Doorstop interview in Canberra about coronavirus (COVID-19)
Read the transcript of a doorstop in Canberra with Minister Hunt, Health's Principal Medical Advisor, Professor Michael Kidd, and Health's Chief Nursing and Midwifery Officer, Alison McMillan, about coronavirus (COVID-19).
The Hon Greg Hunt MP
Minister for Health and Aged Care
Professor Michael Kidd, Michael has joined the Chief Medical Officer's team.
He is a professor of primary care, he is the head of primary health and primary care within the Chief Medical Officer's team, former head of the Royal Australian College of General Practitioners, and a global leader having held a world leading role.
I'm also joined by the Chief Nursing and Midwifery Officer, Alison McMillan, an intensive care specialist in her own right as well as working with the nursing profession across Australia.
I think it's important that we expand the range of coverage so as we have additional support on primary care.
And Nat, who’s providing Auslan interpreting for us today.
Today we particularly want to focus on primary care and support for our magnificent doctors and nurses and allied health workers.
There have been some disturbing reports of abuse. Whether it's towards receptionists and practice managers, whether it's towards nurses or doctors – this cannot be allowed to happen.
It is rare, it is unusual, but nevertheless those reports are real and I would say to everybody: our doctors and nurses, our receptionists, our health workers, our allied health workers, are our heroes in the months to come – if we take care of them, they can take care of us.
And those who breach these rules in terms of safety and abuse will have the full force of the law brought down upon them.
Having said that, Australians love and respect and value their GPs, their nurses, their primary healthcare workers and allied health workers.
So, I want to do two things briefly – one is to set out progress, second is to outline additional actions which we are taking.
In terms of progress, with regards to testing the latest figures I have is that there have now been approximately 147,000 pathology tests carried out in Australia.
On a per capita basis, on the advice that I’ve received from the National Incidence Centre, that means we now have 557.9 approximately tests per 100,000 or greater than 0.5 per cent of the population.
This is, on the advice I have, higher than even Korea which has done a magnificent job with their testing on a per capita basis.
For example, Australia is at over 557 per 100,000; Korea 549; UK 117; USA; Austria 265; France 54.
So, along with Korea and Singapore, we are at the global forefront in terms of the breadth and width of our testing.
Interestingly – and this was something I was discussing both with Michael and with Alison – what that means as well is that we have the lowest rate of any of the major countries for which I have seen figures of positive tests.
Now, why does that matter? What it means is that we are picking up a very large proportion of those tests through the breadth- of those positive cases, through the breadth and width of our testing (inaudible) that approximately 1.2 per cent of total cases tested have been positive, and so, just under 99 per cent of total cases have been negative.
The next thing that we're doing of course is providing many ways for people to seek medical support, and in particular to seek testing where appropriate.
Telehealth, and we’ll say more about that, and Michael in particular is leading the work on this front; access to the GP, where you call ahead if you are concerned you may have any of the symptoms of COVID-19; respiratory clinics or emergency departments for those who are very ill.
In particular with regards to those respiratory clinics I can inform the Australian people that 175 clinics are now running around the country with an additional 31 planned for opening over the course of the next seven days.
Another very important thing, which I’ll ask Alison do address, is infection control.
Over 150,000 people have now completed the online infection control training, that includes many in primary health, in nursing, in aged care.
And this is about literally, literally saving lives and protecting lives.
Good infection control means slowing the spread which means fewer people, which means more lives are saved. It's as simple as that.
In terms of actions, which I'm announcing today, in particular I'm announcing a primary care support package.
This relates specifically to three areas of telehealth, masks and tests.
With regards to telehealth – as I have set out yesterday – we have moved to the third stage of telehealth with allowing additional calls from home by those doctors who themselves may be vulnerable or immuno-compromised.
We are looking, by Monday of next week, through the design which Michael is leading on a daily basis now with our RACGP, our AMA, our College of Rural and Remote Medicine, our Rural Doctors' Association of Australia and others, in having a whole-of-population telehealth capacity - that means for mental health, allied health, general practice.
Very important to stress however that a very large proportion of GP services of course require face-to-face treatment – whether that's cardiac, whether that’s items relating to blood pressure, whether it's other diagnoses – and Michael will set those out.
But that is an extremely important development which is proceeding now at a faster pace than we had previously believed possible.
