If you want to survive a deadly epidemic, move to the West Coast.
Living in isolated, hard-to-access areas would give you the best chance of survival as a disease spreads quickly through the population, says Otago University of Wellington associate professor of public health Dr Nick Wilson.
As the pandemic escalated, the Government should batten down the hatches on schools and military compounds to create safe communities for the healthy - and bar the diseased from entering.
All borders would be closed, with the country remaining self-sufficient until a vaccine was invented or the infectious illness contained.
Wilson and a team of researchers evaluated New Zealand's response to the 1918 flu pandemic, examining the pattern of deaths to discover how best to contend with a wave of disease today.
The 1918 pandemic was the worst natural disaster in a century, with more than 8600 people dying from the disease.
In Wellington, 700 people died in a matter of weeks.
Wellington City Council historian Gabor Toth says bodies were trucked up to Karori Cemetery, first in coffins, then hastily hewn boxes, before simply being shrouded in fabric.
Wilson said at their worst, pandemics could pose risks to the future of human civilisation - particularly if viruses were ever engineered into bio-weapons.
In 1918, hundreds of the deaths were due to overcrowding and poor ventilation, both in military camps as in Featherston, where 163 soldiers died, and on board troop ships.
To prevent this, places where people lived in close quarters - like university hostels and boarding schools - should be emptied before a pandemic struck, Wilson said.
Setting up "bug-free" compounds shut off from the sick was a viable option to prevent disease spread, and more research into this and better border control methods were needed.
While it seemed like a zombie apocalypse scenario, Wilson said these measures had been proven to work.
Pockets of the country managed to stay influenza-free in 1918, by exercising strict controls on entry.
This included Coromandel township, and some schools.
"If we act quickly - and New Zealand is an isolated nation - even if it wasn't the whole country you could isolate the West Coast, or areas where there weren't many roads."
But, while healthcare was much better now than 1918, modern hospitals would still struggle to cope, he said.
"We've got antibiotics and we've got antivirals and we've got vaccines, but what we haven't got is a huge surge capacity in our health system so if tens of thousands of people are sick there won't be enough ICU beds, there won't be enough ventilators to keep people breathing."
The Otago University research concluded that, even given what was known about health in 1918, hundreds more lives could have been saved if authorities had been more organised.
The most recent pandemic to strike our shores was the 2009 H1N1 "swine flu".
New research published in the journal PLOS Medicine said the epidemic killed up to 203,000 people across the globe - a death toll 10 times greater than initially estimated by the World Health Organisation.
The mortality rate in New Zealand and Australia was among the world's lowest.
Regional Public Health nurse Annette Nesdale said nurses had been stationed at borders to screen visitors in 2009.
The swine flu and SARS scares were the catalyst for more detailed national pandemic response plans, she said.
Border closure would be determined by the government, in consultation with the WHO. Fairfax NZ
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