Doorstop interview in Melbourne on 25 July 2020
Read the transcript of a doorstop interview in Melbourne with Minister Hunt about coronavirus (COVID-19) talking about the Victorian healthcare workers, AUSMAT assistance and additional PPE.
The Hon Greg Hunt MP
Minister for Health and Aged Care
Good afternoon. I’m joined this afternoon by Joe Buffone, who is the head of response at Emergency Management Australia and is the executive leader of the Victorian Aged Care Response Centre, which is a partnership with the Victorian Government.
And of course, the Chief Nursing and Midwifery Officer, Professor Alison McMillan.
I want to start again by again thanking our extraordinary nursing staff, our medical staff, our aged care staff for their commitment to managing the outbreak in Victoria.
Their actions have saved lives and protected lives.
I also want to thank the Australian- but especially at this moment the Victorian public.
Their diligence on mask-wearing, their focus on distancing, the difficult actions of staying at home other than for the four reasons, all of these things are helping Victoria to embark upon and then, ultimately, to achieve the goal of flattening that curve.
There's more work to be done, but there is progress that is being made, real progress, life-saving progress.
And today, I would like to take you through the situation, the response with regards to the ADF, and further actions and announcements, in particular, as well as PPE, as part of our aged care response.
Firstly, in terms of the context, the global context remains deeply concerning.
Sadly, every week I've had to report that the pace of global cases continues to accelerate.
One million cases in four days. 16.4 million cases, 651,000 lives lost and, no doubt, the real number is higher.
These are confronting, real human statistics, and they put in place the context for Australia's great challenge.
In seven out of eight states, we are doing remarkably well right across Australia.
New South Wales has been tracing, finding the cases, testing on a huge scale, and controlling that outbreak.
Again, today, numbers which we would always want zero community transmission but they are doing an extraordinary job in tracking down, tracing and making sure that the contacts as well as the cases are isolated.
In Victoria, however, we know that the challenge is great, and it’s a challenge which risks the nation if it's not controlled.
So we thank and support the Victorian Government for the actions that they have taken to date.
The difficult decision that they have taken today is, however, a necessary decision.
I, in particular, want to note that what we've seen now is the country reach over four million tests, which are helping us to find positive cases, and that there have been over 62,000 tests a day on average over the course of the last week.
In relation to Victoria, I'd like to begin with the context.
I think discussing with the Prime Minister today over a number of action-oriented calls, it's very important, I think, for us to set out honestly with the nation and with the state where we are.
As I say, seven out of eight states and territories are in a very strong position, but it could be any state at any time with a disease that has this reach across the globe, clearly heading towards 20 million cases and beyond.
Against that background, it is Victoria now.
The origins of this we know, a hotel quarantine breach with, sadly, catastrophic human outcomes.
A major community transmission as a consequence of that, and some of the challenges that we have seen in the contract tracing program.
Against that background, we have stepped in to assist with that contract tracing and real progress is being made.
The ADF has played an extraordinary role, but I also want to acknowledge and recognise the work of Victoria's Public Health Unit.
As part of that, we also recognise that wherever there is widespread community transmission, and this has been the global example, then there are cases of staff, as sentinels, representatives of that community, who sadly, asymptomatically with no ability to know otherwise for it is not within their knowledge, it is not even in many cases within the capacity of testing.
Those staff have brought such cases into aged care facilities.
The Australian achievement until now has been extraordinary, and that is a testament to our facilities and our individuals.
At this moment, there is a challenge, and that challenge means that we have to protect those residents and to make sure that we are in a strong position.
Our strengths are that the hospital system has been prepared in advance.
Ventilation capability, ICU capability, bed capability are very high.
Victoria's decision today, which the Commonwealth does fully support, to make additional bed capacity is a recognition of the level of outbreak within Victoria.
It's appropriate and it's one which we fully support to reaffirm that.
As part of that, we also have very strong primary care, and across the country, the aged care system is strong.
The biggest challenge is when, due to an infection in a facility, the Public Health Unit determines that a significant number of staff or all staff may need to isolate.
When all staff have to isolate with little or no notice, then that means that there are residents that have to be cared for.
That is our fundamental task.
That's why we have set up, in partnership with Victoria under the leadership of Joe Buffone, the Victorian Aged Care Response Centre.
