Introduction by Croakey: Aboriginal health services have welcomed the Western Australian Government’s recent announcement, based on official health advice, to delay reopening of the state’s borders.
Meanwhile, in the Northern Territory the Central Australian Aboriginal Congress has called for an urgent complete lockdown of Central Australia to provide a “circuit breaker” amid concerns about rising case numbers and hospital admissions, and poor quality housing.
In a statement released this week, Congress Acting CEO Josie Douglas said this would buy precious time for a surge workforce to be assembled and redeployed. “The Commonwealth Government has a critical role here and we call on them to come to the aid of the Northern Territory as we stare down this disaster,” she said.
This follows a recent call from Aboriginal Peak Organisations NT for urgent Federal Government and Australian Defence Force support.
WA was one of the last jurisdictions in the world to contain the community spread of COVID-19 – relying on closing its borders, its geographic isolation and public health measures. Journalist Linda Doherty reports below on diverse reactions to the WA announcement.
Linda Doherty writes:
Aboriginal health leaders in Western Australia who have anxiously watched the spread of COVID-19 through communities in the rest of the country breathed a sigh of relief when Premier Mark McGowan announced the border opening would be delayed.
The decision buys more time to increase the vaccination rate in Aboriginal communities, particularly of the third dose, which provides better protection against the highly infectious Omicron variant.
“We desperately want people to know that vaccination is our best defence against getting very sick and possibly dying from this disease,” said Lorraine Anderson, medical director of the Kimberley Aboriginal Medical Service (KAMS).
“Currently just over 60 percent of our Aboriginal population [in the Kimberley] is fully vaccinated, delaying the re-opening gives our health services more time to fully vaccinate before Omicron reaches the Kimberley.”
Anderson told Croakey that while some remote Kimberley communities had reached booster dose rates of more than 25 percent (in line with the average rate in WA), the overall rate in the region’s Aboriginal population was around five percent.
McGowan has now pegged reopening borders on when the third dose vaccination rate is “up above at least 80 percent, perhaps 90 percent”, with the vaccination of children also a high priority. He said the Government would review the decision in February but at current rates of booster dose vaccination, a reopened border could be as far away as May when the federal election is expected to be held.
In his media conference a week ago McGowan said he was acting on the advice of Chief Health Officer, Dr Andy Robertson, about the escalating health risks of Omicron and the experience in other states, particularly NSW and Victoria, where “they basically have hundreds of people dying, they have mass dislocation in the economy”.
“It would be reckless and irresponsible to open up now, I can’t do it,” McGowan said.
In the Chief Health Officer’s published advice, dated 19 January, Robertson said his earlier advice on 4 November and 10 December was based on modelling of the Delta variant. He recommended the opening be deferred with another review of the transition plan within four weeks, to “enable optimal health management of the anticipated outbreak and mitigate the expected impact on the community”.
He wrote: “Preliminary WA Health modelling of the Omicron variant demonstrates a markedly different picture from the Delta modelling of any likely outbreak, with a more rapid rise in the number of cases, more total cases and greater requirements for general ward beds and ICU beds, even with low to medium TTIQ [test, trace, isolate and quarantine] and moderate PHSMs [public health and social measures]. The preliminary modelling is consistent with the impacts seen in other jurisdictions.”
Robertson said further modelling would be important in determining the optimal opening time, noting that the Omicron variant was a very different disease to Delta and, once established, could only be suppressed, not eliminated. Delaying the re-opening date would enable increased booster and childhood doses, increased access to diagnostic tests, and further work on hospital capacity, he said.
The business and tourism sectors were outraged by the the Government’s decision but the powerful mining sector has backed the Premier. Iron ore, which drives the WA economy, accounted for $150 billion of WA’s $221 billion good exports in 2020-21.
The impact, however, has been felt strongly on a personal level by Western Australians who have not seen interstate or overseas family for two years.
Carl Heslop, WA branch president of the Australian Health Promotion Association (AHPA), said the response had been mixed, with people employed in healthcare “very relieved” while others were frustrated by the continuing separation of families.
