter into premises
– evacuate premises or places
– remove vehicles
– requisition equipment, materials, facilities and assistance
• requirements for government departments and agencies to prepare plans to
continue functioning during and after an emergency.

Cross-references and supporting material

Guide to the National Civil Defence Emergency Management Plan (MCDEM
2015b)
National Disaster Resilience Strategy (MCDEM 2019)
National Civil Defence Emergency Management Strategy (Minister of Civil
Defence 2008)
National Civil Defence Emergency Management Plan Order 2015

128 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Civil defence emergency management declarations
Before the Epidemic Preparedness Act 2006 was enacted, a declaration under the Civil
Defence Emergency Management Act 2002 or an authorisation by the Minister of
Health was required to authorise the special powers of medical officers of health under
the Health Act 1956. These powers are now authorised by virtue of an epidemic notice
having been issued regarding a quarantinable disease, which should lessen the need
for a declaration under the Civil Defence Emergency Management Act 2002. A CDEM
declaration should now be required only when the emergency powers detailed in
sections 85–92 of the Civil Defence Emergency Management Act need to be released
(these powers are summarised in the list above).

State of local emergency

Local agencies should consider the potential need for a declaration of a state of local
emergency under the Civil Defence Emergency Management Act in conjunction with
central government, so that responses are consistent and made in the interests of New
Zealand as a whole. The National Emergency Management Agency recommends to
local authorities and CDEM groups that declarations for any kind of emergency should
be made only when the powers provided by the Act are required and when the
declaration will add value to the response.

State of national emergency

Any declaration of a state of national emergency made by the Minister of Emergency
Management under the Civil Defence Emergency Management Act will be made in
consultation with the ODESC system.

Any declaration of a state of local or national emergency under the Civil Defence
Emergency Management Act in response to a pandemic will be made to support
the Ministry of Health in its lead role.
Civil defence groups can provide assistance irrespective of whether a declaration
has been made.

Cross-references and supporting material

Declarations: Director’s Guidelines for CDEM Sector (DGL 13/12) (MCDEM 2012)

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 129

 Table 9: Summary of specific legislative provisions

Legislation Relevant sections of the legislation

Health legislation

Health Act 1956 Part 3 (Infectious and notifiable management, diseases):

• special powers (sections 70, 71, 71A and 72)
• routine powers (sections 77–82 and 96–101)
• notifying diseases (sections 74, 74AA and 76)
• power to enter premises and examine persons (section 77)
• mortuaries and burials (sections 84 and 86)
Part 3A (Management of infectious diseases): written directions
restricting movement and behaviour and to seek medical
examination (sections 92I to 92L); urgent public health orders to
detain at specified premises for 72 hours (section 92ZF); application
for court orders, including for treatment (sections 92ZF to 92ZJ);
formal contact tracing (subpart 5); prosecution (eg, sections 92V and
92W)
Part 4 (Quarantine)
Under the Health Act, the Health (Infectious and Notifiable Diseases)
Regulations 2016

Epidemic Preparedness Particularly sections 5, 8, 11–15 and 66–69

Act 2006

Health (Quarantine) Regulations 3, 10 and 13

Regulations 1983

Health (Burial)
Regulations 1946

Non-health legislation

Biosecurity Act 1993 Particularly:

• restricting imports of animals and animal products (section 25)
• animal surveillance (sections 43, 109, 114 and 121 and Part 7)
• restricting movement of animals or at-risk goods (sections 130
and 131 and Part 7 (dealing with biosecurity emergencies))

Civil Defence Particularly Parts 4 (declaration of state of emergency) and 5 (powers

Emergency in relation to civil defence emergency management) and section 58
Management Act 2002

Customs and Excise Act Advance notice of arrival (section 12), persons arriving in New
2018 Zealand to provide information (section 28A)

Disease containment measures

Impact on business as usual and key control
measures
A moderate to severe pandemic will probably be characterised by a high level of
absence in the workforce, as people fall ill or stay at home to care for sick relatives and
friends. Essential services such as police, fire, transportation, communications and

130 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

emergency management services need to be maintained during a pandemic. Other
services and supplies, including hospitals, food and other essential items, water, fuel,
gas, electricity, educational facilities, banking, postal services and sanitation, may also
be affected. It is reasonable to assume that normal business activities, regardless of
their nature, will suffer during a severe pandemic, and that there will be lesser impacts
during mild pandemics.

Given the potential severity of a pandemic, New Zealand’s strategy is to take every
practicable step in the designated Keep It Out and Stamp It Out phases before having
to move to the Manage It phase, taking into account the potential impact and
characteristics of the particular novel pathogen concerned. This strategy allows more
time to obtain information about the pathogen and the best way to manage it, prepare
to mobilise health and other sectors for a response and reinforce public understanding
of hygiene measures.

Targeted containment measures may also be applied in the Manage It phase to reduce
transmission of the pathogen. These measures may be implemented to lower
transmission among vulnerable and susceptible communities, and in settings such as
schools and rest homes.

It is important to consider a variety of control measures to prevent, eliminate or slow

down transmission of a pathogen. Modelling indicates that such interventions may
help to eliminate or slow a pathogen’s spread, pending the arrival of a vaccine. Public
health measures could include border management measures, intensified surveillance,
early detection and isolation of cases and quarantine of contacts, promotion of the
importance of strict personal hygiene (especially hand washing), the use of antivirals,
the restriction of public gatherings and the closure of education institutions.

The evidence for the effectiveness of many pandemic control interventions consists
primarily of historical and contemporary observations, supplemented by mathematical
models. New Zealand’s COVID-19 pandemic experience has shown how specific
containment measures can slow the arrival of a virus and save lives. It has also
illustrated that some measures have the potential to increase health and other
inequities; it is always important to consider potential equity impacts.

The particular interventions to be adopted in a pandemic will depend on the phase of

the pandemic, the severity of the disease (a more virulent strain will justify more
socially demanding measures) and the extent of transmission within the country and
community.

In most situations, designated officers encourage people to comply with containment

measures and do not need to use statutory powers. In situations where statutory
powers need to be used, this should be done in a way that is proportionate, people-
centred and offers the least restrictive option.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 131

 Determination of the nature and extent of public health measures to implement
will be based on the key factors summarised in Part B, taking into account their
potential positive and negative impacts on health, society and the economy, and
particularly potential impacts on equity.

Response measures must be proportionate to the risk, based on the best available
evidence and insights from communities and stakeholders. Decision-makers must be
committed to measuring and reviewing the effectiveness and impact of the response
and taking prompt action to recalibrate and update that response as required.

When determining which measures to use, it is crucial to minimise or mitigate potential

social, economic and health impacts. Efforts to manage the public health risk that a
pandemic presents need to also consider proportionality in regard to other health
emergencies, other infectious diseases and other long-term public health challenges
and pressures the health system is facing at any particular time.

Different areas of the country may be under different controls at different times or
even the same time, depending on whether they have cases, are managing a suspected
cluster or are managing district-wide illness. For example, one local area may need to
mount intensive cluster control measures, while areas as yet unaffected by the
pandemic can remain at a state of alert. Action in the affected area should be informed
not only by the need to protect and support the local population but also by the need
to prevent the spread of disease to other localities. Quick, decisive and far-reaching
measures that are temporarily disruptive to the locality concerned but are in the
national interest may be the most effective in the Keep It Out and Stamp It Out phases.

Cross-references and supporting material

Likely Future Pandemic Agents and Scenarios: An epidemiological and public
health framework (Te Niwha 2023) – Section 8

Border management
If a potential pandemic has not yet reached New Zealand shores, it may be possible to
prevent the pathogen from entering the country, or to delay its entry or reduce the
number of importations, allowing other response measures to be put in place (during
the Keep It Out phase). Such an intervention may be feasible because of New Zealand’s
geographical isolation, its limited number of entry points and its well-coordinated
border management systems. In the Keep It Out phase, routine public health risk
management procedures at the border could be elevated, according to the
development of the global situation. Elevated measures may include increasing
information to arriving passengers, providing travel advisories, undertaking clinical
screening, requiring proof of a negative test or vaccination prior to departure, post-
arrival testing, closing the border to certain countries or categories of arrivals based on
risk, and imposing mandatory quarantine for people arriving in New Zealand.

132 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

There is value in trying to keep the pathogen out, or to at least delay its arrival, to allow
time for preparedness activities, pathogen attenuation and a reduction in the time it is
in the country before an effective vaccine becomes available. Border health measures
can be an effective tool to protect New Zealanders from the effects of a future
pandemic that occurs outside of New Zealand. Decisions on whether to implement
border health measures will depend on many factors, including virulence,
transmissibility, the availability of vaccines and treatments.

Specific border actions are described in Table 10 below and in the ‘public health
interventions: border management’ sections of the Phase Action Framework tables in
Part B of this document. Decisions on border management measures will depend on
the situation, including the threat from the particular pathogen, the actions being
taken by other countries, recommendations from the WHO and the possible adverse
consequences of control measures, such as interrupting supply chains. Border
interventions may not necessarily conclude after the Keep It Out phase; they may be
maintained through the Stamp It Out phase.

Cross-references and supporting material

Responding to Public Health Threats at New Zealand Air- and Seaports: Guidelines
for the public health and border sectors (Health New Zealand 2023b)

Approaches to border management

The measures described in the Action Framework support a strategy of exclusion. This
strategy involves limiting arrivals from affected areas, using intervention measures for
those from affected areas intending to travel to New Zealand and quarantining arrivals
who have been, or may have been, exposed to the pandemic pathogen. While
disruptive, limiting arrivals will be particularly important to ensure Keep It Out
measures are sustainable for the weeks or months for which they may be necessary.
Programmes to reduce arrivals from specific regions or countries can include:
• the New Zealand Immigration Service managing visa applications and issuing a
directive on advance passenger screening to reduce carriage of non-New Zealand
residents
• warning travellers to New Zealand prior to their departure that they may be placed
in quarantine on arrival for a specified period
• the Civil Aviation Authority, in liaison with the Ministry of Transport, issuing a Notice
to Airmen of New Zealand border closure
• establishing mandatory entry requirements (eg, evidence of a negative test,
vaccination or prior infection).

Should a pandemic virus prove to be more virulent, exclusion measures coupled with
facility-based quarantine and the use of testing and antivirals (if available) could be
introduced. Initiated early enough, these measures would give New Zealand the best
opportunity to keep rates of infection low and the goal of successfully containing the
disease achievable. However, clear evidence regarding disease characteristics may not

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 133

 be available early on, and decisions may have to be made in the context of this
uncertainty.

Should the virus prove less virulent, a less restrictive strategy of separation could be
chosen. This could require all arrivals from areas/regions/countries of interest to
voluntarily quarantine themselves from the community for a length of time (depending
on the available evidence) after their arrival in New Zealand. All arrivals would be given
hygiene information, advised to report any illness and asked for contact-tracing
information.

Infected travellers are most likely to become symptomatic within two days; this time
period is therefore a suggested duration for voluntary quarantine. This option would
always entail a degree of non-compliance (mandatory home quarantine could be too
onerous to manage). However, it could be more successful than asking people to
quarantine themselves for up to eight days.

Although not as costly or disruptive as facility-based quarantine, self-quarantine at

home can have benefits. It can also be burdensome on public health services, which
may be tasked with managing distributed at-risk passengers. Also, travellers arriving at
the border with no homes or other places to go to (or homes that are far from their
place of arrival) would have to be placed in quarantine facilities for the required time,
or their domestic travel managed appropriately.

Should the virus prove to be serious but not readily transmissible, a strategy that
focused on those arriving who have been in close association with symptomatic people
could be chosen. All arrivals would be given hygiene information, advised to report any
illness and asked for contact-tracing information. Those arriving in close association
with symptomatic people (such as family members, travel group members or people
sitting nearby) would be placed in quarantine and released if the symptomatic traveller
was deemed not to be a case.

The Government would decide which course of action to take. Any decision
might require strong action to be taken initially, until such time as the global
situation becomes clearer. The reasoning for this is that measures can always be
relaxed, but if certain measures are not put in place at the first opportunity, the
option to escalate may no longer be available.

Use of isolation and quarantine for border

management
The modelling undertaken for New Zealand, and the experience of the COVID-19
pandemic, suggests that the most effective single intervention at the border to prevent
or delay the introduction of a pandemic pathogen into New Zealand is to minimise
numbers of incoming travellers. Travel restrictions and the use of facility-based
quarantine, supplemented by antivirals and vaccination where available, would give
New Zealand the best opportunity to restrict the number of cases introduced into the
community and successfully contain the disease’s spread. The Quarantine and Isolation
Capability Readiness Plan (as maintained by the Protection directorate within the

134 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

National Public Health Service) takes a phased approach, providing a range of
functions that can be initiated rapidly as required. Border closures or travel restrictions,
either in general or for specific groups, need to be considered carefully and in a way
that takes into account our international obligations (including the International Health
Regulations 2005 (WHO 2006)) and the New Zealand Bill of Rights Act 1990.

Table 10: Overview of possible border management actions, responsibilities and

relevant legislation

Possible actions Responsibility Legislation

All ships and aircraft arriving in New Zealand from Airlines and shipping Health Act 1956,
overseas are liable for quarantine, and must operators, NPHS section 107; Health
receive pratique to commence operations in New (Quarantine)
Zealand. Regulations 1983

Masters of ships arriving in New Zealand must Shipping operators Health (Quarantine)
inform health authorities of the health status of Regulations 1983
those on board their vessels before arrival. On
arrival, vessels must also submit a maritime
declaration of health to officials. Public health
statutory officers either grant pratique or arrange
to meet the vessel on arrival based on the health
status reports.

Captains of aircraft must report to their agents the Airlines and airline Health (Quarantine)
health status of all people on board at least 15 agents Regulations 1983
minutes before landing in New Zealand. Any sign
of illness among passengers and crew and any
unsanitary conditions on board the aircraft must
be reported to health authorities by the airline’s
agent. Pratique is deemed to have been granted
unless there has been a report of illness or
unsanitary conditions on board.

When illness has been reported by the captain of Public health Health (Quarantine)
an aircraft, public health statutory officers services Regulations 1983
operationalise a process for managing any
potential risk on board the craft and grant
pratique when satisfied that public health risks are
managed. Public health services are responsible
for ensuring all New Zealand international airports
have procedures for managing the public health
risks around the arrival of unwell passengers.

The use of enhanced quarantine is considered for Ministry of Health, Health (Quarantine)
the quarantining of large numbers of people in Public health Regulations 1983
the absence of symptomatic people but where services within NPHS
there is good reason to believe those people may (Health New
have been exposed to the pandemic pathogen Zealand) in
(due to where they have travelled or who they consultation with
have had contact with) as a pandemic relevant agencies
management measure. Locate larger quarantine
facilities for this.

Pre-arrival risk-profiling efficacy and methodology Ministry of Health in No powers required if

(eg, mining passenger name record data) and consultation with voluntary, otherwise a
determination of escalation/relaxation trigger relevant agencies new regulatory power
points are considered (based on modelling of is needed
phases).

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 135

 Possible actions Responsibility Legislation

The use of, exit assessment procedures is Ministry of Health in No powers required if
considered. The determination of such procedures consultation with voluntary, otherwise a
and required authority. relevant agencies new regulatory power
is needed.

Routine border health reporting is required from Airlines and Health (Quarantine)
masters of vessels and captains of aircraft. maritime operators Regulations 1983

Public health services work with airports of first Ministry of Health, No powers required
arrival to ensure all reports of illness on board Health New Zealand, Health (Quarantine)
incoming aircraft are reported to and responded NPHS Regulations 1983
to by public health services.

When the threat of a pandemic exists, airlines are Ministry of Health, No powers required
informed of symptoms of particular concern and Health New Zealand Health (Quarantine)
reminded of the statutory requirement that all and NPHS Regulations 1983
symptoms suggestive of infectious disease must
be reported to the destination airport before the
craft’s arrival.

If an aircraft’s passengers report symptoms that NPHS Health Act 1956,

give rise to suspicion of a quarantinable disease, sections 97B and 101
the plane, its passengers and its crew can be
detained for inspection.

Masters of ships must seek radio pratique from a Master of ship, Health Act 1956,
medical officer of health or health protection medical officer of sections 97B, 99 and
officer between 12 and 24 hours before their health, health 101
expected arrival. The medical officer of health or protection officer
health protection officer may withhold pratique if
not satisfied of the state of health of the ship.
If radio pratique is withheld, the ship may not
berth and people cannot leave or board the ship
without the medical officer of health’s or health
protection officer’s authority, and before the ship
has been inspected.

