Nine out of 10 of the patients with COVID-19 in Northern Territory hospitals are Aboriginal people, a rate which health experts say is "concerning" but, unfortunately, not surprising.
The NT reopened its borders last month and, since then, coronavirus has spread into every region in the territory.
"We predicted this, predicted that the virus would spread like wildfire through our remote communities and this is exactly what we're seeing now," Aboriginal Medical Services Alliance chief executive John Paterson said.
"Aboriginal Territorians are the sickest in this country with all the chronic illnesses and it was just going to be doubly hard for them if they contracted COVID for them to recover.
"It's very alarming, very concerning, we're disappointed."
Kalinda Griffiths, an epidemiologist from the Centre for Big Data Research in Health at UNSW, said Indigenous health experts had long warned high rates of hospitalisations could be a reality.
"The risk for Aboriginal and Torres Strait Islander people to have severe COVID was much greater than for non-Indigenous people," Dr Griffiths said.
"It means the things we've been talking about since the start of the pandemic, around the impact of [COVID-19] affecting Aboriginal and Torres Strait Islander communities, it's coming to fruition."
The NT has the highest rate of Aboriginal and Torres Strait Islander people in Australia, with 30 per cent of its population identifying as Indigenous.
Despite this, Dr Griffiths said the rate of patients with COVID-19 in hospital in the Northern Territory was still disproportionately high.
Dr Griffiths said it wasn't possible to compare the NT's Indigenous hospitalisation rate with the national average, because there wasn't any comparable data.
She said 50 per cent of all of Australia's confirmed cases of COVID-19 had "unknown Indigenous status" listed.
Growing COVID cases in remote Aboriginal communities
Dr Griffiths said Aboriginal and Torres Strait Islander families, especially those living in remote and regional areas, were at risk of "greater transmission" because large family groups often lived under the one roof.
"Ultimately people are living closer together, there is a housing crisis in Australia within Aboriginal communities that really needs addressing," she said.
"This is the reason why we've been talking about the social determinants of health for 20 plus years."
The NT government has introduced lockdowns and lockouts in Central Australia, on the Tiwi Islands and in Arnhem Land to help slow transmission.
Several remote communities are now reporting growing caseloads.
Peak health groups and land councils have been calling for a full lockdown in Central Australia, a region that has some communities where less than 50 per cent of people are fully vaccinated.
Mr Paterson supports the call and also wants additional lockdowns in other remote communities battling outbreaks.
But Health Minister Natasha Fyles doesn't believe tougher restrictions are necessary.
"We believe that the public health measures that are in place are proportionate and appropriate for the COVID situation in the Territory presently," she said.
Dr Griffiths said, as a matter of urgency, more effort should be made to boost Indigenous vaccination rates.
"If we have lower rates of vaccination, it means the risk is higher for severe disease," she said.
Vaccination rates low in some remote communities
Prior to the NT's borders reopening, Dr Griffiths was calling for 95 per cent of Aboriginal and Torres Strait Islander Territorians over the age of five to be fully vaccinated.
"We should have had higher rates of vaccination across the board before opening up," Dr Griffiths said.
"Ultimately, though, the opening has occurred and it's not about finger-pointing or blame, now is the time to ensure those communities have the support with vaccine distribution, and that also includes health promotion strategies to tackle reluctance and vaccine hesitancy in some places."
Dr Griffiths said well-ventilated spaces, face masks and social distancing are all small measures to help reduce future spread.
But the Top End's wet season made having adequate airflow was even more important, she added.
"It's cyclone season, wet season, and because of that people are going to spend more time outdoors which means ventilation is really, really important and making sure there are appropriate measures in place for communities to be able to isolate," she said.
Mr Paterson was concerned about growing caseloads and hospitalisation rates in the weeks ahead, unless something changed.
"There's no doubt there will be a huge increase in cases, and the number of Aboriginal people hospitalised."
