Introduction by Croakey: Victoria has recorded the biggest daily COVID-19 spike to date in Australia, with 288 cases confirmed on Friday for the previous 24 hour period.
The news came as Prime Minister Scott Morrison announced that former Commonwealth Health Department Secretary Jane Halton AO will lead a national review of hotel quarantine arrangements, with breaches of these blamed in part for the escalating crisis in Melbourne.
Victorian media reported that the state’s judicial inquiry into hotel quarantine would begin public hearings within ten days.
Victorian Chief Health Officer Brett Sutton said the latest tally was “a pretty ugly number”, while Premier Daniel Andrews warned the outbreak, which has sent Melbourne and the regional Shire of Mitchell back into Stage 3 lockdown for six weeks, “may get worse before it gets better”.
Victoria is now recommending, though not requiring, the five million residents in the lockdown areas wear face masks in situations where they are leaving their home and physical distancing is not possible, including on public transport and in shops.
Andrews said the state had conducted 37,588 tests on Thursday, “the biggest single day of testing (in Australia) by some considerable margin”, but other numbers are also up. On Friday Victoria had 1,172 cases currently active (up from 932 on Thursday), with 47 people (up from 40) with COVID-19 in hospital, including 12 (up from 9) in intensive care.
The Prime Minister also announced caps on international arrivals and an extension of current international passenger flight restrictions in Victoria, and outlined a comprehensive list of issues on hotel quarantine across the country to be reviewed by Halton, who is a member of the National COVID-19 Coordinating Commission.
This week 3,000 residents in nine public housing towers were put into ‘hard lockdown’, without notice, under police guard and unable to leave even to shop for food for five days.
Eight of the nine towers have now been eased into Stage 3 restrictions, though the ninth will continue to be held under full isolation until for another eight days. People confirmed to have COVID-19 and their immediate contacts have been offered alternative accommodation if unable to isolate safely at home.
Journalist Margaret Simons tweeted a media release from a local community group, Voices From the Block, calling on the Victorian Government to create a committee made up of health experts, community members and residents to coordinate the continued management of the crisis within the towers.
They also called for an independent review of how the state’s health authorities handled the risks to tenants, amid criticisms that the response was led by police rather than health officials.
In the post below, Nicole Bartholomeusz, chief executive officer of cohealth, one of Victoria’s largest community health services, provides insights from the ground on health needs for the towers, including a suggestion that a health clinic be provided on site for these estates “in perpetuity”.
Bartholomeusz says cohealth will support a thorough review into the lockdown, saying it will be important “not just for us but for similar communities across Australia”, to learn from how this emergency action was implemented.
In future planning, she says, she hopes government can prioritise the mobilisation of health workers before police, and recognise the importance of engaging services with existing relationships with the community, “rather than parachuting in those who are clinically competent but don’t necessarily understand the community and their context”.
Nicole Bartholomeusz writes:
The rapid testing blitz undertaken by cohealth and other health organisations at the high rise public housing in Flemington and North Melbourne was a massive challenge which has now enabled the majority of towers and residents to move from hard lockdown back to Stage 3 restrictions, in line with the rest of metropolitan Melbourne.
Around one-third of the 3,000 public housing residents in the Flemington and North Melbourne estates are existing clients of cohealth, and many have pre-existing conditions that make them more vulnerable to the adverse outcomes of COVID-19 like diabetes, chronic disease and respiratory conditions.
cohealth is continuing to provide primary care services and other supports to residents in all nine towers via onsite primary health clinics. Our staff including GPs, nurses, family violence workers, social workers, peer workers, oral health staff, outreach workers and pharmacotherapy and addiction medicine specialists have been on the ground since Sunday and will remain for as long as the community needs.
Residents are being supported via telehealth and face-to-face appointments in the on-site clinics, as well as home consults for those who are too ill to leave or are still in hard lockdown.
The continuing hard lockdown is difficult for the public housing residents at 33 Alfred Street but we should not underestimate the resilience and community spirit of these residents who, throughout this ordeal.
We certainly understand the presence of police can be confronting for some of the residents.
We provide a trauma-informed, culturally appropriate model of care.
We have had a lot of positive feedback from residents that they were relieved when they could look out of their windows and see cohealth staff. We are going out of our way to make sure that we are highly visible to those in the towers by regularly walking the grounds around the towers.
The work that we have been doing with this community over many years has allowed us to build expertise and build trust with the high rise residents.
We have been working hard to not only provide health services but also advising and supporting the many services now seeking to engage with the lockdown community to ensure their care is culturally appropriate and delivers the best outcomes.
The public health experts recommended the lockdown of the towers to protect the residents. It will be important – not just for us but for similar communities across Australia – to learn from how this emergency action was implemented and we will support a thorough review.
While ideally we would have had more time to prepare, I think there is a place for whole of sector health planning for emergency responses such as this and the bushfires so we understand our respective strengths and roles. A key lesson is the importance of engaging services with existing relationships with the community, rather than parachuting in those who are clinically competent but don’t necessarily understand the community and their context. Healthcare is always about context.
In planning to respond to public health emergencies in future, we would hope government can prioritise the mobilisation of the health workforce first and ensure the police are there to support the health effort.
We are hoping the intensive support and focus on the needs of residents, including making it easy to access health services, continue to be a priority for the community and government after the hard lockdown is over.
We will use this opportunity to talk to government about how we strengthen the health service response generally to vulnerable communities including suggesting that a health clinic be provided on site for these estates in perpetuity.
cohealth is a Melbourne-based not-for-profit community health organisation that strives to improve health and wellbeing for all. It provides services to targeted programs and assertive models to address the health inequity experienced by disadvantaged groups. cohealth offers a broad range of high quality, integrated health and support services, including medical, oral, nursing, allied health, pharmacy, counselling, family violence, paediatric care, mental health and drug and alcohol services.
