Australia’s pandemic response is failing spectacularly to provide appropriate care and support to those in greatest need, writes Croakey editor Linda Doherty.
Linda Doherty writes:
Two years into a global pandemic, which has so far resulted in 3,835 deaths in Australia and 2.58 million cases, Health Minister Greg Hunt drew on the Aussie spirit to brag that “we are perhaps better and stronger than we ever realised”.
“Above all else we remain an essentially optimistic nation and people,” Hunt said in his January 25 statement, ‘Two years on, the COVID fight continues’.
The pandemic has exacerbated inequities across the globe and highlighted the need to address them as central to the response to COVID-19; while Hunt acknowledged there was “more work to be done”, he made no mention of the growing global and domestic health, social and economic inequalities.
Health, consumer and social welfare leaders, however, are not “optimistic”, pleading for more assistance and targeted funding, services and communication for those living in poverty, people with disability, Aboriginal and Torres Strait Islander peoples, those with chronic disease and underlying medical issues, low-paid workers, the elderly and people in prison.
The Australian Council of Social Service (ACOSS), the peak body for 4,000 community organisations, has called on the Federal Government to establish a civil society COVID Rapid Response Group to coordinate policy and services to protect vulnerable and disadvantaged communities “who have borne the brunt of this pandemic for two years”.
“The blunt reality is that Australia is still not ready to deal effectively with Omicron,” ACOSS CEO Cassandra Goldie said in a statement.
“Whether its infection rates, access to vaccinations, access to RATs [rapid antigen tests] and other vital health equipment, or access to medical services, this pandemic continues to hit people on low incomes, people from diverse backgrounds and with pre-existing vulnerabilities the hardest.
“There is a critical need for better forward planning, crisis management and prioritisation of resources to support those most at risk and those with the least means to stay safe. The approach to this emergency is totally inadequate.”
Goldie said the Government had refused to release data on how the pandemic was affecting different populations and postcodes and “the deep inequities in who is being affected, and how”. ACOSS said the Government should urgently release data on case rates, vaccination levels and COVID-19-related deaths “especially for groups at greater health risk from COVID-19”, including a breakdown by economic and social status and geographic hotspots.
A recent data analysis by The Sydney Morning Herald showed that low socioeconomic parts of Sydney with the highest rates of Omicron infection had lower rates of the third dose vaccination booster than high-income suburbs.
ACOSS wrote last week to National Cabinet repeating its calls for a raft of measures and protections, including universal free access to RATs; supports for at-risk populations in regional, rural and remote communities; a Vaccine Plus strategy for hospitals to protect the workforce, patients and visitors; and culturally appropriate safe spaces for high-risk groups, particularly First Nations’ peoples, to isolate if they test positive.
“This is especially important in regional and remote communities, where home quarantine is not possible or appropriate,” the letter said.
As previously reported at Croakey, it seems that these concerns are falling on deaf ears at National Cabinet meetings.
Outbreaks in prisons
Aboriginal and Torres Strait Islander justice and health leaders have warned that a surge in infections in prisons risks more deaths in custody.
“The rapid increase of COVID-19 cases in prisons across the country is our worst fear realised, and the situation in the NT is extremely worrying,” said Priscilla Atkins, chair of the National Aboriginal and Torres Strait Islander Legal Services (NATSILS).
“Aboriginal and Torres Strait Islander people are most at risk during an outbreak – and disproportionately likely to be in prison – and the combined impact could be catastrophic. They must be released to save lives.”
“The measures Government have taken to manage COVID-19 in prisons also raise serious human rights concerns – such as isolation in cells for up to 24 hours per day, solitary confinement, cut off from families and legal representation, limited access to hygiene, education and medical care.”
The latest large-scale outbreak at Alice Springs Correctional Centre – where almost half of the 626 people in prison have tested positive since last Friday – comes after serious outbreaks in other states and territories, including at NSW’s Parklea Correctional Centre last September and this month in South Australian jails. The outbreaks have caused anxiety among families unable to contact loved ones in lockdown, added delays to the court system, and stretched the corrective services workforce.
