Introduction by Croakey: Australia’s one-time reputation as a world-leader in managing COVID is badly damaged, with more than half of the nation’s population in lockdown, still-unfolding outbreaks of the highly infectious Delta variant, relatively low vaccination rates, and state leaders attacking the Federal Government on multiple fronts.
Worrying reports continue to hit the headlines, including today’s news that an unvaccinated Sydney student nurse worked while infectious with COVID in two of the city’s hospitals, forcing more than 100 patients and staff to isolate.
As widespread concerns are being raised about the Government’s problematic vaccination messaging and pandemic management, Aboriginal health leaders are sounding the alarm about the need for urgent action to protect communities, particularly in the Northern Territory, writes Croakey editor Nicole MacKee.
Nicole MacKee writes:
Aboriginal health leaders have called for urgent efforts to ensure Northern Territory communities have access to rapid testing results, improved vaccine uptake, support for homeless people, and tighter controls on fly-in-fly-out workers.
John Paterson, CEO of the Aboriginal Medical Services Alliance of the Northern Territory (AMSANT), said “a sense of fear and nervousness” had been felt throughout the community on the weekend when five COVID cases linked to the Tanami Desert gold mine triggered lockdowns in Darwin, Palmerston, and Litchfield local government areas. Today, further linked cases resulted in a 72-hour lockdown for Alice Springs.
Paterson said the Aboriginal community controlled health sector had immediately convened to urgently discuss messaging, involvement in government processes, and strategies to “stay on top” of the outbreak. The Northern Land Council also quickly moved to restrict access to remote communities to essential services only.
Paterson called for increased access to rapid COVID-19 testing throughout the Territory, noting that at least one remote health service had been forced to wait up to four days to receive test results.
“That is just not good enough; we need to turn around a test result within four hours, maximum,” Paterson told Croakey. “One of our Alice Springs clinics can turn it around one to two hours; let’s get more machines out into central Australia.”
Paterson was speaking with Croakey before today’s announcement that Alice Springs would join Darwin, Sydney, Perth, Brisbane, Townsville and other regions, in lockdown.
NT Chief Minister Michael Gunner described the decision to lock down Alice Springs as an “extreme precautionary measure”, after a Tanami Desert gold mine worker had tested positive to COVID on return to his home city of Adelaide.
The mine worker had tested negative before flying out of Alice Springs Airport, but tested positive, along with four family members, after arriving back in Adelaide.
While Gunner said there were no new COVID cases in the NT on Wednesday, he warned that the Territory was “still under threat”.
Dr Hugh Heggie, NT Chief Health Officer, called on the Alice Springs community to stay put to limit any potential COVID transmission.
“Stay at home, or if you are from out of Alice Springs, find someone else that you can stay with,” he said.
Heggie said genomic testing had confirmed the highly infectious Delta strain was involved.
While some visitors may have travelled to Alice Springs to escape lockdown in other cities, Heggie noted that there were now 12 million Australians in lockdown. “That’s nearly 50 percent of our population, so we are all dealing with this around the country.”
Heggie said waste-water testing in Darwin was negative at present, and results in the coming days would be critical.
Waste-water testing in Alice Springs had only started today, he said, due to delays in transporting the required equipment to the city.
He also called on Territorians to wear masks to prevent inadvertent COVID transmission. In Darwin on Wednesday, a 36-year-old man was fined $5,000 for refusing to wear a mask.
Gunner told the press conference that testing remained an important weapon in ensuring there wasn’t hidden community transmission. He said more than 2,6000 Territorians had been tested for COVID in a “testing blitz” on Tuesday. Of these, more than 2,400 had so far been confirmed as negative.
Writing in the Sydney Morning Herald today, Pat Turner, lead convener of the Coalition of Peaks and the CEO of the National Aboriginal Community Controlled Health Organisation, warned that we continued to be “one spark away from a COVID-19 wildfire in Australia’s Indigenous communities”.
She said overcrowded housing combined with high rates of chronic diseases meant that COVID-19 could spread rapidly through Aboriginal and Torres Strait Islander communities.
“It has been because of the leadership of Aboriginal and Torres Strait Islander communities and our community controlled health organisations that our peoples have been relatively unscathed by COVID-19 to date, with 173 cases nationally and no deaths,” she wrote. “We need governments to step up on the vaccine roll out to keep it this way.”
Housing action needed
Serious concerns have been also raised about the impact of lockdowns on rough sleepers in Darwin and in Alice Springs.
Aboriginal health, community and legal organisations said they were frustrated with NT Government’s “flawed pandemic response which continues to see rough sleepers on the streets during a lockdown”.
“The NT Government has scrambled to provide a small amount of accommodation at Batten Rd for rough sleepers awaiting COVID-19 test results, but the sector says it’s too little, too late,” they said in a media statement.
Danila Dilba Health Service CEO Olga Havnen said rough sleepers were aware of the threat, and had been seeking COVID-19 tests, but many had nowhere to safely isolate.
“They’ve done the right thing by getting tested, but with nowhere to go, they’re at risk of contracting and spreading COVID-19,” Havnen said.
North Australian Aboriginal Justice Agency CEO Priscilla Atkins was it was an immense privilege to be able to stay home in a pandemic, and not everyone had that option.
“The NT Government has been far too slow to react to this problem and should have had a co-ordinated plan in place long before lockdown occurred,” Atkins said.
AMSANT’s Paterson said providing support and accommodation for “long grassers” in the NT was critical not only for their safety, but also for the broader community.
“It would have a devastating impact on our communities if a large breakout occurred. We are concerned about the long grassers that are in Darwin and some regional centres, and we need to ensure the appropriate support and accommodation is provided for them,” he said, adding that this would also help when contact tracing was needed. “We can’t allow them to still be on the street.”
