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Press conference in Melbourne

Press conference with Natasha Fyles, Brendan Murphy and Jenny Mikakos.

The Hon Greg Hunt MP
Former Minister for Health and Aged Care

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Natasha Fyles, Northern Territory Health Minister and chair of COAG.  


We’ve had a very cognitive and constructive meeting this morning. The key agenda items have of course been the coronavirus and the Federal Minister and (inaudible) an update. And all states and territories are working together around coronavirus and making sure that all Australians are protected and that their health and safety comes first.  


We’ve also discussed the bushfires and acknowledge that we are joined by the New South Wales Minister around the bushfires. And of course, our sympathies are still out there to those communities that are working through.  


Even though the bushfires have past, there’s many issues outstanding, and as health ministers, we’re certainly still working in that space. And also the National Health Reform Agreement, positive steps forward and each jurisdiction will now continue to work with the Commonwealth. 


So I’ll now hand to the Federal Health Minister. Thank you. 



Look, thanks very much to Natasha Fyles, who’s done a tremendous job as chair of the COAG Health Meeting, to the Victorian Minister, Jenny Mikakos, who’s shown tremendous leadership, I would have to say, on making sure that not only is the health system prepared, Victoria is the leader in the pathology testing with the principal and national reference laboratory, but also has shown great personal commitment to ensuring that any xenophobia or racism within the community is called out, denounced, and support is given to the Chinese-Australian community.  


Along with the Chief Medical Officer, we provided a briefing both on coronavirus around the world and Australian preparedness in working with the states.  

In relation to the global situation, we are now at almost 83,000 confirmed cases and over 2800 lives lost.  


In particular, since yesterday, when the number of countries which have diagnosed their first case had grown to 42, the latest advice from the National Incident Centre, just prior to coming to the COAG Meeting, is that that now has grown at 49 countries around the world.  


So an additional seven countries in the last 24 hours. That confirms the decision that the National Security Committee took after the very important work of the state, territory, and Commonwealth chief health medical officers in providing advice to the Commonwealth on the risk of pandemic.  


We have determined that that likelihood has been reached and therefore, that's why we have activated the Commonwealth coronavirus pandemic plan. In implementing that today, I want to acknowledge and thank and complement all of the states and territories.  


Their work in preparing the hospitals, their work in preparing their medical workforce, is not just exemplary, it is literally world leading. The 15 cases that have been diagnosed in the general community were all isolated rapidly. They were contained individually.  


There was tracing, or what’s called contact tracing, of everybody who had been involved with those individuals who'd been infected, and that process has led to the containment within Australia.  


Having said that, once we have a global epidemic, we have given the very honest warning and we reaffirmed that today, that no country is immune, but we are as well-prepared as any country and as well-prepared as I had believed we were.  


My judgement coming out of the meeting with the states and territories today is that we were better prepared. They were more advanced than I had previously known. Since our discussions on Sunday as a collective with the states and territories, they have taken even greater strides.  


So, Jenny, in particular, Victoria and Natasha, the Northern Territory, you and other states and territories have done a really powerful job. That’s about confidence to the Australian community.  


Whilst there is a global challenge, whilst Australia will face its challenges, the preparation is real and significant.  


Amongst the decisions today, the Commonwealth will lead an advanced primary care planning process to work with our GPs, to work with our specialists, around the country.  


The Commonwealth will lead an aged care advanced planning process to work with our aged care homes. Already, much work has been done, but we want to make sure that they are fully prepared, fully informed and fully assisted going forward.  


And the Commonwealth will lead work in relation to, in particular, the National Medical Stockpile and medical supply chains. The states will- and the territories will lead the work in relation to the hospitals and any respiratory clinics which are to be established.  


I know there are different models in different states. Queensland, for example, is very advanced with their respiratory clinic planning work.  


And so, those elements should provide confidence to the Australian people.  

I just wanted to set those out, to acknowledge, and to thank all of the states and territories and perhaps, turn to the Chief Medical Officer before Minister Mikakos, to outline any developments with the global and domestic virus assessments. 



Thanks, ministers. So, as Minister Hunt said, we are in a state of preparedness in Australia. We have accepted the very strong likelihood that we will get further cases and some further transmission of this virus in Australia given the international situation, with several countries having sustained community transmission.  


But as Minister Hunt and other ministers have said, we are prepared but we are doing more in our preparation. We need to make sure that every part of our health system is fully prepared and that we have a flexible plan that is adaptable to whatever manifestations further outbreaks of this virus bring. 


As we know, and we’ve said on many occasions, the great majority of people infected with this virus have a very, very mild disease. More than 80 per cent of people have a mild disease.  


