Dr Rawiri Taonui Covid Māori | A 4th Mega-Wave, Vaccines vs Variants, the Rich vs the Poor, and Annual Vaccinations 18 April 2021
Despite more than 860 million vaccinations delivered in over 200 countries, the world total has passed 140 million cases and three million deaths. Driven by new variants, a 4th Mega-Wave of Covid-19 that is now sweeping the globe threatens to be the largest since the virus left Wuhan.
The Third Wave
Between September last year to mid-January this year, a large third wave struck the United States, Britain, Europe, and Latin America. Growing at a staggering 20 million new cases per month, the third wave peaked at over 845,000 cases per day in early January. The 3rd Wave abated for about a month, as countries introduced stronger lockdowns and stricter travel rules, and began mass vaccination programmes. Daily cases halved to 370,000.
The third wave brought with it the potential for something more destructive with the emergence of new hyper-infectious strains of Covid-19. These variants made their way around the world because the pre-departure negative test certificate requirement most countries had introduced to counter the third wave largely failed. The absence of encrypted certificates and airline check-in staff having neither the training, the means nor the time to check the authenticity of certificates led to widespread fraud.
In February, the European Police Agency (Europol) issued an international warning about fraudulent negative test certificates. There were arrests in Britain, Span, France, Germany, Canada, Brazil, Slovenia, and the Czech Republic. In one instance, Italy suspended entries from Bangladesh, authorities later charging a lab owner with selling 4,200 false certificates. Three weeks ago, cybersecurity company Checkpoint found 1,200 sites on the dark web selling fraudulent certificates, including one entrepreneur offering buy-two get-one-free.
The 4th Mega-Wave
The 4th wave that is sweeping through countries with weaker health defences in the developing world will become much larger and run longer than the 3rd Wave.
India is driving up numbers in South-East Asia; Brazil is the centre of increasing cases in South America; Indonesia, the Philippines and Papua New Guinea are hubs of new cases in the Western Pacific, and Turkey, France, Germany, and East European countries increasing cases in Europe.
New cases worldwide have topped 800,000 three days in a row. On 15 April, there were 845,128 new cases, the second-highest daily total since the pandemic began. Unchecked, we could see one million cases per day within a fortnight. The world total is racing toward 200 million by June/July.
Variants of Concern
The battle against new variants will run into 2022. Covid-19 is mutating all the time. The more a virus spreads, the greater the opportunity for further mutations. Multiple variants have appeared around the world throughout the pandemic. Most are minor and of little consequence. Every so often, the virus will change in a way that helps it survive and reproduce. Variants that evolve in this direction have a greater chance of infecting more people. Over time, they can become dominant. Early in the pandemic, there was a change named D614G. The D614G strain was more infectious and became the dominant worldwide strain by the middle of 2020.
Since the last quarter of 2020, new variants often descendant extensions of the D614G change have appeared that are more infectious, produce more severe sickness, can evade antibodies, and have higher fatality rates. The World Health Organisation, Centers for Disease Control and Prevention (CDC, USA) and Public Health England (PHE, Britain) track five strains called Variants of Concern (VOCs) where research confirms they have these attributes. The table below outlines the numbered lineage name of each variant, the number of countries with the strain, and a summary of research findings.
B117 is the emerging dominant world strain. This might be because flights from London’s Heathrow Airport reach more destinations around the world than any other country. As they become more mobile, the P1 strain from Brazil and B1351 from South Africa might yet surpass B117.
Variants of Interest
The CDC and PHE also track nine Variants of Interest (CDC) or Variants under Investigation (PHE). These have genetic markers suspected (but not yet proven) of having the same characteristics as VOCs.
There is also concern that one or more of the Variants of Interest has features that could become future dominant. The B117+E282K Bristol variant appears to combine mutations found in both the B117 British and B1351 South African strains. The B1617 variant from India combines the E384K South African change and the L452R change found in the Californian strains. The Nigerian B11318 strain has an estimated fatality rate double that of the B117 variant.