Paterson also raised concerns that drive-through bottle shops had remained open in locked down zones.
“We are very disappointed to see bottle shops opening during a lockdown period,” he said, adding that he planned to raise the issue with the NT Government. “This is a ludicrous decision.”
Far tighter controls on the fly-in, fly-out workforce were also urgently needed in the NT, Paterson told Croakey.
“It’s time for governments to review some of these processes, particularly in these remote mining sites,” Paterson said, noting that the initial case was COVID-free on arrival in Brisbane, and had contracted the virus in quarantine before flying to the mine site.
“We need to review those whole processes now and make sure they are water-tight, so we don’t allow this to happen again.”
He said discussions were also underway to urgently arrange for a “surge workforce” to provide healthcare workers in remote health clinics, as well as some urban and regional clinics.
Paterson added that there was also widespread disappointment among Aboriginal and Torres Strait Islander communities in the NT that next week’s NAIDOC celebrations in the NT, including the 2021 National NAIDOC Awards Ceremony – which was to be held in Mparntwe (Alice Springs) – have had to be postponed or cancelled.
Paterson said the NT outbreak was likely to drive an increase in COVID vaccination rates in the Aboriginal and Torres Strait Islander community.
“This is a timely reminder for our community to consider getting vaccinated,” he said. “This is a very deadly virus.”
Dr Andrew Webster, Senior Medical Officer at Danila Dilba, said the service was highlighting the importance of vaccination as the best way to “protect yourself, your family, and your community”.
“That’s the message that First Nations people have been consistently hearing across the Territory, and it’s getting through to them more and more,” Webster said. “Unfortunately, it’s competing with misinformation, myths and rumours on social media that can make people cautious.
“We want everyone to know that it’s okay to have worries – just go and talk about them with a doctor, nurse or Aboriginal health worker who can help you make the right decision.”
Webster said the recent announcement that vaccination was available to all Territorians would make a significant difference.
“It means that the people who are very keen can be vaccination champions and lead by example for others who are less confident. Seeing friends and family get vaccinated without incident is very reassuring for a lot of people.
“At this point, the biggest barrier for a lot of people is the low availability of appointments, which in some ways is good news – it means that people understand how important it is to get vaccinated.”
While Queensland is expecting to run out of Pfizer vaccines in coming days and WA has also raised similar concerns, Webster said Danila Dilba had a consistent supply of Pfizer vaccines at the moment, “although that may change with the increased demand due to this lockdown”.
He added that the biggest challenge in Darwin and across the Territory was the availability of staff with medical training to deliver vaccinations, and the availability of personal protective equipment (PPE).
Speaking at the Public Health Association of Australia’s National Immunisation Conference on Tuesday, Professor James Ward, Director, UQ Poche Centre for Indigenous Health at the University of Queensland, said the overall response to COVID among Aboriginal and Torres Strait Islander communities was a “good news story”. But there were some challenges ahead.
The “outstanding achievement” of low infection rates and no deaths to date reflected Aboriginal and Torres Strait Islander leadership, early co-ordination, community involvement, and much consultation with communities around the country, he said.
“There has been an outstanding response in preventing COVID in our population, but we all know we are very early into the pandemic.”
Ward said that there had been more than 83,000 COVID vaccine doses delivered to Aboriginal and Torres Strait Islander people up to 20 June, according to Australian Immunisation Register data.
While 4.5% of the general population had received two doses of vaccine, he said that among Aboriginal and Torres Strait Islander people, 2.6% had received two doses.
In the NT, 7.9% of the general population had received two doses of the vaccine, while 3.6% of Aboriginal and Torres Strait Islander people had received two doses.
Vaccination rates dropping
Ward also said, however, that the rates of vaccination among Aboriginal and Torres Strait Islander people across Australia had dropped off in recent weeks.
“This is probably stemming from some negative reporting about AstraZeneca and its outcomes,” he said.
Ward pointed to the AusVaxSafety data, which included data from almost 15,000 Aboriginal and Torres Strait Islander people, that showed low rates of adverse events across the all populations.
He said this data should allay fears among Aboriginal and Torres Strait Islander people that vaccines had not been tested in their population and that those first in line were the “guinea pigs”.
“A whole lot of things might drive complacency … but really social, cultural and political views drive some of this,” Ward said. “Part of the problem is that we are a victim of our own success. A lot of Aboriginal people say ‘this is not our disease, this is a whitefella disease’ and we’ve seen nobody affected by it. That’s a great thing, but it’s playing the wrong way for us at this point in time.”
He noted that changes to vaccine scheduling and guidelines, as required by the Therapeutic Goods Administration, had also dented confidence in the vaccines among “people who are already marginalised and have significant distress in the healthcare system”.
Further barriers have been challenges in navigating booking systems, access to culturally safe and convenient places to have vaccines, and younger populations believing COVID to be an issue for the elderly. Ward also outlined a “roadmap” to improve vaccination rates, including increasing supply.
“We absolutely need to get more vaccine out to our communities and particularly to the Aboriginal community-controlled health sector,” he said.
He said that honest and transparent messaging was needed, focussing not only on safety but on vaccine purpose.
“One of the key things that happened in the early phase of COVID was that our communities developed very strong messaging in culturally appropriate ways, in language, with humour and with some seriousness to tell communities what COVID was,” he said, noting that such strong communication strategies were crucial to improving vaccination rates on the “long road ahead”.
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The Prime Minister’s comments encouraging wider use of the AstraZeneca vaccine in younger people led to further unhelpful controversy and conflicting advice about the vaccination program.
Meanwhile, it seems far from clear whether/if there will be a no-fault compensation scheme for those suffering serious adverse effects from vaccination, despite some preliminary reports suggesting this was on the cards…Yet more questions still to be answered.
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