Preparing for new normal in wake of pandemic response

The conversations with Māori Covid patients in isolation began with a simple question – what matters to you right now?

The answers could vary, explained Lorraine Staunton, (Tuhourangi Ngāti Wahiao, Ngāti Rangiwewehi, Tuwharetoa) service delivery and operations manager at Te Piki Oranga, Māori health provider for Te Tauihu.

“Sometimes they have run out of dog food and they can’t go to a shop any more and they’re freaking out about that, or who’s going to look after their 80-year-old mother who lives down the road that they can’t actually get to now they’re in isolation.”

Te Piki Oranga set up a telehealth service in December last year to reach out to Māori isolating with Covid-19. They weren’t able to contact everyone – at one point 6000 people were isolating, but they were able to call around 300 patients to check in once or twice a day, over the course of seven to 10 days.

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The cases in Te Tauihu escalated rapidly at the end of February and peaked early April, Staunton said.

Sometimes what was needed was to get kai into their home immediately.

Others, living in cars, tents or backpackers with shared accommodation got support to move into Supported Isolation Quarantine motel units.

While they were there, they were given help to get into housing with assistance from Ministry of Social Development, Staunton said.

Parents also needed a hand – Te Piki Oranga have had to get supplies like nappies and milk powder out.

Staunton said in every consultation call people were asked about how their mental health was during isolation.

Young mothers, or single mothers solo parenting with four or five children by themselves found it tough.

“One call I made to someone I said, ‘Oh I couldn’t get hold of you earlier, were you asleep?’. ‘No we drove out to Rabbit Island, we stayed in the car, we didn’t talk with anyone’, they said, ‘it was either that or kill the kids’.”

Some employers were less than accommodating.

“People were ringing up crying and saying ‘my manager keeps hassling me to come into work’, they don’t believe I’ve got Covid, can you help me?’

“I would make call to the manager, [and tell them] you can’t be doing that, you can’t be hassling someone that’s got Covid, they need to isolate, you can’t expect them to be at work.”

Dr Ashley Bloomfield met the Nelson Te Piki Oranga team in Richmond last week.

ANDY MACDONALD / STUFF

Dr Ashley Bloomfield met the Nelson Te Piki Oranga team in Richmond last week.

Once pragmatic issues around food, care and employment were sorted, Staunton said, then you could say ‘OK, what are their symptoms?’.

Many were anxious about the illness itself, and that had to be addressed.

“It’s not just the physical effect of the body, it’s that mental-emotional effect that can actually make someone sick too. They’re fearful, they’ve got a fear around Covid-19, that they will get really sick, that they will end up in ICU and all of that sort of stuff that happened in our first lockdown.”

A lot of Māori whānau had comorbidities, she said. Their vaccination rates were also not as high as the general population.

They could be diabetic, have asthma, or heart conditions. The goal was to keep them out of hospital, and keep them from exacerbating any of the other health issues.

The service also worked with a dietician to produce videos explaining how to boost immunity with kai, before Covid-19 hit.

“We know those unvaccinated whānau needed to have an option, they’re just as important to us,” Staunton said.

“They’re our whānau regardless of the choices they have made.”

At the moment the service is putting together a plan for winter. They’re not sure if telehealth will need to be extended for flu and other respiratory issues.

But what they do know is that change is going to be inevitable.

“The tide changes so often we have to be in preparation mode constantly. We don’t know what the new normal is going to be.”

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