Swine Flu 2009/2010

As Covid-19 sweeps across the world, Eyewitness examines another outbreak that captured the headlines a decade ago.

In July 2009, Lou Lovegrove was a working as a bus driver in Christchurch.

"We assume that's where he got it from", his wife Julie Lovegrove said.

'It' was swine flu, otherwise known as Influenza A H1N1 PDM 2009: the pandemic virus that swept through New Zealand in 2009 and 2010.

The 54 year old came home from work feeling unwell.

"Ï didn't realise what it was. I thought it was a cold and he got sick" Mrs Lovegrove said.

She and the couple's two children also caught the virus but for them it manifested more like a common cold.  

“We were fine but he just slowly got worse.”

Mr Lovegrove, who used a machine for his sleep apnoea, was taken to hospital, put on a ventilator and then placed in an induced coma.

After a week hospital staff tried to bring him out but he slipped back into a coma and suffered a stroke.

Julie Lovegrove remembers feeling a mixture of emotions as her husband's health fluctuated wildly.

"To me it was just a blur."

She had to work but took her children to the hospital to see him every night.

"He looked as though he was getting better and then he didn't.  It was just this roller coaster of getting better, no, yes, no, yes, no."

Lou had been in the hospital for a fortnight when the realisation came.

"He just wasn't coming out. I just knew."

"His whole body just collapsed basically. The virus ate his lungs. His internal organs slowly failed.”  Mrs Lovegrove said.

"They called me in and said 'His heart's going,’ and they wanted to take him off life support.’"

Together Julie Lovegrove and her children made the devastating decision.

“We said ‘Ýes.’ Än hour later he died. It was so quick. Pretty traumatic.”

It had been just over three weeks since he first came home sick.

Ministry of Health figures showed 49 New Zealanders died from swine flu in 2009.  Lou Lovegrove was one of them

“No one saw that coming”

While deaths from a new virus were to be expected, the provenance and type of influenza were not.

Wellington Professor of Public Health and Epidemiologist, Michael Baker said health authorities had been long been anticipating a pandemic, just not this one.

“For a decade the world had been preparing for a different influenza pandemic: H5N1 Avian Influenza Pandemic."

Professor Baker thought it would start in South East Asia or China as there had been avian flu scares there during the 1990s.

“In fact the influenza we got was a very different one, H1N1 and it came from the Americas and I think no one saw that coming.”

The virus originated in Mexico and the World Health Organisation declared the outbreak of novel pandemic H1N1 Influenza to be a public health emergency of international concern on Anzac Day 2009.

“In New Zealand on that same day a general practitioner identified cases of influenza-like illness in a group of high school students who had just returned from a three week trip to Mexico,” Professor Baker said.

A number of the pupils had reported flu-like symptoms on the flight home.

“Nine of them were later confirmed as our first cases of H1N1," he said.

Virologist Lance Jennings said the virus was initially referred to as Mexican Flu before becoming commonly known as Swine Flu as it was believed to have emerged from pigs.

However the disease was actually a triple reassortant virus, that included genetic material from three sources.

“It contains rare genetic material from avian species, human and two pig lineages, so it’s a composite virus,” Dr Jennings said.

However, by crossing barriers, the virus was no longer technically swine flu and instead became known as Influenza Type A H1N1 PDM 2009, he said.

New Zealand now needed a strategy to fight it.

Making Plans

Tucked away in a box that Lance Jennings hasn’t opened since the Christchurch earthquakes is a piece of paper.

You could say it’s an historic document.

“I have New Zealand’s first pandemic plan on the back of an envelope that I wrote with the Australians at a conference in Cairns in 1996.”

Subsequently New Zealand and Australia met to discuss a regional pandemic preparedness plan but New Zealand then “moved forward on its own”, Dr Jennings said.

The country’s first pandemic plan was published in 1997, the same year that the World Health Organisation produced its own pandemic preparedness plan.

“Since that time it has been a living document.”

That meant key information gained during outbreaks of Avian Flu and SARS were added into the plan.

The strategy also included a worst case scenario based on the 1918 Influenza Pandemic during which 9000 New Zealanders died in two months.

Ultimately the H1N1 pandemic fell short of that impact, instead affecting New Zealanders on a level much closer to that of seasonal influenza than a severe new pandemic influenza, Professor Baker said. 

Still it was a busy time for Lance Jennings. He was working with the Ministry of Health, advising on how the plan should be activated, whilst also running the virology service for Canterbury Health Laboratories.

“They were long hours and then, of course, on top of that you’d have teleconferences, as well, to keep up with what was going on internationally.”

There was an increased demand for contact tracing as the number of cases rose. Separate clinics were set up to triage patients and to screen anyone returning from overseas.

“That put a lot of pressure on the laboratory system and the public health systems as well. During a pandemic situation you have staff getting sick as well.”

That first wave of H1N1 peaked in July 2009 but New Zealand hadn’t seen the last of the virus.

Round Two 

Another wave of H1N1 struck in 2010, ‘effectively mopping up those people who had not been affected in 2009,’ Lance Jennings said.

“And, yes, we continued to see more severe outcomes with patients needing hospitalisation, needing respiratory support and sadly dying from 2010.”

One Christchurch woman hit by the virus was Jo Hockham, who went to her GP feeling ‘revolting’.

“Terrible flu, body aches, nausea. It was everything.”

Despite her poor health, she panicked when she told she had swine flu.

“I felt like I was going to die when I found out. That’s when things escalated for me because people were getting really sick and you can die of it,” Ms Hockham said.

She self-isolated at home but was forced to leave her bed when the first major Canterbury earthquake hit in September 2010.

Her family evacuated their seaside home, fearing a tsunami, and drove up a nearby hill to spend the night in their car.

“And I was freezing so I was shivering because I didn’t have enough clothes on for my fevers that I was having so it wasn’t an ideal time.”

The Ministry of Health indicated that second wave of the virus caused a further 20 deaths by late 2010.

Still, Lance Jennings believed New Zealand coped “extremely well” with the outbreak. He said by following the pandemic plan authorities were able to prepare the public beforehand.

“They needed to know what hand and respiratory hygiene was, to protect themselves. They needed to have adequate food and water if they had to quarantine themselves.”

“So community resilience was communicated at that time.”

As the pandemic progressed, clinicians learnt that H1N1 was related to a previous influenza which meant older people already had antibodies and weren’t as severely affected.

They discovered that those most at risk were children and pregnant women and this meant health authorities could target those groups with free flu jabs, which by early 2010 included the swine flu strain.

And those lessons all went back into that “living document” that had been first created on the back of an envelope a decade earlier.

“We had a pandemic plan. We had a good knowledge base of what was going on internationally.”

“And, in a lot of respects, knowledge is power.”