Minister for Health and Aged Care – Adelaide press conference – 1 January 2023

Read the transcript for Minister Butler's press conference in Adelaide on the COVID wave underway in China.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: First of all, Happy New Year. Thank you for coming out on a very warm Sunday New Year's Day. As people are aware, there is a very significant COVID wave underway in China. This follows the decision of the Chinese government about three weeks ago to lift most COVID restrictions that have been in place in that country for some considerable time.

The lifting of Chinese border restrictions on the 8th of January, will also see a large increase in travel between China and Australia and between China and other countries. I want to stress that the Government welcomes the resumption of travel between Australia and China. We know that there are many, many hundreds of thousands of Chinese Australians who have been unable to see family and friends for months in some cases for years and their ability to do that, over the coming period will be a matter of considerable joy to them, particularly as we head into the Lunar New Year period. I also know that universities and university communities are eagerly anticipating the welcome of significant numbers of returning Chinese students over coming weeks to return to their studies in Australian universities, and I know also that the tourism industry will welcome the economic activity that comes from the resumption of travel between one of our largest tourism markets and Australia.

Over the past three days, I've received written and verbal briefings from the Commonwealth Chief Medical Officer Professor Paul Kelly, about the emerging situation in China. Professor Kelly has also met with his state and territory colleagues, Chief Health Officers of all of the jurisdictions to discuss that emerging situation. There is a broad consensus among all of the jurisdictional Chief Health Officers and Chief Medical Officers, that the resumption of travel between China and Australia poses no immediate public health threat to Australians. There's a very broad consensus, and the Chief Health Officers I think, would want to stress that Australia is well positioned right now in the fight against COVID.

We have very high levels of vaccination, particularly in cohorts and the population who are more vulnerable to severe disease or hospitalisation. We have very broad access to testing and to highly effective antiviral treatments. We have strong surveillance systems in place, particularly the genomic sequencing of our tests to ensure that we understand what variants of COVID are present in Australia, as well as wastewater testing across the country. And it's clear from the Chief Health Officer advice that it appears that the Omicron sub-variant BF.7, that appears to be driving the wave right now in China has been present in Australia for several months, probably since the middle of 2021.

Nonetheless, the Australian Government shares the concerns that have been expressed over recent days by a number of other governments, and importantly, by the World Health Organisation, about what the World Health Organisation described yesterday, as “the absence of comprehensive information” about the situation in China right now.

In particular, the World Health Organisation has pointed to the lack of a clear global understanding of the genomic sequencing of cases in China. That genomic sequencing has, in more recent times, at the very least, been shared largely in real time by other countries around the world and is critically important in the detection of new variants of the COVID virus. That lack of comprehensive information has led a number of countries in recent days to put in place various measures - not to restrict travel from China, it's important to say - but to gather better information about what is happening epidemiologically in that country. Countries like the United States, Japan, India, South Korea, Malaysia, Italy, Spain, and in the past 24 hours, England and France to name a few. Those countries, or the arrangements put in place in those countries, largely require testing before arrival in a country like the US or others - testing to happen largely before the departure from China - as well as a range of other measures that have been put in place across the world to collect better information and data.

The World Health Organisation, as I've indicated, described yesterday such measures as, in their words: “understandable” “in the absence of comprehensive information” about the situation in China right now.

In light of that lack of comprehensive information at this point in time, the Government has decided, out of an abundance of caution, to require travellers from China to submit evidence before boarding their flight of a negative COVID test. This arrangement will come into effect 12:01am on the 5th of January, in line with the timing of arrangements from a number of other countries, including the United States and England.

As well, the Government intends to put in place additional measures to collect information, as recommended to me by the Chief Medical Officer. Those arrangements include exploring the feasibility of wastewater testing from aeroplanes. This is a measure that was really an innovation in Australia and is being picked up right now across the world in places including the United States and Europe. Also, reviewing and strengthening our community wastewater testing arrangements across the country. The possibility of voluntary sampling arrangements at airports for arrivals or inbound travellers to be tested upon their arrival into Australia. And fourthly, strengthening our arrangements for the follow up of people in Australia who test positive within 14 days of having been overseas.

I want to stress that these arrangements have not been put in place lightly. I want to stress again, that we warmly welcome as a Government the resumption of travel between our two countries. This is going to be a wonderful thing for families who haven't seen friends and relatives for months, if not years, as I said, particularly as we lead into the Lunar New Year period. It's also going to lead to really important economic activity, particularly in the tourism and international education sectors. And as other countries who've put in place these arrangements have done, I also want to stress that this is a temporary measure, reflecting the lack of comprehensive information right now, about the situation in China.