“It’s been a long time and that’s the challenge now. The decisions being made now clearly need to be about health, not about politics or business,” he said.
“People can put their emotions aside for the sake of health considerations but anything else starts to become a hazard.”
Heslop said the Government could use the extra time “and the goodwill of the people of Western Australia” to continue to increase vaccination rates, particularly the paediatric vaccination program and the third booster shot for the over 12s, and help organisations with ventilation and air quality measures.
The WA AHPA has written to the health minister calling for rapid antigen tests to be freely available to the public. “We don’t want a situation of inequity where people are not able to access the tests,” Heslop said.
The director of the Telethon Kids Institute in Perth and infectious diseases expert, Prof Jonathan Carapetis, told The Guardian that he was surprised at the lack of public health advertising campaigns preparing residents of WA – where people have lived more normally than almost anywhere else in the world throughout the pandemic – for COVID-19.
He said the lack of information from government was causing fear and a lot of anxiety among parents, who were worried about their children catching and spreading COVID once they return to school.
University of Western Australia economics professor Peter Robertson told the ABC that avoiding the lockdowns experienced in many other states and keeping COVID-19 cases low had lifted consumer confidence.
“Through 2021, the economy really boomed. People’s confidence was high, investor confidence was high, the export sector continued to thrive despite the tariff bans by China,” Robertson said.
Negative media coverage about the WA decision – particularly in the eastern states and from Kerry Stokes’ WA media empire – prompted University of Western Australia health and labour economist Dr Ian Li to tweet:
I have been very disappointed by much of the news coverage around the recent news about the WA border decision.
Nowhere else in the world has the population been protected while the economy also thrived.”
Geoff Kitney, veteran political reporter and foreign correspondent, was succinct on Twitter: “How warped has our journalism become when reporters see WA’s handling of Covid as more deserving of criticism than NSW’s?”
It seems a minor point to make in a pandemic but political commentators have noted that WA’s closed borders will limit electioneering on the ground by both Prime Minister Scott Morrison and Opposition Leader Anthony Albanese in a state where three marginal seats could decide the next government.
Meanwhile, the Premier’s capacity to focus on the pandemic and be accountable to the Parliament may be undermined by a requirement to appear in a Sydney court in person next month for a defamation case brought by United Australia Party’s Clive Palmer, who has campaigned against public health measures including vaccination.
A middle road?
The WA branch of the Australian Medical Association said its members had mixed views on the announcement – some doctors, especially GPs, were relieved that more time will be available to prepare, while others were bitterly disappointed and angry about not being able to reunite with their loved ones.
Branch president Dr Mark Duncan-Smith called on the Government to set a date so that there could be a degree of certainty within this uncertainty, and to “recruit and get as many healthcare professionals into WA as possible”.
Some of the harshest criticism from the delayed border opening came from the AMA’s national president, Dr Omar Khorshid, a West Australian, who claimed that Premier McGowan was relying on “some kind of magical vaccination number” when the Omicron variant was already circulating in WA.
“Omicron will get into Western Australia. It has done, and it may well be spreading right now through our shopping centres and other places where people are mixing. So at best, a closed border buys some more time,” he said.
But he acknowledged that WA’s healthcare workers were relieved because “they’re terrified of what they’ve seen in New South Wales” where the Government’s strategy, dubbed by commentators as “let it rip”, is associated with hundreds of deaths, hospitals under extreme stress, mass staff shortages, endless queues for COVID testing and a shortage of rapid antigen tests.
“We must not follow New South Wales…we need to find that middle road of opening ourselves up, but also controlling the spread of the virus, making sure that we protect our health system as best we can. And I think South Australia shows us that there is a middle path.”
The SA response to Omicron has influenced WA’s decision to ensure appropriate testing, tracing, isolation and quarantine and implement baseline public health and social measures such as mask wearing and density limits in homes and high risk venues such as nightclubs.
SA Premier Steven Marshall released data on 14 January from the University of Adelaide and the South Australian Health and Medical Research Institute which showed that public health measures appeared to have flattened the Omicron curve (see this clip for more information).