Vaccines vs Variants
Concern also exists that the Covid-19 vaccines have reduced efficacy against the new variants. The Pfizer-BioNTech vaccine used in New Zealand is still reasonably effective against B117 but markedly less effective against B1351 and P1.
That vaccines are only slightly less effective against the dominant B117 strain offers hope. The PHE has estimated that there were 10,000 fewer deaths in Britain in February because they have vaccinated a sizeable percentage of the over-65 age group. The United States, where B117 has just become dominant, says the substantial number of over-65s vaccinated possibly explains why there are more cases in younger age groups. The CDC estimates that new cases among the first 66 million-plus Americans vaccinated are less than one in ten thousand. Israel, which leads the world in cases vaccinated, and where B117 is also dominant, has seen hospitalizations decline by 36% and 29% fewer patients severely ill with Covid-19.
The Rich vs the Poor
What happens in the developing world will decide the outcome of the race between vaccines and variants. On 9 March, the WHO reported that almost the entire supply of the best vaccines, Pfizer-BioNTech and Moderna, had gone to 75 richer countries while 115 other countries had received very few vaccines. The UN has reported that ‘most poor countries had been unable to administer a single dose of a Covid-19 vaccine, while rich nations had vaccinated their citizens at a rate of one person per second over the last month’.
Poor countries will see the arrival of vaccine doses in the coming days from the WHO administered COVAX programme set up to supply equal access to Covid-19 vaccines. However, the amounts available mean that poor countries can only vaccinate 3% of their people by mid-year, and at best only 20% by the end of 2021.
The dynamics, of wealth, privilege and entitlement are also playing out between the rich and the poor in Western countries. Los Angeles provides an example in adjacent middle-class and working-class residential areas. In the middle-class area, 25% of residents caught Covid-19 last year, 75% have received vaccination. In the working-class area, 75% had caught Covid-19 last year, this year 25% have received vaccination. There are examples around the world of people paying to queue jump. In New Zealand, we have seen non-front line Auckland District Health Board members queue jump to receive a vaccination. There is a black market in vaccines; some sell genuine vaccinations, many do not.
There is a clear risk that the differential in vaccinations between rich and poor countries will see the ascendancy of variants like B1351 and P1 or newer hypervirulent strains from under-vaccinated developing countries. Either scenario will have consequences for the effort to vaccinate the world’s population.
Completing vaccination in rich countries will take until the end of 2021. Pfizer-BioNTech and Moderna are developing vaccines for a second round of inoculation in 2022 to combat the new variants. Should new virulent strains appear, the world will need a third round of vaccination. At that stage, annual Covid-19 vaccinations are likely as we face seasonal bouts of the cold, flu, and the more deadly Covid-19.
Kia noho haumaru
E ngā maruwehi o Whangaroa
E ngā maruihi o te kāinga
Tēnā koutou katoa
👉COVID Vaccination Information Evening
👉Tuesday 30 March 2021, 5pm-6pm
👉Kāeo Memorial Hall, Leigh Street Kāeo
⬇⬇⬇
An information event attended by Associate Health Minister, Hon. Peeni Henare and Minister of Health Clinician.
Nau mai, haere mai.
Tēnā koutou katoa e aku rangatira,
I’d like to announce the release of the COVID-19 Mâori Vaccine and Immunisation Plan, which builds on the Updated COVID-19 Māori Health Response Plan implemented in 2020.
This plan outlines key initiatives that will be undertaken to ensure the COVID-19 Vaccine and Immunisation Programme addresses its obligations under Te Tiriti o Waitangi and supports Māori health and equity.
He mahi ngātahi – Working collaboratively
The COVID-19 response has been a collective effort involving hapū, iwi, hapori Māori, the wider health and disability provider network, and the broader health and disability system, workforce and government. The achievements and progress made are the result of collaboration and kotahitanga.
