Life on the ward: how do you care for Covid patients in prison?
From prisoners to the homeless and people living with disabilities – these are some of the at-risk communities hidden from public view during the pandemic. Now the health workers working with them share their stories.
Dr Michael Novy, emergency department specialist at Parklea correctional centre
Covid was a little bit outside our realm because we were in a relatively protected environment. That whole barrier of being isolated was somewhat beneficial as long as the virus stayed out of there. There was always going to be an outbreak [though]; you can only build a net, it’s never a wall, and eventually something will get through there. Now they were in a closed community where people live together, many who aren’t vaccinated, so it didn’t take long for the virus to spread.
Prison’s a little bit like a game of Jenga – not every bit of wood can go next to every bit of wood – so to move guys around takes a lot of logistics. It was really interesting trying to deliver care through a metal door which was locked. A flap would open up, a finger would come out and you’d do a set of observations, you’d do a temperature [check] and make sure they were OK at least once or two times a day.
We managed to look after about 160 inmates who happened to be positive. No one got very sick. They all got better. So the system worked. Covid is a terrible thing. We’ve lost a lot of people, but we’ve learned as an organisation … we can come together.
Amelia Starky, acting disability network manager
I have a very strong memory of how I felt last year when Covid first came to our shores and we were in the preparedness phase … seeing what was happening overseas and seeing what was coming and feeling really overwhelmed about that. Thank goodness that never arrived at the time, so when Delta came this year I had that internal preparedness.
I started this role at about the time Delta was peaking … so my priority was to get people out of hospital who needed NDIS supports as quickly as possible, because we knew being in hospital was not going to be a safe place for them while we were trying to surge for the Covid response. The case numbers were going up and up and up, and [we were] seeing more … come into the hospital … and I remember the very first time I had a patient that passed away. Seeing it in real life, they were in that room, by themselves, family couldn’t come, nurses weren’t going in hours at a time, and everyone doing their best to give them comfort, but the reality is they’re dying on their own. That was really hard.
It was really overwhelming to see how vulnerable the disability network was in regards to Covid, and Delta in particular, with the slow uptake of vaccinations of people living with disability and the caring workforce.
Matthew Larkin, services manager and homeless healthcare
With the Delta wave of the pandemic, the [NSW] Department of Communities and Justice decided that they were going to set hotels up across the city. We were providing a lot of healthcare to [homeless] people going into there … [and] referring [people] into there as well. As that wave progressed, I made it clear to all of my staff that the biggest thing we could be doing at the moment was vaccinating people, because that was the only way we were going to get out of it.
Historically, services were working in silos for a very long time and in the last few years we’ve been able to come together and form solid partnerships … We knew it wasn’t going to be like your flu shot rollout, it was a multi-dose vial, there was a lot we needed to take into account but we decided we couldn’t do this alone. We reached out to our more formalised partners … and started off relatively early. The first [vaccine day] was 20 May and it was really busy – we were seeing at its peak about 400 people in a day.
We’ve been able to continue on with the hub and we’re really pleased with what we’ve been able to achieve – we’re up [to] 6,000 doses. For me the engagement with my staff … was something to behold. They had side jokes and banter – that kind of engagement and trust is built up over years and years and it eased [participants] into the fact it’s OK to be vaccinated.