Improvements and Persisting Challenges in COVID-19 Response Compared with 1918-19 Influenza Pandemic Response, New Zealand (Aotearoa)

Exploring the results of the COVID-19 response in New Zealand (Aotearoa) is warranted so that insights can inform future pandemic planning. We compared the COVID-19 response in New Zealand to that for the more severe 1918-19 influenza pandemic. Both pandemics were caused by respiratory viruses, but the 1918-19 pandemic was short, intense, and yielded a higher mortality rate. The government and societal responses to COVID-19 were vastly superior; responses had a clear strategic direction and included a highly effective elimination strategy, border restrictions, minimal community spread for 20 months, successful vaccination rollout, and strong central government support. Both pandemics involved a whole-of-government response, community mobilization, and use of public health and social measures. Nevertheless, lessons from 1918-19 on the necessity of action to prevent inequities among different social groups were not fully learned, as demonstrated by the COVID-19 response and its ongoing unequal health outcomes in New Zealand.