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NZMJ 1513.Indd Journal of the New Zealand Medical Association Vol 133 | No 1513 | 24 April 2020 COVID-19—the frontline (a GP perspective) The case for New Zealand to have its own COVID-19 vaccine programme Towards elimination of tuberculosis in New Zealand Changes to management The post-lockdown Variation in volumes and of a non-pandemic illness period should be characteristics of trauma during the COVID-19 used to acquire patients admitted to a level pandemic: case study of effective therapies for one trauma centre during invasive management of future resurgence in national level 4 lockdown for acute coronary syndrome SARS-Cov-2 infections COVID-19 in New Zealand Publication Information published by the New Zealand Medical Association NZMJ Editor NZMA Chair Professor Frank Frizelle Dr Kate Baddock NZMJ Production Editor NZMA Communications Manager Rory Stewart Diana Wolken Other enquiries to: NZMA To contribute to the NZMJ, fi rst read: PO Box 156 www.nzma.org.nz/journal/contribute The Terrace Wellington 6140 © NZMA 2020 Phone: (04) 472 4741 To subscribe to the NZMJ, email [email protected] Subscription to the New Zealand Medical Journal is free and automatic to NZMA members. Private subscription is available to institutions, to people who are not medical practitioners, and to medical practitioners who live outside New Zealand. Subscription rates are below. All access to the NZMJ is by login and password, but IP access is available to some subscribers. Read our Conditions of access for subscribers for further information www.nzma.org.nz/journal/subscribe/conditions-of-access If you are a member or a subscriber and have not yet received your login and password, or wish to receive email alerts, please email: [email protected] The NZMA also publishes the NZMJ Digest. This online magazine is sent out to members and subscribers six times a year and contains selected material from the NZMJ, along with all obituaries, summaries of all articles, and other NZMA and health sector news and information. Subscription rates for 2020 New Zealand subscription rates Overseas subscription rates Individuals* $349 Individual $486 Institutions $604 Institutions $650 Individual article $33 Individual article $33 *NZ individual subscribers must not be doctors (access is via NZMA Membership) New Zealand rates include GST. No GST is included in international rates. Note, subscription for part of a year is available at pro rata rates. Please email [email protected] for more information. Individual articles are available for purchase by emailing [email protected] NZMJ 24 April 2020, Vol 133 No 1513 ISSN 1175-8716 © NZMA 2 www.nzma.org.nz/journal CONTENTS EDITORIAL 53 8 Ocular syphilis in Paci c peoples— COVID-19—the frontline are we making misdiagnoses (a GP perspective) secondary to yaws? Kate Baddock Hannah Gill, Helen V Danesh-Meyer, Joanne L Sims, Mitzi Nisbet, ARTICLES Rachael L Niederer 11 61 The New Zealand oral and Trends in prescription medicine maxillofacial surgeon workforce use by older people in in 2017–18: characteristics, New Zealand 2010– 2015: a practice and prospects national population-based study John B Bridgman, Graham Fulton, Andrew M Tomlin, David J Woods, Simon M-Y Lou, W Murray Thomson, James J Reid, Murray W Tilyard Alastair N Goss 73 23 Is there a role for Rongoā Māori in Ability of the Maze Navigation public hospitals? The results of a Test, Montreal Cognitive hospital staff survey Assessment, and Trail Making Jonathan Koea, Glennis Mark Tests A & B to predict on-road driving performance in current 81 drivers diagnosed with dementia Variation in volumes and Etuini Ma’u, Gary Cheung characteristics of trauma patients admitted to a level one trauma 33 centre during national The prevalence of refractive level 4 lockdown for COVID-19 error and visual impairment in New Zealand among New Zealand children Grant Christey, Janet Amey, in a community with signi cant Alaina Campbell, Alastair Smith socioeconomic disadvantage: VIEWPOINTS is current preschool vision screening effective? 89 Rebecca Findlay, Joanna Black, Towards elimination of Nicola Anstice, Alison Burge, tuberculosis in New Zealand Alison Leversha Ayesha J Verrall, Philip C Hill, Dougal Thorburn, Michael Maze, 42 Lavinia Perumal, Kate Grimwade, The characteristics and outcomes Craig N Thornley, Josh Freeman, of patients with colorectal cancer Mitzi Nisbet, Timothy K Blackmore in New Zealand, analysed by Cancer Network 97 Tania Blackmore, Chunhuan Lao, Why BMI should still be on Lynne Chepulis, Blaithin Page, the table Ross Lawrenson Lisa Daniels, Wayne S Cutfield, Rachael W Taylor, Barry J Taylor NZMJ 24 April 2020, Vol 133 No 1513 ISSN 1175-8716 © NZMA 3 www.nzma.org.nz/journal CONTENTS 101 CLINICAL CORRESPONDENCE Changes to management of a 116 non-pandemic illness during the Perry syndrome: a case of atypical COVID-19 pandemic: case study parkinsonism with con rmed of invasive management of acute DCTN1 mutation coronary syndrome Eileen J McManus, Gemma Poke, Sean Co ey, Anouska Moynagh, Matthew CL Phillips, Fredrik Asztely Belinda Green, John Edmond, Gerard T Wilkins, Brendan Arnold, 119 James Pemberton, Ben Wilkins, Foveal laser pointer injury: are Michael JA Williams laser pointers safe enough for public possession? 