The Northern Territory government has finalised its plan to manage any outbreak of Covid-19 in remote communities, acknowledging that the risk to remote Aboriginal people is “severe”, and suggesting that all unnecessary travel to remote communities be reduced.
NT Health’s Covid-19 plan says people suffering more than one illness and complicated health conditions in remote areas and their distance from major hospitals places residents there “at risk for severe disease from Covid-19”.
“Those who have been to countries currently listed as being at high and moderate risk should not visit unless absolutely essential and cleared with the health service,” the plan says.
It recommends health workers strongly promote flu vaccination to reduce the concurrent burden of the virus, as well as reduce any potential “confusion regarding diagnosis/causes of outbreaks”.
The plan acknowledges the challenges presented by “overcrowding in housing, poor hygiene and other environmental conditions that can increase disease transmission and raise attack rates”.
It notes that access to healthcare is often reduced due to a lack of transport and electronic communications infrastructure.
On top of that, many ill people may present late.
“Health workers should encourage early presentation of all respiratory illnesses, particularly in vulnerable community members, and isolate all respiratory cases who fit the clinical case criteria and their close contacts.”
But it acknowledges isolation is a challenge in overcrowded housing.
The NT government is considering using non-residential community buildings for isolation purposes, including NT government buildings, and planning the delivery of food, prescribed medications and essentials such as disposable nappies to anyone placed in isolation.
There would be “monitoring of the household situation, initially through social contact via telephone – this may be a nonclinical person telephoning daily to ask questions according to a protocol regarding material needs, emotional status and any worsening of symptoms”.
Social isolation could be managed through phone contact with a registered nurse, and if social contact identifies worsening of symptoms “clients without telephone may need home visits, with sufficient distance maintained by contact person ie speak to household through window or from gate”.
But it says “evacuation options are additionally being considered”.
The NT government has employed a communicable diseases nurse in Darwin and one in Alice Springs to provide advice and assistance to primary health carers.
On Monday the Anangu Pitjantjatjara Yankunytjatjara (APY) lands introduced strict rules for entry to their lands, which they can do under the APY Land Rights Act.
“We are protecting our people, especially those who hold our ancient cultural knowledge, and we know they are already vulnerable as they are quite old,” APY general manager Richard King said.
“The problem with this one is it has a 3.4% fatality rate, which is high, but with our cohort, if it gets here, it’s going to be devastating.”
The Aboriginal and Torres Strait Islander advisory group on Covid-19, made up of leaders from the Aboriginal community-controlled health sector, state and territory health and medical officials, Aboriginal communicable disease experts, the Australian Indigenous Doctors’ Association and the National Indigenous Australians Agency had its first meeting on Monday.
There are major issues to consider, “depending on how serious it gets, and events as they unfold”, Olga Havnen, a member of the taskforce and CEO of the Darwin-based Aboriginal health organisation Danila Dilba said on Monday.
“We would need deployment based on where the need is greatest,” Havnen said. “And will people want to do it? This will need a dynamic response.
“But the commonwealth has a clear sense of the need to provide good structures for the vulnerable in our communities.
“The key thing is getting good information, clear and consistent, to our communities,” she said.
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