Where is the light at the end of the tunnel of the Covid-19 outbreak in New South Wales? There will be some restrictions easing when 70% of the NSW population is fully vaccinated, but there is a significant vaccination gap between Aboriginal and non-Aboriginal people.
Aboriginal communities in NSW have been experiencing an alarming rise in the number of active cases. The Covid vaccines, described as 95% effective, were thought to be NSW’s way out of the outbreak. Now, we struggle to see the light at the end of the tunnel.
Aboriginal communities in NSW navigated the first wave of the pandemic with relatively few active Covid cases. However, since this winter, we have had many more cases, most of them in western Sydney and western NSW.
The statistics are stark and shocking. With increasing Covid-19 cases in Aboriginal communities in western and far western NSW in the last week, Aboriginal community-controlled health services within the region pointed out that more Covid vaccine doses are needed to deliver their upscaled vaccination programs such as mobile clinics and drive-throughs. The level of vaccines has not been increased, which is disappointing, to say the least.
Consequently, rural and remote Aboriginal communities in NSW are left unvaccinated during a surge of active cases within the region. Aboriginal communities’ rurality makes them more vulnerable to infectious diseases than other communities in NSW. Longstanding socioeconomic inequities in the regions include limited access to healthcare, higher rates of chronic conditions, economic barriers, geographic isolation, poor housing conditions and limited or no access to clean water. The National Aboriginal Community Controlled Health Organisation’s target of vaccinating 100% of the Aboriginal population before we open up is unlikely to be met, given the lack of resources and vaccine doses supplied to rural and remote communities.
Western and far western NSW regions face a transmissible Delta variant running riot in Aboriginal communities and are crippled by infrastructure gaps that aggravate the outbreak. The lack of adequate infrastructure in Aboriginal communities – and issues associated with its maintenance – hinders responses to the outbreak and can prevent people from complying with public health orders (such as physical distancing, self-isolation and hand washing).
The public health infrastructure in rural and remote NSW is not well understood but is potentially the most fragile. There is an acute shortage of personnel and services in many rural and remote settings. There is also a tendency for policies to be predominantly city-centric, which is now impacting Aboriginal people in rural and remote settings in addressing the Covid-19 outbreak.
Our Aboriginal community-controlled health services are crucial to the public health response in the western and far west region. They can deliver high-quality healthcare and can coordinate upscaled immunisation programs such as seasonal influenza and pneumococcal vaccines. With this crisis, we need the government to recognise ACCHOS and invest in them to deliver upscale vaccination models and take local leadership in coordinating the public health response.
Aboriginal communities urgently need the government to listen to locals’ solutions to the current outbreak. Many Aboriginal communities are taking action by using traditional knowledge and practices such as voluntary isolation, sealing off their own homes and communities, and preventive measures in their languages. Community members are also doing welfare checks and coordinating food hampers for families and individuals. To see light at the end of the tunnel, we need Aboriginal communities to be the beacon of the public health response.
• Dr Peter Malouf is a Wakka Wakka and Wuli Wuli man, who is the executive director of the Aboriginal Health and Medical Research Council of NSW and adjunct associate professor at Sydney Medical School, University of Sydney
