The Government has turned its back on the precautionary path of elimination that has served it so well and is now chasing hard suppression – with young Māori and Pasifika pushed to the frontline.
It’s a path that was forced on Melbourne and Sydney when case numbers became too much, but Prime Minister Jacinda Ardern has opted for it in order to give Aucklanders more freedoms without turning up the risk dial.
Wednesday will see more movement throughout the city, ECE centres open – with other schools signalled to open on October 18 – and household bubbles mingling in outdoor settings at a time when case numbers are trending up and the R value has been pushed over 1.
In plain language, at a time when roughly one in five young Māori and one in four young Pasifika in Auckland are double jabbed, there will be many more pathways for the virus to spread.
It’s possible that this first phase of easing level 3 in Auckland won’t lead to the virus spreading in an uncontrolled manner until vaccination rates are high enough.
It’s also possible that intermixing households, no vaccination requirements for ECE or school staff, and the fact there are about 260,000 Aucklanders who are unvaccinated – although this includes children who are less likely to catch it or spread it – will soon see hospitals overrun.
If that happened, it might be too late by the time Ardern reached for the level 4 lever, given that case numbers only reflect what’s happened in the community one to two weeks ago.
“There is a real material danger of hospitals just being overwhelmed,” said Covid-19 modeller Professor Michael Plank, despite limited outdoor gatherings being relatively low risk.
“Look at Victoria, where they’ve gone from 20 cases a day to 1500 in six weeks. They’ve got higher vaccine coverage than us, they’re still in level 3, they still have a curfew. And they have 100 Covid patients in ICU. We’ve got 250 ICU beds in the whole country.
“It’s going to take very careful management, because we’re still vulnerable to overflowing hospitals and large numbers of deaths.”
This is especially worrisome for marginalised communities, where the virus has seeded in recent weeks.
The Government has already been criticised, justifiably, for not prioritising these groups more, which flew in the face of expert advice.
Director general of health Ashley Bloomfield has said that the virus hunts the unvaccinated, and there is no group more unvaccinated than young Māori and Pasifika.
We know that more than four-fifths of the cases in the Delta outbreak are Māori and Pasifika. They also make up 216 of the 287 currently active cases, while 198 of them are aged under 40.
The Ministry of Health’s latest vaccine data – from a week ago – showed that only 50 per cent of Māori in Auckland aged 12 to 39 had one dose, and only 17 per cent had two doses.
Pasifika rates for the same age group were 61 per cent for one dose and 24 per cent for two doses.
“I think it is going to slam into those groups,” said Māori GP Dr Rawiri Jansen.
The key question, which he didn’t know the answer to, was whether there was enough time for Māori and Pasifika vaccination rates to catch up to non-Maori, non-Pacific rates.
The risk of bubbles of 10 children at ECE centres, while low, could have been further mitigated by mandating vaccination for ECE and school staff – which is not something Ardern has signalled.
That would have helped because, according to developmental paediatrician Dr Jin Russell, infections in schools are typically from adults to children.
She said a report in Sydney showed the risk of an infected child passing the virus to another child in a school setting was about 2 per cent, or lower.
“But there’s a higher risk of adults transmitting to children. For instance, in the ECE context, for an infected adult who was working with children, there was an 8 per cent risk.”
Children aged 1 to 11 typically get a mild or asymptomatic illness if they catch Covid-19, she added, but it was imperative to protect those with pre-existing health conditions, who can have more severe reactions.
Overall she said opening ECEs and schools was reasonable, given the significant harms from prolonged absences in schools.
“When schools eventually reopen, I would love to see vaccine delivery on site, for both eligible students and parents.”
She added that the public health advice around the easing of level 3 might be sound – but it also relied on compliance.
That was surely one of the factorsthat Cabinet considered before making yesterday’s decision, and it’s entirely possible returning Auckland to level 4 might have been met with protests and rule-breaking.
Ardern even hinted at this in saying that allowing small outdoor gatherings would minimise the chances of people breaking the rules and having higher risk indoor gatherings.
But public health experts believe zero cases is still achievable – although increasingly unlikely – and while the long tail has remained, case numbers haven’t exploded.
Ardern could have decided to give public health teams the best chance of keeping case numbers as low as possible.
That would have meant returning Auckland to level 4, looking at rapid antigen and saliva testing to supercharge efforts to test communities where the virus is still circulating, and signalling mandatory vaccinations for essential workers leaving Auckland and for high-risk venues.
The justification for this would have been clear.
It won’t be until Labour weekend when Auckland’s eligible population will hit 70 per cent fully vaccinated, and they won’t all be fully immunised until November 8 – two weeks after the second dose.
Instead, Ardern has chosen to turn her back on elimination and, acknowledging the difficulties of a prolonged lockdown, taken a step in the opposite direction.
It remains to be seen whether her gamble will see a manageable level of cases for the several weeks it will take to lift vaccination rates, or whether it will slam into the unvaccinated.
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