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Why the reopening still holds dangers for some

Summer spells holiday plans for many people but for those vulnerable to the virus, the ‘traffic light’ system presents a whole new set of risks. Katie Kenny reports.

WHEN a positive Covid-19 wastewater result was detected in Stratford, Taranaki, in early November, Sarah pulled her son out of school.

‘‘I work full-time, so I’m in a bit of a situation,’’ she says.

Sarah, who asked to remain anonymous for the sake of her job and because she’s breaking the law by not having her son at school, says unvaccinated children and parents posed too much of a risk to him. The seven-year-old has a rare genetic condition along with bronchiectasis – a long-term lung condition – and asthma. ‘‘He’ll end up in hospital on oxygen a couple of times a year. He’ll pick up a cold, and be unable to fight it off.’’

She feels vulnerable children such as hers have been neglected during the pandemic and Covid-19 has only intensified existing structural inequities in a healthcare system where vulnerable people are underrepresented, she says.

For the many eligible New Zealanders who are fully vaccinated against Covid-19, the introduction of the new ‘‘traffic light’’ framework will feel like a return to normalcy but the move from elimination to coexistence with the virus is deeply concerning for the most vulnerable – particularly as Delta spreads beyond Auckland, and the new variant Omicron looms large.

‘‘The Government has failed to show how it can support people like us,’’ Sarah, who is fully vaccinated, says. While it won’t be a cure-all, she’ll feel better once her son is able to get vaccinated – likely from late-January.

Immunisation Advisory Centre medical director Nikki Turner says those most at risk are the unvaccinated as well vaccinated elderly people with underlying conditions.

Generally, age – more than sex, ethnicity and even underlying health status – is by far the most important factor in determining someone’s risk from Covid-19. In the United States, data suggests more than 75 per cent of Covid-19 deaths have occurred in people over 65. People aged 75-85 were 150 times more likely to die after getting Covid than those in the 18-29 age group.

It’s also common for the immune system to weaken during pregnancy, making pregnant people more susceptible to getting sick.

For most vaccinated people, if they’re unlucky enough to still get Covid-19 they’ll probably have a mild form of the disease. But the vaccine may not work as well in people

‘Checking in, showing a vaccine pass, perhaps if service is slower, these things add up and remind people things aren’t back to normal. And I think some find that hard to deal with.’ DR SARB JOHAL

with compromised immune systems. The spectrum for being immunocompromised varies – from people who take small doses of steroids, to those who have had solid organ or bone marrow transplants. People who have cancer, are immunocompromised or taking medications that suppress their immune system are at increased risk of severe illness from Covid-19. They’re also more likely to have a prolonged infection and transmit the virus to contacts.

Because they might not mount as strong a response to the vaccine as someone with a fully functioning immune system, it’s recommended immunocompromised people get a third primary dose. (This is different to a booster dose, which is offered at least six months after the usual twodose course.) The eligibility criteria are complex, and apply only to people who are ‘‘severely immunocompromised’’. More than 15,000 Kiwis have had three doses so far. (Nearly 70,000 have had a booster dose.)

It is also critical that immunocompromised people have a ‘‘wall of vaccination’’ around them, experts say. This means making sure friends and family are also vaccinated.

So what does all this mean for people travelling from

Auckland, the centre of the Delta outbreak, to visit elderly relatives during the holiday season? Or for pregnant people wanting to go to the office Christmas party?

‘‘It’s worth asking: who in my wha¯ nau has significant medical problems, asthma or respiratory issues? How can I protect them? This is why vaccination is a community, rather than an individual thing,’’ Turner says.

There are other steps families can take to stay safe, such as mask-wearing and physical distancing. While you can still transmit or catch Covid-19 outdoors, the chances are greatly reduced. And if you have to be inside – crack a window or open a door, Turner suggests.

Registered clinical psychologist Dr Sarb Johal says while Covid-19 anxiety isn’t new, ‘‘what is new is how this is going to be something we’re thinking about all the time’’.

‘‘These risks are dynamic, and they’re going to be changing. That’s hard for people. We want hard and fast advice. But what we need to be doing is keeping an eye on things and being flexible and making judgments based on what

situation we’re in.’’

Families and individuals are going to have to make trade-offs based on their own risk profile. Other countries’ reopenings have coincided with a rise of public hostility and incivility: ‘‘People have a strong desire to go back to normal. And checking in, showing a vaccine pass, perhaps if service is slower, these things add up and remind people things aren’t back to normal. And I think some find that hard to deal with.

From December 15, Aucklanders will be able to travel outside their region. Covid-19 modellers and public health experts have warned that summer travel will lead to increased spread of the virus.

Johal says when you go on holiday somewhere, you’re essentially joining that community.

‘‘That’s a lens people can bear in mind. How do you do that in a way that’s good and helpful? How do you contribute socially? If there’s an active outbreak, or active vulnerability perhaps owing to low vaccination rates, perhaps you choose not to go there.’’

NEWS

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2021-12-05T08:00:00.0000000Z

2021-12-05T08:00:00.0000000Z

https://fairfaxmedia.pressreader.com/article/281633898523859

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