Covid may have peaked (again), but it’s not the only sickness worrying officials, writes Stewart Sowman-Lund in this extract from The Bulletin. To receive The Bulletin in full each weekday, sign up here.

It’s the shortest day of the year, meaning it’s also the midpoint of winter. Things can, one would hope, only get better from here – The Spinoff’s Gabi Lardies has you covered with tips for celebrating this milestone. But with colder months means the annual rush of illnesses, some more serious than others. We’ve talked recently about the resurgence of Covid-19 and the ongoing concerns of complacency around vaccinations. That isn’t going anywhere, though as the Herald’s Jamie Morton reported this week, the latest wave appears to have nearly peaked. And that peak is pretty high – Wellington Hospital was even forced to open its first dedicated Covid ward since 2021. It’s not just Covid making people sick this winter and making headlines. As Stuff’s Hannah Martin reports, health officials are warning of a rise in other illnesses, including RSV, influenza and whooping cough.

Whooping cough cases already outnumber 2023

It’s been about six years since the last serious outbreak of whooping cough, which unfortunately means we’re overdue for another. The first five months of the year have seen more cases of the illness than all of 2023. Health NZ warned medical experts to be alert, reported NZ Doctor at the end of last month, “asking healthcare providers to consider [whooping cough] in their differential diagnosis for patients presenting with respiratory symptoms and to encourage vaccination”. During last year’s cluster of cases, there were concerns about low immunisation rates among pregnant women, as this Otago University research explained. It was one of three factors, including “long-standing poor timeliness” for children being vaccinated, the researchers saw as a potential cause for a rise in case numbers and deaths.

We’re not alone in facing an unseasonably high number of cases. In Australia, reported the ABC, New South Wales had its highest number of whooping cough cases in eight years. The UK and America are also experiencing surges, with the Washington Post saying it could be an unfortunate side effect of the Covid pandemic as “children may have missed vaccination appointments” due to stay-at-home orders.

A winter fever

Another illness causing concern among healthcare providers at the moment is rheumatic fever, which is more prevalent in the colder months because it’s typically caused by untreated cases of strep throat. NZ Doctor’s Alan Perrott (paywalled) reported yesterday that Auckland was experiencing its largest wave of rheumatic fever cases in six years, with 28 reported in the first quarter. It may sound like a small number, but rheumatic fever is serious. This Herald report from Nicholas Jones earlier in the year explained that it can inflame and damage heart valves, “resulting in disability and early death – often decades later”. About 140 New Zealanders die from rheumatic heart disease every year. As Perrott wrote, almost 70% of this year’s rheumatic fever cases have occurred in South Auckland and all but six of the infections involve Pacific peoples.

In 2019, Whakaata Māori’s Aaron Ryan noted that Pacific children were 80 times more likely to contract the fever than other groups, in part because of overcrowding and poor housing conditions. A similar surge in cases last year prompted calls for a more equitable approach to the illness, reported The Hui. “If we had a whole lot of Pākehā children in Remuera dying of an infectious disease we would see huge political campaigns and resourcing into it,” said Auckland University’s Dr Anneka Anderson at the time. The Labour government launched a five-year “roadmap” aiming to manage rheumatic fever, with the former associate health minister Barbara Edmonds calling it an “entirely preventable disease”. Since then, the coalition government has dismantled the Māori Health Authority, though the roadmap has survived, according to Health NZ’s website. There’s been little acknowledgement since, but the current minister Shane Reti mentioned rheumatic fever when defending his government’s less centralised approach to healthcare, reported the Northern Advocate in March.

Health workforce in the spotlight

Everything we’ve talked about above contributes to an unpleasant cocktail that has the health workforce on edge. And the chilly temperatures aren’t the only reported freeze. Though Health NZ has since denied it, RNZ reported yesterday morning that budget cuts at Health NZ had led to a hiring freeze on new graduates, with the nurses’ union expressing concern it would mean health workers couldn’t find a job. “We need more of them,” said union boss Paul Goulter. “We’re using internationally qualified nurses, immigrant nurses at the moment, but that does not and cannot substitute for the need to train our own and give them good jobs.” Health NZ has hit back, rejecting any statements claiming there was a freeze on new recruits. “The graduate process is still underway, applicants have expressed their preferences and matching is happening across NZ,” Health NZ chief nurse Nadine Gray said, as Newshub reported here.