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OPINION: We need a COVID 'Plan Zero' for Western NSW

We need a COVID Plan Zero for Western NSW to stomp out the COVID risk in our communities.

As the NSW Minister for Health acknowledged the other day COVID is not the cause of the problems in western NSW. He said: 'Walgett doesn't have the health care capacity to deal with an outbreak'.

Like the NSW Inquiry into rural health, COVID has again placed a spotlight on the problems of understaffing and under-resourcing of NSW rural and remote health, and the lack of coordination between different tiers of government.

This is rebounding on primary health care providers (PHC) in rural and remote towns that are struggling to manage the complex needs of very unwell patients while simultaneously trying to get vaccines into their patient's arms.

Far from leading the COVID response, PHC providers are struggling to get accurate information about what's going on and who is doing what.

Rural and remote NSW has a high proportion of Aboriginal and/or Torres Strait Islander residents, a high prevalence of chronic disease and a high proportion of aged residents.

Our communities should have been part of the first wave of high priority vaccinations in Australia.

Now is the time for a clear Plan to get our communities vaccinated and protected. This means we have to take the politics out of the equation and focus on delivering a plan based solely on the needs of our communities.

We need all the players at the table including local government, primary health networks, local health districts, primary health care providers and pharmacies to activate a strategy to get western NSW to COVID Zero.

This Plan needs to be designed by people who understand these communities. It can take years to build up a trusting therapeutic relationship with patients that enable GPs and nurses to talk about getting vaccinated where there is hesitancy. This is an asset on which our health planning must be built.

The Plan should involve:

  1. a target of 90% of the population vaccinated in the next two months.

  2. all willing primary health care (PHC) providers and pharmacies should be given a supply of Astra Zeneca and Pfizer now - no more favouring one practice or town over another, no more offering vaccines and then shifting them somewhere else - this needs to stop.

  3. Where available, PHC providers should be given the resources to treat their own patients. PHCs have the knowledge of their own patients and can prioritise vaccination based on vulnerabilities. We are at risk of getting vaccines into the arms of the willing, but losing those for whom vaccination is scary or those who do not want to go into a hospital or town. This is a time for primary health care providers on the ground to be supported to do what they do well.

  4. Mobile PHC vaccination clinics should be allowed in small towns to reduce the need for vulnerable people to travel to large centres where they are a a higher risk of infection.

  5. We all need better data that is up to date and sent to all practices every day. If a new vaccine centre is set up everyone should know this without having to look on Twitter. We are duplicating effort because of poor communication and coordination.

  6. We need to be able to import immunisation data on our patients into our practice databases so we can make sure that no-one falls through the cracks.

  7. PHCs need to be supported to deliver home vaccinations if required so we can get to the people who are afraid of going into a clinic or hospital environment - we need to provide a culturally safe program if we are to reach COVID Zero.

  8. There needs to be funding to support PHC. We need nurses to deliver vaccines and doctors to ensure we don't drop the ball on chronic disease management while we attend to this crisis.

This outbreak requires a planned, coordinated and well communicated response with senior leadership buy-in from the Commonwealth.



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