September 12, 2021
Dr Rawiri Taonui | Delta OutBreak | Māori highest number of cases for the first time
There were 20 new cases in the Delta OutBreak today and three new cases at the border. The total number of cases in the Delta OutBreak is now 922.
Māori Cases on the rise
New Māori cases are rising relative to other ethnic groups. Today, there were five new cases in the Māori community, the third time in the last eight days that Māori are the second-highest number of new cases. Yesterday, at 12 new cases, Māori were the largest number of new cases by ethnicity for the first time. At the end of August, Māori averaged about 5% of new cases each day. Over the last eight days, Māori made up 20% (29 of 144) of all new cases.
In a repeat of the August 2020 Auckland OutBreak, within the next two days or by the end of this week, the number of Māori cases will become the second-highest afflicted ethnicity in the Delta OutBreak exceeding both the Asian and Pākehā communities. Last year, a failure by the Ministry of Health to conduct random surveillance testing during July was a primary factor leading to that outbreak. This year, the Pacific Peoples and Māori numbers are the result of the government and Ministry of Health failing to sufficiently heed advice about prioritising Pacific Peoples, Māori, and South Auckland in the vaccination rollout.
The last full release of the ethnic data vaccination programme (9 September) showed that 81.3% of New Zealanders (and 44.3% of Māori) had received at least one dose of the Pfizer-BioNTech vaccine. The overall figure places New Zealand in the top 30 countries on the Bloomberg World Vaccine Tracker, a remarkable increase from about 90th place before the Delta OutBreak.
The number of two-dose fully vaccinated persons is lower. We should expect this given the recentness of our current rapid uptake of the vaccine. Nevertheless, full vaccination is what counts. With 27.4% fully vaccinated, New Zealand ranks 97th in the world on the Bloomberg index, a much smaller improvement on 105th before the Delta OutBreak.
Figures from the Ministry of Health paint a positive picture of Māori vaccination based on the Health Utilisation Service database, essentially our health identity numbers. However, that index excludes about 4% or 200,000 unregistered New Zealanders. The majority are Māori and Pacific Peoples.
The table above is based on the more reliable June 2021 estimate of population. At 44.3% of Māori receiving at least one dose of the vaccine, we are just 0.54 of the 81.3% New Zealand average. And, at 14.4% fully vaccinated 0.53 of the national average. If included on the Bloomberg index, at just 14.4%, Māori would be 130th in the world, five places lower than the 125th we were before the Delta OutBreak.
The reasons for the slow Māori vaccine uptake include underestimating the impact of anti-vaxxers and conspiracy theorists. The government Māori vaccination programme falling woefully short, including not promoting the vaccination of whānau of all ages together as has been spectacularly successful for indigenous peoples in Canada and the United States.
There are also issues of access, transport, and the ability to navigate the online booking system. Justifiably historical distrust and its affine being last in the queue and lacking the confidence to push forward are also factors.
Auckland Level 4 or Level 3
Tomorrow, the government will consider whether Auckland goes down to Level 3. The general figures are positive. The increase in the number of contacts of cases has slowed considerably. Contact tracing has reached 87% of contacts of which 92% have had at least one test. There are 352 recoveries of the total 922 Delta cases. Locations of Interest are down from 498 at peak to 133.
The steadily rising number of Māori cases, possible linkages with the five recent cases associated with Middlemore Hospital, any of the three sub-clusters officials are not certain are ringfenced, or unresolved unlinked cases may portend a Delta surge in the South Auckland Māori community. Coupled with a continuing low Māori vaccination rate, Auckland should stay at Level 4 for at least another week.
The Elimination Strategy
Implementing an immediate Level 4 lockdown when the government announced the first case on 17 August was the right course of action. Extrapolating the maximum infectivity of Delta over the first 21 days of the OutBreak, New Zealand could have had up to 3,700 cases. Instead, we had 600.
Can we eliminate Delta? Yes, we can. The main risks are secondary bounce-back infections from the 599 active cases in MIQ and whether Delta can take advantage of the low Māori vaccination rates. This is where elimination will be won or lost.
The government regularly advises the team of 5 million to stay the course. We need to remind the government to stay the course.
Noho haumaru, stay safe.
Dr Rawiri Taonui