Aboriginal Covid cases climb as Australian vaccination ‘surge’ falls short

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New data shows Aboriginal people in NSW and the ACT have been heavily and disproportionately affected by Covid-19, amid concerns that even after two months of “surge” efforts in 30 Indigenous communities, vaccination rates will not be high enough to withstand further outbreaks.Door-to-door work by trusted local health workers to answer questions and counter vaccine hesitancy has been effective in raising rates.© Photograph: Dan Himbrechts/AAP Door-to-door work by trusted local health workers to answer questions and counter vaccine hesitancy has been effective in raising rates.

Ten per cent of all Covid cases in NSW and the ACT are Aboriginal and Islander people, meaning they have been affected at twice the rate of other Australians.

In the past three months, there have been 7,000 cases, 700 hospitalisations, 80 people in ICU and 14 deaths among Aboriginal people, according to data from the National Aboriginal community controlled health organisation (NACCHO).

Prime minister Scott Morrison said on Friday that Australia had made a “massive breakthrough” in reaching the 80% fully vaccinated milestone.

“We are breaking through in the economic recovery that will now follow from the success of that vaccination program,” Morrison told reporters. “We are seeing Australia open up and this is something that we’re all terribly excited about.”

But concerns remain that the targeted surge in Aboriginal communities has not lifted enough to protect them from the virus.

Two months ago, in response to criticism of the slow vaccine rollout among priority groups and the growing gap in vaccination rates, the federal government’s Covid taskforce announced a surge plan to target 30 Aboriginal communities nationwide, to increase vaccination rates and counteract misinformation and hesitancy.

Analysis of the most recent data by Guardian Australia shows that the surge effort has produced some positive results, but the gap between the Indigenous and the overall vaccination rates remains high.

In many areas the gap is no longer increasing, and has decreased by a small amount in some areas, such as the Central Coast and Wollongong local government areas.

Western Australia remains well behind, despite the additional resources, with the gap continuing to rise in Geraldton, and the Swan and Kalgoorlie regions.

Overall, there is a 19 percentage point difference between the Indigenous and overall first-dose vaccination rates in most of the priority areas.

NACCHO says its figures also show the rise in vaccination rates from the surge is not enough to get those 30 priority areas above 80% fully vaccinated.

“I think there’s what the government considers a surge area, and what the community-controlled sector thinks is a surge area, and we think all of our areas are priorities,” epidemiologist and medical adviser to NACCHO, Dr Jason Agostino said.

“South Australia and Queensland have given quite firm dates on when they’ll open up, and at this rate there’ll be a number of Aboriginal and Torres Strait Islander people un-immunised. And we’ve seen in New South Wales, ACT and Victoria, what happens then.”

The community-controlled health sector has long warned that Covid spreads rapidly in Aboriginal communities where there are high comorbidities, crowded housing and poorer general health. The far western NSW town of Wilcannia made international headlines when it recorded its first case in mid-August, and within 10 days had the highest transmission rate in NSW, sparking anger and outrage.

NACCHO is calling for greater involvement in planning for living with the virus as borders reopen.

“We’re essential to the response as we’re going to be more burdened with seeing Covid positive people than other general practices,” Dr Agostino said.

“There needs to be shared decision-making at the local level, and our Aboriginal community controlled health organisations need to be involved in the pandemic response in our clinics, because many of our patients will be people with Covid.”

Agostino is a member of the Aboriginal and Torres Strait Islander advisory group on Covid-19, which was set up in March 2020 to advise the federal government. It has just held its 95th meeting.

“We continue to meet regularly with [the Federal Health] Department and the different states and territories around their responses. At the moment we’re emphasising that living with Covid is about Aboriginal and Torres Strait Islander communities living with Covid, because they’re being disproportionately affected.”

Related: Federal Covid taskforce’s vaccination surge in Indigenous communities a ‘mad scramble’, ALP says

“Door-to-door” work by trusted local health workers to counter hesitancy and answer questions about vaccination in community languages has been effective.

“It is staff intensive and time intensive work, but it makes a difference,” he said.

On Friday national cabinet agreed to update its outbreak management plans, in partnership with the Aboriginal and Torres Strait Islander community sector, and would look at how to manage any outbreaks at December’s meeting.

It remains unclear if the possibility of outbreaks would delay borders reopening.

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