107 Kelvin Ngan, Sacha Moore The post-lockdown period should be used to acquire effective OBITUARY therapies for future resurgence in SARS-Cov-2 infections 122 Kurt L Krause, Richard Furneaux, Geoffrey Wynne-Jones Paul Benjes, Margaret Brimble, Charles Riddle, Dean Williams, Tony Davidson, William Denny, Peter Rothwell, members of the Lawrence Harris, Simon Hinkley, Wynne-Jones family Peter Tyler, James E Ussher, Vernon Ward 100 YEARS AGO 112 125 The case for New Zealand to A Case of Chronic Bulbar Paralysis have its own COVID-19 vaccine By F. F. A. ULRICH, M.B. programme James E Ussher, Graham Le Gros, Miguel E Quiñones-Mateu, Shivali A Gulab, Melissa Yiannoutsos NZMJ 24 April 2020, Vol 133 No 1513 ISSN 1175-8716 © NZMA 4 www.nzma.org.nz/journal SUMMARIES The New Zealand oral and maxillofacial surgeon workforce in 2017–18: characteristics, practice and prospects John B Bridgman, Graham Fulton, Simon M-Y Lou, W Murray Thomson, Alastair N Goss We surveyed all of New Zealand’s oral and maxillofacial surgeons (OMS) to update fi ndings from a similar survey done in 2001. The fi ndings highlight a number of problems—some long- standing, others emerging—in our OMS system. Because more surgeons are now working exclusively in private, there is greater stress on those who are working in the public hospital system, especially with more facial trauma and cancer cases to be treated. More resources need to be put into training surgeons who will take up hospital appointments and provide essential after-hours emergency services. Ability of the Maze Navigation Test, Montreal Cognitive Assessment, and Trail Making Tests A & B to predict on-road driving performance in current drivers diagnosed with dementia Etuini Ma’u, Gary Cheung While drivers diagnosed with a dementia are twice as likely to be involved in a motor vehicle accident compared to cognitively intact older adults, the majority of drivers diagnosed with a mild dementia will still pass an on-road driving assessment. With specialist driving assess- ments being expensive and no longer publicly funded, this study aimed to evaluate the ability of three quick to administer cognitive tests to predict driving performance in individuals with dementia on a specialist on-road driving assessment. This study provides clinicians with a quickly administered maze navigation test (MNT) and an interpretation of the commonly used MoCA cognitive screening test that can help inform the need for a specialist driving assessment. The prevalence of refractive error and visual impairment among New Zealand children in a community with signi cant socioeconomic disadvantage: is current preschool vision screening effective? Rebecca Findlay, Joanna Black, Nicola Anstice, Alison Burge, Alison Leversha The current preschool vision screening was effective in detecting amblyopia (lazy eye) but poor at detecting refractive error (need for glasses) in a study of mainly Māori and Pacifi c children living in socioeconomic disadvantage. The current vision screening programme is likely to be increasing inequities. More than half of children with refractive error passed the screening. Ten percent of children did not receive screening and a further 11% were iden- tifi ed for rescreening, which was not completed prior to starting school. Urgent attention is required to review the B4SC vision screening protocol to improve equity by ensuring that all children receive appropriate vision screening and eyecare. The characteristics and outcomes of patients with colorectal cancer in New Zealand, analysed by Cancer Network Tania Blackmore, Chunhuan Lao, Lynne Chepulis, Blaithin Page, Ross Lawrenson Bowel cancer in New Zealand is common and we have relatively poor survival compared with other countries. We have shown that for younger patients the outcomes from bowel cancer in New Zealand are not affected by where you live—but there are regional variations for older patients with better outcomes for those living in the Northern and Southern Regional Cancer Networks. However, the greatest survival disparity continues to be found for Māori and Pacifi ca patients. NZMJ 24 April 2020, Vol 133 No 1513 ISSN 1175-8716 © NZMA 5 www.nzma.org.nz/journal SUMMARIES Ocular syphilis in Paci c peoples—are we making misdiagnoses secondary to yaws? Hannah Gill, Helen V Danesh-Meyer, Joanne L Sims, Mitzi Nisbet, Rachael L Niederer This paper was an audit assessing the demographic and clinical features of patients with ocular disease consistent with syphilis and positive treponemal serology in Auckland. It wanted to compare patients who lived in a Pacifi c nation before 1960 with all other patients, as they may have returned a positive treponemal serology due to prior yaws infection, rather than syphilis. The results demonstrated that the presentation of older, Pacifi c Peoples was different to others in the study, and that alternative causes for ocular infl ammation should be considered as differentials.
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