NEIL MITCHELL:
Well, I was about to take a quick break but I'm not sure. Professor Kelly may have - yes, Professor Kelly has called in, Chief Medical Officer for Australia. I suppose he's the national equivalent of our own Brett Sutton and he's on the line now. Professor Paul Kelly, good morning.
PAUL KELLY:
Good morning, Neil. How are you going?
NEIL MITCHELL:
I'm okay. Thank you for your time. Okay. To put the Sydney outbreak in context, how concerning to you?
PAUL KELLY:
Look, concerning, yes. We declared it a Commonwealth - or I declared it a Commonwealth hotspot a couple of days ago, on the basis of the growing numbers of cases, the wider number of exposure sites, the geographic spread, and particularly the unlinked cases, the so-called mystery cases. And so, yes, it was concerning. Very, very good news overnight, though. They have really done a great job in linking together many of the sites that were previously mysteries. So, that shows that they are getting on top of that actually.
NEIL MITCHELL:
Well, we're [indistinct] shy in Victoria for obvious reasons, but is it too early to tell or can you make an assessment on the situation we have in Victoria with two positives now?
PAUL KELLY:
Yeah, so that's a link with the Sydney outbreak, in fact. There was one chap that found he went to a party up there, where there have been quite a large number of cases from that event last weekend, and there's now that second case, who I understand is a close work colleague. But, you know, that hasn't gone further. That's all under control, I believe. Brett Sutton and the rest of the team down there do a great job in tracking down these events; the plane that that gentleman came back on as well. And I think, for your listeners, very important, as always, if you're contacted, go and get that test, isolate, whatever the authorities are asking you to do. Keep an eye on the website, and make sure if you've been to any of those exposure venues, you do that yourself. And if you're at all unwell, get that test done.
NEIL MITCHELL:
But you feel that it's under control? I would have thought there'd be some nervousness about people on the plane having been in the community. I think 100 people visited the dry cleaners where he worked, who are obviously being traced and tracked, but there's a potential there that they've been out in the community when positive as well.
PAUL KELLY:
Yes. So, you know, we've got to be realistic here that, you know, we do - and your team down there in Melbourne have been really good at this during the previous outbreak that's now definitely under control [indistinct] to find contacts and then contacts of contacts. And that wide scope is useful. But the risk for those contacts of contacts is extremely low. I think that needs to be recognised. And so, whilst it's important to listen and do what's asked, the risk is actually very low. So I think the fact that they've found out that guy quickly and took the appropriate steps to decrease that chance of it spreading to the community will pay a great dividend.
NEIL MITCHELL:
So you are confident we can get through without another eruption, here?
PAUL KELLY:
I think in Victoria, yes, at the moment. But the Sydney situation, there are a large number of cases. And you know, that remains to be seen how that plays out. At the moment, looking much better than it was even 24 or 48 hours ago, because of that chasing down of the mysteries, yeah.
NEIL MITCHELL:
I know it's a state decision, but when a state goes into lockdown, do they consult you? Do they have a sort of throw it around the table with you and say ‘gee, you know, this is the situation, do we need to lock down or can we contact trace our way through it?
PAUL KELLY:
So we've been back to daily meetings, sometimes twice a day meetings, at the Australian Health Protection Committee with our famous group that includes Brett Sutton from you(*) and all the chief health officers from all the states like myself and a few experts. So we've been meeting daily to talk about - to receive reports and to talk about what's happening in all of the situations where that's happening. But ultimately, the states have the say on the public health actions in their own state, and that includes, of course, domestic border restrictions and so forth. So, yes, it's talked about. Yes, advice is sought. But ultimately, that decision is with, you know, with the state governments.
NEIL MITCHELL:
There does seem to be a difference in strategy between the New South Wales Government and the Victorian Government. New South Wales seems to be more willing to go with contact tracing as a first line. We seem to go to lockdown more quickly. Is that a fair assessment I'm making?
