Dr Rawiri Taonui: The race against time and racism

By Te Ao - Māori News

By Māori health researcher Dr Rawiri Taonui, in partnership with Te Ao Māori News.


In 1982 Race Relations Conciliator Hiwi Tauroa’s report A Race Against Time said New Zealand was in a race to provide equality for Māori. Māori numbers in the Delta outbreak show nothing has changed.

Māori were 40 (54%) of the 74 new Delta cases announced today. Māori are the highest for the 25th day in a row. The five highest daily Māori totals in the outbreak have come in the past seven days.

The number of Māori cases has more than doubled over the past fortnight from 388 on October 11 to 924 today. Pacific peoples are the most impacted demographic, with 1,101 cases during the outbreak. However, Māori cases are rising three times faster than Pacific cases. Māori cases will pass the total for Pacific Peoples in six to seven days.

Suffering is not a competition. The reality is that the government has failed to deliver equity for Māori and Pacific Peoples. Māori and Pacific Peoples were 62% of new cases today, 66% of cases since Auckland went to Alert Level 3, 72% of all Delta cases since the outbreak began, 60% of all active cases, a staggering 77% of hospitalisations, and one each of two deaths so far.

Cases to come

This situation looks only to worsen. Key risk indicators are rising. The average number of daily cases is seven times higher than in the first week of Auckland at Alert Level 3. New cases with community exposure are six times higher, and daily unlinked cases 18 times higher. Unlinked cases over the past fortnight are 27 times higher.

The number of managed active cases passed 1,300 for the first time today. Active cases are no longer going into quarantine or isolation, Health  director-general Dr Ashley Bloomfield today saying they will isolate at home "to support the system". The fact is the system has no room.

The number of new cases in the wider outbreak rose 44% (382) to the week ending October 18 and 76% (677) to the week ending October 25. An increase over the next week to November 1 of between 50% to 80% will mean another 1,000 to 1,200 new cases of which 450 to 550 will be Māori. Total Delta cases will reach 3,700 to 3,900. The Māori total 1,300 to 1,400.

The Health Service User index, which the Ministry of Health employs to calculate vaccination numbers, undercounts Māori by 7%. Adjusting for this undercount, just 46.1% of Māori are double vaccinated. Another 18.9% have had their first vaccine. Together, 65.0% of Māori have received at least one dose. Māori remain well behind the rest of the population.

The positives

On the positive side, while three times higher than in the first week of Alert Level 3, hospitalisations (41) and ICU cases (5) are holding. Delta has not yet overrun the health system. On current indicators, this is only a matter of time.

Alongside the immense personal courage of frontline health workers, Māori health providers are making heroic efforts to close the vaccination gap. Nearly 119,000 Māori have received a first or second vaccine dose since September 15. This 42.6% increase is higher than any other ethnicity and more than double for the Pākehā population (20.4%).

Māori providers are also undertaking huge work with the low 54.7% vaccinated 12 to 34yrs Māori cohort (23.6% one does only, 31% fully vaccinated). Over the past six days providers have vaccinated another 7,000, the highest increase of all Māori age groups.

The number of Māori who have received at least one vaccine (65%) is 75% of the overall New Zealand total (84.2%), a rise of 23% since early August.

Race against time

Prime Minister Jacinda Ardern has declined to include an equity vaccination figure for Māori, saying she will turn on the traffic lights in each district health board when overall vaccinations reach 90%  because "it is important to reward those who went out and did the right thing".

In saying that, the Prime Minister ignores that the age-structured rollout disadvantaged Māori because 51% of our population is aged under 35. The rollout was also structurally racist because it prioritised and privileged 400,000 Pākehā over 65 years while making 50,000 Māori over 45 years with the same or higher heath risk profiles wait in line.

Racism

Pacific and Māori have endured online racial abuse during the outbreak, Pacific peoples for spreading Delta and Māori for supposedly being slow to vaccinate.

The irony is that Māori and Pacific make up just 5.7% of those who have brought Covid-19 across our borders. Non-Māori and non-Pacific comprise 94.3%. And neither is the majority Asian or Indian who have also been subject to racist abuse. At 53.4%, the single majority are Pākehā. They have brought the virus in, have access to better health care and were prioritised in the vaccination rollout. Māori and Pacific Peoples pay the price for a porous border, poor health care and a discriminatory vaccine rollout.

We are indeed in a race against time and racism.

Dr Rawiri Taonui