Most Aboriginal and Torres Strait Islander adults are at risk for serious illness from COVID, but immunization coverage requires patient identification.
Two-thirds of Aboriginal and Torres Strait Islander adults (59%) have an increased risk of developing severe illness from COVID-19, being admitted to intensive care, requiring mechanical ventilation, or dying.
These are the sobering results of a new study, led by the National University of Australia and involving researchers and practitioners from RACGP, the National Aboriginal Community Controlled Health Organization (NACCHO) and the Lowitja Institute.
According to the authors, the research reinforced the need for Aborigines and Torres Strait Islanders to remain a priority group in the vaccine rollout, as well as in the broader response to the pandemic.
But as Australia prepares to ease restrictions as states aim to meet vaccination targets, Professor Peter O’Mara, a man from Wiradjuri and chair of RACGP Aboriginal and Torres Strait Islander Health, fears some communities remain unvaccinated – and vulnerable.
‘[NSW Premier] Gladys Berejiklian says it’s going to open at 70% in double dose and we’re getting close to it quickly, luckily, âhe said. gp news.
“But if indigenous communities are only 55%, given the cultural ties and overpopulation, it’s going to be absolutely devastating.”
Ensuring that all Aborigines and Torres Strait Islanders have the opportunity to be vaccinated is first and foremost about being identified. But Professor O’Mara says he is aware that some GPs find it difficult.
âFor some doctors this has been a bit of a challenge as some patients will have fair skin like me,â he said.
âIt’s part of our challenge as space educators over the years to say that you don’t expect a native man to stand there with knees, a spear, a big long gray beard. and really deep black skin.
âWe come in all shapes, sizes and colors, so you won’t know until you’ve been asked this question. “
Following the Australian Institute of Health and Welfare (AIHW) good practice guidelines, the standard question to ask is: “Do you identify yourself as an Aboriginal and / or Torres Strait Islander?” “
Professor O’Mara acknowledges that some general practitioners may be concerned about how to ask the question. He advises approaching it like any other, the same way as asking about the family’s medical history.
âI’ve been doing this my whole life and I’ve only had one person who got mad at me to ask,â he said.
âIt was an older man and he said, ‘Why do you want to know that? and I said, âWell, if you’re an aboriginal, I know aboriginal people have diabetes, kidney disease, and other things at higher rates, and I have toâ¦ be more vigilant about that. And he said, âOh. Well, I am not â.
âOften it’s just a matter of explanation. But you can guarantee that if you’re embarrassed to ask the question, the person might be a little reluctant to answer it, so just ask it in the vein of any other question.
Alternatively, Professor O’Mara says GPs can use COVID-19 and vaccination to start the conversation.
âYou might say, ‘Due to the COVID situation, we are checking to see if we have any native patients. Are you an Aboriginal or Torres Strait Islander? “, did he declare.
If a patient identifies as an Aboriginal or Torres Strait Islander, Professor O’Mara suggests trying to make a connection by simply asking, “Where is your crowd coming from?”
âThis is also what we do as aboriginal people across the country,â he said. âYou could say, ‘I’m not native, but I lived in Mudgee’ or ‘The countryside over there is beautiful.’
“Most of the time, if you respectfully try to experience our people and our culture the right way, people will really embrace it and they really like to tell you that.”
Firms can also strive to create a culturally safe space by having Aboriginal artwork and signage, as well as country recognition in the waiting room. There are also health related posters developed by NAACHO that may be helpful.
âIf you’ve got that stuff around, people are at least thinking, ‘Maybe this environment is happy to recognize who I am and will have some respect around it,â Professor O’Mara said.
Although there have been reports of vaccine reluctance among Aboriginal and Torres Strait Islander communities, rates are increasing, but there is still some way to go.
While the Australian Technical Advisory Group on Immunization (ATAGI) recommends AstraZeneca for people over 60, Professor O’Mara says the critical nature of immunizing indigenous patients means that alternative arrangements need to be considered in the whenever possible.
âNative people have reason to be wary of these things because of what has been done in the past,â he said.
âIf you have an Aboriginal person who wants to get the vaccine but is reluctant to get AstraZeneca, just give him Pfizer. Do it.
âEvery department I had this conversation with said it was a good idea; we just need to protect the aboriginal people.
Through community-led efforts, Aboriginal and Torres Strait Islander communities have been largely protected from COVID-19. But that has changed since the Delta outbreak of NSW.
Professor O’Mara says it is important for the rest of Australia to heed the warning.
âThe saving grace will be to vaccinate the community because the overcrowded situation in the houses and that kind of thing, we cannot solve this problem overnight,â he said.
“But in three weeks we can solve the vaccine problem.”
However, cultural identification is essential.
âI study almost every day because I want to be the best doctor I can be. I haven’t seen an easier way to save lives than to do it, âsaid Professor O’Mara.
âIt’s so easy, but so important. “
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COVID-19 Vaccination on Aboriginal and Torres Strait Islander Health
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