Eight Indigenous people have died after contracting COVID-19 in South Australia since the beginning of the pandemic, SA Health has revealed.
The deaths are among more than 260 in South Australia, which has seen several serious outbreaks in Aboriginal communities.
SA Health's approach to managing COVID-19 in Aboriginal communities has been centred on quarantine hubs, a temporary form of accommodation that also includes health services supporting people who test positive.
SA Health's director of Aboriginal health Tanya McGregor, a Yaruwu woman, has spearheaded the COVID-19 response for Indigenous communities.
Quarantine hubs
Ms McGregor said the quarantine hubs were a culturally sensitive approach and a "critical element" for planning SA Health's pandemic response.
"Our regional quarantine hubs in Ceduna and Port Augusta are about providing an environment for Aboriginal people, especially from remote communities, to cohort together with family or other community members that are COVID positive to minimise the spread in the community," she said.
"Medi hotels and individual rooms in high rises and so on are not necessarily places where Aboriginal community members feel comfortable.
"The cultural element has been central to that thinking and planning."
With many Aboriginal communities put into SA Health-sanctioned lockdowns under the Biosecurity Act in early 2020, Ms McGregor said it was a collaborative effort to work out how to protect vulnerable communities when they came out of those lockdowns in July a few months later.
"In planning with communities we've heard the key elements to support people to comply with what the isolation and quarantine requirements are."
SA Health was criticised for calling for tenders for the quarantine facilities just days before the state opened its borders in November 2021, leading to statewide outbreaks.
Far west case low
COVID-19 cases have been kept relatively low in the west of the state among Ceduna's Aboriginal population, both transient and permanent, even during recent spikes.
Ms McGregor said it had been all team effort between the town's quarantine hub Emu Farm, local Aboriginal health service Yadu Health, Ceduna Aboriginal Corporation and the Ceduna Hospital.
"Yadu Health did a lot of the original contact tracing. They know their community and Ceduna Aboriginal Corporation offered up their land to house Emu Farm," she said.
"One of the things we have learnt during COVID-19 is that collaboration with organisations and government services means better-connected support.
"Our regional health networks have really stepped up."
The Emu Farm facility was empty for some periods of time when case numbers were particularly low.
Ceduna District Health Service executive officer and director of nursing Andrew Lane said the COVID response was a masterclass in how different service providers could work together.
Mr Lane said it had been a challenge to keep local Aboriginal communities safe but the collaborative approach to identify cases early and come up with a specified plan has kept vulnerable people safe.
"When we've started to see outbreaks in communities, inter-agency cooperation has come as second nature to us," he said.
Overcrowding proves isolation issue
Sometimes due to housing shortages, one residence in remote Aboriginal communities that make up the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands can host up to 20 people, which creates COVID-19 isolation challenges.
There are about 93 active COVID-19 cases on the APY Lands, and there have been 524 in total according to SA Health data.
"Overcrowding has been a long challenge for many Aboriginal communities not just in remote areas but also in the metro, that is one of the reasons we have established these [quarantine] hubs," Ms McGregor said.
She said that during the pandemic every Aboriginal person who contracted COVID-19 was assessed by SA Health and moved based on their personal, at times complex, health requirements.
"When people are quarantining at home, they will be medically assessed and risk assessed as not everyone is suitable to quarantine at home."
She said this meant some people from remote communities were taken to Adelaide for isolation during their infectious period to be closer to specialist medical services not available in regional and remote parts of the state.
She said another COVID-19 response guided by community input had been the quarantine camp in Port Augusta, which was set up in a similar way to Emu Farm in Ceduna.
"We have ensured we are using community leaders in our response in Port Augusta," Ms McGregor said.
"The facility has predominantly housed people from the APY Lands who can't safely isolate at home due to overcrowding.
"That is the benefit of these facilities, people can remain close to home while infected and stay medically stable."
Highlighting misinformation
One of the biggest challenges during the pandemic, Ms McGregor said had been SA Health's effort to combat misinformation online.
She said young people in the community with access to social media and the pace at which information churned had proved a problem for getting the correct health messaging out.
"Individuals can get information quicker from overseas than they can [from us].
"Stop the spread and stay strong has been our message and we've worked really hard in making sure Aboriginal communities have been informed."