Minister Butler press conference in Adelaide - 7 July 2022

Read the transcript of Minister Butler's press conference on new advice on fourth COVID-19 doses; vaccination strategy and capacity; vaccination information campaign; masks.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MARK BUTLER, MINISTER FOR HEALTH AND AGED CARE:

It’s very clear that across the country now we’re still only in the early stages of a building third Omicron wave, just this year alone. It is a wave that is driven by new subvariants of the Omicron variant – BA.4 and BA.5 and it’s becoming a very serious pressure on our health and hospital system.
 
What is clear about BA.4 and BA.5 is that they are even more transmissible, even more infectious than the earlier subvariants that drove the summer wave, the BA.1 wave in January and the BA.2 wave in April and May. They are more transmissible. But what is particularly unique and different about BA.4 and BA.5 is that they are very good at evading people's immunity. So if you have immunity through vaccines, or through having had COVID before, you are still susceptible to the dominant subvariant of COVID in the community right now. Just because you had COVID earlier this year does not mean you are now not at risk of getting COVID again with this third Omicron wave.
 
As I said this is placing real pressure on our health and hospital systems. States across the country are reporting increased numbers of cases and increased numbers of people requiring admission to hospital because of COVID. There are now almost 4000 hospital beds across the country filled by patients with COVID. That's an increase of almost 1000 in just the last few weeks. And the number of people in Intensive Care Units or ICUs is up 40 per cent in the past week or 10 days alone. And we're only just at the early stages as I said.
 
Now being up to date with your vaccines is crucial to protecting you against the risk of severe disease and particularly the risk of hospitalisation or worse. As I said, even if you have had COVID before. There was a terrific take up of the first two doses of vaccine in Australia once the vaccines finally arrived in this country. We have one of the highest rates of double dose vaccination in the world. But what we know about the Omicron variants is that two doses of vaccine is simply not enough to give you protection. Even if you have been infected.
 
There are still more than 5 million Australians for whom it has been more than six months since their second dose, who are eligible for a third booster dose but have not taken it up. I urge you to go out and get that third dose. It will provide you and people around you with more protection against this highly infectious subvariant BA.4 and BA.5.
 
For more than three months, over 65 year olds and other groups as well have been able to get a fourth winter boost dose. But that again has not been fully taken up. More than 40 per cent of people over the age of 65 have not yet had their fourth dose. Again, I encourage you to do that. Older Australians are far more susceptible to the risk of severe disease or admission to hospital under these subvariants. It is crucial that you get a fourth booster dose as soon as possible.
 
Now this morning, I've decided to accept further advice from the technical advisory group on immunisation to expand the fourth dose through this winter to a much larger group in the population. Until today, the fourth dose was available only to Australians over 65, to Aboriginal and Torres Strait Islander Australians over the age of 50 and a range of younger groups at particular risk of COVID illness, including younger Australians with a compromised immunity. Today that group will expand dramatically.
 
There are three elements to this decision I just want to run through. The first is that from today, the technical advisory group on immunisation has recommended that all Australians aged 50 and over take a fourth dose of COVID vaccine. So, all Australians aged 50 and over.
 
ATAGI has also recommended that for Australians aged between 30 and 49 who feel that they want to take a fourth dose, that will be available to them but will be an individual decision. It is not a specific recommendation of ATAGI.
 
And the third element of the advice I've accepted today is that the interval between doses of vaccine or the interval between having been infected with COVID and getting your next dose of vaccination has been narrowed from four months down to three months.
 
Now, this decision that I've accepted will reduce severe disease and will relieve pressure from our hospital system. The decision takes effect from the coming Monday the 11th of July to give primary care providers, in particular our community pharmacy sector, the thousands of GP surgeries that have been working hard to deliver vaccinations now for some time. It gives them time to start making bookings. There are almost 10,000 points of primary care, pharmacies, and GP surgeries where you can go and get this fourth dose. We have lots of capacity in the system. They're running at a much lower level of activity than they were at the peak of vaccinations last year, about 80 per cent lower, so there's lots of capacity in the system. And there is lots of vaccine in the system, more than enough to accommodate first of all, people catching up with those booster doses I've said they're overdue for, their third dose or even their fourth dose if they are over 65s, as well as the impact of the decisions I've just announced today.
 