PAUL KELLY:
Yeah, that's a fair assessment. And again, that's a decision that needs to be made at state level. But I would say that all of the states are using the kind of the nationally agreed approaches, which includes [indistinct], trace, isolate, that contact tracing elements, and mask use and lockdowns when necessary, whether that's what they've done in New South Wales in the last 24 or so hours about restricting movements to a certain extent in a voluntary way, as well as mask-wearing and restrictions on numbers of people in particular venues and the like. It is a different philosophical view, I think, about what, you know, whether to go hard and fast or a little bit less hard. But I think fast action is the key part. And all of those elements remain. They remain elements of the response. And so, Kerry Chant and her team up in New South Wales, will, and I know they are, looking at all of that, all the time. So it depends on the data.
NEIL MITCHELL:
I don't want to put you in conflict with Victoria, but that's part of the problem. I feel that - I sense that Victorians, because we have had so many lockdowns and I don’t think anyone disputes last year when we lost 800 people, it was necessary. But we've gone to lockdowns. We look at New South Wales and see them managing a way through it, God willing, at this time with the latest one. And for that reason, I sense that some people are losing trust in the management in Victoria in the way it's being managed. Now, are there options? You say philosophical difference, are there options for Victoria?
PAUL KELLY:
Yes, look, there are options. But you're quite right, Neil. I'm not going to go and do [indistinct] on state-based matters. As I say, we talk through these elements every day. And Brett or one of his team comes every day and they hear from other states of what they're doing, and then they have to give - they're asked to give those quite difficult conversations…
NEIL MITCHELL:
Yeah, sure.
PAUL KELLY:
…[indistinct] to say, look, here's the options. And then ultimately, it's the Government that needs to make those decisions. And in hindsight's easy but public health, you're always looking at whatever information you've got at the time, trying to predict what happened [indistinct]… And if it works, it works. If it doesn't, then that's also [indistinct]…
NEIL MITCHELL: Something pretty scary today in the Journal of Psychiatric Research - and it's peer-reviewed - that they estimate, in the survey they've done, 10 per cent of Victorians during last year's restrictions and horrible days, 10 per cent of Victorians seriously considered suicide, 10 per cent. Could you believe th at?
PAUL KELLY:
Certainly, a high number. It's true(*). And there's no doubt that there is a link between the physical and the mental health aspects of COVID, both from a direct effect, from the physical nature of getting the disease and what that leads to, you know, afterwards, and of course, the tragedies you mentioned. There were a large number of people that died in Australia, which is dwarfed enormously by what's happened in the rest of the world. And I think when we talk about what we've done in Australia in terms of controlling the pandemic, that's what we've avoided. And so, you know, these are the important statistics to take into account.
NEIL MITCHELL:
Yup.
PAUL KELLY:
But so's the counterfactual of what would have happened if we hadn't done that lockdown.
NEIL MITCHELL:
I was talking recently to Professor Terry Nolan, former head of ATAGI, as you'd be aware, and now at the Doherty Institute, and he was talking about the possibility of having to review the vaccine rollout in the sense of give everybody one dose of AstraZeneca while you've got it. And then down the track, look at a booster with Pfizer or extending the period for AstraZeneca. So, you don't wait three months, you wait four or five. Is there any consideration given - being given at the moment to extending or changing the gap between doses one of two of either AstraZeneca or Pfizer?
PAUL KELLY:
Look, we're always reviewing, and our ATAGI group - and Terry was on that group some years ago, I think, but not at the moment - are always looking at what's happened internationally. They're very linked in with international views on these matters, as well as the latest data. At the moment, we're sticking with our current settings. So firstly, if you've had a first dose of AstraZeneca or Pfizer, make sure you have a second dose of AstraZeneca or Pfizer when you're booked in. Don't delay, don't cancel, and don't mix and match would be the - is the clear message.
NEIL MITCHELL:
Evidence is emerging that mix and matching might, in fact, be positive, isn't it?
