Northern Territory Covid: ‘Nightmare choices’ facing the Top End

One part of Australia was ridiculed for bringing in some of the toughest Covid rules in the world, but they’re on the edge of a disaster if the virus gets in.This week, the Northern Territory attracted global attention as it unveiled some of the most stringent Covid-19 vaccine rules on the planet.Conservative commentators around the world posted videos of the territory’s leader speaking about the mandates — saying it was proof that Australia had lost the plot.The rules mean that tens of thousands of Northern Territory workers could be fined or blocked from their workplaces unless they get vaccinated.They make it mandatory for many workers who interact with the public to have their first jab by November 12. Second doses will need to be completed by December 24.If they’re not, workers won’t be permitted to go to their workplace and could be fined $5000 for failing to comply with a mandated health directive.It is the latest in a series of brutal decisions the Top End has made since the pandemic began, but — to the credit of its 246,500 residents and their government — they have managed to keep the virus at bay.The territory has only seen 222 people infected with the virus within its heavily-protected borders and not a single person has died.It’s a remarkable achievement but, as more heavily-populated parts of the nation begin to rely on vaccines as a primary form of defence against the virus, Territorians know it can’t last forever.The territory’s tough border stance may begin to soften slightly soon — with the Chief Minister this week saying it was likely that he would begin to wind back restrictions from the end of November.But the harsh new rules on vaccines show it is not messing around when it comes to jabs. What conservative commentators who shamed the territory on social media this week perhaps don’t understand is the reason why it is taking such a hard line stance on Covid.Its Chief Minister Michael Gunner outlined in a press conference a few weeks ago just how desperate the healthcare situation is in the Top End.He said the disparity between what Sydney and Melbourne can cope with and the Northern Territory were huge.“While other states are planning to let Covid spread in their communities, full-scale community transmission is not something we can contemplate up here even with high vaccination rates,” he said.“We don’t have the hospitals that Sydney and Melbourne have. We don’t have the same ICU capacity, and we have a lot of other health challenges to manage up here on top of Covid.“So we need to do everything possible to prevent a situation like NSW happening here. We don’t have hundreds of ICU beds. We have 20 ICU beds in the territory.”Of those, he said authorities could “probably” assign eight for Covid patients — up to five in Darwin and up to three in Alice Springs — but that is it.He said the desperately low number of beds meant authorities would be left to make “nightmare choices” once Covid seeps into the territory.“We’ve done the planning, mapping out the worst case scenarios, the choices we would have to make about who gets a bed and who doesn’t,” he said.“Who gets a ventilator and who doesn’t. Who gets the best chance to live and who doesn’t.“We have thought about those gut-wrenching and nightmare choices. We don’t want to make them.”Hospitals are already at capacity without any Covid cases — leaving medical workers in the territory worried about what will happen when the virus begins to spread.Australian Nursing and Midwifery Union NT secretary Cath Hatcher told that Alice Springs hospital was at 90 per cent capacity now, while Royal Darwin Hospital is “always between 100 and 120 per cent”.At the beginning of this month, there was declaration of a Code Yellow at the Royal Darwin Hospital for the fourth time in 12 months.A Code Yellow means some non-essential surgeries are cancelled to help redirect capacity to other parts of the health system, including the emergency department.Overcrowding and capacity problems at RDH have been an ongoing issue, with the Australian Medical Association NT (AMA NT) labelling it a “persistent crisis” in 2018.On top of all that Ms Hatcher said there had been a persistent staff shortage across the territory. “There’s actually a shortage of nurses right across the county, because we’ve had to stand up quarantine facilities, vaccination hubs, swabbing centres and help with contact tracing,” she said.“However, the territory has always struggled to recruit and retain nurses and midwives compared to some of the other states where they might have an oversupply.“We usually have full capacity throughout the dry season but at the end of that, it’s hotter and it’s humid and people tend to not like it. They either love it or they loathe it and they leave. “We’ve always struggled through the wet season with staff and the permanent people tend to pick up the extra shifts to make sure everywhere is fully staffed.”She said clinics in rural and remote areas are struggling the hardest to retain staff — further increasing the risk to Indigenous populations if Covid breaks out.She said Aboriginal communities were already at higher risk than average because of a higher rate of comorbidities in the population.The territory’s government has also expressed concern this week at the “worryingly low” rates of vaccination in Aboriginal communities — which means they are facing a triple whammy.All in all, the territory is playing a right-risk game in the pandemic and Chief Minister Gunner doesn’t seem to be prepared to take a gamble.“We know Covid is coming eventually. We know we can’t keep it out forever. But that does not mean we just let Covid rip and hope for the best,” he said.“There is no best in that scenario. We will not do that.”In a statement to a NT Health spokesman said the territory had a pandemic plan that will continue to be reviewed and updated according to the current status of the health response and in the event of an outbreak. “NT Health has 24 ICU beds and all our hospitals have Covid-19 management plans which include surging up to increase bed capacity as required,” they said. “Resources and staffing would be reconfigured in alignment with the plans and the specific situation at hand.“Regular assessments are undertaken regarding appropriate inpatient accommodation depending on the levels of care required. Covid-19 is an evolving situation and NT Health’s focus continues to be on vaccination to protect the community of the NT.“An enhanced nursing recruitment strategy is in place, complemented by a reinvigorated overarching recruitment campaign to attract staff to the NT.”

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