Our concern, of course, is preparing for any patients who have the more severe disease that need hospital treatment and respiratory and other support. I do want to reiterate though that at this stage, we are still contained in Australia.  


We do not have any evidence whatsoever of community transmission in this country. So whilst we are preparing and we are realistic about what might come in the future weeks, we are not in a situation where anyone needs to be concerned.  


No one should go around wearing and wasting facemasks, please. We are not wanting the community to panic but we are obviously being transparent with the community that we think the international situation does mean it that it is very likely we will get some more cases in Australia in coming weeks. Thank you. 



Thank you. Jenny Mikakos, Victorian Minister for Health. Look, today, were very happy to be hosting the COAG Health Council here in Melbourne.  


Melbourne of course has played a very important role, particularly at Dougherty Institute has been a world leader in terms of the development of a vaccine to COVID-19. Look, this has been a very, very constructive COAG Health Council.  


We have spent the vast majority of this morning talking about our preparedness as both state, territory and Commonwealth governments, in responding to the threat of COVID-19. And what’s been apparent from the discussions is that we are all working as one, putting politics aside and making sure that we are putting the best interests of Australians first.  


And so we want to reassure the community today that there is a high level of preparedness by all of our governments around the country in how we respond to this evolving issue. The discussions we had today is really about making sure that all parts of the health system work seamlessly together, that is from our GPs and our pharmacists to our hospitals and our aged care sector.  


And so, we've been having very regular phone conversations but it was great to meet face to face today and to be able to continue those conversations. 

Our chief health officers have been doing stellar work, they’re in daily contact with each other and we had the opportunity to acknowledge the work of Professor Brendan Murphy and but also all of our chief health officers in making sure that we’re giving up-to-date health advice to the community. 


We haven't never tried to downplay these issues here. We’ve been very candid with the community about the risks that are involved. We don’t want people to be alarmed. The risk still remains low in Australia at the moment but we know that the situation internationally is evolving and we need to be prepared for what is coming.  


So we will continue to provide regular updates to the community but most importantly, we are getting on with the job of making sure our health system in Australia will be able to respond to this issue. Thank you. 



Great. Happy to take your questions. 



Is the greatest risk likely to be in aged care? 



Within Australia, we have identified- because of the nature of the coronavirus around the world, that the elderly are the most vulnerable, that is clinically well-established. I think the last figures that I saw was that the median age for loss of life was about 71 and a half.  


And that means that those that are elderly and in particular those that have difficulties with immune system are most at risk and that is why that’s our absolute top priority. 



In terms of what is being stockpiled by way of resources and whatnot, is there enough masks and hands gels, sanitisation, does Australia have enough? And is there an issue with getting those supplies in? And also, if those supplies are activated, how will people access them through the GP and pharmacy? 



Sure. So firstly, we are well stocked. The national medical stockpile includes approximately 20 million masks and we’ve already provided some through the bushfire crisis and some through the- what are called the primary health networks.  


One of the things that we did focus on was making sure that we do have strong supply chains. That’s part of our job; that is one of the items that is a specific Commonwealth action item. And so we’ll continue to go forward.  


We’re well-prepared and as the Chief Medical Officer has said, even though it seems like a very basic point, soap and water are, you know, as good a hand hygiene as anything else. Brendan? 



Thanks. Obviously, medical supplies are an important issue and we’re obviously looking at all things, not just masks in particular, equipment and all consumable supplies. But many of those supplies do come from China.  


We’re doing a lot of work to make sure that we- what we take stock of what we have nationally and make sure that we can replenish what we need to.  

So there's a lot of work to be done in that space. 



In terms of access though, how would that work? If you did activate some of those supplies? 



So our stockpiles, the states and territories also have stockpiles. The priority is obviously to protect frontline clinicians and we will work with states and territories, primary health networks or any other bodies to make sure that supplies are delivered to where they are needed. 



(Inaudible) most Australians will end up getting coronavirus? 



I think it’s too early to make any predictions. There are lots expert views. I think that is one scenario but his scenario- is talking about it over a long period of time and becoming an endemic virus. One of the things we’ve learned with pandemics or significant outbreaks is you don't want to be too rigid in your planning and your expectations.  


We don't quite know how this virus, if it comes to Australia, will behave, whether it’s a slow spread or a more rapid spread. We just need to be prepared for all eventualities and be flexible. I’m not- I don’t think it’s helpful to make any absolute predictions. We made them in the swine flu pandemic and we got them wrong.  



