Dr Rodney Jones

The Government has this morning announced $10 million more assistance, particularly for  Pasifika in South Auckland, in a clear acknowledgement that this latest Delta outbreak has hit those communities hard.

This latest tranche will help providers and organisations distribute over 50,000 more food parcels and 20,000 essential wellbeing packs.

Since 17 August 2021, a total of $69.31 million in additional funding has been provided by Government agencies to support providers and organisations serving their communities.

“In particular, the Pacific community in Auckland has been impacted by the current outbreak. They’ve made up over half of those having to self-isolate, resulting in entire support networks not being able to activate and mobilise,” Social Development Minister Carmel Sepuloni said.

“This funding aims to support them and provide continuity through what is a challenging time, and as we stamp out COVID-19 from the community.”

It also underlines what one of the Government’s top Covid advisors, economist Dr Rodney Jones told a Select Committee last week and then repeated again on “Q+A” yesterday morning; the Delta outbreak in Auckland is centred among Pasifika in South Auckland and is as much a consequence of inequality and poverty as anything else.

“What makes this outbreak so different is the receiving environment; in other words, South Auckland,” he told the Committee.

“Not only are we encountering a different virus to what we did last year, but we are also encountering it in a different setting now.

“This is the outbreak we feared as long ago as February 2020 because that different cultural and socioeconomic setting of South Auckland makes it a much more challenging outbreak to deal with.”

Jones said what was concerning  was the high positivity rate in South Auckland (positivity is the percentage of Covid tests that prove positive.)

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He said the concern with a high positivity rate was that there might be undetected background cases still circulating in the community.

“But what we need to take away from this experience is that Delta thrives on inequality,” he said.

“We must ensure that after this episode, after this outbreak, that we now deploy spending and public health resources to South Auckland because that is going to remain our ongoing frontline in the battle against Covid.

“That’s what has been exposed this time.”

Jones said he and his colleagues had noticed the same pattern in Sydney and Auckland; the Delta outbreaks started in the more affluent suburbs (in the east in Sydney and on the North Shore in Auckland)  and then moved quickly to the lower-income suburbs.

There it spread faster because of higher population density, poorer housing with high transmissibility.

“In those denser communities, more essential workers, more mobility in a lockdown leave those communities very vulnerable,” he said.

Jones said this would not be the last outbreak of Delta.

I think what we have to understand is this is the first of many outbreaks we’re going to have,” he said.

“This is not the last, and so we need to learn from this.”

Jones was critical of the fact that vaccine resources had not been moved to South Auckland as a priority when the outbreak began and of the slowness of testing.

“We need businesses free to test; we need community testing; we need marae to have testing capability, using rapid testing, using saliva testing, and globally there are all sorts of tests now being used, and we need to speed up the approval of those tests,” he said.

“We need those now.”

And he was particularly critical of the long history of underinvestment in Middlemore Hospital.

What we see in Singapore is people are still going on to oxygen, still into Intensive Care; we need to invest heavily in Middlemore,” he said.

“We need more negative pressure wards.

“We need to invest heavily because South Auckland is going to be our frontline.

“And I think we need to see that we’ve left gaps in the past, and this is our moment to fill those gaps.”

In March, the Auditor General, John Ryan, reported to the Health Select Committee that the Counties Manukau District Health Board, which runs Middlemore, continued to run a deficit.

It had been operating at a deficit since 2016/17, reaching a peak of $153 million in 2018/19. In 2019/20 the deficit decreased to $80 million.

In the 2019/20 financial year, CMDHB incurred over $14 million in unfunded operational and capital costs due to Covid-19.

The National Asset Management Programme  Report for DHBs published by the Ministry of Health in June 2020 noted that many intensive care units, operating theatres and emergency departments were in “poor or very poor” shape’.

As part of Covid-19 response, Counties Manukau DHB redeployed over 100 staff across the region for contact tracing, assessment centres and mobile testing.

During the August 2020 resurgence, 149 staff were redeployed.

The Auditor-General said that as part of the Covid-19 response, CMDHB postponed non-acute planned care during lockdowns.

“As a result, planned care activity dropped to 26% of normal,” he said.

“CMDHB is focussing on improving planned care waiting lists but expects that return to pre- Covid-19 waiting list levels will take most of 2020/2021.”

(That was written before the current lockdown)

Overall, the Auditor General reported that Counties Manukau was meeting only about 53% of its performance targets.

“We should use this as a way of saying we need to change,” said Jones.

“It’s well known that Middlemore Hospital was one of the most under-resourced.

“It’s difficult politically always to prioritise an area; I understand that.

“But Covid is not going to go away, and we’re going to be battling this for some time.”

Appearing with Jones, the former Reserve Bank Chief economist, Dr John McDermott, said we had to learn rapidly from what had happened and actually apply our resources to where the biggest risks were.

“And if they happen to be in South Auckland for whatever reason, that’s where we need to apply those resources,” he said.

That Pasifika are disproportionately likely to get Covid is clear from Ministry of Health statistics showing the ethnic breakdown of Covid cases since Case One last year.

Though European New Zealanders make up 70.2 per cent of the population, European covid cases come to only 41.9 per cent of the total.

Maori make up 16.7 per cent of the population, but their cases make up only 7.4 per cent of the total.

But Pasifika make up 8.1 per cent of the population; however they make up 22.6 per cent of the total Covid cases.

Nothing has shone the spotlight on the poverty and inequality that prevails among  South Auckland’s Pasifika population as brutally as Covid.