Happy to take questions.

JOURNALIST: Will this impact relate trade relations with China?

BUTLER: Well, I want to be clear that this is a measure that's been put in place by a range of countries across Asia, North America, and Europe, and a measure or a series of measures described by the World Health Organisation in the past 24 hours, as understandable. This is a modest measure, to require travellers from China to submit a negative test before boarding their aeroplane. There are a range of other measures that we're going to put in place here in Australia, that will have no impact on those travellers directly: measures to improve the surveillance or the gathering of information here in Australia. And I don't expect that to have any broader impact.

JOURNALIST: Minister, are they PCR tests, or are they RAT tests that they need to qualify for?

BUTLER: We will provide further information in the very near future about that. The important thing is to ensure that those tests are verifiable, and robust. Different arrangements are being put in place across the globe right now. We will be very clear, we're talking to airlines right now and other agencies about that. And further information about that will be provided in the very near future, including on the Smart Traveller website.

JOURNALIST: So what did Professor Kelly warn you about? Particularly, if we know that the main variant is already here has been here for some months? If we know that, you know, that, certain experts have said there's not a particular risk of you know, increased infection because COVID is already peaking in Australia. What was the warning about that lack of knowledge? What was he particularly concerned that might happen?

BUTLER: We will publish the advice that was provided to me by Professor Kelly. I don't particularly want to seek to paraphrase his advice. What I did say earlier in my remarks, is that all of the Chief Health Officers share a broad consensus that Australia is well positioned in the fight against COVID, right now. Well positioned in the fight against COVID in an environment largely of open borders across the globe. And I think Australians broadly welcome that: welcome their ability to travel, welcome their ability to reunite with family and friends overseas or here in Australia with them travelling here.

But out of an abundance of caution, a range of countries have taken the view that we need to put in place some arrangements while we get a more comprehensive information about the situation in China. This is developing very quickly; I think all reports indicate that. Case numbers are climbing very quickly. And there are concerns in an environment of cases spreading so quickly about the possibility of the emergence of a new variant. Now, there's no evidence of that right now, this is a measure taken out of an abundance of caution to provide Australians and the Australian government with the best possible information about a fast evolving situation.

JOURNALIST: So do you accept with no evidence of sort of what you've just said that this is as much diplomatic decision as it is a health decision?

BUTLER: No this is a measure taken out an abundance of caution to provide the Australian Government and community with as much information as we possibly can get about a fast evolving situation. We welcome the resumption of travel between our two countries, it's going to be a great thing economically. And for many, many tens or hundreds of thousands of people who've been separated from family and friends. But the World Health Organisation has pointed to the lack of comprehensive information about the situation in China - a fast evolving situation. That's why they've described these measures which have been taken by a wide range of countries across Asia, North America and Europe as understandable.

JOURNALIST: Do you accept this will have diplomatic implications, what has China's response been to this?

BUTLER: The Government informed the Chinese government this morning about our intentions. I'm not aware of a response to that. But these are measures that have been put in place by, as I say, a range of different countries across Europe and North America and Asia. It won't come as any surprise to the Chinese government with Australia putting this arrangement in place, I think, given the broad range of countries that have taken similar steps over the last 48 to 72 hours.

JOURNALIST: You're essentially saying that the Australian Government doesn't trust the information that's been provided by the Chinese government about the outbreak?

BUTLER: The World Health Organisation ultimately is the best arbiter of that and they have pointed, as I've said over the last day or two, to the lack of comprehensive information about the situation in China, given the size of the population there and the size, evidently, of the COVID wave that is underway there. Of course, all other nations of the world will be concerned about the emergence of variants as they are in other COVID hotspots around the world, as we have been over the last three years. So in the absence of that comprehensive information right now, at this point in time, we're putting these plans in place these measures out of an abundance of caution. We want those measures to be temporary, we'd love to see them be very short lived. But they reflect a lack of comprehensive information that not only Australia has, but the World Health Organisation has pointed to in recent times.

JOURNALIST: So surely the Government is worried that this could impact the progress we've made on trade sanctions?

