Dr Rawiri Taonui | COVID Māori Update 11 May | Level 2 the certainty of new cases and an outbreak
|11 May 2020 21:00 PM|
|Author: Dr Rawiri Taonui|
|Photo images supplied / Dr Rawiri Taonui|
COVID Māori Update 11 May | Level 2 the certainty of new cases and an outbreak
Moving to Level 2
Balancing the economy and people, and in the shadow of undertesting non-European communities, Prime Minister Jacinda Ardern has announced that New Zealand is moving to Level 2. As predicted in this update, we will start moving to Level 2 this Thursday 14 May. The shift will be staged. Gyms, malls, cinemas, restaurants, retail, and cafes can re-open on Thursday. Schools will re-open on Monday 18 May. Bars will re-open on Thursday 21 May. Gatherings at homes and social gatherings will be limited to 10 people. Border restrictions will remain in place.
The Prime Minister has spoken to the strength of our response, high testing, robust contact tracing now able to trace up to 10,000 persons per day. She has also acknowledged that we have been reporting new cases on most days and that experts have informed the risk of further silent transmission. The Prime Minister noted an example from South Korea where after bars were re-opened, one person with COVID-19 led to 40 further infections which took 1,500 tests to control.
There will be New Cases
Based on the numbers and location of recent new cases in our largest DHB areas, it is certain there will be new cases and a possible further outbreak in one of our larger urban DHBs. Further certainty of this is driven by the exceedingly high number of Level 4 and 3 breaches the Police and Māori checkpoints have addressed.
The government will have balanced progress to date against the economic costs of remaining at Level 3, and, the likelihood of further cases and an outbreak against a strengthened capacity to manage those, the likelihood that these will be localised, and/or if spread more widely, such as through regional travel, they will remain within capacity to manage. Localised Level 3 or 4 restrictions are possible. The likelihood of new cases spread from urban centres could undo much of the excellent work Māori have done in the regions to keep COVID-19 at bay. Māori are still at risk there. Pacific are still at risk particularly in big centres. The likelihood of new cases spread from urban centres could undo much of the excellent work Māori have done in the regions to keep COVID-19 at bay. Māori are still at risk there. Pacific are still at risk particularly in big centres.
Economic Cost vs People vs Culture
The economic cost of COVID-19 will have weighed heavily on the government decision. Estimates are that current subsidises have been costing the government $500 million per day. The government is set to borrow $25 billion to meet costs related to COVID-19. Some experts suggest this will grow to $60 billion. Tax revenue was down $187 million in March. Initial estimates from the Reserve Bank are that $10 billion was wiped from the economy during the first two weeks of Level 4, and a further $5 billion during Level 3.
The national-level case numbers (below) support the government’s decision for a gradual move to Level 2, because this allows further time to detect new cases, have close to 100% recovered cases, achieve further ZERO case days and close gaps in testing. On that basis, the government cannot be accused or prioritising the economy over people.
However, the absence of mention about under-testing of Māori, Pacific and Asian communities shows that the government is prioritising re-opening the economy over the situation of non-European communities. Today, no mention at all.
This has been a feature of the COVID-19 response. Māori are a priority at-risk vulnerable group, yet no Māori Minister has presented at a daily briefing. Many of the measures put in place to support Māori were late and/or only came after significant pressure. The government and the Ministry have been poor on the question of checkpoints. The COVID-19 Māori Response plan was a fiction with Māori authorship fabricated by Zoom and email. And for all their wonderful charisma and dedicated calm, both the Prime Minister and Director General of Health Dr Ashley Bloomfield, apart from ‘Kia ora koutou katoa’, are demonstrably awkward in Kaupapa Māori and multi-cultural contexts. There has been a magnificent contribution from the Māori and Pacific communities in bringing us to a Level 2 decision. Today, we did not rate a mention.
New Zealand Situation
New and Total Cases
Reported as 3 new cases, there are 4 new cases today and 1 case redefined as negative. More correctly, there are 3 cases added to the total. Total cases are 1497. There are no new deaths. Total deaths stay at 21. New cases are single-digit or ZERO for 23 consecutive days. The 10-day trend is: 6-2-0-0-2-1-2-2-2-3. We have made considerable progress but have not eliminated COVID-19.
There can be a concern that there is some massaging of the figures. For example, there is a distinct drive wherever possible to redefine probable cases as negative. We can also remember that 2 weeks ago we took 3 cases off our total because they were reported as infected in Uruguay. However, these cases were repatriated to New Zealand. The more proper course of action was to ask Uruguay to remove them from their total and add them to our total because this is where they live. New Zealand has also adopted the practice of only reporting confirmed cases to the WHO although WHO stipulates that both confirmed and probable cases be reported. This speaks to pressure on the government to minimise numbers.
