Omicron and equity

By Dr Rachel Mackie, Chair of Te Akoranga a Māui

These are ideas for how members and practices could increase equity. We’d love to hear your ideas too so we can develop and add to this resource. Email us at communications@rnzcgp.org.nz 

You can also download these ideas as a PDF.

Analysis of New Zealand’s earlier COVID-19 outbreaks showed clear and predictable inequities, such as Māori being 2.5 times more likely to require hospitalisations for COVID-19 infection compared to non-Māori and non-Pacific people. Read more in this article by Dr Maia Melbourne-Wilcox and Professor Sue Crengle.

Seek and find 
Proactively search for Māori patients who are not vaccinated and talk to them about vaccination, answer their concerns, and help them find their nearest vaccination centre (if that’s not with you). Even if people don’t want to be vaccinated now, keep the door open so they know they can contact you if they get in trouble. 

PHOs and practice leaders can search Māori patients too, looking for those with diabetes, obesity, and lung conditions (people who are likely to have worse outcomes) to ensure whānau are vaccinated.

Flag it, review it
Flagging the notes of high-risk patients so they get triaged and reviewed proactively if they contact the practice is a good idea because it also creates a scenario where you can check-in about COVID preperations. 

Make sure whānau have resources 
The Ministry of Health has 44 care coordination centres that have been established across the country and can support you to support patients with social needs. You can access them through your PHO or DHB. In the Auckland region all Māori patients are assigned to a hub that will allow for practical help such as kai and hygiene items.  Referrals also can be made to MSD.

Develop a list of trusted resources in your practice. For example, where to go for kai to be dropped off, which chemist can drop off medication, and where can hygiene items be dropped off.

Health Navigator’s managing COVID at home has good information for whānau

Practical tips from your trusted practice will be valued – you could make a factsheet to hand out at reception... or one to go into the local pharmacy’s bags. How do people prepare for Omicron? What happens if someone is isolating at home and needs childcare? 

Who can they call if they need help? 
Be really clear with patients about how and when to raise the alarm if they’re self-isolating at home. As health professionals we often think everyone knows this; they don’t. 

Print out the Ministry of Health’s preperation checklist for patients (even if people don’t have the resources to buy additional supplies they can consider access to medicines).

If whānau need to self isolate this tells them what will happen during that time.
 
How will you contact your people?
If you have a Facebook page then sharing your content on it is a great idea because people can share that trusted information with their less-connected communities and to other local groups and pages. 

Texting is an option and the College communications team uses a service called TextaHQ at the cost of about 14 cents a message. The service often advertises discounts for COVID messages so it’s worth getting in touch with them.

Are you able to do home visits for some of your patients? How will this happen realistically, is there another service in your area that can assist?

How can we welcome whānau who aren’t patients? 

We know that Māori will be hit hard by any COVID outbreak and that sometimes that’s also a population group that doesn’t have strong ties to primary care. Now is the time to make sure that approaching you for help is really easy. Forget the check ups about missed smear tests, or the talks about smoking, or weight loss – that’s all important but it’s for another time. 

Focusing on supporting them for COVID and their preparedness will do far more for your relationship and right now that’s the crucial conversation to have. 

Do you know what your DHB’s plans are?
Talk to your DHB now to better understand their plans if there’s an outbreak in your community and how your patients will get access to hospital services if they need them.