Canberra Press Conference, 11 March 2022 - on Kimberley Kitching, Japanese encephalitis, extensions to vaccination/booster plan, winter preparedness plan for COVID and flu
Read the transcript of Minister Hunt at the Canberra Press Conference, on 211 March 2022, on Kimberley Kitching, Japanese encephalitis, extensions to vaccination/booster plan, winter preparedness plan for COVID and flu.
The Hon Greg Hunt MP
Former Minister for Health and Aged Care
I want to start just by offering my condolences to the family of Senator Kimberley Kitching.
It’s just a tremendous loss. I had the privilege of knowing Kimberley for quite a long period now, and, I’ve known her husband since university. So, to Andrew and to all of the family, it’s just an immensely sad moment.
And it is a tragic reminder of the risks that people face in their 50’, and it is important to have our heart checked. But, just in relation to Kimberley, I’d reflect and say that, probably there was no person in the Parliament with a better sense of humour, or who laughed more.
And she had a real, sort of, energy for life, as well as a steely eye on national security above other things. So, just a great loss to the Parliament, to the nation, but, above all else, to her husband Andrew and her broader family and friends.
More generally, today Dr Bennett and I wanted to address National Cabinet and the extensions which are being put in place, as well as, as part of that, the Japanese encephalitis and the national plan which Dr Bennett has helped to lead, in conjunction with the states. The states have principal roles of the public health units, but the Commonwealth is supporting.
So, just to commence in terms of the winter preparedness plan for COVID and flu, which is being considered together today by the National Cabinet. I’m pleased that the Australian Government will be supporting that with a $2.1 billion plan across three areas – across vaccines, across vulnerable populations, and, across support for aged care.
This has been developed in conjunction with the states, and I thank them for their assistance and their cooperation.
In particular, extending existing vaccine arrangements until the end of the year – that’s a $570 million plan and contribution. And so, that process of continuing to support vaccination will go through the course of the year.
Secondly, there’s the support for the vulnerable populations, of the principal item of a $329 million package is subject to the final agreement of the states.
The extension of the concessional rapid antigen test program, this program, so far, has delivered over 20 million rapid antigen tests. There’ve been over 5.5 million collections by concession card holders, pensioners, low-income, people on disability.
So, that’s been a very important program, and that will be extended by three months to 31 July. And just to remind everybody of the terms, that means, over any 3-month period, 10 rapid antigen tests available for free, a maximum of five per month.
At the moment we have 5,500 pharmacists that are participating in the program, and delivering the rapid antigen tests.
And, as I say, already over 20 million tests at approximately 3 million per week. And so, that’s a real success, and I just want to thank all of those involved; our pensioners and concession card holders for coming forward; our pharmacists for helping to be the distribution channel.
And by having over 93 per cent of pharmacies participate [inaudible] we have multiple points of presence right around Australia to assist people.
Then, in relation to residential care and disability, we’re investing an extra $1.2 billion over the course of the next six months, with a particular focus on provision of PPE which is over $900 million of that funding.
Those three elements are all part of the preparedness plan. And what we’ve done, and Dr Bennett will take you through this, is prepared for the worst contingencies and, as ever, seek to beat those outcomes.
In terms of all of the predictions of worst-case scenarios with regards to impact on hospitals for Omicron, we were able, as a nation, to in fact be the best of the scenarios over the course of summer - not without challenge and difficulty and hardship, but nevertheless with the strong support of all of those involved in the system.
That then leads me to the other element. In addition to the winter preparedness plan, we will be extending to 30 September - and that is again subject to continuous review - the National Partnership Agreement with the states. That supports the state hospitals on a 50/50 basis, as well as testing and other related costs in the public health sector.
So far, we’ve paid out $9.9 billion under the National Partnership Agreement with the states, and so that’s a very important contribution. It gives certainty over the course of the next six months and, as has been the case throughout the pandemic, that will continue with review.
Where that leads us to, in terms of the vaccination program, we have, yesterday, passed the 12 million mark for boosters, and today we will pass the 55 million dose level for total vaccinations delivered under the COVID-19 program in Australia.