Recovered and Active Cases
1386 or 92.6% of all cases have recovered. Recovered cases are over 13 times higher than active cases. As predicted in this update, there is a new sub-100 low of 90 active cases, more than 10 times lower than the peak of 930 active cases on 6 April. This very wide gap suggests a reduced risk of widespread transmission in multiple areas. As above, the most likely scenario is further new cases and an outbreak localised in or spread from one of our main centres.
Days Since New Cases
The 4 new cases today include 1 each from 3 of our largest 5 DHBs, Auckland, Waikato and Waitematā, and, 1 in MidCentral. Our 5 largest DHBs, Auckland, Waitematā, Counties Manukau, Waikato, and Canterbury have reported new cases over the last 10 days.
This tells us that our large urban DHBs are the likely source of new cases and clusters. Notwithstanding under-testing of ethnic groups in the regions, and increased travel between the regions, the regions present as a safer and less likely source of any new cases.
8 of 20 DHBs have ZERO active cases. This sends a positive message as we move to Level 2. However, we need note that the majority of ZERO case DHBs have also under-tested Māori, Pacific and Asian communities. Therefore, while the figures are promising they do not impart 100% confidence.
There were a record 3,865 tests yesterday. The total is 194,191 at a rate of 38,838 tests per million. We are in the right ballpark. Countries like Lithuania, Israel, Estonia, Denmark, Portugal, Ireland, Spain, Belgium, and Italy have testing rates between 40,000 and 60,00 per million.
Under-testing of Māori, Pacific and Asian communities
Data released on 30 April for 114,000 tested individuals, showed much progress in testing Māori and Pacific communities during the second half of April. However, gaps remain. Compared to the national average, Māori and Pacific were under-tested in 11 DHBs each. The Asian community was tested under the national average in all 20 DHBs.
Even taking a statistically sound average of 22.5 tests per 1000 of population, and the reasonable assumption that all testing does not need to be equal, that is ethnicities in each DHB should be between 10% over and under the national testing average, Māori were below the average national rate in 7 DHBs, Pacific in 9 DHBs and the Asian community on average more than 40% below in 18 of the 20 DHBs.
The Asian community is already 12.2% of all cases compared to their 15.7% demographic, but on extremely low testing. For instance, Māori testing is higher but Māori cases only 8.5% of all cases and with a demographic of 16.5%. This suggests a good probability that there are further undetected cases in the Asian community. Of equal, if not more concern, if this deficit is not made up in the first week of Level 2, the Asian community might become subject to heightened racism.
There have been more than 58,000 tests conducted since 30 April. This should cover more of the gaps. On balance we can conclude that gaps remain. As the Prime Minister reiterated today, it will become vitally important that anyone with any respiratory symptoms, like a sniffle, chest congestion or a cough should get tested as soon as possible. This is important if we are going to Level 2.
There are ZERO new Māori cases today. The total stays at 126. There have been 19 ZERO days since 12 April and only 1 new case in the last 10 days. The 10-day trend runs: 0-0-0-0-1-0-0-0-0-0. The lower trend for Māori relates to more Māori living outside of the regions of our largest DHBs. With the immaculate ethnic inaccuracy of an imperial dissimulator, the Ministry of Health says Māori are 8% of all cases. Māori fall slightly to 8.4%. The single decimal place is important for tracking the current trend.
There is 1 new Pacific case today. The total is 80. There have been 11 ZERO days since 20 April. The 10-day trend runs: 1-2-0-0-0-0-0-1-0-0. With the immaculate ethnic inaccuracy of a non-egalitarian equivocator, the Ministry of Health says Pacific are 5.0% of all cases. Pacific cases dip slightly to 5.3%.
Ethnic Figures Indexed to Census 2018
The following table shows the ethnic percentage by all cases, the population percentage by Census 2018 and the percentage of cases indexed against the Census. For example, Māori are 8.4% of all cases, 16.5% by demographic in Census 2018, and an index of 50.9% or just over half of their 16.5 percentage of the population in Census 2018.
Change to Update
From tomorrow, the update will change from daily updates to 2 to 3 times per week. This is not because there is no longer need for concern, but rather because now that we are moving to Level 2, there are several other issues to research and write about, including whether the checkpoints worked, the performance of the Ministry on Kaupapa Māori, what it is that is different about this epidemic and a raft of issues around the economy, unemployment and the social, mental health and welfare of our communities.
Noho haumaru, stay safe and self-sovereign, Dr Rawiri Taonui.
Copyright © 2020, UMA Broadcasting Ltd: www.waateanews.com