“Delta prospers with inequality”: South Auckland strategy needed, experts warn

Experts say the government needs to prioritize more money and health resources for South Auckland. And it will continue to be at the forefront of New Zealand in the fight against Covid-19.

They state that targeted community-led immunization, faster testing, more resources for Middlemore Hospitals are top priorities, and higher data transparency is important.

A test station for the congregation of the God of Manguere.
Photo: RNZ / Marika Kabazi

Talking to today’s Health Selection Commission, Covid-19 modeler Dr. Rodney Jones said the Delta Variant exploited New Zealand’s vulnerabilities.

He said the blockade was working and the number of new cases is expected to continue to decline, but “in Delta, we don’t know what causes the problem.”

“What we need to remove from this experience is that Delta is unequal and prosperous,” he said. “We must now ensure that we deploy spending and public health resources in South Auckland, as it remains our ongoing front line in the fight against Covid.

“Generation time is only 4 days from the onset of index 1 people to the onset of infection with others. Therefore, less time, more dense communities, more important workers, more in blockages. Many agility leaves them. The community is very vulnerable. “

He said South Auckland, which has a high proportion of Maori and Pacific people, “stays at the forefront,” and the strategy had to be specially designed to explain it.

“This is an outbreak that I was afraid of long before February 2020. Due to the different cultural and socio-economic environment of South Auckland. [more] A challenging outbreak to deal with.

“You can’t leave vulnerabilities. Covid finds a way to exploit them. You need the biggest. If you don’t take a minority community, the vulnerabilities will remain.”

Dr. John McDermott, Executive Director of Motu Economic and Public Policy Research, said that while other countries depended on contact tracing and initially proved successful in fighting the virus, Delta has proved successful in many other countries. Said it was running faster than the system.

“We then need to learn quickly, embrace it, and apply the resources to where they really are at greatest risk. If for some reason you are in South Auckland, you need to apply those resources. . “

Jones said there are three factors in how to manage things better.

“I think there was an assumption that the blockade achieved the exclusion. Elimination actually involves the various strategies that need to be adopted today.

“When we did the exclusion, we were the first country to pursue the exclusion, and as you know, in the thirties we first created the welfare state. I … I think we have to be the ones who do this. I don’t think there are any examples we can actually see … this is very specific to us. “

Targeted vaccination

Dr. Shaun Hendy, a Te Pūnaha Matatini Covid-19 modeler, estimates that increasing vaccination levels from 30% to 50% of the population can reduce the time to reach elimination by about half, according to special committee modeling. He said he did.

Jones felt that vaccine resources should immediately prioritize South Auckland and that vaccination efforts should follow a “bottom-up” process undertaken through the community.

“What we don’t want to do is find that in a few weeks we get stuck and lack an important community that remains vulnerable.”

He said the government needed to work with community groups in advance to build immunization and public health proliferation capabilities.

“What we have to look at is what immunization rate we can reach. We need to create that level of protection, which is most important. Then there is that level of protection. You also need to understand how it is affected. “

As a researcher, he said he has sought Maori knowledge specifically in vaccination planning, especially given the health inequality already present in the system.

“We consider ourselves to be Covid analysts, so our model can’t explain the gap, but it’s important in thinking about it, and we listen, learn, and We went out to get a better understanding. The kind of challenges we face.

“Delta variants don’t give us time”

Second, the test toolkit should have more options, including saliva and rapid antigens, which needed to be approved for faster use, Jones said.

“PCR testing gives you ultimate certainty, but you need companies, communities, and marae with the ability to test using rapid testing with saliva testing, and therefore around the world. All kinds of tests are used in and speed up approval. Need now.

“What we have to understand is that this is the first and not the last of many outbreaks we experience. Therefore, from now on, and just relying on PCR tests, people will be able to drive people. You need to learn how to make them wait 6 hours in. Time, leave us on the hind legs.

He was initially skeptical of rapid testing, but said Covid-19 was an ongoing challenge and Delta needed a quicker response.

“This is in progress. 2020 is very important and the delta is dynamic. Leaks occur and a series of outbreaks occur, so rapid testing should be an important part of the toolkit.

“In the case of occasional false negatives, it is all the positives that are obtained early that make the difference.

“We have to find every case and the delta variant doesn’t give us time.”

Funding Middlemore

The third priority was increased investment in Middlemore Hospital. According to Jones, Singapore offers the best model for vaccination, which accounts for more than 80% of the population, but still manages more than 300 cases.

“Vaccination is much better in terms of hospitalization and ICU use, but Singapore reminds us that we still have a long way to go.”

“What we see in Singapore is that people are still heading for oxygen, the ICU. We need to invest heavily in Middlemore and need more negative pressure wards. . “

Photo: RNZ / Claire Eastham-Farelli

He said hospitals have suffered years of underinvestment and need the ability to surge in the event of an outbreak.

“The advantage of a wealthy country is that we start with a better starting point of increasing ICU beds and hospital beds. Today we have the ability to approach health for decades. So, in a sense, we need to use this as a phrase. We need to change it. “

“Middlemore Hospital is one of the most underfunded hospitals. It’s politically difficult to prioritize the region, but Covid isn’t gone and we’ll be fighting it for a while.”

transparency

Jones said data based on the onset of symptoms rather than the date of the positive test led to more accurate modeling.

He mentioned much of the wealth of data that the Ministry of Health needed to share more widely.

“I think transparency is very important and will fix expectations and self-confidence. I think we need more transparency. We need very detailed data online that people can access. Individuals themselves models You can create, access, and get started. Understand it.

“This shouldn’t be an elite. It’s something we have to live with, a better understanding that people can build better, and it comes through information.”

However, he was uncertain whether a stand-alone Covid-19-focused health body would help.

“I give my personal opinion. From emergency response led by the Ministry of Health to ongoing response, I think there is an argument that we need to use a variety of tools, and perhaps agencies.

“There are pros and cons because adding layers doesn’t always help if the strategy is wrong in the field.”

According to Hendy, the modeling report was sometimes sent to the Prime Minister’s Office and the Cabinet before it was published, but researchers had the final say on when and how it would be published.

“We strive to give the government heads-up. We don’t always give heads-up. The choices are left to us. We have the final say when we announce things. Have, but we try and make sure the minister is exposed to work … as they understand what’s coming. “