An investigation into the country's August 2020 Covid-19 outbreak has found there was delay in contact tracing for Pacific people, contributing to widening health disparities.
The study by Pacific Perspectives found of the 179 cases in that outbreak 59 percent were Pacific people, many living in areas of high socio-economic deprivation and with higher rates of co-morbidity (the presence of two or more diseases).
Of 2528 registered contacts, (46 percent of whom were Pacific), overall 41 percent were reached within four days of onset of disease in the case.
But that was significantly lower for Pacific people (31 percent) than for other ethnic groups.
The study found the significant delay in the timeliness of care for Pacific people showed the public health response was inequitable for those at highest risk.
It found that compared with all other ethnic groups, Pacific people were more likely to live in 'high deprivation' neighbourhoods and had the highest rates of household crowding.
Pacific people also made up a high proportion of border workers who were more likely to be exposed to incoming travellers, the study said, making an undiagnosed Pacific border worker the most likely root source of this outbreak.
It was expected that an outbreak disproportionately affecting Pacific people in South Auckland would occur, the study said.
It contrasts with the initial March 2020 outbreak where cases were predominantly imported by returning Kiwis, with a significant number of those affected younger adults of New Zealand European ethnicity.
One of the authors of the study, Debbie Ryan, said the research showed a one size fits all approach did not meet the needs of the people most at risk and contributed to "widening equity debt".
She said it showed the need for a culturally inclusive response in future outbreaks.
The study also noted that these same Pacific communities in south Auckland were the most affected by New Zealand's measles epidemic the year prior.
Lessons for the future
South Auckland GP and chair of the Pasifika GP network Dr Api Talemaitoga said the findings of the study were no surprise.
He said many had predicted Pacific people would be more susceptible to the Covid-19 virus.
"They're factory workers, they're cleaners at the airport, in hospitals, and so they were at high risk of exposure to the the virus," he said.
Talemaitoga said: "We thought if this virus takes hold, then it would spread like wildfire in those living in overcrowded situations."
He acknowledged that in a time of crisis everyone was still learning, however, he hoped the health sector and community learned from the experience, to make sure future interventions were up to scratch.
"A future response needs to involve the community leaders and clinicians from the Pacific community because they will come up and they will assist our health workers or our Ministry of Health with how best to make the interventions work in a culturally appropriate way."
Dr Talemaitoga said one example was contact tracing.
He said contact tracers ringing up people in the Pacific community who may be already suspicious of health services, sometimes presented negative connotations of a government agency (such as immigration) ringing up to check on them.
It contrasted with language appropriate people who used the cultural protocols ringing to talk people through the messages of the pandemic, which proved a more successful approach.