If illness is reported, depending on the symptoms Airlines and shipping Health Act 1956
reported, health authorities can arrange for ill agents (for
people to be met, and (if they are extremely reporting), NPHS
unwell or meet the case definition and exposure
risk factors for the pandemic disease) transported
to a hospital or other designated facility.

The medical officer of health can examine any Medical officer of Health (Quarantine)
person suspected of suffering from or having health Regulations 1983,
been exposed to a quarantinable disease. regulation 22; Health
Act 1956, section 97

If authorised by the Minister of Health, or if an Medical officer of Epidemic

emergency has been declared under the Civil health Preparedness Act
Defence Emergency Management Act 2002, a 2006; Civil Defence
medical officer of health can require people to Emergency
submit to medical examinations and isolate or Management Act
quarantine them as he or she sees fit. 2002; Health Act 1956,
section 70(1)(e), (ea),
(f) and (fa)

Ensure emergency departments (or other facilities) NPHS No power required

are advised of cases being transported.

136 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

 Possible actions Responsibility Legislation

Grant pratique to the craft once the public health NPHS Health Act 1956,
risk has been managed. section 107

Consider the use of the following public health Ministry of Health,

interventions: NPHS, border
• quarantine of arrivals from specific regions or agencies
countries
• closure of the border for specific categories of
people (eg, those arriving from or travelling
through a particular country)
• pre-arrival risk-profiling
• pre-departure testing requirements
• post-arrival testing requirements
• vaccination requirements for arrivals
• exit assessments
• contract-tracing information management
• ensuring air and shipping lines and ports are
kept up to date in terms of their reporting
requirements
• other measures as described in Responding to
Public Health Threats at New Zealand Air- and
Seaports (Health New Zealand 2023b)

Cluster control
Background to cluster control
The aims of the Stamp It Out (cluster control) phase in a pandemic are:
• to control or eliminate the disease after its limited introduction into New Zealand (in
conjunction with rigorous border management) or, failing this,
• to delay early transmission of the disease to allow more time for emergency plans
to be activated, and
• to obtain epidemiological information with which to inform pandemic management
response.

The rigour with which cluster control measures are implemented needs to be related to
the rigour of border controls. The continuing introduction of new imported cases
would eventually overwhelm the capacity of public health services to respond to
outbreaks. The WHO accepts that the spread of a pandemic cannot be prevented
effectively in continental countries with multiple land borders and entry points: in such
countries, cluster control attempts are likely to be of less benefit compared with wider
pandemic management. However, the WHO notes that the prevention or delay of the
importation of the pandemic into isolated island nations with limited entry points such
as New Zealand may be possible. For this reason, the Action Framework includes
cluster control measures.

Public health cluster control measures depend on early recognition of imported and
secondary cases through early diagnosis and notification to public health services.
When the number of cases is limited and cases are recognised early enough, cluster

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 control interventions may be able to limit, slow the spread of or control an outbreak.
Once the pathogen is widespread in a community, interventions aimed at reducing
spread may have little effect. However, cluster control measures may be maintained
throughout the response phases of a pandemic in higher-risk settings (such as
institutions, rest homes, early childhood education services and schools) and in higher-
risk populations.

The identification of early imported (primary) and local (secondary) cases through
astute clinicians and surveillance will trigger case investigation and contact-tracing
procedures by public health services, under the direction of a medical officer of health.

Targeted cluster control measures may be maintained in the Manage It phase to offer
additional protection in institutions and among vulnerable and susceptible
communities.

The Ministry of Health has developed guidelines for public health services to assist
their decision-making in the implementation of cluster control measures in a
pandemic.

Cross-references and supporting material

Likely Future Pandemic Agents and Scenarios: An epidemiological and public
health framework (Te Niwha 2023) – Section 4.8

Isolation and quarantine for cluster control and

pandemic management
Voluntary or compulsory isolation of cases and quarantine of contacts are potentially
important measures to prevent or slow the spread of a pandemic at all phases of a
pandemic response, particularly in the context of border and cluster control.

Isolation and quarantine may be used in combination with post-exposure prophylaxis,

using antivirals distributed to contacts at the border control and cluster control phases.
Modelling indicates that this combination of programmes will be more effective than
isolation and quarantine on their own in controlling the spread of a respiratory-type
pandemic, providing antivirals are effective against the particular pandemic strain.

However, evidence and experience suggest that, in the Manage It phase, when there is
sustained transmission in the general population, self-isolation may be better than
active interventions to isolate patients and identify and quarantine contacts. More
rights-limiting measures may be socially disruptive and not be the best use of limited
health resources.

Use of antivirals for cluster control

The provision of effective antiviral medication to people with pandemic-like
respiratory-type illness and for the post-exposure prophylaxis of contacts may reduce

138 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

the likelihood of spread. Antivirals, if they are effective against the pandemic virus, will
be used early in a pandemic as part of efforts to contain or eliminate initial clusters by
providing treatment for cases and post-exposure prophylaxis for close contacts, as
determined by the medical officer of health within the scope of national guidelines. If
the pandemic becomes more widespread within New Zealand, it is expected that
antivirals will be reserved for the treatment of cases, with prioritisation based on equity.

Restriction of movement
Isolation and quarantine could be used as part of the entry assessment of domestic
travellers into more isolated communities where no cases have occurred. Alternatively,
exit assessment of domestic travellers from areas where the pandemic is widespread
could be undertaken.

The ability of communities to slow the entry of the virus by restricting entry or exit will
depend on local geography and associated logistics. Prolonged cessation of travel into
a geographic region may be difficult to implement because of social and economic
imperatives for continued contact. Essential goods and services invariably need to pass
through internal borders.

Decisions concerning the compulsory restriction of movement into and out of an area
must take into account the likely effectiveness of the strategy, as well as other costs
and benefits (including the potential to prevent morbidity and mortality as compared
to potential social and economic impacts) and how these affect equity.

Hygiene and physical distancing

Messages about personal hygiene and measures to increase physical distancing in a
pandemic are a critical part of any pandemic response. The public should be advised to
avoid crowded spaces, adhere to infection control measures such as cough and sneeze
etiquette, avoid mixing with other people if a person is coughing or sneezing, and
regularly and effectively wash and dry their hands. Such messages must be
disseminated during any pandemic, however mild or severe. Public gatherings are
likely to be a means of transmission during the early stages of a pandemic. Although it
is likely the public will of their own accord avoid mixing during the course of a severe
pandemic, compulsory cancellation of public gatherings (or restriction of numbers)
may be instituted in certain circumstances (eg, in an attempt to control a cluster
outbreak). In other circumstances, employers and businesses may decide to close, or to
postpone or cancel an event in the interests of staff health.

Situations or events involving large numbers of people in confined spaces (such as

public transport systems or large events in crowded indoor venues) are more likely to
contribute to disease transmission than, for example, local rugby club matches in the
open air.

An inevitable tension exists between promoting physical distancing and encouraging

community support. The key message of physical distancing (to avoid unnecessary
contact with others) is at odds with the key message of community support (to be
aware of other members of the community and provide support if necessary). People

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 may respond to physical distancing messages in a disproportionate manner, avoiding
all contact rather than just unnecessary contact. Physical distancing messages should
not encourage discrimination or prejudice, and should make explicit the fact that
people who have close personal contact with cases will not necessarily become cases
themselves.

The issue of the tension between physical distancing and community support should
be openly raised. Physical distancing measures should be discussed from the planning
phase. When these measures are implemented, information should then be given
about the importance of community support and about how to minimise risk while
maintaining social contact.

Community support and engagement will be required at all stages of the pandemic in
varying forms. Early engagement with community leaders is important, to balance risks
and benefits and to ensure that community needs are met and those at the highest risk
of severe disease are supported.

Closure of or restrictions on education institutions

The closure of, or other restrictions on, early childhood education services and schools
in an affected area during a pandemic in the Keep It Out and Respond To It phases
may make a significant contribution to controlling spread. Decisions by medical officers
of health to close these institutions will be influenced by the epidemiology of the virus
(eg, in terms of age groups typically affected and severity) and local circumstances but
must be balanced against the potential impact of a closure on children’s learning and
social needs and parents’ needs for childcare. Education institutions may also decide to
close voluntarily: such decisions need to take into account local circumstances and the
advice of the medical officer of health. Measures other than closures can also be
considered (eg, rostering particular year groups off school and limiting large
assemblies).

While early childhood education services, schools and tertiary institutions may be
closed, their premises would not necessarily be closed in a quarantine sense. For
example, staff could continue to go to work to deliver services, hold online classes or
carry out ‘alternative duties’ for their employer or another agency. School premises
may be used for alternative purposes; for example, as CBACs.

The Ministry of Education has developed pandemic planning guidelines for early
childhood education services, schools, kura and tertiary educational organisations. The
Ministry of Education is responsible for leading the response in the education sector,
although a medical officer of health may initiate a written direction (for example,
requiring students or staff to stay away from the institution) by consulting with the
head of the institution, under Part 3A (section 92L) of the Health Act. Any educational
service closure, including closure of afterschool care, school holiday programmes and
activities affecting children or adolescents, may impact parents, the workforce and
productivity. For example, during COVID-19 educational services were delivered
remotely, online; it was necessary for parents of young children to support or supervise
this. National and international evidence showed that, during the COVID-19 pandemic,
a disproportionate number of women exited the workforce. Childcare and other caring
responsibilities may have contributed to this decline.

140 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

It is important that decisions concerning the closure or reopening of educational
institutions are well communicated so that parents, employers and others can put
appropriate plans into place.

Cross-references and supporting material

‘Education work stream’ in Appendix C: Intersectoral Pandemic Group work
streams

Limitations on cluster control operations

Cluster control may not be warranted if the first indication of a pandemic arriving in
the country is a large outbreak or several outbreaks (which would indicate a similar
number of second- and third-generation contacts already incubating infection and an
escalating number of contacts). In this case, immediate activation of the Manage It
phase may be considered.

The main limitation on cluster control is expected to be the availability of staff with
sufficient skills to undertake control measures. Health New Zealand, in consultation
with kaupapa Māori and Pacific providers, will need to plan for the rapid redeployment
of staff to help with public health control activities, including border management
activities. Resources will mainly come from the health and disability sector (public
health services, hospitals, kaupapa Māori and Pacific providers, primary care services
and non-governmental organisations), but other sectors may be able to contribute (eg,
police, local government, education, veterinarians and the biosecurity sector). High-
intensity responses may not be sustainable for more than a few weeks. However, if
border management is rigorous, the numbers of imported cases are limited and the
reproductive rate of the virus is relatively low, control efforts could be continued for
many months.

Manage It
Transition to pandemic management
In the Manage It phase, the strategy may see a reduction in restrictions, including in
terms of individual interventions and population-wide actions. However, some actions
from the Stamp It Out phase may continue, including:
• public health involvement in emergency management through the CIMS
• public advice on symptoms and dealing with the illness, through 0800 helpline
numbers, the media, and digital channels
• voluntary or mandatory isolation of affected people at home or in hospital – on
advice given through clinical services (eg, CBACs), 0800 helplines, Care in the
Community and public health services
• voluntary or mandatory home quarantine of contacts

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 141

 • targeted cluster control measures in institutions and for vulnerable and susceptible
populations
• education sector closures, alternative ways of delivering education (eg, online
teaching) or restrictions on activities or attendance numbers
• physical distancing measures, including social distancing at work, working from
home and encouraging non-essential workers to stay at home
• disseminating advice to postpone non-essential local and national travel
• imposing restrictions on public transport
• imposing restrictions on public gatherings
• surveillance through analysis of data from settings such as CBACs, primary health
care providers and hospitals; mortality data; public health data; and surveys
• continued border management – by this stage, international travel would be
expected to have reduced substantially
• ongoing pandemic vaccination planning and implementation.

Past pandemics have varied substantially in terms of their effects on health and society.
If a pandemic is mild, such as the influenza pandemics of 1968 and 2009, then existing
health services will be able to cope, albeit with some adjustment. People would receive
health services largely as they do at any other time, through hospitals and general
practices, and some interventions noted above would not be required.

If a pandemic is moderate to severe, such as the COVID-19 pandemic, then alternatives

to regular health service provision will be required. It should be noted, however, that
even in a substantial pandemic most people will suffer uncomplicated respiratory
illness, which will resolve itself.

Self-management at home will be necessary during a severe pandemic. This can be

safe and effective, if the public has good information about how to look after
themselves and others and how to identify complications and seek advice should they
occur. Self-management can be supported through remote care by primary care
services or specialised support such as care in the community. Additional support may
be required for those in unsuitable accommodation, or with limited means to support
themselves or their whānau.

While regular home visits to all patients by health professionals may not be possible,
other means of contact can be maintained (eg, telehealth or e-health), to identify social
and health needs requiring further intervention or escalation.

Care in the community

Public preparation for a future pandemic is important for New Zealand’s preparedness
as a whole. Individuals and whānau should have a plan that addresses:
• how they will manage if they live on their own
• identification of pre-arranged contacts
• how they will obtain necessary supplies if they are unwell or subject to movement
or other restrictions.

142 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

The public should be informed about effective IPC practices, such as thorough hand-
washing, covering coughs and sneezes, mask wearing, keeping an appropriate distance
from others where at all possible and staying home if sick.

In a pandemic, advice will be made available on self-care, care of others and how to
seek help, including how to access social and health support. Proactive community
support will be required for some groups that are at higher risk of poor outcomes.

Telephone triage
In the event of a pandemic, Health New Zealand will activate telephone triage systems
that the public can access for health information and advice. These systems will reduce
the need for the public to go to primary care or hospitals. Assessment and care of
those ill with influenza in the community could play an important role in a pandemic,
because high rates of infection may mean that all except the seriously ill will need to be
cared for at home.

A 24-hours a day, seven days a week call centre system will give the public continuous
access to professional advice and information.

Cross-references and supporting material

National Health Emergency Plan (Ministry of Health 2015)

Community-based assessment centres

A moderate to severe pandemic emergency will put significant pressure on

primary and community services, as well as hospital emergency services and
ambulances. Health New Zealand, in consultation with primary and community
providers, particularly Māori and Pacific providers, and ambulance services,
should plan the most effective and integrated way for health services to respond
to large volumes of demand in a significant health emergency while maintaining
normal health services to the greatest degree possible.

Community-based assessment services must be flexible enough to meet the needs of

differing (eg, urban and rural) communities, and will need to reflect the severity of the
particular pandemic and the particular nature of community health services needed,
which may also change during the course of the event.

Health New Zealand, in conjunction with local primary health care services, should plan
for CBACs to be established in an emergency.

The purpose of a CBAC is to provide additional focused primary-care capacity while

diverting people away from business-as-usual health facilities such as GP clinics and
pharmacies to minimise the risk of transmission. A sudden increase in demand for

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 primary care services for people with infectious disease symptoms may arise during a
pandemic.

In a pandemic, CBACs may provide one or more services, including vaccination, testing
or the provision of test kits, assessment of possible cases and distribution of antivirals
or antibiotics.

Community-based assessment centres require clear clinical leadership, with strong

management and administrative support. They provide clinical assessment, advice,
triage and referrals as necessary, but no inpatient or observation services. They can be
established in any facility with the resources for the required clinical services, in
locations where they can best meet the needs of the local community: for example,
within a medical centre, a hospital outpatient facility, a community hall or a marae.
(A different approach will be required in a marae context; consultation with relevant
communities will be required.) Community-based assessment centres may also need to
be close to pharmacy services. In some sparsely populated areas, mobile CBACs could
be considered.

Health New Zealand will locally make final decisions on the activation, nature and
location of CBACs, and will widely publicise their purpose and location.

A CBAC training and education pack is available for CBAC staff orientation and may be
sourced from Health New Zealand emergency managers.

Cross-references and supporting material

Guidance on Community-based Assessment Centres and Other Support Services
(Ministry of Health 2008b)
National Health Emergency Plan (Ministry of Health 2015)
COVID-19 Care in the Community Framework (Health New Zealand 2022)

Clinical assessment and treatment

Although most people with the pandemic illness should be able to remain in their
homes and look after themselves, people with severe symptoms may require
assessment or referral to secondary care. That assessment may take place over the
telephone or at a CBAC. It will include a decision about where and how to treat the
patient, based on factors such as the severity of the patient’s illness, the presence of
pre-existing co-morbidities and available resources.

