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Community key to pandemic protocols

John Ryan McLane says the Ebola pandemic in West Africa during 2014-15 was more in line with what people see in Hollywood depictions of mass health crises. PHOTO/GETTY IMAGES

GIANINA SCHWANECKE
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A Featherston resident with more than 20 years of experience in public health settings, including on the frontlines of the Ebola pandemic, says working with the community is key.

Featherston resident Dr John Ryan McLane. PHOTO/SUPPLIED

An ambulance crewman just out of high school, John Ryan McLane went on to become a nurse while completing his Bachelor of History.

From there it was on to a Masters in International Relations, and Masters of Public Health.

“I’ve always been fascinated by current events in history, but it’s very satisfying to have the very hands on, concrete experience that comes from working in the field,” he said.

“I really became fascinated by the health of entire populations and how that was affected by their environment, politics and social issues.

“From there it was a natural fit in pandemic and infectious diseases work.”

His PhD work with the University of Otago, focusing on the 1918 influenza pandemic in the Samoas, Tonga and Fiji, brought him to New Zealand and eventually Featherston after landing a role with the New Zealand government.

“Western Samoa, as it was known then, had the world’s highest death rate, whereas American Samoa was one of a few places in the world where no one really died.”

He attributed the different mortality rates to a range of factors including differing political, physical, economic and social conditions.

For example, the American Navy helped the American Samoan chiefs to implement quarantine steps, which included closing the border for two years.

But in neighbouring Western Samoa which had been occupied first by German colonists and then the New Zealand military, the traditional nobles had been weakened and there was no community authority to lead efforts to protect against the pandemic.

“In 1918 and in pandemics since, leadership has been important, but it’s been just as important to get the locals’ agreement that it is in their interest and worth their sacrifices to stop the disease from spreading,” he said.

McLane found many of the lessons from his study of the 1918 influenza pandemic still held true today when he was sent to the frontlines during the Ebola pandemic in 2014-2015.

“When the Ebola crisis became a global crisis, New Zealand was one of the countries which spun up a response,” he said. “I was part of that.

“Once we got in place all the guidelines to deal with any potential exposure and screening at the border, we worked with the Australians to open up a clinic in one of the centres of the outbreak in Sierra Leone.

“I volunteered and went over and worked for about two months during the height of the pandemic in West Africa in the red zone treatment centre as a nurse.”

He said the Ebola pandemic was more in line with what people see in Hollywood depictions of mass health crises.

“It had very dramatic symptoms and a very high death rate. About two-thirds of those who were infected probably died despite our best efforts.”

It also included the most severe infection control measures which McLane had experienced.

“We could only go into the red zone for two one-hour periods each day because we would overheat in our suits so quickly.”

He said pandemics had to be able to target some area of vulnerability in our populations to take off in a way that is “society changing”.

“Ebola impacted the local communities but was able to be kept generally localised to West Africa.”

Despite this, the Ebola pandemic had led to some positive changes.

Like the 1918 influenza pandemic which led to the creation of national and local public health organisations and increased formalisation of the medical profession, the Ebola pandemic led to the rapid creation of tests and a vaccine, and work done to speed their creation in future outbreaks.

McLane said globalisation was a help rather than a hindrance in this regard, as medical professionals and governments worked together.

“We’ve known for a long time that society is vulnerable to a respiratory pandemic.

“The flip side to the fact that we are at risk because people travel so much globally is that it in some ways it’s really reduced our vulnerabilities.

“It allows us to recognise early when outbreaks occur, collaborate to develop vaccines or treatments and distribute those.”

He said one of the reasons we haven’t had an outbreak of this scale in 100 years was because of globalisation and better communication.

“One-hundred years ago many of the Pacific Islands learned about the influenza pandemic from newspapers which were carried on the same ships which carried the infection. Now we are aware in near-real time of outbreaks across the globe.

“All I can really say is that history shows that pandemics are a community-wide crisis, which has to be addressed by the population,” he said. “They cannot be solved only from above.”

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