A Tongan cybersecurity expert says the country’s health data hack is a “wake-up call” for the whole region.

Siosaia Vaipuna, a former director of Tonga’s cybersecurity agency, spoke to RNZ Pacific in the wake of the June 15 cyberattack on the country’s Health Ministry.

Vaipuna said Tonga and other Pacific nations were vulnerable to data breaches due to the lack of awareness and cybersecurity systems in the region.

“There’s increasing digital connectivity in the region, and we’re sort of . . . the newcomers to the internet,” he said.

“I think the connectivity is moving faster than the online safety awareness activity [and] that makes not just Tonga, but the Pacific more vulnerable and targeted.”

Since the data breach, the Tongan government has said “a small amount” of information from the attack was published online. This included confidential information, it said in a statement.

Reporting on the attack has also attributed the breach to the group Inc Ransomware.

Vaipuna said the group was well-known and had previously focused on targeting organisations in Europe and the US.

New Zealand attack
However, earlier this month, it targeted the Waiwhetū health organisation in Aotearoa New Zealand. That attack reportedly included the theft of patient consent forms and education and training data.

“This type of criminal group usually employs a double-extortion tactic,” Vaipuna said.

It could encrypt data and then demand money to decrypt, he said.

“The other ransom is where they are demanding payment so that they don’t release the information that they hold to the public or sell it on to other cybercriminals.”

In the current Tonga cyberattack, media reports say that Inc Ransomware wanted a ransom of US$1 million for the information it accessed. The Tongan government has said it has not paid anything.

Vaipuna said more needed to be done to raise awareness in the region around cybersecurity and online safety systems, particularly among government departments.

“I think this is a wake-up call. The cyberattacks are not just happening in movies or on the news or somewhere else, they are actually happening right on our doorstep and impacting on our people.

Extra vigilance warning
“And the right attention and resources should rightfully be allocated to the organisations and to teams that are tasked with dealing with cybersecurity matters.”

The Tongan government has also warned people to be extra vigilant when online.

It said more information accessed in the cyberattack may be published online, and that may include patient information and medical records.

“Our biggest concern is for vulnerable groups of people who are most acutely impacted by information breaches of this kind,” the government said.

It said that it would contact these people directly.

The country’s ongoing response was also being aided by experts from Australia’s special cyberattack team.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

The Marshall Islands is a live demonstration that the omicron BA.5 variant is the most contagious covid variant yet to appear.

In the first five days of the outbreak in the Marshall Islands, more than 10 percent of the population in Majuro, the capital, has tested positive, reports the Ministry of Health and Human Services.

From initial confirmation of a handful of positive cases in the community on August 8, the number of positive cases skyrocketed to the one-day total of 1064 testing positive on Saturday, August 13, at the three community-based “alternative care sites” established to test and treat local residents.

This brings Majuro’s total in the wake of the outbreak to more than 2000 cases in a population estimated at 20,000. There were nine early hospitalisations, with most reported to be recovered by Sunday.

President David Kabua on Friday signed a proclamation of a “State of Health Disaster,” which outlines duties of all ministries and government agencies to respond.

It also gives the government the power to access emergency funding for the response to the initial outbreak.

Health authorities reported two deaths in the first week — both men. The first was a 23-year-old man, the second a 69-year-old.

Both pronounced dead
They were both pronounced dead on arrival at Majuro Hospital’s emergency room, Health officials said. Their vaccine status was not announced.

Majuro experienced a chaotic first couple of days as alternative care sites (ACS) were rolled out at two local schools and at an outdoor sports court, with thousands of islanders crowding in to get tested.

By Friday the influx of hundreds of volunteers to support the Ministry of Health and Human Service in managing the flow of people led to improvements in the service.

“What we are seeing at these sites is what we expected, the ACS sites are getting better and more organised as we go along,” said Health Secretary Jack Niedenthal Sunday.

“Much of the chaos is beginning to die down, though it is still there for sure, but this will continue to get better.”

Spread was not contained to Majuro Atoll, the capital. Within a day of the initial confirmation of positive cases in the Majuro community last Monday, the first case was identified on Ebeye, the densely populated community next door to the US Army’s Reagan Test Site at Kwajalein Atoll.

In addition, several isolated outer atolls at week’s end were reporting multiple residents with covid-like symptoms.