So that’s an extraordinary national collective achievement which has provided immense protection.
To put it in context, we are now vaccinating at just over 520,000 doses a week, and we are at an almost inconceivable 96.5 per cent of the population over 16 that have had at least a first vaccination, and 94.7 per cent of people who have had their second - and that’s continuing to increase. And then in terms of our boosters, the 12 million boosters represent 65.3 per cent of the eligible population.
So, Sonya will take you through the fact that we want to encourage people to continue coming forward. We’re almost at two-thirds of the eligible population, but we would say to everybody: even if you have had Omicron, a booster is an important part of your protection.
It’s not over, and there will inevitably be new variants, and there will inevitably be a level of virus within the community going forward - that’s now without doubt. And so, I think it is very important that those who haven't had their boosters, if you could consider it, could come forward, I think that would be immensely valuable to protect you, but also to help protect everybody else.
Then just to note that in terms of children, [inaudible] this week, we’ve already passed 5 per cent of the children’s population that have had their second dose in just a few days, and now, well over 100,000- 113,000 kids.
And in aged care, as of yesterday, we’re at 91.5 per cent of eligible residents have had their booster. And so, to everybody involved – to all of the families that have provided the support, to the residents, to their carer’s, and to the vaccinators, I want to thank them.
The final thing that I want to mention is that Dr Bennett, who is actually an international expert in this area, has been leading the national coordination to assist the states and territories in response to the Japanese encephalitis virus. And so, as part of that national response plan, we’re providing $69 million, primarily across three areas.
Firstly, is in terms of the prevention – so that’s vaccine and communications. In terms of the vaccines, we have 15,000 vaccines in the country and we are purchasing an extra 130,000 based on the public health advice.
Sonya will go through the way that’s being provided and allocated. Secondly, as part of that, we also have a $5 million information and awareness campaign, effectively, mosquitoes, covering up, wearing repellent, doing all the things that people are used to doing to protect themselves where they’re in an area that there are mosquito borne diseases.
In addition to the preventative work, the vaccines and the covering up, there’s the vector control, actual mosquito eradication, and there’s $17.5 million that’s been provided for surveillance and mosquito eradication and control in affected areas. And then, with regards to the pigs and piggeries, there’s $10 million to support the state health and environment and agriculture departments in their work with piggeries to assist with control.
So, you know, we know this a matter of concern but the states are being very proactive with strong Commonwealth support and I want to thank them.
On that, I will turn to Dr Bennet, firstly, with regards to Japanese encephalitis, but then secondly, in relation to the winter preparedness plan.
Thank you. Thank you, Minister Hunt. Good morning everyone.
So a little about Japanese encephalitis virus which you’ve probably seen and read about. It’s not a new virus internationally, so it’s been widespread throughout South East Asia for a long time. There’s been a vaccine available for decades. But it is new to mainland Australia.
So, certainly in Australia, we’re familiar with the virus because defence forces have long been vaccinated against JEV when they need to go into a Japanese encephalitis virus endemic country.
Since the 90s, we’ve seen Japanese encephalitis outbreaks in the Torres Strait and there’s been a lot of work there including, now, an annual vaccination program for residents in at risk islands on the Torres Strait.
So we understand and we know the virus but what we hadn’t anticipated was seeing it emerge as quickly as it has in piggeries through- across four states. And also associated, of course, with a number of human cases that we’re also now seeing.
But we have a lot of expertise. We’re fortunate in Australia, a lot of expertise, entomologists and environmental health people who deal with mosquitoes because, of course, we have dengue and we have other viruses in the same family as Japanese encephalitis like Murray Valley virus and Kunjin, so we know how to respond.
There’s been a really swift response by states and territories so Health is working with our agriculture colleagues, at all levels of government really. And they’ve really mounted a swift response to both, A, identify areas where piggeries are affected, and B, man a swift response to manage any ongoing transmission of that virus through controlling pig movement as well as controlling the mosquito population.
And we’ve got surveillance as well going on to ensure we detect any future cases of encephalitis in piggeries or humans.