(Inaudible) Commonwealth planning for aged care homes, if there is a case at an aged care home what’s the planning (inaudible)? 



There are a number of options and they all depend on the circumstances in any aged care home.  


Professor Murphy will be leading a planning workshop with the aged care sector and the states and territories will be involved on that.  


We’ve already been doing considerable work. So of course, the first is to provide the capacity for a patient to be isolated within a hospital.  


Second, if this were a very advanced epidemic within Australia, the capacity for isolation within and then the third would be alternative arrangements. But if you think of those as stepped levels or what we call, rings of containment, we’re working on those rings of containment approach. 



Did the states ask for more money today to deal with the coronavirus?  



What we agreed was that we would assess the resource requirements in both Commonwealth and state going forward. So our primary focus today was on preparedness and I thank all of the states for that. 



(Inaudible) concern that they don’t have enough supplies, that they’re not prepared enough to face this crisis, should they be more involved in this process and what can we do to help (inaudible)?  


So I want to thank the AMA and the College of GPs who’ve been outstanding leaders in working in those sectors. We've been in constant engagement with the general practice community but next week, again, the Chief Medical Officer will be leading a roundtable with the general practice community.  


And we've already responded to and provided resources through the national medical stockpile and it has been mobilised along the way.  


We provide the masks to primary health networks and where they’ve required them, they been able to access them. So I’m speaking later today with the heads of the AMA and the College of GPs and it’s literally a constant daily engagement. 



(Inaudible) the number of new cases outside China? Is there a need to look at wider travel bans beyond China now? 



So the general principle is that foreign affairs and trade is taking the advice of the chief health medical officers. This is the body known as the Australian Health Protection Principles Committee. The chair of that is Brendan.  


And if they recommend, then we implement. But we’ve been following the medical advice as the basis for any travel advisories or travel bans. 



In that vein are you concerned about the Olympics in Japan and the Australian athletes travelling there given that they are closing schools down and so on at the moment? 



So Japan at this point is in a containment phase and they’re taking their steps to actually, I think, get ahead of it. And we, you know, appreciate and acknowledge what they are doing. I think that they are preparing now so they don't have to face that eventuality.  


But our priority is very clear. In the same way that Jenny and Natasha are focused on the health of the citizens, we are focused first and foremost on the health of our athletes.  


We haven't hesitated to take decisions in the interest of the health of Australians, even though they may have brought other consequences, such as economic consequences and we won't hesitate to do that. But the question of the Olympics will be determined in some months.  


Japan and the IOC will be making global decisions, but Australia will be a part of that process. 



What’s your latest thinking on the Grand Prix and other similar mass attendance events in Australia?  



The message from today, from the states and territories, was go about your ordinary business. Go about your ordinary business. Go down to the Chinese restaurant, go out to the football or the Grand Prix or the netball. At this point, coronavirus is contained in Australia. 

The messaging of this week is because of the global spread, there is a high likelihood that it will come to Australia at some point. Our message is that we are prepared for that moment because we are not immune but it is very important; go about your daily business. 



Just on the preparations, have you looked today at plans today for schools, like we have to? 



I’ll let Jenny talk about it. 



Close them down or those sorts of. 



Sure, thank you. Well of course, as part of our planning, we're looking every possible scenario.  


So we're looking at contingency planning, whether we’ve got moderate risk to the community, moderate spread of COVID-19, right through to severe.  


And of course, we won't be ruling things in or out. It’s important that we tailor our responses accordingly based on need. So at this point in time, there’s certainly no need for us to be envisaging doing that. But of course, we need to look at what the risks may be.    I should point out, and of course Professor Brendan Murphy can add to this as well, that the risks to children has been a very low one.  


We’ve not had children who have been severely impacted by this. It’s tended to be elderly people who’ve been most ill. But of course, we need to respond to the situation as it arises.   


I just wanted to make one further comment, if I could, around the supply chain, because we’ve had questions about that before. And the need for us to be nimble and respond to the evolving situation. Of course, a lot of our supply chain, our suppliers, are actually from overseas.  


As demand grows internationally, and perhaps some supplies in China might be impacted by their own local manufacturing having been shut down, we need to be innovative. We need to nimble. So Greg and I have been having discussions around local manufacturers here in Victoria that might be able to scale up their production.  


We might be able to look at a local company here that might be able to scale up production of face masks for example.  So they are the types of conversations we are having. 


We are planning for every type of contingency here. And we need to be prepared for the worst. We hope for the best, but we are preparing for the worst, of course. 



