In recent weeks, Victoria has seen a surge in COVID-19 cases while other states have no or a small number of cases. Even though the Victorian government has acted quickly to re-enact restrictions around Victoria and lockdowns in certain postcodes and public housing towers, the government has been heavily criticised for how it has handled the outbreak. The outbreak can be traced to breaches in hotel quarantine where security guards were infected and carried the virus to their families. Even though these breaches are currently being investigated under a judicial inquiry, multiple factors have contributed in expanding the outbreak to a large number of people. In this blog post, I will talk about how the Victorian government has failed to update Victorians on the changing COVID-19 situation and restrictions before investigating some of the factors behind this problem. I will end the blog post by drawing some lessons that all states should follow to continually inform people on the changing COVID-19 situation.
What went wrong in Victoria?
There have been numerous cases where the Victorian government has not promptly informed and updated people on the changing COVID-19 situation and restrictions. Melbourne public housing tower residents reported that they were not informed of the strict lockdowns in their residence and only realised their situation when they saw police surround their building. In addition, on 1st June, Victoria increased the maximum gathering size to 20 people in households and public places. However, cases started to rise as the virus was being transmitted in big family gatherings that exceeded the maximum number from people who were supposed to self-isolate. This resulted in the Victorian government reintroducing stricter restrictions on gatherings on 22nd June.
These examples, combined with the confused messaging from federal and state governments, highlight the consequences of not properly informing people of the continuing risk of COVID-19 and the need to stay safe. These consequences are even worse for people who cannot understand the information in English or who cannot access the internet to be informed. These factors are present in migrant communities who are more likely to miss out on important health information due to their poor English literacy or their inability to access the internet. Hence, I measured English literacy and internet accessibility in Melbourne suburbs and see whether these factors are affected in COVID-19 hotspots (defined as having at least five non-overseas-acquired cases since 1st June 2020 and posing a high risk of recent community transmission and undetected coronavirus cases). English literacy and internet accessibility data for each Melbourne suburb were collected from the 2016 Census of Population and Housing conducted by the Australian Bureau of Statistics.
Associating poor English literacy with COVID-19 hotspots
Melbourne has a lot of migrant communities with some people unable to listen to or read English. As a result, they may not understand in a timely manner the dangers of COVID-19 and how they can stay safe, increasing their susceptibility to being infected. Hence, I investigated whether COVID-19 hotspots in Victoria were associated with poor English literacy. Poor English literacy was defined as a person who cannot or poorly speaks English. Spoken English was used as it was the only English literacy measure available in the 2016 Census, but it does relate to a person’s ability to understand spoken or written English and their ability to communicate their understanding to other people.
We can see in the graph above that COVID-19 hotspots (marked in red) tend to have a high proportion of people with poor English literacy. In fact, nine out of the twelve hotspots (75%) are in the top 25% of suburbs with the highest poor English literacy in Melbourne.
When plotted over a map, most of the COVID-19 hotspots are clustered around areas of high poor English literacy, particularly in the north and west of Melbourne. These are areas where people with poor English literacy may not readily understand from English resources and news the risks of COVID-19 and the measures and restrictions in place to keep them safe. Their poor spoken English skills may also impair their ability to communicate with health workers on what they should do to stay safe.
It is essential; therefore, that these people are engaged in their native language so that they can understand the risks of COVID-19 and how to stay safe. This can come not only from their relatives who can understand English but also from community health workers and community leaders who can speak in their native language. This was something suggested by public housing residents who say that a lack of community health workers in their residences made it difficult to inform people with poor English literacy about the strict lockdown measures in their residences.
Associating internet access with COVID-19 hotspots
Translated resources are available online on the DHHS website. However, people with poor English literacy may find it difficult to navigate themselves on the internet to access these translated resources or to understand in English what is happening. In addition, people with no internet may not be informed on time on the changing situation and restrictions, making it difficult to adapt and to follow restrictions. Hence, I also investigated household internet access across Melbourne to see if it is also correlated to COVID-19 hotspots. Internet access is defined as anyone in the household who can access the internet via fibre/cable (ethernet or wi-fi) or mobile broadband (3G or 4G).
Looking at the above graph, all COVID-19 hotspots are in the top half of suburbs where a high proportion of households do not have internet access. In particular, eight out of the twelve hotspots (66%) are in the top quarter of suburbs where a high proportion of households do not have internet. People in these households are less likely to be updated on the COVID-19 pandemic, guidelines and restrictions on time. Hence, they may not readily take measures to protect themselves against COVID-19.
When plotted on a map, the COVID-19 hotspots are clustered in areas where there is a high proportion of households with no internet connection, particularly around north and west Melbourne. These may present blind spots where people may not understand the dangers of COVID-19 and how they need to report themselves if they are infected.
In these areas, it is important that these people are engaged by alternative means such as television, in-person (by knocking on their doors and reminding them of the guidelines) and communities. The Victorian government has taken steps to recruit health workers in providing COVID-19 information and public health advice to all residents in hotspot areas, including those whose English literacy is poor. However, this initiative should be expanded to suburbs near hotspots where a high proportion of households cannot access the internet. This will ensure that these people are informed on the situation and public health measures from official sources of information.
Conclusion
The COVID-19 outbreak in Victoria started with the botched hotel quarantine system, where security guards who were not trained on infection control contracted the virus and spread it to their families. But other factors played a role in propagating the outbreak in Victoria, including the failure to communicate the risks and restrictions in a timely manner to other people. This failure is aggravated in migrant communities who have poor English literacy and people with no internet who cannot update themselves on the changing situation. As a result, they are less likely to be informed on how to stay safe which increases their susceptibility to being infected or transmitting the virus.
It is therefore very important that these people are informed on the changing COVID-19 situation and restrictions by alternative means, particularly on engaging community leaders which was markedly absent in outbreak planning by federal and state governments. This is a lesson that should urgently be learnt and implemented not only by the Victorian government but also governments in other states that are easing restrictions. This ensures that everyone, including those from migrant communities, is well-informed in a timely manner the continuing risk and changing situation of COVID-19 so that they can take steps to stay safe and prevent a resurgence of the infection.