In the event of a moderate to severe pandemic, there may not be enough qualified
health professionals in operation to be able to assess all suspected cases. Information
for the public on how to care for themselves and others at home during a pandemic
will be provided to the public through various communication channels. Alternative
models of care, such as kaupapa Māori and Pacific providers and remote services
(telehealth) may also be used to provide the clinical assessment and treatment needed.

144 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Hospital treatment
If people with the pandemic illness are assessed as needing hospital care and
resourced beds are available, they will be referred for treatment. As demand for
hospital care in a moderate to severe pandemic is likely to exceed supply, public and
private hospitals will need to prioritise admissions, rationalise non-acute services and
review staff rosters. Capacity to admit people to hospital during the Manage It phase is
likely to be limited during a mild to moderate pandemic and considerably constrained
during a severe pandemic.

Emphasis should be placed on high-quality supportive care in the community, to

prevent hospital admissions and ensure the holistic care of individuals and whānau.
Ensuring high-quality community care may include liaising with a broad variety of
groups and stakeholders, including local councils, non-governmental organisations,
kaupapa Māori and Pacific providers and voluntary groups.

Cross-references and supporting material

Likely Future Pandemic Agents and Scenarios: An epidemiological and public
health framework (Te Niwha 2023) – Section 4.11

Pharmacists
In a pandemic pressure on pharmacy services may be high due to increased demand as
well as staff absences because of illness or family responsibilities. Pharmacy services
will likely be involved in the provision of front-line advice to the public, handling an
increased demand for dispensed prescriptions and over-the-counter treatments of
pandemic-related symptoms. As the COVID-19 pandemic proved, there is also likely to
be high demand for administering vaccinations, distributing masks and performing
point-of-care tests. Pharmacists may also have a role in supervising the dispensing of
antivirals and antibiotics in CBACs.

Pharmacists will continue to dispense non-pandemic medicines during a pandemic and

will need to engage in resolving supply chain difficulties caused by interruptions in
international manufacture and supply.

Health New Zealand may need to liaise with pharmacists to reach agreement on the
prioritising of pharmacy services.

Antiviral medicine
Pandemic-specific antiviral drugs can reduce the duration and severity of illness if
given within 48 hours of the onset of symptoms and can reduce the incidence of
secondary complications. In accordance with advice from the WHO and other expert
advice, New Zealand maintains a supply of influenza antiviral medications as part of
the national reserve supply. The specific type and quantity of antivirals in that supply
are currently under review as at November 2023. There is good evidence that the

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 145

 antiviral oseltamivir reduces the duration of illness and reduces viral levels; the
evidence is less robust for any reduction in hospitalisation or mortality.

Some members of the public may purchase their own antiviral medication. Once the
nature of the pandemic disease becomes clear, the Ministry of Health will publish
advice for individuals on when and how to best use their own supplies.

It is possible the pandemic virus strain could develop resistance to antivirals, limiting
their effectiveness. The pandemic virus strain will be monitored for resistance, and any
developments will be incorporated into modified usage policies and advice to
individuals.

During the COVID-19 pandemic, there were antiviral medicines available to treat early
COVID-19 at home, including ritonavir with nirmatrelvir (Paxlovid) and molnupiravir
(Lagevrio).

Cross-references and supporting material

Likely Future Pandemic Agents and Scenarios: An epidemiological and public
health framework (Te Niwha 2023) – Section 4.10

Antibiotics
Secondary infection with pneumonia-causing bacteria is a common complication of
respiratory infection. To ensure antibiotics can be provided for the treatment of
pneumonia during a pandemic, Health New Zealand has enhanced the supplies of
antibiotics held in New Zealand and included provisions for the Cook Islands, Niue and
Tokelau.

Vaccination
Pre-pandemic vaccines
From time to time, the Ministry of Health may purchase small quantities of vaccines
made from a circulating strain of a new influenza virus that has the potential to cause a
pandemic. These will be held in reserve to be used if a pandemic eventuates. Following
the recent health reforms, the Ministry retained responsibility for setting the national
reserve supply’s policy direction (including composition) and transferred the supply
chain functions (including procurement and storage) to Health New Zealand.

Cross-references and supporting material

National Health Emergency Plan: H5N1 pre-pandemic vaccine usage policy
(Ministry of Health 2013c)
Likely Future Pandemic Agents and Scenarios: An epidemiological and public
health framework (Te Niwha 2023) – Section 4.9

146 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Pandemic vaccine
Since January 2010, New Zealand has maintained an advanced purchase agreement
with vaccine manufacturers for the supply of pandemic vaccine. However, there will
always be some months’ delay between the declaration of a pandemic and the arrival
of pandemic vaccine supplies in New Zealand. This is because a vaccine that will
protect against the pandemic strain cannot be made until that strain has developed
and is identified.

Pandemic vaccine orders and vaccination campaign strategies will be influenced by

several factors, including the nature (including the virulence) of the pandemic virus, the
size of pandemic waves that may have already affected the population and the
probable timing of vaccine deliveries. The process of vaccinating the population may
be further complicated if each individual needs to be vaccinated more than once.

Depending on the availability of the pandemic vaccine and the characteristics of the
particular pandemic, careful consideration should be given to identifying priority
groups for the implementation of a large-scale vaccination programme. During COVID-
19, priority was given to vaccinators, front-line health care workers, border and other
essential workers and population groups at higher risk of poorer health outcomes
(eg, people with pre-existing/long-term conditions, pregnant women, the elderly,
Māori, Pacific peoples and people with disabilities). Priority groups should be
determined based on clinical and epidemiological data.

Depending on transmission rates, the severity of the illness and the efficacy of vaccine
in preventing transmission and reducing poor health outcomes, the government may
consider imposing restrictions under legislation on people who choose not to accept
vaccination, in relation to work, access to premises and other activities. If legislative
measures of this nature are adopted, consideration needs to be given to the New
Zealand Bill of Rights Act, legitimate exemptions, international travel requirements and
public acceptability in light of the wider framework of response measures.

Should a pandemic vaccination campaign be necessary, the Ministry of Health and

Health New Zealand will work together in developing guidance. As well as focusing on
priority groups, such campaigns would need to pay detailed attention to planning for
logistics (eg, to ensure adequate needles and syringes, sharps containers and other
vaccination equipment and supplies), the cold chain, workforce training, phasing and
strategies to minimise wastage. Experience from COVID-19 demonstrated the
importance of using Māori, Pacific and other providers to maximise the vaccine uptake.

Any pandemic vaccination programmes need to take account of New Zealand’s

responsibilities to the Cook Islands, Niue and Tokelau. Decisions on the purchase of
pandemic vaccine for New Zealand’s use should also consider the extent to which New
Zealand may be expected to contribute to the global vaccination programme (as it did,
for example, via the COVAX facility during the COVID-19 pandemic).

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 147

 Cross-references and supporting material
Likely Future Pandemic Agents and Scenarios: An epidemiological and public
health framework (Te Niwha 2023) – Section 4.9

Other clinical supplies

Normal supply chains to New Zealand may be severely interrupted during a pandemic
due to a reduction in international manufacturing and supply chains. It will be a priority
to ensure health care workers and first responders are protected, because they provide
care for the population. There are various clinical supplies held in Health New Zealand
stores and bulk stores around the country. These are funded and managed by Health
New Zealand, but the Ministry of Health determines the composition of strategic
reserves and approves their use.

Enhanced supplies of personal protective equipment include general purpose masks

and P2 grade masks, gowns, aprons and gloves. Stocks of intravenous fluids and
associated equipment, such as giving sets, injection devices, needles and syringes,
have also been enhanced.

Large numbers of deaths over a short time could affect the capacity of normal services
to dispose of dead bodies within a reasonable or culturally acceptable timeframe, or to
safely store dead bodies until disposal is possible. Health New Zealand holds supplies
of body bags. Like other clinical supplies, these remain under the oversight of the
Ministry.

Due to the possible disruption of international and national manufacturing and

distribution of supplies for other diseases and conditions, it may be necessary for the
Ministry of Health to set prioritisation criteria for other critical clinical supplies in short
supply.

Cross-references and supporting material

Guidance on Infection Prevention and Control during an Influenza Pandemic
(Ministry of Health 2006a) – Under review
National Health Emergency Plan: National reserve supplies management and
usage policies. Third edition (Ministry of Health 2013a)
Ministry of Health web page ‘National reserve supplies’:
www.health.govt.nz/our-work/emergency-management/national-reserve-
supplies

148 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Laboratory diagnosis
The overall approach to diagnosing pathogens with pandemic potential, and the
management of cases, will be affected by the pandemic alert status as determined by
the WHO and the Ministry of Health. During the early phases of a pandemic in New
Zealand (Keep It Out and Stamp It Out), health providers should be able to access
diagnostic tests with the maximum sensitivity and specificity and a turnaround time of
less than 24 hours, to assist a rapid public health response.

Once a pandemic pathogen has entered New Zealand, the need for highly sensitive
testing will diminish, except for the purpose of accurate diagnoses for seriously ill
individuals. However, periodic testing may be required to examine for
antimicrobial/antiviral resistance, if such a treatment is available.

It is preferable to take samples for viral diagnosis during the first three days after the
onset of clinical symptoms. However, samples may be taken up to a week after the
onset of illness, or even later in severely ill or immune-compromised patients. The
specimens of choice will be dependent on the pathogen of concern. In general, for
samples for respiratory pathogens nasopharyngeal and throat swabs will be
appropriate.

A nucleic acid-based method (eg, polymerase chain reaction or real-time polymerase

chain reaction test) is generally optimal for detecting a novel pathogen; this can be
modified to detect an emergent pathogen. During the early phases of a pandemic,
samples from suspected and probable cases will be tested locally or (using the
laboratory transport network) sent to a referral laboratory for testing, confirmation and
characterisation. During later phases, when infection is widespread, the testing strategy
may alter.

The Ministry of Health and Health New Zealand, with assistance from the New Zealand
Microbiology Network and New Zealand Diagnostic Laboratory providers, will work
together to review and develop guidelines for collecting, handling and transporting
human specimens for laboratory diagnosis of pathogens with pandemic potential.

Cross-references and supporting material

National Laboratory Guidelines for Pandemic Influenza: Collection and handling of
human specimens for laboratory diagnosis of influenza with pandemic potential
(Ministry of Health 2006b)
Likely Future Pandemic Agents and Scenarios: An epidemiological and public
health framework (Te Niwha 2023) – Section 4.5

Care of the deceased

The standard planning model for a severe pandemic assumes about 41,000 deaths
over an eight-week pandemic wave, with approximately 26,500 in the peak week. For
context, New Zealand averages about 623 deaths from any cause per week in normal
times. Clearly, this will have an impact on normal services for dealing with the

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 149

 deceased. Health New Zealand emergency planning processes include provision for
managing larger than normal numbers of deceased.

Under section 46AA of the Burial and Cremation Act 1964, no one may dispose of a
body without a doctor’s certificate or coroner’s authorisation. If people are instructed
to stay at home during a pandemic, some may die from pandemic illness without
having seen a doctor. Although a natural consequence of illness, such deaths must be
reported to the coroner under section 13(1) of the Coroners Act 2006. This may cause
additional delays and pressures on coronial services.

Role of agencies
Several agencies are involved in managing matters relating to the dead during a
pandemic, as follows.
• The New Zealand Police is an agent for the coroner.
• Births, Deaths and Marriages within the Department of Internal Affairs is responsible
for registering deaths. Section 38 of the Births, Deaths, Marriages, and Relationships
Registration Act 2021 requires every death in New Zealand to be notified and
registered in accordance with that Act.
• The Ministry of Justice is responsible for the coronial system. Normal coronial
processes will continue for other deaths (eg, homicides) during a pandemic.
Coronial services in a severe pandemic will come under enormous pressure.
• The Ministry of Business, Innovation and Employment/WorkSafe New Zealand is
responsible for health and safety in the workplace, including for funeral directors
and pathologists, one aspect of which is preventing the spread of disease.
• The Ministry of Health is responsible for public health issues and administering
burial and cremation legislation.
• Health New Zealand receives information on the medical cause of deaths (see
section 46AA(2) of the Burial and Cremation Act 1964) via the Death Documents
online.
• Territorial authorities are responsible for registering mortuaries and providing
cemeteries. In a pandemic, funeral directors, territorial authorities and managers of
denominational burial grounds may face challenges, including pressure on space.
• Regional councils and territorial authorities are responsible for ensuring compliance
with the Resource Management Act 1991 in regards to burial and cremation. A high
number of deaths may present challenges in terms of the establishment or
extension of cemeteries and burial grounds, the installation and operation of
cremators, and so on under the Resource Management Act.
• In a pandemic, funeral directors will carry out their existing roles, which includes
registration of deaths with Births, Deaths and Marriages; signed identification of the
deceased; transfer of the deceased from the place of death to a funeral home;
placement of the deceased into an identifiable body pouch; transfer of the
deceased to a local cemetery for burial or, where possible, a crematorium for
cremation; and providing support for families in the community. During a pandemic
event, specific restrictions may be imposed.

150 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Coronial issues
During a pandemic, some deaths will require coronial assessment. The Office of the
Chief Coroner will maintain a database of suspect and confirmed cases of pandemic.
The Ministry of Health and the Office of the Chief Coroner, under a specific
memorandum of understanding, will work together during a pandemic to share
information on each case during a pandemic and to ensure public information is
released as consistently as possible. Coronial findings may take a long time to process
before being released to the Ministry of Health.

Infection hazards from bodies of people who have died from the
pandemic pathogen
The Health (Burial) Regulations 1946 enable medical officers of health, health
protection officers and the coroner to obtain information, direct embalming processes
and set conditions for the hygienic storage, transport and disposal of the dead, as
required. Advice for handling of deceased in a pandemic will need to be adapted
based on the particular pathogen and transmission pathways involved.

Dead bodies will not transmit a respiratory pathogen. However, some post-mortem
activities (eg, lung biopsies or other specimen collections) may generate droplets or
aerosols that can transmit the pathogen. These guidelines are not intended to provide
advice for pathologists.

The degree of risk from handling the bodies of people who have died from the
pandemic pathogen is considered low. Bodies do not need to be bagged. Viewing and
embalming pose only a low risk of infection and are considered safe.

While the deceased may not pose a risk, people who were in contact with the deceased
before they died may have been exposed to the virus, and therefore need to be
particularly careful to practice hygiene and personal protection procedures as advised
by the Ministry of Health.

Table 11: Infection hazards from bodies of people who have died from pandemic

Function Action Responsibility Authority

Care of the The degree of risk for handling bodies of Ministry of Health, Health Act 1956,
deceased people who have died from the pandemic Health New Zealand, Burial and
pathogen is considered to be low. Ministry of Business, Cremation Act
Bodies do not need to be bagged. Innovation and 1964, Health and
Employment / Safety at Work Act
The viewing and embalming of bodies are
WorkSafe New 2015
considered safe.
Zealand

Gatherings, tangihanga and funerals

With any death it is important that relatives and friends have an opportunity to grieve.
Any restrictions imposed on gatherings, tangihanga and funerals should be
proportionate and based on risk.

In the height of the pandemic, if physical distancing measures are in place, and
depending on the transmission characteristics and virulence of the pathogen, it is

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 151

 possible that mass gatherings at funerals and tangihanga will be discouraged,
prohibited or otherwise limited.

Health authorities should encourage communities and funeral directors to plan such
gatherings with an awareness of the risks and to think about this issue in advance,
evaluating the risk of transmission against the importance of cultural practices and
protocols. Even when funerals and tangihanga may proceed, it might be appropriate to
encourage physical distancing, limit the numbers of people attending such events,
encourage or require the wearing of masks and other IPC measures. To ensure cultural
practices are considered in the context of a pandemic and any identified risks,
engagement with experts in tangihanga will be undertaken by those coordinating the
health response to develop key messages and protocols.

Emergency powers are available under section 70 of the Health Act 1956 to prohibit or
limit mass gatherings, which can include funerals and tangihanga, should public health
needs require it. Once this power is authorised, either by the Minister of Health or
because an emergency has been declared under the Civil Defence Emergency
Management Act 2002, the Ministry of Health will provide advice on its
implementation.

