The most perilous place in Australia's COVID outbreak is nowhere near Sydney.

In April 2020, children in the northwestern NSW town of Wilcannia erected handmade signs along the Barrier Highway, urging travellers and truck drivers not to risk bringing COVID-19 into their tiny community.

"Please don't stop. You're dangerous to us," one read.

"It's too dangerous to stop in Wilcannia," read another.

Nearly 18 months later, Wilcannia's fears are being realised.

This small town on the banks of the Darling River, has 70 active cases of COVID-19, which roughly equates to one in every 10 residents battling the virus.

That is the highest rate of COVID-19 transmission anywhere in Australia. 

The outbreak has been traced back to a funeral on August 13 when no public health orders were in place prohibiting such gatherings in regional NSW. It is now in lockdown, along with the rest of the state, but the damage is already being done.

"They just have body bags."

Like many regional communities, Wilcannia is a town in a precarious position.

Roughly 60 per cent of its residents are Indigenous; a population identified as more vulnerable to serious illness from COVID-19.

And many large family groups live together under one roof — ripe conditions for transmission of the highly virulent Delta variant of COVID-19.

This also makes isolating incredibly difficult. 

Some who've tested positive have to stay in tents. And as cases grow, plans are in motion to transfer others to a nearby caravan park or a medi-hotel in Broken Hill — the nearest regional centre, some 200km away.

For those who need medical care, Wilcannia has just one tiny hospital, and one transport ventilator. 

When a COVID-positive local, who is also suffering pneumonia, presented at emergency with breathing difficulties last Wednesday night, she was forced to wait outside in the cold for close to an hour before staff came out to assess her condition.

In videos posted to social media last week, Barkindji woman and Wilcannia local Monica Kerwin said it felt like Wilcannia had largely been ignored by authorities who have coordinated the state's pandemic response.

"They don't have a COVID plan here. They don't have ventilators," she said. "I think they just have body bags."

Even food supply has been an issue.

Many residents in isolation have been aided by a local food drive, Coordinated Food Support for Wilcannia, which has distributed hundreds of food hampers, water, and assisted with grocery deliveries in the town.

The initiative is a joint effort by local volunteers and community organisations, and has been met with an influx of donated goods and funds. An associated GoFundMe appeal on behalf of the local Aboriginal community controlled health organisation, Maari Ma, amassed more than $300,000.

"The outpouring of support for the welfare of Aboriginal people in the remote town of Wilcannia is really heartening," the initiative wrote on social media. "Wilcannia is a community that on every other day of the year feels marginalised and ignored, so the care and concern being felt in the community is deeply appreciated."

The crisis in regional NSW.

Wilcannia is not alone in this crisis.

Several LGAs in NSW's regions are in precisely the situation they have dreaded since the pandemic first emerged in early 2020. 

There are currently 42 active cases in the western LGA of Bourke, and 453 in Dubbo in the state's central west, putting fragile regional health systems under unprecedented strain.

"A lot of people are frightened," one Dubbo resident recently told Mamamia. 

"I didn't think it would affect me how it has. We've waited since the beginning of the Sydney lockdown for it to affect Dubbo. Then when it was actually announced, I felt really anxious."

Over the weekend, the city recorded Australia's first Indigenous COVID-19 fatality. The man, aged in his 50s, died in hospital on Sunday. He had underlying health conditions and had not been vaccinated.

Listen: The Quicky speaks to an epidemiologist, a political reporter, and a public policy expert to find out what life might be like if this virus simply never goes away. Post continues below.

There's been criticism that the Federal COVID-19 vaccination rollout has left Australia's Indigenous population behind. 

The Guardian recently obtained confidential NSW Government data that showed vaccination rates flagging among Indigenous people in every region of the state. In the Far West Local Health District, for example, where Wilcannia is located, the rate of vaccination among the Indigenous population is reportedly half that of the remainder of the population.

That's despite Aboriginal and Torres Strait Islander people being identified as a priority group at the beginning of the national vaccine rollout in March.

Several community leaders and Indigenous organisations have criticised the delivery of Pfizer vaccines to regional and remote communities as 'patchy'. Some have also cited vaccine hesitancy stemming from misinformation on social media, changing government messaging about eligibility, and general mistrust of Government.

The Federal Government, however, has defended its protection of Indigenous communities.

Speaking to the media on Tuesday, Health Minister Greg Hunt said vaccines have been available in Wilcannia since March.

"We've recently upped the number of vaccines available," he said. "We’ll continue to fight in every community, and the Royal Flying Doctor Service, Australian Medical Assistance Teams, the Australian Defence Force, as well as Commonwealth vaccination clinics, state vaccination clinics, GPs and pharmacies are out there doing that vaccination work in Indigenous communities, and supporting Indigenous Australians wherever they are."

Feature image: Getty.