"When you're the only health service provider, if there's a flood, or there's a cyclone or there's multiple COVID cases, that's a disaster in and of itself."
That's the view of Sinon Cooney, Katherine West Health Board chief executive, after Cyclone Tiffany this week brought into stark relief a sobering reality - the intersection of COVID-cases, Indigenous health resources reaching crisis levels and a big natural disaster could be catastrophic for Top End remote communities.
Tiffany was a category one system, but at one point was forecast to be a more destructive category three system. It signaled the start of the wet season in the Top End, which experiences - on average - two to three cyclones a year. And there are growing concerns about the effects of the next "big" one in a COVID era.
Ngukurr - a First Nations community near the east coast of the Top End, roughly three-and-a-half hours by road from Katherine - was one of the places hit hardest by Tiffany.
Around 100 people took refuge in the town's cyclone shelter on Wednesday, which became a logistical nightmare once COVID protocols were implemented.
"COVID has definitely added an additional element of difficulty to it," Brock Schaefer-Walker, Deputy CEO at Yugul Mangi Development Aboriginal Corporation, said.
"We were trying to think about people going to the shelters and you know, if you've got a mass amount of people in there with the mask mandate currently, in effect, have we got enough masks?
"Luckily on Monday we pulled in a stockpile of masks and rapid antigen tests."
Mr Schaefer-Walker said it was just lucky that there were no confirmed cases of COVID in Ngukurr
"So that makes it easier. We are very, very fortunate," he said.
However, many remote communities have COVID cases, including those serviced by Aboriginal Community Controlled Health Organisation (ACCHO) Katherine West Health Board.
Katherine West chief executive, Sinon Cooney, said managing these cases from some of the most remote parts of the country, as well as other outbreaks, has taken up all of the organisation's already limited resources, leaving little time for disaster planning.
"The current COVID situation is really resource intensive and is really taking so much of our time and energy that there isn't a great deal of time to be able to focus or dedicate to overall primary health care work, but also to preparation and planning for other things," he said.
Mr Cooney said with their current resources, a natural disaster could be catastrophic.
"When you're the only health service provider, if there's a flood, or there's a cyclone or there's multiple COVID cases, that's a disaster in and of itself," he said.
"But when all of those things come up - short staffing, floods ... we also we also drive the ambulance, we also, you know, deliver standard care throughout the day.
"So all of these things create just incredible pressure on our already stretched remote services.
"It wouldn't take much more to tip things into a really difficult situation for us all."
Mr Cooney said things were set to get more challenging as the NT started to "live with COVID", meaning COVID-positive cases would be cared for in the community instead of being transferred to major centres.
"When things were incredibly low risk right at the start the resources that were available, were so ginormous," he said.
"And then as things got harder and more difficult, the resources dispersed because people went: you know, we've got to get back to normal.
"Well, none of us can really get back to normal."
Charles Darwin University Northern Institute's Associate Professor Akhilesh Surjan said the Northern Territory needed to act now to ensure it was prepared to handle two disasters simultaneously to avoid a catastrophe.
He said although this was a new challenge for the Territory, there were situations they could model its approach on.
"This is certainly a challenging time to cope with the demands of Cyclone and COVID-19. But when we are saying this we must be aware that we have seen cyclone and COVID-19 in Queensland, we have seen bushfires as well as COVID-19 risk in other jurisdictions," Associate Professor Surjan said.
"So when it comes to remote and regional NT, I guess the challenges could be unique in some ways, but the lessons could have been learned from other jurisdictions to effectively address this rather than leaving the people in remote areas without tending to their health issues, especially the COVID-19 spread."
He said the government must formulate "back up plans" for when frontline services were overwhelmed in times of disaster.
"Emergency response services, including health services, they're already short staffed for a variety of reasons. They are also overstretched due to increased workload for the last few months, at least three months," Associate Professor Surjan said.
"When it comes to disasters and climate change, we are talking about building resilience in the society and communities.
"I'm talking about ... adding an extra layer of volunteers who are trained, and preparing also people from VET and university sectors who are in the health and community related areas especially, and any other who would like to volunteer they can be trained, so that if needed, they can be deployed.
"If we fail to do that COVID-19 transmission could be so significant."
Associate Professor Surjan said climate change was only going to increase the likelihood and severity of natural disasters into the future, with the pandemic not ending any time soon.
"The NT was considered as a safe haven for a long period of time. But, you know, all that is the thing of the past now," he said.
"We have to learn to live with it. So learn to live with it with a good preparedness."
Acting Police Commissioner Michael Murphy moved to reassure Territorians that they were prepared for such a situation.
"The plans that go into this, are constant," he said.
"[We are] always reviewing our plans every year but always during operations as well to make sure we have the right resources, the right people, and the right contingencies in place to ensure there's no loss of life and to protect property," he said.
"On the basis of any sort of weather event or emergency response, there's always an evaluation process that we'll go through. And we'll go through this one as well.
"And any improvements or feedback from community or stakeholders will take on board and continue to improve."
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