It is also why we need to make sure that every patient, every patient who’s COVID positive that needs and would benefit from hospital care is able to immediately access that hospital care.
And I thank the Victorian Government for the points that they have made today that that will be the standard which they adopt.
I think that's a very important step going forwards.
In relation to the specific actions, we have now have the ADF in place.
Today, the figures that I have from General Frewen – JJ Frewen - 1463 ADF members in Victoria, a range of responsibilities.
They are involved in checkpoint control. They are involved in ensuring that isolation is being maintained. They are involved in testing.
Overnight, we have had ADF medics step into an aged care facility to ensure there was support on-site. And in addition, they are very involved in the tracing program.
They've been involved in making sure that the public health unit in Victoria has support in terms of logistics to achieve that goal of tracing every case, every day.
Every case, every day is the standard which must be achieved in each state and territory, and I'm pleased that the ADF, under Commodore Hill, has been able to assist.
In addition to that, we have 28 foot teams on the ground, following up cases where the public health units have been unable, through no fault of their own, to make contact with either positive cases or contact with those positive cases, very important work which the ADF is carrying out.
We also have 21 ADF in Colac assisting with the outbreak management response there.
I’ll turn to the work of the ADF, in particular to- our support or the aged care residents.
Aged care residents represent approximately seven per cent of the cases in Victoria which have been diagnosed since 1 July.
They are, like everywhere, a consequence of a major outbreak, hotel quarantine major outbreak.
The aged care workers, as are the health care workers, are sentinels of their community and community transmission.
In this case, what we see is that that means this is a frail community.
And with all of their extraordinary leadership and strength, I want to praise our aged care workers, praise our aged care teams, praise our aged care facilities and the families for their work in supporting this community.
Against that background, there are, however, four significant steps.
One, we have established under Joe’s leadership, the Victorian Aged Care Response Centre and Joe will take you through their actions which, above all else, though, can be boiled down to two things: workforce in and transfer of residents to hospital where they need that additional support.
Those are the two fundamental responsibilities.
Secondly, we will be bringing in an AUSMAT team I have spoken with Len Notaras, the Director of AUSMAT, and AUSMAT will be coming to Victoria.
Len is currently formulating those numbers.
We will provide those numbers once they have been confirmed.
But AUSMAT, which has helped out in other states and territories, will be coming to Victoria.
They have assisted with quarantine, they have assisted in Western Australia, they have assisted in activities around the country and they are the best of the best.
They are the SAS of the medical world.
Furthermore, we have put out a call for interstate nursing staff.
South Australia in particular has taken the lead on that. They are formulating those resources.
And then finally, with regards to PPE or personal protective equipment, we will be allocating a further 5 million masks from the National Medical Stockpile for aged care support within Victoria, and this will be triggered immediately.
And for the first time, as an additional measure, over and above everything which has been done previously, 500,000 reusable face shields will be made available for aged care in Victoria.
All of these measures are coming together to provide that additional support for our beautiful, older Australians who are one of the reasons that we've taken such difficult measures.
But they are so vulnerable, many of them are frail. And this disease particularly preys on the elderly.
It's indiscriminate but, in particular, it focuses on the elderly. So that's our task and that's our responsibility.
I'll ask Joe if he'll give an update on the centre, and Alison, in terms of nursing and aged care.
Thank you, Minister, and good afternoon.
You've heard the Minister talk about the community that we are focused on. They are vulnerable and they do have special needs.
So there's been a tremendous collective effort and partnership to stand up the response centre Pretty much over the weekend.
And it is in partnership with the Victorian Government, whilst being Commonwealth-led.
I think there's an important factor here, that the key focus of the centre is to unify the effort across every aspect of the aged care sector.
That's with the providers, that's with the aged care workers, that's with the Victorian Government, and also, across the Australian Government.
We have significant expertise that is supporting the centre.
We have specialist geriatricians, we have ADF, we have doctors, we have nurses, we have emergency management specialists; all contributing to unify the effort.
I want to echo the Minister's comments about the workforce, and it's both the aged care workforce and the support workforce.
So the cleaning staff, the catering staff, all of those people are essential to what the work that we're doing here.
The key focus is there is no doubt it is a challenging environment.
We are battling against a virus that we do not know where it's going to pop up.
We have no - you know; it'll suddenly pop up in areas where it's unexpected.
