TV interview with Minister Butler and David Speers, Insiders ABC - 10 July 2022

Read the transcript of the TV interview with Minister Butler and David Speers from ABC's Insiders, on fourth doses; COVID vaccines; COVID antiviral treatments; information campaign; masks; emergency leave payments; Telehealth.

The Hon Mark Butler MP
Minister for Health and Aged Care

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General public

DAVID SPEERS, ABC INSIDERS HOST: Mark Butler, welcome to the program.


SPEERS: So, before we get to who should and shouldn't get a fourth vaccine dose, how worried are you about this latest COVID wave in Australia?
BUTLER: I think health authorities across the country are worried about this third Omicron wave for the year. We already have about a quarter of a million people today with COVID officially and probably many more tens of thousands without having officially reported or not having symptoms. There are about 4000 people in hospital now with COVID. And we're still seeing several hundred, a few hundred deaths every week from COVID. So, this is very serious. The unique thing about this particular wave, which is driven by two new subvariants of Omicron, BA.4 and BA.5, is that people are getting reinfected with these new subvariants. The fact that you had COVID earlier this year, the fact you might have only had COVID a couple of months ago, does not necessarily protect you from getting infected again. And that was the very strong advice from the Chief Health Officers just on Friday when they said that the reinfection period would now be shortened from twelve weeks to just four weeks. So, if you have had COVID and four or five weeks later start to get symptoms again, you should get tested and isolate.
SPEERS: How serious could this get? You mentioned 4000 in hospital at the moment with COVID and deaths are running at about 300 a week. How bad is it going to get in the next six weeks?
BUTLER: I think across the states we expect case numbers to continue to climb for some weeks yet. We're still relatively early in winter; hospitals are still pressured by influenza as well as a range of other illnesses. There is very real pressure on our hospital system right now and health authorities are worried that hospitalisations will climb even more quickly which is why we've acted so quickly to get those fourth doses broadened in terms of eligibility. And why today I've announced much broader access to these very effective antiviral medicines.
SPEERS: Tell us about that. So, the antivirals have been limited to those who had underlying conditions. What are you announcing today?
BUTLER: I'm announcing today that everyone aged 70 or over will have access to these antiviral medicines—tablets, capsules that you can take at home. Only recently, to get antiviral treatment, you had to go into hospital and have it intravenously. Now if you are over 70, you will automatically have access to those medicines on the PBS, probably only $6 just for a round of that. If you're over 50 you'll have to show that you've got a couple of risk factors that make you particularly vulnerable to severe COVID which might end you up in hospital. But if you are such a person you should also take that advice from your GP. These are cheap medicines, and they are very effective. They'll reduce the incidence of severe disease across the community and very importantly relieve that pressure we're now seeing build on our hospitals.
SPEERS: I assume they have a shelf life. I think the shelf life for these treatment drugs are only about 18 months. How long until the ones we've got, I think we've got more than 2 million courses of them. How long before they have to be disposed?
BUTLER: The former government ordered 1.3 million doses of these two medicines Paxlovid and Molnupiravir and to their credit they did, but the problem is they've been sitting in warehouses rather than getting out into people, actually doing their job, which is why we've made this decision. We're talking with the companies now and the authorities about those shelf lives to make sure that we get the full benefit of the medicines that the former government ordered. We'll have further to say about that in due course.
SPEERS: So, they might be given a longer shelf life basically.
BUTLER: That's certainly my ambition. What I really want though, is to get them out of warehouses on the pharmacy shelves and into people who are at risk of severe disease. And that's really the impact of the decision I've announced today which we’ve fast tracked.
SPEERS: On vaccines now, the recommendation as of Thursday and this will be taking effect from tomorrow: it's recommended the fourth dose for everyone over 50. For those over 30 though, those in their 30s and 40s, they can get a fourth jab. But ATAGI says the benefits are limited. Some might be confused what to do here. We know there are more variant specific vaccines that are being looked at the moment from Pfizer and Moderna. Should they wait for those or should they go and get the fourth jab that's there now?
BUTLER: The real driver of the fourth dose decision is to protect people who might be at risk of severe disease during this winter; this third Omnicom wave which we've just talked about. And there's not a lot of evidence that people who don't have underlying health conditions, aged 30 to 49, are at particular risk of severe disease which is why it's a fairly soft recommendation. Just really the ability, if you want a bit of a boost to your immunity and you're of that age, you can go out and get a fourth dose. My overriding message for that age group though is get your third dose. There are still about two and a half million people in their 30s and 40s who haven't got their third booster dose. That's the real kicker. That's the thing that gives you a very big boost in immunity against severe disease or even worse. There are still more than 5 million Australians who’ve had their second dose more than 6 months ago but haven't yet had that crucial booster which is why we've rolled out the information campaign we had. The boosters are critical. Third doses are critical. And if you've had that by all means think about a fourth dose and if you're over 50, it's recommended you get a fourth dose because that will lift your immunity over the course of this winter.
SPEERS: Just on that third dose. The figures that you point out there. Around 5 million Australians haven't had the third dose. It's nearly a third of the eligible population. It's even worse amongst Indigenous Australians, nearly a half haven't had that third dose, so what more can you do to get that that third dose rate up?
BUTLER: We're trying to talk about it every chance we get David and we've also rolled out an information campaign that I asked my department to do as soon as I was appointed. I made a criticism of the former government before the election campaign that there just wasn't enough energy around the importance of boosters. Too often the message was it was almost just a nice thing to get rather than something that was critical to your protection against particularly these Omicron variants. I mean, the message from our health authorities is clear. Two doses of the vaccine is simply not enough to protect you fully against this Omicron variant.
SPEERS: If it's so critical, though, and you're right, you talked about this before the election - before the election you even suggested an incentive payment of 300 bucks for people to get a vaccine - why don't you come up with an idea like that that might actually shift this number to get more people having a third dose?
BUTLER: We've put out an information campaign. We think that is the way to start to reinforce the importance of getting this third dose. As you say there are particular cohorts in the population that have lower than average rates. There's an information campaign particularly targeted to First Nations communities to get that rate up from about half where it is now, although I have to say very pleasingly, it's much higher than that, amongst older members of First Nations communities. We've got to just improve awareness for people.
SPEERS: Is that enough, running information campaigns, I'm sure help, but we no longer have the sort of requirement to get the third dose that we had for the second dose. Let's be honest, that's why the second dose rate is so much higher than the third dose.
BUTLER: Of course, of course, but we've moved to a different phase of the pandemic, David now we're beyond the emergency phase where you see lockdowns and mandates and emergency payments and such like. We're really at the point now where there needs to be maximum information to the community so that they can make informed decisions themselves and make sure they have available to them vaccines, including the fourth dose and medicines if they're at risk of severe disease. That is the approach I think deep into third year of a pandemic.
SPEERS: You say we've moved to a new phase of the pandemic that you just told us we're in a new wave, it's very serious. We're going to see hospitalisations increase, you’re worried about this. Are we're really in a new phase of the pandemic where we don't need to consider some of these old measures like mask mandates in particular? Why don't we look at that just for the next six weeks?
BUTLER: There's no advice to me or to any of the state health ministers that we should reintroduce broad based mask mandates. The Chief Health Officers only met in the last couple of days and there was no such advice given by them. Again, I think the broad view is that in this phase of the pandemic, mask mandates and things like that are best done in a targeted way. So, there are mask mandates in aged care and health facilities, on public transport, on aeroplanes and such like and very clear advice from the Chief Health Officers that if you're in a crowded indoor space with no ability to socially distance, you should give very strong consideration to wearing a mask today. That's the health advice right now, David.
SPEERS: You only have to go to the movies or a shopping centre or the footy to see how ineffectual a recommendation is, so many people not wearing masks. Wasn't one of the lessons of the pandemic that these things, mask mandates for a fixed period work?
BUTLER: They do but we're deep into the third year. We're deep into the third year David and the health advice that we're all receiving, it's only been issued again in the last few days is that these sorts of mandates, this phase of the pandemic are best done in a targeted way, particularly focusing on risk of severe disease among the vulnerable population. That's the advice that we're following.
SPEERS: Pandemic leave payments have also come to an end. You've decided not to extend them. If people are still required to isolate when they have COVID. Unlike any other illness, you've got to isolate if you have COVID. Why shouldn't they be given sick pay?