I think what’s important to understand about Japanese encephalitis virus, which I’ll call JEV - it’s just easier - is that it is transmitted to humans through the bite of an infected mosquito. So humans cannot transmit it to each other. And the virus itself maintains its lifecycle through wading birds, or water birds and pigs, but pigs are the main amplifying host, what we call an amplifying host.
So it means that the virus can rapidly increase in pigs and easily infect a mosquito which can then infect a human. So that sort of leads to why the response is really around controlling that virus in both pigs and mosquitos. Very similar to Murray Valley.
At the moment, we’re dealing with where the virus is and responding that way, but we’re also mounting a surveillance effort to really understand where the virus may have been and where we expect it to go through both surveillance of animals, mosquitos, and humans, and looking at whether modelling can tell us where it is meant to go.
So from a human point of view, those most at risk and recommended for vaccination are being identified by public health authorities, and they are really people who work in the affected piggeries at the moment, and those going in and doing mosquito and animal control in those piggeries.
CDNA, the expert group that you’ve heard of, we’ve established an expert working group for JEV. It’s got arboviral experts as well and we’ve also got representation from ATAGI, and they’re all working together to develop both a vaccination strategy and a mosquito surveillance and response plan.
With respect to the next stage of the vaccination strategy, because I think everybody’s interested in who should get a vaccine. Public health authorities, as I said, will be identifying and, in fact, this week we’ll have already started providing vaccine to those directly at risk, and the next stage will really be future proofing where we expect we might see the JEV and providing vaccine to other piggery workers around areas we expect to be at risk, and other people working occupationally with mosquitos as well.
So we’ll continue to monitor that as it evolves. This is the short term response. We expect that we’ll need to monitor and respond over the longer term. It’s too early to say whether or not JEV could be eliminated from Australia again.
Most experts think that’s very unlikely given the extent of the spread, so we can expect that we’ll need to develop and monitor management planning into the future, which may well include looking at other populations that might need vaccine as they’re at risk.
So moving on to the winter preparedness plan. As the Minister said, we’re very conscious this winter that, not only will expect to see potential rises in COVID cases, but we’ll also start to see influenza circulating with the opening of the international borders.
So the winter preparedness plan has really been developed around both of those thing, noting influenza as well is a serious illness. And the response measures, the focus will shift from preventing transmission completely because we know that vaccines aren’t completely effective against transmission, but they are affective against severe disease.
So the focus will shift to preventing- protecting those at risk of severe disease from post-COVID and influenza.
Important to note for influenza, we’ve had vaccination programs for many, many years now which are highly successful, including those at risk. So we always have good uptake of influenza vaccine in residential care facilities. So the elderly are at risk.
Different to COVID, young children are at risk for flu. So there is a national immunisation program for children under five as well, and we would encourage parents to get their children vaccinated for influenza, noting we haven’t seen flu in Australia for a couple of years because of the measures for COVID and we do expect it will start circulating in more significant numbers this year.
But as the Minister said, with respect to COVID, we are hearing, of course, about the BA2 variant of Omicron which is increasing across states. We expected to see that. We’ve seen it internationally. We know that it’s more transmissible which is why it is overtaking the BA1 variant of Omicron.
But it doesn’t appear to result in more severe clinical outcomes and the vaccine appears to be as effective against BA2, Omicron variant, as BA1.
So it’s very important to- for those we have got a highly vaccinated population for the first and second dose. I think with the booster, people are still considering uptake, but it’s very important, I think, before winter. Two doses is not effective as three for Omicron, so the evidence is very clear that a third dose of COVID vaccine is required to really lift your protection severe disease as well as infection for Omicron.
Other measures are, I think, you know, what will be useful this year – the measures that we see in hospitals and aged care facilities around infections control, the improvements we’ve seen, the management of outbreaks, they will also go a long way to supporting influenza circulation in our community.
And apart from influenza there’ll be a number of other respiratory viruses start to circulate as well, so all of those measures will continue to be- residential care facilities will continue to be supported during this winter, noting that we expect to see both circulated.
And, I think, people as well, the behaviours that we’ve learnt with COVID and Omicron will- hopefully people will also probably practice those more than we might’ve in the past, so things like making sure you do stay home when you’re unwell, washing your hands, cough hygiene, wearing a mask if you feel you want to protect yourself against COVID in crowded indoor spaces.