But our centre is bringing that unity of effort across all of those areas.
There's a couple of key focal points for it.
The first one, as the Minister has said, is the immediate response.
We’ve got three facilities right now, that there is significant effort.
And the priority of quality of care and safety for the residents is number one and then the safety of staff is in there as well; critical factors.
Now, all decisions that are made, and sometimes they are difficult decisions that are made, around whether residents stay in situ or have to be moved out are being made by experts, and they are quite difficult decisions.
Our current focus is that primary response.
The second factor is the workforce. We need the workforce.
They are specialist people in their own right. They understand the aged care system.
So we have, again, a team of experts that are working up models of workforce.
In some instances, we are running out of people to actually look after these, and so the options there are potentially to move them into the healthcare system.
We can't afford to do that because then the healthcare system is stressed.
So we're doing everything possible to do that.
The third point is around preventing; preventing this to occur any further.
So we've got, again, a team of specialists and you've heard the shift in recommendations of the use of face masks, the distribution of those, and making sure that the facilities have the PPE or the protective equipment that they need.
As I said, it has been a tremendous effort to get the centre up, but there are challenges ahead.
Everybody is doing everything they possibly can to provide that best care and safety to our most vulnerable.
Thank you, Minister.
Thank you. Alison?
Good afternoon. Firstly, I, too, would like to echo my enormous gratitude to the nurses, patient care assistants, everyone who is out there rallying to support our most vulnerable.
I know that for many nurses and patient care attendants who work in aged care, this is a challenging time, and I acknowledge that there is a fear associated with caring for complex cases in a COVID-19 situation.
But our role is to provide care and compassion for those who are the most vulnerable, and what I've seen so far is an enormous effort of nurses coming out of acute hospitals and voluntarily going into aged care facilities and providing that vital care and supporting those people.
As you've known, we've seen over the weekend, one of the aged care facilities, St Basil's in Faulkner, we moved out of that facility and relocated 75 residents and 36 of those remain in place because it was the decision that that was best placed for them because of the nature of their needs, particularly those related to dementia.
So we work collaboratively with the hospital system and with everyone else to make sure we can maintain the safety of residents.
But I have to say, and again I’ll say it to all of my nursing and associate colleagues, particularly patient care assistants, I, too, have been in a COVID-positive environment.
I went to St Basil's a couple of times last week to work within that facility to help make some of the decisions we needed to make about staffing and moving.
It’s fearful for us all but there is good training on the use of PPE and there is plenty of PPE out there.
You need not worry that it’s not available for you to look after yourself.
So please don't be frightened.
Please think about those that need your care so that we can support all of those vulnerable Victorians across the state.
Thank you, Minister.
Happy to take questions. We'll start with those in the room and then come to those on the phone.
Has the Government dropped the ball on aged care given the fact that we’ve had problems in New South Wales with aged care and COVID, and this was coming to Melbourne?
No, I think it's actually the opposite.
It's precisely because of the experience we've had that we're able to set up an aged care response centre.
To think of it this way, Victoria- and let me look at the figures here.
So Victoria has had approximately 6900 cases since 1 July.
That is an explosion of cases in one city of one state. And against that background, there are no areas that are immune.
We've seen that our hospital staff have been sentinels for their community. Equally, the aged care staff have been sentinels.
And the fact that, from time to time, public health units will indicate that staff will have to isolate, I think it’s important to consider whether all staff need to isolate immediately because it's critical that there is a transition plan.
That's a decision made at the state level, so we respect that.
But it's absolutely critical – and this is Joe's work – that there is a clear warning, that there's a clear transition plan so as staff can be put in place.
But the fact that we've been able to setup the PPE to make sure that there is a national call for staff, that AUSMAT is available, because so many Victorian staff, whether aged care or hospital or health worker have had to isolate is an indication of the preparation that goes into this.
These outbreaks, 80 centres have got cases, 780 odd people have been infected. Doesn't that show that you weren't prepared, the lessons weren’t learnt from New South Wales?
What are you indicating should have happened?
I’m indicating that, now that Victorian nurses are going in there, and nurses from South Australia, couldn't this have been avoided with better training and better staffing, and stopping the staff going from centre to centre?
Staff going from centre to centre shouldn’t be stopped? Because that’s.
No, no that's not the major.
