With locally spread Omicron cases accelerating rapidly in Western Australia, Aboriginal health providers remain worried about the vaccination rate and how COVID-19 outbreaks will be dealt with in vulnerable communities.
It comes as WA's largest remote Aboriginal community has been placed into lockdown after multiple positive COVID-19 cases were detected.
Health authorities said the cases were detected in Bidyadanga, 180 kilometres south of Broome, on Wednesday evening.
The double-dose Indigenous vaccination rate in WA sits about 25 per cent below the overall state figure – it is about 70 per cent, compared to 95 per cent.
In the Kimberley town of Halls Creek, the double-dose rate is around 56 per cent.
While it is a big jump from 23 per cent in November, Yura Yungi Medical Services chief executive Brenda Garstone said the health service was trying to boost the figure before Omicron arrived on its doorstep, with a number of locals vulnerable and suffering chronic disease.
There are serious concerns about how authorities would deal with a COVID-19 outbreak in Halls Creek given overcrowding is rife and there is a shortage of health workers.
"We're really worried because we don't have the staffing or resources living in a remote town," Ms Garstone said.
Battle against misinformation
Ms Garstone said it had been an uphill battle convincing some of the town's population the vaccine is safe.
"Unfortunately there's pockets of our community who are still outright refusing to take the vaccine, there's still all these conspiracy theories going out there," she said.
"There's still people digging their heels in which is really sad.
"We're trying to convince them that this is going to be life saving if they take up the vaccine option."
Ms Garstone said information sessions would be held this week showing evidence that vaccines were safe and reduced hospitalisations.
Sessions like this and conversations tackling misinformation have been critical in boosting vaccine uptake.
Vaccine commander Gary Dreibergs was this week in Derby, one of the local government areas being targeted by the federal government's Operation COVID Shield rollout.
"If you want to prevent your family from getting seriously ill, if you want to protect old people, you want to protect your children, get vaccinated, that's as simple as it is.
"There's nothing more we can do than telling people what the facts are."
NT body issues Omicron warning
Over in the Northern Territory, John Paterson knows all too well what the impacts of the virus can be.
As well as seeing the effect on the ground from providers every day in his role at the helm of the Territory's peak Aboriginal health body Australian Medical Services Alliance NT (AMSANT), he spoke to the ABC as he recovered from his own brush with COVID.
"The first three days, it's like a big Mack truck hitting you; aches, pains, all these strange feelings.
"I'm a firm believer, I can't emphasise the importance of having being triple-vaxxed, that's prevented me from severe infection, and possibly hospitalisation."
Mr Paterson said AMSANT pushed hard against the opening of the NT border in Christmas, saying just a bit more time would have helped communities prepare.
"We were run off our feet, we still are today, trying to combat it and put in place public health measures," he said.
Most patients hospitalised with COVID in the NT are Indigenous.
Mr Paterson said the WA Government and communities needed to ensure they had strong COVID outbreak plans in place, including making sure food supplies were adequate, and considering where people would isolate.
Like Ms Garstone, he flagged overcrowding as an issue, and has been calling for governments to provide specific isolation facilities.
"When governments say, 'Self-isolate, look after yourself, take care, deal with COVID at home' – that might work in suburbia and capital cities, but it ain't gonna work in remote communities," he said.
Indigenous leader warns of 'faceless care'
The state's peak body for Aboriginal community-controlled health services, the Aboriginal Health Council of Western Australia (AHCWA), said Indigenous vaccination rates had come a long way in the past 12 months through partnerships across the sector, but says efforts needed to be kept up.
AHCWA chair Vicki O'Donnell said she expected vaccination rates to rise further as cases grow in the state.
Beyond vaccines, AHCWA flagged "serious issues" last week with the state government's COVID Care at Home program, designed to deliver virtual monitoring care for COVID-positive people.
The council said the program did not address concerns raised about accessibility barriers for Aboriginal people in metropolitan areas, as well as those in remote and regional locations.
"The COVID Care at Home Program is a system we would describe as mainstream," Ms O'Donnell said.
"What we know is Aboriginal people wish to be cared for by people they know and trust, and a system of care delivered by a faceless person over the phone from the eastern states is not going to work for many, probably most, Aboriginal people."
Ms O'Donnell said a gap could arise, with local services needed to fill that gap without more resources, taking away from other service provision.
AHCWA said the current program did not engage GPs or Aboriginal community-controlled health services with COVID-positive patients, when ongoing care for vulnerable people would be needed.
A WA Health spokesperson said the COVID at Home program was not compulsory.
“There is nothing stopping GPs staying in regular contact with their patients even when they are on the program,” the spokesperson said.
The spokesperson said a doctor from AHCWA was included on the clinical group which designed the program, and a meeting was held with Aboriginal medical services around “their wishes as to how they would like to manage their patient cohorts”.
'We've done everything we can': Premier
In addition to the Bidyidanga outbreak, the community of Mantamaru, or Jameson, located about 1,000 kilometres north-east of Kalgoorlie, has now recorded a total of six COVID cases – the first in a remote WA Aboriginal community in the Omicron outbreak.
Premier Mark McGowan said the cluster was confined to that community, and the government was not looking at introducing broader restrictions across the Goldfields.
He said "various plans" were in place to manage outbreaks in remote communities, which he said were of particular concern as COVID-19 numbers rose.
"We have rules about who can go in, and if there are outbreaks, we basically lock the communities down and require people to quarantine, and if anyone is very unwell, we get them out and into hospital," Mr McGowan said.
The Premier also said a number of strategies were underway to boost trailing vaccination numbers.
"We've done everything we can to get Aboriginal people vaccinated," he said.
"We've had clinics, we've had advertising campaigns, the [Police] Commissioner, the Chief Health Officer, myself, have been out there advocating constantly.
"The fact it's now in one Aboriginal community will hopefully spur action, and more people will get vaccinated."
