How Aotearoa New Zealand rapidly revised its Covid-19 response strategy: lessons for the next pandemic plan.

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. [ABSTRACT FROM AUTHOR]