NRSG371 Building Healthy Communities

Introduction:

The COVID-19 pandemic has led to a worldwide loss of life and unprecedented challenges to the life of the public. It has caused challenges in the food systems and the general working of the world. The pandemic has affected the social and economic status by putting more than millions of people at risk of falling into the depths of extreme poverty and undernourishment. The current estimated cases are nearly 700 million people and it could increase up to 132 million by the end of the year. This pandemic has been caused by an infection from a virus called the coronavirus and once a person is infected there are certain symptoms that are associated with the infection such as fever, cough, tiredness, loss of taste and smell, sore throat, rash or discolouration on skin. This infection has caused a large amount of fatality and deaths irrespective of age, sex and presence of comorbidities. The rate of death due to infectious diseases in Australia is the fourth most common cause. This is a paper that aims to discuss the importance of COVID-19 as an infectious disease in Australia and the impact that it has had on the Australian community of the disabled.

Prevalence of infectious diseases in Australia:

Any infectious disease is spread through transmission, these are also known as communicable diseases as the person in contact with the infected has a high risk of getting infected as well. There is a high burden of infectious diseases in Australia. According to reports, it has been stated that all individuals get diagnosed with a minimum of one infectious disease throughout their lifetime. There are many different infectious diseases that affect the population, the most common being influenza followed by hepatitis A, hepatitis B, and hepatitis C, HIV/AIDS, gastrointestinal conditions and tuberculosis.

It has been noted that there is a high prevalence of HIV/AIDS in the population and it has doubled especially among the aboriginal and Torres strait islander men over last five years (AGHD, 2016). There is a prevalence of gastrointestinal infections that have been analysed and it has been noted that most of the infections are caused due to the outbreak of salmonella enterica and is most commonly seen in children. There is a high prevalence of commonly seen skin, ear, and eye infections that are seen in the aboriginals, the main cause of which is poverty and unstable housing conditions. It does lead to a lot of problems and is most difficult to treat them. The children in this population are the most affected and contamination and overcrowded spaces poses as the main risk factors.

Prevalence of COVID-19 in Australia:

Currently the infectious disease that has affected the population greatly is the pandemic that has spread due to the coronavirus SARS-CoV-2 virus (Marriott et al., 2021). This is a condition that is affecting millions and it is predominant mode of transmission is through direct contact with an infected person especially via the respiratory droplets is indirectly through contaminated fomites. It has been noted that the incubation period for covid is 5-6 days and it mainly ranges from 1-14 days (Australian Government Department of Health, 2019). The period of the infection remains uncertain as it has been noted that the onset of the infection takes almost 48 hours after the symptoms show.  

There have been recent reports that are published in 2021, that have stated that the covid-19 cases are prevalent and have increased in the Aboriginal and Torres Strait Islander people. There is an approximate increase of 0.5% of all the Australian cases. Cumulatively it has been noted that there are 23,696 cases that have been notified in Australia and 428 deaths in 2020. From august of 2020 there has been 3,767 deaths. In Victoria the majority of cases were detected which was 90% of all Australia 3,628 (COVID-19 National Incident Room Surveillance Team, 2020). The recent report of November 2020 has stated that the number of covid cases ins Australia in Victoria was at 305.9 people per 100,000 of the population.

There have been a more or less 50-60 new cases that are reported in Victoria since august of 2020. In November the government had relaxed the rule of lockdown and there was the start of businesses and Australia witnessed a second wave of the coronavirus infections majorly affecting Victoria (Health and Pharma, 2021). According to recent reports it has been noted that among the disabled persons in Australia, generally it is difficult for them to carry of activities of daily life with ease and with the spread of this infection it has become even more difficult for this vulnerable section of society to function.

There is a high risk of morbidity and mortality for the disable in Australia as they are already diagnosed with certain underlying medical conditions and this has become frightening for them as the health sector is under prepare to meet the urgent health care needs of the people with disability.  In general, as the cases keep rising there is an immediate urgent need of health care assistance and with the disabled people the assistance has to be extra careful (AIHW, 2020). There is not enough information on the spread of covid in this particular population, there is a recent report that has stated that 7% of the disabled have been affected by the coronavirus pandemic. People who are suffering with a long-term disability or health problems have reported to be affected by the pandemic as well, there are almost 10% of the people affected. there is a poor level of confidence that they have about this health condition (ABS, 2021). This may affect them drastically.

