By focusing on processing a higher rate of returnees and overlooking testing of border staff, the Government placed New Zealanders – especially vulnerable Pacific and Māori communities – at risk.
COMMENT: The Covid-19 outbreak in Auckland is disproportionally impacting Māori and Pacific communities. During the first wave, Māori and Pacific were 14 percent of all cases. In the current second wave, Māori (nine cases) and Pacific (53 cases) are 87.3 percent of cases in the Auckland-centred outbreak.
During the first wave, Māori and Pacific communities had the lowest ratio of cases to demographic percentage of the population. The differential impact of the Auckland outbreak now means that as of August 18, for the first time, Pacific cases (8.4 percent) are over their demographic share of the population (8 percent).
An unanswered question
Why did it take three weeks, from a possible infection start date of 15 to 20 July to detection of the first case on August 11 to discover the first case in the cluster? The answer is that the Government and the Ministry of Health reduced community-based and the surveillance/random testing, which would have picked up this new wave of Covid-19.
On Monday, Director-General of Health Dr Ashley Bloomfield congratulated the Māori and Pacific response to Covid-19. In particular, he applauded them for being the highest tested communities in New Zealand. What he overlooked was that Māori and Pacific achieved this by replacing the Ministry’s symptomatic over asymptomatic priority with one saying we are vulnerable so test as many of our people as possible. The Ministry also conducted random testing toward the end of the first wave.
Between April and the end of June, testing averaged 134,000 per month with a high of 165,000 in May. In July, testing fell by 100,000 to low of 66,000. Testing sometimes averaged just 1000 a day across the whole country and at times was as low as 500 or 600 per day. New Zealand plummeted from the 25th-highest testing country in the world to 45th.
The decline in testing coincides with the beginning of the Auckland cluster. If a higher rate of testing had been maintained, the Auckland outbreak would have been detected earlier. Simply put, more testing – 120,000 tests per month – means a greater likelihood of detecting new cases.
The decline in testing
In early June, the Ministry passed testing back to DHBs. The DHBs closed many Community Based Assessment Centres (CBACs) because the first wave emergency had passed, they wanted to save costs, and because random testing ceased in favour of a return to an emphasis on testing symptomatic patients only.
Some testing was also passed back to medical centres, many of which were struggling financially. While testing was free, seeing the doctor to approve testing was not, and according to some patients, their medical centres began adding surcharges for example on asymptomatic patients seeking a test, reportedly as high as $100. The combined effect was a decline in surveillance or random testing as a protective measure against a second wave.
Managed isolation and quarantine
The Government also dropped the ball on community testing because of a preoccupation over the border and MIQ facilities.
After several people left MIQ without being tested in the first half of June, the Government said it would tighten MIQ security, regularly test all border and MIQ staff, and consider either slowing the rate of New Zealanders returning home or increasing capacity in the face of a worsening global situation to bring more home sooner.
Housing Minister Megan Woods and Air Commodore Darryn Webb commissioned a review that found significant stress in MIQ in managing increased flows of arrivals. The report described staff as demoralised and the broader system faltering. Changes and training followed. Unfortunately, over the next five weeks, the MIQ dealt with seven escapes and two attempted break-ins, which led to more security upgrades and more pressure to perform.
In addition, the Government, rather than slow the rate of returning New Zealanders, chose instead through kindness to increase the number of MIQ facilities by 10 hotels over three weeks to July 18.
This placed further pressure on MIQ. Over 72 days between March 26 to June 16, 19,416 returnees had passed through MIQ at an average of 270 people per day including 30 positive cases. Over the next 56 days to August 11, 17,342 returnees had crossed our borders at a 40 percent higher rate of 377 per day. Positive cases increased by 120 percent to 66. The increase diverted attention away from surveillance-centred community testing.
Testing border staff
Clearly, the Government’s attempt to both fix MIQ and raise its capacity explains why the Ministry of Health was unable to fulfil the June 23 promise from the then-Minister of Health David Clark that it would be a requirement to regularly test all frontline border staff in customs, biosecurity, immigration and other airport workers – as well as people employed in managed isolation and quarantine facilities and international air and maritime crew.
By the first week of August, it was clear that 63 percent of the 7000 MIQ staff had never been tested. Bloomfield has attempted to explain that the testing was ramping up. He has also admitted that it was voluntary rather than required. With six facilities in 36 percent Māori and Pacific South Auckland, others in 20 percent Māori Hamilton and 30 percent Māori Rotorua, the Ministry risked exposing vulnerable communities to a second wave of Covid-19.
By focusing on processing a higher rate of returnees, overlooking testing of border staff dropping testing by 100,000 tests in July, the Government and Ministry placed Pacific and Māori communities and indeed all New Zealanders at risk. Pacific people are paying a high price for low testing.
