Joined by the Chief Medical Officer (inaudible) update on coronavirus globally, nationally, and additional responses.
At the global level, the number of cases has now exceeded 88,000; that’s diagnosed. Obviously, we recognise that is the formal number, and that in parts of the world may be significantly higher.
We now have almost 3000 lives lost, very sadly, and that includes of course the loss of Mr Kwan here in Australia.
In addition to that, the number of countries and regions who have reported a first case has now grown to 67, and that includes additional countries such as the Dominican Republic, the Czech Republic, and Luxembourg.
Within Australia, the total number of cases is now 29.
An initial 15 that came from China or had been in direct contact with those from China.
As a result of that, all of those were isolated, treated, and all have cleared the virus and returned home.
Ten cases from the Diamond Princess, where we brought those Australians home, and they have been in quarantine now for over a week in Howard Springs. Sadly, as we learned yesterday, James Kwan from Western Australia was the first Australian to lose his life.
It was obviously, deeply saddening and tragic for the Kwan family, but for many others who would’ve been affected along the way.
As well as that though, we now have four cases from Iran, one in Queensland, two in New South Wales, and one in Victoria.
All have been isolated, all are under treatment, and most significantly, contact tracing has been started by the states and territories.
And in the case of Queensland, they have set up the first respiratory clinic to test and to let any patients who have been in contact with the Iranian traveller, have a place to go where they can have dedicated testing, treatment, and analysis.
Now in response to all of these, we are meeting daily through the chief health officers and the Chief Medical Officer chairing.
In particular, over the course of the weekend, as you’re aware, we increased the travel advisory to Iran.
And as part of that, put in place the travel bans.
We have also now, I can announce, increased the travel advisory for Italy, on the advice of the chief health and medical officers around the country, that has been raised to level two for the whole of the country, and level three for selected towns in the north.
Level two means: have a high degree of awareness, and level three is: reconsider travel.
Significantly, as well, the chief health and medical officers have recommended that if you are returning from Italy or South Korea, and you work as a healthcare worker or as a residential aged care worker, you should not attend your regular work for 14 days.
And so that’s an additional level of protection which has been advised by the chief health and medical officers and accepted by the Australian Government.
I might ask the Chief Medical Officer, Professor Brendan Murphy, to add.
PROFESSOR BRENDAN MURPHY:
So thanks, Minister. So I think as we have been saying for some time, these additional cases that we’ve seen over the weekend from Iran were expected, and I think as we also said over the weekend we had a very high index suspicion that the caseload in Iran was much greater than being reported, because of the death rate.
So even though we have a relatively low travel volume from Iran, we have had these four cases.
And that’s why Iran has been a particularly special case, and whilst we haven't been pushing at the chief health officers for more travel bans, this case was one that was particularly avoid the burden of travel from Iran.
So as the Minister’s said, we’ve had these additional cases.
But as we’ve always said, we are extremely well prepared in Australia.
So all of these new cases have been contract traced, been managed as the last cases were as state and territory public officials.
We have, as Minister Hunt said, we still got concerns about Japan and South Korea.
But they are working hard to control their outbreaks, but we are still concerned that people who come back from those countries and any other high risk countries and may present with a COVID-19 infection.
The most important thing for anyone coming from an area of risk is to monitor their health and isolate if they become unwell, with any sort of flu-like symptoms, contact their doctor or the hospital and let them know.
That’s the time when people are most infectious is when they are symptomatic.
The additional precaution of asking people to isolate from Iran and those people working with vulnerable people from South Korea and Italy, particularly northern Italy, is because some people may develop mild symptoms and we wouldn’t want to expose healthcare situations or aged care situations to people who might be earlier in the stages of a disease.
But the most important thing, anyone who has come back from a country with a COVID-19 outbreak who gets unwell in any way, please isolate yourself and contact medical advice.
Thank you, Minister.
Professor, how would you describe the situation today compared to this time last week, is it any worse or is it better or (inaudible)?
PROFESSOR BRENDAN MURPHY:
It is pretty much as we expected.
With the developments over the last week with the significant spread in the outbreak outside of China, to a number of countries, now over 60, and many of them with some significant outbreaks.
As we’ve said, we are in a position where we're going to expect to see more cases in Australia, and we are prepared, and we are preparing for even greater numbers.
We’ve got lots of preparation under way across the health sector, and we are in a very good situational preparation. But this is pretty much as we expected.
Can you detail what happens to people in airports when they’re arriving, for example, in transit from a country that may have a ban in place, onwards to somewhere that doesn't have a ban, or in stopovers?
And also people who are arriving, are they- who’s been checked, and what procedures are in place for people who do have illnesses? Are they being put somewhere?