The Human Rights Law Centre said the consequences of COVID-19 infection in Australian jails will be “devastating” because people in prison were at greater risk of harm and death, with almost one-third having a chronic medical condition like asthma, cancer, cardiovascular disease and diabetes or a disability.
“The risk and potential for serious harm is multiplied by the fact our prisons are overcrowded, unhygienic and unhealthy places at the best of times, with limited access to health care and generally poor conditions,” the centre said.
NATSILS supported calls by the North Australian Aboriginal Justice Agency (NAAJA) for an emergency response at the Alice Springs Correctional Centre, including the early or temporary release of prisoners, to manage the growing outbreak.
“Since the start of the pandemic in 2020, NATSILS and our members have been calling for Australian governments to take a range of justice-related measures to stop the spread of the virus, including releasing at-risk Aboriginal and Torres Strait Islander people from prison, diversion, policing, bail, testing, medical care, housing and social supports,” NATSILS chair Priscilla Atkins said.
“To date, almost two years on, few, if any, of these proactive measures have been taken by Australian governments.”
Failing people with disability
Disability advocates want the Disability Royal Commission to investigate “the failure of Australian governments and responsible parties” to keep people with disability safe during the COVID-19 pandemic and particularly through the Omicron wave.
The board of peak body People With Disability Australia (PWDA), recently wrote to Royal Commissioner Ronald Sackville asking him to convene an emergency hearing: “The number of people with disability who have been lost to COVID-19 and preventable death is steadily increasing and we fear that the situation will worsen without urgent measures”.
PWDA said people with disability were still living in crisis, continue to be unprotected and had difficulty accessing essential medical and health services, including COVID-19 testing and RATs, and had encountered economic hardship from having their National Disability Insurance Scheme funding reduced or removed “placing them at further risk”.
One of the most damning claims – made previously by the disability sector – is that policy decisions by governments and health bureaucrats “actively deprioritised people with disability within triage and health systems and failed to comply with Australia’s obligations to work within an ethical framework”.
International experience shows that people with disability are at increased risk of COVID-19 infection and more likely to become seriously ill or die, according to the Centre of Research Excellence in Disability and Health at the University of Melbourne.
“In the UK, people with intellectual disability were eight times more likely to die of COVID-19 than the general population, and disabled people made up 58% of deaths,” the Centre said.
Due to a lack of targeted Australian Government communication about COVID-19 risks and protections, many support groups have been left to develop their own resources.
“The Commonwealth Government did not do any targeted communication [to people with disability] about vaccines before mid-2021,” the Centre said.
Two years into the pandemic, the Centre warned in a recent position paper that Australia has “reached the most dangerous time yet” for people with disability and that without urgent action “we will see major adverse impacts…including death”.
“Right now, people with disability are at high risk of not getting essential supports for ordinary daily activities from eating to assistance with personal hygiene.
“They are also at very high risk of being infected with COVID-19 from workers and their household members, especially if they and/or their workers and household members are not fully vaccinated or have not received booster doses.”
Expand the national narrative
Public health communication about COVID-19 was almost always a national narrative about the impacts on the general population and failed to adequately cater for people who are medically vulnerable, such as the immunocompromised and people undergoing cancer treatment, according to consumer and cancer advocate Susannah Morris.
“The national message is ‘Omicron is milder, stay at home, most people will not need medical attention, do try and get a test’ . . . but if you’re living with an underlying medical condition, getting that test can be extremely difficult,” she said.
“This group matters, too, but they are often forgotten.”
Morris represents the Health Consumer Council of WA on government committees and is a member of Breast Cancer Network Australia. She said consumer groups around the country were reporting that people in the medically vulnerable cohort were going back into “sheltering behaviour”, too afraid to leave their homes and put themselves at risk of COVID-19 infection.
As in the disability sector, Morris said there was a lack of targeted information for the medically vulnerable and widespread confusion when criteria for vaccines and other protective measures changed.