And Michael and our medical community have helped made that possible.
Second, in relation to the medical community with regards to masks, we've just had 1.5 million masks arrive in the previous couple of days.
There is mask production being developed in Australia, and I mentioned previously that we are expecting 54 million masks by the end of April.
I'm now advised that in fact 30 million of those will be in the country within the next two weeks, ahead of schedule, which I think is important.
We will count them when we've got them.
But what that will allow us to do is to provide a very important commitment to our general practitioners of 5 million masks delivered through the primary health networks to support them in their work over the period between now and 30 June.
Beyond that there will of course be more, but this is coming from our discussions with the general practices and the primary health networks.
That is a very important commitment to their work and their safety.
We will ask them, of course, to be as careful in the use as possible because we are working within our capacity.
But these are important steps forward in providing safety and confidence to our general practitioners.
In relation to additional tests, I announced last week that 100,000 tests were due – 97,000 to be precise.
Those 97,000 test kits have all arrived in Australia.
We have additionally secured a further 100,000 – 63 of those 1000 on top of the 97,000 that arrived last week have arrived in Australia today.
This boosts our capacity and then in addition to that, and this is very important to our doctors in a general practice setting and other health workers in that general practice setting, we have ordered 1.5 million point-of-care tests and they will be provided as is appropriate as they arrive.
And again, I will count them when they arrive.
But they will allow us to assist with greater testing of health workers themselves to give them the confidence, and where appropriate, (inaudible).
So that is to some of the questions about expanding the broadest and widest of global testing regimes still further.
With regard to aged care, our aged care providers are doing an extraordinary job.
I'm advised that right across the country, with over 200,000 residents in aged care, 11 so far on the advice I have, have been diagnosed and sadly, three lives have been lost, but they are infection control experts and they are doing a remarkable job.
And the support package that we announced last week is about keeping people working in aged care and adding.
In our hospitals, very important questions have been asked about ICU and ventilator capacity.
I will ask Alison to add to this with her personal expertise.
Currently, there's a standing capacity of about 2000 ventilators through the ICU beds.
We are looking to double that, using existing arrangements and stock that is currently available, to 4000.
More than that, though, today work is being done, led by the Chief Scientist Alan Finkel in conjunction with others on Australian production which could add an additional 5000 invasive and non-invasive respiratory and ventilator units to the Australian capacity.
That is still to be finalised but I want to give you the forward plan.
And then finally, in terms of research, vaccine, anti-viral and respiratory research is all under way and being commissioned in Australia. Thank you for your patience.
I apologise if that was a little bit extended but I think Australians are hungry for information on action.
Thank you, Minister. And I’d like to start by thanking my colleagues, the general practitioners, the other health professionals, nurses and allied health professionals, continuing to work in primary care and continuing to support the healthcare needs of the members of their communities.
As the Minister has said, ten days ago, the nation issued a wide expansion of the capacity to use telehealth item numbers to support the care of people, meaning that many vulnerable people do not have to go, first up, to a general practice or to other health settings where they may be at risk of encountering other people who may be infectious.
This has been one of the most significant changes we've seen in Australian general practice in my working lifetime of 35 years, and this is rolled out in three stages.
The first stage, ten days ago, was a number of items which could be used by general practitioners and others to contact people who are deemed to be vulnerable.
The vulnerable people in our population are people who are aged 70 or over, people who are Indigenous and aged 50 or over, women who are pregnant, the parents of children under the age of one year, people with chronic diseases which may put them at increased risk if they become infected with the COVID-19, and people who are immune compromised.
The second stage was expanding the number of consultations which could be carried out, particularly adding in opportunities for midwives and for GPs involved in obstetrics.
The third stage was announced by the Minister yesterday in conjunction with the President of the Australian Medical Association, the President of the Royal Australian College of Practitioners.
And this was to ensure that healthcare professionals who are vulnerable themselves who meet those categories are able to use the telehealth items and not be put at increased risk.
We don't want to lose many of our workforce from actually being able to actively support their patients.
The fourth stage, which we're now preparing for, is further expansion of the telehealth item numbers and we're looking very closely to see what sort of consultations are safe to carry out using telehealth and what consultations still require, as the Minister has said, a face-to-face consultation with a healthcare provider.
It is absolutely imperative for the Australian public that we continue to have strong primary care available to the people of Australia through their chosen general practice and through other health practitioners.