Funeral directors may face significant demand. Funeral directors themselves may be
suffering the effects of significant morbidity and mortality among their number, and
consequent resource difficulties. Funeral directors will need to manage the reaction of
bereaved whānau and friends if there are limitations on funerals and tangihanga, as
well as ensuring they comply with requirements. This means their capacity to provide
grief therapy and to work as fully as they normally do with families and friends may be
compromised.

Refrigeration and storage of bodies

Bodies may need to be stored for a time, because they cannot be prepared for burial
or cremation in a timely manner or because remains are unidentified. Bodies that need
to be preserved indefinitely should be stored in refrigerated containers that can
maintain temperatures below –24°C. Care should be taken to avoid thawing and re-
freezing remains. Unembalmed bodies may be stored in refrigerators of temperatures
above 0°C for up to five days before muscle and bone is likely to decompose.

Burial
If there is no medical certificate stating a person’s cause of death, or the body cannot
be identified, police will refer the matter to the coroner. While awaiting coronial
direction, bodies should be placed in cold storage.

Despite the predicted increase in the number of deceased in a severe pandemic, the
Ministry of Health advocates burial in separate graves or cremation whenever possible.
Mass graves should not be necessary – it is preferable to hold bodies in cold storage
rather than to bury them in mass graves for later disinterment and reburial.

Local Government New Zealand and the Funeral Directors’ Association of New Zealand
have indicated that they could manage an increase in number of deaths in a pandemic
situation.

152 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

The Funeral Directors’ Association of New Zealand has indicated that funeral directors
are confident they have capacity to transport greater numbers of bodies during a
pandemic (subject to the availability of protective safety gear, fuel and so on), and that
unembalmed bodies could be buried in body bags instead of caskets, if necessary.

Cremation
The Cremation Regulations 1973 make provision for the Minister of Health to permit
cremations to be carried out, or to authorise medical referees to permit cremations to
be carried out, without complying with some duties required of a medical referee,
subject to such exceptions or conditions as the Minister may specify or impose.

Funeral directors have indicated that in a pandemic situation, bodies may not be
embalmed if there is undue pressure on the handling of remains. If the deceased is to
be cremated, unembalmed remains should remain in cold storage and only be taken to
the crematorium just prior to cremation.

The continuity of gas supplies to operate cremators may be a risk. The Ministry of
Business, Innovation and Employment’s website includes energy supplies in its list of
essential infrastructure to be maintained in a pandemic.

Transport of bodies to or from overseas

Limitations on air transport may mean bodies will need to be stored before transport
can occur (see the storage recommendations given above).

Where a body is to be transported between countries, the normal procedure is for a

funeral director in the country where death has occurred to consign the body to a
funeral director in the country to which the body is to be transported, designated by
the relatives of the deceased. The funeral director in the country to which the body is
to be transported advises the former funeral director of the requirements imposed by
the country of destination.

Health and biosecurity permits are not required for the importation of human remains
into New Zealand.

Health approval is not required to export bodies from New Zealand, but the country of
destination may impose requirements on importation. The medical officer of health or
health protection officer within the NPHS can prepare a health authority statement for
bodies being exported from New Zealand on request from a funeral director overseas.

When the body of a person who died in New Zealand is to be transported outside of
New Zealand, the death must be notified to Births, Deaths and Marriages for
registration before the body leaves the country.

Welfare arrangements
A pandemic may affect the physical and psychosocial wellbeing of large numbers of
people who may suffer bereavement, severe illness or separation from families and
support. People may also experience loss of employment and income, along with social
and community isolation.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 153

 The ability of individuals to be self-reliant and for communities to remain resilient in
the face of these challenges will be vital. Well-developed community support networks
will go a long way to assisting individuals and communities to respond to and recover
from a pandemic. It will be essential to educate people on how to prevent the spread
of the pandemic pathogen and provide information on actions they can take to be
self-reliant.

Local civil defence emergency management groups will coordinate welfare support by
government and non-governmental organisations in communities as required.

Welfare provision in a pandemic will follow the same guidelines as for any emergency
response; it will involve supporting people through the coordinated provision of:
• food and shelter
• support of those unable to care for themselves; for example:
– people who have no family or friends able to assist them
– people whose caregiver is sick and so is unable to care for them (eg, children,
people with disabilities and older people living with a caregiver)
– people who depend on external help (eg, those relying on home support)
– people who are required to isolate or quarantine and need support to do so.
• financial assistance
• psychosocial support to promote recovery.

In most emergency situations in New Zealand, immediate welfare will be coordinated

and provided by local authorities, with support from non-government and central
government agencies. In large-scale emergency events, overall coordination is
provided by civil defence emergency management groups and the National Welfare
Coordination Group (NWCG) working to support the process as required. It is
important to ensure that Health New Zealand and the Ministry of Health respectively
liaise closely with these groups to ensure seamless coordination of services.

At a national level, the NWCG’s role is to identify the nature and scope of the
immediate response required from central government and to ensure the
responsibilities of individual agencies within the group are met. The NWCG works with
member organisations in an integrated and supportive way, assisting regional and local
activity and obtaining government approval for the appropriate levels of assistance for
the relief of those affected by the event.

Cross-references and supporting material

‘Welfare work stream’ and ‘Civil defence emergency management work stream’
in Appendix C: Intersectoral Pandemic Group work streams

154 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Managing the economic impact
The severity and duration of the pandemic will have a critical bearing on the range of
responses that the Government considers to help mitigate the immediate impact and
support rapid recovery.

A severe pandemic is likely to have serious adverse short-term effects on the economy
and on most individual businesses. In addition, uncertainty about how serious any
pandemic may turn out to be, how long it may last and when things may return to
normal may have a major impact on business and consumer confidence. Such
confidence effects are likely to play a major role in the severity of the economic impact
and the speed of the recovery.

Due to disruptions to international and national manufacturing and distribution

networks, certain critical goods may be in short supply and exports may be disrupted.
As a result, policies that aim to restore confidence and support demand, maintain
normal commercial relationships and promote a quick return to work are likely to be
the most effective in mitigating economic impacts. This means looking to ensure that,
as far as practical:
• macroeconomic policy can respond appropriately to help maintain economic
stability
• any risks to financial stability are recognised and managed
• providers of infrastructure and other services essential to other economic activity
have taken steps to maintain the continuity of those services
• businesses have arrangements in place to manage their exposures in a serious
pandemic and to maximise the chances of emerging from a pandemic with their
viability (and their employment relationships) maintained
• households and individuals can continue to meet their immediate financial needs
• subsidies are considered where appropriate.

The COVID-19 pandemic demonstrated that countries that tried to implement less
stringent control measures, due to economic concerns, often had to impose prolonged
periods of lockdown or quarantine, causing more detriment to the economy in the
long run. Stricter measures in initial lockdowns in New Zealand allowed a quicker
transition and faster economic recovery.

A mild pandemic, such as the first wave of the influenza A H1N1 2009 pandemic, is
unlikely to have a significant impact on the economy and society.

Cross-references and supporting material

‘Economy work stream’, ‘Infrastructure work stream’ and ‘Workplaces work
stream’ in Appendix C: Intersectoral Pandemic Group work streams

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 155

 Business continuity
Ensuring private business and public agencies have robust arrangements for business
continuity must be a particular focus for all phases.

The COVID-19 pandemic showed that a severe pandemic can cause widespread,
prolonged disruption. This disruption can be caused by many compounding factors,
including staff absences, public health measures and supply chain disruption.

The impact of the disruption caused by a pandemic could make it hard for businesses
and public agencies to continue to function as normal, so it is important to plan ahead.
Businesses and agencies should identify which aspects of their business are essential to
maintain and consider the people and resources they need to maintain those aspects.

Planning should consider:

• possible alternative work practices, such as remote working or working with social
distance practices in place
• contingencies for staff absences and disruption to critical resources or suppliers
• staff welfare, including immediate, medium-term and long-term personal recovery
issues, stress and grief
• how businesses can protect their workers, including in terms of personal protective
equipment, which may be in high demand and short supply at the time of a
pandemic.
• what services may need additional support to manage surge in demand (eg, IT
support services)
• The continuity of key decision-making roles, including delegated authorities (eg,
authority to make payments).

In a severe pandemic, priority access to infrastructure services, including petroleum

supplies, electricity and telecommunication services, cannot be guaranteed.
Infrastructure providers and others with priority needs should consider the possibilities
for making individual arrangements as part of their business continuity planning and
engage directly with their suppliers where appropriate. They should make their needs
known to regional CDEM group controllers in advance.

Cross-references and supporting material

Ministry of Health’s web page ‘Workplace pandemic influenza guidance’:
https://www.health.govt.nz/your-health/healthy-living/emergency-
management/pandemic-planning-and-response/workplace-pandemic-
influenza-guidance

Maintenance of essential services

The Ministry of Business, Innovation and Employment is leading work to promote
business continuity, with support from the National Emergency Management Agency

156 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

and the Ministries of Transport and Health, across the infrastructure sectors of energy
(electricity, oil, gas and coal), communications (telecommunications, broadcasting and
post), transport and water and waste.

In general, pandemic planning in the infrastructure sector is well advanced. General

business continuity plans exist for lifeline utilities, and most of those utilities have
developed a specific pandemic business continuity plan.

Ongoing work in preparing for a pandemic includes:

• improving plans (by testing and exercising them and identifying potential
bottlenecks to service delivery)
• ensuring plans can be implemented (by ordering needed supplies, enabling working
from home and, where necessary, talking to CDEM groups about their needs)
• sharing plans externally (by working with service providers and integrating plans).

Completed plans should be regarded as living documents that undergo review as new
information becomes available.

Travel restrictions
Internal travel restrictions imposed in response to a moderate to severe pandemic pose
challenges for servicing of infrastructure (eg, the maintenance of electricity lines,
internet cables and gas pipes), delivery of goods and a wide range of other social and
economic activities. Any such restrictions will be determined at the time in the light of
not only the nature of the pandemic but also the need to protect the communities and
maintain key services in affected communities. The implementation and maintenance
of travel restrictions are both planning-intensive and resource-intensive, and require
significant public communication. Decision-makers will need to consider exempting
certain groups of essential services from internal travel restrictions, in terms of the legal
and public health implications of such exemptions. Infrastructure providers and
transport operators are expected to plan for and implement arrangements to enable
necessary service continuity during travel restrictions.

Cross-references and supporting material

‘Infrastructure work stream’ in Appendix C: Intersectoral Pandemic Group work
streams’

Manage It: Post-Peak

Overview
It is important to maintain vigilance when a pandemic wave is waning. In this phase,
the pandemic may be far from over. The immediate priority in the Manage It: Post-
Peak phase is to continue managing the impacts of the pandemic, scaling back the

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 157

 response where appropriate and transitioning to the recovery phase as required, while
preparing for the likelihood of further waves of infection. The timing, severity and
magnitude of a potential increase will always be subject to considerable uncertainty,
but it is prudent for recovery preparations to begin at this phase.

Once the pattern of demand for services returns to normal seasonal levels after a first
pandemic wave, agencies need to take the opportunity to learn from the experience
and to prepare for the high probability of further waves of infection.

The process of the management and scaling down of the response will vary from
district to district and from agency to agency, depending on local circumstances. The
National Health Coordination Centre, if it is still activated, will also scale back its
activities, while continuing to coordinate the national response.

The two objectives at this phase are to:

• manage – to continue to respond to and manage the impact of the pandemic on
individuals (in particular, those at higher risk), the population, health and other
services and the economy, while scaling back the response as appropriate to
changing local circumstances, and transitioning to the recovery phase
• prepare – to ensure New Zealand is prepared at national and district levels for
further waves of infection, the timing, scale and severity of which cannot be
predicted.

Key areas of uncertainty

The key areas of uncertainty in the Manage It: Post-Peak phase are as follows.

Will the number of infected people increase?

It is highly likely that, after a first wave, New Zealand will experience a further increase
in case numbers.

When will the number of infected people increase?

Further growth in case numbers could occur at any time. This could begin in the short
term: that is, if the decline in numbers proves to be short-lived and the number of
cases starts to climb again. Alternatively, and more probably, case numbers could
increase as part of a subsequent wave of infection some time in the few months or
even years following the initial peak period, as has been observed in previous
pandemics. All four influenza pandemics over the past 120 years have demonstrated
multiple waves of infection. The intervals between successive waves have ranged from
as little as a few months to as long as two to three years. Several years after the WHO
declared the emergency phase of the COVID-19 pandemic over, COVID-19 had not yet
developed a seasonal pattern, as seen with influenza. The virus is continuing to change.

How many people might get sick?

In three of the last four influenza pandemics, the second wave produced more deaths
than the first wave, and sometimes significantly more. Depending on the proportion of

158 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

the population infected in the first wave, it is prudent, for planning purposes, to
assume that any resurgence of a pandemic virus may affect more people than the first
wave. This will depend on potential mutations/changes to the aetiological
agent/pathogen, and the consequent impact on virulence and pathogenicity, including
in terms of the transmissibility and severity of the pandemic illness. This was seen
during COVID-19 waves internationally: the delta variant caused greater rates of
hospitalisations and deaths. The impact of the delta variant in New Zealand is in
contrast to the impact of the omicron variant, which had increased transmissibility that
made it very difficult to control: strategies that had been effective in previous waves,
such as case and contact tracing, became less so. With community outbreaks or
widespread transmission, there is always a risk that some population groups will
experience higher rates of infection and poorer health outcomes. Response strategies
need to be adapted accordingly.

How severe will the illness be?

Future resurgences may not have the same characteristics as a first wave. The virus may
change in terms of its transmissibility, immune evasion, clinical severity, response to
antivirals/therapeutics or vaccination (if available), or the population groups it affects
most Furthermore, the COVID-19 pandemic showed that a pandemic illness can have
inequitable health consequences for different population groups.

A new wave
If the level of infection overseas rises again, or changes in virulence or pathogenicity
affect the level of risk, it will be necessary to review actions within New Zealand. The
Ministry of Health will provide advice on the anticipated severity and impact of a
second or further waves during the Manage It: Post-Peak phase. The mix of actions
from earlier phases that are implemented in the case of a new wave will depend on
several factors, as follows.
• If vaccination of the New Zealand population has been completed to an
appropriately high level and the vaccine is effective and safe for all population
groups, then the level of response required will be considerably reduced. The
burden on health services may be redistributed from hospital to community care
services.
• If a vaccine is not available, then actions from the Keep It Out phase to the Manage
It: Post-Peak phase need to be considered.
• If certain population groups (eg, infants, the elderly or pregnant women) have not
received the vaccination because it has not been registered for use by those groups,
then targeted support programmes will need to be implemented for those groups.
• If the uptake of vaccination in the population has been low, then actions relevant to
the phase will need to be implemented in addition to promotion of vaccination.
• If the duration of immunity from vaccination or prior infection wanes, targeted
interventions may still be required. Booster vaccination programmes may also need
to be considered.

See Part B for key factors influencing decision-making in this phase. Note that, in
addition, it is necessary to prepare for transition to the recovery phase at this time.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 159

 COVID-19 and previous influenza pandemics have demonstrated that over several
years, multiple waves of infection with different characteristics should be expected.
Factors affecting the likelihood, timing and size of subsequent waves include the
availability, effectiveness and uptake of vaccines; viral characteristics, including the rate
of mutations and population susceptibility; and the nature, intensity and duration of
public health and social measures implemented in response to the event (See Figures 3
and 4 below).

Figure 3: COVID-19 average daily case numbers in New Zealand, 2020 to 2023

Figure 4: COVID-19 average daily case numbers in New Zealand, 2020 to 2021

Long-term impacts of pandemic pathogens

Consideration should be given to potential long-term sequalae and the subsequent
impact on individuals and health service provision. This will potentially include the
need for further/ongoing research to describe the associated syndromes and planning
for adequate health service provision and support for individuals over the longer term.
For example, long COVID is now well recognised; some individuals report a diverse
range of symptoms for weeks or months after the expected recovery period. The
Ministry of Health has established a long COVID programme in response.

160 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Recover From It
Definition of ‘recovery’
Recovery: the coordinated efforts and processes to effect the immediate,
medium-term and long-term holistic regeneration of a community after an
emergency.

Recovery activities will be minimal following a mild to moderate pandemic wave with a
low rate of deaths and workforce absence and little social and economic impact (as in
the first wave of the influenza A (H1N1) pandemic in 2009). A Recover From It phase
may not be required.

However, the recovery phase will be prolonged in a severe pandemic that has had
significant impacts on social and economic environments over an extended period, as
seen in the COVID-19 pandemic.

