By Aden Miles Morunga, Local Democracy Reporter

“It’s exciting to know that I am involved in making history and that my contribution will leave a legacy for my tupuna and mokopuna to be proud of.”

The words of Waikato Pasifika health advocate Mareta Matenga, who is helping lead a new Pan Pacific Community Hub in Hamilton.

“I am supporting the development of an integrated wellbeing service delivery model which will see different K’aute Pasifika-owned entities operating seamlessly in the same space,” Matenga said.

“This involves me supporting Leaupepe Rachel Karalus, K’aute Pasifika CEO, to support the development of this model, by working alongside other consultants who are also working on the development of the hub.

“My role is specific to the actual services that will work out of the new hub and preparing the team to transition well to the hub.”

The Pan Pacific Community Hub will include an integrated health centre, a stand-alone early learning facility and an open fale-style community space.

The fale is expected to open in September, followed by the childcare and early learning centre in November. The wellbeing component is set to open early next year.

Free or low cost services
The hub is expected to offer free or low cost services in health, social, employment, housing and education.

K’aute Pasifika said the hub would enable the trust to better support the holistic wellbeing of families using Pacific models of care.

It will also increase connectedness and the sense of identity, and celebrate and support academic, sporting, creative and leadership potential and achievements.

Born and raised in Kirikiriroa (Hamilton), Matenga’s parents Ere (nee Marsters, Pamati Island) and the late George Ford (Vaipae, Aitutaki Island), together with her eight siblings have dedicated their lives to serving the Hamilton Cook Island Community and their Pacific Islands Presbyterian faith community.

Matenga is well-known within the Waikato community and has more than 20 years’ experience working in community development and community-led approaches.

“I remember being involved over the years in many community fono to dream and discuss how a place like the Pan Pacific Community Hub will help our community thrive and to celebrate our Pacific-ness in Kirikiriroa,” she said.

Matenga said it was exciting to be involved in creating history and that her contribution would leave a legacy for her tupuna and mokopuna.

Strong community experience
K’aute Pasifika chief executive Rachel Karalus said Matenga’s strong community experience and connections were an asset to the organisation and the Waikato community.

“Mareta is a well-known and respected community leader who has dedicated herself to support not only her Cook Island community but all the communities in the Waikato,” she said.

“Mareta’s extensive experience in community engagement, community development and planning large scale projects and events will be invaluable to the development of the Wellbeing Service Delivery Model, that will sit inside and across the Pan Pacific Community Hub.”

Matenga said she was also grateful for the 20 years she had worked at the Hamilton City Council, and the vast experiences working with the Waikato community.

“I’m a proud Cook Islander and love knowing that my community support me, not only in the city of Hamilton, region of Waikato, Nation of Aotearoa, but also throughout the world.”

Public Interest Journalism funded through NZ On Air.

Dr Rāwiri Taonui says tamariki Māori make up 53.3 percent of all cases of those aged under 12 and 63 percent of all hospitalisations of under 12s.

According to Dr Taonui’s analysis, when Pasifika children are included, 82 percent of cases and 78.3 percent of hospitalisations of those under 12 have been Māori or Pasifika.

• READ MORE: Other NZ covid outbreak reports
• Solomon Islands orders 60 hour lockdown in Honiara

Taonui has contributed to a Ministry of Health working group for vaccination of Māori aged 12 years and under.

He described the statistics as disturbing and said they reflect the higher disease burden on Māori in the current outbreak.

Omicron remained a serious risk for unvaccinated Māori and Pasifika, and the tamariki rollout should focus on equal outcomes with Pākehā, he said.

“Pacific and Māori peoples face similar prejudice. This is our brown pandemic.”

Dr Taonui said data emerging from overseas backed the need to prioritise Māori and Pasifika children in the vaccination rollout.

Rise in child infections
“Last week, the American Academy of Paediatrics reported a 50 percent rise to 199,000 child infections and a 66 percent rise to a record 400 child hospitalisations in one week at the end of December,” Dr Taonui said.

“The lesson [is that] a small percentage of severe young cases among an enormous number of mild omicron cases equals a serious number of cases among the young and vulnerable.

“Tamariki are the taonga in the future of our whakapapa. At 24.6 percent of our population, Māori communities will be concerned that our tamariki are 29.2 percent of all Māori cases,” Taonui said.

A new international study this month by the University of Auckland’s Professor Stuart Dalziel showed children are at risk of severe outcomes from covid-19.