Is there a special room in airports where you’re dealing with people, or special teams of medical staff?
So I will say this – there are isolation procedures available in all of the airports where we have international arrivals like Border Force and Agriculture together have been putting that in place.
In particular, what we have done is we’ve set out those countries which are high risk and therefore being specifically investigated upon arrival, and that will continue to be the case.
But also, all arrivals will be receiving material about the circumstances that they may face if they have come from overseas.
And I know that both Agriculture and Border Force are working together on this.
If they have come from overseas, they will be receiving materials about if they have any of the symptoms, steps to take in Australia.
With Italy you’ve upgraded the advice. Are you considering a travel ban itself, and what is in the advice relating to a travel ban for Italy?
So, I think it’s very important to set out the process here. What we do is where there is medical advice, then we will follow that medical advice, and so we’ve allowed the chief health and medical officers to operate in full confidence that they can make their judgements based on sound medical assessments.
They’ve been ahead of the curve.
They have helped us as a country be ahead of the curve, knowing that the National Security Committee and DFAT have and will continue to accept their advice.
And so by giving them the freedom to operate independently, we’ve been able to get the best advice.
And I’ve got to say, Australia has not just prepared but we have consistently pre-empted, but we’ve done that by allowing not just Brendan, but all of the Australian Health Protection Principal Committee to operate as independent advisers.
What was the medical advice against a ban on Italy and South Korea at this stage?
So, I’ll let Brendan.
PROFESSOR BRENDAN MURPHY:
So, the view at the moment was that travel bans are - at this stage, when we have an outbreak in many countries – a way of delaying the burden of new cases coming in.
It’s no longer possible to absolutely prevent new cases coming in, given the increasing changes in epidemiology around the country.
So in the case of Iran, there’s such a high risk that a travel ban is worth doing because it will slow down the number of cases.
You cannot stop Australian citizens coming back. Some of the cases that came back from Iran with the disease are Australian citizens.
It’s a way of slowing things down.
At the moment, the medical advice was that the situation in Italy and South Korea, where they have large outbreaks but they’re confined and being localised, the risk- the proportionality of putting in a travel ban wasn’t justified in terms of its benefit to the health protection of the Australian community.
So just following up on that quickly – if we were to impose a travel ban on Italy, would that require a wider ban on the EU because of the Schengen Agreement? Is that one of the factors [indistinct]?
No- I might answer that one.
What we’ve done is we’ve made decisions based on individual country risk, as they medical advisers have provided that advice.
As you’ve seen over the weekend, we didn’t hesitate at the start of February to impose what was of course a very difficult decision to stop people coming from China, other than Australian citizens and permanent residents and their immediate family.
And that did have very significant ancillary consequences, but we made that decision.
And the freedom that the medical advisers have is to give their advice, and the commitment that we have is to work with it and to embrace it and to accept it.
And so that remains the situation.
Over the weekend- well, over the last week, advice to upgrade the advisories and travel warnings with regard to Japan and Korea and Mongolia, advice on Iran over the weekend, advice now on Italy that has been lifted.
And so our commitment is we will continue to implement the measures which the medical advisers recommend.
Can you please speak to some of the latest science we know on this? Is there any more information about the prevalence of cases spreading before their symptoms? Is the 14-day quarantine still best advice for it, where are we at on the latest there?
PROFESSOR BRENDAN MURPHY:
Sure. So, the 14-day quarantine is still what we think, the best advice with a margin for error.
The evidence is coming out that the incubation period is generally less than 10 days, but we are keeping- the international community is keeping the 14 days to provide a window of safety.
We do believe that there are some people whose symptoms are so mild that they may be almost unaware that they’re infected, particularly just as they become infectious.
So that’s one of the reasons why quarantine is still being practised for very, very high risk situations.
But, all of the evidence suggests that people are most infectious when they’re symptomatic.
So, that’s still the most important piece of advice, to isolate when you’re symptomatic.
So can I just clarify on my earlier question about transit and stopover travellers? Do we have those people coming through our major airports to countries that don't have travel bans, and how do we treat them if we do?
So our situation remains that where we have travel bans in place, those are blanket bans in relation to Australia, but any particular details I will refer to Border Force and get them to respond to you directly.
So if you were, for example, from Iran transiting through Sydney, going somewhere else, you’re not allowed?
Well, we have a ban on people arriving in Australia from Iran who are non-nationals.
The Andrews Government in Victoria has criticised the Federal Government for delaying the release of names of people on board a flight to Melbourne from Bali on 23 February; a woman on that plane had coronavirus. What’s your response to that?
I'm not aware of that criticism. I was with the Victorian Minister on Friday and they were effusive.
We stood together in a press conference and they said nothing other than thanks and gave strong support to the Federal Government.
