Māori cases declining faster than all other ethnicities | Dr Rawiri Taonui

By Contributor

By Māori Covid-19 Analyst Dr Rawiri Taonui, in partnership with Te Ao Māori News.


Māori cases Week ending 10 January

Māori were 69 (31.2%) of 221 new cases last week. This is the lowest number of Māori weekly cases in four months.

After seven new cases on Monday, Māori are 44.9% of total cases in the outbreak, 25.1% of active cases, 38.9% of those hospitalised, and 52% of all deaths.

Māori Cases declining faster than all other ethnicities combined.

Heightened vigilance in Māori communities following the holiday travel opening of the Auckland border is driving a decline in Māori cases.

Māori were 53.1% or 1,832 of 3,447 new cases during the four weeks ending December 6. In a major turnaround, Māori cases have decreased an average of 31.1% in each of the last five weeks, almost twice the 17.7% decline for all other ethnicities combined.

The reversal is a testament to the work of Māori community leaders, Te Rōpū Whakakaupapa Urutā, the Iwi Leaders Forum Pandemic Response Group, the Whānau Ora Commissioning Agency, Māori health providers, and Māori checkpointers. Their efforts, an elegant riposte to the cognitive impertinence of online racists trashing Māori vulnerabilities.

The decline in Māori cases mirrors an equal and opposite increase in Pākehā cases reflecting their willingness to frolic in other communities during a pandemic.

Māori Risk Assessment

There are several metrics for measuring risk, such as comparing data by 100k of the population in the current outbreak.

On that measure, Māori are 10.6 times more likely than Pākehā to become infected, 7.9 times more likely to be hospitalised, and 9.2 times more likely to die.

On another index comparing the number of hospitalisations and deaths, one in 17.6 Māori cases hospitalised have died compared to one death for every 20.5 Pākehā hospitalisations. Māori have the most deaths under 40yrs of age.

Unvaccinated Māori make up 69.6% of all Māori Covid-19 infections. This is significantly higher than the 62.7% unvaccinated cases in the national total.

Māori Vaccination

Comparing the Ministry 2020 HSU (Health Services User) (571,050 Māori 12yrs+) with the 2020 NZ Statistics Estimated Resident Population (644,980 12yrs+) shows official vaccination figures undercount Māori by up to 74,000.

This writer uses a more conservative undercount estimate of 46,000 to maintain accuracy when extrapolating the simpler national level calculation across the complexity of 20 DHBs and multiple age cohorts.

Based on the undercount adjustment, 81.4% of Māori have received at least one dose of the vaccine, 11.7% lower than the national figure. Nationally, 75.8% of Māori are fully vaccinated,  13.1% below the national figure.

The vaccination gap between Māori and other ethnicities is closing but slowly. Many make much of Māori mistrust of government, but more damaging is government mistrust of Māori now avidly exploited by anti-vaxxer misinformation.

Working from well behind, Māori health providers have expended all efforts leading the vaccination of more than 96,000 Māori since November 1. This 23.7% increase is higher than the combined 21.3% increase of all other ethnicities.

Māori Vaccinations by DHB

Based on the undercount there are no District Health Boards (DHBs) with Māori vaccination levels over 90%. Fifteen have passed 80% at least one vaccine dose, five have reached 80% fully vaccinated. Northland remains the lowest fully vaccinated DHB on 69.2%.

Māori Omicron Risk

Omicron is rampaging across the world with more than 13 million cases in the last five days. New daily cases are two to three times higher than the previously single-day record of 904,000 in April last year.

Omicron is the most infectious/transmissible Covid-19 variant. Omicron can evade antibodies produced by those who have recovered from previous Covid-19 infections. Vaccines have reduced efficacy against sickness but with third booster shots maintain good protection against severe illness and hospitalisation.

Omicron cases a higher proportion of milder sickness and a lower proportion of hospitalisations and deaths. However, we cannot take Omicron lightly. The emerging pattern across the globe is one of increased hospitalisations and deaths among low-vaccinated and vulnerable communities.

Māori are vulnerable. The government has moved booster shots forward from six months to four months. Britain has made booster shots available for vulnerable communities at three months. We should do the same for Māori.

We cannot pause on inevitability. The outcome of an Omicron event for Māori will be shaped by what Māori do now.

MIQ

The increasing number of Omicron cases crossing the border into Managed Isolation and Quarantine (MIQ) is the main risk to Māori.

More than 20 of the previous breaches of MIQ into the community since June 2020 occurred when MIQ was managing more than 30 active cases at any one time. As of 10 January, there were 294 active border cases in MIQ not including community cases.

On January 2, the Ministry reported there were 90 Omicron cases at the border. The ministry no longer updates this figure. This might be to assuage concern in the community. If so, the ministry confuses the difference between concern and preparedness.

5-11yrs Vaccination Rollout

The U12yrs vaccination rollout begins next week. The government and ministry must accord an urgent priority to the Māori (and Pacific) 5-11yrs vaccination rollout.

Māori under 12yrs comprise 28.7%of all Māori cases. Proportionately, this is 16.2% higher than the 24.7% of under-12yrs in the national total of all cases.

Maori under 12yrs have been 12.8% of Māori hospitalisations. This is 64.1% higher than the 7.8% of under-12yrs hospitalisations in the national total.

Of equal concern, when comparing the 2020 HSU (115,560) with the 2021 NZ Statistics estimate of the resident population (127,980), there is an under-count in this Māori age cohort of up to 12,000.

Prioritising the 5-11yrs Māori rollout includes establishing a decision-making Māori vaccination leadership group with adequate resourcing. It also means impressing upon DHBs that Te Tiriti o Waitangi goals extend beyond kōrero consultation, kia oras and karakia to include equal outcomes for Māori alongside Pākehā. Equity without equality is always empty.

Noho haumaru, stay safe.

Dr Rawiri Taonui.