As COVID arrived in remote areas of the Western NSW Local Health District (LHD), health workers on the ground mobilised testing and outreach services in a matter of hours.
While the LHD set up makeshift testing facilities that would service the droves that followed, Walgett Aboriginal Medical Service (AMS) acting chief executive Katrina Ward sent out staff to collect swabs from close contacts to be processed back at the clinic.
“It just gave that speed of results because otherwise you were waiting a good 12 hours before it got back to Dubbo [pathology],” she said.
“At one stage my staff worked until midnight trying to get through the close contact tests just to alleviate a lot of the fear and anxiety off the community.”
Remote health clinics like the Walgett AMS were given access to a rapid PCR testing device called GeneXpert.
Each machine can test four swabs at a time and produce results in about 45 minutes — much faster than the tests taken at hospitals and pop-up clinics, which are sent to pathology labs.
The technology is part of the Aboriginal and Torres Strait Islander COVID-19 Point-of-Care Testing Program, an federally funded initiative managed by the Kirby Institute in partnership with Flinders University.
No waiting worries
Kirby Institute epidemiologist Louise Causer was tasked with rapidly onboarding clinics across the country.
“We’ve got seven clinics in NSW and more than 80 across the program nationally,” she said.
“It’s for people who might find it difficult to isolate, people who are in crowded housing and, for example, staff at the clinic where if they had to wait two or three days might shut the whole operation down.”
A small air-conditioned room at the back of the Bourke Aboriginal Corporation Health Service was retrofitted into a rapid testing pathology clinic in late August.
Health Services manager Claire Williams said two positive cases of COVID-19 were detected in its first week of operation.
“We’ve found it useful in encouraging people to come forward to get tested, because they know it will be a fast turnaround,” she said.
“People are worried how long they might have to wait if they get tested, worried they’ll be stuck at home or that they’re not going to have access to food or income.”
Lost tests an admin ‘error’
Western NSW LHD chief executive Scott McLachlan said a “small number” of tests taken on August 17, 18 and 19 at Dubbo Showground were lost due to an administrative error.
“We took some extra tests off of Laverty to try and get those processed quicker than normal,” he said.
“Some of them did get lost in a process that we’ve now picked up and we’ve got back to all of those people with their results.”
Mr McLachlan said it was an “exceptional step” during an onslaught of tests at Laverty and did not want the incident to stop people getting tested.
Ms Ward, who travels the 130 kilometres between Walgett and Brewarrina to oversee both clinics, said the best testing and vaccination turnout has come when teams on the ground have been empowered to lead the response.
“It causes more complication and confusion when you’ve got two different organisations working against each other,” she said.
“Even though we’re in a crisis situation, we still have to build those relationships with community to get things rolling in the correct way.”
AMS clinic also act as vaccine hubs and have been expanded to include door-to-door jabs in some of the most vulnerable satellite towns and villages at the coal face of the outbreak.
“We’ve found doing outreach to people’s homes and making sure that they’ve got the correct information is really important,” Ms Williams said.
“But we’re also doing outreach to offer testing to anyone, with or without symptoms, while we’re there to try and get good coverage in the community.”
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