You said yesterday that multiple centres being infected by one person working at multiple places.
I think what you'll find is that right across the world, as well as here, where you have a major community outbreak- let us go back to the source of this.
A massive breach of hotel quarantine.
Over- nearly 7000 Victorians have been infected just this month.
That goes to all parts of that society.
And where there are asymptomatic cases, for example, Alison, St Basil's, she spoke with- there were 20 nurses at that point that were in isolation because of being tested positive.
The vast majority of them had no symptoms.
And so, that is the global challenge.
The greatest threat to any institution is a major community outbreak.
Against that background, we've responded, but it's absolutely critical not to pretend that anybody, any system is immune once you have a major community outbreak.
Just on individual centres, we’ve heard from the Premier earlier today that some are just trying to move all of their residents out.
He’s kind of indicated they’re giving up in a way.
What do you make of what individual centres are doing? Are you happy with how they are handling things?
Look, overwhelmingly, we understand the actions taken by the centres.
Sometimes the public health units, as in the case of St Basil's, have indicated that large numbers of staff should immediately isolate.
The Victorian Public Health Unit, I believe Alison indicated, all staff.
So imagine a centre where all of a sudden you are given the decision by the public health unit, all staff must isolate, there are then no staff.
And with no notice and no staff, then there is an immediate need for action.
And so we have taken that action. We’ve stepped in and stepped up.
Going forward, one of Joe's fundamental tasks is to make sure where the Public Health Unit in Victoria is considering that, they have to consider two other things – the workforce safety, as was a very important part in fact of what happened in New South Wales, that's an important element of how New South Wales was able to manage it.
And then secondly, to make sure every resident who does need hospitalisation is given it.
We had a very concerning report yesterday from Bupa, a major provider, that they had extreme difficulty getting patients into public hospital. That's not acceptable.
Where there are patients that need that support, they must be given it.
There can be no excuses. The beds are available. The workforce is available.
We have one of the finest public health systems in the world here in Victoria as well as around Australia, and that is, like every case, every day for tracing, every resident who needs that support must be given that access.
Would you be comfortable with family, a friend, a loved one living in one of these aged care homes in Victoria? These privately run ones?
My father lived in one, yes. And.
Are you happy with the conditions now?
It's a difficult decision for any family and it's a difficult time.
My father lived in one, and we knew that that meant he was in the later stages of his life.
I cannot imagine better care that my family and my father could have got, and I speak, I think, for hundreds of thousands of families around the country.
So, yes. And the idea that our carers, that our nurses are not providing that care, I think, is a dangerous statement to make.
They are wonderful human beings and I won’t hear a word against them.
Because the Premier today has said.
I will not hear a word against them.
Minister, you say that this couldn't have been anticipated, yet coronavirus has been in the community so there's always the potential for a community outbreak.
No, I didn't say couldn't be anticipated.
The important point is that where you have mass community transmission, wherever it is in the world, once it's deeply within that community, then the risk of transmission from healthcare workers, as we're seeing in Victoria, where there are very, very high numbers of hospital staff, through no fault of their own but is representative of the community, as well as aged care workers, is real and transparent.
The best defence is low or no community transmission. Sorry, I interrupted.
My question is about foreseeability. So, this was a potentially foreseeable event that has happened –a community outbreak in Victoria that gets into aged care.
So why wasn't there a workforce planned to account for that months ago?
Well, there is, and there has been. And that's exactly why we’ve been able to step in.
But when there are enormous numbers of workforce who are not just ill but as a consequence, for each worker who is ill, there are huge numbers that are isolating.
Then that has an impact on the Victorian system.
They have had their challenges. They are rising. They are rising to the occasion, but sometimes there is a pretence that awareness and preparation can prevent the community transmission having an impact on nurses, doctors or aged care workers.
They are part of that community.
And so, once you have a catastrophic hotel quarantine breach which leads to a catastrophic community transmission, then that is part of the environment which everybody has to manage.
The fact that they've been able to step up- imagine the circumstance of St Basil's, where 100 per cent of the staff were immediately furloughed on a public health order.
Then we've actually gone in, stepped in as a consequence.
There couldn't have been a more difficult situation, and Alison and her team were in there, and they have saved lives and protected lives, precisely because of the preparation that was put in place.
Sorry, how long do you expect the intervention, with nurses going into aged care homes to last? Do you have a timeframe on that?
