Radio interview with Minister Butler and Patricia Karvelas, ABC Radio National – 5 August 2022

Read the transcript of the ABC Radio National interview with Minister Butler on the COVID-19 response, isolation rules, the monkeypox response and vaccines, primary care and the Climate Change Bill 2022.

The Hon Mark Butler MP
Minister for Health and Aged Care

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PATRICIA KARVELAS: The first fortnight of the 47th Federal Parliament has ended, with the Albanese Government gaining traction on a core election promise.
Labor's signature climate legislation passed through the Lower House. And while it's one step closer to enshrining the commitment to reduce Australia's emissions by 43% by 2030 in law, challenges still lie ahead on the broader questions.
And there have also been developments on the health front, with National Cabinet being briefed that Australia may have seen the worst of the current wave of the COVID Omicron variant, although there is a warning that we will see other waves and outbreaks.
But it isn't the only virus authorities are keeping their eyes on, with increasing cases of monkeypox being reported around the globe and some vaccination news there. The federal health minister is Mark Butler and he joins us this morning. Minister, welcome.
KARVELAS: The chief health officer, Paul Kelly, believes, based on the current hospital figures, that the current COVID wave has peaked. But he talked about a long tail. How much pressure will remain on the health system?
BUTLER: We've been watching these data for a few days now. They've been dropping off for a little while and really importantly, the hospital numbers have been dropping off for a number of days now. They're several hundred below the peak that we saw a couple of weeks ago. But still there are close to 5000 Australians in hospital with COVID. That's close to one in 12 public hospital beds.
There's no question that our doctors and nurses, other hospital workers are still under enormous pressure, although it does appear—we're increasingly quietly confident—that the peak has appeared a little earlier than the earlier feared.
KARVELAS: You were warning of millions of infections before spring. Just how bad was the third Omicron wave?
BUTLER: It was very bad. You know, we were getting 300,000 plus cases per week officially. And we know from sampling blood donation, sampling wastewater, the positivity rates in our PCR systems that the likely number was more than twice that.
We were getting many hundreds of thousands infected every week and that was obviously really hitting the economy hard because so many people were furloughed or isolated. But really importantly was placing enormous pressure on our hospital system similar to the pressure, similar to the pressure we saw in summer with that first wave but it's much harder in winter because hospitals get so many other cases through their doors in winter, as well as flu cases.
KARVELAS: Now, the chief health officer also warned that this isn't the last COVID wave.
AUDIO, CHIEF MEDICAL OFFICER: This will not be the last wave. We will continue to have to plan for that, be ready to know when that's happening and to respond to it accordingly.
KARVELAS: Okay. Sorry about that. Yeah, that is the chief health officer, Paul Kelly. So how is Australia prepared for future waves? We know vaccine booster rates remain low despite the warnings about the winter COVID wave.
BUTLER: We got the third booster dose flights have flatlined, which is something I'm very concerned about. We've been rolling out information campaigns, as is a number of state governments, about the importance of getting your third dose.
There are still 5 million people who are more than six months since having their second dose, and I really encourage those people to go out and get it. Over 65s are doing very well. About 95% of over 65s have had their third dose—highly protective against severe disease—and two thirds of them have had their fourth dose.
The fourth dose program’s going very well. Since we expanded that a few weeks ago we've been seeing more than half a million people get that fourth dose every week. But I am worried about the third dose. In terms of the longer term, Patricia, we've been very focused for the last several weeks in getting through this winter, lifting the number of fourth doses, expanding access to the highly effective antiviral treatments and supporting state hospital systems.
But we're now in the process of starting to plan the longer term because all of the advice is that, unfortunately, this virus is not going away, and we still don't know, there's still not a clear pattern to how it's settled in. It's not become a seasonal virus in the way that influenza is around winter, for example. We're in the process of planning, and as the Prime Minister said yesterday, he and the premiers and chief ministers yesterday again resolved to work together on those longer-term plans.
KARVELAS: I've got some longer-term plan questions that I'm really interested in. I'm often asked from, you know, regular people not connected to the health world or the journalism world. When will isolation end for COVID? We've had this disease with us for a couple of years now. Is that the plan? At some point, are we going to end the isolation for COVID? When do you envisage that happening?
BUTLER: I've got no advice before me from the chief health officers or any public other public health experts for that matter, that there should be an end to isolation at any particular date.
There's no question that people isolating for seven days, as utterly inconvenient and sometimes distressing as that is, it's an incredibly important public health measure. We know that particularly with these Omicron variants, people are highly infectious over the course of those seven days.
And we've seen the data, for example, that people are still very infectious between days five and seven. I know there's a bit of public debate about whether we should drop the days from 7 to 5 as is the case in the US. But there's still a lot of data that shows that on day six and day seven people are still highly infectious. I think this is something obviously like everything that will continue to be closely monitored by the chief health officers as they come together and others as well.
But there's nothing before me, I don't think there's anything before other health ministers—we're meeting this morning actually—to suggest that there's going to be any change to the decision any time soon.
KARVELAS: And in terms of the of first principles, I spoke to the New South Wales Premier some time ago and you know, he was the one agitating for the five days. Okay, that's not happening. But he also said while you have a rule that people must legally isolate, you need payments to follow that. So does that mean you need to have a, you would you be considering that rather than the September deadline, where that's ending?
BUTLER: As the New South Wales Premier said at the time, when he did float the need for a debate about us isolation rules he also said that that now wasn't the time to do it.