Professor Dalziel said greater numbers of children were being infected and needing hospital treatment.

“There is a perception that covid-19 is only a very mild infection in children. Unfortunately, for some of these children, covid-19 results in severe disease,” Professor Dalziel said.

The study followed more than 10,300 children at 41 emergency departments in 10 countries, including New Zealand, Canada and the United States.

It found that more than 3200 children tested positive for covid-19. Of those, three percent experienced severe outcomes within two weeks, including cardiac or cardiovascular complications such as myocarditis (inflammation of the heart) and neurological, respiratory or infectious problems.

Twenty-three percent were hospitalised and four children died.

More than 30,000 children’s doses have been given across the first three days of the vaccination rollout for children aged 5-11 years.

Local Democracy Reporting is a public interest news service supported by Asia Pacific Report, RNZ the News Publishers’ Association and NZ On Air.

Pacific Island New Zealanders are now 90 percent fully vaccinated against covid-19, and a public health expert is urging them to keep up that momentum in the New Year.

In a daily briefing, the Ministry of Health said 90 percent of eligible Pacific people in New Zealand had now had both vaccines.

Associate Professor Collin Tukuitonga from the University of Auckland said that is a tremendous effort and the threat of omicron is the next challenge.

• READ MORE: Covid-19 Fiji: 1 death, 309 new cases amid third wave
• NZ covid-19 update: 105 new community cases, two further deaths in past two days
• Other NZ covid outbreak reports

He hopes the community embraces booster shots to guard against the more infectious variant.

“It looks as if the two doses doesn’t give you enough protection for omicron, and the most important priority now is to get people to get their boosters as soon as that’s possible.”

He hopes as many regions move into lower levels of restrictions in the government’s Framework Protection system people will still stay vigilant, contact trace and get tested.

“There’s a risk that people might have gone back into a lower level of alertness, so I would hope that we maintain that [alertness].

Ramp up once again
“In mid-late January I think we’re going to have to ramp up once again in respect of rolling out the vaccine for the young ones.”

Children aged between 5 and 11 become eligible for covid-19 vaccinations in mid-January, and those 12 and older are already eligible.

Dr Tukuitonga said rolling out vaccinations for children could also be a challenge, and parents may need encouragement.

“Parents are perhaps less certain about the benefits and more concerned about risks. So every effort is going to be needed to get the vaccination rollout in children up to the kind of levels that is needed.”

This article is republished under a community partnership agreement with RNZ.

An Auckland councillor says he is astounded by the lack of cultural awareness shown by the authorities towards Māori and Pacific communities this far into the pandemic.

Manukau ward councillor Fa’anana Efeso Collins said covid-19 has become a Māori and Pacific outbreak, and South Auckland in particular is bearing the brunt.

He said calls over the past year for Māori and Pacific representatives to be at the decision-making table had been largely ignored.

• READ MORE: Auckland DHBs hit 90% first vaccinations
• Covid-19 update: 113 new community cases in New Zealand today
• Other NZ covid lockdown stories

Collins said those designing the response seem to have little knowledge of the communities, and it was showing.

“[We should have] people who are on the ground who understand our communities — right from the very beginning our request was that they be around the table that makes the decisions.

“And so these decisions are so far detached and disconnected from the realities on the ground.”

Fa’anana said the fact the government’s process for dealing with people in self-isolation was not practical was a glaring example.

Two patients died at home
This week two patients with covid-19 died while isolating at home.

On Friday a man in his fifties died in a Mount Eden apartment block after discharging himself from hospital on Wednesday.

And a 40-year-old man died while self-isolating in Manukau on Wednesday.

The cause of death has not been determined in either case, but the Health Ministry said the deaths were being considered as part of a wider systemic review it was carrying out with Auckland district health boards (DHBs).

Fa’anana said authorities were warned self-isolation would not work, and that for many families in South Auckland, it’s next to impossible.

“You know, the Ministry of Health says everyone gets sent an email. I think it’s time to get real — none of us read emails.

“And so I think that’s the level of lack of intelligence that perhaps we’re seeing from the Ministry of Health because they’re not on the ground, they don’t understand our communities.”

Battling the Health Ministry
“Fa’anana said health reforms cannot come soon enough.

Fa’anana’s criticisms come as Whānau Ora is battling the Health Ministry in court to try get access to personal data on unvaccinated Māori released to them.