All remote island flights suspended
All flights on Air Marshall Islands and all government ships to remote islands were suspended August 9 in an effort to contain the spread. But travellers from the previous week to remote islands unwittingly caused the spread.

August 12, a special Air Marshall Islands flight took a health team to Wotje Atoll, confirming multiple positive cases, training the local health aide to conduct further testing, and leaving a supply of PaxLovid and other therapeutic medicines for islanders, according to health officials.

RMI COVID-19 Update eo in an 08-12-2022. pic.twitter.com/lsjjXfWVin

— V7AB Radio Marshall Islands (@v7abradio) August 11, 2022

Health teams were attempting to visit other remote islands for similar follow up Sunday, but all AMI pilots reportedly tested positive, putting flights in limbo.

Although the government did not require a lockdown, most churches cancelled in-person services Sunday and the one main road in the capital atoll was unusually quiet as people appeared to be staying home.

Restaurants also saw the number of customers decline dramatically, although most continued to see ongoing demand for takeout meals.

“We at the Ministry of Health and Human Services are very proud of the response that has come in from all corners of our country to help us deal with the health crisis,” said Niedenthal.

The ministry struggled in the initial phase of the outbreak with more than 200 of its staff, including many doctors and nurses, testing positive for covid — many exposed before they knew it was circulating in the community.

Covid-free success
Until last week the Marshall Islands had successfully employed some of the world’s strictest quarantine rules for people entering the North Pacific nation. This had kept it covid-free for the first two-and-a-half-years of the covid pandemic.

A reduction of quarantine time in recent weeks, coupled with unprecedented numbers of people coming in through the managed quarantine process is suspected to be the cause of the outbreak.

The government had earlier announced it was going to eliminate the managed quarantine requirement and open the borders on the October 1.

“As expected, the outbreak continues to gain strength,” Niedenthal said on Sunday.

“We had over 1000 cases in Majuro yesterday, almost double from the previous day. About 75 percent of the people we test are positive, which is an incredibly high positivity rate.”

Outbreak escalating
Last week, as the outbreak was escalating, Majuro traditional leaders sent a letter to President Kabua calling for the borders to be closed and opposing the announcement that medical teams arriving this week would not be required to quarantine.

The medical surge support teams are from the US Centers for Disease Control and other agencies. Niedenthal emphasised the importance for delivering services to the public by these medical professionals.

He described these as “boots on the ground medical support professionals” and said they would be tested on arrival and then sent right into the field to support ongoing services by local Health authorities.

“As a country we have moved from prevention to mitigation because we are now fighting this disease,” he said.

“The days of quarantine upon arrival are now over. I know some people are nervous about this, but we at the Ministry of Health are not and we are the ones on the frontline,” Niedenthal said.

“Please respect these public health decisions. We knew this would have to be a fast shift in strategy that would trouble some people because we had been working so hard (and) successfully to prevent the disease from coming into the Marshall Islands.”

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

Late last month, New Zealand Health Minister Andrew Little stated what most who work in health already know.

Healthcare is all about people – the people being cared for and the people doing the caring.

Population growth, ageing and a pandemic mean there is no shortage of those needing care, but in New Zealand and globally, there is a chronic shortage of healthcare workers.

Little stopped short of calling it a crisis, but researchers and international agencies alike agree with a survey of New Zealand doctors that the health workforce is in crisis.

In 2016, the World Health Organisation (WHO) projected a global shortage of 18 million healthcare workers by 2030. That was before the covid-19 pandemic. Between 80,000 and 180,000 healthcare workers have died globally during the pandemic’s first 16 months, according to the WHO’s conservative estimate.

“Public statements from political leaders that there is ‘no crisis’ in the health system have seemed increasingly out of step with doctors’ experience over the past year” https://t.co/dXMhA38XIO

— Emma Espiner (@emmawehipeihana) July 11, 2022

Add to this the impact the pandemic has had on the mental health of frontline health staff, including reports of post-traumatic stress disorder (PTSD), and a healthcare workforce seven times more likely to have severe covid and now carrying the burden of long covid.

It’s clear healthcare is no longer the attractive sector it once was.

A highly mobile workforce and a global shortage
Like the cost-of-living crisis, the health workforce shortage is not unique to Aotearoa New Zealand.

This year’s budget included NZ$76 million for medical training and primary care specialists, but doctors who started training this year will not be specialists until 2034.

