'We can save lives': Tasmania’s isolated north-west succumbs to Australia’s strictest coronavirus rules
On Sunday afternoon, more than 1,000 healthcare workers in north-west Tasmania received a text message warning they would be told to self-isolate, and to watch a press conference given by premier Peter Gutwein for more information.
The press conference began at 4pm. Gutwein announced the immediate closure of two hospitals in Burnie – the North West Regional hospital and North West Private – due to an outbreak of coronavirus among hospital staff. Anyone who had worked at either hospital from 27 March onwards was told to go into mandatory self-isolation from 7pm that night. The order included their families or anyone sharing a house.
With just three hours of warning, between 4,000 and 5,000 people were locked down.
Many did not have supplies or are living with vulnerable family members. The Tasmanian government has said healthcare workers will be provided with alternative accommodation if they can’t self-isolate at home, and with groceries if they need them but to access that support they need to call the Tasmanian public health hotline.
“We are hearing from members that they can be on the phone for up to three hours to get that support,” said Emily Shepherd, branch secretary of Australian Nursing and Midwifery Federation Tasmania. “To be informed via text message was pretty hard to take.”
As of midnight on Sunday, the seven councils which make up the north-west region of Tasmania were under stricter coronavirus restrictions than any other part of the country. As well as forcing up to 5,000 people to self-isolate, the Tasmanian government put a ban on all non-essential businesses. Extra police patrols, already in place to ensure Tasmanians heeded warnings about not heading to the coast or visiting their shacks on the Easter long weekend, are now ensuring residents are abiding by the new restrictions.
“Never before has a premier had to ask a community to do this,” Gutwein told reporters on Monday. “I’ve got to admit, the responsibility rests heavy on me in having to make these decisions. But I would ask that you work with us. This is the best way that we can get on top of this – that we can stop the spread of this insidious disease, and importantly, that we can save lives.”
The source of the infection
The most likely source of the outbreak is the Ruby Princess cruise ship, which has been linked to more than 660 Covid-19 cases and at least 13 deaths since it returned to Sydney on 19 March.
On 30 March, a woman in her 80s who had been a passenger on the cruise ship passed away in the North West Regional hospital. She was the first person in the state to die after testing positive to Covid-19. A man in his 80s, who had also been on the ship, died in the same hospital the next day.
Three days later, on 3 April, two staff at North West Regional hospital tested positive and the Department of Health and Human Services set up an incident management team to control the spread.
On 7 April a third person, a man in his 80s who was also a passenger on the Ruby Princess, died at North West Regional hospital. Over the next five days two more people died at the same hospital, and the virus had spread to more than 30 healthcare workers at the hospital as well as at North West Private hospital, and other allied health workers in the coastal city. Sixty staff were stood down and told to self-isolate.
As of Monday Tasmanian had 144 cases of coronavirus, all of which, excluding those that came from international travel, could be traced back to the state’s north-west.
Tasmania’s director of public health, Dr Mark Veitch, said the Ruby Princess was “one of our strongest leads for looking at the source of the infection”.
What is unknown is how the virus spread from infected patients to healthcare workers.
“That’s the $64,000 question,” the Health and Community Services Union Tasmanian secretary, Tim Jacobson, said.
Healthcare workers have told Guardian Australia they have had some difficulty accessing appropriate protective equipment, with shortages of N95 masks in the emergency wards. Staff also requested showers be installed so they could wash before going home to their families, but the portable showers did not have heaters – and Tasmania is cold in April.
Staff were also initially working across wards, going from wards that housed people with Covid-19 to wards with no known cases.
Veitch said epidemiologists were working to trace the spread from the 60 known cases.
“There’s a lesser possibility of it spreading from the inanimate environment to people, but we’ll be looking particularly at how it could have passed from person to person through the hospital community,” he said.
Reports began circulating that the virus may have spread at a party allegedly held by hospital workers, which Shepherd said was an “unsubstantiated” and hurtful rumour.
“They feel a sense of failure, like they have been shut down,” Shepherd said. “To have those unsubstantiated rumours on top of that is very upsetting.”
Twenty-three people who were in hospitals in Burnie were transferred to the Mersey Community hospital in Devonport, 46km down the coast, on Monday.
Tasmania’s health minister, Sarah Courtney, said Mersey hospital “has the PPE it needs” but had also been advised to ensure “geographical separation of patients who are Covid positive as well as patients who are not Covid positive”.
The defence force was called in to thoroughly clean and disinfect both North West hospitals, with the aim of getting the emergency department running again. In the meantime, Courtney said, they had increased ambulance resources and aeromedical support.
“I’d like to reassure all Tasmanians that if you’re on the north-west coast and you’re experiencing a medical emergency, please do not hesitate to call 000,” Courtney said. “We have plans in place to make sure that you get the highest-quality care.”
Aged care providers stopped accepting residents returning from either North West Regional or North West Private hospitals last week. At least one aged care home has told staff they would only provide masks to residents who have symptoms and are in isolation, and recommended staff forgo PPE in other circumstances.
Jacobson said those reports were “alarming” and there was no reason for aged care homes, which have been given priority access to the national medical stockpile, not to have access to adequate PPE.
Challenging community ambivalence
Before this weekend, it was sometimes difficult to convince locals to take the threat of coronavirus seriously, said Burnie mayor Steve Kons.
“The attitude certainly changed in the last week or so,” Kons said. “Being an isolated place you don’t have the expectation that you will be impacted as much as other areas. But what’s happened to the hospital up here and the isolation orders has certainly driven the message home.”
More than 20 people were charged with breaching public health orders over the weekend, including two men who took a 500km round trip from Railton to Strahan –two north-west towns – to purchase a car for sale on the side of the road.
“With the additional stronger restrictions on retail activity now in place in the north-west – there are fewer reasons to leave your home,” said acting deputy police commissioner Jonathan Higgins.
North-west Tasmania is known for its independent streak, an attitude that saw communities of shacks built without permission on public land and saw some locals drive around fences cutting off 4WD tracks.
It’s also one of the most vulnerable areas in the population, with an older population, high rates of chronic illness and lower levels of education. Up to two-thirds of the population receive at least one form of welfare payment, said Kons. Many do not have access to a computer or the internet.
It’s a community convinced of its isolation from the rest of the world – because the rest of the world does not often come knocking.
Jacobson said there seems to have been an attitude, across a number of regional areas in Australia, that “this is a city virus”.
“Most of the media around it has been on very big outbreaks in New York and London, and there seems to perhaps have been a trend of country people not following the guidelines around social distancing,” he said. “We don’t know if that’s the case in the north-west of Tasmania.”