Last time former New Zealander of the Year Lance O'Sullivan was on The AM Show, he called the media reaction to the growing coronavirus threat "a lot of hysteria, a beat-up".
Now he's fearing COVID-19 could kill thousands of New Zealanders if it comes here, with our health system underprepared for the influx of potentially tens of thousands of patients.
The latest international figures show more than 82,500 people have been confirmed infected and 2810 dead. While the vast majority of cases and fatalities so far have been recorded in China, where it began, the outbreak reached a turning point this week - more new cases are now being reported outside of China than in.
When Dr O'Sullivan appeared on The AM Show at the end of January, the death toll was only 81.
"I am concerned that we're going to get pushed down this track of going crazy on this hysteria, we're going to create these pandemic camps," he told host Duncan Garner. "The real issue is, we've got other, bigger problems that we should be looking at."
Those views, he says, were based on assumptions COVID-19 would sputter out, like SARS, which infected more than 8000 people and killed 774 in 2003 - most of them in China, Hong Kong and Taiwan.
"New Zealand wants leaders who are prepared to say, 'Okay - we got it wrong,'" Dr O'Sullivan said on Friday. "And maybe in this situation we are dealing with something that's a bit more serious than [it seemed] on first appearances... We'd seen SARS, and SARS almost shut down the world, and it turned out to not be very much. So it was with that in mind - let's not do that again."
He's not the only doctor to have underestimated COVID-19. James Freeman, an Australian doctor and friend of Dr O'Sullivan's, made the same mistake. The pair were working together this week when the outbreak came up in conversation.
"He mentioned coronavirus, and I said, 'I wrote this article to tell people not to worry about it too much,'" said Dr Freeman. "He said, 'So did I.' And I said, 'Ah yeah - I'm going to have to recant on that, because this is looking a lot more serious than we thought.'"
The outlook for New Zealand
If the virus gets loose in New Zealand, based on what we've seen so far, it's likely at least 5000 people would die - and that's a conservative estimate based on what happened on the Diamond Princess, a cruise ship on which the virus ran rampant.
"We know for a fact there were 3700 people on that boat. We know 700 of them become infected - so we can see about 20 percent of people getting infected," said Dr Freeman.
"Of those 700 people we can see 29 of them are listed as critically unwell, and so far there have been four deaths.... that's one in 1000."
Garner quickly calculated that would mean 5000 deaths, to which Dr Freeman replied: "You end up with a large number, yeah."
But that could be a best-case scenario.
"The expectation is there will be more deaths than that, because in China it's over a 50 percent mortality rate if you're critically unwell," said Dr Freeman.
Let's say half the remaining cruise ship patients who are critically unwell die - that's 19 out of 3700 now. Scaling that up to New Zealand's population, we're now looking at a potential 25,000 deaths.
Health system already 'bursting at the seams'
Even if New Zealand's high-quality health system manages to keep the death toll down, the Diamond Princess experience suggests around 40,000 people could fall critically ill in an uncontained outbreak.
"That's going to be a large number of people potentially unwell," said Dr Freeman.
Dr O'Sullivan said general practices are already "bursting at the seams", and with China producing much of the world's medicines - including antibiotics, which will be necessary to treat any secondary infections (antibiotics are useless against viruses themselves).
"I really have an aversion to trying to create hysteria and panic, but there are concerns about whether we are ready enough for this."
The last worldwide pandemic - 2009's swine flu - infected about a quarter of the world's population and killed hundreds of thousands of people, later studies showed.