So, everything we have, we’re sharing as soon as we have it. I am not aware of the circumstances in that case because it would be Border Force, but I imagine they are collating the entry cards and details.
And as they have it, they provide it.
Mr Murphy, does Mr Kwan’s death call for a review of how you’ve treated patients coming back from the Diamond Princess? Does anything else need to change?
PROFESSOR BRENDAN MURPHY:
No, not at all. I think this very unfortunate death was- we’re always going to have a first death and as we know, people are more susceptible to a fatal outcome when they’re older and frailer.
I think our response with the Diamond Princess was exemplary.
We brought these people home, we have quarantined them, and a number of them have developed the disease, whereas they might have otherwise been led into the community and infected people on a plane.
So we’ve protected the Australian community. But anyone who became unwell in Howard Springs in Darwin was given the most high level medevac back to their home state and put in the best possible care.
So, I think the Diamond Princess repatriation was an exemplary piece of public health.
Yeah. I will add something to that.
There are those that didn’t want us to impose a quarantine on the Diamond Princess passengers and I realise it was a very, very difficult and stressful situation for people who, through no fault of their own, had been in two weeks’ quarantine, and through no fault of their own, was subject to a further two weeks’ quarantine.
But the alternative of letting them out on commercial planes and then into the community, we know would have seen at least 10 passengers, 10 now patients, be in a position to spread the virus, again through no fault of their own.
And so, that decision to both bring them home, but to provide supervised quarantine with, really, the SAS of medical teams, the AUSMAT teams, on site, testing daily, has put them in the safest position but it’s put the community in the safest position.
I'll take one last from Phil and then we’ll have to.
Was it a mistake in hindsight why the Japanese authorities to keep the people on that ship, and not put them in a more effective form of quarantine rather than those ships, which would act as incubators?
PROFESSOR BRENDAN MURPHY:
I think the Japanese faced a huge logistic problem with so many people and where to put them. I'm sure they are deeply reviewing the strategy that was used at the time.
Look, we made the decision we made because it was clear that the quarantine had not succeeded in containing the virus on the ship. That is absolutely clear, and borne out by subsequent events.
Just one more question. There are still 150 Australians in Wuhan who have been living through this nightmare, I guess, in many ways.
Many of them children. Some of them are running out of medications. Some of them are running out of food. The Australian Government doesn't seem to want, or have the intention of rescuing them. What's your message to them?
I would say this – that there were unfilled places on some of the flights. Everybody was contacted, and all were offered. However, we are constantly reviewing the situation.
At this stage, however, we have no further plans for evacuations out of Wuhan.
Alright, thank you very much. We will have to finish now.
(Inaudible) the ACT Health Minister this morning-
The ACT Health Minister mentioned a shortage of protective equipment this morning. She said that the national stockpiles needed to be lifted. What are the numbers there? What's happening?
What we announced on Friday is that, as part of the work of COAG, we're constantly reviewing primary care, aged care, hospitals and the medical stockpile.
We're continuing to do that.
I met this morning with the head of the TGA, Professor John Skerritt, who’s reviewing all of the medicines requirements in Australia. It was actually very comforting.
He has a team within the TGA that is looking at medicines and all medical equipment in Australia.
They already have that role, but they have stepped that up. And what he was finding in terms of medicines was stronger than I had hoped, which was very good.
And in terms of personal protective equipment, we have a national stockpile which has 20 million, but we're always looking to add to those 20 million masks and other items.
The suits, not the masks.
If the ACT Minister has any questions, I'd be delighted to receive them.
I met with the ACT Minister on Friday, and we discussed, amongst other things, personal protective equipment and that wasn’t raised on Friday.
So if they have any further issues, we're open, either myself, the Chief Medical Officer or the National Incident Centre.
Look, I will say this – these are all immensely important questions, and this is a time of concern for many people in the community.
At this stage, in the last few weeks, we have had the four cases in the community.
We got ahead of those, with the travel ban from Iran to Australia.
And this is all working to a very clear structure of the declaration by the Chief Medical Officer of pandemic potential in January: the travel restrictions that have been imposed; but most significantly, the standing up of the National Incident Centre, the National Medical Stockpile, the National Trauma Centre and then the development of the pandemic plan, and then the activation of the pandemic plan.
We are at the first stage of three stages.
Think of it this way: it's effectively containment; and then in stage two, we have delay and mitigation; and in stage three, we have recovery.
And we're still at stage one. But for the Australian people, the preparation is immense.
The ability to adapt and to deal with it is a national task shared with the states.
And so, whilst we're not immune, we are prepared and ultimately, we will get through this. Thank you.
PROFESSOR BRENDAN MURPHY: