Pearls and Irritations

A dark hole sits at the heart of multicultural Australia – the data by-pass on how the COVID19 virus pandemic is affecting our culturally diverse communities. 

While quite properly extraordinarily careful measures have been taken to identify and protect vulnerable Indigenous people, governments in all jurisdictions have been rather more cavalier about our multicultural reality and the disease. This works both for the impact of the disease on communities, and the contribution that communities make to containing or transmitting the disease.

Now with the second wave rising in inner northern Melbourne, these issues have suddenly come to the fore with a vengeance. The Victorian government doubled down on multicultural communication, admitting it had only started this late in the day in response to the resurgence.

Despite the national government’s reiterated claim that Australia is the world’s most successful multicultural society (never true and especially not so now), one of the fundamental requirements of a multicultural society, that social facts as they effect social groups should be enumerated and recorded, has been consciously and systematically avoided. In the USA and the UK ethnicity or race are clear indicators of vulnerability. In Australia, who knows? The only public commentaries are anecdotal reflections, and a shared belief apparent among the managers of the pandemic in government until the Melbourne resurgence that for the most part the disease is confined to Anglos either local or travelling in.

The first study of the question (based on an online survey through Sydney University) appeared on June 5, where the key findings demonstrated that lower levels of health literacy are associated with poorer practices in health protection. A key indicator of low health literacy even among English readers, was a language other than English spoken at home. Other factors (age etc.) exacerbated this effect.

While multicultural health issues can be quite well researched, and state health agencies usually record data that allows an understanding of the potential cultural and social influences on health and illness, a perfect storm of absence has been generated around the corona virus – and not because as the US President opined, it should be called the China Virus or more recently the “Kung Flu”. In the process of preparing this article I used every element of my research network to discover what it would be possible to say with any degree of certitude, while also identifying where and why the data for policy was failing so substantially.

Collecting data

The story apparently begins with the National Notifiable Diseases data base, created in its current form about fifteen years ago, with its associated Surveillance System. The data is collected under state public health legislation reflecting the WHO definition of surveillance as “continuing scrutiny of all aspects of the occurrence and spread of disease that are pertinent to effective control”. One would expect that given the social dimensions of this definition, demographic data beyond age, Indigenous status, gender and location would be pertinent. Perhaps but in fact, no such data are collected on ethnicity, language spoken, or country of birth. Asking the national government what is being revealed by the ethnic characteristics of groups infected by the disease, tested for the disease or under-represented in testing, reveals nothing. In a detailed response from the National Incident Response coordinator Radha Khiani on behalf of Minister Hunt, I was informed that data on ethnicity was not collected on the NNDSS because it was not routinely collected by pathology labs, though the states and the Commonwealth worked together “to coordinate an evidence based response”.

Perhaps then the jurisdiction testing schedules might help – yet no ethnicity data is collected on individuals tested (they use the NNDSS criteria), even though with many hundreds of thousands of tests done this data would be of enormous potential value. What of incidences of infection – over 7000 so far? The schedules that are used in the various jurisdictions to determine the pathway of infection and permit tracing to be pursued, a primary method of controlling disease spread, does include country of birth and language spoken at home. However it appears that these questions only get asked IF an interpreter is required, and it is impossible to discover how many of the 7000+ cases even used an interpreter – this data is held in individual jurisdictions and is not collected centrally nor released lcoally. So the assumption appears to be that the spread of the disease is geographic rather than through social networks; in the earlier lockdown phase this may have been be an acceptable proposition, but after that? Given that the correlation of neighbourhood with ethnicity varies considerably, knowing where outbreaks occur does not help adjust strategies for tracing contacts per se through ethnic networks across cities and regions.

Harassment of minorities – is it better not to know?

It has been put to me by many people in the system that it’s good we don’t know the answer to my query, because were such information to leak out it would intensify racism and put hotspot groups at risk of attack, abuse and stigmatisation. It is clear that abusive harassment of cultural minorities, especially but not only Chinese and other Asians, Jews and Muslims, has been intensifying both online and off during the pandemic. When the level of abuse had risen to the point that Australian Chinese leaders were petitioning the government for action, PM Morrison and Minister Tudge came forward, decried the abuse, and while reiterating the claim about the success of Australia’s multiculturalism, proclaimed that racism has no place in Australian society. The victims of abuse were advised to complain to the Human Rights Commission. When the information about Muslim Australians leaked out in Melbourne, the usual suspects (News Limited outlets and especially Andrew Bolt) were quick to scream “tribalism” about Muslim pandemic hot spots. This had earlier been ignited by the Victorian government mentioning “large families”, quickly read as code for Muslims, Arabs and other ethnic groups.

It is possible then that adequate data might reveal something else – that ethnic communities are missing out on access to adequate testing and disease identification, indicating structural and systemic discrimination exists at the most fundamental level, a finding evident in US studies.

Furthermore, Morrison made reference to the fact that Australian Chinese communities had gone into lockdown and isolation far earlier and with greater discipline than many other groups, thus exemplifying social responsibility in the face of the pandemic. As we now know, the Chinese government has publicly identified Australian racism as a major issue for Chinese citizens thinking of visiting Australia in the future, suggesting they might be safer elsewhere. Despite government statements, a coalition of ethnic and Indigenous organisations has called for the reactivation of the Australian Anti-racism Strategy operating before 2015 but cancelled by the Abbott government.

The failure to collect data on cultural background and language leaves potentially vulnerable groups without adequate information, and epidemiologists and public health officials without a realistic sense of the landscape in which they need to move. If sanitary social distancing and testing are the key weapons against the disease at least in the short term, then rigorous documentation of how the pandemic is affecting different groups must underpin strategies that seek to protect the vulnerable and ensure potential “spreaders” can take appropriate and rational precautions.

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