So, despite the fact it’s not mandatory in a lot of places anymore, we can all obviously choose to do that if we wish to further protect ourselves against COVID because we know that masks are effective.
And probably the last point I’d like to say: as we shift to that protection of at-risk of severe disease. Of course we’ve also got a wider range of treatments available to us, and for those who are at risk of severe disease and those people are sort of – those categories are well known at the moment – we’d encourage you to really go and get an early test.
Not just a rapid antigen test, but an early test, and that way you’ll be able to access treatment much more quickly if in fact you do have COVID and/or flu, so there are treatments for preventing progression to severe disease for both COVID and flu.
So for those at risk, if you are unwell, please go and access an early test and get into that treatment and care pathway.
So I might leave it there, Minister.
Thanks very much, Sonya. We’ll start with questions, if we could start, as you look at the camera, front left-hand side and just work across the room, please.
Do you have any modelling on how both flu and COVID are going to impact healthcare systems?
We’re looking at modelling, so we don’t have that yet but we’re certainly- that will be part of the winter preparedness plan that National Cabinet discusses today.
So that work’s being done as to what exactly is needed with respect to data, so you need to understand what you need to be looking at to model and expected outcomes. But that is underway, yeah.
How will you release that modelling?
That won’t be a decision for me. I think we’ll probably take that on notice, but I’ll leave it there, yeah.
Yeah, so I mean what we’ve done is we’ve done a first round of work on the winter preparedness plan, done the funding which is the support for vaccinations for vulnerable populations, for aged care and for health systems.
So we’ve actually prepared on the worst-case scenario with regards to flu and COVID, and so all of those protections are in place. And then what we’ve going to go back to now with the latest information on Omicron cases and also any early signs on flu is to do a next round of modelling, and that’s being commissioned out at National Cabinet today.
Thank you. Next, please.
How has the Omicron new sub variant been factored into what modelling will be done, compared to a whole new variant of the virus itself? How different would you foresee the new sub variant being to a whole new variant entirely?
And also, Minister, just on a related issue, we have seen given the mental health impacts of the floods in New South Wales and Queensland. The Government has already flagged mental health support for some areas of affected regions; will there be further mental health support, given that the impacts of these floods will last for weeks, months, even longer?
Sure. Sonya, if you respond on BA2, I’ll address the mental health.
Yeah, thank you, Minister. I think the Minister made a good point, that the winter preparedness plan plans for the worst.
It’s difficult, if not impossible, to plan for every scenario. We don’t know what characteristics different variants will have. I think with BA2 being more transmissible than BA1, that’s the worst-case scenario with the transmissible side. But there’s a whole lot of other things- factors that need to be taken into account.
We still don’t know – the growth of cases we’re seeing in Australia – how much of that is BA2, how much of that is really restrictions being lifted and people mixing more, and how much of that is waning immunity.
So, there’s a whole range of factors that go into that. The modelling that gets done, whatever it gets done for, we’ll give you a best and worst-case scenario, and usually you pitch it somewhere in the middle and you plan for both.
I think what we’ve learned over the last two years, we now have a range of tools in the toolkit. And I know that people use tools and toolkit a lot, but it’s true, and they’re all in place. So we now have adequate and ready access to rapid antigen tests, adequate and access to treatments for those at risk.
We know what public health and social measures need to be implemented ted in the worst-case scenario, which we don’t think we’ll get to. You know, we’ve got improved hygiene behaviours in the community, so there’s a range of things that can be implemented, and they are all in place already.
And so, the modelling just really tells us what we- should be telling us what we expect will happen in any case.
So, with regards to the mental health, Any natural disaster can produce deep trauma, both temporary and long lasting, and that’s why the early action is immensely important.
There’s a total package of $31 million for mental health across the flood-affected zones; the first $10 million of that, as you rightly point out, is for specifically the Lismore and broader area, which approximately half is for Headspace to focus on children, and half is for Royal Far West to provide services across the area with a children’s focus but also support for adults.
