The COVID-19 outbreak experienced in Western NSW from 10 August 2021, when the first COVID-19 case was identified in Dubbo, was the first outbreak of the virus in rural and regional NSW. To combat rapidly rising COVID-19 case numbers, a range of service responses were activated, initially in Dubbo and then in surrounding communities as virus transmission occurred.
The timeline for service activation detailed below demonstrates how quickly emergency plans were implemented and resources deployed. In addition, the public health unit surged a contact management team to manage local cases. This team provided general support and advocacy for COVID-19 cases and referred to Mental Health Drug and Alcohol for specific support, where required. The team included a surged Aboriginal workforce, which was invaluable in providing a culturally safe and competent response to the Dubbo community and more broadly across the district.
22 July - Establishment of a COVID-19 Call Centre as a central contact point for people living in Western NSW for questions, information and issues relating to COVID-19.
12 August - Operationalisation of the COVID Care in the Community program. This included 24/7 care for COVID-positive patients with health concerns, delivered remotely to their home, and providing access to specialised health services and social support.
Mass COVID-19 testing initiated and in place across all local government areas (LGA) by 18 August. This included a mobile testing team in Dubbo to provide in-reach predominantly to Aboriginal people.
13 August - Support for community home isolation through cultural support for Aboriginal patients and their families, provision of food and medication deliveries, and home testing for patients with COVID-19. More than 1300 food and care packs and 100 kids’ packs were delivered.
14 August - Initiation of LHD-led health accommodation for patients with COVID-19 and close contacts unable to isolate in their own homes. More than 100 people were accommodated from August 2021 to June 2022. Of these, 22% were homeless and a further 15% were referred due to domestic violence.
17 August - Support from the Australian Defence Force (ADF) was provided. The ADF worked with the NSW Police Force to enhance monitoring of compliance with isolation and stay-at-home orders. They also worked with district and other service providers across Western NSW staff mass vaccination clinics.
The outbreak demonstrated the vulnerability of Aboriginal populations to the spread of COVID-19 and how Aboriginal people can be disproportionately impacted. From August to December 2021, there were 1334 cases in Dubbo LGA and 715 (54%) of these were among Aboriginal people. This was despite Aboriginal people making up only 11% of the total population in the Western NSW Local Health District; in Dubbo itself this figure is 15% (ABS 2016). There were 12 deaths recorded in the Dubbo LGA, 4 (33%) of which were Aboriginal people.
Disadvantaged and vulnerable populations impacted by the outbreak faced significant barriers to compliance with public health measures, including overcrowded housing, homelessness, domestic violence, mental illness, and drug and/or alcohol dependence. Treating and supporting the whole person or family unit (that is, providing food, medication, and social and wellbeing supports in addition to COVID-19 clinical care) rather than treating the disease only, was key to suppressing the virus.
The Tubbagah People of the Wiradjuri Nation are Dubbo’s traditional owners.
Reference:
Australian Bureau of Statistics (ABS) 2016, Dubbo, Census All persons QuickStats.
Priscilla Stanley1