Everyone, no one more than state hospital systems who are battling with this third Omicron wave. And although we can be quietly hopeful that we've passed the peak of it, it's still a very significant way of hitting the hospital system.
I think it's all about proper timing here. We've got a lot of work to do still to get through this wave. And then undoubtedly there will be debates as we move into spring about our policy settings, including what you've just raised.
KARVELAS: Okay. So it is on the table keeping payments for as long as you legally require people to isolate.
BUTLER: No, no, I'm not I'm not saying that. I'm not saying that at all.
KARVELAS: That is what I'm asking, though.
BUTLER: I'm not saying that at all. A decision was taken earlier. But in terms of isolation settings and those other public health measures, you know, all of that all of that, I think, is constantly being reviewed and monitored by public health authorities.
KARVELAS: I just want to move to monkeypox, another virus that was discussed at national cabinet. Yesterday you announced that 450,000 doses of monkeypox vaccine have been secured. When are they due to arrive and how will they be rolled out?
BUTLER: 22,000 of those doses are arriving in the next few days. I don't have exactly a date for when they land, but that it's this week or early next week.
These were highly difficult to get hold of. As you imagine, monkeypox has only ever really been endemic in countries in Africa. And in the last 13 weeks, we've seen it spread to 76 other countries, particularly in North America and the UK and Europe.
But we have 58 cases here in Australia as well. So there's been a burst of activity by governments to get their hands on the newest third generation vaccine, which is the one we've got hold of.
We're now only one of a very small list of countries that has supplies coming to us in 2022. I've seen reports already this morning that the New South Wales Government and the Chief Health Officer there, Kerry, Chant has plans to start rolling out those vaccines to high risk groups early next week.
We've been talking for weeks now with state governments about how they'd roll them out. We will not we won't be doing that from the Commonwealth. We've organised the supply and we'll be providing those supplies to State governments to roll out.
But that will happen very, very soon. We'll get the rest of our 100,000 dose order over the course of the next couple of months, for 2022. And next year, we've got 350,000 doses on order as well. That's a very large order pro-rata for our population compared to what we've seen in North America and Europe. So our government's worked very hard—I think we had 27 meetings with the company, Bavarian Nordic over the last several weeks to secure that supply for Australia.
KARVELAS: Given that it isn't a sexually transmitted disease. Are you worried some communities and I'll be really specific here, the gay community, may be vilified. How do you be sort of cautious about the messages around this?
BUTLER: We're really conscious of this. It's important to say that anyone can get monkeypox. And we're seeing cases outside of that community across the world and certainly have over many years in Africa as well. But there is also no question that this overwhelmingly has affected gay, bisexual and other men who have sex with men. So although it is it is a virus which anyone can get children, adults and then virus that can be particularly dangerous for people with immunocompromise or pregnant women. There is a particular community that's been affected.
I'm old enough to remember the 1980s Patricia. Not just the terrifying, tragic loss of life, but also the awful stigma and discrimination that grew out of that pandemic or epidemic.
And we're really conscious to guard against that while also protecting a community that has been overwhelmingly affected by this, which is gay, bisexual and other men who have sex with men.
We're working very closely with the Federation of AIDS Organisations, the clinicians in HIV Medicine ASHM and people living with HIV. These are organisations that over 40 years have built extraordinary networks and capability, and we've engaged them really to work closely with their communities.
But I take your point. Andrew Barr, the ACT Chief Minister made this point over the last 24 hours. It's really important that we get the balance between recognising the need to protect that community while also assuring people that this is actually a virus that can impact everyone and not allow the stigma we saw arise in the 1980s to come back because that would be an awful tragedy.
KARVELAS: Just on another issue, doctors have told The Australian newspaper that the nation is facing the collapse of bulk billing. Are we on the verge of saying GPS are advising they can no longer continue consultations or just these out-of-pocket fees which are unaffordable for so many Australians?
BUTLER: I said in the lead into the campaign, I said at the AMA national conference last week that the most worrying thing for me about the health system right now is the state of general practice. I'm terrified at the number of young medical graduates choosing general practice. It used to be about half of all medical graduates did that. Now it's only 15%. We have seen gap fees skyrocket for those who pay gap fees, which is about one in three Australians. The average gap fee to go and see a GP now is more than the Medicare rebate itself for the first time in Medicare's history.
So I'm really concerned about the state of general practice. It really suffered over the last nine years. There were six years where effectively GPs had a wage freeze under the former government and that's really hit them hard. That's why general practice was really the centrepiece of our health policy. I've already started working with our Strengthening Medicare Taskforce, which was which has a substantial investment in general practice attached to it.
It will be providing recommendations later this year to roll out next year and a range of other things that we're doing in general practice as well. But I don't pretend that that's going to turn things around in one year.
There's a lot of work to do here. We had some really frank discussions with the doctors groups, nurses groups and others a couple of weeks ago about just the depth of the challenge. But that we've got to we've got to turn this around because if general practice is not thriving as a centrepiece, a backbone of our health system, we're going to face terrible consequences.
KARVELAS: Just finally, in turning to the climate bill, where obviously your government had a victory yesterday in the Lower House floor passing a signature policy. Opposition Leader Peter Dutton said last night that the Albanese Government, your Government's attempt to end the climate laws will take Australia down a very dangerous path and that there are worrying signs on the gas prices, unreliability, lights out. What do you what's your response to his warning that we're going to see prices go up and the lights out now.
BUTLER: We're headed down a path that has the endorsement of the Business Council, the Minerals Council, the Chamber of Commerce and Industry, the Australian Industry Group that represents manufacturing, all of the energy groups, conservation groups, state governments.
The only participant in the national political debate that's checked out of this is Peter Dutton and his coalition. This is the end of a long, dark chapter in Australian politics that we saw this week. Of course there's lots more to do. Anthony Albanese and Chris Bowen have said that.
KARVELAS: But do you read his comments as keeping, you know, that he plans to keep the fight on this going?
BUTLER: I thought that was clear from their extraordinary behaviour over the last couple of weeks. Just complete refusal to engage in this debate. All that they could do over the course of the debate was to try to raise that hoary old chestnut of nuclear power, the most expensive, slowest form of energy to roll out, while the rest of the parliament, the rest of the business community and the rest of Australia was just wanting to get on with it.
KARVELAS: Mark Butler, we're out of time. Thanks for coming on the show.
BUTLER: Thanks, Patricia.

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