Māori Covid-19 data analyst Dr Rawiri Taonui with his Omicron update.
Omicron in the community
On Sunday, Prime Minister Jacinta Ardern and Chief Health Officer Dr Ashley Bloomfield confirmed that 10 cases of Covid-19 in Nelson had the Omicron variant.
The cases are members of the same family. All eligible members are double vaccinated. The group recently attended a wedding and other events in Auckland. There were well over 100 people at these events. There is no clear link with the border.
The Prime Minister said this means ‘Omicron is now circulating in Auckland and possibly the Nelson-Marlborough area if not elsewhere’. The Cabinet has therefore decided to switch the country to the RED traffic light system with full effect from today.
Projection of numbers
Government modeling suggests Omicron could hit 1,000 cases a day in three weeks and 7,000 cases a day in six weeks, including up to 1,800 cases a day in Auckland.
Omicron is hyper-infectious and transmissible. There is a lower percentage of serious cases, hospitalizations and deaths. However, a small percentage of extremely sick people in a very large-scale Omicron event could overwhelm the healthcare system.
RED traffic light
The RED traffic light is not containment:
- Businesses can continue with capacity limits based on one meter spacing.
- Hospitality using vaccine passes can accommodate up to 100 people seated and a single server. Hospitality venues without vaccine passes should be contactless.
- Masks and social distancing are important in retail outlets, public transport, public places, schools, educational and healthcare institutions. Schools can remain open with masks required from the fourth year.
- Events with vaccine passes can have up to 100 people. Events without vaccine passes are limited to 25.
- There are also different requirements for locations using or not using vaccine passes.
Health and demographic risks for Maori
Maori and Pacific communities, the unvaccinated and the anti-vaxxer community, and the poor and disabled are most at risk from Omicron.
Maori have a high risk of infection due to higher co-morbidities including cancer, high blood pressure, heart disease, respiratory diseases such as asthma, diabetes, obesity, liver disease or kidneys, inflammatory conditions, immunocompromised states and autoimmune diseases.
Maori are also at risk due to reduced access to health services. Many Maori in areas like Te Tai Rāwhiti, Northland, the West Coast and the Bay of Plenty live some distance from emergency healthcare. Health care in many large semi-rural Maori-populated areas lacks adequate critical care capacity.
The overall socio-economic and demographic profile of Maori creates a higher specific risk of transmissibility that Omicron can easily exploit. For example, more Maori are living in overcrowded or temporary housing. Our population is younger and more social. More Maori are in prison. Maori have higher rates of mental illness. Each is a vector for higher transmission. A larger percentage of Maori are contract or casual workers.
Vaccination deployment vulnerabilities
Last year’s age-based vaccination rollout put Maori at a disadvantage as it pushed our vulnerable but younger population to the back of the vaccination queue.
Maori and other healthcare providers have made a magnificent effort to reduce this gap from 23.2% in mid-September to 10.3%. However, this still leaves 17.6% of Maori over the age of 12 unvaccinated and therefore particularly vulnerable to the hyper-infectious variant of Omicron.
Inequality of booster shots
International evidence has shown that the efficacy of double vaccination declines faster against Omicron than the Delta variant. A third Pfizer booster dose increases protection:
• Effectiveness of 55 to 65% against infections.
• 70% protection against symptomatic diseases.
• 90% protection against hospitalization, including in populations aged over 65.
New Zealand began rolling out the third booster on January 5 with a four-month qualification period following the second vaccination.
According to figures from Sunday, Maori uptake of boosters at 18.9% of the eligible population over 18 is also well below the national average of 27.0%.
The 105,000 Maori vaccinated since November 1 will also not be eligible for the booster until March 1 or later. It is too late to avoid a significant risk of Omicron devastating Maori communities.
The government must shorten the qualifying period to three months to fulfill its obligation under Te Tiriti o Waitangi to actively protect Maori lives. Britain allows recalls after three months for vulnerable communities. Australia also moved to a three-month waiting period.
Tamariki Maori Vaccination
Preliminary data from the start of last week shows the deployment of tamariki Māori over five to 11 years in Auckland is 50% that of non-Māori/Pacific children.
The government and ministry must appoint a tamariki vaccination monitoring group with access to the data to discuss the rollout with officials and the government and must do so now.
Preparing for Omicron
Omicron will put significant pressure on the healthcare system. Many Maori homes and communities will be left to fend for themselves. There will also be supply disruptions with higher numbers of sick and isolated workers at home.
The following is an essential 10-point basic checklist preparing to protect your whānau and whakapapa during a higher caseload during an Omicron outbreak.
- Make a plan to isolate infected members of your whānau separately from others at home.
- Face coverings, gloves, hand sanitizer or other disinfectant, tissues or old towels, trash bags, and basic surface cleaning supplies will be important items to protect your whānau. Do not hesitate to think budget. Most ready-to-use kitchen, laundry, and bathroom surface cleaners are multipurpose.
- If possible, try to have enough food for the household for up to seven days.
- Many whānau will not be able to afford such a reserve. In this case, it is important to connect and make your situation known to other whānau, Maori or mainstream community initiatives such as food banks so that they can provide support in this way.
- Gather the things we use when we have a bad head cold like paracetamol ibuprofen, throat lozenges, ice packs, drinks, soup packet cups and steam rubs. This will be a challenge for many whānau. Cheap brands from supermarkets or online are often the same and much cheaper than more expensive brands. These will not cure Covid-19 but they will help manage the symptoms.
- If you are self-isolating at home, find someone outside of your household who can help deliver food, medicine or other essentials.
- If the house has more than one bathroom, one should be assigned to HIV-positive people. In households with only one bathroom, clean surfaces after each use, leave windows open and fans on.
- Do not hesitate to seek help or advice from traditional or Maori health providers, Department of Health online services or other community groups. Maori suppliers will better understand your situation. Your well-being is important.
- Don’t neglect your mental health. Books, games, arts and crafts, Internet access, and streaming services can all help fight boredom.
- If you feel comfortable, hang a Covid-19 Tracer sign or QR code on your door to let visitors know you are self-isolating.
Kia kaha koutou kia noho haumaru tō whānau. Be careful.
Dr. Rawiri Taonui