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CAROLINE McELNAY Piloting our pandemic response

Words: Bridie Witton Image: Robert Kitchin

She is one of the most powerful women in New Zealand who advises Prime Minister Jacinda Ardern on the coronavirus pandemic. But it wasn’t until director of public health Caroline McElnay was watching Ardern address the nation on March 21, 2020, announcing a new alert level system to control its spread, and moving the country to level 2, that the gravity of the situation dawned on her.

‘‘I remember having been at briefing meetings beforehand, where that was the content of the advice that was being given,’’ she says. ‘‘But it wasn’t until I was standing watching that I got the hairs tingling on the back of my neck and [realised] that, actually, this was pretty significant.’’

The coronavirus pandemic engulfed the world last summer, spreading to almost every country and upending global travel, economies and health systems. Millions have died.

The 1pm Covid-19 updates catapulted director-general of health Ashley Bloomfield, an unassuming public servant, into celebritydom with memes, songs and towels with his face on them following thereafter.

McElnay is second to Bloomfield, and part of a hugely successful political communication machine which generated mass compliance with some of the strictest pandemic restrictions in the Western world. Despite holding a key role in the pandemic, and a top job at the Ministry of Health since 2017, McElnay has less of a public profile.

Her voice, which still carries an Irish lilt, wavers at times during the 1pm briefings. Sitting in a meeting room at the ministry, she is harried but assured, and before the interview ends there are people at the door, wanting her attention.

But does she feel powerful?

‘‘I don’t feel powerful at all,’’ she says, laughing. ‘‘It’s a very privileged role, actually, and I feel a lot of pressure to do the best that I can, [and] be the best that I can.’’

McElnay took the top job five years ago, after a long career at Hawke’s Bay District Health Board. She moved to Wellington the same day her youngest child left for university. ‘‘So they flew the nest, and I flew the nest.’’

Her husband and the dog are still in Napier, a home she returns to every weekend to decompress.

The pandemic may have caught most of us by surprise, but it is an ever-present concern in the public health world, where McElnay has been working since she finished her training in medicine in Belfast, Northern Ireland, in the mid-1980s.

McElnay grew up on dairy farm in the countryside near the coast in Bushmills, Co Antrim. She was one of seven children and, although her family didn’t have a lot of money, she was able to go to university.

‘‘Certainly that was the situation for me and my siblings, [to have] these opportunities that my mum and my dad didn’t have.’’

New Zealand and Northern Ireland have much in common culturally, she says. Both are rugby mad, and are spiritual places steeped in history.

But she grew up in the time of the Troubles, a period of violent sectarian conflict in the British territory between the mostly Protestant unionists (loyalists), who wanted Northern Ireland to remain part of the United Kingdom, and the mostly Roman Catholic nationalists (republicans), who wanted Northern Ireland to become part of the Republic of Ireland.

The 1998 Good Friday peace accord mostly ended the violence but the UK’s 2016 decision to leave the European Union, taking Northern Ireland with it, reignited old feuds.

McElnay’s family was never personally touched by the conflict, but some of her friends had loved ones killed or were ‘‘caught up in situations which were quite challenging’’.

‘‘When I was at university in Belfast we had bomb explosions and there was army patrolling the streets, things like that which my children haven’t had to experience.’’

She left Belfast to continue her training in Manchester, before coming to New Zealand for a year’s secondment. It was here that she met her husband, Giles, who followed her to back Manchester but convinced her they needed to raise their family in Napier. In 1995, they moved to Hawke’s Bay, with a baby. They would have two more children.

From that year, she had a few roles in health administration in Hawke’s Bay, but always as a public health doctor. In her time there she fronted New Zealand’s first case of Sars in Hawke’s Bay and a listeria outbreak, and returned early from a sabbatical following a 2016 campylobacter outbreak.

She was always interested in public health; the factors that drive poor health and what you can do about it; but an email from the International Health Regulations last January about the novel coronavirus would sideline the majority of her work.

Although public health officials had planned for pandemics, Covid-19 brought a lot of unknowns. Experts had to get up to speed ‘‘really quickly’’ on the technical parts of the virus and work out the best strategy to deal with it.

‘‘And then, of course, any strategy is only as good as your ability to implement it, which is where the whole-of-government approach comes in, and the whole-of-community because you have to have the community on board to be able to implement the sorts of things that New Zealand has done,’’ she says.

‘‘We do talk about building the plane as you fly it [and] there’s a large element of that you just have to accept.’’

McElnay and her husband, both keen trampers, had been walking the Queen Charlotte Track in Marlborough in the days before the lockdown announcement in March 2020. So Giles went home to Napier and she went to Wellington to work ‘‘incredibly long days’’ with no weekends. They wouldn’t see each other for seven weeks.

She later joined bubbles with her two adult daughters who live in Wellington, while her son went home to Napier. ‘‘I keep saying that I’d quite like to experience a lockdown where I can sit at home and do nothing,’’ she says.

It’s been continuously busy since then, but McElnay and her team of four doctors now work at a sustainable pace and do take days off. ’’Now what we’ve realised is we’re no good to anyone if we’re tired and burnt out so actually we have to pace ourselves. We learnt that last year, only after the fact when we felt really exhausted.’’

The virus is better understood now, which has eased the pressure from the Delta outbreak and lockdown. ‘‘We’ve done this before. We’ve got systems in place, we’ve effectively built the plane – we’re just tweaking it right, making it go faster.’’

New Zealand’s approach to the pandemic has been widely praised around the world. It has also meant people have spent much of this year – before the ongoing Delta outbreak – living a normal life.

It is through this work that she has been propelled into the limelight. She had dealt with the media as director of public health and through her work in Hawke’s Bay, but not on this scale.

Earlier Covid-19 updates had taken place at the ministry, but they were moved to the Beehive theatrette where McElnay would front at press conferences broadcast to the country.

‘‘And you’re suddenly standing beside the prime minister,’’ she says. ‘‘You have that slightly either out-of-body experience of the uncanny ‘I can’t really believe that I’m here standing, and that there’s cameras and reporters, sitting in front of me’.’’

McElnay is popular with reporters because she follows up on details and information she doesn’t have at hand. She says she sees the value of working with the media to get information out, and being transparent and honest.

It is work that has been all-consuming. But when asked what she would like her legacy to be, it is to leave a lasting impact on New Zealand’s shameful health inequality, especially for children. ‘‘And that’s what I would have wanted to be able to spend more time on in this job here at the ministry.’’

It’s an important piece of work that she hopes she can resume once the pandemic workload is eased. But first she would like to have a ‘‘little bit’’ of a holiday.

‘‘We do talk about building the plane as you fly it [and] there’s a large element of that you just have to accept.’’

National Portrait

en-nz

2021-09-25T07:00:00.0000000Z

2021-09-25T07:00:00.0000000Z

https://fairfaxmedia.pressreader.com/article/282248078708311

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