Can I reassure Australians that our government is absolutely committed to doing everything we can to get Australia through this difficult winter. Already in just a few weeks of government, we've extended the funding to state hospital systems to help them with the impact of COVID, a decision worth more than three quarters of a billion dollars, a decision made by the Prime Minister, Premiers and Chief Ministers. We've rolled out widespread campaigns over the past couple of weeks, reinforcing the importance of people being up to date with their vaccination and getting those booster doses for which they are eligible. And today I've announced the expansion of this crucial fourth dose to get us through the winter.
 
Finally, I've also put a strong case before the Pharmaceutical Benefits Advisory Committee asking them to expand access to these highly effective oral antiviral treatments, tablets and capsules that can be taken at home and dramatically reduce the risk of severe disease particularly for older Australians and I'm eagerly awaiting advice from that advisory committee about our submission. I'm happy to take questions.
 
JOURNALIST:

Minister, what evidence is there to support allowing people aged 30 to 49 getting a fourth dose?
 
BUTLER:

ATAGI has said in their decision which I've published in the last half an hour, along with my decision to accept that advice. They've said that the evidence of impact of this age group, 30 to 49 year olds, if you don't have another health condition is still a balanced evidence, which is why they've not made a formal recommendation for that age cohort to have the vaccine. What they do say is that if you're in the healthcare industry, if you are worried about the impact that having to isolate if you get COVID has on your life, you should feel free to go out and get that fourth dose.

JOURNALIST:

Why allow them if you're not recommending and there's not a specific recommendation, won't that just cause confusion within that group of the community?
 
BUTLER:

What is clear from ATAGI's advice is that taking a fourth dose will boost your immunity. What ATAGI says is that this younger group aged between 30 and 49 is at relatively low risk. I say relatively low risk of severe disease, hospitalisation, or death. And the major focus of the fourth dose campaign is to reduce that risk of severe disease, hospitalisation and death, which is why there's such a strong focus on people aged over 50 as well as younger people who have compromised immunity or other health conditions. There is no question that taking another fourth dose will boost your immunity, particularly if it's been several months since you had your booster. Some people had their boosters over the course of summer. So, if their immunity is waning from their third booster dose, they will get a boost in their immunity from their fourth dose and that will improve their chances of avoiding BA.4 and BA.5 somewhat. But really, ATAGI has said this is not a cohort that they're primarily worried about in terms of a risk of severe disease or hospitalisation
 
JOURNALIST:

We've seen the slow uptake already on this fourth dose with over 65s. What do you expect the uptake to be for over 30s?
 
BUTLER:

I was critical of the former government, really for not having enough energy behind the booster campaign in the lead up to the election. I think it's really important that all governments and health experts continue to reinforce the message that two doses of vaccine is simply not enough. And for older Australians who are at higher risk of severe disease, even three doses now is not regarded as sufficient. To get fully protected you need to get out and get these booster shots as they become available to you. That's why we rolled out the sort of information campaign that before the election I was calling on the Morison government to roll out, but they didn't. You've seen some states roll those campaigns out. We've got to keep drumming home this message that the pandemic is not over. We're entering a third wave that is placing enormous pressure on our health and hospital system. And we all have a responsibility to be up to date with our vaccinations.
 
JOURNALIST:

Minister, the question was what do you expect the uptake to be?
 
BUTLER:

We don't have a particular number in mind. What we saw was a great uptake of the first two doses of Australians when they had the opportunity to get those first two doses, we had some of the world's best rates of that. We've got to ramp up that information campaign just to remind Australians that two doses now is not enough.
 
JOURNALIST:

Do you acknowledge though that it has been slow, and do you expect it to be slower?
 
BUTLER:

No, I expect it to speed up. We've got the information campaigns out there. States are driving home this message. Health experts are driving home this message and I think Australians are starting to see the impact of this growing third wave on their health and their hospital systems through this winter, compounded by the impact of influenza as well.
 
JOURNALIST:

Why have over 65s been more hesitant to get a fourth dose than say their third?
 
BUTLER:

The fourth dose has been available to over 65s now for about three months and about 60 per cent of over 65s have had their fourth dose. They were very enthusiastic about getting their third booster dose which provided them with good elevated levels of immunity. I do want to reinforce to people over that age group and now to people over 50 as well. A fourth dose will give you added protection against severe disease and the risk of going to hospital. We can't say that message enough.
 