The organisation wants to use the data for directing campaigns to increase vaccination rates among Māori.

The ministry has agreed to provide some of the data sought. It agreed to supply individual’s vaccination status for previous clients of Whānau Ora services, and anonymous vaccination status data to street level, to show unvaccinated areas in communities.

While the ministry has so far refused to hand over the full personalised data, after a High Court ruling this week it agreed to work with Whānau Ora to identify places where “outreach to Māori is most needed”, and to identify what data sharing was needed in those cases.

South Auckland health workers going door-to-door
Manurewa-Papakura ward councillor Daniel Newman said the ministry’s vaccination campaign had fallen short and left too many people vulnerable to the virus.

He said the government’s failure to set vaccine targets for Māori was already having consequences, and that is showing in hospitalisation statistics.

In his ward, frontline healthcare workers have resorted to door-to-door visits in an effort to reach vulnerable and vaccine-hesitant residents.

However, that could potentially expose them to people who are infectious with the virus and are isolating at home, he said.

He called on the government to protect healthworkers by letting them know where people are isolating at home with covid-19.

“It’s really important that we stay safe, because not only do we need to protect our own health, but we can’t become conduits for covid-19 ourself.

“The important thing for us is that we have enough scale that we have the ability to get to enough people as soon as possible.”

He said the door-to-door approach was necessary: “We’re in a race against covid-19 which is seeding in those streets, we need to get people protected before they become unwell.”

This article is republished under a community partnership agreement with RNZ.

The warning is stark — New Zealand is on the verge of a “tsunami” of dementia cases and the government can ill-afford to merely acknowledge the University of Auckland’s Dementia Economic Impact Report 2020.

And while it may not receive the priority which goes to dealing with the covid-19 pandemic, it is nonetheless a concern.

The report found an estimated 69,713 people — or 1.4 percent of the population — were living with dementia in 2020 and that number is projected to more than double to 167,483 — or 2.7 percent of the population — by 2050.

• READ MORE: Number of New Zealanders with dementia will increase in 30 years — report — RNZ Checkpoint

The alarming statistic is that the number of Māori, Pacific and Asian people with dementia is expected to triple, while the number of Europeans with dementia is expected to double.

“This is the fourth dementia report we’ve written and the last three reports have all talked about the baby boomer generation coming up to retirement age and people living longer,” says Dr Etuine Ma’u, lead author of the report and a Tongan.

“So we have this massive bulge of 65-year-olds coming through since 2011. This report now is saying, look at the tsunami, the surge of cases that is here now,” the senior lecturer at the University of Auckland and consultant psychiatrist at Waikato hospital says, sounded a stark warning.

“It is concerning because at the moment we’re sitting at about 15 percent of the population of people with dementia being Māori, Pasifika and Asian and that is going to rise to a quarter and they are growing a lot quicker because the population is ageing a lot quicker.

Worry that it’s an underestimate
“The worry is that it is an underestimate and that is because we had a paper out earlier this year looking at the risk factors for dementia and what is shown is that, particularly for Māori and Pacific, their risk factor burden is a lot higher than European which means that they are probably at a higher risk of developing dementia anyway,” Dr Ma’u says.

At the same time that the report was launched, an updated action plan was also presented to Associate Health Minister Dr Ayesha Verrall.

“The plan is really a call to action for the government, the plan is really trying to highlight to the ministry the urgency of addressing dementia,” Dr Ma’u says.

While the reports have all been acknowledged, nothing further has been done since 2008.

“I don’t think that they have (the past four governments) paid attention to them in any practical sense. They’ve always acknowledged the reports when they have come out and they’ve always acknowledged that the problem is coming,” Dr Ma’u says.

“I think what is urgent about the current report is that it really shows the problem is here right now.”

Closer to home
For report co-author Auckland University of Technology associate professor Dr Rita Krishnamurthi, a stroke and dementia researcher, it is much closer to home.

Her father, Venkata Chalam, died in July 2014 from dementia and that proved a spur to her studies into dementia.

“That was my motivation to do something about this insidious disease because in the last years of his life it was particularly bad,” she says.

“Culturally too, we weren’t going to put him in aged residential care (ARC) where he wouldn’t get the comforts of home, like food and company that he was comfortable with.

“My mother (Sita) wouldn’t hear it; she insisted that he was cared for at home.”