How likely a scenario- I know we have to consider from one extreme to the other. Based on the fact that most cases have been (inaudible) we do expect Australia to get more cases. What would you tell Australians to be prepared for? Will we see loads of elective surgery cancelled so hospitals can respond? Will we see clinics set up in every state? What’s the most (inaudible) here? 



I will ask Professor Murphy of course to respond, but as part of our planning as states and territories that run our hospitals, of course we are looking at all these contingencies.  

So as I said, we are looking from the moderate through to the severe. It may well mean that elective surgery is either cancelled or moved to private hospitals.  


We are exploring capacity with the private hospital system so we can free up beds, both admitted places and in our ICU. So we are looking at all of the possibilities if the need presents.  

We have had temporarily clinics set up in the Royal Melbourne Hospital Emergency Department when we had our first cases here in Melbourne.  


That is no longer operating now, but if we get further cases, of course, we will look at setting up dedicated respiratory clinics in our emergency departments so we can ensure that our emergency departments aren’t overrun with patients.  


Of course, our primary carers, our GPs will play a fundamental role here. They will probably be seeing the vast bulk of patients, because most patients will be moderately sick, and so they’ll be able to get the care that they need, recuperating at home and getting the support they need from their GPs and local pharmacist. But I’ll ask Professor Murphy to add more to this. 



Thanks, Minister. So as I've said before, it's really hard to predict. What we are going to try and do when we get our first cases, if we get our first cases is to try and contain as much as possible by isolating people in their homes. Most people would need hospital treatment. 


We probably will be setting up dedicated primary care clinics, either through state and territories or through GP practices, through the PHNs, trying to get people who get infection to isolate at home and delay the spread. So there are lots of models, but one scenario would be over two to three months.  


You had a slow spread of infection amongst a part of the community, but with a small number of people needing hospital treatment for severe pneumonia. If that is a bigger number, that could have significant impacts on the hospital system and the sort of things Minister Mikakos said.

But I think it is very important we remember how well-prepared we are, we remember how mild most people get this disease, and we just take it at a proportionate and careful way as it comes. 



(Inaudible) It’s also known that our hospitals at the moment are struggling. The emergency departments are- we hear every year, especially. 



(Inaudible) Correct, but there is a lot of elective work that hospitals can do. There’s a lot of diversion that hospitals can do. And in previous occasions, they’ve shown they can step up, increase capacity, delay or cancel elective work.  


So we have lots of contingency plans. Every state and territory public hospital is well prepared. Now I just say something about Children.  


I think Minister Mikakos said that one of the surprising features about this virus is how few children seem to have been identified as infected. Its’s very unusual compared to, say, influenza. We don't know whether children might be getting the disease, but are so mild they are not being picked up, they’re not becoming sick, or whether they are somehow less susceptible. 

That’s going to be a really important thing to find out. But whatever the reason, the fact that we're not seeing lots of children getting sick in China and other parts of the world is a great thing. 



One more here, and then we’ll have to go. I apologise. 



Whether there are any quarantine facilities is being looked out? Because you said people might not be sick enough for the (inaudible). 



Yeah, so, we are fortunate in that Christmas Island is the principal national quarantine facility. And those that went there, even though there was some questioning beforehand, gave a very positive account of just the extraordinary support they had, both from Border Force, from Defence, and, in particular, from our AUSMAT medical teams.  


And here, Natasha, I want to thank you, Howard Springs and the Northern Territory community, who have hosted two waves of people that have been evacuated and brought back to Australia. And then we are continuing to work and we did discuss this today, with states and territories on options.  


But it would always have to be a double green light, it would have to be something which the Commonwealth felt was a sufficiently secure quarantine facility, but which was approved and considered appropriate by each individual state. 



You can't identify something closer to home in each capital for those purposes? 



Look, all of the states and territories are looking at what is appropriate for their needs were there to be a significant expansion. I will finish on one other very positive note.  


We've announced today that Kyleena, a contraceptive, a long lasting contraceptive will be available; 200,000 women will have access to a low-dose slow release contraceptive on the Pharmaceutical Benefits Scheme from 1 March.  


It will generally operate up to five years. It’s simply about choice and flexibility. So it’s been a big day. Important developments on many, many fronts. It wouldn't have happened without the support of the state and territories.  


And you know, there are many challenges in running a country. But one of the things Australians can really understand is when the chips are down, when there are challenges that sense of one unified Australia has been there.  


And that's really something that Australians can be proud of and something which can give Australians a real sense of hope that we will get through this. Thank you. 



Brendan, just quickly, do you have an update on the Perth case, the one that’s in isolation?  



No, I'm afraid I don't. 


No, okay. Thanks.

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