ABSTRACT

Public health lessons from one pandemic become the planning assumptions for the next one. Aotearoa New Zealand’s 2017 pandemic plan was derived from past experience of influenza. When Covid-19 emerged as a major global health threat, it took time for the realisation to crystallise that this infection was so different from influenza that it required a completely new pandemic response strategy. In this paper we describe how early evidence about SARS-CoV-2 transmission from China led to the adoption of an elimination strategy in Aotearoa New Zealand, making it the first country to choose elimination as a specific policy response. We discuss how further evidence has shaped the selection and design of Covid-19 pandemic control measures such as border restrictions, case and contact management, hygiene practices and use of face masks, physical distancing, and vaccines. This experience demonstrates the need for a different approach to the design of the next national pandemic plan. We identify key early evidence that will be required to develop a flexible and appropriate public health response to a new pandemic threat. We present a framework for a new pandemic plan that aims to learn from the Covid-19 experience by making as few limiting assumptions as possible.