Cultural and social norms were the primary reasons Māori, Pasifika and the Asian communities were hesitant to make use of the ARC.

“The other problem is that because Europeans (or Pakeha) make up the overwhelming majority of the population over 65 with dementia, all of the interventions and services are pitched at that group,” Dr Ma’u says.

Not culturally appropriate
“So they are not culturally appropriate, they are not really acceptable particularly to Māori, Pasifika and many Asian populations. They are not using those services and that means that they are carrying the burden of care and the cost associated with it themselves.

“And that is what the report shows quite strongly.

“We need tailored services, we need tailored intervention and what we need the Ministry of Health and the government to wake up to is that if in the next 20 years non-European people with dementia are going to make up a quarter of all the people with dementia then we are going to have to start targeting services and developing services and targeting policy that is acceptable and appropriate to these different groups.

“There is no one size fits all approach,” he says bluntly.

A year ago research into dementia found 12 significant risk factors that brought the onset of dementia into people.

“There was a big paper that came out a year ago with The Lancet which identified 12 potentially modifiable risk factors for dementia and they calculated what is called the population attributable fraction which is effectively the amount of dementia you could potentially prevent if you could completely get rid of those risk factors,” Dr Ma’u says.

“The risk factors broadly speaking fall into two categories — those that increase the risk of damage to the brain like high blood pressure, diabetes, smoking, alcohol, physical activity and diet and then there are factors that impact on your competent reserve, which is basically your brain’s ability to cope and to compensate for any damage.

Active social network
“That is around maintaining a healthy and active social network, your level of education because it challenges the brain more.

“Hearing is a massive one because people who have difficulty hearing have a problem with socialising.”

The cost of hearing aids in New Zealand is a major prohibiting factor, he says.

“We’re hearing things like funding hearing aids is going to make a massive difference but in New Zealand, they are horrendously expensive.”

He makes it clear that the health industry is not geared up to deal with the wave of dementia cases that is impending.

“Are we ready, the short answer is ‘no’, it is the message that Alzheimer’s New Zealand wanted to push across when they presented their dementia plan to the Associate Minister for Health,” he says.

“I don’t think we are prepared: based on the dementia report the costs are really high, estimated at $2.5 billion. Because we are looking at an extra 30,000 people with dementia in the next 10 years and an extra 100,000 people in the next 30 years, even based on today’s dollars, the cost per person is around $30,000-$35,000.

“So we are looking at an extra billion dollars that the government is going to have to find in the next 10 years alone just for dementia and I don’t think the health budget can sustain that.

No cure for dementia
“There is no cure for dementia at the moment, and the only way we can reduce cost is by reducing the prevalence, reducing the number of people.”

He says what is more disquieting is that no studies of the disease have been done in the wider Pacific.

“I don’t know,” he says when asked if studies have been done in the Pacific.

“I can only speak from the Tongan point of view and I can say there are no studies and I’m pretty sure that there aren’t any in Samoa and Fiji either,” Dr Ma’u says impassively.

“Based on the work we did earlier on the risk factors for dementia in different populations in New Zealand I suspect the prevalence of dementia in the Pacific is going to be quite high, the risk factor burdens are going to mirror those of the Pacific population in New Zealand so I think it is going to be high.”

While it isn’t getting the daily headlines that covid-19 is, and he acknowledges that the pandemic deserves the attention, as opposed to dementia which is a silent creep.

“Covid-19 is a huge problem, you just have to look at Auckland to see how massive it is, but dementia is an insidious problem that is just going to keep getting bigger if we don’t do anything about it now,” he says.

Costs of healthcare
“The earlier people get diagnosed, the earlier they put interventions in place, the longer they can live well at home and the longer you can delay things like entry to aged residential care (ARC)… and residential care in New Zealand is where most of the costs of healthcare and the cost of dementia sit.

“We have shown in our report over half of the economic costs of dementia is around social care, predominantly paying for residential care and paying for community care. If we can reduce the number of people entering residential care by supporting them better at home then ultimately you will reduce the costs.

“That’s why personally my big push is around dementia prevention and that is ultimately going to be the way we reduce the costs.

“We are also talking about the need for tailored intervention, the tailored services that Māori, Pasifika and Asian populations are actually going to find acceptable.

“I don’t think we provide the level of service and interventions to people with dementia that they need, there is a deficit all the way across and from my point of view there is a difference in uptake that Europeans use compared to Non-Europeans.

