24 Aug 2020

New approach needed for Covid management - academic

From Afternoons with Jesse Mulligan, 1:15 pm on 24 August 2020

Elana Curtis is calling for a "new recipe for pandemic management", saying aspects of the current community outbreak response are paternal and racist. 

Dr Curtis, a member of Te Rōpū Whakakaupapa Urutā - the National Māori Pandemic Group, tells Jesse Mulligan the new Auckland cluster has underlined the threat posed to vulnerable communities.

The Associate Professor and Public Health Medicine Specialist at Auckland University's Te Kupenga Hauora Mā says  a new way of dealing with the Covid threat is now needed.

“In the first wave we were lucky that it was predominantly younger Pākehā travellers coming back from overseas and we were lucky that we shut the borders, which was a really good move.

“What that meant was luckily our brown communities, our Māori and Pacific communities, those measures that were put in place to stop the virus getting into our communities.

“We are lucky in that regard that the overall response actually did work quite nicely in the last round, but obviously this latest outbreak is completely different.”

This time the major community cluster is centred around south Auckland’s socio-economically poor Māori and Pasifika communities, with people in those communities also employed in the isolation centres and border facilities.

Not only is there greater risk of exposure, once exposed the risk of severe complications, because of existing health inequalities, is also greater.

“The impact of Covid is potentially going to have very dire consequences.”

There are 10 people in hospital from 101 infections this time round, reflecting this health vulnerability.

Dr Curtis says the community representatives are currently not at the table of government shaping the current health response, to make decisions grounded in experience of Maori and Pasifika. She characterises some decisions take it their absence as shocking, paternalistic and racist.

“This immediately jump to mandatory isolated – that wasn’t there last time. That wasn’t there when all the non-Māori and Pacific, young Pākehā travellers were Covid cases, so why is it here this time. Why have you done mandatory quarantine isolation for all the brown cases and not the white cases, if I’m going to be really blunt about it.”

Rather than potentially criminalising these communities, Dr Curtis would like to see a response that works with community representatives, empowering people to take appropriate steps to protect themselves.

“A Treaty-compliant approach would actually allow the solutions to come from Māori and Pacific community, not mandated down from the top.”

She says the government’s response is a signal that officials have no trust the capacity of these communities to respond themselves.

Director-General of Health Dr Ashley Bloomfield is responsive to these issues and softens when approached by communities, but she says it shouldn’t be necessary to have these conversations.

“There are just things here that could be done better… We need a plan that has flexibility to make decisions based on Māori and Pacific realities. At present it’s mostly done on a Pākehā reality.

“For example, around tangihana restrictions. That didn’t really take into account how tangihana was and the fact that we could still maintain the transmission risk… There is a way that we could have both met Māori reality around tangihana and also met public health expectations for infectious disease control.

“A new recipe for pandemic control would actually have a truly meaningful relationship with Maori communities and put their needs at the centre.

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