The Government’s Covid management strategy yesterday began its re-entry into reality, and bits seemed to flake off in the process.
The Whanau Ora Commissioning Agency, Te Pou Matakana, is to seek an injunction in the Wellington High Court to try and force the Ministry of health to hand over National Health Index numbers to organisations like the Waipareira trust so they can reach people not registered as patients with their VaxBus.
A spokesperson for the trust, Joe Lose, confirmed the case would be heard before Judge Wilson Isaac this morning.
The injunction comes with the release yesterday by the Government of maps showing that in many provincial and rural areas, the Maori Covid vaccination rate is well behind other ethnic groups.
That appears to have prompted the Prime Minister to take off a three-day tour of predominantly Maori areas on the East Coast promoting vaccinations.
Then the Government’s own advisor on Covid testing, Professor David Murdoch from Otago University, told the daily Covid media conference yesterday that the Ministry of health had been too slow in introducing saliva testing and had missed opportunities on introducing anti-gen testing.
In the background, the Ministry and District Health Boards (DHBs) have begun planning for the inevitable increase in Covid cases which will be cared for in the community.
One Primary Healthcare Organisation (PHO) told its GP members this could involve caring for cases at home or in community facilities rather than managed isolation facilities.
The PHO said the care would initially be by telehealth.
But there is a crisis with a shortage of healthcare staff.
Covid Response Minister Chris Hipkins appeared to acknowledge this yesterday.
“I am looking at the number of health workers that we are needing to get into the country at the moment,” he said.
He said this was because “ultimately we need them in our health workforce.”
But the overriding issue confronting the Government is the low Maori vaccination rate.
Overall, 58.3 per cent of Maori have received one dose of vaccine compared with 81.5 per cent of Europeans and a nationwide average of 80.3 per cent.
The Maori uptake is improving. Maori Health researcher Dr Rawiri Taonui working with Maori TV’s Te Ao news, said yesterday that over the past three weeks, Māori (19.4%) and Pacific (18.7%) had the largest increases in vaccination since September 15.
Prime Minister Jacinda Ardern started her eastern trek in a town she partly grew up in, Murupara, which according to Ministry of Health figures released yesterday, has the lowest rate for first doses of the Pfizer vaccine in the country, with only 32.6 per cent so far receiving their first dose.
A local GP, Dr Bernard Conlon, is to appear before the Medical Council later this month over comments he made about the need for informed consent before patients had a vaccination.
His medical centre does not promote vaccinations.
Though Murupara’s low vaccination rate may be explained by the vaccine scepticism of the local GP, Maori rates generally are in part a consequence of the late rollout of the vaccine.
Because Maori are disproportionately younger than the overall population, and because the rollout was staggered by age, there is a large number of unvaccinated Maori under 34 who have been eligible to be vaccinated only since September 1.
In contrast, 90 per cent of Maori aged over 65 have received their first dose. Hipkins said yesterday that the original goal with Maori communities was keeping the virus out, but once again, he suggested that low vaccine supplies had been an issue.
“Ultimately, earlier in the campaign, our focus was on trying to stop Covid getting into those communities in the first place, and we were actually very successful in doing this,” he said.
“As vaccination numbers became more available, we were able to move more quickly to open up the vaccines to a much greater group of people.”
Now the issue is whether the Maori vaccinators can work fast enough.
That is why the Chief Executive of the Waipareira Trust, John Tamihere, is behind today’s move to get an injunction to open up the data.
“Our people are not vaccinated because the people who run the present system are not of us or by us,” he said on Wednesday.
“They designed a system for middle-class non-Māori New Zealanders, who have done very well.”
The Government also came under criticism for its approach to Covid testing in a report from the Covid-19 Testing Technical Advisory Group chaired by Professor David Murdoch from Otago University.
The report said New Zealand had been slow in preparing for and adopting saliva testing, largely because of concerns about its reduced sensitivity and, consequently, about maintaining the elimination strategy.
“Saliva testing lends itself particularly well to surveillance testing because of the need for frequent sampling,” the report said.
The report said rapid testing was possible with Rapid Antigen Testing (RATs), “which usually test anterior nasal swab samples (that can be self-collected, or collected by a healthcare worker) and are able to provide a much quicker turnaround time for individual tests (less than an hour) than most PCR-based tests (typically 1-2 days) and some have the potential to be deployed as point-of-care or self-tests without the need of a laboratory.”
But the report noted the RATs tests were less sensitive than the nasal swab or saliva tests.
“It is almost inevitable that RATs will have a role in the reconnection strategy for Aotearoa New Zealand, and it is critical that the country is prepared for this,” the report said.
But at the Covid media conference, Murdoch was critical of the way the Ministry of Health had dealt with testing options.
Media: “Could we have better prepared for the eventuality of moving out of the elimination strategy, which we’ve done as of as of Monday? Could we have been better prepared in terms of saliva testing and rapid antigen testing so we could be rolling it out en masse now?’
Murdoch: “I think we could have been better prepared, yes.”
“The focus on elimination and having the best test I think did drive a certain conservatism and, partly justifiable, on the best test,” he said.
“Looking back. yes, we’ve probably missed a few opportunities just to get things up and running.”
But Associate Health Minister Ayesha Verrall has announced that the Government and businesses were now working together to pilot the use of rapid antigen testing in workplaces.
“This follows the introduction of rapid antigen testing at Middlemore Hospital,” she said.
“It will start within the next few days at Auckland City and North Shore hospitals and be used as a point-of-arrival test in the self-isolation pilots in Auckland and Christchurch from October 30 to Wednesday, December 8 2021, with final travellers exiting self-isolation on December 22 2021.”
In their public statements, Ministers like Hipkins and Verrall are inching closer to confirming what the GPs are being told; that now the elimination strategy has been abandoned, there will be more cases of Covid in the community but they will be able to be looked after outside hospitals.
“What has changed is the availability of vaccines, and that means that COVID doesn’t have to be a serious disease for most people like it was previously, and that does allow us to evolve our approaches,” said Verrall.
But everything is dependent on vaccines.