Recovery activities should begin during the response phases and continue into the
medium and long term. Planning for the transition from Manage It to Recover from It
needs careful consideration and should include a wide variety of agencies. The
transition will be influenced by the severity of the pandemic, the status of response
activities, resourcing issues, financial and political factors and whether recovery
structures have been established.

The general cornerstones for recovery, and a description of the national structure that
may need to be put in the place for recovery management in a moderate to severe
pandemic are outlined in Appendix D: Recovery.

Planning for recovery

A coordinated approach to recovery planning at local, regional and national levels will
be important to ensure recovery activities are effective. The main recovery focus will be
on health, social and economic domains and ensuring an equitable transition to
‘business as usual’. If routine health care services (eg, screening, dental care,
immunisation and specialist appointments) have been interrupted by the pandemic,
resumption of normal services and addressing the backlog will require significant
attention and resources across the health system. Key agencies concerned with social
issues, health, the economy and business will play a lead role in recovery planning.
However, there may also be impacts on natural and built environments; for example,
from a lack of maintenance. Relevant agencies may therefore also be involved.

The development of pandemic recovery plans can be informed by existing recovery

plans for other forms of emergencies, but need to address the unique nature of a
pandemic. For example, the onset of a pandemic may be slower than the onset of
other forms of emergency, but the pandemic will extend across many months, and may
come in waves, thus affecting society for a longer period. The course of a pandemic
may evolve into long-term endemicity, making it challenging to know when the

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 161

 country should enter the Recover From It. Recovery activities may be staged to match
the course of the pandemic as it unfolds.

Psychosocial recovery planning

Recovery encompasses the psychological and social dimensions of the regeneration of
a community. The process of psychosocial recovery from emergencies involves easing
the physical and psychological difficulties individuals, families/whānau and
communities have experienced, as well as building and bolstering social and
psychological wellbeing.

Recovery planning also needs to encompass community wellbeing concepts such as

social cohesion and social trust, which may have been negatively affected by restrictive
public health measures. Efforts to restore public trust and manage mis- and
disinformation will be vital.

Psychosocial support is an important issue to incorporate into recovery planning.

Psychosocial support addresses an individual’s emotional, spiritual, cultural,
psychological and social needs in the immediate, medium- and long-term recovery
phases following an emergency event. It also contributes to the wider community
social structure and to mechanisms for supporting the community as a whole, such as
existing culture and heritage, sports and leisure, and education and faith groups within
the community. Psychosocial support must provide for those providing psychosocial
support services as well as those who are receiving them.

Psychosocial recovery planning is intersectoral in nature. It requires coordination

between agencies at national, regional and local levels and spans all the phases of
emergency management, including planning.

Cross-references and supporting material

Framework for Psychosocial Support in Emergencies (Ministry of Health 2016b)

General considerations for recovery following a

moderate to severe pandemic
A pandemic event will affect the whole of New Zealand. The impacts may be felt
differently in different regions at different times, but overall impacts will not be isolated
to a geographic area.

Prioritisation of recovery activities

The prioritisation of recovery activities in a severe pandemic to bring some level of
usual daily function back to society is a key issue. A basic approach may involve:

162 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

• placing a primary focus on reinstating services providing the basic necessities of life
(that is, food and clean water) as soon as practical and promoting the concept of
community self-reliance in this respect
• placing a secondary focus on reinstating law and order, telecommunications
(including the internet), banking services and financial assistance services (welfare
support)
• decisions as to when to reopen or otherwise transition back to normal for
educational institutions
• acknowledging that government agencies and the private sector may not be able to
deliver their usual services for an extended period, necessitating an ongoing
process of prioritising services and managing resources while meeting public
expectations.

Community networks
Communities differ in terms of levels of public and private sector representation and
ethnic or socioeconomic make-up. These differences will determine the nature and
effectiveness of targeted recovery activities. Agencies should identify and make use of
existing community networks in each unique area.

Social factors
Numerous social issues may arise during recovery. Staffing capacity for the delivery of
all government services, and psychosocial support for vulnerable communities, Māori,
minority ethnic groups and others that experience inequity, may require particular
support. After a pandemic it may be necessary to establish a ‘one-stop-shop’ recovery
centre. Such centres may be useful for providing communities with a variety of support
services delivered through central government departments, local government, non-
governmental organisations and other agencies. They could minimise travel and
inconvenience for affected people and facilitate coordination and liaison between relief
and recovery services.

Some communities or population groups may have experienced particular hardship,

either because of the disease or because of the impacts of response measures.
Misinformation and disinformation may also contribute to a reduction in social
cohesion. Active effort should be made to rebuild and maintain public trust and
confidence.

Public expectations
Agencies will need to manage public expectations at national and local levels if
communities face a long period before a return to usual daily functions. This
management of expectations must be led at a national level and delivered, enhanced
and supported at a regional level.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 163

 Cross-references and supporting material
Recovery Management: Director’s guidelines for CDEM groups [DGL 4/05]
(MCDEM 2005b)
Guide to the National Civil Defence Emergency Management Plan (MCDEM
2015b)
Exercise Pomare: Post Exercise Report (Ministry of Health 2018)
Aotearoa New Zealand Strategic Framework for Managing COVID-19 (Ministry of
Health 2023a)

All-of-government pandemic recovery coordination

For the majority of the COVID-19 pandemic, the Ministry of Health was the
lead agency for the health system response and the Department of the Prime
Minister and Cabinet assumed the role of coordinating the all-of-
government response. This approach may be appropriate for future events.

Effective recovery requires planning and management arrangements that are accepted
and understood by recovery agencies and the community.

In a mild pandemic, special recovery structures and arrangements will not be required.

Following a severe pandemic, participants in the recovery process will be numerous,

including central and local government, non-governmental organisations, community
agencies and individuals. Each of these groups has a role to play in determining how
the recovery progresses. Recovery arrangements must cover both preparation and
implementation.

In the context of a severe pandemic, recovery planning and response require an all-of-
government approach at local and national levels. Strong leadership and clear
accountabilities are necessary, and the development of appropriate relationships is
critical. In these circumstances it will be necessary to consider a national recovery
management structure, as outlined in Appendix D.

It is likely that the social and economic domains will be those most significantly
affected; these will therefore most require the attention of special task groups.
However, built and natural environments may also be affected, so agencies concerned
with these environments could have a role to play. The way in which these issues are
addressed may have long-lasting effects on the community, and may be costly in
financial and resource terms.

The transition from response to recovery

The transition from response to recovery in a pandemic should be staged, and may
vary geographically. The transition should be event-driven rather than time-driven. It is

164 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

expected that the transition, including the transition of lead agencies, will be discussed
and agreed at the national level for implementation nationally, regionally and locally.

The principal aspects of the transition to recovery are:

• ensuring recovery structures are established before transition occurs
• implementing recovery task groups
• preparing a national recovery action plan that is drafted in consultation with
recovery task groups
• developing a communications plan with relevant recovery agencies
• ensuring the transition is equitable and proportionate
• remaining prepared for and alert to further waves of infection and maintaining
preparedness for other concurrent events (eg, earthquakes or cyclones).

If a transition to recovery has taken place after the first wave and a second wave
emerges, recovery may need to be scaled down and response activity reactivated.

Recovery responsibilities in the health sector

Ministry of Health
Following a moderate to severe pandemic, the Ministry of Health’s responsibilities will
include participating in an all-of-government recovery approach and overseeing the
national coordination of health and disability sector recovery activities. The Ministry
may also need to develop national policy for the prioritisation of health supplies and
services, to ensure national consistency across Health New Zealand districts.

The Ministry of Health will take the lead in managing national public information on
the recovery of health services. The Ministry will work with other government agencies
and the national recovery manager or recovery coordinator (if one has been
appointed) to ensure a coordinated recovery.

The Ministry of Health may seek to enable relevant emergency powers to be retained,
if such powers will assist in significantly reducing the duration of the recovery period
and protecting public health. The Ministry will also be responsible for ensuring that
triggers for either an escalation or a standing-down of recovery activities are event-
driven rather than time-driven.

The Ministry will provide advice about psychosocial recovery activities and support
programmes for the public and health personnel. It will do this in partnership with
other agencies within the NWCG. The Ministry will also monitor and report to ministers
on the effectiveness of recovery activities led by Health New Zealand in delivering
improved hauora outcomes for Māori .

Health New Zealand

Health New Zealand’s responsibilities will include participating in all-of-government
recovery activities at district, regional and national levels and overseeing the district
and regional coordination of health sector recovery activities. Health New Zealand may

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 165

 need to implement national policy for the prioritisation of health supplies and services,
to ensure national consistency across regions and districts.

Health New Zealand and the Ministry of Health will work with other government
agencies to manage public information so that messages remain complementary and
unambiguous. Health authorities will need to disseminate advice about psychosocial
recovery to individuals and affected communities and to implement support and
recovery programmes for the public and health personnel in partnership with the
CDEM sector.

Additional roles include:

• participating in all-of-government recovery activities at district, regional and
national levels to bring whānau voice and the interests of Māori into decision-
making
• taking direct responsibility for (some) recovery activities focused on supporting
Māori, including commissioning services or distributing funding where particular
communities have been seriously affected
• engaging with policy development led by the Ministry of Health or other agencies
to centre the interests of Māori in discussions and influence decisions to better
address problems faced by whānau Māori.

Cross-references and supporting material

National Health Emergency Plan (Ministry of Health 2015)

166 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Appendix C:
Intersectoral Pandemic
Group work streams
These Intersectoral Pandemic Group work streams are the default arrangements. The
work stream descriptions that appear below are included here primarily for reference.
In the event of an emerging pandemic threat, the Ministry of Health will rapidly update
them in conjunction with the relevant agencies.

Health work stream

Agencies
Ministry of Health (lead), Health New Zealand, Te Puni Kōkiri

Legislation
Burial and Cremation Act 1964 and Health (Burial) Regulations 1946
Epidemic Preparedness Act 2006
Health Act 1956
Health (Infectious and Notifiable Diseases) Regulations 2016
Health Practitioners Competence Assurance Act 2003
Health (Quarantine) Regulations 1983
International Health Regulations 2005 (WHO 2006)
Medicines Act 1981
Pae Ora (Healthy Futures) Act 2022
Radiation Safety Act 2016 and Radiation Safety Regulations 2016

Key documents
National Health Emergency Plan (Ministry of Health 2015)Facility-specific and regional
coordination plans
Guidance on Infectious Disease Management under the Health Act 1956 (Ministry of
Health 2017b)

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 167

 Websites
Ministry of Health ‘Emergency Management’: www.health.govt.nz/your-
health/healthy-living/emergency-management
Ministry of Health ‘Being Prepared’ (Ministry of Health 2013b):
www.health.govt.nz/your-health/healthy-living/emergency-
management/pandemic-planning-and-response
Health New Zealand ‘Communicable Disease Control Manual’:
www.tewhatuora.govt.nz/for-the-health-sector/health-sector-
guidance/communicable-disease-control-manual
WHO ‘Preparedness and Resilience for Emerging Threats (PRET)’:
www.who.int/initiatives/preparedness-and-resilience-for-emerging-threats

Roles and responsibilities

Ministry of Health
The Ministry of Health is the lead agency for setting the overall strategy and policy
framework for the health sector in planning for and responding to a pandemic. The
Ministry of Health’s stewardship and oversight role for health system includes
collaboration with Health New Zealand. The Ministry also has a monitoring and
assurance function for these health entities. The Ministry’s particular responsibilities in
a pandemic include:
• activating a national emergency response, including by activating and running the
National Health Coordination Centre
• undertaking national intelligence and planning, including by liaising with, and
reporting to, the WHO and other international bodies responsible for providing
high-level advice and recommendations to national authorities
• advising the ODESC system to activate the National Crisis Management Centre if
necessary
• developing strategy and policy for Māori health outcomes
• monitoring the overall performance of the system in terms of preparedness and
response.

Shared responsibilities
Some responsibilities are shared across two or more agencies, including:
• maintaining standard operating procedures for the National Health Coordination
Centre that clearly identify roles and responsibilities consistent with the CIMS
organisational strategy identified in the National Health Emergency Plan (Ministry of
Health 2015) (Ministry of Health, Health New Zealand)
• ensuring sufficient staff are trained and exercised to participate in the National
Health Coordination Centre at short notice, and maintaining a knowledge base on
pandemic planning and response (Ministry of Health and Health New Zealand)

168 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

• convening expert advisory groups and disseminating clinical and public health
advice to relevant audiences, including the public, using a range of channels
(Ministry of Health, Health New Zealand)
• providing information and advice to ministers (Ministry of Health, Health New
Zealand)
• liaising nationally with, and advising, other government agencies (Ministry of Health,
Health New Zealand)
• overseeing the health and disability sector response nationally to ensure the
consistency of advice given and action taken across the country (Ministry of Health,
Health New Zealand)
• instigating and standing down universal or targeted public health assessments
(Ministry of Health, Health New Zealand)
• coordinating services and resources nationally, as required (Ministry of Health,
Health New Zealand).

Health New Zealand

Health New Zealand is the lead agency for planning for and responding to a pandemic
at the national, regional and local levels within the parameters set by the Ministry.
Health New Zealand’s particular responsibilities during the response include:
• coordinating with the medical officer of health and the CDEM controllers in the
regions
• providing appropriate support to the NPHS and local/regional public health services
so they can carry out their core functions
• implementing its major incident and emergency plan or pandemic plan, as
necessary, and contributing to implementation of the applicable regional incident
coordination plan
• implementing instructions, advice and guidelines issued by the Ministry of Health
through the regional coordination team
• ensuring hospitals and health services function to the fullest possible extent during
and after the emergency, including in terms of IPC and laboratory capacities
• ensuring community-based health services are available to meet increased demand
for assessments, including by establishing CBACs as required
• implementing vaccination campaigns
• commissioning and operating national quarantine capability
• using information produced by the Ministry in communicating with local
communities, agencies and providers
• communicating with and supporting health and disability providers in the regions,
including ambulance services, primary care providers, aged care providers, non-
governmental organisations and Māori and Pacific providers
• liaising with other agencies at a local level, as appropriate (including local
government, CDEM agencies, education providers, welfare agencies, border
agencies and national health groups with local representation)
• commissioning te ao Māori solutions and other services for Māori communities
(Hauora Māori Services)

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 169

 • contributing to the regional coordination team, providing inter-regional support for
health services and implementing regional decisions at a local level.

National Public Health Service (Health New Zealand)

Public health services that are part of the NPHS are responsible for:
• developing and implementing plans for public health emergencies
• maintaining and enhancing surveillance of public health
• maintaining and enhancing border health response activities
• operational intelligence
• managing ‘cases’ (people infected with a pathogen, whether symptomatic or not)
and ‘contacts’ (people who have, or may have, been exposed to a pathogen, but
who have not yet developed, or may not develop, symptoms), including in terms of
investigation, arranging for welfare/manaaki and using control measures (including
statutory powers) as necessary
• integrating public health technical advice, planning and response with Health New
Zealand district- and hospital-level planning and response and with primary care
services
• accessing support from Health New Zealand and other agencies to maintain core
functions
• advising local agencies and lifeline utilities about the public health aspects of their
planning and response
• investigating, assessing and responding to events involving risks to public health
• ensuring advice and actions are consistent across the country.

Te Puni Kōkiri
The role of Te Puni Kōkiri is to:
• engage with whānau, hapū, iwi, Māori individuals, Māori organisations and Māori
communities to ensure their needs are being met
• work, as required, with relevant government agencies to facilitate and coordinate
support for Māori
• oversee Whānau Ora commissioning agencies.

Ambulance providers
Ambulance providers will be responsible for the continuation of their service and the
appropriate management of increased demand during a pandemic. Ambulance
providers will also provide representatives for Health New Zealand national and
regional groups and CDEM groups, as required.

ESR
ESR is responsible for coordinating national, real-time notifiable disease surveillance
and data analysis, so transmission patterns throughout New Zealand can be
monitored. This will involve surveillance elements such as wastewater epidemiology,
genomics, modelling and other functions.

170 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

ESR’s laboratory at the National Centre for Biosecurity and Infectious Disease in Upper
Hutt is the WHO National Influenza Centre and reference laboratory for New Zealand.
This laboratory maintains the capacity to isolate, diagnose and characterise a pandemic
influenza virus in a high-containment laboratory. It is expected that ESR will also be
involved in national reference testing for other pandemic pathogens. In addition, ESR
will serve as a key contact to facilitate communication among, and provide scientific
advice to, agencies within New Zealand and internationally.