It is essential the Ministry continues to encourage and enable this unified effort as part of the COVID-19 Elimination Strategy for Aotearoa New Zealand. The successful delivery of the Programme will be critical to meeting the objectives of the Elimination Strategy.
Ko Te Tiriti te pūtaketanga – Fulfilling our obligations under Te Tiriti
The Ministry is committed to fulfilling its obligations under Te Tiriti o Waitangi as part of the COVID-19 Maori health response, including through working in partnership with our iwi and Māori health provider network. Initiatives include:
· governance and partnership
· targeted vaccination approach
· Māori health and disability provider support
· workforce development, and
· tailored communications.
The Programme will help to manage the impact of COVID-19 on Māori which will enable us to:
· provide our most at-risk groups with a layer of protection through the vaccine to minimise the potential harm of contracting COVID-19,
· potentially reduce the risk of transmission in the community, and
· support the health and disability system’s readiness and resilience if there is an outbreak, both by vaccinating certain health workers early and by vaccinating the groups most at risk of severe illness if they contract COVID-19.
Te Pūtea – Funding for a targeted Māori response
To ensure the Programme is responsive to Māori and delivers on equitable health outcomes, the Ministry has committed $39 million for a targeted Māori response. Of this funding, $11 million will support Māori and iwi health providers to prepare for their delivery of the COVID-19 immunisations and $24.5 million will go towards support services for whānau to improve access to COVID-19 immunisation services.
Hei tîmatanga – First stage of the Programme
Our first focus is to get this $11 million directly to selected Māori and iwi health providers who have existing vaccinator capabilities. The funding will be allocated through a population-based funding formula and our focus will begin in April with the Counties Manukau DHB region. This funding will support providers to prepare their workforce, operational infrastructure, and systems needed to deliver the COVID-19 vaccine to whānau, hapū, and iwi.
It is intended for this investment to leave a legacy to help build the capability and capacity of the Māori health sector for future programmes.
You can read the plan online here.
If you have any questions, please feel free to contact the team at: maorihealth@health.govt.nz
Mā te Atua koutou e manaaki hei ngā rangi e tū mai nei,
Nāhaku me aku mihi aroha,
COVID-19 Vaccine Rollout Plan
10th March 2021
Today marks an exciting milestone in our fight against COVID-19. Minister Hipkins announced the COVID-19 vaccine rollout plan and Minister Henare shared how we’ll support Māori communities throughout the vaccination campaign.
I want to speak to these two announcements and share what they mean for you and your whānau.
Vaccine rollout announced
The Aotearoa vaccine rollout plan sets out the order in which the COVID-19 vaccine will be administered across the motu.
The plan focuses first on protecting those most at risk from being exposed to COVID-19, reducing the risk of future community cases and lockdowns, and then protecting those most at risk of getting seriously ill if they get the virus.
The sequencing plan provides certainty to the over two million people who can expect to start being vaccinated during the initial stages of our roll-out over the next 3-4 months.
Our plan is to vaccinate Aotearoa in four broad groups, these are:
1. Our 50,000 border and MIQ workers, their household contacts and the people they live with. This started last month, and the vast bulk will be completed this month, with at least one dose administered.
2. Approximately 480,000 frontline workers and people living in high-risk settings. Starting with the 57,000 healthcare workers on community frontlines, and then moving through to healthcare workers protecting our most vulnerable and some priority populations. Anyone who lives in the Counties Manukau DHB area who is 65 and older or has an underlying health condition is also included in this group. Vaccination of these people started in February and will continue through to May.
3. Priority populations. Approximately 1.7 million people who are at higher risk if they catch COVID-19 – this is planned to start in May. Whānau Māori and Pacific communities will feature significantly in this group, not only as kaumâtua and elderly aged 65 and over, but also because our people suffer disproportionately from other conditions which make them more vulnerable.
