‘By protecting ourselves, we can allow others to come and enjoy the paradise we have here’
When the first batch of ‘precious’ Covid-19 vaccines landed in Rarotonga, coinciding with the much-anticipated NZ travel bubble, there was a sense of relief and hope for the freedoms it may bring. But freedom is fragile and there’s much at stake, as Hanna
It’s raining as the first quarantine-free flight from Auckland touches down in Rarotonga, mist settling on the craggy mountains commanding the heart of the island. Cook Islanders consider rain a blessing during events of significance: particularly auspicious as the plane is carrying more than just passengers – it’s carrying the promise of a more normal life.
Onboard flight NZ940 are the first 302 travellers the country has seen in more than a year, each breaking into applause on arrival. Tucked away in the cargo hold are the first 405 vials of Pfizer/ BioNTech vaccine — enough to vaccinate just shy of a quarter of the island’s population.
The flight, and its contents, represented a first step: the beginning of an 80-day programme which will see 10,189 Cook Islanders vaccinated. It also heralded the start of New Zealand’s vaccine roll-out to the Pacific, with Aotearoa set to provide enough doses for at least 1.2 million people in the coming year.
Rarotonga is untypically quiet in the days following that first flight. Smatterings of tourists scooter along the main road, but stretches of sand and beachfront loungers are mostly empty. These moments are tranquil, but underscored with the knowledge the country’s Covid-free status could be lost if just one thing went wrong. If one person with the scratchy start of a sore throat didn’t get tested before setting off on holiday; or if a leak at the border went undetected.
It’s a tension widely felt and the question of why there was not more time to vaccinate the country before the border opened comes up often. Minister for Pacific Peoples Aupito William Sio says New Zealand committed to getting vaccines to the Cooks at the ‘‘earliest possible time’’. Planning for the rollout and two-way quarantine-free travel bubble were undertaken in parallel, rather than one being contingent on the other. But no time is wasted once those prized vials arrive.
The first shipment touched down in Rarotonga at 2.20pm on May 17 (local time). Less than three hours later, Health Secretary Bob Williams rolled up the sleeve of his red button-down to become the first person vaccinated, alongside 31 others jabbed that day.
After completing his 20 minutes’ observation, Williams felt ‘‘awesome’’. The otherwise painless moment was a ‘‘milestone’’ — the start of a new chapter.
On the morning of the roll-out’s first full day, the atmosphere at the Nikao social centre, where border and frontline health workers park their cars and wait for their ride up to Rarotonga hospital, is jubilant.
A dozen people bundle into a hospital shuttle bus, snaking up the hill to be welcomed by a chorus of ‘‘Kia orana, aere mai’’.
Met by the Cook Islands Health Ministry Te Marae Ora and Red Cross staff, each person is given a dollop of hand sanitiser and a disposable face mask before their jabs.
In typical tropical fashion, the weather turns quickly and often but as rain lashes down, spirits are high.
In a back room, tucked away from the noise, Charlie Emmanuela and a handful of other nurses have been working since 5.30am.
She is among five people on the dilution team, whose job it is to reconstitute the vaccine with saline and painstakingly draw out the five, six or seven doses each vial allows.
A nurse practitioner in public health, Emmanuela says getting started was nervewracking.
Once the fridge is opened, they have two hours to dilute the vaccine. Once diluted, there are six hours before it can no longer be used. By midday on the first full day, they’d drawn about 70 vials — approximately 420 doses.
‘‘So far, so good, we’re just waiting for the people now,’’ she smiles.
The people come. There are so many in the first few days that the island exhausts its first supply and has to delay the next scheduled vaccinations to allow for a second shipment to land.
Fewer than 10 days into the roll-out, approximately 80 per cent of people on Rarotonga had received their first dose, once again outstripping supply.
In her office upstairs at Rarotonga Hospital, never far from the action, Dr Yin Yin May didn’t expect to be at the helm of the Cook Islands’ Covid19 vaccine roll-out but now the head of health services at Rarotonga Hospital feels ‘‘very responsible’’ for its success.
She was the second person in the country to receive the vaccine. ‘‘This is a very big moment,’’ she says.
The roll-out is the first ever mass vaccination programme for adults in the Cook Islands, a colossal undertaking, and one which ‘‘means a lot’’ to her. ‘‘I feel very privileged to be part of this.’’
Softly spoken and always smiling, she is everywhere at once – poised to act if anyone needs her, or if anything goes wrong.
