Despite Australia’s great success in containing Covid-19, the recent community outbreak in Victoria Melbourne suburbs with higher levels of migrants raises concern about some gaps in pro-active engagement and planning tailored to deliver culturally appropriate public healthcare responses.
On Monday and Tuesday 75
and 64 new cases respectively are reported. Affected areas are detailed on the
Government link: Government Link
The Victoria Premier also just announced this afternoon 10
Melbourne postcodes involving many suburbs are going on lockdown as per Premier Press Conference.
Most Australian
States have reported “0” outbreaks over the last few weeks, in a few cases only
single digits. So while we are all wishing Victoria the very best outcome, we
are wondering what is going on there? And are other states at potential risk?
The Victoria
Government confirmed today that genomic sequencing has just shown
the recent source of spread specifically came from hotel quarantine sites where
travellers are kept. The infection controls at these sites failed resulting in
hotel staff picking up Covid-19 from returning travellers and then spreading to
families (Press Conference: Victoria Premier)
This verifies media
reports over the last two weeks that people may have been moving around, some
unaware they were infectious.
It also raises
question that while Governments were rightly early on focussing on reorganising
how hospital and GP medical sites interacted with the public, how much thought
went into non-medical sites such as hotels for quarantined people?
Particularly, who was thinking about hotel staff such as security guards and
others?
For instance,
Governments rightly saw it fit to put in place Telehealth Medicare payments for
our medical GPs to safeguard their practices and patients from infections. Also
some states offered their healthcare workers on clinical frontline tackling
Covid-19 free accommodation options away from their home to minimise passing
infections to family members.
Now let’s turn to
security guards and other precariously employed staff at hotel sites
accommodating quarantined travellers. What risk identification strategies were
undertaken early on? And significantly what mitigation measures were put in
place to minimise acquiring and passing on infections to families and
community?
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| Hotel Security Guard: image Courtesy Shutterstock |
How much were issues of
frontline hotel staff taken into account at planning level?
It is not uncommon to
hear that people working in these sites hotels and hospitality in general their
working conditions tend to be low. And we can only imagine the precariousness
when some such as security guards are sent by contracting agencies.
Could it be that we
have been somewhat overlooking need for thorough mitigation measures for lowly
and precariously employed workers who sometimes tend to include large numbers
of migrants?
This is not to take
away the amazing measures that the Fed Government has put in place such as the
doubling of Jobseekers payments or the Job Keeper payments. These remain
historical and benefit people across population groups.
For those with
“policy” hats, it helps if we reflect deeper on theoretical debates about
public goods, private goods and mixed goods, and the justifications why we may
decide a certain issue require attention.
In this case, we
should not neglect that a hotel security guard and his family need as much
protection. Otherwise Covid-19 could be spread far and wide from hotel
parameters to community sites. The working conditions of a security guard are
essential. We have seen this issue before with aged care workers in Nursing
Homes, Baggage Airport Handlers and such.
I also think
guaranteeing paid sick leave to precariously employed workers if they have
confirmed Covid-19 cases unfortunately does not go far enough. How about the
impacts when they go about to work with flu-like symptoms or when they are
waiting for test outcomes? If aged care cases are to go by this is how some
have passed on Covid-19 to others.
Again to those doing
policy, surely there are “positive externalities” that come about and benefit
the whole community if you ensure hotel staff and their security guards, food
delivery people, casual aged care people are reasonably renumerated. Otherwise
we all as a community pay some price such as the reimposition of Melbourne
lockdowns, impact on business, impact on population mental wellbeing and so
forth.
Although Governments
are clearly doubling effort to stem the tide in Victoria, there are also
reports that Governments could have done more to consult and collaborate with
communities so that Governments could benefit from bottom-up knowledge perspectives.
The national Peak
migrant body FECCA reported that the Government engagement with migrant
communities across Australia was inadequate.
The Government’s own
Expert Panel, the National COVID-19 Health and Research Advisory Committee noted
that the community feedback indicated that Government
engagement occurred "on an ad-hoc basis or not at all" (SBS).
The Panel:
Warned the Federal Government of a
"missed opportunity" to prevent coronavirus outbreaks in high-risk
groups like migrant communities, several weeks before a spike of cases in
Victoria [Reference…….]
Further, according to the ABC the Expert Report released on 21 May 2020
- Pinpointed that migrants and refugees were one of the groups at-risk of acquiring Covid-19 and unknowingly spreading it as well.