For as long as there’s a serious public health outbreak in Victoria.
And do you anticipate nurses from other states – you mentioned South Australia – coming on board if the workforce here gets fatigued, like we had in the bushfires for example?
Well, we're operating as one country, and in the same way that we've assisted other states at other times – for example in north-west Tasmania, AUSMAT came in with the ADF to assist – we've had a free flow of people across borders to assist on multiple occasions in multiple ways. And- so I won't put a timeframe.
It's about need. So I might turn to those who are on the telephone. To Dana.
Thanks, Minister. Just two questions. First of all, how satisfied have you been with Victoria's contract tracing efforts early in this outbreak?
And also, what is happening with the aged care workforce support package that the Federal Government announced nine days ago?
Sure. So, firstly, in terms of the contact tracing, Victoria is working very, very hard to track down every case every day.
The ADF has come in to support them.
They've been dealing with some of the residual cases, and I recognise that when they went from minimal number of cases a day – in parts of June it was as low as zero community transmission cases in Victoria a day – to hundreds and hundreds.
That's a large challenge, but with the support of the ADF, real progress is now being made, and that's fundamental to flattening this curve.
And, you know, we're going to get there.
In terms of the aged care support package, I understand Minister Colbeck will have more to say. But we have just announced AUSMAT, interstate nurses, 5 million masks and 500,000 face shields as part of that.
A question for Joe Buffone. Obviously, you've got significant experience in Victorian emergency management.
I'm interested in your thoughts, since arriving over the weekend to man the aged care response centre, what sort of weaknesses and shortcomings have you identified in Victoria's emergency management structures and protocols that are in place?
Tom, Joe Buffone here.
Look, it's not about identifying weaknesses.
This is actually around the unification of effort, and the emergency management arrangements are absolutely sound and, you know, have been demonstrated over many, many, many years to work effectively.
But this is about unifying the effort across a range of different players that probably normally would not operate in the emergency management space.
So that's the main focus with that.
We are embedded in the State Control Centre. We work literally side-by-side with the State Control Centre, with Department of Health and Human Services here in Victoria.
That's the main focus of it.
Thanks, Minister. Just continuing on the contract tracing issue, towards the end of June, Victoria was reporting already in only 15 to 20 cases, the overwhelming majority were either under investigation or not connected to a source.
New South Wales is recording similar numbers to what Victoria recorded a month ago, but only one- today no cases under investigation.
Is that what led you to say that New South Wales is in a very different place to Victoria? And do you think that the state's avoided a second wave?
So, New South Wales is tracking down the cases on a daily basis.
They are able to provide a report to the Chief Medical Officer, Professor Paul Kelly, on a daily basis, where they can run through each case.
They can run through the source, the origins, the movements of that individual, the contacts that have been identified.
And that's why we're seeing what we regard as being stable numbers, but always we want to drive toward zero.
So at this stage, we believe that they are doing everything that they can do but, most significantly, everything that they should do.
So I want to acknowledge that work that's being done.
Around the country, everybody is having a real fundamental commitment to supporting each other.
So these are difficult times – a major outbreak of a deadly disease.
And yet, as we see with our nursing staff, as we see with our ADF, staff that worked right through the night having worked through the day in aged care facilities, Australians are coming together and I think at this moment it's very important to leave two messages.
One is the Australian community is rising to support Victoria, is stepping in, and that's an extraordinary thing.
The second is that we will get through this. It is difficult. It is agonising. There is human loss. And to recognise that is to see the pain of what is a global pandemic, and it is a global pandemic.
But get through this we will, because our resolve is clear, our capacity is absolute, and the organisation of our amazing leaders such as Alison and Joe and others, will help steer us through, and, ultimately, this is something that we will defeat. Thank you very much.
Minister, do you think we’ve reached the peak?
Look, I'll let the numbers speak for themselves. We won't regard it as being on a downwards trend until we've seen seven days of consistent improvement. Thank you.
And just in terms of responses to families, there’s been some families that have complained in the last week or so that they haven’t been able to get information about their loved ones. Are you trying to improve that situation? Is that a concern for you?
Well, we've stepped in to make sure that those actions are being taken.
For example, a centre has had all the staff put on furlough for public health reasons, then we've stepped in to take that action. Thank you.