Other microbiology laboratories

A network of microbiology laboratories in New Zealand (including ESR) will coordinate
and deliver testing.

Ongoing work
The health work stream is responsible for addressing five key areas, each with their
own objectives:
• pandemic intelligence
• health and disability sector capability and capacity
• Ministry of Health logistics
• government and sector leadership and coordination
• public information management.

Biosecurity work stream

Agencies
Ministry for Primary Industries (lead)

Legislation
Biosecurity Act 1993
Hazardous Substances and New Organisms Act 1996
Health Act 1956
National Animal Identification and Tracing Act 2012
Wild Animal Control Act 1977

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 171

 Key documents
Critical Biosecurity Event Response Protocol 202310
Policy for MAF’s Response to Risk Organisms (Ministry of Agriculture and Forestry 2008)

Websites
Ministry for Primary Industries ‘Resources: Biosecurity 2025’:
https://www.mpi.govt.nz/biosecurity/about-biosecurity-in-new-
zealand/biosecurity-2025/resources-biosecurity-2025/
Government Industry Agreement for Biosecurity Readiness and Response:
www.gia.org.nz/

Roles and responsibilities

Ministry for Primary Industries
The Ministry for Primary Industries is responsible for monitoring animal populations for
influenza and responding to outbreaks in animals. That Ministry will also report to the
World Organisation for Animal Health, the international veterinary agency responsible
for international animal health issues.

Ongoing work
The Ministry for Primary Industries is the lead agency for planning for and responding
to an outbreak of highly pathogenic influenza in animal species. It also has a role in the
context of human pandemic influenza. In particular, the Ministry for Primary Industries
is responsible for:
• surveillance of influenza and other potential zoonoses in animals
• responding with investigation and laboratory diagnosis to public enquiries about
sick animals, including through the exotic pest and disease hotline
• preparing technical and other information on illnesses in animals
• preparing technical response policies considering such matters as detection,
vaccination, culling and disposal
• establishing and implementing import health standards to control the risk of
potential zoonoses in animals entering New Zealand through the importation of
animal material.

10
This response protocol (dated 1 November 2023 and still in draft as of May 2024) is jointly owned by
HNZ, MoH and Biosecurity NZ.

172 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Law and order and emergency
services work stream
Agencies
New Zealand Police (lead), New Zealand Defence Force, New Zealand Fire Service,
Ministry of Justice, Department of Corrections, New Zealand Parole Board, National
Emergency Management Agency, Ambulance New Zealand, Department of the Prime
Minister and Cabinet

Legislation
Civil Defence Emergency Management Act 2002
Coroners Act 2006
Corrections Act 2004
Defence Act 1990
Epidemic Preparedness Act 2006
Fire Service Act 1975
Fire and Emergency New Zealand Act 2017
Policing Act 2008

Key documents
Influenza Pandemic Medical, Human Resources and Personal Protective Equipment
Guide (New Zealand Fire Service 2006)
National Influenza Pandemic Action Plan (New Zealand Fire Service 2008a)
National Pandemic Influenza Action Plan (New Zealand Police 2008)
Regional Influenza Pandemic Action Plan (New Zealand Fire Service 2008b)

Websites
New Zealand Police: www.police.govt.nz
New Zealand Fire Service: www.fire.org.nz

Roles and responsibilities

New Zealand Police
Police responsibilities in a pandemic are the same as in any emergency:
• maintaining law and order
• responding to requests from the medical officer of health

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 173

 • taking all measures within their power and authority to protect life and property,
and to assist with the movement of rescue, medical, fire and other essential services
• assisting the coroner as required by the Coroners Act 2006
• coordinating movement control over land, including communications and traffic
control.

New Zealand Defence Force

During a pandemic, the New Zealand Defence Force will offer aid to other agencies to
the greatest extent possible. However, its resources may be compromised, through
illness of available personnel and other commitments, including commitments
overseas, and responsibilities for other government-directed contingency tasking.

Where available, New Zealand Defence Force equipment and personnel may be able to
assist in local or regional situations where normal services are under pressure. In
general, government agencies do not assume that substantial assistance will be
available from the New Zealand Defence Force, on the basis that its help would be in
addition to other arrangements. The priority tasks of the New Zealand Defence Force
will be centrally controlled to meet government-directed priorities.

Fire and Emergency New Zealand

Fire service responsibilities in a pandemic are the same as in any emergency:
• firefighting to control, contain and extinguish fires
• containing releases and spills of hazardous substances
• undertaking urban search and rescue
• redistributing water for specific needs (eg, to preserve health and hygiene in
stricken areas).

Ministry of Justice
During a pandemic the Ministry of Justice’s role is to provide services to support law
and order. It is responsible for providing essential court services, coronial services,
support to the judiciary and policy advice. It will also advise and inform the Ministers
for Courts and Justice on the provision of essential services and other matters that may
arise.

Department of Corrections
The Department of Corrections’ role in a pandemic is to ensure the safe and secure
containment of New Zealand’s prisons and the continued monitoring of high-risk
offenders.

New Zealand Parole Board

If an epidemic management notice is in force in respect of a pandemic, the New
Zealand Parole Board, the chairperson or a panel convenor acting alone can make
release decisions about offenders on the basis of documents only.

174 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

National Emergency Management Agency
The National Emergency Management Agency will support CDEM groups, their
controllers and local government to address the expected consequences of pandemic on
their communities. It is hosted by the Department of the Prime Minister and Cabinet.

Ambulance providers
See information on the Health work stream above.

Department of the Prime Minister and Cabinet

The Department of the Prime Minister and Cabinet serves the Governor-General, the
Prime Minister and the Cabinet, and helps to coordinate the work of core public service
departments and ministries. Its role in pandemic planning and response is to assist in
coordinating all-of-government activities through the ODESC system.

Department of Internal Affairs

The Department of Internal Affairs’ major roles and responsibilities during a pandemic
are to provide:
• executive government support (eg, continued support to members of the executive,
publication of the Gazette, maintenance of the translation service and the Visits and
Ceremonials Office)
• identity services (eg, births, deaths and marriages; and passports and citizenship in
support of passports, if required)
• policy support for local government, if required.

Ongoing work
The focus of the law and order and emergency services work stream is to plan for the
impact of a pandemic on law and order and emergency services agencies in New
Zealand and, in a pandemic, to maintain law and order, support border agencies and
contribute towards the control or elimination of pandemic influenza.

The objectives of this work stream are to:

• determine national and regional law and order responses
• identify areas in which health agencies, the New Zealand Police and other agencies
and their designated officers (particularly medical officers of health) will require
support
• update New Zealand Police national and district emergency plans
• develop internal and external New Zealand Fire Service contingency plans
• assist in the Department of Corrections’ internal and external planning
• work with other agencies to clarify the role of the New Zealand Defence Force
between and during pandemics, and identify trigger points for that role.

The work stream is convened as required to address law and order and emergency
services planning and response issues.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 175

 Civil defence emergency
management work stream
Agencies
Central government agencies
National Emergency Management Agency (lead), Ministry of Health, Health New
Zealand, Ministry of Business, Innovation and Employment, Ministry of Social
Development, Ministry of Transport, Ministry for Primary Industries, New Zealand
Police, Oranga Tamariki

Other agencies
CDEM groups, local authorities, Local Government New Zealand, the fast-moving
consumer goods (FMCG) sector

Legislation
Civil Defence Emergency Management Act 2002
National Civil Defence Emergency Management Plan Order 2015

Key documents
New Zealand Local Authority and CDEM Group Pandemic Planning Guide (MCDEM
2006c)
Guide to the National Civil Defence Emergency Management Plan 2015 (MCDEM 2015b)
16 CDEM group plans
Director’s guidelines for the CDEM sector
FMCG sector contingency plan(s) (proposed)

Websites
National Emergency Management Agency: www.civildefence.govt.nz
Get Ready: https://getready.govt.nz/

176 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Roles and responsibilities
National Emergency Management Agency
The roles and responsibilities of the National Emergency Management Agency in a
pandemic, in support of the Ministry of Health as the lead agency, are to:
• support CDEM groups and local government to manage the consequences of the
pandemic illness on their communities
• facilitate local CDEM support to the FMCG sector to enable that sector to maintain
sufficient food and grocery supplies to point of sale during a pandemic
• coordinate the CDEM welfare, infrastructure and lifeline utility aspects of a
pandemic.

Ministry of Health
See information on the health work stream above.

Ministry of Business, Innovation and Employment

The Ministry of Business, Innovation and Employment will provide advice on measures
to mitigate impacts on energy and information communication technology services.

Ministry of Social Development

See information on the welfare work stream below.

Ministry of Transport
See information on the infrastructure work stream below.

Civil Defence Emergency Management groups

The role of CDEM Groups in a pandemic, in support of the health sector-led response,
is to prioritise and coordinate the regional CDEM interagency responses to support
communities, through:
• providing or arranging the provision of suitably trained and competent personnel
(including volunteers) and an organisational structure for the group in its area
• providing, arranging the provision of, or making available materials, services,
information and any other resources necessary to support the response
• responding to and managing the non-health adverse effects of the pandemic in its
area
• reporting on the coordination of the CDEM welfare, infrastructure and lifeline utility
aspects of a pandemic.

Local authorities
The roles and responsibilities of local authorities in a pandemic, in support of the
health sector-led response, will be to provide local leadership, maintain essential local
government services, provide a local CDEM response and support the activities of the
CDEM group to address the community consequences of the pandemic.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 177

 Fast-moving consumer goods sector
Representatives of the FMCG sector will coordinate during a pandemic to maintain
essential food and grocery supplies to point of sale. Coordinating organisations include
the New Zealand Food and Grocery Council, Retail NZ, Retail Meat New Zealand,
Fonterra, Horticulture New Zealand, Progressive Enterprises, Foodstuffs, Colgate
Palmolive and Goodman Fielder.

Ongoing work
The CDEM work stream is focused on facilitating the development of plans to identify
and deal with CDEM pandemic preparedness and response issues. This includes
supporting local government to address its roles in providing community leadership
and managing community services and assets and its CDEM functions in support of the
health and disability sector.

The objectives of the CDEM work stream are to:

• support local government to provide ongoing local government leadership and
governance in their communities
• support CDEM groups to develop contingency plans to identify and deal with
regional CDEM pandemic preparedness and response roles
• support the FMCG sector to develop plans to maintain the FMCG supply chain and
retail operations
• develop a CDEM support plan for a pandemic response
• coordinate the CDEM welfare, infrastructure and lifeline utility aspects of a
pandemic response.

Cross-references and supporting material

‘Welfare arrangements’ in Appendix B: Explanatory material

Welfare work stream

Agencies
Central government agencies
National Emergency Management Agency (lead), Ministry of Social Development,
Ministry of Health, Health New Zealand, Whaikaha, Ministry for Primary Industries,
Ministry of Business, Innovation and Employment, Accident Compensation Corporation
(ACC), Te Puni Kōkiri, Ministry of Education, Ministry of Foreign Affairs and Trade,
Inland Revenue Department, New Zealand Police, Oranga Tamariki

178 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Other agencies
New Zealand Red Cross, Ambulance, Salvation Army, Victim Support, Insurance Council
of New Zealand

Legislation
Children, Young Persons, and Their Families Act 1989
Civil Defence Emergency Management Act 2002
Injury Prevention, Rehabilitation, and Compensation Act 2001
Ministry of Maori Development Act 1991
Social Security Act 1964
Tax Administration Act 1994

Key documents
Individual welfare agencies’ pandemic plans and guidelines
Director’s Guideline for Civil Defence Emergency Management Groups and agencies with
responsibilities for welfare services in an emergency [DGL 11/15] (MCDEM 2015a)
Framework for Psychosocial Support in Emergencies (Ministry of Health 2016b)

Websites
Ministry of Social Development: www.msd.govt.nz
National Emergency Management Agency: www.civildefence.govt.nz
Ministry of Health: www.health.govt.nz

Roles and responsibilities

Ministry of Social Development
The Ministry of Social Development is responsible for:
• continuing ongoing payments to existing clients
• providing financial assistance to new clients
• providing care and protection, youth justice and residential services
• working with other government agencies and non-government agencies to provide
a coordinated welfare response
• activating a 0800 government helpline , if necessary, to provide immediate,
coordinated information about the services and assistance available to people
affected by the pandemic.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 179

 Health system
Within the welfare work stream, the health system’s primary role is to:
• coordinate the provision of psychosocial welfare support at the national level
• promote evidence-based best practice and principles for psychosocial support
interventions
• facilitate the coordination of planning and interventions during all phases (see Part
B) between service providers, mental health services and other health and disability
service providers.

The Ministry of Health is also responsible for working with National Welfare
Coordination Group agencies to establish whether health and disability service
providers and the public have a need for further information or guidance concerning
welfare arrangements and psychosocial support issues.

National Emergency Management Agency

See information on the law and order management work stream above.

Ministry for Primary Industries

See information on the biosecurity work stream above.

Accident Compensation Corporation

The Accident Compensation Corporation’s primary responsibility will be to maintain its
activities in accordance with the Injury Prevention, Rehabilitation, and Compensation
Act 2001. Its Influenza Pandemic Business Continuity Plan defines its activities from the
first notification of human-to-human transmission of pandemic influenza to closure of
ACC’s businesses because staff are unable to continue their work.

It will, to the extent possible, ensure:

• people can continue to lodge claims
• clients can receive quality health and rehabilitation services
• clients continue to receive weekly compensation payments
• seriously injured clients are as well supported and cared for as possible
• health service providers are paid for the services they provide to ACC clients.

The Accident Compensation Corporation will also prioritise communication with clients
and payments to staff. At the onset of a pandemic, ACC will form a pandemic response
team to ensure all activities and available resources are coordinated and engaged to
meet defined goals.

Ministry of Business, Innovation and Employment

See information on the border and workplaces work streams below.

In a pandemic, the Ministry of Business, Innovation and Employment’s role is to act as a

liaison point for the wider tourism sector, including by providing information to visitors
about available support. The former Ministry of Tourism is now part of the Ministry of

180 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Business, Innovation and Employment. The Ministry co-leads a shelter and temporary
accommodation sub-function.

Te Puni Kōkiri
See information on the health work stream above.

Ministry of Education
As part of the welfare work stream, the Ministry of Education acts as a liaison point for
the wider education sector (see information on the education work stream below).

Ministry of Foreign Affairs and Trade

See information on the external work stream below.

Inland Revenue Department

See information on the economy work stream below.

New Zealand Red Cross, Ambulance, Salvation Army, Victim

Support, Insurance Council of New Zealand
Non-governmental agencies play an important role in the welfare work stream.
Depending on the scale of the pandemic and the specific welfare arrangements in
existence at the local level, such agencies perform both an advisory role at the national
level and an operational role as part of welfare advisory groups and local welfare
committees at a local level.

Ongoing work
The National Welfare Coordination Group, convened by NEMA, is a national, strategic
welfare group that plans, supports and helps coordinate welfare activity when
assistance or support is required at a national level. At the community level, welfare is
planned for and delivered through the CDEM structure, which includes local welfare
committees and welfare advisory groups. The NWCG supports the local and regional
response through representation on these groups.

In pandemic planning, the objectives of the NWCG are to:

• coordinate the provision of an integrated government welfare response
• support government agencies to identify and address welfare issues such as the
provision of accommodation, the delivery of food to vulnerable households,
financial assistance and the care of children
• ensure welfare agencies continue to provide essential services during a pandemic.

Cross-references and supporting material

‘Welfare arrangements’ in Appendix B: Explanatory material

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 181

 Education work stream
Agencies
Central government agencies
Ministry of Education (lead), New Zealand Qualifications Authority, Education Review
Office, Teaching Council of Aotearoa New Zealand, Tertiary Education Commission,
Careers New Zealand, Ministry of Health, Health New Zealand.

Legislation
Biosecurity Act 1993
Education and Training Act 2020
Education (Early Childhood Services) Regulations 2008 (and associated licensing
criteria)
Education (Hostels) Regulations 2005
Education (Pastoral Care of Tertiary and International Learners) Code of Practice 2021

Key documents
Pandemic Planning Kit (Ministry of Education 2016), including
• a pandemic planning guide for schools, early childhood services and tertiary
education organisations
• templates for: a pandemic plan for education organisations, an action plan for
hostels, an action plan for international students, communications guidelines.

