15 May 2020


A structured model for COVID-19 spread: Modelling age and healthcare inequities


Executive Summary

  • We develop a structured model to look at the spread of COVID-19 in different groups within the population. We examine two case studies: the effect of control scenarios aimed at particular age groups (e.g. school closures) and the effect of inequitable access to healthcare and testing. These scenarios illustrate how such evidence could be used to inform specific policy interventions.
  • An increase in contact rates among children, which might result from reopening schools, is on its own unlikely to significantly increase the number of cases. However, if this change in turn causes a change in adult behaviour, for example increased contacts among parents, it could have a much bigger effect.
  • We also consider scenarios where outbreaks occur undetected in sectors of the community with less access to healthcare. We find that the lower the contact rate between groups with differing access to healthcare, the longer it will take before any outbreaks are detected in any groups who experience unequitable access to healthcare, which in Aotearoa New Zealand includes Māori and Pacific peoples.
  • Well-established evidence for health inequities, particularly in accessing primary healthcare and testing, indicates that Māori and Pacific communities in Aotearoa New Zealand are at higher risk of undetected outbreaks. The government should ensure that the healthcare needs of Māori and Pacific communities with respect to COVID-19 are being met equitably.