The experience of epidemics in other parts of the world has shown us that if the primary care system collapses, we are at risk of more loss of life from regular conditions which could have been prevented perhaps than from the infectious agent itself.
So we are working with the peak organisations to further expand the telehealth item numbers, and the Minister has provided you with further details on that.
Thank you very much. And Alison, on the three topics of infection control, isolation, and ICU.
Thank you, Minister.
So, firstly, as the Chief Nursing and Midwifery Officer for the Commonwealth Department of Health, I do speak to all nurses and midwives out there.
You are at the forefront of this experience and we know we face challenging times ahead.
But I'm confident that all of my colleagues out there will rise to the occasion very proudly as we've seen in the history of nursing and midwifery over 200 years.
But the community need to take their place and they need play their part.
So I'm going to remind everyone again of what you can do to contribute to everyone's safety.
If you're sick, stay at home. Do not go out. Get other people to do things for you, but you need to stay at home.
For everybody else, this means we need to maintain that social distancing.
We've all seen it out there in the community already. We're all walking around each other. Please keep that up. It's really important.
Hands – wash your hands frequently, wash them before you eat, wash them after you've been to the bathroom, or use the alcohol hand sanitiser as often as you like.
Cough etiquette and sneezing. Remember – it's really important you cough or sneeze into your elbow. If you use a tissue, throw it away straight away and wash your hands.
All of us need to play a part in this, and this is how the community can help protect everyone.
The Minister has spoken around intensive care, and we will need to expand and double our intensive care capacity, and that work is being done in collaboration with the intensive care doctors and nurses out there, who are going to rise to this occasion and provide the care we need to those most vulnerable.
And to speak finally to one particular topic, and that is that we ask everyone, if you are tested positive – that is the moment you go home.
Don’t go to the pharmacy, don’t go anywhere else, don’t go to the shops.
Please go straight home and ask others to help you.
There is a pharmacy system that now will come to you, and you can find the details of that and the details of many of the things that you ask on our website, health.gov.au.
Thank you very much.
Overnight, we’ve seen Boris Johnson’s government in the UK announce some stricter enforcement measures. In preparing the public for what might happen here, how long before Australia might face such a situation?
So, these are matters which the medical expert panel – or what’s known as the Australian Health Protection Principal Committee – are assessing today, and discussing with the National Cabinet tonight.
The general direction, obviously, is about people spending more time at home, obviously keeping the distance.
These ideas that some have heard of of house parties – they’re out. They are out, let me absolutely clear on that.
I will let the very group that is charged with that do that work today, but we are developing a staged approach.
We recognise and appreciate what has happened in other parts of the world, and indeed all of us are learning from each other.
But obviously, this notion of greater isolation, more time at home, less time out in groups, is what we are encouraging.
With the communication campaign under the two point- five- four-billion-dollar package, sorry, the ads that we are seeing on TV at the moment, you have the hygiene ad that says wash your hands thoroughly, but it doesn’t say for 20 seconds; you have the aged care ad that says there are going to be restrictions but go to the generic health.gov website to find out what they are; long letters in newspapers.
In natural disasters, governments have capacity to send mass text messages to actually get in people’s faces.
Why is that kind of thing not happening, given we are still repeatedly seeing people breaching or not understanding social distancing?
So one of the items which is in part of the next phase, as we continue to expand the advertising, will be direct text messaging.
Minister Hunt, is it inevitable that more businesses will have to temporarily shut down and that there will in effect be a lockdown in this country, like in Britain, where people are basically ordered to stay at home except for essential services?
Sure. So, I won’t pre-empt and I’m not, for any other reason that I think it's entirely appropriate, that the health professionals because they have guided our actions, which have meant that we have been able to prevent the onset and the spread in Australia far longer than many others, that I will allow them to do their work.
We have always indicated, as the Prime Minister said and the National Cabinet said, that this was stage one.
It is not the last stage, and I think I should be very upfront and honest about that.
Right as we speak, those next stages are being designed and the timing and the implementation measures for it are being carefully considered.
What's the value of the National Cabinet? It pulls all our health professionals together, it pulls our leaders together, so as they can take these steps together.
Minister, you talked about the widespread testing that’s being done here in Australia, and the Deputy Chief Medical Officer indicated last night that there are some changes looming around deciding who should get a test.