Impact of the pandemic on the disabled:

The pre-existing problems that the adults and children are suffering from make it very difficult for them to understand and deal with new problems especially infections. There are many reports that state that the disabled people are prone to and susceptible to infections as they may be suffering with underlying medical conditions that may cause them more harm. It has been noted that people with disabilities are at a higher risk of contracting the virus and getting infected as they require extra help and outside support to carry out simple activities such as movement in and around, therefore, it is very difficult for them to physically distance themselves especially those living in congregate settings (Newby et al., 2020).

Staying at home for a significant part of the disabled people is a default and therefore, the people that live with them are an important part of their daily routine. While considering the different disabled communities such as the people with intellectual disabilities, as well as a number of other communities such as the Deaf-Blind community, it has been noted that social distancing is not an option. The deaf-blind community in fact are the people that require the most assistance, they cannot go without touch and people that require assistance may not be able to go on with normal life without these bare necessities (Wilson, 2020).  The covid-19 pandemic has had an adverse effect on the disabled people as a sudden lack of touch and physical interaction has made it extremely difficult for them to understand what is going on. Preventative measures such as social distancing and self-isolation has become more challenging for the disabled people more now than ever before.

The added issues that have been noted is the economic issues for the disabled.  The People with Disability Australia are under the deferral government and they fund the Disability Support Pension that the disabled are eligible for, however, covid response relief for the disabled was not proficient and to make up the loss in health care assist, the government has recognized that 50% of the disabled are from the poorer section of society and they have willing granted to double the costs and cover the problems that they need to be assisted with. The disabled people have been noted to suff4r with higher levels of mental distress and stress. Most have been clinically diagnosed with depression and those already diagnosed have reported elevated levels of depression, high levels of anxiety and fears of contracting this infection. This pandemic has also caused the disabled to be diagnosed with psychological issues and loneliness.

Role of the nurse with the community:

In Australia, especially there has been an increase in the need for public health response to covid as the commonwealth government is responsible to provide the required health care assistance. With the high levels of psychological problems and the impact of covid-19 on the disabled. There is a need for the registered nurse to work with the community using the Strength based approach as that will help them un understanding all the possible issues that may be present and they will be readily equipped to deal with them instead of wasting precious time (Gottlieb & Gottlieb, 2017). 

They should also work with the different stakeholders that are responsible in ensuring that the disabled are looked after in this pandemic properly and are assisted well. The disabled population are a high risk than the others to contract this virus. This is because they have many other comorbidities that make them low in their immunity and they are predisposed to the virus (Desroches & Melissa, 2021). There are reports that have reported the different experience that the disabled have had, they have reported that it is difficult for them to stay without the carers that care for them and they are finding it very difficult to self-isolate (Dickinson & Yates, 2020). Touch and communication are essential for the disabled. There have been reports that state that care and support is most important for the whole community and the nurse plays a key role in the experiences of the disabled.  The nurses are to spread proper education and information regarding this virus for the benefit of the disabled. As all people are paranoid and are uninformed about the measures that should be taken to prevent this spread.

It is the role of the nurse to ensure that the carers of these patients are well-informed about the precautionary measures that are required to be taken. The nurse has spread the message on the importance of hand hygiene and sanitization. It is very important for the people that are caring for the disabled should not contract the virus as they will be bound to isolate themselves leaving the disabled to fend for themselves which is impossible (Goggin & Ellis, 2020). All carers have been given instructions to wear masks of good quality to prevent transmission of the coronavirus through respiratory droplets (Moreno et al., 2020).

The mask that has proven to be most effective is the N95 mask and has been shown that the least amount of transmission can happen through this mask. There is a need for all to use hand sanitizers and washing hands, especially after touching anything that has come from outside the room. Sanitizing all things is important as the virus can be attached to anything and in case it is not sanitized or washed with soap properly the chances of contracting the virus is high. In Australia, the National Disability Insurance Scheme has been funded by the commonwealth and state and territory governments to look after the disabled at this time of the pandemic.  They have taken it upon themselves to provide health care services to them and ensure that all people even if they are not a part of the scheme but are disabled should get the immediate nursing interventions (Kavanagh et al., 2021). The nurses are working with the government and the state along with the non-profit organisations to provide the necessary assistance that is required.

Conclusion:

The covid -19 is a battle that is fought by the entire world and there is a special importance that the disabled should get. The information hat is present is not enough on the problems that hey still might be facing. There is a need for detailed reports and studies to understand their problems and rh nurses should work together in ensuring that they are helping the disabled to fight through this pandemic as they need the health care assistance the most.

References:

ABS. (2021). Household Impacts of COVID-19 Survey, April 2021. Australian Bureau of Statistics. Retrieved 24 May 2021, from https://www.abs.gov.au/statistics/people/people-and-communities/household-impacts-covid-19-survey/latest-release.

Gottlieb, L. N., & Gottlieb, B. (2017). Strengths-Based Nursing: A Process for Implementing a Philosophy Into Practice. Journal of Family Nursing, 23(3), 319–340. https://doi.org/10.1177/1074840717717731

AGHD. (2016). Communicable diseases. .health.gov.au/. Retrieved 22 May 2021, from https://www.health.gov.au/health-topics/communicable-diseases

AIHW. (2020). People with disability in Australia, Prevalence of disability - Australian Institute of Health and Welfare. Australian Institute of Health and Welfare. Retrieved 24 May 2021, from https://www.aihw.gov.au/reports/disability/people-with-disability-in-australia/contents/people-with-disability/prevalence-of-disability.

Australian Government Department of Health. Coronavirus Disease 2019 (COVID-19): CDNA national guidelines for public health units. Canberra: Australian Government Department of Health; 11 January 2021. [Accessed on 24 May 2021.] Available from: https://www1.health.gov.au/internet/main/publishing.nsf/Content/7A8654A8CB144F5FCA2584F8001F91E2/$File/COVID-19-SoNG-v4.1.pdf

COVID-19 National Incident Room Surveillance Team. (2020). COVID-19, Australia: Epidemiology Report 18 (Fortnightly Reporting Period Ending 7 June 2020). Communicable diseases intelligence (2018), 44. DOI: 10.33321/cdi.2020.44.70

Desroches, Melissa L et al. “Impact of COVID-19: Nursing challenges to meeting the care needs of people with developmental disabilities.” Disability and health journal vol. 14,1 (2021): 101015. doi:10.1016/j.dhjo.2020.101015

Dickinson, H., & Yates, S. (2020). More than isolated: The experience of children and young people with disability and their families during the COVID-19 pandemic. Melbourne, Australia: Children and Young People with Disability Australia (CYDA). https://parliament.vic.gov.au/images/stories/committees/paec/COVID-19_Inquiry/Submissions/2b._Children_and_Young_People_with_Disability_Australia.pdf

Goggin, G., & Ellis, K. (2020). Disability, communication, and life itself in the COVID-19 pandemic. Health Sociology Review, 29(2), 168-176. https://doi.org/10.1080/14461242.2020.1784020

Health and Pharma. (2021). Australia: COVID-19 cases per 100,000 population by state 2020 | Statista. Statista. Retrieved 24 May 2021, from https://www.statista.com/statistics/1103944/australia-coronavirus-cases-per-100-000-population-by-state/.

Kavanagh, A., Dickinson, H., Carey, G., Llewellyn, G., Emerson, E., Disney, G., & Hatton, C. (2021). Improving health care for disabled people in COVID-19 and beyond: Lessons from Australia and England. Disability and health journal, 14(2), 101050. https://doi.org/10.1016/j.dhjo.2020.101050

Marriott, D., Beresford, R., Mirdad, F., Stark, D., Glanville, A., Chapman, S., ... & Matthews, G. V. (2021). Concomitant Marked Decline in Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Other Respiratory Viruses Among Symptomatic Patients Following Public Health Interventions in Australia: Data from St Vincent’s Hospital and Associated Screening Clinics, Sydney, NSW. Clinical Infectious Diseases, 72(10), e649-e651. https://doi.org/10.1093/cid/ciaa1256

Moreno, C., Wykes, T., Galderisi, S., Nordentoft, M., Crossley, N., Jones, N., ... & Arango, C. (2020). How mental health care should change as a consequence of the COVID-19 pandemic. The Lancet Psychiatry. https://doi.org/10.1016/S2215-0366(20)30307-2

Newby, J. M., O’Moore, K., Tang, S., Christensen, H., & Faasse, K. (2020). Acute mental health responses during the COVID-19 pandemic in Australia. PloS one, 15(7), e0236562. https://doi.org/10.1371/journal.pone.0236562

Wilson, K. (2020). The COVID-19 pandemic and the human rights of persons with mental and cognitive impairments subject to coercive powers in Australia. International journal of law and psychiatry, 73, 101605. .

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