Unlike in New Zealand, where people have some choice about where and when they are vaccinated when called up, here the process is ‘‘really tight’’.
People can’t miss their opportunity to receive a jab. Once it’s gone, it’s gone.
After the first round of vaccination in Rarotonga ends on May 31, staff head to the island of Aitutaki to vaccinate for three days, before returning to Rarotonga to start a 14-day stint of second doses, and later moving on to the Pa Enua (outer islands).
The northern group of islands are farther flung. Some don’t have airstrips, making them accessible only by boat.
While officials aim to reach Pukapuka – one of the most isolated of the Cooks, about 1140km from Rarotonga – next month, the New Zealand Defence Force may be required to get vaccine to other remote atolls.
There is a lot of pressure. May needs to order the correct amount of vaccine at least 72 hours before it is required.
By the end of the first week of vaccination, not a single dose had been wasted. ‘‘We understand how precious it is,’’ she says.
Though the vaccine is a welcome step towards the islands opening up again, the potential fallout from Covid-19 looms large. Just a handful of cases could overwhelm the Cook Islands.
As a realm country, Cook Islanders are New Zealand citizens and rely on Aotearoa’s healthcare system. New Zealand is a safety net, and will be in the event of an outbreak.
If one person tests positive, the Cooks would call on New Zealand to speed up and co-ordinate contact tracing.
The health system – already operating with scant resources – has been shaken up in the face of Covid-19. During the throes of the pandemic, the health ministry shifted Rarotonga Hospital’s emergency department and outpatient care to the Tupapa community health clinic.
There are just two emergency beds there for the whole population, compared with six at the hospital. Tupapa’s dental services are emergency
‘Ten cases in Auckland doesn’t matter so much. Ten cases in Rarotonga is a big deal. It’ll be an exercise, for sure.’ UNIVERSITY OF AUCKLAND ASSOCIATE PROFESSOR COLLIN TUKUITONGA, Pacific public health specialist and associate dean in the Faculty of Medical and Health Sciences
only, and elective surgery has been paused during the roll-out.
University of Auckland Associate Professor Collin Tukuitonga, Pacific public health specialist and associate dean in the Faculty of Medical and Health Sciences, was in the Cook Islands before the bubble opened to help assess the country’s preparedness.
Contact tracing was ‘‘not quite up to it’’, but has since been bolstered. With only nine community nurses to do all the work, they ‘‘just didn’t have enough people’’.
The nation has a ‘‘very small’’ health service, with about 17,000 people sharing six to seven doctors and four ventilators. ‘‘All up, the health service has about 30 to 35 people.’’
Puna (community health) clinics dotted across the island’s five districts have shut their doors for 10 weeks, as staff have been deployed to help facilitate the vaccine roll-out and maintain services at the hospital.
‘‘Clearly if there was an outbreak, it would need to be supplemented in some way,’’ Tukuitonga says.
Two doctors, four nurses and a pharmacist are being sent to the Cook Islands from New Zealand on two-week rotations as part of a Medical Assistance Team.
Clad in matching cargo jumpsuits, the team moves between the hospital and Tupapa. While not part of the vaccinator workforce, they ensure essential health services are maintained.
While local doctors and nurses do the best with what they have, they are ‘‘limited’’ in terms of staffing and resources.
However, the Cook Islands have a leg-up on tracking people down, Tukuitonga says.
Everyone knows everyone — something that becomes apparent when you walk the main drag, or visit the Saturday morning market.
It’s hard to say what the country could and couldn’t handle, but ‘‘it wouldn’t take much to overwhelm them’’.
‘‘Ten cases in Auckland doesn’t matter so much. Ten cases in Rarotonga is a big deal,’’ Tukuitonga says. ‘‘It’ll be an exercise, for sure.’’
That concern was realised sooner than many had hoped when a Cook Islands man tested positive for Covid-19 in Rarotonga on June 5, after travelling from Egypt via Auckland in May.
But tests deemed him a historical case so he will be added to New Zealand’s tally, instead of the Cook Islands’.
Speaking to those coming to be vaccinated, it is clear some are nervous. Their fears are similar to those expressed around the world: the vaccine is new, it was developed quickly – is it safe? Anti-vax sentiment appears uncommon, but misinformation is circulating.
Eric Toleafoa is a member of the Religious Advisory Council, a board that advises government and traditional leaders on religious matters – a core tenet of life for most Cook Islanders. Council members were among the first to receive the vaccine, as a show of faith that ‘‘this is safe, [and] a responsibility as Christians that we should participate in’’.