JOURNALIST:

Minister, you talk about enormous pressure on the health system in a looming way. We've also got rising flu numbers, hospitals here are at capacity. Have you got any contingency plans with the states for improvised hospitals, pop-up hospitals?  Converting warehouses into hospitals just to warehouse people who are maybe don't need the intensive care that some cases will need.
 
BUTLER:

The operation of the hospitals is under pressure across the country. It's not just here in South Australia. We're seeing particular pressure on the eastern seaboard right now. I think all hospital systems are expecting that to move across the country over the coming weeks and months. Everyone's been quite upfront about that. Hospitalisation numbers now are about 3800 COVID hospitalisations. That is still a fair way below the peak we saw in January, which was over 5000. But there's no question those numbers are going to continue to increase.
 
At their first National Cabinet meeting, the Prime Minister and the Premiers and Chief Ministers agreed to our offer, the Commonwealth's offer to extend our funding support, which under the previous government was due to expire at the end of September, to extend that through the rest of the year, to provide that additional support to states that are dealing with this pressure on the frontline and their hospital system. Now if it gets much worse than where we are right now, of course, states will be putting in contingency arrangements to ensure that the best possible care is provided to their community and if they require support from the Commonwealth for that beyond the agreement we've already extended, then we're of course open to talking about that.
 
JOURNALIST:

Minister, we're going to see a massive expansion of those people who can get a fourth dose. Are we going to see a situation where millions of people are two doses ahead or two doses behind others and given that disparity, is that going to be a problem?
 
BUTLER:

Even if there's a very quick uptake of this expanded eligibility, which brings in I think about another 7 million people or so to the fourth doses, that is still a level of activity way below the peak we saw in 2021 where people were rushing to get their second dose because the vaccines had finally arrived in Australia. So right now, we're seeing in the community pharmacy sector and GP surgery sector vaccination activity running at only about 20 per cent of the rate we saw at the peak last year. So in spite of the fact GPs and pharmacies are very busy, there is still the capacity to ramp up that effort. And there's more than enough vaccine in the system.
 
JOURNALIST:

You mentioned these particular variants that are driving this new wave at the moment are particularly good at evading immunity. What do you say to the sentiment out there in the community that think the fourth dose might be pointless?
 
BUTLER:

What I will say is that even though this subvariant is good at evading previous immunity, whether that immunity flows from vaccines or previous infection, these vaccines are still incredibly effective at preventing severe disease and hospitalisation. And worst of all, the risk of death. We're still seeing more than 300 Australians on average every week lose their lives to COVID right now. Hospitalisations are right up, ICU admissions are up 40 per cent in just the last week or so. So that death rate unfortunately is not starting to drop away. So I'll just reinforce - although this variant is still very good at evading immunity from infection, getting a fourth dose will boost that immunity around transmissibility but most importantly, we know it is very effective even against BA.4 and BA.5 in preventing severe disease.
 
JOURNALIST:

What do you say to other jurisdictions state governments that might be considering temporary COVID restrictions or mask mandates in certain sections of the community to deal with this new wave? What would you say to them right now? Would you support things like those things?
 
BUTLER:

Our approach to this and I think the approach of most responsible parties has been to follow the health advice through this pandemic. We're now well into the third year of this pandemic. And I think the view across the health authorities, the Chief Health Officers and certainly leaders of government, is that we've passed the time of very broad based mask mandates. Obviously, there are still mask mandates in places where there is a particularly high risk of transmission or high risk of impact or severe disease, so aged care facilities, health facilities, public transport, on planes and such like, and they remain in force really across the country. I think the response to that from Chief Health Officers and leaders of government has generally been not to reintroduce broad base mask mandates in the third year of a pandemic, but to call on people to think very carefully, when they're indoors, and not able to socially distance, to give very strong consideration to wearing a mask. It will reduce the impact of transmission.
 
JOURNALIST:

Do you acknowledge that obviously that there are a lot fewer legal levers available to governments and jurisdictions to prevent this looming wave or to reduce its severity?
 
BUTLER:

Over the course of last year, as Australia was finally able to vaccinate itself as the vaccines finally arrived in Australia, all governments moved to quite a different setting in response to the pandemic. We're able to move away from lockdowns and broad based mandates to ensuring that people were properly vaccinated. We're trying to roll out much more readily these new very effective antiviral treatments to particularly protect people at risk of severe disease.
 