Meanwhile, Labour’s solution is to undertake an international recruitment drive. It is hailing New Zealand as one of the easiest places in the world for healthcare workers to come to. But are our newly opened borders attractive enough?

Overseas recruitment drive for nurses gains ‘good response’ https://t.co/RZrM4fW67L

— RNZ News (@rnz_news) July 13, 2022

In my health economics lectures I often use an anecdote about the Indian doctor who gets a job in the UK (colonial ties and a multicultural society), the British doctor who moves to Canada (less administration and more family friendly hours), the Canadian doctor who moves to the United States (specialists have much higher earning potential), and the US doctor who undertakes missionary work in India.

This highlights two issues: the health workforce is highly mobile and employment isn’t always about money. Aotearoa New Zealand is competing in a global health workforce market, and minister Little recently acknowledged the health sector as “fiercely competitive”.

But this isn’t a new phenomenon for New Zealand.

The health workforce in New Zealand has one of the largest shares of migrant workers, with 42 percent of doctors and almost 30 percent of nurses foreign-born (second only to Israel and Ireland, respectively). This is much higher than the aggregate estimates showing one in six doctors practicing in OECD countries studied overseas.

The OECD estimates the number of foreign-born doctors and nurses in OECD countries has increased by 20 percent, twice the growth rate of the overall increase across the workforce. This is what is most concerning.

The health workforce is not equally distributed. Migration of workers from low- and middle-income countries to high-income countries like Aotearoa New Zealand is a real threat to achieving universal health coverage and sustainable development goals.

New Zealand needs to be mindful that promoting our open borders is not at the expense of under-performing health systems with much greater need.

Losing healthcare workers to Australia
Outflow is also a problem in New Zealand, with New Zealand-trained doctors and nurses crossing the Tasman every year. Add to this the international recruits leaving New Zealand for Australia and there most definitely is a health workforce crisis.

As our nearest neighbour, Australia is aggressively recruiting staff. And like pavlova and Phar Lap they are happy to claim what is ours as theirs. An easier route to citizenship and voting rights will make Australia even more desirable.

How can New Zealand compete in this market? Minister Little refers to encouraging New Zealanders to return home, including lifting their pay. Research shows it’s not all about income. Location and professional development opportunities are important factors when choosing career moves.

The healthcare reforms helped tempt me back to New Zealand after 22 years away. Perhaps working in a system which has equity as its focus may encourage those who are clinically trained to return as well.

There is considerable research to inform policies around retention and recruitment. The New Zealand Ministry of Health may wish to look to the UK, which was historically dependent on EU health and care workers and now has a health workforce depleted by both Brexit and the pandemic.

In the recent LSE-Lancet Commission on the future of the NHS, British scholars argued a sustainable workforce needed integrated approaches to be developed alongside reforms to education and training that reflect changes in roles and the skill mix, and more multidisciplinary working.

The LSE-Lancet Commission authors flagged the need for better workforce planning. New Zealand’s approach to workforce forecasting has also been criticised previously.

Planning aside, a possible solution worthy of discussion is the required skill mix of the workforce, particularly with technological advancements and changing health needs. For example, the introduction of non-medical prescribers has improved job satisfaction, released clinical time and increased patient access.

New Zealand’s once-in-a-generation health reforms offer a logical time to undertake workforce reforms. We need to learn from our own historical mistakes and avoid disconnecting the workforce from the policy reforms.

If minister Little and the ministry are to solve this, he will first need to admit there is a health workforce crisis.

Aotearoa New Zealand is unfortunately not alone in its quest to adequately staff healthcare, but the transformation of the health sector to create a more equitable, accessible, cohesive and people-centred system means New Zealand is uniquely placed to put those people who deliver care at the centre.

Dr Paula Lorgelly is professor of health economics, University of Auckland. This article is republished from The Conversation under a Creative Commons licence. Read the original article.

Article by AsiaPacificReport.nz

After guiding New Zealand through two and a half years of a pandemic, Dr Ashley Bloomfield’s time as Director-General of Health has come to an end.

We look back on some of the key moments during his time in the role:

22 May 2018
Dr Ashley Bloomfield was named as the new Director-General of Health while he was serving as the acting chief executive of Capital and Coast District Health Board.

2019
The health system faced some big challenges in 2019. Dr Bloomfield fronted health responses to both a measles outbreak and the Whakaari/White Island disaster.