4. The remainder of the general population – approximately 2 million people. This will start from July.
If you’re wondering when you’ll be able to get your vaccine, kia mau tonu mai – an online tool that helps whānau find out when they can get vaccinated will be launched shortly. It will describe the four broad groups and will take people through a series of questions to work out when it’ll be their turn.
I want to reiterate the Minister’s kōrero, getting vaccinated is the best way we can keep our whānau safe against COVID-19. Kia kaha rā e hoa mā!
Funding to support Māori
The Government has committed dedicated funding and resources for Māori communities to prepare for the COVID-19 vaccination programme.
Initial funding of about $39 million will ensure Māori communities and providers are prepared for the roll out of the COVID-19 vaccination programme in their hapori.
An initial 40,000 courses of the COVID-19 vaccine will be provided specifically for Māori and Pasifika health providers giving the providers the flexibility to best meet the health needs of our people.
The funding and vaccine allocation is as follows:
• $24.5 million for the development of community-based vaccine support services that will support Māori Health Providers to engage and prepare their communities for the COVID-19 vaccination programme
• $11 million to be provided directly to Māori Health Providers to help build provider infrastructure and workforce capability
• $2 million for iwi to deliver dedicated and tailored communications campaigns to their whānau
• $1.5 million for workforce development
• 40,000 courses of the COVID-19 vaccine as a starting point for Māori and Pasifika health providers.
I will continue to provide updates through this pānui as the funding is distributed.
COVID-19 Māori Vaccine and Immunisation Approach
Many of you have been asking for a detailed plan on how we will support whānau Māori throughout the COVID-19 vaccination campaign.
Now that decisions have been made on the overall rollout, a document outlining the COVID-19 Māori Vaccine and Immunisation approach is being finalised and will be made available online in the next week.
This document outlines key initiatives incorporated across the Programme that focus on ensuring the fulfilment of Tiriti o Waitangi obligations and achieving equitable outcomes for Māori.
These initiatives include:
• Iwi/Māori involvement in the governance of the programme and in technical advisory groups,
• targeted vaccination approach,
• provider support,
• workforce development,
• communications.
Through these, the Ministry will support and resource Māori communities and organisations to prepare for and participate in the roll-out of the COVID-19 vaccine.
Keep watch of my pānui for more updates.
Finally, I want to remind you and your whānau to get all your information on COVID-19 and the vaccine from our trusted sources;
If you have any pātai, please feel free to contact me or my team at: maorihealth@health.govt.nz
Te Kahu o Taonui [Te Tai Tokerau Iwi Collective], has played a vital role in supporting local whānau and communities during the COVID-19 crisis. Its ongoing influence will be critical as Te Tai Tokerau enters the recovery phase.
One of the big gains for TKoT is our representation on the Northland Civil Defence Emergency Management (CDEM) Team in response to COVID-19. The CDEM Group provides regional leadership during a crisis and this is the first time Te Tai Tokerau iwi have had representation here.
For communities like Whangaroa which are off the main highway, has patchy internet access and no septic or water mains; building resilient whānau and communities is the top priority.
A collective iwi database has given TKoT a much clearer picture of where its vulnerable whānau are living as well as the region’s energy, water and housing needs. We, Ngātikahu ki Whangaroa has confidence that Te Kahu o Taonui will still be as active as it is now in two to three years’ time.
In light of the current COVID-19 pandemic, please abide by the restrictions put in place by governing authorities as these protocols are put in place to keep you and your loved ones safe.
Contact us if you require assistance and you are unable to receive it elsewhere - i.e. genuine homelessness, overcrowding, single persons over 55, those most vulnerable to complications due to either isolation or medical issues, etc.
If our agency cannot help you directly, we will be able to direct you to the right support.
If you require further information on how to help stop the spread of infection, please visit the following pages for current and official updates.
Te Rōpū Whakakaupapa Urutā | National Māori Pandemic Group
The official New Zealand Government website for information about the COVID-19 pandemic. Please follow protocols to help keep those who are vulnerable to infection in our communities safer.