But then, in addition to that, there's $20 million which is being made available across all of the flood-affected areas. So that's five primary health network areas in Queensland and five primary health network areas in New South Wales.
And the bulk of that funding is for what are called psychological therapies, and those psychological therapies are precisely about providing better access to psychological support for people who may be suffering from trauma, anxiety, depression, PTSD or any other related conditions.
And the other element which we learnt in relation to the response to the bushfires is that community resilience is quite an important collective element. And so programs that communities are developing themselves and implementing in their own areas.
So as part of that $20 million for across the entire flood-affected zone, three million of that will be for community resilience or wellness grants. And they have worked very powerfully and effectively in the bushfire-affected zones.
And I've seen the work, for example, that they played in Corryong and related areas, and so that's an important learning that we've taken from that. So thank you. I appreciate the question.
Dr. Bennett, you kind of touched on it already, but face masks – would you be recommending people voluntarily wear face masks when they’re at the shops, at the movies, visiting friends at home and that sort of thing, even though it's not mandatory in a lot of places at the moment?
And I guess on a second related one, on the topic of complacency I guess, can you talk to us a bit about reinfection with COVID? I think this is the first season where a lot of people have gotten COVID in the last couple of months. What would you say to someone who’s already gotten COVID? Can they get as sick the second time around? What's going to happen?
Both very good questions. And I think the first question around voluntary wearing of masks, we're all asking ourselves, right? So ourselves, our families about should we or shouldn't we still wear a mask.
I think people, if they wish to further protect themselves against getting COVID, and clearly it's most important for those who are at risk of severe disease, then they should, and should wear a mask when they're indoors, in crowded settings, on public transport. And in fact, we're seeing people still continue to do that.
So it is an individual choice, but it's available and accessible and so people can make that choice themselves, both to protect themselves and transmission.
So as I said, I think we're all asking ourselves those questions and our tolerance for when we might wear a mask and might not will differ depending on how you perceive your risk, I think.
So, reinfection – so, another important question, because I think potentially part of the reason we might not be seeing booster uptake is that people have had COVID and they think they don’t need a booster. That’s not the case. So, it is the case that after infection, you will be much better protected for a period of time the same way you are immediately after a vaccine. In fact, CDNA have just come out and moved their period for when after infection, where you don’t have to isolate from four weeks to eight weeks. So, it is longer than we thought.
But having said that, after that your protection, like a vaccine, does continue to wane. So, it’s important if you’ve had infection, and you don’t think you need a booster or you’re considering a booster, we would recommend you do still need a booster.
The optimal time that AHPPC, we’ve been discussing this lately, is considering is about six weeks post-infection. That means by the time you’re at the eight-week mark, and we think your protection wanes, the vaccine will have kicked in on top of that.
So, you know, please, for those people, and there’s probably a significant proportion of the population and maybe while we’re not seeing booster coverage high, just reconsider your need for a booster around that six-week mark.
Yes. So, I’ll just add to that. We’re at almost two-thirds of the eligible population that have had boosters, which I think is excellent progress. But for those that’ve had Omicron over the summer, now’s the time to get your booster. If you haven’t had it, please come forward. Now the time to get your booster.
By the time we reach the middle of winter, it's going to be about six months since some of our most vulnerable citizens have had their booster shots. Now, what we know about waning efficacy of booster shots, is the Government considering perhaps a second booster, a fourth shot ahead of winter, ahead of that surge to protect people who might have had waning efficacy from their original boosters?
Sure. So firstly, thank you. That's actually a very important question.
We've tasked ATAGI, the Technical Advisory Group on Immunisation to provide advice on that. They have been meeting now for many weeks to consider that question. It's more likely than not that there will be a booster recommended for those above a certain age; 65 is the most likely age, and that's the current thinking.
And Sonya can add more, but we're expecting that advice from ATAGI within the next three weeks, if not earlier. And so, they're well advanced. They've been doing deep research on immunity, on waning and on the situation around the world.
Just to give you the update at this stage, the most likely direction, which is not in any way to pre-empt their decision but just to be completely transparent about the latest thinking, is they are potentially going to recommend a second booster, which would then be potentially the start of an annual program for people 65 and above.