27 January 2020
“Kia ora koutou katoa, welcome to the Ministry of Health, thank you very much attending this briefing this afternoon. My name is Dr Ashley Bloomfield, I’m the Director-General of Health.”

After two and a half years of a pandemic, it is probably hard to remember a time when Dr Ashley Bloomfield needed to introduce himself.

Before New Zealand had its first case of covid-19, back when it was referred to simply as a coronavirus (WHO would name it covid-19 on 12 February 2020), Dr Ashley Bloomfield and Director of Public Health Dr Caroline McElnay held a media stand-up.

Like most of the early briefings, it was held at the Ministry of Health.

It was two weeks after the first confirmed case outside of China had been identified and across the ditch, Australia had four cases. There had been 56 deaths worldwide.

28 February 2020
Almost exactly one month later, New Zealand’s first covid-19 case was confirmed in someone that had returned from overseas.

Reminiscent of a format we would come to know more intimately as time went on, the evening news would cut to a live press conference where Dr Bloomfield and then-Health Minister David Clark would provide more details of New Zealand’s first case. (Prime Minister Jacinda Ardern was in Australia at the time.)

The following day, supermarkets would see a rush of customers buying up toilet paper, hand sanitiser and tinned food.

March 2020
We would start to hear a lot more from Dr Bloomfield as the second, third and fourth (who had been at a Tool concert) cases of covid-19 were confirmed in early March.

By the end of the month New Zealand would be in lockdown and Dr Bloomfield had become a daily part of our lives.

“It did feel a little bit like I was having a performance review at one o’clock every day, broadcast live on television. But that’s as it should be — your job is to ensure that we’re being held accountable for our response,” he said.

Daily cases had jumped to numbers in the eighties and the briefings had shifted to the Beehive, against a backdrop of yellow and white striped Unite Against Covid-19 branding.

On 29 March, during the 1pm briefing, Bloomfield would announce New Zealand’s first covid-19 death.

4 May 2020
“No new cases”. For the first time since New Zealand went into level 4 lockdown on 25 March, Dr Bloomfield announced there were no new cases of covid-19. It would be a phrase we would hear more of as the first community outbreak would start to slow.

And it evoked such emotion that “There are no new cases of covid-19 to report in New Zealand today” came second place in Massey University’s Quote of the Year.

August 2020
In an effort to encourage people to test for covid-19, Dr Bloomfield had his first covid-19 PCR test while filmed at a community testing site.

“It was much less painful than tackling Billy Weepu on the rugby field a couple of weeks ago.”

*Raises eyebrows
With millions of people stuck at home in isolation watching daily media briefings, it was no surprise that Dr Bloomfield would find himself in meme-territory.

This was Dr Bloomfield’s response when he was asked about 5G in 2020:

And a year later when Covid-19 Response Minister Chris Hipkins said people should go outside and “spread your legs”.

The Guardian on the Hipkins quote.

Festival debut
Who would have thought Dr Bloomfield would grace the main stage at Rhythm and Vines festival?

December 2020
Dr Bloomfield was awarded the New Zealand Medical Association’s highest accolade — The Chair’s Award

17 August 2021
The prime minister announced another nationwide lockdown after a case, assumed to be the delta variant, was detected. That meant the 1pm briefings, and daily doses of Dr Bloomfield, were back too.

22 September 2021
As New Zealand tackled the delta outbreak, Dr Bloomfield broke the news that we may never get to zero cases of covid-19.

A portrait pie of Dr. Ashley Bloomfield. Photo: Supplied / Devoney Scarfe

October 2021
During Super Saturday, Dr Bloomfield was caught on camera busting a move at one of the community events.

Dr Ashley Bloomfield’s dance moves.

6 April 2022
Announced he was stepping down.

“It seems we’re at a good point in terms of the pandemic, the response is shifting, I’m also confident that the system is in good hands with the changes that are afoot, and most certainly my family will be very pleased to have a little more of my time,” he said.

May 2022
Dr Bloomfield tested positive for covid-19 while he was at the World Health Assembly in Geneva, Switzerland.

