We don’t know how many Australian Indigenous people lost their lives during the 1918 Spanish influenza pandemic; they weren’t counted in the country’s official statistics. When the 2009 H1N1 (Swine Flu) pandemic hit Australia, the Indigenous population recorded almost five times as many deaths as the non-Indigenous population. Now, as Covid-19 spreads across Australia, some doctors have warned that whole communities may be wiped out.

Jason King is an Aboriginal primary health care physician working in Yarrabah, Australia’s most disadvantaged community, in far north Queensland. The most disadvantaged, but not the most isolated: Yarrabah is just a 45-minute drive from Cairns. When I spoke to King on the phone last week, he rattled off a list of statistics about the Yarrabah community, 90 per cent of whom are Aboriginal and Torres Strait Islanders.

There are 3500 people in the town, but only 350 homes. Some houses have up to twenty people living in them. They are not all connected to the power grid. Some have poor access to running water. Around 850 people are over the age of 50, and 80 per cent of them have a chronic disease. More than 80 people are over the age of 70. The community has the highest rate of rheumatic heart disease in the world.

‘I get cold sweats thinking what this would all mean for Yarrabah,’ King said. ‘Overcrowding tells this story straight away. There’s no physical way for an individual who wants to isolate to isolate here. It’s not physically possible.’

The doctors in Yarrabah don’t have what they need to look after their patients. ‘I can’t ask my clinicians to do testing if they can’t adequately protect themselves,’ King said. ‘We’re scrambling to look for an overseas supplier for things as simple as gloves, hand sanitiser and masks.’

Yarrabah is not an anomaly. Indigenous communities across Australia, in both rural and urban areas, have high rates of chronic disease, overcrowding and a lack of access to clean water. The government acknowledges the stark inequality. Addressing the nation at the end of March, the prime minister, Scott Morrison, recommended that anyone over the age of 70 go into self-isolation; for Indigenous people, it was anyone aged over 50.

Entry into remote communities has been restricted to essential services only, and an Aboriginal and Torres Strait Islander Advisory Group on Covid-19 has been set up to co-ordinate the response. But time is running out and our two best defences against the disease – social distancing and hand-washing – are impossible in many communities.