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Closing the vaccination gap

Rick Morton on how governments let down some of those most at risk from Covid-19, and what that means as we open back up.

As vaccination rates across Australia continue to surge, the country is preparing for life after lockdown.

But focusing on the headline, national vaccination rate masks the fact that many vulnerable groups, including Aboriginal and Torres Strait Islander communities, have been left behind in the race to get vaccinated.

For the first time leaked government documents have revealed the disproportionate burden Indigenous communities have borne during this pandemic.

Today, senior reporter for The Saturday Paper Rick Morton on how governments let down some of those most at risk from Covid-19, and what that means as we open back up.


Guest: Senior reporter for The Saturday Paper, Rick Morton.

Show Transcript

[Theme Music Starts]

RUBY:
From Schwartz Media I’m Ruby Jones, this is 7am.

 

As vaccination rates across Australia continue to surge, the country is preparing for life after lockdown.

 

But focusing on the headline, national vaccination rate masks the fact that many vulnerable groups, including Aboriginal and Torres Strait Islander communities, have been left behind in the race to get vaccinated.

 

For the first time leaked government documents have revealed the disproportionate burden Indigenous communities have borne during this pandemic.

Today, senior reporter for The Saturday Paper Rick Morton, on how governments let down some of those most at risk from Covid-19, and what that means as we open back up.

 

It’s Tuesday, October 19.  

[Theme Music Ends]

RUBY:

Rick, throughout this pandemic, we haven't really seen outbreaks of COVID 19 in Aboriginal and Torres Strait Islander communities. That changed a few months ago, though, particularly in regional New South Wales. So at this moment in time, do we know how big the risk is in these communities? 

 

RICK:
The good news is that things are starting to get a little bit better. So the outbreak in Wilcannia, which is a town in far north western New South Wales, which has had the highest per capita rate of COVID 19 infections in the entire country, is under control. They haven't had a single Covid case for two weeks, which effectively means they've gotten rid of it for the time being. 

 

But that is just one community, and one problem has been getting the data to show what is going on across the country, particularly in these under-reported areas. Now, getting that kind of information has been really hard because it's kept in a whole bunch of different departments and institutions and systems. And that's always been the concern because given how at risk indigenous communities are due to high rates of chronic health issues and a lack of resources which are all consequences of ongoing colonisation, we need to know what the profile looks like for these communities. 

 

But recently, I did get my hands on some confidential briefing papers that were prepared for the federal government that show what impact COVID 19 has had on Aboriginal and Torres Strait Islander people, and it's pretty concerning stuff. 

 

RUBY:
Mm so what did those briefing papers say, Rick? What did you find out?

 

RICK:
At a top line level Aboriginal and Torres Strait Islander people who have been infected with COVID 19 at a rate of almost two and in some cases more than three times higher than the non-Indigenous Australian population.

 

RUBY:
Right. So that's a pretty significant difference. 

 

RICK:
Yeah, it's pretty bad. It's the big gap now. Nationally, the difference in infection rates is already pretty stark. But if you go into the actual figures, the rate of infections per 100,000 Indigenous people since the start of this year is around 500, compared with around 300 for non-Indigenous people. So that's 300 per 100,000 of the population. 

 

But things get even worse when you look at certain age brackets now. Nationally, for people aged 30 to 39, the rate of infection amongst Aboriginal people is twice that of the rest of the population. 

 

In New South Wales, where the outbreak has significantly impacted Aboriginal communities, it's more than three times the rate of non-Indigenous Australians. And this all flows on to rates of serious illness, hospitalisations and deaths as well. 

 

RUBY:
OK, can you tell more more about that Rick? To what extent are these Covid-19 cases becoming instances of serious illness, or even deaths?  

 

RICK:
The documents I have showed that indigenous people in their 50s who contracted COVID 19 died at twice the rate of the rest of the population, and the rate of hospitalisations were higher amongst that community as well. 

 

Archival tape -- Rick Morton:

“Hey, Jason, it's Rick Morton here from *The Saturday paper*. How are you going …”

 

RICK:
So I spoke to Dr Jason Agustina is a medical adviser with the National Aboriginal community controlled health organisation Nacho, and he was really concerned about 

what these numbers suggested. 

 

Archival tape -- Dr Jason Agustina:
“Actually, when you do comparisons by age groups and you say that, yeah, for that. Forty to sixty year old age group with the vaccinations and where and where, you know, where of some Aboriginal culture would have that early onset of chronic diseases at the rate of death around three times that of more Indigenous people.”