“The report shows that Europeans are using $5000-$8000 more of social care which shows that Māori, Pasifika and Asians don’t go into aged care as much as Europeans do.
“Maori, Pasifika and Asians aren’t wanting to put their loved ones into care because they don’t see it as a place that will meet the needs of their loved ones and that has to change,” Dr Ma’u says.

Awareness of dementia is a problem too, how does one discuss a family member suffering from this disease?

Awareness slowly growing
“It is slowly coming to the public’s attention and the awareness is slowly growing,” he says.

“There is a lot of stigma associated with dementia particularly in Pacific cultures, there is a really poor understanding of what dementia is and the names that are used for it.

“The way it is understood varies from being a part of normal ageing and something just happens and you just have to accept it and deal with it.

“Or through it being something of punishment or karma for bad things done in earlier life.

“We need to shift that mentality to reduce that stigma so that people understand that the changes that are happening in someone’s cognition needs to be looked at, needs to be assessed and diagnosed so we can get the interventions early to provide as much support as possible”

The irony is there is no term to describe dementia in the Islands.

“In Tongan, there is no specific term for dementia. In Tonga the psychiatrist (Dr Mapa Puloka) is trying to get a definition as catastrophic decline “Holo Tamaki’’, effectively trying to describe the deterioration in someone, otherwise, it’s called “Loto Ngalongalo” which means forgetful or they call it “Alasaima’.

“General understanding, they call it crazy ‘fakasesele’.”

The stigma is such that people don’t talk about the deterioration in one’s mental capacity once caught in its vice-like grip that there is no escape from.

When it becomes real

This is where it becomes real. Helen Reddy, daughter of the former leader of the National Federation Party, the perennial opposition in Fiji, Jai Ram Reddy comes into focus.

Jai Ram Reddy is currently in Auckland, at an ARC, suffering from Alzheimer’s disease. Gone is the charisma, the magnetism and the flamboyance of the once-proud politician and lawyer who revelled in reciting verse and chapter the works of Shakespeare.

He served as the Minister of Justice and Attorney-General in the coup-stricken Dr Timoci Bavadra government in 1987.

He was the first Indo-Fijian that was accorded the right to address Fiji’s Great Council of Chiefs and at the zenith of his powers in 2003, was elected to the International Criminal Tribunal for Rwanda in Tanzania.

Sadly, however, when Helen, herself a lawyer and a senior crown prosecutor in London, endured the MIQ system in Auckland to get to see her father he was a mere shadow of his former self.

That didn’t deter Helen, on one occasion during her visits to see her dad she played a ghazal (old Indian song) from Jagjit Singh.

The lyrics read:

“Hmm hmm hmm … ha ha ha
Hmm hmm hmm … ha ha ha
Hoshwalon ko khabar kya bekhudi kya cheez hai
Mindful people don’t know about senselessness
Hoshwalon ko khabar kya bekhudi kya cheez hai
Mindful people don’t know about senselessness
Ishq kijiye phir samajhiye
Fall in love, then you’ll understand…
Ishq kijiye phir samajhiye zindagi kya cheez hai…”

As Helen relays wistfully:

“I saw dad again today. Moments of lucidity. I played the first song on this Jagjit Singh track and he stroked my face so lovingly xx”.

The New Zealand government has announced details of its Covid-19 Protection Framework, involving the roll-out of a “traffic-light” system once all district health boards hit 90 percent full vaccination rates.

A vaccine certificate will be central to the new framework.

The system will involve three settings – green, orange and red.

• READ MORE: Covid-19 update: 104 community cases reported in NZ
• Other NZ covid lockdown reports

“If you want to be guaranteed that no matter the setting that we are in, that you can go to bars, restaurants and close-proximity businesses like a hairdresser, then you will need to be vaccinated,” Prime Minister Jacinda Ardern told media today.

She was accompanied by Deputy Prime Minister Grant Robertson, Covid-19 Response Minister Chris Hipkins and Associate Health Minister Peeni Henare as the government also announced enhanced:

• financial support for businesses and those families struggling under restrictions, and
• a new $120 million fund to boost Māori vaccination rates and protection of communities.

Ardern said the vaccination certificates would allow businesses to be able to open and operate at any level.

Targeted local lockdowns
If cases start to climb in areas with lower vaccination rates in lower-income communities, much more highly targeted and localised lockdowns could be used if needed, she said.

