Inequities in COVID-19 Omicron infections and hospitalisations for Māori and Pacific people in Te Manawa Taki Midland region, New Zealand

Abstract

Covid-19 impacts population health equity. While mRNA vaccines protect against serious illness and death, little New Zealand (NZ) data exists about the impact of Omicron -and effectiveness of vaccination -on different population groups. We aim to examine the impact of Omicron on Māori, Pacific and Other ethnicities and how this interacts with age and vaccination status in the Te Manawa Taki Midland region of NZ. Daily Covid-19 infection and hospitalisation rates (01/02/2022 -29/06/2022) were calculated for Māori, Pacific and Other ethnicities for six age bands. A multivariate logistic regression model quantified the effects of ethnicity, age, and vaccination on hospitalisation rates. Per-capita Omicron cases were highest and occurred earliest among Pacific (9 per 1,000) and Māori (5 per 1,000) people and were highest among 12-24 year-olds (7 per 1,000). Hospitalisation was significantly more likely for Māori (OR=2.03), Pacific people (OR=1.75), over 75-year olds (OR=39.22), and unvaccinated people (OR=4.64). Length of hospitalisation is strongly related to age. Covid-19 vaccination reduces hospitalisations for older individuals and Māori and Pacific populations. Omicron inequitably impacted Māori and Pacific people through higher per-capita infection and hospitalisation rates. Older people are more likely to be hospitalised and for longer.

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“…7 14 This was supported by statistical modelling early in the pandemic, which estimated that the infection fatality rate of COVID-19 would be 50% higher for Māori compared with non-Māori when age was the dominant risk factor and 2.5 times higher if underlying conditions were prioritised 15 and was subsequently observed during outbreaks. 16 This early identification of increased exposure to risk and severe outcomes for Māori from COVID-19 led to preemptive organisation and action from both Māori health and other social sector workers, and communities. 17 18 A key focus of this work was the early establishment of Te Rōpū Whakakaupapa Urutā (the National Māori Pandemic Group)-a voluntary (and largely unpaid) coalition of health professionals to provide expert public health and clinical advice for whānau (extended family groupings), Māori health providers, community groups and iwi (Māori tribal groupings).…”

“…7 14 This was supported by statistical modelling early in the pandemic, which estimated that the infection fatality rate of COVID-19 would be 50% higher for Māori compared with non-Māori when age was the dominant risk factor and 2.5 times higher if underlying conditions were prioritised 15 and was subsequently observed during outbreaks. 16 …”

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“…Data about COVID-19 infections, hospitalization, and death across ethnic groups in other countries have been very limited and consisted at the early phase of several studies that estimate the severity of illness and death based on existing risk factors. In New Zealand, for example, Maori people were substantially more likely to have comorbidities associated with higher risk of severe COVID-19 illness and death (McLeod, et al 2020 ; Steyn, et al 2020 ; Whitehead, et al 2023 ). In Australia, researchers working with Indigenous people have asserted that longstanding health and socio-economic inequalities between Indigenous and non-Indigenous people are likely to worsen because of the pandemic (Priest, et al 2020 ; Markham and Smith 2020 ).…”