- Said migrants are more likely to have a chronic disease and miss out on important health information
- FECCA identified state and federal governments’ collective failure to engage with community leaders
- Band-Aid afterthought solutions are used instead of carefully designed policy and program responses to migrant communities
- Lack of willingness to intentionally draw important input from vulnerable members of the community early on to ensure solutions are inclusive and designed appropriately
Also, according to
the The Conversation online
newspaper, ‘’spatial concentration” seems to be a factor in most of the
Melbourne suburbs associated with the rise in new Covid-19 cases. “People in overcrowded or unaffordable or
insecure housing may have less control over their immediate environment and
less capacity to isolate themselves” (The Conversation 29 June 2020).
People on low incomes could be under pressure to attend work
despite feeling unwell to meet their everyday expenses. The high cost of living
does not simply go away just because you manage to negotiate rent reduction
with a Landlord (The Conversation 29 June 2020). For more info see The Conversation Link on: Overcrowding and Housing Affordability Stress-Melbourne.
The Melbourne
lockdown starts in a few hours. The extensive community testing blitz continues
with public health staff knocking at homes in suburbia with reports some people
are refusing to be tested. And we now know the Premier for Victoria is putting
in a place a Judicial Inquiry to
look at look at how infection control breaches took place involving hotel
quarantine staff (See SBS Link for Victoria Premier Press Conference.
I am tempted to make
some suggestions. But even as I do, and as restrictions are eased in my state in
the west of Australia, I am left with a lingering feeling that “There go many
of us but by Grace God”. Our hearts across the country are with Victoria.
Suggestions
- Forced test if are to occur should be of non-invasive type such as Saliva test. This may foster trust than forced internal swabs, ethically better to spit sample in a container especially if person is forced.
- Judicial inquiry being commissioned by Victoria Premier should look at how vulnerable frontline roles as security guards, hotel workers or whatever are protected from contracting Covid-19 and passing to their families. But this should not be an exercise in transferring risk to these precariously employed people
- Just as the nation gives incentives for medical GPs to receive Telehealth payments, consider how you incentivise these lowly paid workers such as contracted security guards and hotel staff at quarantine sites.
- Casual workers with flu-like symptoms should be considered for paid leave and not wait until they tested and proved as Covid-19 positive. If Australia focuses on simply compensating those with proven Covid-19, we run the danger of having some people with flu-like symptoms turn up at work and spread the virus.
- Migrant community engagement should not be simply reduced to language translation – there is more to it than that. Mere language translation strategy runs the danger of simplifying things to a ‘white’ mainstream Western lens.
- A public health approach must pro-actively include culturally targeted strategies from the beginning, not in a reactive way as an afterthought.
References
The Conversation. Overcrowding and affordability stress: Melbourne’s COVID-19 hotspots are also housing
crisis hotspots 29
June 2020, https://theconversation.com/overcrowding-and-affordability-stress-melbournes-covid-19-hotspots-are-also-housing-crisis-hotspots-141381
ABC, Author: Stephanie Dalzell. Government warned of coronavirus 'missed
opportunity' to protect migrant communities before Victorian spike. 24 June
2020. https://www.abc.net.au/news/2020-06-24/government-warned-failing-engage-migrant-communities-coronavirus/12384800
The New Daily. Quarantined Australians face testing
crackdown amid reports of refusals. 26 June 2020. https://thenewdaily.com.au/news/coronavirus/2020/06/26/quarantined-testing-hotels-virus/?utm_source=Adestra&utm_medium=email&utm_campaign=PM%20Extra%20-%2020200626
SBS, Government rubbishes reports migrant communities weren't
included in coronavirus response. https://www.sbs.com.au/news/government-rubbishes-reports-migrant-communities-weren-t-included-in-coronavirus-response
FECCA
[Federation of Ethnic Communities Councils] CALD Resources for COVID-19: http://fecca.org.au/coronavirus/
Victoria
Translated Corona Virus Resources for People from Culturally and Linguistically
Diverse Backgrounds. https://www.dhhs.vic.gov.au/translated-resources-coronavirus-disease-covid-19?fbclid=IwAR1Pk8iNCH6gxMT4VWGKDcGMUCDTY0l1PADeerWynPH9yQ7ZQ_4toihHj7w
Premier
for Victoria. Statement from the Premier. 20 June 2020. https://www.premier.vic.gov.au/statement-from-the-premier-45/
Premier
for Victoria, Statement from the
Premier. 25 June 2020. https://www.premier.vic.gov.au/statement-from-the-premier-46/
National COVID-19 Health and
Research Advisory Committee. https://www.nhmrc.gov.au/about-us/leadership-and-governance/committees/national-covid-19-health-and-research-advisory-committee#:~:text=The%20National%20COVID%2D19%20Health,project%20support%20for%20the%20Committee.
The Conversation, Overcrowding
and affordability stress: Melbourne’s COVID-19 hotspots are also housing
crisis hotspots, 29
June 2020, https://theconversation.com/overcrowding-and-affordability-stress-melbournes-covid-19-hotspots-are-also-housing-crisis-hotspots-141381
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