It had been difficult, for example, to spread the message that the Australian Technical Advisory Group on Immunisation (ATAGI) recommended on December 24 that people who are immunocompromised and/or have underlying medical conditions (in specific categories) receive three primary doses of a COVID-19 vaccine and then a fourth booster dose to improve protection against the Omicron variant.
Among a myriad of concerns raised with governments is the changing criteria on who is eligible for the fourth booster dose, such as people undergoing cancer treatment who need clarity on when they can access the vaccine booster.
“Some people feel like they have gone to pillar to post. It’s not straightforward for the consumer or even for the GP or specialist to be 100 percent sure,” Morris said.
Health Consumers Council WA acting Executive Director Clare Mullen said recent meetings with consumer representatives in Western Australia had reinforced the strong message that people need more information on COVID-19 protections and risk factors and specific plans for the medically vulnerable, people with disability, Aboriginal and Torres Strait Islander communities and Culturally and Linguistically Diverse communities.
“There’s an opportunity to involve more consumers in plans as they are developed, not just as recipients of those messages,” she said.
SOS on food security
Darwin ABC Radio journalist Lizzy Trevaskis took to Twitter this week to highlight food shortages in the Northern Territory due to supply chain disruption from flooding in South Australia. Supplies of fresh fruit and vegetables, dairy and meat were scarce, with Territorians posting photos on Twitter showing empty supermarket shelves.
Hundreds of kilometres of freight lines have been flooded in South Australia, crippling supply chains from Adelaide to Western Australia and north to Darwin.
The floods are having a devastating impact in Central Australian Aboriginal communities and town camps where thousands of people are in isolation due to COVID-19 outbreaks or as a precautionary measure.
Relief agency Foodbank, which provides food to those in need, has run out of stock in its Alice Springs warehouse and said it needed another 50 pallets of food to distribute to families in isolation.
“They’re all in isolation, they don’t have any stock going out there… there are hungry people, there are hungry children,” Jessica Wishart, who runs Foodbank’s operations in Alice Springs, told NITV.
“We just really need the government to get on board… if we can’t get supplies in through trucks then they’re going to have to look at air freight and we hope that’s sooner rather than later.”
Outback Stores issued a statement on 2 February about its logistical challenges in maintaining food supply to several remote Indigenous communities due to the flooding of the Stuart Highway and localised flooding across Central Australia.
“Like all retailers, Outback Stores has been affected by the freight interruptions between Adelaide and Alice Springs, as well as to freight routes from Western Australia and Queensland,” it said.
“In addition, some communities have become inaccessible due to flooded roads and airstrips. Currently the communities heavily affected are Papunya, Canteen Creek, Wetenngerr, Santa Teresa and Mt Liebig. While these communities have access to a moderate range of grocery products, some stores are starting to run low on fresh fruit and vegetables and perishable dairy items.”
Outback Stores said it is working with business partners and key stakeholders on alternative transport methods to maintain food supplies.
In Western Australia, where the State Government has extended the state’s border closures in an attempt to stop mass transmission of Omicron, Aboriginal leaders are very concerned about food security. Aboriginal Health Council of Western Australia chair Vicki O’Donnell told Croakey last week that WA needed better food security planning to deal with potential COVID-19 outbreaks – and this was before flooding affected supplies.
“We have already experienced COVID-related food shortages in the metro area, and we know we will see this flow on to remote communities,” she said.
Bill Shorten, Federal Opposition spokesman on Government Services, said Labor’s policy to expand the merchant fleet from the current number of 12 ships could be used in such emergencies to get food and essential supplies into communities.
“The lack of an Australian merchant fleet meant two Norwegian-flagged supply vessels were needed to supply fuel, food, water and supplies to the stranded people in Mallacoota in Victoria during the 2019-2020 bushfires,” he wrote in The West Australian today. “It shouldn’t take a war or a crisis to show us how much we need our own fleet.”
• This article was updated after publication to include the Outback Stores statement.
See Croakey’s archive of stories on health inequalities.