In this special Corona Virus edition 13
1.NACCHO suite of measures James Ward and Dr Jason Agostino
2. Donna Ah Chee Combined Aboriginal Organisations Central Australia
3. In Broome, the Kimberley Aboriginal Medical Service
4.Australian Indigenous Doctors : Worst of COVID-19 is yet to come
5.Dr Mark Wenitong Cape York update
6.AMSANT Special control measures urgently in NT
See NACCHO Corona Virus Home Page
Read all 13 NACCHO Aboriginal Health and Coronas Virus Alerts HERE
“The Aboriginal Community-Controlled Health services sector has mobilised and leading an advisory group alongside Governments and is meeting regularly to work on a management plan specific to the Aboriginal and Torres Strait Islander populations.
In the coming days and weeks much more will be required to ensure Aboriginal and Torres Strait Islander communities across Australia have protocols in place to respond to the virus, contain it and eventually recover.
In the meantime, we must do all we can to protect our most vulnerable in our communities including our Elders, who are the keepers of knowledge and stories, and the backbones of our communities.
If we don’t, we should all hang our heads in shame.”
James Ward is director of the University of Queensland’s POCHE Centre for Indigenous Health. Jason Agostino is a general practitioner at Gurriny Yealamucka Health Service , a lecturer and research fellow at the Australian National University, is a Medical Advisor at NACCHO and a member of the Aboriginal and Torres Strait Islander Advisory Group on COVID-19.
See part 1 below : This article first appeared on The Conversation
2. Donna Ah Chee Combined Aboriginal Organisations Central Australia
“All organisations were really clear that we need to make the entire NT and the tristate region a Special Control Area for COVID 19.
This means that we want to apply the same travel restrictions that apply to international visitors nationally to visitors to the Northern Territory from any Australian jurisdiction.
“This is really our only hope of preventing the NT from experiencing the type of exponential spread that is now being seen in Sydney, Melbourne and other Australian cities. More of the same will just give the same outcomes,”
Donna Ah Chee CEO Congress Alice Springs is one of the spokespersons for the Combined Aboriginal organisations (CAO) pictured above . See in Full Part 2
3. In Broome, the Kimberley Aboriginal Medical Service
“We’re saying the tourists should be staying home.
It’s not that we don’t want them; it’s just that in the current environment, it’s not safe for them and it’s not safe for us.
My message to them would be that you should stay home and look after your own health for this year until we can get through this. Maybe travel next year.
The Kimberley already records high rates of patients dealing with diabetes, kidney disease and other conditions that significantly increase vulnerability to coronavirus.
While Broome remains a major tourist destination in its own right, popular destinations like the Dampier Peninsula and Gibb River Road bring significant numbers of visitors to remote communities.
We’ve got a lot of sick people across the Kimberley.
Should we get a positive in any of our communities, it becomes quite dangerous.”
In Broome, the Kimberley Aboriginal Medical Service (KAMS) chief executive Vicki O’Donnell says tourists pose an unacceptable risk to vulnerable Aboriginal populations across the Kimberley
Part 4 :The President of the Australian Indigenous Doctors Association has predicted the worst of COVID-19 is yet to come, with the virus most likely to “peak” over the next three-months.
“The modelling says that the peak of this at the moment might come around May or June.
The diseases we have are often complex, particular diabetes which is intensively worse in our mob..that means that there’s a potential there that COVID-19 will hit our mob harder.
The taskforce formed reasonably early on in the crisis and have been working very, very closely together to address the response to government and the response to communities on how to best manage COVID-19 for our populations and our mob.”
The modelling was important as it assisted medical authorities in implementing effective strategies around the predicted spike and decline of new cases of COVID-19.”
President of the Australian Indigenous Doctors Association (AIDA), Dr Kristopher Rallah-Baker, told NITV News he was particularly worried about people living in Indigenous communities who he said were most vulnerable to the virus.
Part 1 Continued NACCHO suite of measures James Ward and Dr Jason Agostino
As the COVID-19 pandemic evolves, we need to ensure the most vulnerable people in our communities aren’t left behind. This includes Aboriginal and Torres Strait Islander people, especially those living in remote and very remote areas.
COVID-19 particularly impacts the elderly and those with underlying conditions such as cardiovascular (heart) disease and diabetes.
For Aboriginal Australians, COVID-19 has great potential to wreak havoc in our communities.
Around 50% of adult First Nations people live with one of the major chronic diseases such as cardiovascular (heart) disease, kidney disease or cancer. Almost one-quarter have two or more of these chronic conditions.
These risks are compounded by where we live. One in eight First Nations people live in overcrowded housing. This means COVID-19 could spread rapidly. And overcrowding poses real challenges for isolating suspected cases.
This overcrowding is worse in remote settings, which face significant challenges in containing and responding to the COVID-19 pandemic because:
- health services are already at capacity
- the workforce is already reliant on fly-in-fly-out staff, including many from New Zealand which has imposed quarantine restrictions
- there is little access to testing for COVID-19, with long delays for results
- little information is available, especially for those who speak English as a second, third or fourth language.
How can we mitigate the risk?
Our communities aren’t sitting idle. They have put in place mitigation strategies and are awaiting further instructions, assistance and financial stimulus to help them through this pandemic.
Some regional groups – such as the Northern Land Council, the Anangu Pitjantjara Yankunytjatjara Lands (APY Lands in South Australia) and the Torres Strait Islands and Papua New Guinea border cross regions – have stopped issuing new permits for visitors and cancelled all non-urgent travel and visits by government and non-government agencies.
