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Covid-19 cases found in Hauraki – Expert Reaction

Three new Covid-19 cases in rural Waikato, south of the Auckland border, have exposed a hole in the Alert Level 4 boundary.

The cases are in the same household as a person released from remand at Mt Eden prison, into their nine-person household in Kaiaua/Whakatīwai.

The SMC asked experts to comment on:

Auckland-Waikato border

Dr Dion O’Neale, Principal Investigator, Te Pūnaha Matatini; and Lecturer, Physics Department, University of Auckland, comments:

“Although we would never claim to have predicted this specific case or scenario, it’s not too surprising to see spread between Auckland and this region of Waikato, just south of the Auckland Region border. When we look at the patterns of people’s movements, even just for work and education, we see lots of potential interactions that spill over from the Auckland Region to areas like Miranda-Pūkorokoro, where Kaiaua is located.

“In fact, our naïve algorithm that uses community detection based on the number of potential work and school interactions between people living in different areas, would put the Miranda-Pukorokoro area in the same community as the Auckland Region, based only on these interaction patterns. That is, it would have suggested that Kaiaua/Miranda-Pūkorokoro should have been inside the AL4 region with Auckland, along with some of the other areas in Northern Waikato — all along the Auckland Waikato border. There might, of course be other specific reasons not to include Miranda-Pūkorokoro and similar areas within the Auckland AL4 region, such as access to shops, or healthcare, though it is worth noting that Kaiaua is actually within the Counties-Manukau DHB — another indication of how connected that part of Aotearoa is to the Auckland Region.

“While the details of the interaction in this case are different from what our model considers, in that the individual involved was moving between a prison and a dwelling and was moving across a controlled regional boundary at a time when many employment (and all education) movements are restricted, we shouldn’t be surprised to see that the same broad patterns of movement and interaction hold in this case. The patterns of how people move in general are, to first approximation, roughly similar to how they move for work and education.”

Note: Dr O’Neale co-authored a paper on the regions most vulnerable to Covid spread from Auckland during the early stages of this delta outbreak.

Conflict of interest statement: I, along with others from Te Pūnaha Matatini, are funded by Department of Prime Minister and Cabinet to provide advice on the COVID response and from a Health Research Council grant to look at equity related to COVID in Aotearoa.


Professor Andrew Geddis, Faculty of Law, University of Otago, comments:

“It’s important to remember that individuals released on bail have not been convicted of any crime. They are as yet only accused of committing an offence. As such, rather than being imprisoned for something they may not have done, release on bail is a legal right for most alleged offenders facing charges of less than three years. Nothing in our response to Covid has changed this basic legal right, and nor should it.

“Consequently, the Covid Order establishing different alert levels and setting the rules for moving between them specifically recognises that a person may be bailed to an address in a different alert level. If a Court makes such an order, the person is legally entitled to travel to that address. Otherwise, if this is the only suitable address for bail, that person would have to remain imprisoned while different alert levels are in place.

“In the immediate case, however, the bailed individual was released on electronic monitoring. This involves a requires a quite lengthy assessment of the suitability of a particular address. Therefore, well before the bail hearing, the Department of Corrections and the Court would have known that the individual was going to be moving from a level 4 to a level 2 environment. It seems strange, therefore, that a Covid test was not administered before this bail hearing so that the judge could decide whether it was more suitable to bail the individual to the Waikato address or to a MIQ facility. That appears to be a procedural flaw that should be rectified in the future.”

No conflict of interest.

Professor Claire Breen, Faculty of Law, University of Waikato, comments:

“There is a balancing act here. A person on remand in prison has the right to apply to be released on bail. Then it is up to a judge to decide whether to release that person with the judge looking at questions like whether that person has somewhere to stay and what special conditions apply. One of these conditions could be release on bail with electronic monitoring (EM) to a specific address, for those who apply for it.

“On the other hand, the Courts still have to be satisfied that, amongst other things, that the proposed EM address is appropriate for the purpose of bail with an EM condition and what ‘appropriate’ means in the context of a Level 4 lockdown, where considerations of public health must also be taken into account.”

No conflict of interest declared.

Professor John Hopkins, Professor of Law specialising in Law and Disasters, University of Canterbury, comments:

“This case shows that the much vaunted all-of-government approach being applied to the COVID pandemic has, at times, been skin deep. Although the political response has been impressively coherent, at the administrative level siloisation remains a big problem. This is nothing new. The New Zealand government structure has suffered from such administrative silos (colloquially described as the “headless chicken” school of management) since the New Public Management reforms of the 1980s. This government has attempted to address this through the recent Public Service Act reforms, but this in itself is not enough.