The restrictions from Boxing Day 2021 included density limits for indoor seated hospitality, 10 people in homes, and mask mandates for indoors and high-risk settings.
Marshall said this had resulted in a daily case likely peak of 6,000 to 10,000 cases instead of the predicted 30,000 to 40,000 cases.
Public Health Association of Australia CEO Adjunct Professor Terry Slevin said the SA data showed that a decision to return to a “flatten the curve” strategy now appeared viable and “an essential course of action”.
“Easing restrictions aimed at promoting the spread of the virus in the name of ‘opening up the economy’ have clearly backfired,” Slevin said in a statement.
“The rapid spread of disease has crippled the workforce, and therefore the functioning of the economy.”
In Aotearoa/New Zealand, one of the few countries to contain the spread of the Delta variant, strict new public health and social measures were this week reinstated as Omicron spread. Prime Minister Jacinda Ardern cancelled her wedding in response to the new limits on gatherings. The restrictions require mask wearing, social distancing, caps on customer numbers indoors in hospitality venues and events.
Aboriginal health sector response
Aboriginal and Torres Strait Islander medical peak bodies have consistently called for higher vaccination rates before any pandemic restrictions are lifted.
Vicki O’Donnell, chair of the Aboriginal Health Council of Western Australia (AHCWA) for the state’s 24 Indigenous controlled medical services, said the sector also wanted a regional plan for COVID readiness that included the 30 percent of people who may not be able to monitor COVID at home.
“Western Australian needs to increase its Aboriginal vaccination rates before the state border opens,” said O’Donnell, who is also CEO of the Kimberley Aboriginal Medical Service (KAMS).
“While some Aboriginal communities in Western Australia are highly vaccinated, others are very low; with the current average for the state sitting at around 68.3% for first dose; 54.3% for second dose and 7.2% for third dose vaccinations.”
“We would also like to see more data about the Omicron variant as it is playing out in the eastern states, and a more comprehensive understanding of its impacts.”
This should take into account life stories “to counter the lack of local, lived experience of the hospitalisations and deaths caused by the virus in Western Australia” and more information about its effects such as Long COVID, she said.
“Our sector is still waiting on guidelines and directions from the state regarding use of rapid antigen testing. We also have strong concerns around food security for our remote communities.”
O’Donnell, a Nyikina Mangala woman, today received the Medal of the Order of Australia for her services to WA’s Indigenous communities.
She said emerging evidence showed the third dose was the best protection against serious COVID-19 and urged Aboriginal communities to protect themselves against the Omicron variant by getting fully vaccinated.
There are more than 200 remote Aboriginal communities in Western Australia, across the Midwest, Gascoyne, Pilbara, Goldfields and Kimberley regions, and their residents are more vulnerable to COVID-19 than other Western Australians, according to official government advice.
Strict travel restrictions have been in place in most remote communities for two years, with the only people allowed to enter including residents, essential workers and suppliers, for family, education, and cultural reasons, or for emergencies.
WA’s remote Aboriginal communities have largely kept COVID-19 at bay but have watched as the coronavirus ripped through other remote Indigenous communities around Australia, such as in Wilcannia in NSW, Yarrabah in far north Queensland, and in the Northern Territory.
The NT is currently experiencing a growing number of COVID-19 outbreaks in both urban and remote Indigenous communities. NT Acting deputy chief medical officer Marco Briceno told SBS that many Indigenous patients were in hospital for existing medical conditions.
“We are seeing COVID affecting more Indigenous Territorians, affecting people in high-risk settings and those individuals tend to have a higher need for hospital care,” he said.
An Australian Medical Assistance Team was this week flown in to Galiwin’ku on Elcho Island where there is a growing cluster of cases but many residents did not want to leave their home to travel to the Howard Springs quarantine facility on the mainland.
Lorraine Anderson, KAMS medical director, said she and her colleagues were carefully monitoring the COVID outbreaks in the Northern Territory.
“We have been keeping a close eye on the NT situation and have been in contact with our colleagues in the ACCHO sector there,” she said.
“We have certainly observed the importance of robust communication processes with communities where outbreaks are occurring.”
See Croakey’s archive of stories on public health.