 

RICK:
Now what he pointed to was the fact that it was really the lower rates of vaccinations  in Aboriginal and Torres Strait Islander communities that were making them so vulnerable to getting ill. And now that obviously just seems to make sense. But it's not something we've done well at as a country in terms of keeping at the top of our mind.

 

Archival tape -- Dr Jason Agustina:
“And so it's really worrying to think what's going to happen even with lower vaccination rates and not a lockdown. So it's a really nervous time for the communities.”

 

RICK:
And he was really worried about what happens, you know, after the lockdown is over as we begin to ease those restrictions and we've still got vaccination rates in these communities that are much lower than the statewide averages. 

 

RUBY:
Mmm. So Rick, how did this happen? How did vaccination rates in Aboriginal and Torres Strait Islander communities fall so far behind? 

 

RICK:
It's multifactorial, of course, but the locus of all of this is actually around the changing medical advice surrounding the AstraZeneca vaccine and the storage requirements for Pfizer.

 

Archival tape -- Senate hearing:
“I declare open this hearing of the Senate Select Committee on COVID 19. Today's public hearing will focus on vaccination and Aboriginal and Torres Strait Islander people.”

 

RICK:
Earlier this month, a senior official in the Department of Health, Dr Lucas De Tuca, told a Senate enquiry into COVID 19 that at the beginning of the vaccine rollout, everything was going actually quite well.

 

Archival tape -- Dr Lucas De Tuca:
“And so throughout the commencement of the primary care rollout in early March, up until late April, vaccine was vaccination was occurring at an equivalent rate.” 

 

RICK:
Now. You'll note that, he said until late April and then he goes on to say there is a very clear moment in which that gap commences. 

 

Archival tape -- Dr Lucas De Tuca:
“The gap started to appear in mid to late April, and there's a very clear moment in which that commences, and it's following the change of clinical guidelines on the preferred use of the AstraZeneca vaccine for people 50 years and over.” 

 

RICK:
Now what happened in mid-to-late April? The vast majority of Aboriginal and Torres Strait Islander people 0were suddenly thrust into a situation where the most accessible vaccine and, as it turns out, one of the most protective vaccines. AstraZeneca was no longer the preferred vaccine. And that's because of the changing ATAGI advice.

 

Archival tape -- Dr Lucas De Tuca:
“But then unfortunately, the discovery and the advice related to the very rare clotting side effect, advice from ATAGI on the 8th of April and changes to the programme on the night of April…” 

 

RICK:
But the Pfizer vaccine at that point in time wasn't particularly accessible.That is because it could only last for five days, according to official advice. Once it had been distributed and thawed, so taken out of the freezers and that was particularly challenging given how widely distributed these communities were. 

 

So while the government and regulators worked on a situation and that was, you know it took about a month, it was this month-long gap where it was impossible to access Pfizer in GP clinics and other primary care settings because of that Therapeutic Goods Administration advice. 

 

Now, everything else since late May has been a game of catch up, and we have already seen the consequences of that. In fact, the real question now is what happens next? 

 

RUBY:
We'll be back after this. 

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RUBY:
Rick, since April, vaccination rates amongst Aboriginal and Torres Strait Islander people have fallen behind. That started happening because of this confusion around the medical advice about the AstraZeneca vaccine and was then compounded by the lack of supply and the difficulty of transporting the Pfizer vaccine. But that issue has largely been resolved now. So what are the factors that are contributing to this vaccine gap at this moment in time? 

 

RICK:
Well, across the country, the worst regions for indigenous vaccination are almost all in Western Australia and Queensland, there's one that's in the Northern Territory. So just by way of example, in Queensland, the Kuranda East and Tablelands region, the first dose coverage for indigenous people is below 27 per cent. 

 

In the East and West Pilbara, both regions, for example, just 22 per cent of the 7000 indigenous people that live in those regions have had a single dose of a COVID 19 vaccine. So remember, this is single dose. We're not even talking about double doses yet. 

 

Archival tape -- Latisha Hope:
“There are a range of different bits of misinformation and hesitancy that are happening across indigenous Australia. So some of it is around general health concerns because of comorbidities.”

 

RICK:
Now, in the Senate hearing last week, one issue that was flagged was that there is some hesitancy in Aboriginal communities.

 

Archival tape -- Latisha Hope:
“Some of it is around deep cultural belief. Some issues around history of practise with government”

 

RICK:
Deputy Chief Executive of the National Indigenous Australians agency Latisha Hope, who's Bundjalung and Torres Strait Islander woman, told senators that there are a range of concerns and fears in some of these Aboriginal communities.

