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Recent figures suggest gun violence in New Zealand is on the rise. Between 6,000 and 8,000 shotguns are imported annually. The challenge specific to managing shotgun injury is the wide field of damage caused by multiple pellets. It is easy to overlook a single pellet when assessing a patient with distracting injuries. BMS-536924 This case highlights this lesson and the significant injury that can arise from a single pellet.Serology is now a well-established diagnostic tool for the diagnosis of COVID-19 infections in New Zealand. Using local and international experience, we provide an overview of serological response to infection and vaccination as well as the use and interpretation of antibody tests in our setting. We also discuss the potential future role of post-vaccination serology testing as a correlate of immunity. We conclude that, given the pitfalls of testing, clinical microbiologist advice is necessary for interpretation of high-consequence cases.173,766 New Zealanders suffer from visual impairment. The associated health-system costs are $523 million in total, or $3,008 per person. Yet eighty percent (80%) of blindness is avoidable if detected on time. Public health services have an increasing workload but are also limited by material and technical resources. Optometry practices continually increase referrals (up to 100% in one year) that cannot be solved on time, reducing the efficiency of the service. Teleophthalmology works by improving the efficiency of screening and monitoring and integrating eye healthcare and by decreasing referrals by up to 40%.Medical students from the University of Otago, Christchurch Department of Medicine were involved in their local COVID-19 response. A group of ten students helped with the assessment of individuals at community-based assessment centres or mobile testing units. They primarily helped assess and test individuals alongside experienced healthcare workers. The students gained valuable clinical and public health experience. Key learning points were the risks of pandemic involvement, identifying local barriers to healthcare and developing an appreciation for an evolving health response. Overall, students felt that preparation for future involvement could benefit further pandemic responses.Structural discrimination worsens physical health inequities and significantly reduces life expectancy for people with mental health and addiction issues. Aotearoa has recently made some notable changes in health policy by formally recognising the physical health needs of people with mental health and addiction issues. The COVID-19 vaccination sequencing framework provides an important opportunity to protect and promote the health of people with addiction and mental health issues. An expert advisory group, convened as part of the Aotearoa Equally Well collaborative, considered findings of a literature review on the vulnerability of people with mental health and addiction issues of contracting and dying from COVID-19. Evidence indicates an association between mental health and addiction issues and infection risk and worse outcomes. The group concluded mental health and addiction issues should be recognised as underlying health conditions that increase COVID-19 vulnerability, and that people with these issues should be prioritised for vaccination. For too long the health system has failed to address the life expectancy gap of people with addiction and mental health issues. Now is an opportunity to change the kōrero. People with mental health and addiction issues experience significant physical health inequities. Addressing these inequities must be integral in modern health policy-including our COVID-19 pandemic response.

In response to the COVID-19 pandemic, the New Zealand government enforced a nationwide ‘alert level 4’ lockdown from 26 March to 27 April 2020. We assessed the impact of this lockdown on New Zealand’s public ophthalmology service.

An anonymous online survey was sent to all New Zealand-based fellows of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) after lockdown. Respondents provided retrospective assessment of practice patterns and their personal health during the COVID-19 lockdown. This was supported by national-level administrative data, allowing survey findings to be contextualised.

Fifty-seven respondents (response rate 49%) working in the public health system participated. A large majority of respondents reduced elective clinic and surgical volumes by at least 75% (82% and 98%, respectively). National-level information confirmed clinic reduced to 38.2% of normal and elective operating volumes to 11.5%, with virtual visits increasing 17.9-fold. Elective clinic and electivegy in New Zealand. Virtual visits for selected patients allowed ongoing management without risking virus transmission.

To determine the impact on the Capital & Coast District Health Board (CCDHB) urology service of the implementation of nationwide healthcare restrictions in response to the COVID-19 pandemic.

This is an observational retrospective study over a 21 working day period during the implementation of National Hospital Response Framework Alert (NHRFA) level 2. We obtained patient data during this period and a corresponding control period prior to the pandemic. The data was focussed on the volume of operating theatre cases, outpatient consultations, procedural clinic appointments and the estimated avoided outpatient travel.

Total urology admissions decreased by 27% during the 21-day NHRFA level 2 period. However, acute surgical procedures increased by 30% whereas elective surgical procedures decreased by 32%. Outpatient consultations overall decreased by 32% during NHRFA level 2 despite virtual phone consultations increasing by 274%. Procedural clinic appointments decreased by 85%. The virtual platform also saved each patient an estimated 22.7km of average travel.

The data demonstrate the effects of restrictions in response to a crisis and set a precedent for future management in such scenarios. The data also show how service efficiency can be optimised while providing an environmentally friendly alternative for routine clinical practice.

The data demonstrate the effects of restrictions in response to a crisis and set a precedent for future management in such scenarios. The data also show how service efficiency can be optimised while providing an environmentally friendly alternative for routine clinical practice.