Māori disparity: The greatest failure of NZ’s Covid response?

Jack Tame
Source: Q and A

History will record the decision to move Auckland to Alert Level 3 as the turning point in New Zealand’s Delta response.

Within days of the decision to relax the harshest public health restrictions, case numbers surged. New Zealand’s ‘Elimination’ strategy was abandoned. Six weeks later, daily case numbers hit triple-figures.

The move to Level 3 followed a huge surge in vaccinations.

Even though Covid-19 hadn’t been eradicated from the community, higher vaccination rates increased the Government’s tolerance for risk.

When asked at the September 20 press conference about the risks of shifting with active Delta cases in the community, the Prime Minister Jacinda Ardern compared the situation to previous Covid-19 outbreaks, which were managed at Level 3 before any of the population was vaccinated.

“The vaccination rate tool is important. We haven’t had that tool in behind us, supporting our alert level restrictions. We do now,” she said.

Dr Ashley Bloomfield stood at her side.

“The difference this time is that it’s Level 3 with high and increasing rates of vaccination,” he said.

What neither mentioned in the press conference was the Māori vaccination rate.

At 45 per cent, it was approximately 26 per cent below that of New Zealand’s general population.

Despite warnings from Māori health providers and academics, Auckland moved to Level 3 when less than half of eligible Māori had received at least one jab.

As Māori public health expert Dr Rāwiri Jansen warned in North and South, it was a "perfect f***ing storm".

Another Rawiri, Dr Rawiri Taonui, has been analysing daily cases throughout the outbreak.

When Auckland moved to Level 3, Māori made up 13 per cent of all-time Delta infections in New Zealand. Today, Māori make up 36 per cent of all-time infections.

During the first week of November, roughly half of daily cases were Māori.

Ardern signalled we may need to slow down Covid-19 vaccinations so we don’t run out.

Taonui’s modelling suggests that in early December, Māori will make up more than half of all Delta cases ever recorded in New Zealand.

“This is now shaping up as the biggest social, economic, and health issue to affect Māori since the Second World War,” he told me.

Seven weeks since the move to Level 3, Ardern was challenged again on the pivotal decision to move to Level 3.

Despite her comments at the time, the Prime Minister now says vaccination rates weren’t a significant contributing factor.

“The suggestion that vaccination rates were the basis of that decision is not correct” she said on Q+A.

The Government was well aware of the disparity in Māori vaccination rates at the time of the move – the information was publicly available.

But the Prime Minister rejected criticism that the decision to move Alert Levels ultimately led to a surge in Māori infections.

“Your suggestion that we have made decisions that somehow consciously exposed people to risk, is wrong.”

Since the move, Māori have recorded more than 1300 Delta infections.

This failure has many roots.

An intergenerational mistrust of the state, borne of past grievances and betrayals, is often cited as a contributing factor in lower Māori vaccination rates.

Counties Manukau, which has handled more cases than any other DHB, has a large Māori community.

Demographically, Māori are younger than other New Zealanders, which pushed their eligibility until later in the vaccine rollout.

Māori in remote communities have reported problems accessing the vaccines.

In Tairāwhiti, locals had to crowd-source to fund a vaccination bus.

The Government has acknowledged some failures of its own.

Māori community providers were ignored until late in the game.

GPs were excluded from the early vaccine rollout.

In recent weeks the Government has pumped millions of dollars into Māori community health providers to try and boost vaccination rates.

Critics will say Māori, like all citizens, must take some personal responsibility for protecting themselves and their communities against a widely-publicised pandemic.

And as Jacinda Ardern has noted, it is true that any top-level government decisions about our Covid-19 strategy must consider the full spectrum of impacts and pressures, outside of those which solely affect Māori.

Ultimately though, the numbers bear out a sad truth.

When Jacinda Ardern moved Auckland to Level 3, Māori communities were severely under vaccinated.

The Government knew this.

In the time since, Māori have been disproportionately infected. It is likely they will disproportionately die.