Panic buying is causing a shortage of grocery supplies in remote indigenous communities, forcing many vulnerable Aboriginal and Torres Strait Islander people to travel long distances to shop, exposing them to the spread of COVID-19.
Dennis Bate, chief executive of Mai Wiru, a not-for-profit organisation that runs stores in the 103,000 sq km Anangu Pitjantjatjara Yankunytjatjara Lands in South Australia's far northwest, said he was very concerned about the knock-on effects of hoarding.
Mr Bate said store managers in remote indigenous communities were receiving as little as 40 per cent of their orders as suppliers met increased demand from big retailers.
The Mai Wiru stores, often the only place for hundreds of kilometres where indigenous people can shop, are struggling to secure basic items, including toilet paper and baby formula.
"They can't simply get in a car and drive to the next supermarket, and the consequential effects on these already vulnerable communities could be disastrous," Mr Bate said.
Central Land Council, which covers more than 750,000 square kilometres in the southern half of the Northern Territory, says governments must act or residents will continue to defy orders and travel to regional towns for supplies.
"They must monitor the price of key food items in remote community stores and come down hard on any price gouging," chief executive Joe Martin-Jard said.
"We need immediate freight subsidies and supply guarantees for these stores so they can reduce their prices and don't run out of essential supplies."
Even before the pandemic hit, remote community residents paid on average 60 per cent more for a healthy food basket in their local stores, with a lettuce costing $10, Mr Martin-Jard said.
"People pay $5.50 for tinned steak when they could buy it at a major supermarket for $1.70," he said.
"Some tins of food at that (community) store go for $10."
Richard King, general manager of APY Lands, agreed food security was crucial to stop remote indigenous people from travelling.
Reducing the cost of fresh fruit and vegetables would be an incentive to stay home, Mr King said.
The coronavirus was a prime opportunity to promote healthy eating, he said, and community stores were already pricing sugary soft drinks higher than bottled water for that reason.
They have also agreed to reduce fuel supplies to deter driving.
Educating the community about the need for social isolation was paramount, Mr King said.
Brenda Garstone, chief executive of Yura Yungi Medical Service in the small West Australian Kimberley town of Halls Creek, said staff were working around the clock doing just that, as well as giving flu jabs to the elderly and contact tracing.
Two local health workers have contracted the disease but so far, no indigenous people - who are considered particularly vulnerable due to high rates of diabetes, heart disease and other health issues - had been identified as contacts.
Ms Garstone said responding to the virus had distracted the service from its core work and forced it to close the doors of its health centre, replacing face-to-face consultations with telephone advice and triage.
Residents were deeply shocked when they learnt of the first positive result, she said.
"It's devastating for Halls Creek," she told AAP.
"It's been one community that's taken a lead role to minimise the impact of COVID-19.
"Now that it's in our community, it's in complete disarray."
She said Halls Creek needed help, including setting up a camp outside the town to accommodate those infected.
"We're stretched already right now," Ms Garstone said.
National Rural Health Commissioner Paul Worley stressed the need to isolate and care for any confirmed cases in rural and remote areas, warning in an editorial in Rural and Remote Health that outbreaks would push available health services to their limit.
"Systems and people are strained to breaking point," he wrote, suggesting sweeping changes to cope with the crisis including greater integration of services between towns and smaller centres, and affordable and accessible telehealth.
He also raised concerns for Australia's rural health workforce, especially elderly clinicians.
"While drive-through testing points are operating in metro areas, how do small rural communities manage testing without putting at risk the same clinicians and facilities that are needed for treatment?"
APY Lands was the first indigenous body to close its borders last month, saying Aboriginal and Torres Strait Islander people were 8.5 times more likely to be hospitalised during a virus outbreak, citing the 2009 swine flu crisis.
Mr King said APY Lands' isolation was its strength, covering an area three times the size of England but with a population of just 3500.
"We're lucky - it's sort of an island in itself," he told AAP.
The WA government has prohibited intrastate travel, with exempted people including health workers, and has strictly restricted access to remote indigenous communities.
In the Kimberley, which had an indigenous population of 14,400 at the most recent census, movement between the four local government areas is not allowed.
In the Northern Territory, non-essential travel to or through remote communities is not recommended and a special purpose permit is required for long term or ongoing projects with Aboriginal people on their land.
Australian Associated Press