 

Archival tape -- Latisha Hope:
“Some of it is around just really radical thinking in terms of, you know, if you have any Covid shot, it reduces your Indigeneity or it, as well as all the conspiracy theories that we've seen kind of manifest in this conversation.”

 

RICK:
And she said, this is a really important social process, social process, as well as the logistical process. 

 

Archival tape -- Latisha Hope:
“So that localised conversation and working very closely with Aboriginal and Torres Strait Islander people, the communities, the Indigenous sector.”

 

RUBY:
So is there a plan then Rick, to address this particular issue and I suppose also the bigger issue of just low vaccination rates more broadly? 

 

RICK:
Well, things are beginning to accelerate. The COVID 19 vaccination taskforce commander Lieutenant General John Frewen told the Senate committee hearing last week that the vaccination of Aboriginal and Torres Strait Islander people was his number one priority. 

 

Archival tape -- John Frewen:
“We are developing acceleration efforts for Aboriginal and Torres Strait Islander communities in the lowest vaccinated 31 government areas and for all communities across the country.” 

 

RICK:
He did concede that progress will be incremental, but he said we remain committed to working community by community to get this done. 

 

Archival tape -- John Frewen:
“And to ensure as many indigenous Australians are vaccinated as early as possible.” 

 

RICK:
Now that's what happened in Wilcannia because of the crisis there, they ended up going door to door and going to people finding them where they were and offering the vaccinations that way through those trusted indigenous leaders, Aboriginal controlled medical services and the rest. 

 

They are focussing at the moment on 30 priority local government areas. 20 of them are in urban metropolitan regions, 10 are remote and frewen told the Senate hearing that that's largely done on the basis of who's most at risk, but also where the largest numbers of people are and trying to find those large populations where the vaccination rates are still quite low.

 

RUBY:
Mm and that Rick, really points to the fact that this is a race -- because the virus is spreading, New South Wales and soon Victoria will be opening up, and eventually the whole country will as well. The overall vaccination rate is looking good, but it seems like that is masking these lower rates within some Aboriginal and Torres Strait Islander communities. So will this plan to ramp up the rollout work - and will it work in time?  

 

RICK:
So the milestone that New South Wales will hit or has probably hit by the time this podcast comes out actually is 80 percent double dose on average across the state. The goal of the COVID 19 vaccination task force for Aboriginal and Torres Strait Islander people is to get to 80 per cent first dose by the end of October, and that's considered a bit of a moonshot at this point. So we are talking about significant gaps. 

 

So we will see more death and more illness in the most marginalised communities over the coming months, and that should be at the top of everyone's minds. 

 

I suspect it played a part in the delay in regional travel in New South Wales, which was meant to come into effect this week, actually but that's been delayed by at least a week. 

And that's the kind of stepping lightly around these issues that we're going to have to face.

 

The Chief Medical Officer Paul Kelly said that, you know, as per the Doherty modelling, we may need to see these targeted local lockdowns or social restrictions put back in place for these communities. But that's not fair either, right? 

 

So it should all be about vaccines. That is the one ticket to good health and a relatively normal life that we've got right now. 

 

RUBY:
Rick, thank you so much for your time. 

 

RICK:
Thanks for having me once again, Ruby. 

 

OSMAN:
Also in the news today,

 

Archival tape -- ICAC hearing:
“… Her official functions and or a breach of public trust by refusing to exercise her duty to section 11 of the ICAC act  …”

 

OSMAN:
The anti-corruption hearing investigating former NSW premier Gladys Berejiklian commenced on Monday.

 

Archival tape -- ICAC hearing:
Subsection 2 of the independent commission against corruption act.

 

If it pleases the commission…. 

 

OSMAN:
ICAC is investigating whether Berejiklian breached public trust and encouraged corrupt conduct while she was in a secret relationship with former state MP Daryl Maguire. 

 

Archival tape -- ICAC hearing:
Is it right that at that point in time Mr Maguire had been engaged in corrupt conduct? 

 

Archival tape -- Gladys Berejiklian:
“I didn’t know, I couldn’t make any assumptions at that stage. He was professing his innocence.”

 

OSMAN:
The inquiry will focus on Berejiklian’s conduct in relation to 35 million dollars in grants issued in Maguire’s electorate.

 

Archival tape -- Gladys Berejiklian:
“I didn’t know. I was in shock, I didn’t know what to think.”

 

OSMAN:
And, federal Liberal MPs have endorsed Prime minister Scott Morrison’s commitment to net zero emissions by 2050 in the lead up to the Glasgow climate summit next month. 

 

The federal Nationals are still deciding whether they will also support the plan. 

 

I’m Osman Faruqi, this is 7am. See ya tomorrow for the headlines.

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