But Sonya, you may want to add something as potentially having sat in on some of those discussions.
And I thank you, Minister. I think that's exactly right. ATAGI is actively considering that, and I think the parameters they're looking at, at which age threshold would that be appropriate.
And they'll look at the evidence around, again, the risk of severe disease and then other conditions which put people at risk of severe disease. And we all know that certainly immunosuppressed people are a part of that group, but they're actively considering that at the moment, and we do expect an answer shortly.
You know that then does lead to the question around vaccination and how that's provided, particularly when the influenza season’s rolling out.
But as I said, there's already good influenza vaccination programs in place. And as the Minister’s announced that support for vaccination both from the states and territories and the Commonwealth within reach for COVID vaccination to aged care facilities will continue.
Thanks Minister. Is July-August expected to be the most intense period for the co-mingling of flu and COVID?
And what's your message to employers about staff availability and broader disruption from a lot of infections?
In terms of the timing, I'll leave that to Sonya.
The second thing, though, with employers, we obviously saw an absolute peak in Omicron cases, and we're not expecting anything at those levels again.
There would’ve been a significant number of undiagnosed or unreported cases where people may not have tested over summer, but where they isolated or their families were affected. So, we're not expecting anything at those levels combined.
But what we have done today with the winter preparedness plan is to prepare for the worst-case scenario of flu and COVID coming together.
So, in a sense, COVID infections are a little bit like a bouncing ball, that the highest bounce is likely to have been in January, and then it will progressively decrease over time.
But there will be a bounce as it goes into winter. The specific timing on that is obviously not determined. It will depend on the variants, but that's why we're preparing, as per the previous question, for if ATAGI recommends, we've already got in place all of the plans for that second booster for the vulnerable population expected to be that that might cover about four million people.
And our older Australians have been extraordinary vaccinated. We're at 99 per cent two-dose vaccination and high 90s for boosters for the over 70s already. So, they've been extraordinary in coming forward.
Sonya, if you wanted to add anything? And then we'll have to finish up.
Thank you, Minister. Yeah, with respect to timing, I mean, we've got a lot of experience with influenza.
We know that August is the peak month for influenza. Having said that, you know, pre-COVID we were starting to see more cases in the intervening winter period. But by and large August will be the peak. We haven't had experience with transmission in winter with COVID yet.
It may be an earlier peak; it may be at the same time, it may be later. Or in fact, we might only see one of the viruses predominate, which is why we’ve planned for both. We've planned for the worst, that we'll have both peaking and circulating at the same time.
But I agree with the Minister. I don't- we don't expect to see the cases that we saw in in January. And as far as businesses go, I think again, and I think we've all learned a lot from the last two years, and we would really encourage businesses to support staff in staying home when they're unwell with influenza.
So, you know, we're not talking isolation per say, but just the behavioural practises of if you're unwell, then you should be staying home and looking to businesses to support that.
Yeah, the other thing here, I think, Tom, that's relevant is, and Sonya might be able to give you a little bit on this, the development of what are called multi [audio skip] tests, and these are able to detect both flu and COVID from the one test.
And that's something which we're looking to introduce over the course of the coming months. And our public health teams and our testing teams have been working together on that.
Sonya, if you just wanted to provide that information and then I actually have to go to Cabinet, I apologise.
Thanks, Minister. Yes, so, as the Minister said, it's called multiplex PCR, so it already exists for a range of microbes. But COVID has up until now been tested in isolation and in a test.
But what it means is that on one sample from somebody, you know, a machine can run and test for a range of viruses. I think what is being looked at for a combination of COVID and influenza, remembering we have different types of influenza. We've got A and B.
So, looking at a test, a multiplex test that can test for COVID, influenza A and B, and probably a number of other respiratory viruses like respiratory syncytial virus.
Now, that work is underway, there's a whole process for that occurring, which, you know, logistics and other- as well as the science around that. So, we're hoping that will be in place during winter.
It might not be in place at the beginning of winter, but certainly I’d expect we'd be seeing multiplex testing in hospitals and for those at risk by, you know, mid-winter.
Thank you very much, everybody. Take care and all of the best.