The red setting would allow hospitality to open with vaccine certificates, but gathering limits and physical distancing, masks and other public health measures would be used.

“This will still feel like a huge amount of freedom relative to what Auckland has now,” Ardern said.

Watch the announcement

Today’s covid-19 strategy announcement. Video: RNZ News

A group of doctors have hit the phones to support Pasifika families who have tested positive for covid-19 and been transferred into managed isolation.

The chairperson of the Royal New Zealand College of GPs’ Pasifika chapter, Monica Liva, said about half the people infected with the virus in Auckland were Pasifika.

She contacted Pasifika doctors who could talk to people in their first language and hear any concerns they might have.

• READ MORE: Other NZ covid lockdown reports

“It’s also to take off the load off the MIQ medical team, so that they can focus on the urgent covid-19 needs,” Dr Liva said.

Dr Liva said she had been heartened by the number of GPs agreeing to help.

TikTok take-up for vaccines
The North Island iwi Ngāti Porou have launched a covid-19 vaccination campaign aimed at rangatahi using the social media platform TikTok.

The video challenge calls on young people to encourage their whānau to get vaccinated.

Ngāti Porou’s Taryne Papuni said TikTok was a natural first pick to get the message across.

“That’s one of the mediums that they’re always on, always on the TikTok or the Instagram.

“We thought yeah, we can reach a lot of our people, a lot of our young ones that way and hope that the young ones will actually lead for their elders.”

Earlier this week, Ngāti Porou hosted a vaccinations clinic at Te Poho o Rawiri Marae.

There have also been multiple events on this weekend targeting Pasifika vaccination rates.

18 new community cases in NZ
The Health Ministry reported 18 new community cases of covid-19 in New Zealand today, with all but two epidemiologically linked to previous cases.

There was no media conference today. In a statement, the ministry said there were now a total of 1165 community cases associated with the latest outbreak of the delta variant of the virus.

It said 934 of Auckland’s 1148 cases had now recovered.

The ministry said there were five cases in the past fortnight that were still not linked to previous cases.

The 16 linked cases reported today are all in isolation at home or in MIQ.

This article is republished under a community partnership agreement with RNZ.

Auckland’s move to alert level 3 has also triggered speculation about whether the national covid-19 elimination strategy has failed or is even being abandoned. While the New Zealand government denies it, others clearly believe it is at least a possibility.

The uncertainty is troubling. If elimination fails or is abandoned, it would suggest we have not learnt the lessons of history, particularly when it comes to our more vulnerable populations.

In 1918, the mortality rate among Māori from the influenza pandemic was eight times that of Europeans. The avoidable introduction of influenza to Samoa from Aotearoa resulted in the deaths of about 22 percent of the population.

• READ MORE: New Zealand government takes a calculated risk to relax Auckland’s lockdown while new cases continue to appear
• The real challenge to covid-19 vaccination rates isn’t hesitancy — it’s equal access for Māori and Pacific people
  
• Research shows Māori are more likely to die from covid-19 than other New Zealanders
• Other NZ covid lockdown reports

Similar observations were seen in subsequent influenza outbreaks in Aotearoa in 1957 and 2009 for both Māori and Pasifika people. These trends are well known and documented.

And yet, despite concerns we could see the same thing happen again, there have been repeated claims that an elimination strategy cannot succeed. Some business owners, politicians and media commentators have called for a change in approach that would see Aotearoa “learn to live with the virus”.

This is premature and likely to expose vulnerable members of our communities to the disease. Abandoning the elimination strategy while vaccine coverage rates remain low among the most vulnerable people would be reckless and irresponsible.

In short, more Māori and Pasifika people would die.

Far better will be to stick to the original plan that has served the country well, lift vaccination coverage rates with more urgency, and revise the strategy when vaccination rates among Māori and Pasifika people are as high as possible — no less than 90 percent.

Least worst options
After 18 months of dealing with the pandemic, it’s important to remember that Aotearoa’s response has been based on sound science and strong political leadership. The elimination strategy has proved effective at home and been admired internationally.

Of course, it has come with a price. In particular, the restrictions have had a major impact on small businesses and personal incomes, student life and learning, and well-being in general.

Many families have needed additional food parcels and social support, and there are reports of an increasing incidence of family harm.

The latest delta outbreak has also seen the longest level 4 lockdown in Auckland, with at least two further weeks at level 3, and there is no doubt many people are struggling to cope with the restrictions. The “long tail” of infections will test everyone further.