BUTLER: We don't take these decisions lightly. We don't put these measures in place lightly. They are well-calibrated after we've taken advice from the Chief Medical Officer. He's consulted with the Chief Health Officers, we've had a look at what's happening around the world in like countries, and we've paid particular attention to the views expressed over the last 24 or 36 hours from the World Health Organisation.

JOURNALIST: So is the Trade Minister going to go to China in February to meet his counterparts?

BUTLER: That's a matter for the Trade Minister.

JOURNALIST: Does China have the resources to test these departures out of their country?

BUTLER: China is a well-resourced country. And I'm very confident that these measures will be able to be actioned by travellers from China, whether they are Chinese or Australian citizens who are currently working and living in China, will be able to access the sorts of tests that not only Australian Government is going to require before departure. But as I've said, governments from India, Malaysia, Japan, South Korea, United States, England, France, Italy, Spain, and others, I'm sure. So this is a modest measure. The requirement to have a test within 48 hours of departure, we think is a response that's modest and well-calibrated to the lack of information we currently have about this fast evolving situation and will be a relatively minor impost on people who are wanting to travel to Australia will welcome them here, whether they're coming to see friends or relatives as tourists or as returning international students.

JOURNALIST: Can I ask you, a number of measures about COVID-19 are actually changing today - funding arrangements, things like that. You said Australia's well positioned, but the wave that was meant to be over by now continues, the burden of long COVID continues to grow. The state and federal governments haven't really firmed up their position about who's going to pay for long COVID care and in what form it'll take around the country. Well, how are those discussions going and where do you when do you hope to have some some firm responses to these things bedded in?

BUTLER: There were a range of questions in that one. Let me deal with the long COVID situation first of all. Obviously, there's a great deal of concern across the world about a range of phenomena that have been described as long COVID. That description refers to a range of different things that may well be symptoms that that endure for up to three months beyond the actual infection but largely resolve after that. Long COVID can also come in the form of quite specific symptoms, for example, cardiological symptoms that require cardiological treatment. More worryingly or more difficult to diagnose is some of the multi-system disorders that people are experiencing for a considerable period of time after their infection, leading to things like fatigue, brain fog and a range of other symptoms. These are difficult to diagnose, difficult to treat. I'm very glad that the House of Reps Committee on Health decided this as their first inquiry. They're expected to report very early in the new year. And I think that will add a lot to the evidence that we have here of the prevalence and the particular nature of long COVID in Australia, because it will differ from other countries that have big spikes and COVID cases before widespread vaccination, for example.

Ultimately, I think the treatment of long COVID will largely happen in the primary care system. And as you know, the primary care system through Medicare is largely funded by the Commonwealth. We're set up, we're well set up to deal with this sort of range of symptoms. State governments have put in place in some areas long COVID clinics as extensions of their hospitals for people to go in and seek some initial advice and some initial treatment. But over the coming months, I think particularly as we get evidence in from this inquiry, which has been very active and received a lot of evidence from experts and patients and medical practitioners alike. I think we'll have much better information at hand as state governments in the Commonwealth to start to put in place and comprehensive measures to what is going to be a very significant burden on our community, certainly a burden on those individuals from impacted by it, but also a burden on our health system.

JOURNALIST: If we could change tack, if that's okay. January 1 obviously with the PBS some changes to that now. What kind of medical conditions will benefit from the PBS prescription savings from today?

BUTLER: A vast range of conditions will benefit from the largest ever price cut in the history of the Pharmaceutical Benefits Scheme - a history that extends to 75 years. Today, medicines for general patients will be up to 30 per cent cheaper than they were yesterday. Only $30 instead of somewhere in the order of $45 per script, will be the bill that general patients face when they go to pharmacists. This is going to be of enormous benefit to as many as three and a half million patients. If you're a family with three general patient scripts to fill every month, you may be saving as much as $500 every single year because of this cut to PBS medicine prices.

Now as we've gone through the community, talked to pharmacists and talked to patients, but particularly pharmacists, it's become very clear to us that this cat is not only excellent for hip pockets of millions of Australians’ households, it will also be great for their health. The ABS has told us that almost a million Australians every single year go without filling a script or the defer the filling of a script that their doctor has said is important for their health because they can't afford to. Pharmacists have told us case after case of their customers coming into their pharmacy presenting them with a number of different scripts needed for their family, and asked their advice about which ones they can go without because they can't afford to fill them all. So this is a really great measure at a time of unprecedented cost of living pressure on Australian households. But it's also something that's going to be really good for Australia's health.