Internal Ministry of Education planning documents, including:

• the Ministry of Education Managers’ Pandemic Planning Guide
• the Strategic Management Group Pandemic Response Plan
• pandemic management policy.

Websites
Ministry of Education: www.minedu.govt.nz

Roles and responsibilities

Ministry of Education
The role of the Ministry of Education in a pandemic is to coordinate the response for
the education sector and ensure arrangements are publicised for:
• early childhood services

182 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

 • schools
• tertiary education organisations
• education agencies (the Ministry of Education, the Education Review Office, the New
Zealand Qualifications Authority, Careers New Zealand, the Teaching Council of
Aotearoa New Zealand, the Tertiary Education Commission and Education New
Zealand).

Ministry of Health and Health New Zealand

Within the education work stream, the role of the Ministry of Health and Health New
Zealand is to provide information, guidance and resources to education providers as
required.

Ongoing work
The education work stream coordinates pandemic planning and response for the
education sector, including early childhood services, schools, tertiary education
organisations and education agencies. This involves about one million people,
including staff and students.

The objectives of the education work stream are to help education agencies and
providers to:
• prepare suitable response plans
• incorporate their pandemic plans into their emergency management plans
• identify their essential services in a pandemic and take steps to ensure these
services can be effectively carried out in a pandemic.

Cross-references and supporting material

‘Closure of or restrictions on education institutions’ in Appendix B: Explanatory
material
Part A: Setting the Scene

Border work stream

Agencies
New Zealand Customs Service (lead), Ministry of Health, Health New Zealand, Ministry
of Transport, Ministry of Business, Innovation and Employment, Aviation Security
Service, Maritime New Zealand, Civil Aviation Authority, Ministry of Foreign Affairs and
Trade, Ministry for Primary Industries, New Zealand Defence Force, New Zealand Police,
The Treasury, Department of the Prime Minister and Cabinet

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 183

 Legislation
Customs and Excise Act 2018
Epidemic Preparedness Act 2006
Health Act 1956
Health (Quarantine) Regulations 1983
Immigration Act 2009
International Health Regulations 2005 (WHO 2006)

Key documents
Responding to Public Health Threats at New Zealand Air- and Seaports: Guidelines for
the public health and border sectors (Health New Zealand 2023b)
Regional and local airport action plans
Regional and local marine port action plans
The New Zealand Pandemic Plan
Draft Notice to Airmen (not for public release)

Websites
Ministry of Health ‘Border health measures and controls’: www.health.govt.nz/our-
work/border-health/border-health-protection/border-health-measures
Aviation Security Service and Civil Aviation Authority: https://www.aviation.govt.nz/
Ministry of Business, Innovation and Employment, Immigration New Zealand:
www.immigration.govt.nz
Maritime New Zealand: www.maritimenz.govt.nz
Ministry of Foreign Affairs and Trade: www.mfat.govt.nz
Ministry of Foreign Affairs and Trade, Safe Travel: www.safetravel.govt.nz
Ministry of Transport: www.transport.govt.nz
New Zealand Customs Service: www.customs.govt.nz

Roles and responsibilities

New Zealand Customs Service
The New Zealand Customs Service is the lead agency for many border functions and
also provides secretariat for the inter-agency Border Executive Board. In general terms,
its responsibilities in a pandemic are to provide information, enhanced assessment and
facilitation based on risk and to implement restrictions on trade and travel.

In a pandemic, the New Zealand Customs Service will be involved in implementing

such measures at airports and seaports. Many of the responses will be at the direction

184 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

of Cabinet and may involve a range of statutes, but certain powers under the Customs
and Excise Act 2018 may also be used.

Ministry of Health
The Ministry of Health is responsible for national intelligence and planning, including
liaison with the WHO and the other international bodies responsible for providing
high-level advice and recommendations to national authorities; providing public
information, including through 0800 advice lines and the internet; and facilitating
public access to travel advisories that border control agencies produce.

Ministry of Transport
See information on the civil defence emergency management work stream above.

Ministry of Business, Innovation and Employment

See information on the civil defence emergency management work stream above.

Aviation Security Service

The Aviation Security Service will assist with operational aspects of a pandemic
response at international airports by, for example, carrying out perimeter patrols and
foot patrols and providing airside escorts to ensure aviation security is not
compromised. The Aviation Security Service may assist the New Zealand Customs
Service with other airport-related tasks if it has resources available.

Maritime New Zealand

Maritime New Zealand will perform its statutory functions and provide advice to
border agencies on ship and port safety and security.

Civil Aviation Authority

In a pandemic, when a decision has been made to limit or halt international air traffic,
the Civil Aviation Authority will issue Notices to Airmen as appropriate. It will also
provide advice to health authorities on the ability of aircraft to use aerodromes if
aircraft need to be redirected after their arrival in New Zealand.

Ministry of Foreign Affairs and Trade

See information on the external work stream below.

Ministry for Primary Industries

See information on the biosecurity work stream above.

New Zealand Defence Force

See information on the law and order and emergency services work stream above.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 185

 New Zealand Police
See information on the law and order and emergency services work stream above.

The Treasury
See information on the economy work stream below.

Department of the Prime Minister and Cabinet

See information on the law and order and emergency services work stream above.

ESR
See information on the health work stream above.

Ongoing work
The border work stream is primarily focused on the Keep It Out phase. A range of border
management options is possible. Priority will be accorded to responses at the air border
first, followed by the sea border (which is considered more manageable).

The objectives of the border work stream are to:

• maintain and plan for possible border responses to a range of pandemic scenarios
• maintain a flexible suite of responses that can be used independently or in
combination, to manage incoming (and potentially outgoing) flows of travel and
trade to limit the spread and impact of pandemic illness
• consider decision-making processes, logistical issues, legislative powers or
restrictions and the costs and implications of proposed responses
• identify trigger points and understand the roles of other responsible agencies.

Cross-references and supporting material

‘Border management’ in Appendix B: Explanatory material

External work stream

Agencies
Ministry of Foreign Affairs and Trade (lead), Department of the Prime Minister and
Cabinet, Ministry of Health, Ministry for Pacific Peoples, New Zealand Defence Force,
New Zealand Police, New Zealand Customs Service, Ministry for Primary Industries,
Tourism New Zealand, Ministry of Education.

186 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Legislation
Consular Privileges and Immunities Act 1971
Diplomatic Privileges and Immunities Act 1968

Key documents
External Communications Plan by Ministry of Foreign Affairs and Trade (not a public
document)
Pandemic plans for New Zealand posts overseas by Ministry of Foreign Affairs and
Trade (not public documents)

Websites
Ministry of Foreign Affairs and Trade: www.mfat.govt.nz
Ministry of Foreign Affairs and Trade, Safe Travel: www.safetravel.govt.nz

Roles and responsibilities

Ministry of Foreign Affairs and Trade
During a pandemic, the Ministry of Foreign Affairs and Trade is responsible for:
• reporting on international developments and liaising with other governments on
pandemic response measures
• providing pandemic-related information to New Zealanders abroad
• providing consular assistance to New Zealanders abroad affected by the pandemic
• providing foreign missions in New Zealand information to help them provide
consular assistance to their nationals during a pandemic
• facilitating New Zealand’s contribution to international efforts to prepare for and
respond to the pandemic, including by:
– providing development assistance to partners to support preparedness for
pandemics
– responding to requests for assistance from developing countries, in conjunction
with other countries and agencies.

Department of the Prime Minister and Cabinet

See information on the law and order and emergency services work stream above.

Ministry for Pacific Peoples

The Ministry for Pacific Peoples’ role during a pandemic will be to provide appropriate
agencies with advice and support to ensure key messages reach Pacific communities
around New Zealand in a culturally responsive manner.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 187

 Ministry of Health, New Zealand Defence Force, New Zealand
Police, Ministry for Primary Industries and New Zealand Customs
Service
As part of the external work stream, the Ministry of Health, New Zealand Defence
Force, New Zealand Police, Ministry for Primary Industries and New Zealand Customs
Service provide advice and assistance as required to the Ministry of Foreign Affairs and
Trade as the lead agency.

Ministry of Business, Innovation and Employment

As required, the Ministry of Business, Innovation and Employment can activate the
Visitor Sector Emergency Advisory Group, which includes Tourism New Zealand,
Tourism Industry Aotearoa, the Inbound Tour Operators Council, the Ministry of
Business, Innovation and Employment (Major Events), the Ministry of Education
(International Education), Sport New Zealand, the Ministry of Foreign Affairs and Trade
(Economic) and the Ministry of Health (Communications). The role of this group is to
assess the impact of the pandemic on the tourism and education sectors and to
develop and disseminate targeted information to international visitors, intending
visitors and the wider tourism sector network.

Ongoing work
The external work stream focuses on the international dimension of New Zealand’s
pandemic planning. Aided by reporting from New Zealand’s foreign missions abroad,
the group monitors international planning efforts, and in a pandemic will monitor the
global spread of the pandemic and international efforts to respond to it. The work
stream focuses on Pacific planning and coordinating New Zealand’s international
activities.

The objectives of the external work stream are to:

• develop a consular response for New Zealanders overseas
• prepare New Zealand posts overseas to respond to a pandemic
• develop an external communications strategy
• coordinate New Zealand’s international activities in response to the pandemic
• facilitate New Zealand’s contribution to international efforts to prepare for and
respond to the pandemic, including by:
– providing development assistance to partners to support preparedness for
pandemics
– responding to requests for assistance from developing countries, in conjunction
with other countries and agencies.

188 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Economy work stream
Agencies
New Zealand Treasury (lead), Reserve Bank of New Zealand, Inland Revenue
Department, Ministry of Social Development, Ministry of Business, Innovation and
Employment, Ministry of Foreign Affairs and Trade, State Services Commission,
National Emergency Management Agency, Ministry of Health, New Zealand Customs
Service

Legislation
Public Finance Act 1989 (section 25)

Key documents
Impacts of a Potential Influenza Pandemic on New Zealand’s Macroeconomy (Douglas et
al 2006)

Websites
Ministry of Social Development: www.msd.govt.nz
The Treasury ‘Pandemic Issues’:
http://www.treasury.govt.nz/publications/pandemic-issues

Roles and responsibilities

The Treasury
The Treasury is the Government’s primary economic and financial advisor. Its pandemic
influenza planning has included commissioning work looking at measures to mitigate
the economic shock from a pandemic and encourage a rapid recovery, and
contributing to working groups looking at more specific issues with significant
economic implications.

The Treasury’s primary role in a pandemic will include the continued running of the
Government financial system and advising on measures to mitigate economic impacts.

Reserve Bank of New Zealand

The Reserve Bank of New Zealand is responsible for providing physical currency (notes
and coins) and operating the inter-bank settlement system that allows transactions
between firms and households to be settled. It is also responsible for the conduct of
monetary policy, foreign exchange intervention and supervision of the banking system.
In a pandemic, the Reserve Bank will ensure that core systems are maintained,
including, if necessary, by pre-positioning currency supplies outside of Wellington.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 189

 Inland Revenue Department
The Inland Revenue Department plays a key role in the economic and social wellbeing
of all New Zealanders by ensuring revenue is available to fund government
programmes and ensuring people receive the payments they are entitled to. Some
normal compliance and information services may need to be suspended during a
pandemic. However, to the greatest possible extent, the Inland Revenue Department
will ensure that in the event of a pandemic revenue collection services are maintained
and customers receive their entitlements.

Ministry of Business, Innovation and Employment

See information on the civil defence emergency management work stream above.

New Zealand Customs Service

The New Zealand Customs Service has a facilitation role in trade, and provides the
second largest source of government revenue. Customs’ duty deferment and payment
schemes were small but key responses during the COVID-19 pandemic. Customs
supports a resilient supply chain, works closely with importers and exporters and
addresses non-tariff barriers in other jurisdictions.

Other agencies
Within the economy work stream, the Ministry of Social Development, the Ministry of
Business, Innovation and Employment, the Ministry of Foreign Affairs and Trade, the
Public Service Commission, the National Emergency Management Agency and the
Ministry of Health will provide advice and assistance as required to the Treasury as the
lead agency.

Ongoing work
The agencies in the economy work stream have looked at measures to mitigate the
economic shock from a pandemic and encourage a rapid recovery. When required,
these agencies also advise the Ministry of Health on specific pandemic planning
measures, such as the purchase of pandemic vaccine.

The objectives of the economy work stream are to:

• protect the Government’s financial system − this involves contingency planning to
ensure that government payments keep running in a pandemic, and that the
Treasury, the Inland Revenue Department, the Ministry of Social of Development
and other agencies regularly update and review their business continuity plans
• maintain financial stability − the Reserve Bank of New Zealand is updating its
business continuity plans and meeting with banks to discuss their preparedness and
business continuity plans
• formulate macroeconomic policy − the Reserve Bank of New Zealand and the
Treasury have examined the robustness of monetary and fiscal policy frameworks to
withstand a potential shock of this nature and scale

190 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

• ensure firms’ preparedness − including by working to assist firms with their
preparedness to cope with disruptions to their supply chains and markets and other
effects
• provide support to firms and households.

Infrastructure work stream

Agencies
Ministry of Business, Innovation and Employment (lead), Ministry of Health, Ministry of
Transport, National Emergency Management Agency

Legislation
Civil Defence Emergency Management Act 2002
Energy (Fuels, Levies and References) Act 1989
International Energy Agreement Act 1976
National Civil Defence Emergency Management Plan Order 2015
Petroleum Demand Restraint Act 1981
Water Services Act 2021

Key documents
Guide to the National Civil Defence Emergency Management Plan 2015 (MCDEM 2015b)

Websites
National Emergency Management Agency: www.civildefence.govt.nz
Ministry of Business, Innovation and Employment: www.mbie.govt.nz

Roles and responsibilities

Ministry of Business, Innovation and Employment
In a pandemic, the Ministry of Business, Innovation and Employment will provide
advice on measures to mitigate the impacts of the pandemic on energy and
information and communication technology services.

Ministry of Health
In a pandemic, the Ministry of Health will work with the water regulator, Taumata
Arowai, to advise on measures to mitigate impacts on the water and waste sectors.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 191

 Ministry of Transport
In a pandemic, the Ministry of Transport will advise on measures to mitigate impacts
on transport services and activate its Transport Response Team to liaise with the
transport sector about the status of critical transport infrastructure and services.

National Emergency Management Agency

In a pandemic, the National Emergency Management Agency will coordinate lifeline
utilities in accordance with the arrangements outlined in the National Civil Defence
Emergency Management Plan Order 2015 and the Guide to the National Civil Defence
Emergency Management Plan 2015 (MCDEM 2015b).

Ongoing work
The Ministry of Business, Innovation and Employment is leading the infrastructure work
stream across the energy, communications, transport and water and waste sectors to
ensure that key infrastructure services continue to be provided during a pandemic with
minimal disruption.

The objectives of the infrastructure work stream are to:

• raise awareness among infrastructure providers of the value of continuity planning,
through central agencies where practical
• encourage infrastructure providers to strengthen their business continuity plans to
take account of human resource matters
• provide information to infrastructure providers to assist with their continuity
planning
• receive briefings from infrastructure providers on the state of their readiness
• maintain relationships with key infrastructure providers and central agencies.

Workplaces work stream

Agencies
Central government agencies
Ministry of Business, Innovation and Employment / WorkSafe New Zealand (lead),
Public Service Commission, Ministry of Health, National Emergency Management
Agency, The Treasury

Other agencies
Business New Zealand and key sector networks, New Zealand Council of Trade Unions
and affiliated unions

192 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Legislation
Employment Relations Act 2000
Health and Safety at Work Act 2015
Holidays Act 2003

Key documents
Ministry of Business, Innovation and Employment guides, presentations and other
resources (accessible from WorkSafe New Zealand’s website) to help employers and
employees minimise the risk and impact of a pandemic, including:
• frequently asked questions
• information to assist with business continuity planning
• detailed workplace health and safety guidance, including advice on IPC and the use
of personal protective equipment in workplace settings
• generic workplace scenarios illustrating possible control options by which
workplaces can manage pandemic-related risks.

Websites
Ministry of Business, Innovation and Employment: www.mbie.govt.nz
WorkSafe New Zealand: www.worksafe.govt.nz

Roles and responsibilities

Ministry of Business, Innovation and Employment
The Ministry of Business, Innovation and Employment / WorkSafe New Zealand, in
consultation with key government agencies and stakeholder groups (in particular,
Business New Zealand and the New Zealand Council of Trade Unions), has prepared
employment relations and health and safety guidance material for workplaces to help
them to plan for, prepare for, respond to and recover from a pandemic.

