Power-sharing to effect equity-focused, safe and sustainable region-wide COVID19 containment in 2021.

Abstract

Public health units were established in Victoria in late 2020. The Grampians Public Health Unit (GPHU) serves more than 260,000 people living in 13 local government areas (LGAs) across 49,500sqKms extending west from Ballarat (Wadawurrung country) to the South Australian Border. Our principle aim for the year was to limit COVID19 spread in our region until we achieved high levels of vaccination in eligible people. The GPHU enacted work which resulted in, by December 2021, between 2.5 and 10 times fewer total COVID19 cases/ 100,000 than elsewhere in Victoria, with less disruption, distress and morbidity accordingly. Across the Grampians region all local health protection assets were mobilised in coalition with the local leaders inside and outside health, inside and outside government who were daily responsible for their community’s health and well-being. Additionally, through a genuinely peer process of working with community leaders, primary care teams and multi-sector professionals, by November 2021 more than 95% of the eligible population were double vaccinated (in some towns 100%), and we were confident that the vast majority of our most vulnerable community members, including those who were homeless, isolated, frail, unable to leave their home or from culturally diverse communities had been provided with access to vaccination. Strategies to build local coalitions for COVID19 response were founded on power-sharing, equity, safety and sustainability: supporting and building capacity in local leaders (rather than directing), reaching out to and vaccinating early those most at risk regardless of who paid for their care, adhering strictly to safety requirements and public health obligations at all times, and integrating local public health actions into the usual business of local government and agencies as a sustainable platform for whole of region population health improvement into the future.