JOURNALIST: You mentioned obviously millions of Australians will see a benefit in savings. Concession cardholders the losers here, they tend to be worse off almost about 50 cents a script and then data from the Department of Health showing 90 per cent of those accessing PBS are concession card holders so the changes aren't really benefiting as many people as what the numbers may indicate?

BUTLER: Of course pensioners and concession card holders received a huge cut to the maximum they would pay across the year for their medicines on the 1st of July. On the 1st of July, the maximum that a pensioner would pay across a 12 month period for their medicines was slashed by 25 per cent. So, across the year, a pensioner will pay no more than $5 per week for all of their medicines needs. As I said, a cut of 25 per cent on the first of July. I don't accept that we haven't really made some very significant improvements to the hip pocket position of pensioners and concession card holders. We did that on the 1st of July last year. But what we also know is that general patients are often not on particularly substantial incomes, often on low to middle incomes, but fall on the wrong side of the concession cardholder income test, have been paying some of the highest prices for medicines for general patients in many countries to which we usually compare ourselves. That's why Labor in Opposition took a decision to put in place the largest cut to the price of medicines for those patients, those millions of patients who don't have access to a concession card.


JOURNALIST: Minister very, very quickly, what's your New Year's message and one of the hopes on the agenda 2023?

BUTLER: Australians worked just so hard over the last 12 months to get through the third year of this unprecedented pandemic, they went out got themselves vaccinated, they dealt with some, you know, very substantial waves of COVID, as we started to open up and lift the border restrictions and put an end to the lockdowns that had been such a feature of Australian life through 2020 and 2021. And through 2022, we saw a lot of death, we saw a lot of illness, we saw enormous pressure on our hospitals and broader health system, with huge numbers of cases through Australia through four different Omicron waves: the beginning of the year, in autumn, in winter, and then most recently, over the last couple of months. So Australians had just done wonderfully stepping up to everything they needed to do to protect themselves and protect their loved ones, particularly vulnerable members of their families. And that's why I really wanted to stress that broad consensus of the Chief Health Officers that Australia is really well positioned right now: high vaccination rates, good rates of access to treatment, particularly for older Australians or people who are otherwise vulnerable to severe disease. We’re well positioned, as we move in, it's awful to say, the fourth year of this pandemic, to make sure that 2023 is a much better year than the one we've just had.

JOURNALIST: Just back to this China situation, Minister, how many people who are arriving into the country from China each day at the moment?

BUTLER: Look, we're still getting final details or final information about that, as I say, borders don't fully open in China, until the 8th of January. That's when the quarantine arrangements for returning travellers are lifted by the Chinese government. So I think what most governments around the world expect is a very substantial build in travel from China: you've got Lunar New Year, I know our universities very much looking forward to Chinese students returning to study on campus rather than on Zoom, or over WebEx. So we expect a substantial lift in travel from China, and the Special Administrative Regions over the coming weeks, frankly, not just months.

JOURNALIST: Can you just clarify as well, I know we addressed this stuff, but the type of tests that travellers will need to take prior to boarding the plane and getting to Australia?

BUTLER: We'll put out the finer details of those arrangements in the next day or so and they'll be put out on Smart Traveller as well. As I said, these arrangements come into effect from 12:01am on the 5th of January, so this Thursday, so in four days' time or so. The test must be taken within 48 hours of departure. So we will make sure that any traveller is intending to come to Australia as soon as Thursday, the 5th of January will have good notice of what those arrangements are. We're talking about the final details of those arrangements right now with different agencies of government or also with the airlines.

JOURNALIST: You indicated it was a PCR test, initially, didn’t you?


JOURNALIST: Is it practical to think that PCR tests are going to be made available to Chinese citizens or people in China prior to boarding?

BUTLER: I don't want to freelance on this: we will make our decision very clear about that in good time. The point of principle that I want to stress is those tests, whether they're PCR or rapid antigen test, must be verifiable and they must be robust. And so you know, we're talking to airlines and agencies about that right now. We'll put in place a set of arrangements that frankly gave the most convenience to people who want to come to Australia, travel to Australia from China, but as I said, are verifiable and robust.

JOURNALIST: And just to be clear, what happens if someone arriving from China tested positive? Will they be turned away here at the border? Or will this screening be undertaken prior to boarding a flight?

BUTLER: We'll publish all of those finer details over the next day or so. They'll be published in the usual way including on the Smart Traveller website. Thank you.

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