Misunderstood: Delta drama for family of 55

It’s not like we’re the first Samoans to end up in hospital

Aniva Epati’s bitter laugh can’t hide her anger.

“There were a lot of issues,” she says, “stuff that the people at the top don’t understand. We poor people go in there and we face the drama. I would tell them all off: ‘Get out of the job, you are useless.’ Ha.”

Known to all as Auntie, the 79-year-old is a matriarch of the wider Epati family, 55 people in eight households spread across west and central Auckland. All were caught up in the Assembly of God COVID-19 subcluster in August.

People from three of the family’s households attended the multi-congregational service in Māngere that has resulted in more than 800 positive cases and one death.

If the consequences for the family had been restricted to the vagaries of the virus’ Delta variant – 12 of the 55 eventually tested positive – the family might not be feeling so angry.

“Systemic problems, racism, there’s a lot there, you know?” says Christina Epati, the oldest of eight siblings.

“I didn’t expect it to happen to us, but it did, and thank goodness we had the support of our whole aiga (family). If we didn’t have that, I don’t know what direction we would have taken.”

The family feels like they were battling the health system as much as the virus and, after dealing with poor communication, failed assurances, incoherent contact tracing, cultural ignorance, and one false negative, they want to share their story in the hope of prompting improvements.

This story is the result of two Zoom meetings between the family and New Zealand Doctor Rata Aotearoa.

Christina Epati’s nephew, Vaaiga Autagavaia, is a GP at Ōtara Family and Christian Health Centre. Dr Autagavaia says it was “probably pure luck” his elderly relatives did not suffer more serious outcomes, and he found watching the process unfold was “disappointing, frustrating and saddening, all at once”.

He is incredulous the system continues to struggle with Pacific peoples despite the lessons that should have been learned from previous lockdowns.

“A crisis shouldn’t be an excuse. A crisis should give you even more reason to make sure every patient right is upheld. So, this experience has been hard to watch for everyone, but speaking as someone who is passionate about equity and social justice, it’s not surprising.

“But if this is the baseline for the care we can expect,” says Dr Autagavaia, “and it’s only a few months ago that this happened, what does that mean as we move to a community-based approach to managing COVID?

“This is what GPs have been saying, that we were running on fumes before the pandemic, so how is it that we, all of a sudden, are going to fill the tank up again and go above and beyond from here?

“It’s not that GPs don’t want to try, that primary care doesn’t want to try, but we just know that to meet the needs of our families, just as it has been told by my family, it’s going to be a real struggle.”

Both of Christina Epati’s parents, Pelesala and Fuisa Epati, contracted COVID-19 after attending the service at Māngere’s Assembly of God church on 15 August, just before New Zealand moved to Alert Level 4.

Both quickly became unwell; her father had to be admitted into North Shore Hospital before their positive test results were confirmed.

Despite all the sudden attention from health agencies, the language barriers and lack of information meant they struggled to understand what was happening.

“From getting tests done, the anxiety, the not knowing what to expect, not knowing what was happening to them physically, the numerous phone calls from people from different health agencies asking them the same repetitive questions: it was difficult for them, especially when they were feeling unwell,” says Christina Epati, the couple’s eldest daughter.

“We weren’t being told anything, and they started to fret about whether or not they were going to be picked up. They waited for days and their health was deteriorating. My dad was making us ring the ambulance to just come and do checks on them, because he was really worried about his heart and his breathing. Yeah, it was massive.”

A few hours after they made it to a managed isolation and quarantine centre, Christina was called by the facility’s interpreter to say their mother was unwell.

“He told us he was having to push the staff to get her to hospital, which was disheartening.” But she says it was also a relief, as they knew their parents would be reluctant to ask for help.

Her father’s health then declined rapidly as they awaited the ambulance, so they were both picked up and were to be taken to different hospitals, until the family intervened and argued for their parents to be kept together at Middlemore Hospital.

At the same time, the Epati aiga were looking online for information. Christina managed to reach a friend, a nurse who could explain COVID-19 in more detail. Health officials had until now offered nothing but instructions, and the parents were feeling anxious.

She managed to call her father and explained, in Samoan, what he could expect to feel, the likelihood of severe breathing problems, and not to panic.

“If we hadn’t been able to communicate that message, I don’t know if he would still be here with us. We’re not medical, we don’t have that background, we were only going off what people were sharing with us, but we had to find it out for ourselves.”

The family are grateful for the help provided by Middlemore staff, but say it was still another week before Mr and Mrs Epati were provided with an interpreter and could speak to their family.

Meanwhile, Christina’s brother, Matty Epati, back in New Zealand after living in Australia, had been exhibiting COVID-19 symptoms while bedridden with gout. He was assured a mobile unit would be sent to test him and his niece, but it took three days to arrive.

Matty Epati says this had become a pattern. He suggests that, “if you say you are going to do something, then do it”.

After testing positive, he was told by MIQ staff to share a room with his niece, a suggestion the family rejects as culturally inappropriate.

“I’d told them we needed separate rooms, so I stood in the corridor and said ‘no, I’m, not going in that room. You can either get us separate rooms like I asked, or you can take me back home’.”

By now the subcluster had exceeded 100 cases and the family was feeling the stress, to the point of feeling harassed by the contact tracers.

“They were ringing one family who had seven kids seven times,” says Christina Epati.

“Another sister has got the five children, her, an elderly mum and hubby, and she was being called eight times from eight different people contact tracing, and she’s a young mum you know, she’s like, what is going on?”

The process mystified the extended family; some households who they thought would be close contacts weren’t being called at all.

And the outbreak continued to grow.

Tali Meavale, who lives with his 74-year-old mother, was a close contact and had been self-isolating in his room. On the morning of 25 August, Mr Meavale was called and informed his test was negative.

“Then I opened my door to my mum, and we went shopping. We went to PAK’nSAVE, Countdown and the dairy then we came back home, and then they called again and said, ‘oh, sorry, you tested positive’ – after I’d put my mum at risk, all those workers at risk.”

Mr Meavale was asked if he could make his own way to MIQ but, worried about the possibility of infecting others, he asked to be picked up. Despite being a known positive case in the community, he was not taken to MIQ for another four days.

He stuck to his room as much as possible, but still had to share the bathroom, toilet and kitchen with his mother, who was not ill and was being regularly tested.

He arrived at MIQ on 29 August. On his third day, his mother’s sixth test returned a positive result and she immediately joined him.

Mr Meavale kept himself busy posting brief Samoan-language cartoons that help explain the illness and what happens if you become infected.

His (and Christina’s) aunty, Aniva Epati and her daughter Lillyan also arrived at MIQ on 29 August but, while her nephew was enjoying the peace and quiet, she was feeling forgotten. Aside from the morning call to check on their symptoms, she says no one checked to see if they were okay.

She says they were given no information on what was happening to them, or what to expect if she got ill.

They had done nothing wrong, but she says it felt like prison.

As for exercise: “When it’s raining, they ring: ‘do you want to go for a walk?’ When it’s fine, they don’t ring. That’s a good trick.”

Another of Christina’s sisters, Janice Epati, was pregnant when she tested positive. The risk of pneumonia saw her spend three days in hospital, but not before the humiliation of having to strip down and put on PPE gear in the car park in front of staff.

“It’s not like we’re the first Samoans to end up in hospital,” says Christina Epati.