“In a disaster, such incoherent approaches are amplified and the consequences are far more serious. In this case, it did not take a rocket scientist (or a public health expert) to realise that allowing prisoners to leave L4 areas without testing (which appears to have been the case) was not a good idea. However, lacking an effective overall emergency administrative infrastructure (which in theory the National Emergency Management Agency should provide) such oversights and mistakes will happen. It seems that finally New Zealand’s luck in avoiding such consequences from its effective, but rather ad hoc response, may be running out…”

No conflict of interest declared.

Hauraki and rural areas

Dr Clive Aspin, Associate Dean Māori & Senior Lecturer in Health, Victoria University of Wellington, comments:

“As one of the regions in Aotearoa first visited by Cook and subsequent colonial exploitation, Hauraki and its people have borne the brunt of colonisation.

“Today with the spread of COVID-19 into Hauraki, we are reminded of the harmful long-term impact of threats such as these to health and wellbeing. The potential to exacerbate current disparities is significant and all precautions need to be taken to protect people from further harm.

“Some areas of Hauraki such as Coromandel have high numbers of Māori living there. Up to 30% of people in the northern part of Coromandel identify as Māori. The potential for COVID to exacerbate disparities and put overwhelming pressure on health services is significant.

“I am from Hauraki and I know that levels of anxiety among my whānau and the people of Hauraki are high.

“The government needs to act with haste to resource initiatives to prevent the spread of COVID-19 across Hauraki. The local Māori health provider is a key stakeholder in protecting the health of Māori, especially the elderly and it is imperative that they receive adequate resources to respond to the extra demands that this outbreak places on their services.

“People in rural locations of Hauraki face overwhelming barriers to care and support, and attention must be provided to ensure that these do not prevent people from getting much needed culturally appropriate COVID-related health services. There needs to be an exerted effort given to increasing vaccination rates as a matter of urgency.”

No conflict of interest.

Dr Jesse Whitehead, Research Fellow, Te Rūnanga Tātari Tatauranga – National Institute of Demographic and Economic Analysis, University of Waikato, comments:

“We know that access to health facilities, including vaccination services, is worse in rural areas of Aotearoa. This is true even for communities with ‘priority’ populations that are at a higher risk of severe outcomes of Covid-19 infection. Our latest research highlights that neighbourhoods with a high proportion of Māori, high proportions of older people, areas of high socioeconomic constraint, and rural communities all have worse access to Covid-19 vaccination services.

“This has translated to inequitable vaccination coverage, particularly for Māori. In regions where access to vaccination services is worse, the rate ratio of vaccination coverage for Māori is also worse. Although we are yet to see an urban-rural or socioeconomic breakdown of vaccination coverage, I would expect that there are also significant ethnic, socioeconomic, and rural-urban inequities in vaccination coverage within DHB regions.

“In this particular situation, it appears that in Kaiaua, Te Korowai Hauora o Hauraki have done a fantastic job of pre-empting this risk and have been taking mobile vaccination clinics to Kaiaua Marae. However, this won’t necessarily be the case for rural, remote or socioeconomically constrained communities in other parts of the country. We need to be doing all that we can to ensure that 100% of the eligible population has the opportunity to become vaccinated, and we need to prioritise coverage for populations at greatest risk of severe outcomes from Covid-19 infection – Māori, Pacific, disabled people, older people, and people living with socioeconomic constraint.

“That will mean bringing the vaccine to people and giving Māori and Pacific communities the resources to achieve high rates of vaccination against Covid-19.”

No conflict of interest.

Associate Professor Garry Nixon, Department of General Practice and Rural Health, University of Otago, comments:

“It’s important we get good data on vaccination and testing rates in rural areas. People in rural communities do have to travel further in order to access work and services – including education and health – vaccination and testing. Māori are more likely than non-Māori to live in rural areas and we know that at a national level vaccination rates are much lower for Māori. We don’t yet have data on the additional impact of rurality on vaccination and testing rates. In light of recent events this is becoming increasingly important and will hopefully be available soon. It will help identify gaps in rural areas that can then be targeted.

“I agree with Te Rōpū Whakakaupapa Urutā co-leader Sue Crengle, that until we have excellent vaccination rates in all communities, including isolated rural communities where many Māori live, we need to take a conservative approach to relaxing lockdowns.”

No conflict of interest.