Professional history

• In May 2018, Dr Bloomfield was appointed the new Director-General of Health.
• Dr Bloomfield was the acting Chief Executive for Capital & Coast District Health Board from 1 January 2018.
• From 2015-2017, he was chief executive of the Hutt Valley District Health Board – the first clinician to lead the Hutt Valley District Health Board.
• In 2017 Dr Bloomfield attended the Oxford Strategic Leadership Programme.
• Prior to becoming chief executive at the Hutt Valley DHB, Dr Bloomfield held a number of senior leadership roles within the Ministry of Health, including, in 2012, acting Deputy Director-General, sector capability and implementation.
• From 2012-15 he was Director of Service, Integration and Development and General Manager Population Health at Capital & Coast, Hutt and Wairarapa District Health Boards.
• From 1999-2008 he was a Fellow of the Australasian Faculty of Public Health Medicine. Since 2008 he has been a Fellow of the NZ College of Public Health Medicine.
• In 2010-2011 he was Partnerships Adviser, Non-Communicable Diseases and Mental Health at the World Health Organisation, Geneva.
• Dr Bloomfield obtained a Bachelor of Medicine and Bachelor of Surgery at the University of Auckland in 1990.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz

A second person with covid-19 who was isolating at home has died in New Zealand, the Ministry of Health has confirmed.

In this afternoon’s covid media briefing, where it was revealed there were 163 new community cases of covid-19 today, Director of Public Health Dr Caroline McElnay said St John Ambulance attended a call this morning after an emergency call to an address in the suburb of Mount Eden and found a person dead on arrival.

The man in his fifties is understood to have been recently treated in hospital.

“Health authorities in Auckland are working with the police and ambulance crew to review the circumstances around the death,” Dr McElnay said.

Deputy Prime Minister Grant Robertson said it was his understanding the dead man was admitted to hospital on Monday and discharged himself from the hospital on Wednesday.

He said there had been phone contact with them on Wednesday and Thursday.

“I am confident in the system. Obviously when we introduce a new system like self-isolation we need to continully monitor it and that’s happening,” he said.

Looking at wider system
“Between the Ministry of Health and the Auckland regional public health, they’re looking at both these specific incidents, but also at the wider system.

“It’s important to note there are still enquiries going on about the cause of death at the moment and we’ve just got to all make sure we allow that to occur.”

Robertson said before it was decided that a person could self-isolate, there was a public health assessment of issues like the circumstances of someone’s accommodation.

A medical assessment also determined the person’s suitability as a candidate for self-isolation.

“We’re not in a position at the moment to be able to say what the cause of death was for either patient,” Roberston said.

Dr McElnay said the coroner would look at both deaths.

Article by AsiaPacificReport.nz

A group of doctors have hit the phones to support Pasifika families who have tested positive for covid-19 and been transferred into managed isolation.

The chairperson of the Royal New Zealand College of GPs’ Pasifika chapter, Monica Liva, said about half the people infected with the virus in Auckland were Pasifika.

She contacted Pasifika doctors who could talk to people in their first language and hear any concerns they might have.

“It’s also to take off the load off the MIQ medical team, so that they can focus on the urgent covid-19 needs,” Dr Liva said.

Dr Liva said she had been heartened by the number of GPs agreeing to help.

TikTok take-up for vaccines
The North Island iwi Ngāti Porou have launched a covid-19 vaccination campaign aimed at rangatahi using the social media platform TikTok.

The video challenge calls on young people to encourage their whānau to get vaccinated.

Ngāti Porou’s Taryne Papuni said TikTok was a natural first pick to get the message across.

“That’s one of the mediums that they’re always on, always on the TikTok or the Instagram.

“We thought yeah, we can reach a lot of our people, a lot of our young ones that way and hope that the young ones will actually lead for their elders.”

Earlier this week, Ngāti Porou hosted a vaccinations clinic at Te Poho o Rawiri Marae.

There have also been multiple events on this weekend targeting Pasifika vaccination rates.

18 new community cases in NZ
The Health Ministry reported 18 new community cases of covid-19 in New Zealand today, with all but two epidemiologically linked to previous cases.

There was no media conference today. In a statement, the ministry said there were now a total of 1165 community cases associated with the latest outbreak of the delta variant of the virus.

It said 934 of Auckland’s 1148 cases had now recovered.

The ministry said there were five cases in the past fortnight that were still not linked to previous cases.

The 16 linked cases reported today are all in isolation at home or in MIQ.

This article is republished under a community partnership agreement with RNZ.

Article by AsiaPacificReport.nz