As we approach the two-year anniversary of the World Health Organization’s declaration of COVID-19 as a pandemic, a symposium this week heard about the critical importance of effective community engagement and strong partnerships.
The symposium was hosted by a new Australian Institute for Infectious Disease (AIID) collaboration between the Doherty and Burnet Institutes and the Australian-French Association for Research and Innovation.
Croakey editor Alison Barrett attended the event, which provided a platform for clinicians, research academics and community organisations to discuss some of the challenges, highlights and lessons learnt from the pandemic response so far.
Alison Barrett writes:
Many lessons from HIV/AIDs research have not been sufficiently applied to COVID-19, according to keynote speaker, Nobel Laureate Professor Françoise Barré-Sinoussi.
The response to COVID-19 should have learnt from HIV/AIDs in the 1980s and 1990s, and anticipated social and economic inequities and addressed them accordingly, she said.
“Many of the same issues exist – [we] still have weak health systems, and lack of human resources in different countries,” Barré-Sinoussi said.
“We already knew from HIV that inequities critical in stopping access to treatment and diagnosis. We cannot continue like that.”
Director and CEO of Burnet Institute Professor Brendan Crabb agreed with these comments. He told the audience that one of the biggest lessons from HIV was the importance of listening to communities, but that those lessons were still not entirely learnt.
Community engagement
Community engagement to ensure important public health messages are being conveyed effectively was one of the key themes raised by speakers throughout the symposium.
Victoria’s Acting Chief Health Officer Professor Benjamin Cowie said one of the challenges early in the pandemic was engaging meaningfully with all communities, particularly those including people born overseas.
Cowie said that while it was important to have public health messages translated into diverse languages, it was important to build trust and collaborations with members of culturally and linguistically diverse communities.
While it takes time to build relationships and this can be a challenge during a time-sensitive pandemic, Cowie said, “we can’t afford to leave anyone behind. It is critical to take time to build engagement”.
Engagement with vaccine ambassadors, faith leaders and primary care clinicians in Victoria saw a transformation of vaccine uptake in hard-to-reach communities, he said.
In a similar vein, Deputy Director at the Burnet Institute Professor Margaret Hellard told the symposium, “unless the public are engaged in restrictions, you’ll get nowhere”.
The Optimise Study led by Burnet and Doherty Institutes aims to address this by recording real-time perspectives of Victorians’ experiences of COVID-19 and how they respond to public health measures.
Co-design with priority populations is a big aspect of the Optimise Study; it is critical to understand communities’ needs and perspective in order to develop appropriate resources.
“Communication of the information should be developed with community so that key communities, particularly those with social and structural disadvantage, have access to information in a way that is accessible to them. Health equity,” Hellard told Croakey.
Hellard said it was not only important for the community to know how to access information about how to protect themselves, but structures needed to be in place to support activities such as quarantining, self-isolating, testing, and vaccine access.
Co-designed resources from the project will be made publicly available in upcoming months.
Valuable community support
CEO of Living Positive Victoria Richard Keane discussed challenges in engaging the Victorian HIV positive community in continuity of care during the pandemic. More than half of new HIV diagnoses are in people born overseas.
The pandemic heightened social isolation and mental health issues for many people in the Victorian HIV community, who found the events of the past two years very triggering.
“Discourse around COVID deaths has not helped their wellbeing,” Keane told the audience.
Online or small-group events, when permitted, and phone conversations when needed with members of the HIV community were important ways to help people cope.
Keane said that improved digital connections within the community were one of the benefits to come from COVID-19.
However, to ensure culturally and linguistically diverse people were not over-represented in new HIV diagnoses moving forward, equitable access to in-language information and interpreters was vital.
He raised concerns that the enormous financial cost of COVID-19 in Australia would mean less funding for vital support services like Living Positive Victoria, a concern echoed by LiverWELL CEO Melanie Eagle.
Scientific highlights
The symposium highlighted the significant gains made in scientific research and innovations during the pandemic, including in identifying the innate immune response in children, evaluations of rapid antigen tests and innovations in ICU.
Genomic sequencing and modelling have been critical in guiding the response and political decisions.
However, one of the most significant scientific achievements of the past two years is the development of COVID-19 vaccines.
Moving forward, speakers expected that vaccines will continue to be vital in minimising severe illness and deaths from the virus.
However, great inequities in vaccine distribution exist across the globe. Only 10 percent of people in low-income countries have received at least one dose of a COVID-19 vaccine.
Some countries, including the Democratic Republic of Congo and Yemen, have vaccinated less than two percent of their populations.
Inequities also exist within countries. In Australia, where 79.5 percent of the total population have received two doses of a COVID-19 vaccine, inequities exist.
The proportion of people to have received two doses in Far North Queensland and the Barkly region in Northern Territory – all with high proportions of Aboriginal and/or Torres Strait Islander people – is far less than the rest of Australia.
Low rates of COVID-19 vaccination in Aboriginal and Torres Strait Islander people in Western Australia, particularly in the Pilbara region, is also concerning given the WA border opening today. ABC reported details of a big push to promote vaccination in many remote communities in WA.
As we open up and become more engaged socially, it is important measures are taken to protect priority populations and those at greater risk for severe-COVID.
Public health matters
On 21 February, OzSAGE, of which Crabb is a member, released a statement recommending:
- Indoor mask mandates and QR code contact tracing remain
- Free rapid antigen tests are provided
- Access to workers compensation for people infected at work
- Develop and release planning for the management of future variants of concern
- Urgent increase in third doses of vaccination and planning for the distribution of vaccination to the 6 month and 5 year old group, ready for when
- Clear education to the Australian public explaining why the pandemic is not over.
This latter point was also made by Professor Margaret Hellard, who told Croakey:
Clear, transparent communications with the community. As people at this meeting have highlighted – this is not over.
The community needs to understand that, and Australia needs a clear pandemic plan for coming years for COVID-19.”
Overnight, the White House released America’s ‘National COVID-19 Preparedness Plan’ which has four main goals:
- Protect against, and treat, COVID-19 through increasing vaccination rates, ensuring sufficient supply of rapid-at-home tests and high-quality masks, and ensuring equitable access to COVID-19 healthcare and public health resources
- Prepare for new variants
- Prevent economic and educational shutdowns
- Continue to lead the effort to vaccinate the world and save lives.
The symposium highlighted the significant scientific gains throughout the pandemic, while also acknowledging the lessons learned from challenging lockdowns, burdens on healthcare workers and the difficulties in rolling out a mass vaccination program.
But, if we are to really learn from HIV and COVID-19, it is clear more needs to be done to engage with priority populations and reduce inequities.
See this archive of Alison Barrett’s columns, the COVID-19 wrap