In a pandemic, the Ministry of Business, Innovation and Employment / WorkSafe New

Zealand will be responsible for:
• reviewing and maintaining the currency of key messages to employers on
responding to a pandemic
• responding to enquiries and complaints from workplace participants.

Public Service Commission

The Public Service Commission is responsible for overseeing, managing and improving
the performance of the state sector of New Zealand and its organisations. It advises
agencies on pandemic-related issues; in particular, on:
• attendance in the workplace, including an employee’s refusal to work during a
pandemic and remote working arrangements (usually working from home)

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 193

 • leave arrangements and salary payments during a pandemic
• coordinating staff to provide wider support during a pandemic to help maintain
essential services, by undertaking alternative duties
• approaches to take if a medical officer of health closes the workplace.

Ministry of Health, National Emergency Management Agency,

Ministry of Business, Innovation and Employment and the
Treasury
Within the workplaces work stream, the Ministry of Health, the National Emergency
Management Agency and the Treasury will provide advice and assistance as required
to the Ministry of Business, Innovation and Employment / WorkSafe New Zealand as
the lead agency.

Ongoing work
The workplaces work stream aims to provide general workplace health and safety and
employment relations information to workplace participants about the risks associated
with a pandemic, as well as generic guidance about managing those risks. This
guidance includes supporting material for Ministry of Business, Innovation and
Employment staff about pandemic issues and a business continuity plan to ensure the
maintenance of key delivery services to workplaces by the Ministry of Business,
Innovation and Employment during a pandemic.

The objectives of the workplaces work stream are to:

• facilitate the ability of workplace participants to take a planned and flexible
approach to a pandemic that is tailored to their particular workplace situation
• assist employers, employees and other workplace participants to work together to
develop effective risk management approaches to the impact of a potential
pandemic
• ensure that workplace participants use legislative and regulatory frameworks to
guide their planning, rather than adopting legalistic approaches
• ensure that the options adopted by workplace participants during a pandemic are
directed towards the best possible recovery from the event.

194 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Appendix D:
Recovery
Cornerstones of recovery
Recovery has eight cornerstones, as follows.

1. Recovery is a short-, medium- and long-term process.

2. Recovery starts on day one of the response and can continue in many ways on a
long-term basis: possibly for years or even decades.

3. Recovery is an integral part of the four Rs (reduction, readiness, response and

recovery) to be applied across all hazards and risks.

4. Recovery addresses the management of all hazards as consequences of

emergencies that affect communities. This means planning and activation should
be designed around managing the consequences or effects of given events,
rather than planning for the event itself.

5. Recovery encompasses the community and social, natural, economic and built
environments (see Figure 5). This interaction must involve members of the
community and be supported by local, regional and national structures.

6. Recovery must be planned and evaluated.

7. The unique nature of a pandemic means there may be several waves of infection.
Recovery activities should continue throughout subsequent waves but may be
combined with response activities.

8. Recovery is a process of regeneration. In practice, this means that life after a

pandemic is likely to be different in many ways. The long-term impacts will affect
different people and communities in different ways and contribute to inequities.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 195

 Figure 5: Integrated and holistic recovery

Source: Focus on Recovery: A holistic framework for recovery in New Zealand – Information for the CDEM
sector [IS 5/05] (MCDEM 2005a).

Cross-references and supporting material

Focus on Recovery: A holistic framework for recovery in New Zealand –
Information for the CDEM sector [IS 5/05] (MCDEM 2005a)
Recovery Management: Director’s guidelines for CDEM groups [DGL 4/05]
(MCDEM 2005b)
Director’s Guideline for Civil Defence Emergency Management Groups11 (MCDEM)

National recovery management

structure
The National Civil Defence Emergency Management Plan Order 2015 and the Guide to
the National Civil Defence Emergency Management Plan (MCDEM 2015b) set out
arrangements for national recovery activities.

National recovery management procedure applicable to a pandemic is based on a

structure of multi-agency task groups paralleled at local, regional and national levels
(see Figure 6), aimed to ensure that recovery activities in the immediate, medium and
long term are coordinated. Agencies should work together in the Plan For It phase to
ensure their recovery arrangements will provide a coordinated and timely response.

11
https://www.civildefence.govt.nz/cdem-sector/guidelines

196 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

In a moderate to severe pandemic, which will be by its nature widespread, it is likely
that the ODESC would convene to provide strategic coordination and recovery
prioritisation. This committee would then advise the Cabinet Committee on Domestic
and External Security Coordination of the national direction of recovery activities and
the possible establishment of a national recovery office coordinated by a national
recovery manager or recovery coordinator: such a position can be established under
the provisions of the National Civil Defence Emergency Management Plan Order. The
national recovery office would then coordinate an all-of-government approach after a
pandemic event.

The Government expects that health coordinators, medical officers of health and CDEM
group controllers will collaborate to manage response at a regional level (see
‘Coordination arrangements nationally and locally’ in Part A). Decisions should be
made jointly as much as possible within this partnership. Joint decision-making
processes in the recovery stage should follow the national approach, including the
likely decision to appoint a regional recovery manager and establish a regional
recovery office. All recovery plans should take a ‘system level’ approach across all
health entities and ensure that the delivery of any recovery activities at the local level
are determined by local arrangements and recovery plans and reflect the regional and
national recovery management structure.

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 197

 Figure 6: Possible national recovery management structure in a pandemic
National

Source: Guide to the National Civil Defence Emergency Management Plan 2015 (MCDEM 2015b).

198 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

Appendix E:
Glossary
The following definitions and abbreviations apply for the purposes of this document.
Words in bold in the definitions are defined elsewhere in the glossary.

ACC Accident Compensation Corporation

agencies Bodies including:

• government agencies such as public service departments,
non-public service departments, Crown entities and
offices of Parliament
• non-government agencies
• lifeline utilities

alert codes for A set of codes used by the health and disability sector to
health disseminate information and trigger a series of actions (as
outlined in the National Health Emergency Plan). The four
codes are:
• Code White – information/advisory
• Code Yellow – standby
• Code Red – activation
• Code Green – stand-down/recovery

Cabinet Committee A Cabinet committee the Prime Minister chairs that includes
on Domestic and ministers responsible for the departments that will play
External Security essential roles in domestic and external security events.
Coordination Central government uses this committee to manage
significant crises or security events in which impacts of
national significance warrant the coordination of a national
effort

case A person infected with a pathogen, whether symptomatic or

not

CBAC community-based assessment centre

CDEM civil defence emergency management

CIMS Coordinated incident management system

Civil defence A committee of elected representatives from local authorities

emergency that integrates civil defence emergency management
management (or planning and responds to and manages adverse effects of
CDEM) group emergencies within a region

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 199

 Community-based A capability or facility that may be set up by Health New
assessment centre Zealand during an emergency; commonly used in instances
of mass evacuations, infectious disease outbreaks affecting
many people and mass casualty incidents

contact A person who has, or may have, been exposed to a pathogen,

and who has not yet developed, or may not develop,
symptoms

Coordinated An organisational structure that allows the multiple agencies

incident involved in an emergency to work together to manage it
management systematically, under a coordinated operational response.
system The system involves common terminology and operating
structures, integrated communications and other shared
management processes

Coronavirus A large family of viruses that cause a range of respiratory

infections, including the common cold and more severe
diseases such as Middle East respiratory syndrome (MERS)
and severe acute respiratory syndrome (SARS).

COVAX A multilateral effort co-led by Gavi (the Vaccine Alliance), the

Coalition for Epidemic Preparedness Innovations, the World
Health Organization and UNICEF from 2020 until
31 December 2023. During the COVID-19 pandemic, COVAX
aimed to accelerate the development and manufacture of
COVID-19 vaccines and to support fair and equitable access
to vaccines for every country in the world

COVID-19 A disease caused by the virus SARS-CoV-2

disinformation False or modified information knowingly and deliberately

shared to cause harm or achieve a broader harm

Domestic and A system comprising the Cabinet Committee on Domestic

external security and External Security Coordination, the Officials’
coordination Committee for Domestic and External Security
system Coordination and the Officials’ Group

Domestic and A situation that:

External Security • is the result of a happening, whether natural or otherwise,
Coordination including, without limitation, any explosion, earthquake,
system emergency eruption, tsunami, land movement, flood, storm, tornado,
cyclone, serious fire, leakage or spillage of any dangerous
gas or substance, technological failure, infestation, plague,
epidemic, failure of or disruption to an emergency service
or a lifeline utility, or actual or imminent attack or warlike
act
• causes or may cause loss of life or injury or illness or
distress or in any way endangers the safety of the public
or property in New Zealand

200 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

 • cannot be dealt with by emergency services alone, or
otherwise requires a significant and coordinated approach
under the Civil Defence and Emergency Management Act
2002

epidemic A disease affecting or tending to affect an atypically large

number of individuals within a population, community or
region at the same time

ESR Institute of Environmental Science and Research Ltd

FMCG Fast-moving consumer goods

four Rs An expression that stands for:

• reduction – identifying and analysing long-term risks to
human life and property from natural or non-natural
hazards; taking steps to eliminate these risks if
practicable; and, if not, reducing the likelihood and the
magnitude of their impact and the likelihood of their
occurring
• readiness – developing operational systems and
capabilities before a civil defence emergency happens,
including self-help and response programmes for the
public and specific programmes for emergency services,
lifeline utilities and other agencies
• response – actions taken immediately before, during or
directly after a civil defence emergency to save lives and
property and to help communities recover
• recovery – the coordinated efforts and processes used to
bring about the immediate, medium-term and long-term
holistic regeneration of a community after a civil defence
emergency

H1N1 2009 A strain of the influenza A virus that caused a pandemic in

2009

H5N1 High pathogenicity avian influenza

hazard A source of potential harm that may cause, or contribute

substantially to, the course of an emergency

health emergency An emergency that presents a serious threat to the health

status of a community; or when the usual resources of a
service or provider are overwhelmed or have the potential to
be overwhelmed; or when there is a loss of services

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 201

 Health New An independent statutory entity that leads the day-to-day
Zealand (Te Whatu running of the health system across New Zealand, delivering
Ora) functions at local, district, regional and national levels. It
manages all health services, including hospital and specialist
services, and primary and community care

Health New A national emergency management team which, depending

Zealand emergency on the nature of the emergency, will lead, support or monitor
management team the operational health sector response at the national,
regional or district levels

Health New Under the CIMS structure, the person with overall
Zealand National responsibility for coordinating a national emergency
Controller response

influenza A contagious viral disease of the respiratory tract

characterised by fever, headache, cough, myalgia, prostration,
coryza and sore throat

IPC Infection prevention and control

isolation The process of separating sick people with a contagious

disease from people who are not sick

lead agency The organisation with the legislative or agreed authority for
control of an incident

lifeline utility A service or network that provides the necessities of life (eg,
power and gas, water, sewerage, petrol, roading, transport of
essential supplies, radio, television, air travel and shipping)

likelihood A general description of probability range or frequency used

in risk management

local describes a designated population or a provider group

working in a specific geographical area. The Health New
Zealand locality has overall responsibility for providing health
and disability services in an emergency to a local population.
However, local provider groups also have obligations to
provide services in an emergency

medical officer of An officer designated by the Director-General of Health

health under section 7A of the Health Act 1956

MERS Middle East respiratory syndrome

misinformation Information that is false or misleading, though not created or

shared with the direct intention of causing harm

national The person who leads the Ministry of Health National

coordinator Health Coordination Team and has overall responsibility for
coordinating emergency response at the national level

202 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

National Crisis The National Crisis Management Centre (NCMC) is the
Management central government emergency management operations
Centre centre. It is designed for many agencies and for any type or
level of emergency

National Health A virtual or physical emergency operations centre established

Coordination to lead the national response to a health emergency, or if
Centre required, to a significant sub-national emergency.

National Health A team within the Ministry of Health, comprising members of

Coordination Team all Ministry directorates and other agencies/organisations as
required, that coordinates the national emergency response
in a health-related emergency

National Health A Ministry of Health umbrella plan (Ministry of Health 2015)

Emergency Plan that incorporates health emergency-specific action plans,
such as the New Zealand Pandemic Plan and the Multiple
Complex Burn Action Plan. The National Health Emergency
Plan provides guidance for the New Zealand health and
disability sector for emergency management

National Public The service within Health New Zealand responsible for
Health Service operational public health within New Zealand; it functions at
(NPHS) national, regional and locality levels

National reserve National reserve supplies have been developed to ensure

supplies that as far as is possible, health services have continued
access to specific critical supplies during large or prolonged
emergencies.

National Welfare An all-hazards, multiagency group, convened by the National

Coordination Group Emergency Management Agency to coordinate multi-region
or national welfare support before, during and after
emergencies

NPHS Emergency The team that coordinates public health responses and public
Management Team health input to other health emergencies

ODESC Officials’ Committee for Domestic and External Security

Coordination

Officials’ Committee A committee of government chief executives charged with

for Domestic and providing strategic policy advice to ministers. It provides
External Security support to the Cabinet Committee on Domestic and
Coordination External Security Coordination and oversees the areas of
emergency readiness, intelligence and security, terrorism and
maritime security. Activation of ODESC is at ministerial
request

pandemic An epidemic that becomes very widespread and affects a

whole region, a continent or the world

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 203

 personal protective Equipment used by clinical and non-clinical staff to protect
equipment them from hazards (eg, gloves, masks, eye protection,
respirators, gowns and footwear)

Planning and The team responsible for collecting, evaluating and

intelligence team disseminating information related to an incident

primary health care Care and services that general practitioners, nurses,
pharmacists, dentists, ambulance services, midwives and
others provide in the community

primary health A grouping of primary health care providers that provides

organisation primary health services either directly or through its
contracted providers, funded by Health New Zealand

provider An organisation or agency providing health and disability

services (eg, a Health New Zealand locality, a primary health
organisation, a Māori health provider, a non-governmental
organisation or an ambulance service)

public health services Refer “national public health service” above

public information The collection, analysis and dissemination of information to

management the public in a timely manner

public health A formal declaration by the WHO of an extraordinary event

emergency of determined to constitute a public health risk to other
international concern countries through international spread of disease and to
potentially require a coordinated international response

quarantine A process to separate and restrict the movement of people

who have been or may have been exposed to a contagious
disease

rapid antigen test A diagnostic test suitable for self-testing or point-of-care

testing that produces a result within 5 to 20 minutes

recovery The coordinated efforts and processes undertaken to effect

the immediate, medium-term and long-term holistic
regeneration of a community after an emergency

regional coordination A body that coordinates the regional emergency response in

team a health-related emergency

risk The possibility of a negative outcome or harm as a

consequence of a hazard; often specified in terms of an event
or circumstance

SARS Severe acute respiratory syndrome

secondary care Treatment by specialists to whom a patient has been referred

by primary health care providers

204 NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION

situation report A report (commonly called a SitRep) of an incident that is
usually given at regular intervals. This report provides a
snapshot of the situation and the response. There is a
template for this report in the emergency management
information system, to ensure standardisation

standard operating An approach an agency has documented that provides the

procedure clear directions and detailed instructions needed to perform
a specific task or operation consistently and efficiently

support agency Any government agency that helps the lead agency during
an emergency. Support agencies are determined by the
potential consequences of the emergency

Te Aka Whai Ora An independent statutory entity that was established under
(Māori Health the Pae Ora (Healthy Futures) Act 2022. In updating this
Authority) interim plan the Ministry consulted with Te Aka Whai Ora to
ensure its statutory functions were appropriately
incorporated. On 30 June 2024 Te Aka Whai Ora was
disestablished and its functions transferred to the Ministry of
Health (policy and monitoring) and to Health New Zealand,
Hauora Māori Services (service commissioning, planning and
delivery)

tertiary health care The treatment given in a health care centre that includes
highly trained specialists and often advanced technology

triage The sorting or classification of casualties according to the

nature or degree of illness or injury

Whaikaha (Ministry of A ministry set up in partnership with the community and

Disabled People) Māori to improve outcomes for disabled people, reform the
wider disability system and coordinate the Government's
disability policies

WHO World Health Organization

NEW ZEALAND PANDEMIC PLAN: A FRAMEWORK FOR ACTION 205

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