Aboriginal and Torres Strait Islander people (Aboriginal people) are at higher risk of adverse outcomes from COVID-19 due to high prevalence of underlying conditions (e.g., rheumatic heart disease, diabetes, bronchiectasis), crowded housing conditions, and poor access to healthcare. These factors increase both the likelihood of rapid spread and the likelihood of serious illness and mortality. It is therefore imperative that well-considered measures are put in place to minimise the impact of outbreaks should they occur in remote communities and to prevent spread to other communities. Mathematical modelling is a powerful tool for designing and evaluating such measures in a timely and cost-effective manner.
We are using a mathematical model of COVID-19 transmission in remote Aboriginal communities to inform the Emergency Response Plan being coordinated by the Aboriginal and Torres Strait Islander Advisory Group on COVID-19 (COVID-19 Advisory Group). The aim of this work is to design and evaluate strategies for responding to COVID-19 outbreaks in remote communities in order to minimise their impact and to prevent spread to other communities. This work was requested by the Communicable Diseases Network Australia on behalf of the COVID-19 Advisory Group and will be presented to the Australian Health Protection Principal Committee (AHPPC) and the National Indigenous Australians Agency.
We are repurposing an existing model of sexually transmissible infection transmission in remote Aboriginal communities to account for COVID-19 transmission. The model is individual-based and accommodates an interconnected age-structured metapopulation of remote communities (varying in size from 100 to 3,5000 residents) and a large regional centre (10,000) residents. The model will be used to evaluate a range of strategies for controlling the impact and spread of COVID-19 including case isolation, contact quarantine and contact testing at individual, household and whole community levels.
This work will be used to directly evaluate the likely success of different strategies in limiting the size of outbreaks in communities and the degree of spread to other communities. It will further inform other models that have been developed to estimate the impact on health services and to prioritise resources.
This work will assist in minimising the impact of COVID-19 in a highly vulnerable population. This population already has a disproportionate burden of chronic diseases, which will be exacerbated by any long-term consequences of infection with COVID-19. This project can therefore be considered an important component of the Close the Gap Indigenous Health Campaign.