There is no easy way to protect the most vulnerable people from the life-threatening risk of covid-19, and the likely impact on the public health system if it were to get out of control. The alternative, however, is worse.

We know Māori and Pasifika people are most at risk of infection from covid-19, of being hospitalised and of dying from the disease.

Various studies have confirmed this, but we also must acknowledge why — entrenched socioeconomic disadvantage, overcrowded housing and higher prevalence of underlying health conditions.

More than 50 percent of all new cases in the current outbreak are among Pasifika people and the number of new cases among Māori is increasing. If and when the pandemic is over, the implications of these socioeconomic factors must be part of any review of the pandemic strategy.

Lowest vaccination rates, highest risk
Furthermore, the national vaccination rollout has again shown up the chronic entrenched inequities in the health system. While the rollout is finally gaining momentum, with more and better options offered by and for Māori and Pasifika people, their comparative vaccination rates have lagged significantly.

Community leaders and health professionals have long called for Māori and Pasifika vaccination to be prioritised. But the official rhetoric has not been matched by the reality, as evidenced by our most at-risk communities still having the lowest vaccination coverage rates in the country.

Te Rōpū Whakakaupapa Urutā (the National Māori Pandemic Group) and the Pasifika Medical Association have repeatedly called for their communities to be empowered and resourced to own, lead and deliver vaccination rollouts in ways that work for their communities.

Te Rōpū Whakakaupapa Urutā have also said Auckland should have remained at level 4, with the border extended to include the areas of concern in the Waikato.

As has been pointed out by those closest to those communities, however, their advice has consistently not been heeded. The resulting delays only risk increasing the need for the kinds of lockdowns and restrictions everyone must endure until vaccination rates are higher.

There is a reason we do not hear many voices in Māori and Pasifika communities asking for an end to elimination. Left unchecked, covid-19 disproportionately affects minority communities and the most vulnerable.

“Living with the virus” effectively means some people dying with it. We know who many of them would be.

Dr Collin Tukuitonga is associate dean Pacific and associate professor of public health, University of Auckland. This article is republished from The Conversation under a Creative Commons licence. Read the original article.

The national strategy of vaccinating against covid-19 through general and mass events is not working for Māori, with even clinics that prioritise Māori and Pasifika being “swamped” by Pākehā, a covid-19 researcher says.

Earlier this week, opposition Act Party leader David Seymour tweeted out a vaccine code reserved for Māori, encouraging his supporters to use the code themselves.

The code was sent by Māori health provider Te Whānau o Waipareira via confidential email to its clients as part of a push to lift Māori vaccination rates that are less than two thirds of the non-Māori rate.

• READ MORE: Māori vaccine equity scheme criticism blows back on Seymour
• Other Local Democracy Reporting stories at Asia Pacific Report

Te Whānau o Waipareira CEO John Tamihere said Seymour was trying to sabotage attempts to make the rollout more equitable.

He said his clinics had vaccinated five times as many Pākehā as Māori and Pasifika.

Independent writer, researcher and advisor Rāwiri Taonui, who focuses on covid-19 in Māori communities, said the story was similar around the country and different strategies were now needed to turn around low vaccine uptake by Māori.

“At the moment our main strategy is to have mass vaccination events and some are prioritised for Māori and Pasifika but what’s happening is those events are actually being swamped by Pākehā, quite a lot of them,” Taonui said.

“A better strategy would be to collate information about where whānau live or have whānau gather at marae and have mobile vaccination units go out to the community.”

Booking ‘navigators’
Taonui said another idea would be to bring in booking “navigators” to help Māori, especially kaumātua, who are finding it difficult to book online, and to help whānau book group vaccinations.

In the Whanganui District Health Board region, nearly 54,500 doses of Pfizer have been delivered – just over 49 percent of the total due to be delivered in the local rollout.

Māori health providers are running clinics throughout the region, including in rural and isolated centres and in marae communities, and on Friday a walk-in clinic is being held at Te Ao Hou Marae in Whanganui from 10am-2pm.

• New Zealand reported 21 new community cases of covid-19 in the country today. Director-General of Health Dr Ashley Bloomfield said all the new cases were all in Auckland. This follows three days in a row with 20 new cases.

Local Democracy Reporting is a public interest news service supported by RNZ, the News Publishers’ Association and NZ On Air. Asia Pacific Report supports this project.