PAUL KELLY:
Well, emerging, I think, is the important part of that statement, Neil.
NEIL MITCHELL:
Yeah.
PAUL KELLY:
So, you know, we've got literally tens of millions of doses have been given on the not mixing around the world of either AstraZeneca, AstraZeneca; or Pfizer, Pfizer; or Moderna and Moderna, whatever it is. That's the evidence we have of safety, of effectiveness, and that's the important part. The other side of the mixing - look, it may become a thing at some point, but at the moment, we're only got very small studies, less than 1000 people in published studies at the moment on that basis. And it's mostly laboratory studies and not real world or even clinical trial data. So, I think we go with the evidence. We've always done that right through the pandemic. We stick with that for the time being. We've got plenty of those - you know, plenty of AstraZeneca to have a second dose. We should continue with that if anyone has had it first. It is much safer. The risk of this rare but serious side effect is very, very low, extremely low. And it hasn't actually occurred in Australia yet.
NEIL MITCHELL:
The AstraZeneca side effect, what do you mean? The clotting's occurred. Oh, you mean, is it -
PAUL KELLY:
[Interrupts] Yeah. In the second dose, I mean.
NEIL MITCHELL:
In the second dose. Oh, I'm sorry.
PAUL KELLY:
Yeah.
NEIL MITCHELL:
What about Pfizer? There's increasing reports about possible problems with Pfizer and heart issues, particularly in young men.
PAUL KELLY:
Yes. So that has emerged. And we're certainly, you know, I'm looking at that from international data. It hasn't emerged as an issue here in Australia. But as you say, it is mostly in the younger age group, and by younger, I mean teens and 20s, which, you know, apart from those people that are in those - in the priority groups of health care workers and the like, we're not really doing. So, we're keeping an eye on that. And we'll take the lead from those that have been doing it more.
NEIL MITCHELL:
I know you're in a hurry. Just very quickly, Dr Norman Swan on the ABC floated conspiracy theory saying that the federal authorities were offered heaps of Pfizer and knocked it back. Pfizer's denied it. Is it true or not?
PAUL KELLY:
It's completely false.
NEIL MITCHELL:
Can you tell James Merlino that? He's spreading it now. Our little Premier - our Acting Premier. Anyway, I won't get you into that. [Laughs]
PAUL KELLY:
I'll leave that one with you, Neil.
NEIL MITCHELL:
I thought you might. And final point, are we winning? Are we going to win?
PAUL KELLY:
Yeah, we're going to win. The vaccine is rolling out. We're doing all of our planning now about what a post-vaccination Australia looks like. You know, that will be an important step, you know, into next year. It's a tough thing. The virus keeps throwing curveballs at us, you know, new variants and the like and the next thing and the vaccine issues, you know, we've dealt with in terms of side effects. But we're getting there. We'll just keep going. That's the way we get there.
NEIL MITCHELL:
And is Delta a significant worry in this New South Wales situation?
PAUL KELLY:
Well, that's the latest of the variants of concern. We know it's more transmissible, but all of the things - all of the tools we have in our toolkit, including the vaccine work.
NEIL MITCHELL:
Okay.
PAUL KELLY:
And you know, there'll be more variants along the way. There'll be more things that we'll need to learn as we do. And we just need to take that on board, adjust where we need to and then keep going.
NEIL MITCHELL:
And if we get vaccinated, you think we can get through without another major wave such as Victoria saw?
PAUL KELLY:
That's certainly the hope. We are- we do remain at risk because we've just had very few cases in Australia. So, you know, message to your audience, don't hesitate. If you are eligible to get the vaccine, get that booking and get that jab in your arm. That's the important thing for you, your family and the community.
NEIL MITCHELL:
Thank you for indulging me for so long. Take care. Thanks for your time.
PAUL KELLY:
Good on you, Neil. See you later.
NEIL MITCHELL:
Chief Medical Officer, Professor Paul Kelly.
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