Can you give us an update or take us through what change we're likely to see and when?
Sure. So, two things, one of which I have actually announced during the course of this discussion.
One is the greater provision to ensure that our health workers are themselves safe.
It's very important to give them the confidence, because their degree of commitment and courage should not be underestimated.
They are, as I have said previously, the heroes of the coming months.
And secondly, as we receive these newly approved – they were only approved over the weekend and in some cases in the last 24 hours – what are called point-of-care tests or finger-prick tests, they will be deployed, which will then allow for greater testing of patients within the general practice setting.
The pathology tests, or what is known as PCR, are a critical component. They’re the extra 63,000 as part of another batch of 100,000 that are arriving today.
They allow us to have the highest grade of tests, but these ones will allow some additional testing as we proceed.
At the moment it’s been: people who get tested are those who’ve had either direct contact or have travelled overseas recently. There was indications that those benchmarks for who gets tested will change.
Can you speak to whether there's going- or perhaps the professor could speak to whether there’s going to be a change in those factors for individuals as to deciding whether they get tested?
That will be a decision of the medical expert panel.
In regards to the Queensland election, we're about to have- of the local government elections, we're about to have a few million people lining up to vote on the weekend.
Even with social distancing measures, is this a risk and should the elections be considered, at least, being postponed given the risk?
To be honest, it's not something that's been brought to my focus. I will leave that one for the Queensland Government and the Queensland Chief Health Officer.
What could stage two- we’ve had stage 1, the pub shutdowns. What could stage two potentially involve, and is lockdown later than stage 2? And secondly, I think Kieran was trying to ask you about the- what progress there is with these anti-malarial drugs to potentially- and anti-HIV drugs to potentially treat the illness?
So, there's very significant work which is being done. I apologise if I’ll- I’ll go to the last part first and then flip it.
In terms of the work of the University of Queensland, Professor David Paterson, I had the privilege of speaking with him over the previous days.
We have joined with the Queensland Government in supporting that. In addition there have been philanthropic contributions.
They are doing a wide expansion of the clinical trial. And there’s both an HIV drug and a hexachloroquin, which is being considered as part of it.
Then there are new proposals which have come to us today which have been brought forward by the Walter and Eliza Hall Institute – one of the great medical research institutes, not just in Australia but in the world, a storied home of Nobel Laureates.
And that institute is looking at the potential for prophylaxis, or preventive deployment. And we are considering that immediately, and I have hopeful that within the next 48 hours, that they will have provided a strong case, but I am very predisposed to accept that.
So right now, we’ve opened up the $13 million round for proposals with regards to antivirals, so suppressing or- the effects and hastening the treatment.
I've not previously heard until now of the potential for possible prevention, but it's very heartening that the Walter and Eliza Hall Institute has put this forward.
And in addition to that, the respiratory medicine, which is about making sure that the process, in many cases, of effectively flooding the lungs is limited.
These are saving lives in the extreme cases. So those are all proceeding on those fronts.
I’ll try Jonathan again.
So, stage 2, I will respectfully leave that to the medical expert panel, which is working on that.
But there are a series of gradations here, which is about progressive social isolation, where we believe that that is required.
But above all else, people don't need to wait.
What we're doing here is making sure that the message of the Chief Medical Officer, the Chief Nursing and Midwifery Officer and of the Government is: if you can take steps to spend time at home, do that.
Minister Hunt, one of the key aspects of health through this will be mental health, come the time people are locked away and isolated.
In the past few days, we've seen the phone network collapse in some cities; Telstra calls unable to get through; broadband networks are slowing down.
What assurances can you give that people will be able to keep in touch and keep communicating and that the telecommunications system can hold up?
So, two things. Firstly, obviously, the Communications Minister Paul Fletcher, who himself was part of the telecommunications sector in his previous work, is focusing on that.
That is his number one job.
Secondly, we are expanding the capacity of telehealth, as Michael has indicated today, which will include mental health as part of it.
So GPs, mental health, allied health, will all be part of that. I don’t know-
How many ICU nurses are there in Australia and how do we expand that extra workforce to account for the 2000 extra ventilators, for example?
Okay. I actually can't answer the question about how many. I’ll have to take that on advisement.
Is there a shortage, perhaps? Or do we need more?
There's not a shortage, but the way that we've delivered nursing care and intensive care in Australia is generally by predominantly, particularly in the metropolitan, that the nurses have an extra qualification, like myself, which means they're an ICU trained nurse.
And that is- a very large proportion of the nurses who work in intensive care have that qualification.
What we will need to do and what we’re working with the college that represents critical care nurses is to look at how we can use that workforce more broadly, bring in other nurses who can be given some training, and work as a part of a team to be able to deliver and expand the care.
So we're looking at also bringing back intensive care nurses who may have moved on to other things; people who may have retired or chosen to take a different path.
So we are looking for every opportunity to expand the capacity of our intensive care nursing workforce.
One here and then Claire, and then, I think that might be it. Thank you.
Minister, just touching upon what the Chief Nursing Officer said earlier, it seems like there potentially had been cases where people who had been officially diagnosed with coronavirus had then gone out and purchased supplies.
Does there need to be some sort of change in the messaging that's going to people who have been diagnosed so they know that they have to remain at home?
Yes. Look, I think that's a very important question. And this was exactly Alison's point – If you are diagnosed and given a positive test, go straight home.
I am staring down the barrel of the camera and saying: go straight home.
There are many means to ensure that you are provided with both medical care, critical supplies and medical supplies through the pharmacy at home, home delivery program, which we have stood up and which has now been operating for over a week.
I thank you. That’s a very important question.
Claire, I think, with the last one.
On telehealth, my understanding is if you are not a vulnerable person yourself or your healthcare provider, your doctor, is not vulnerable, you are still expected to go in person, face-to-face. I understand you're expanding that.
But why not have every item that's already under Medicare able to be made telehealth and let the health professional individually be able to choose? Because surely, they would be best placed to know if they can deliver that.
So, I’ll make a brief answer and then I’ll let Michael answer.
So we are moving to what is called whole-of-population telehealth. So, every Australian will have access to that.
And Michael is now working through with the medical leaders in the country the way in which that can be done, precisely to achieve two things.
One is to ensure that everybody who needs face-to-face treatment or assessment is given that face-to-face. That is such a fundamentally important part of our system.
Secondly, also, we want to make sure that we are protecting the smaller general practices from any unintended consequences.
We're very much encouraging people if they have any symptoms, of course, to ring ahead rather than just turning up.
We have had many examples of people appearing at general practices and at other healthcare settings with symptoms of fever or cough or sore throat. Very important that people ring ahead.
It's also very important for those people who fall in the vulnerable categories to make contact with their general practice if, for example, they have a regular appointment booked over the days ahead.
Ring ahead and ask your general practitioner: is this something we can do as a telehealth item instead?
What we're wanting to do is to protect the most vulnerable people in the nation, at the same time, stopping the spread.
Just before you go, if that's alright, I know there are some regional Australians who are worried that increased pressure on hospitals and GPs in the city might mean that locums that service regional and rural areas may not be available for them.
Is there planning in place, or can you give us your thoughts on what's being done to make sure there are still medical services for rural and regional Australians?
Yep. I’ll be meeting at 1 o’clock with the representatives of the Rural Doctors Association of Australia and the Australian College of Rural and Remote Medicine.
We're very concerned to ensure, especially in smaller rural communities, that those communities continue to have access to the same high-quality primary care as people in other parts of the country.
There is wonderful work that’s taking place across the country, with groups of doctors coming together, knowing perhaps in this town there is a vulnerable doctor who needs to be doing telehealth.
How can the doctors in the nearby towns assist the patients of that doctor? How can we all work together? I am heartened to see how my colleagues are coming together at this time of crisis.
So, look, I will finish on that note, and I want to speak directly to the Australian people.
I know, and deep in my heart, I know these are uncertain times and there are many people who will legitimately be concerned, whether it's about their employment, but above all else, about their health or the health of their family members.
Our task is for all of us, for all of us together, to take the steps with regards to distancing.
It's so contrary to our nature but it's essential to our future.
So to take those steps, which will protect each of us in ourselves but all of those around us.
And at the same time, our task is to reduce the infection and reduce the spread, but to increase the capacity.
These announcements today, particularly for primary care, are about providing increased capacity but also letting the Australian people know that as we flatten the curve and reduce the infection, we're increasing the capacity, and these are the things that over the coming six months will allow us to get through it, because get through this together, we will.
Thank you very much.