Far from home and able to speak only very little English, the international student from Colombia was unsure where to turn after becoming gravely ill with coronavirus.
I was so frightened because I couldnt breathe, the 24-year-old, who lives in Melbournes CBD, said through a translator.
The truth is, I didnt know where to go to get help. My family overseas knew I had contracted COVID-19, but I didnt want to tell them how sick I really was.”
When Ms Duque was first contacted by a doctor from Cohealth she had lost her job due to the pandemic and was so seriously ill that an ambulance had to be called. She spent the next 10 days fighting for life in intensive care.
She has since recovered from the virus, but the trauma of the experience has stayed with her.
“I don’t know if I would be here if I hadn’t been taken to hospital,” she said.
Dr Allard is working alongside a team of 40 doctors and nurses who have been assessing COVID-19-positive Victorians’ capacity to self-isolate safely and linking people up to social support services.
They uncovered troubling barriers in pockets of the community where the virus is spreading, including among ethnic minorities and those with insecure employment, who have struggled to quarantine for the required fortnight due to complex medical needs and other social factors such as the threat of losing their jobs.
All positive cases detected in hotspot catchment areas will now be referred by Victorian public health officials to Cohealth clinicians to ensure they have a personalised “self-isolation plan”.
Each positive case referred to the program is asked a series of questions including: “do you have enough money to pay the rent this month?” and “is it safe for you to remain in your home?” to identify social factors that may prevent them from quarantining.
Clinicians will also assist disease detectives in contact tracing for these cases.
More than 600 Victorians have so far been connected to medical treatment through the program, 90 per cent of whom have received care for the virus at home, while more than 60 people have been admitted to hospital.
The clinicians will also work alongside newly-formed suburban outbreak response teams set up to curb spread in high-risk communities and prevent family clusters.
Among those already referred to the program was an aged care worker who was unable to pay his bills and feared losing his job if he didnt go to work.
Some who have tested positive have been removed from their homes and into safe accommodation due to family violence, while others have been linked to financial support or welfare services, delivered food packages, connected to housing services, or to drug and alcohol counselling.
In some instances, Cohealth has called employers directly to ensure patients who are infected with the virus do not feel pressured to go to work.
A COVID-19 positive man was also immediately moved to emergency accommodation as he was unable to safely isolate in the rooming house he shared with 12 others.
These are the sort of social complexities that we see every day,” Dr Allard said.
“This virus is very much impacting people from a variety of backgrounds, including some very vulnerable groups. The best way to support them in terms of compliance is to give them the appropriate social supports.”
While Victoria’s first wave of coronavirus infections was largely returned travellers, the second surge has raged through Melbournes ethnically diverse and lower-income suburbs.
Cohealth chief executive Nicole Bartholomeusz said the findings of the pilot debunked misconceptions that Victorians were deliberately disregarding health directions.
Ms Bartholomeusz said support, not just compliance, was critical to ensuring people isolate safely.
“The only way we are going to be able to fully transition out of COVID is if we address the social inequities that prevent people from self-isolating,” she said. “Its the missing piece of the puzzle.”
Liberty Victoria expressed alarm at the idea of detaining people who might spread COVID-19 arguing the proposed law would unfairly target those with severe mental health issues.
We are particularly concerned that people who arent intentionally doing the wrong thing … people who for many reasons have vulnerabilities that make them at risk of not doing the right thing might be detained, said Liberty Victoria spokeswoman, Gemma Cafarella.
Thats really going to disproportionately affect people experiencing mental health issues, homelessness and a those with other forms of socioeconomic disadvantage.
“A persons right to liberty is a very important human right and taking away somebodys liberty should always be the last resort.
Ms Cafarella, said programs such as one being run by Cohealth were far more effective at addressing the underlying cause of why people werent self-isolating.
Its far more sensible to have health based approach, rather than a punitive approach and detaining people against their will, she said.
Melissa Cunningham is The Age’s health reporter.