BUTLER: This emergency payment was designed by the former government and the state government. So, it's a co-own scheme if you like to come to an end on the 30th of June. And we've got a trillion dollars in debt. We have eye watering deficits as fast as the eye can see, and at some point, emergency payments of this type have to be wound up as we move into this new phase. That's a decision the former government took and that's a decision we've decided to follow as well.
SPEERS: But again, we're in this new wave that you've just talked about how serious it is. Casuals if they get COVID, should they just isolate and go without an income? Or should they risk turning up at work with COVID? What's your advice to them?
BUTLER: Of course, there are state rules to isolate, and these emergency payments just simply have to be wound up at some point.
SPEERS: Why now at the start of a new wave, a third wave. I mean, the ACTU, some of the retail and hospitality industry groups are all saying, for the safety of our workforce you need to have a COVID pandemic leave payment still in place, so people do isolate.
BUTLER: I accept that whenever you end an emergency payment of this type it is going to impact people and I deeply regret that of course, but at some point, these emergency payments simply have to be wound up. We don't have the financial capacity to keep making them forever. They were intended to wind up on the 30th of June. That was the decision taken by the former government and all state governments who are co-signatories to that scheme, and it's a decision we've had to continue.
SPEERS: So, if things get really bad in the hospital system in the coming six weeks, you won't reconsider this or mask wearing or any of these things that are being phased out?
BUTLER: Look, of course, governments remain open to considering developments in this pandemic and we take the health advice. We are committed to making sure that we do everything possible to get through this winter safely. That's why we've acted so quickly. To bring new energy to the fight against COVID, extending hospital payments to the states for three more months. $750 million. As I said, extending eligibility to vaccines to treatments, a new information campaign to promote the importance of boosters, bringing Jane Halton in to commission advice about fitness for purpose of our vaccine and treatment procurement arrangements. There is real energy we're bringing to this fight against COVID.
SPEERS: Just need to be clear here if someone advises you, apart from all those groups that are currently advising you, that the pandemic leave payments are going to be important in the next couple of months through the winter to keep people at home who've got COVID will you reconsider this?
BUTLER: We’ve said these emergency payments can't continue forever. We have an extraordinarily difficult budget position, which means hard decisions have to be made. But of course, we will keep an eye on all of the developments in this pandemic and make sure the community is protected.
SPEERS: Some opening there is how we should read this. If things get worse, you might come back to this?
BUTLER: This pandemic is a fluid pandemic and it's not behind us by any means. But we need to be honest with the Australian people that the budget is in a very bad position and emergency payments cannot be continued forever.
SPEERS: The other thing you've decided not to extend is about 70 different telehealth services that were put in place to deal with COVID. Doctors are pleading with you to reconsider this one as well, pointing out the pandemic isn't over. Would you reconsider any of those telehealth services?
BUTLER: Some doctors are, David, and some doctors have made the point that clinically it's a very good decision to put a limit on telephone consultations. This was a decision taken and telegraphed by the former government many months ago. The important thing for your viewers to understand, David, is that telehealth is now a permanent feature. Although it's obviously always best if possible, to have a face-to-face consult with your doctor. If you need to consult with them remotely you can still do that for short consults, and for longer consults. The decision though is to limit telephone consults, where there's no face-to-face engagement at all to consults up to 20 minutes and the clinical advice to me and to my former colleague Greg Hunt was that there's good reason for that. For complex longer consultations that face-to-face engagement you get, either in person or at the very least through FaceTime or Skyping or whatever face to face video consult you do, is clinically important. That's why I've continued that decision.
SPEERS: What if you're an older or vulnerable Australian not so good at Skype? You don't have a high-speed internet connection, perhaps. But you want that longer consultation to find out all your conditions, whether you should get these antivirals that we're just talking about. I don't understand why he can't just do it on the phone.
BUTLER: The clinical advice has been there's good reason not to do longer complex consultations without some ability to have face to face engagement. Now, six out of seven of these consultations are under 20 minutes that won't be impacted. You can do it over the phone, or you can do it over video, but I've had some clear advice, or my predecessor had the same advice that there's good reason to require face-to-face engagement for consults over 20 minutes and there's been substantial notice given to doctors about this. There really has been substantial notice.
SPEERS: All right, Health Minister Mark Butler we’ll have leave it there. Thanks for joining us this morning.
BUTLER: Thank you, David.

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