Numbers tell story of remote Covid surge

At any given time there are up to 14 people packed under Emma Costello’s roof, sleeping four to a room. There’s no mystery why Covid finally hit Indigenous Australia hard and fast.

Grandmother Emma Costello, right, shares a roof with 13 of her family members across three generations in Yarrabah, south of Cairns. Picture: Brian Cassey

There’s no mystery why Covid-19 finally hit Indigenous Australia hard and fast. The numbers tell the story.

And in the hard-scrabble township of Yarrabah, south of Cairns, the equation goes like this: 378 homes for 3500 people equals more than 90 per cent of the chronically overcrowded households penetrated by the virus.

The grim calculus is playing out across the far-flung reaches of the nation’s top end where Omicron is spreading unchecked through one community after another, overwhelming longstanding efforts to keep vulnerable Indigenous populations safe.

When Emma Costello’s 25-year-old son, Jeremiah, fell ill a fortnight ago and tested positive in Yarrabah she was panic-stricken. She has 12 children and 22 grandchildren who cycle between her blue besser-block home on Workshop Road and a second family property.

At any given time there are up to 14 people packed under her roof, sleeping four to a bedroom. Husband Colin, who is battling cancer, bunks down in the living room.

How on earth was she supposed to stop them getting infected? “It was a big concern … we had no other place to go,” said Ms Costello, 59.

In any case, Jeremiah had the compounding complication of rheumatic heart disease and needed care. “We did not want to leave him,” she said.

So they isolated the young man in a bedroom, posted a sign on the front gate telling people to stay away and hoped for the best.

They’ve been lucky: no one else in the house has come down with the virus. Yet.

The good news is that the combination of a strong if belated catch-up in the vaccination rate and reduced virulence of the latest Covid variant has so far kept hospitalisations and deaths low in Yarrabah, a snapshot of what’s happening in embattled Indigenous communities from steamy Cape York to central Australia’s Pitjantjatjara lands and the Kimberley in dusty northwest WA.

Yarrabah resident Gillian Bann, right, takes a swab at the Covid test station. Picture: Brian Cassey

But it doesn’t change the immutable pandemic arithmetic: that as the case numbers surge, fatalities will inevitably increase, mirroring the trajectory in the wider community.

The situation in Queensland, home to some of the nation’s largest stand-alone Aboriginal and islander townships, is particularly acute because of the delayed onslaught of Covid.

Prior to the state border reopening to NSW and Victoria eight weeks ago, there was limited person-to-person transmission and not one known Indigenous death.

The Queensland government reported this week there had been 11 Indigenous deaths to date from 16,256 known infections. Nationally, 45 have died.

Jason Agostino, medical adviser to the National Aboriginal Community Controlled Health Organisation, warned that Indigenous people were being admitted to intensive care or dying at twice the rate of other Australians. He knows “Yarrie” well from working there as a fly-in GP.

Isolating the infected in homes where people lived on top of each other had been a recipe for disaster once the virus broke in.

“Two years into the pandemic we should have had solutions for them and we don’t,” Dr Agostino said. “The main thing is that people needed to be provided with alternative accommodation if they don’t want to be isolated in a crowded home. That’s why we are seeing the spread.”

Yarrabah’s Gurriny Yealamucka health service has kept careful count. Since the outbreak erupted in January, 701 people have tested positive – one in five in the town – affecting 342 households, or nine tenths of the housing stock. Currently, 89 homes have an active Covid case.

Nuksa Neal, nine, and sister Lormoya Neal, five, are helping grandad Percy Neal tend to vanilla plants on his small Yarrabah farm. Picture: Brian Cassey

On average, 11.5 people shared a three-bedroom, one-bathroom house, said chief executive Suzanne Andrews. But the health service had identified homes crammed with up to 18 occupants.

“We’ve been real deadly with the vaccine and the rollout, but how do we put a lid on this new variant to stop the spread?” she said. “We can’t because of the number of people living in the same house. It’s crazy.”

Ms Costello, the family matriarch, sometimes loses track of who is sleeping over. She starts to count them off: in addition to husband Colin there’s two adult daughters, their partners and four kids, aged 5 to 8; Jeremiah, his partner and their little one made 13 in the house. Who was missing? Oh yes, the baby: “We’re a cosy mob,” she said.

Mayor Ross Andrews said the community was doing all it could. People mostly followed health ­instructions to isolate or quarantine and wore face masks when out and about.

After a slow start to the vaccine rollout – fewer than a third of those eligible were doubled-jabbed as of October last year – local health teams had gone door to door to lift the rate to 82.6 per cent, a saving grace.

The state government had helped by covering the cost for some families to sit it out in ­nearby Cairns and of establishing a Covid isolation unit at the drug and alcohol centre outside town. But this met only a fraction of the demand.

“When the government says, ‘go and isolate or quarantine’, they are talking from a position of privilege,” Mr Andrews said.

“We can’t actually do that … if one member of a household is ­infected, he or she will pass the virus on because of the overcrowding. It’s been a challenge navigating around that.”

Thankfully, there had been no Covid deaths in Yarrabah and only five hospitalisations – among them, the town’s oldest resident, “Pop” Alfie Neal, 98, just home after a week of inpatient care in Cairns. Health service boss Ms Andrews said the community received a wake-up in 2018 when measles broke out, infecting hundreds.

A report went to the state and federal government identifying the entwined risk factors of overcrowded accommodation and poor hygiene, compounded by lack of access to running water in the jammed and dilapidated living conditions. The name of the virus had changed, but the infection settings remained.

“We have been hammering this overcrowding issue in the housing for as long as I can remember, but at the end of the day, it falls on deaf ears,” a frustrated Ms Andrews said.

Defending the state government’s response to overcrowding, Queensland Health Minister ­Yvette D’Ath said on Friday: ­“Ultimately you cannot force people to change their living ­arrangements. I know and sadly I have heard in some communities they do not accept Covid is real and they have tested positive, that they are refusing healthcare, so they are still in those homes with those cases.”