‘‘Covid ain’t going away anytime soon. It’s important we can do whatever we can to protect ourselves in order to protect others, especially the vulnerable,’’ Toleafoa, who heads the Seventh Day Adventist Church, says.
While many are supportive, misinformation about the vaccine, largely from social media, is starting to appear. ‘‘It’s important that we understand the purpose of the vaccine is to protect us and those around us.’’
The vaccine roll-out is critical amid the injection of tourists, he says. ‘‘By protecting ourselves, we can allow others to come and enjoy the paradise we have here.’’
Ready to welcome those tourists is the Little
Polynesian resort. Perched on a stretch of golden sand in Titikaveka, it has recently awoken after more than a year lying dormant. The 14-room highend hotel, alongside Pacific Resort Hotel Group’s three other offerings, has been empty since the border closed.
The group’s chief executive Marcus Niszow gets misty-eyed speaking about going to get his vaccine.
His adult children, half a world away in Santiago, Chile, were fully vaccinated months ago, and have been waiting for word on when Dad would be too.
After record occupancy levels in 2019, last year hit hard. ‘‘It was a really difficult and tough time for our team … this was definitely the worst-case scenario end of the spectrum.’’
That the vaccine is finally here ‘‘has really given us some peace of mind’’ and he is upbeat about the future now the travel bubble is open.
It had been a slow start – the first flight saw 17 of Pacific Resort’s 64 rooms occupied, and four at Little Polynesian – but for the first time in a long time, it was something.
It will be a while before they break-even – they are nearly $3 million in the red – but ‘‘we’re on the road to recovery’’.
Now operators are working again, any border closure or pause on travel due to an outbreak could be devastating, he says.
Standing on the sand overlooking a pristine passage of water, guides from Ariki Adventures are giving their first sea scooter safety briefing to tourists in more than a year.
Kave and Jules Tamaariki, originally from Wellington, have been running the marine tour service, offering paddleboarding, snorkeling and sea turtle safari tours, for more than six years.
Pre-Covid they were operating 2-3 tours a day. It was ‘‘full on’’, Jules Tamaariki says, sitting outside the cafe where they feed ika mata (raw fish) and garlic bread to tourists who work up an appetite at sea.
When Covid-19 first emerged, many thought they would be in the clear by May.
‘‘Then May was June, then June was July . . . ‘‘ Business dried up overnight. They were kept afloat by the wage subsidy, which is set to finish at the end of this month.
‘‘Without it, we would have gone home – to our old homes – a long time ago.’’
Covid-19 would have been ‘‘devastating’’ for the Cooks, she says. ‘‘We’re one big village. It would have been around in a flash.’’
That’s a threat Tamaiva Tuavera – Captain Tama, as he is better known – remains wary of.
Overlooking the crystal-clear Muri Lagoon, the Cook Islands flag is flying for the first time in 15 months.
‘‘That tells us a lot about what’s been going on,’’ says Tuavera, who has been running Captain Tama’s Lagoon Cruises since 1992.
Speaking on the eve of its first tourist cruise since the border closed, Tuavera hopes it will be busy again soon but doesn’t count on that happening overnight.
Of 16 staff, only five remain on the islands. The rest have taken up work at a freezing works in Invercargill until business is booming again.
While Tuavera, MP for Ngatangiia village, is grateful vaccines are available, he questions why the roll-out didn’t start sooner. He has ‘‘deep concern for the safety of my people’’, and wanted Cook Islanders to have a fighting chance at being protected before the border opened.
Tuavera received his first dose of vaccine in the first days of the roll-out but ‘‘even now, I don’t feel safe’’. ‘‘It’s just another jab until you get the second one, that’s the protection part.’’
Though he’s assured New Zealand would be a helping-hand in the event of an outbreak, one question endures: ‘‘How many of our people will get sick?’’
‘‘Even during the [changing alert levels] people were still hugging each other and kissing – that’s what scares me. Our happy-go-lucky lifestyle.
‘‘I pray to God that everything will be fine.’’
Four weeks on from those first doses arriving, the end of the vaccine roll-out is in sight. As of June 9, more than 9500 doses have been administered across Rarotonga and Aitutaki.
The first lot of second doses started on Tuesday. But in welcoming that historic flight, Prime Minister Mark Brown warned: ‘‘This is just the start, there’s a few more hard yards for us to get through.’’
While the Cook Islands is not yet ready to open its doors to the rest of the world, it gets closer each day.