Death by COVID19 is brutal, lonely. For Maori we cannot repeat history this is why
VIDEO: Korero between Dr Anthony Jorden & Matthew Tukaki
UPDATE to this article: I want to thank the oldest living descendant of the whanau in the photo displayed in this article that originally caused mamae when it was first published some years ago without their permission. I want to not just thank them but also whanau members who have also reached out and have granted permission for its use in this article. Their message is that if the publication draws attention to the kauapa then proceed. Thank you from the bottom of my heart whanau.
There are few Maori alive today who have a living and direct memory of the impacts of the Spanish flu on our communities, particularly across the North. In 1917 and early 1918, the H1N1 strain of influenza swept the world, reaching New Zealand in early summer. It came back to Aotearoa by soldiers returning from Europe at the end of the First World War that would ultimately claim the lives of more than 8,000 New Zealanders.
To put things into perspective around 16,000 New Zealanders lost their lives on foreign battle fields in the “war to end all wars” and yet at home thousands would die not through conflict, but through the arrival of a deadly virus. The Spanish flu took an exacting toll on Māori. Over 2,160 died (a death rate of 4
2.3 per 1000 compared with the European rate of 5.5. per 1000). That compares with nearly 350 who died in the conflict of World War One.
Back in 1918 /19 there were no vaccinations and whanau died a terrible death – an infection would lead to the break down of the lungs and in almost every case death in highly impoverished Maori communities was a certainty. The health system in our regional and remote communities was non-existent with Maori essentially stepping up with little in terms of logistical or supply support – non-Maori health workers often refused to go into these communities because they knew that they too could lose their lives. As the pandemic began to dissipate other realities began to also sink in that would see many of these communities take years and decades to recover, if at all. Children lost parents; parents lost children. Grandparents, aunties, and uncles were lost – and with that went knowledge, stories, and whole whakapapa.
Image: A Maori burial scene / Public Health Summer School public lecture 7 Feb 2018 Professor Geoffrey W. Rice FRHistS
But, because very few people have that direct link, we somehow think this has all passed into history – and our young people and those in their middle years are the ones we need to be targeting with the brutal reality of what happens because of not getting things right as opposed to the running down rabbit holes on the increasing spread of misinformation.
It’s not misinformation that whole whakapapa was wiped out, or 2,160 of our people lost their lives. Or that for each of our Maori people lost in the Spanish Flu epidemic tens of thousands would be impacted.
Why is understanding our history and the grief visited on our people so important? Because right now, as we get down to the pointy end of this pandemic the largest tool in our arsenal to combat COVID19 is the vaccine; something that wasn’t available to any of our people back in 1918/19. And when I look at vaccine rates across some of those same communities impacted by the Spanish Flu, I see us lagging as a people – and yet this time around we have something that is different in our own arsenal – an army of nurses, medical professionals, social and community service workers as well as GPs and Hauora.
Across our older population groups 50-65+ we are making headway. But the vast rump of the Maori population is in the aged groups of 20-49 with our youngest able to be vaccinated in the 12-19 category – and its these whanau we need to get the message to so as not to repeat history. Why? Because the Delta variant of this Coronavirus is much more deadly.
The Delta variant – one of four “variants of concern” that have evolved from SARS-CoV-2, the virus that causes COVID-19 – is more than twice as infectious as the original virus and as infectious as chickenpox. A recent study from China, the potential source country, reported that people infected with the Delta variant can carry 1,000 times the viral load as those infected with the original virus. That study also found that people infected with the Delta variant carry detectable virus earlier than with the original virus (four days versus six days after exposure) and another study found that they remain infectious longer (18 days versus 13 days).
And death by Corona Virus or COVID19 is brutal, painful and exacting. This from science.org:
“When an infected person expels virus-laden droplets and someone else inhales them, the novel coronavirus, called SARS-CoV-2, enters the nose and throat. It finds a welcome home in the lining of the nose, according to a preprint from scientists at the Wellcome Sanger Institute and elsewhere. They found that cells there are rich in a cell-surface receptor called angiotensin-converting enzyme 2 (ACE2). Throughout the body, the presence of ACE2, which normally helps regulate blood pressure, marks tissues vulnerable to infection, because the virus requires that receptor to enter a cell. Once inside, the virus hijacks the cell's machinery, making myriad copies of itself and invading new cells.
As the virus multiplies, an infected person may shed copious amounts of it, especially during the first week or so. Symptoms may be absent at this point. Or the virus' new victim may develop a fever, dry cough, sore throat, loss of smell and taste, or head and body aches.
If the immune system doesn't beat back SARS-CoV-2 during this initial phase, the virus then marches down the windpipe to attack the lungs, where it can turn deadly. The thinner, distant branches of the lung's respiratory tree end in tiny air sacs called alveoli, each lined by a single layer of cells that are also rich in ACE2 receptors.
Normally, oxygen crosses the alveoli into the capillaries, tiny blood vessels that lie beside the air sacs; the oxygen is then carried to the rest of the body. But as the immune system wars with the invader, the battle itself disrupts this healthy oxygen transfer. Front-line white blood cells release inflammatory molecules called chemokines, which in turn summon more immune cells that target and kill virus-infected cells, leaving a stew of fluid and dead cells—pus—behind. This is the underlying pathology of pneumonia, with its corresponding symptoms: coughing; fever; and rapid, shallow respiration (see graphic). Some COVID-19 patients recover, sometimes with no more support than oxygen breathed in through nasal prongs.
But others deteriorate, often quite suddenly, developing a condition called acute respiratory distress syndrome (ARDS). Oxygen levels in their blood plummet and they struggle ever harder to breathe. On x-rays and computed tomography scans, their lungs are riddled with white opacities where black space—air—should be. Commonly, these patients end up on ventilators. Many die. Autopsies show their alveoli became stuffed with fluid, white blood cells, mucus, and the detritus of destroyed lung cells.”
That last sentence should be telling “Many die. Autopsies show their alveoli became stuffed with fluid, white blood cells, mucus, and the detritus of destroyed lung cells.”
And I dying they are not surrounded by whanau as some other disease like cancer – generally they die alone with just hospital staff present. There are often no funerals or tangi – no goodbyes to the dead as we know them in our traditions. And like so many other diseases are the stories that emerge of what we should have done or could have done. The thing with death is there is no could have done because by that stage it is already too late. It is done.
Why am I writing this? Because if we do not start openly talking about the harsh reality of what could happen and, as much as possible, prevent it then any number of fake YouTube or Facebook posts wont change the reality that some whanau might face – and we owe to ourselves, our whanau and our whakapapa that the memory of those who lost their lives in the Spanish Flu epidemic mean that we don’t forget the valuable lessons they have left us – and tools now at our disposal to do something about it – in other words the Vaccine.
Going down rabbit holes of mis-information and conspiracy theories are not an excuse you want to be rolling out as you have to watch a funeral on a ZOOM or Facebook live saying “I should have listened” – now is that time to listen.
Matthew Tukaki is the Chairman of the Ministry of Health’s Maori Health Monitoring Group and Chair of the National Maori Authority.
Study and research paper links: Viral infection and transmission in a large, well-traced outbreak caused by the SARS-CoV-2 Delta variant
Clinical and Virological Features of SARS-CoV-2 Variants of Concern: A Retrospective Cohort Study Comparing B.1.1.7 (Alpha), B.1.315 (Beta), and B.1.617.2 (Delta)
Current New Zealand Ministry of Health Vaccination Numbers (COVID19 as of the 14th of September 2021)