Covid-19 notifications in Tairāwhiti nearly doubled to 26 for the week ending 5 October, compared to 14 cases the previous week. Nearly all of the increase was due to 6 cases notified on Friday 29 September and 10 cases on Monday 2 October. Since Monday, there have only been one or two cases notified each day. The wastewater data continued to decline for the week ending 1 October, but the wastewater collection is from early in the week; so we may see an increase next week. There have been no Covid hospitalisations since 21 September.
Typhoid cluster update
The number of cases in the cluster continues to grow. Last week, there were six confirmed and one probable case; now there are eight confirmed and three probable cases. All the cases remain in group of 36 workers living together in five locations; all ate food cooked by the likely source.
Other notifications
Last week, we only had one non-Covid notification: a case of Shiga Toxin-Producing Escherichia coli (STEC). On 1 September, I wrote on about this potentially life-threatening infection. And in more detail in: gastro in Tairawhiti
We again had an STEC notification this week, but I wonder if this is a case where the organism is present but not causing disease, but more a reflection of dysbiosis - an imbalance of the bacteria in the gut following another enteric infection.
Tuberculosis
The only other notification was for tuberculosis (TB) in a person from a high incidence country. In other words, the infection was likely not locally acquired, but we need to follow contacts to make sure of no local spread.
A person with TB is usually only infectious when they have symptoms (coughing). The number of TB organisms seen in the sputum gives an indication of the level of infectiousness; in this case none were seen. We await more test results to confirm the diagnosis.
This was the first TB notification since December 2021. Since January 2020, seven TB cases were notified, including this one. Only two of these seven were likely locally acquired - probably when they were children at a time when there was a high prevalence of TB in Tairāwhiti. Good that this is no longer the case.
Public Health and Politics
“Medicine is a social science and politics is nothing else but medicine on a large scale. Medicine as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution; the politician, the practical anthropologist, must find the means for their actual solution”. Rudolf Virchow 1848.
Virchow has been called the father of modern pathology and founder of social medicine - recognizing the importance of the social determinants of health.
In this political season, heath seems to play a minor role; despite the growing gap between demand for health services and its supply. And the fundamental importance of good health for a good life.
The need to invest more in prevention does not have the same demand as for more treatment using ever more expensive therapies. Voters must demand more of politicians to address the commercial and social determinants of health.
Next week
As always, look forward to your feedback and suggestions; and any questions on the data. Thank-you!