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Anthony Zwi

"It feels like we're a soft target because we don't have a big voice" 
                                                                 – A resident of one of Melbourne’s locked-down public-housing tower blocks

Australians have been shocked at the resurgence of COVID-19 in the state of Victoria and the associated top-down control measures recently introduced. 

The country had been doing well in controlling the spread of the virus. An island continent that stopped international travel early, Australia also took other measures, including hotel quarantine for all returned travellers; campaigns about physical distancing; the promotion of cough and hand hygiene; comprehensive testing and contact tracing; PPE for health workers; an effective network of health services; good communication and decision-making between states, territories and federal government; and policymaking based on public-health advice. By 3pm on 12 July 2020, Australia had reported 9797 cases and 108 deaths

The resurgence of COVID-19 infections from mid-June, almost all in Victoria, was largely traced to a serious failure in implementing hotel quarantine measures to the agreed standard. 

Victorian data (released 12 July) showed 273 cases diagnosed in the previous 24 hours. The shift from overseas-acquired infections to those transmitted and acquired locally has caused alarm. In the seven days up to 11 July, 621 new cases were reported, 535 (86%) of which were locally acquired. 

An additional concern was the differentiated restrictions. Across the metropolitan Melbourne area and Mitchell Shire from midnight on 8 July, residents were required to stay at home (except for  work, education, access to care, household shopping, and exercise), but nine public housing towers were singled out on 4 July for much harder “lockdown” and “detention” orders (see latest details; this still applies to one tower), the most severe in Australia to date. 

Residents were to remain in their apartments, with information, services, supplies and coronavirus tests to follow. The speed of the lockdown and the manner of its implementation shocked them and the broader community, perceived as heavy-handed, police-heavy, and information-light. Many residents only became aware of the lockdown when 500 or so uniformed police surrounded the buildings and informed them. 

The public housing towers, or “the flats”, as residents call them, provide rental accommodation for people in need, including those who have experienced domestic violence, homelessness or unemployment, or are living with disabilities. They come from diverse backgrounds and ethnicities, including refugees and asylum seekers, and form close community bonds. Families in the tower blocks may span generations. Those employed include essential workers in transport, social and health services, community organisations, and small businesses. These jobs entail high exposure to the public with consequent risk of infection.  

The lockdown reinforced the inequities of COVID-19 spread: older people, minority ethnic and Indigenous communities, and those engaged in essential services are all at greater risk. Quite apart from the public health response, other issues were simultaneously being tested: multiculturalism, leaving no one behind, and human rights. 

Fear, anxiety, and, in some cases, anger characterised residents’ responses. Worries about the risk of infection, mental health, nutrition, childcare, and access to medicine, services, and supplies were widespread. People resented the term “detention”, especially given some residents’ prior experiences in refugee camps and asylum seeker detention centres. Early mixed messages of the likely duration of the lockdown were also confusing: detention orders indicated it could be up to 14 days, but public announcements referred to five. 

The public-housing lockdown magnified the gritty relationships between bureaucrats and community representatives. While policymakers were anxious to control risks of spread, residents perceived insensitivity to their diversity. They reported feeling violated, being treated like criminals, and left without explanations in their own languages. The Victorian Premier, Daniel Andrews, asserted that there was “very significant community engagement”, but community members reported feeling stigmatised, discriminated against, and patronised. 

VicHealth produces COVID-19 education materials translated into 55 languages, but details of the rationale for and mechanisms of the lockdown were not accessible to non-English speakers. The limited involvement of trusted community-based service providers fuelled resentment and mistrust.   

While Australians appreciate the severity of the surge in cases, the urgency of prompt public-health action, and the dilemmas facing the Victorian government, questions are being asked. 

Could more warning of the impending harsh lockdowns have been provided? Why were the Australian Federal Police, and not health and social service professionals, the first on site? What mechanisms for consultation with civil society organisations are in place, and to what extent do these organisations have agency and resources to respond to the circumstances, concerns, and sensitivities of affected communities?  

Premier Andrews committed financial support and promised the tower residents that the lockdown would be eased as soon as possible – once everyone had been tested and a plan agreed. By 9 July, the hard lockdown measures continued for one tower, while the others reverted to the general stay-at-home measures applied across Melbourne. Particularly high rates of infection were evident in one tower. Residents and public health experts have sought confirmation that those with coronavirus can be placed with their families in appropriate hotel quarantine facilities, and that anyone whose health deteriorates will be given access to appropriate health care.  

Months ago, community leaders and a range of social service organisations raised the need for appropriate messaging and engagement with ethnic communities in a letter to Federal Health Minister, Greg Hunt. This noted that “messages about behaviour change and social isolation are not getting through to CALD [culturally and linguistically diverse] communities, leaving them vulnerable as community transmission of the virus begins to climb”. The wide range of respected co-signatories urged government to work closely with civil society and to engage them actively. 

Rights-based approaches should underpin all initiatives. Australian authorities need to build trust and be trustworthy in working with migrant and marginalised communities. State authorities should adhere to principled guidelines relating to migrants and refugees during this pandemic: these highlight equal treatment and non-discrimination, the right to health, and obligations to combat stigma, racism, and xenophobia. They specifically note the right to information, the importance of acknowledging and responding to gendered inequalities, and of attention to, and engagement with, marginalised groups.  

Policymakers need to learn quickly, with the benefit of relevant community input. They need to draw in, and draw on, the wide range of ethnic community associations, organisations, and community leaders, young and old, to help frame, educate, and structure community responses. They must empower and resource them to actively engage and assist with communication, shaping responses and rebuilding trust. These are the partners for government who can best identify those who are particularly vulnerable within already vulnerable communities, and direct support to where it is most needed. Designated coordination structures and responsibilities need to be established with recognised and trusted organisations to assist with food and nutrition, health and protection. These mechanisms can assist in ensuring that everyone is able to access services, information, advice, and testing – and feel safe in the process.

In the coming days, Victoria’s rates of COVID-19 are expected to increase substantially, as are the numbers of people hospitalised and needing intensive care.  The situation will get a lot worse before it gets better. 

Anthony Zwi is Professor of Global Health and Development in the School of Social Sciences, University of New South Wales.

 

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