The Northern Territory government is also considering a full lockdown, Territory wide.
But these measures are only the start of what is required.
The National Aboriginal Community Controlled Health Organisation (NACCHO), the peak body representing more than 140 Aboriginal community-controlled health services, has called for urgent information about:
- evacuation procedures for people with COVID-19 and suspected cases
- how to ramp up the workforce and health services in the case of an outbreak
- how to get appropriate, clear and concise messaging out to communities.
The peak body has also called for a suite of measures to help communities prepare for the pandemic, including:
- regional COVID-19 testing services to be urgently implemented
- support for existing Aboriginal health services to modify their structures and create respiratory clinics away from normal health services
- urgent supplies of personal protective equipment (PPE, which includes gowns, masks and goggles) to be made available
- urgent identification and sourcing of appropriate housing for suspected and confirmed cases
- existing medication supplies not to be interrupted but rather prioritised across all settings
- for access to food and other essential items – such as sanitation supplies, cleaning products and soaps – not to be compromised as the pandemic progresses.
We can’t wait long for action
The warnings from around the world are clear: the earlier these requirements are met, the better the outcomes will be.
We have a moral responsibility to do better than we did in the 2009 H1N1 pandemic. This pandemic ended up with 3.2 times more Aboriginal people admitted to hospital than non-Aboriginal people, four times as many admissions to intensive care units and 4.5 times the number of deaths.
Part 2 The NT must become a Special Control Area for COVID 19 or else there will be a lot of preventable deaths
The Combined Aboriginal Organisations of Alice Springs held a special meeting to discuss the threat of COVID 19 to Aboriginal communities across Central Australia.
“All organisations were really clear that we need to make the entire NT and the tristate region a Special Control Area for COVID 19. This means that we want to apply the same travel restrictions that apply to international visitors nationally to visitors to the Northern Territory from any Australian jurisdiction.”
“This is really our only hope of preventing the NT from experiencing the type of exponential spread that is now being seen in Sydney, Melbourne and other Australian cities. More of the same will just give the same outcomes,” said Donna Ah Chee one of the spokespersons for the Combined Aboriginal organisations (CAO).
“If we don’t protect the regional centres in the NT then we are not protecting remote communities. Aboriginal people move in and out of our regional centres all the time for life saving health care, to get back on to Centrelink payments and to buy food at affordable prices.
This will not just stop overnight. We have to make sure that the regional centres in the NT are also protected in order to protect our remote communities,” said Peter Renehan, another spokesperson for the CAO.
“In addition to this, there are many vulnerable people living in town camps and other areas in the regional centres. They also deserve to be better protected,” he continued.
“We have to stop pretending that the health system will cope no matter how well prepared we try to make it. We don’t have the workforce or the infrastructure in intensive care to cope with the surge that will come if we let this pandemic unleash its full force on the NT. Look at Italy, Holland, Spain and other European countries – they all thought they could cope and are now telling us not to make the mistakes that they made,” continued Donna Ah Chee.
“Apart from the inability of the health system to cope, our communities cannot suddenly overcome the additional susceptibility to this infection due to underlying chronic diseases, overcrowding, lack of food security, inadequate income and many other social determinants that will see this virus become a “super spreader” if allowed in. There is no immediate fix to these issues,” said Peter Renehan.
“We must do everything possible to stop this virus from entering the NT. We don’t accept a flatted curve we want a continuous flat line when it comes to COVID 19 and this is our best chance of achieving this,” concluded Donna Ah Chee
5.Dr Mark Wenitong Cape York update
6.AMSANT Special control measures urgently in NT
Aboriginal Medical Services Alliance (AMSANT) today expressed support for a proposal to make the entire NT and the tristate region a Special Control Area for COVID 19. The measure would simply apply the same travel restrictions that are now mandatory for international visitors arriving in Australia, to visitors to the Northern Territory from any Australian jurisdiction.
“New Zealand and Tasmania have led the way in forward-thinking, decisive action to fight this virus. We must follow their lead”, AMSANT CEO, John Paterson said.
“The recent spike in numbers of confirmed cases in other jurisdictions, particularly NSW, Queensland and Victoria, points to an exponential growth of spread. Yet the NT remains without any cases”.
“This offers a narrow window of opportunity to introduce measures now to prevent the spread of the virus into the NT, or at least significantly delay and minimise any spread.
“Extraordinary circumstances call for extraordinary measures”, Mr Paterson said.
“Our Aboriginal population comprises the most vulnerable group in Australia and the projections for the likely health impacts of COVID 19 are nothing short of devastating.
The H1N1 virus in 2009 resulted in death rates amongst the Aboriginal and Torres Strait Islander population six times that of the non- Indigenous community and the need for ICU beds around eight times more. The risk factors for COVID 19 are greater and hence the impact is likely to be higher than for H1N1.
“With the whole-of-population death rate for COVID 19 estimated to be between 1 – 4 per cent, this could translate to a death rate of between 6 – 24 per cent or more for Aboriginal and Torres Strait Islander people.
Unchecked spread of the virus would also quickly overwhelm the health system, which is underprepared and under-resourced to cope with any surge in demand.
“Adopting jurisdiction-wide travel restrictions is also necessary for protecting remote communities due to the significant movement that occurs between urban, regional and remote Aboriginal communities, particularly to access health care, government services and affordable food.
“We need to minimise the potential for contact at urban and regional centres to spread the virus back to remote communities.
“This once-only opportunity we have to introduce a measure that can turn back the tide on this virus must not be missed”, Mr Paterson concluded.