Measures can be more targeted, as I say, at areas of high risk like aged care facilities, and then rely upon individuals to act responsibly on the basis of good health advice which we've seen rolled out over the last couple of days where people do say if you're indoors and you can't socially distance, really give strong consideration to wearing a mask because it will reduce the chances of transmission.
 
JOURNALIST:

Minister, governments across the country during the pandemic pointed to health advice as reasons to change particular things. There is no specific recommendation from ATAGI to expand the fourth dose eligibility for those aged 30 to 49. So, does this decision move away from that move to follow the health advice?
 
BUTLER:

What ATAGI has said here is to make it available for 30 to 49 year olds. It is going to boost their immunity and if they choose to take a fourth dose and they're up to date with their third dose, then that's something that ATAGI has said they will support. But they're not moving to the point of actually recommending it. They've said the evidence for over 50s is very clearly in favour of a broad-based program to try to vaccinate with a fourth dose everyone in the country over the age of 50. The evidence is not there for that between the ages of 30 and 49. And so ATAGI has taken the decision to leave that up to the individual decision.
 
JOURNALIST:

Does that not though then put the jury out to people? I mean, could this then fuel more confusion amongst the community about whether or not they should or they shouldn't and then fuel essentially a slower uptake?
 
BUTLER:

I think Australians at that age group will understand the advice from ATAGI which I've accepted. We are, as we move deeper into this pandemic, well into the third year, moving to a blend of government decisions and individual responsibility. What ATAGI has said is that at this point in time, the focus particularly on younger people should be on getting that third dose if you haven't. But if you have had the third dose and you want to boost your immunity, particularly through this winter, as we see case numbers climbing, then that is something that they support you doing. ATAGI meets very regularly. They've made again very clear that they will continue to update their advice as the evidence becomes clearer about new subvariants, about the impact of this third Omicron wave and also about the impact of changing vaccines as companies start to present variant vaccines that are targeted at these Omicron variants to regulators. So this is not a sort of fixed picture. This is something that ATAGI I think very expertly is updating as this pandemic changes.
 
JOURNALIST:

Does the government have, like it had with the first and second doses and even with the third dose, a goal or a target of the number or the portion of the community to get this fourth vaccine. Are you working towards a target?
 
BUTLER:

We're working to maximise the uptake. We want to see the wonderful response to the first two dose campaign where more than 95 per cent of over 16s now have had two doses of vaccine. Let's work to maximise that number because we know two doses is not sufficient protection against these Omicron numbers. We haven't got a number. What we want to do is to encourage individuals to act on that health advice. Vaccines are widely available, they're free of charge, and they will provide you with much greater protection than you currently have.
 
JOURNALIST:

On ATAGI, why have there been reports of ATAGI discussions leaked to the media?
 
BUTLER:

I’m not going to get into that. I received the advice formally from ATAGI during the middle of this morning. I took time to consider it, I decided to accept it and shortly after that I published that decision and their advice. I’m doing this media conference now and now I’m focused on how to implement it.
 
JOURNALIST:

Just a minor thing, Minister, but have you deliberately positioned yourself with the flags over that way. Is that just a, nothing deliberate?
 
BUTLER:

No, I just walked in. I didn’t set the room up. I only just noticed it now, I just walked from that door, so thank you for pointing that out.
 
JOURNALIST:

Sorry, so just back on vaccines. Given the significant expansion of the fourth dose, will you be encouraging states to reopen mass vaccination hubs and clinics to support GPs and pharmacies already rolling out the vaccines across the country.
 
BUTLER:

I’m very confident that we have enough primary care points for this next stage of the campaign to be implemented. What you’ve heard from across the country is for state governments wanting to bring as many of their, particularly nursing workers, their nurses, out of vaccination clinics back into their hospital systems, which are heaving under pressure over the course of this winter. Some of those state vaccination clinics across the country remain open. It may well be that some of the state governments use those clinics to fast track the fourth dose for their health care workers. Some state governments have talked about that. It’s obviously a matter for them. I understand that state governments will be wanting to shift as many of their healthcare workers away from the vaccination campaign into their hospital systems to deal with this unprecedented pressure we’re seeing right now during this winter. I’m very confident that the Commonwealth-supported parts of the vaccination system, which are the community pharmacy sector and the GP sector, can deal with this. If states continue their vaccination clinics, that’s all well and good. That will contribute to the effort. But I well and truly understand any state government deciding to try and reallocate some of those resources back into hospitals.
 
Thanks everyone.

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