Chief Medical Officer Professor Paul Kelly's interview on ABC News Breakfast on 12 January 2024

Read the transcript from Chief Medical Officer Professor Paul Kelly's interview on ABC News Breakfast about COVID-19.

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THOMAS ORITI, ABC NEWS: Several states have warned of another COVID wave driven by this new variant. It's called JN1. The New South Wales Chief Health Officer says the variant is partially to blame for the state's highest level of COVID in a year, while Victoria's Health Department says the variant has contributed to an increase in community transmission along with hospitalisations of COVID cases. However, experts say so far there's been no evidence that JN1 is more severe, and this comes as data published by the Federal Government in December showed that less than a quarter of people over the age of 75 were up to date with their booster shots, and just 30 per cent of aged care residents have been vaccinated in the past six months. Professor Paul Kelly is Australia's Chief Medical Officer, who joins us now. Professor, good morning. Thank you for your time.

PAUL KELLY: Good morning, Thomas.

ORITI: How worried are you, firstly, about the JN1 variant?

KELLY: Uh, look, it's a variation on a theme of the Omicron COVID virus that we're very used to now. I somewhat lost count in the number of strains that have come from Omicron, but I think I'm right in saying JN1 is a sub-sub-sub-sub variant of Omicron. So it's related to other previous ones that your listeners would have heard about. It's been labelled a variant of interest though by the World Health Organisation on the 20th of December. And so we are interested, we are monitoring, and we have seen in Australia over quite a rapid period, you know, since early December that that new strain has- is now the dominant strain in Australia, as has occurred in many other countries. As you said in your introduction, there's no evidence, though, that it's related to more severe disease. And when you look at the wave we're having now, which is substantial- you know, I know people that have COVID, I'm sure you and many of your listeners would also know people. So that's a sign that COVID is circulating in the community. But there's really been no evidence of an increased rate of death, even and including in aged care, and ICU rates remain relatively stable. So whilst there's a lot of cases, and yes, it has had an effect on hospitalisation as you mentioned, particularly in the eastern states, there is evidence to show that this wave is less severe than previous waves, and this is the way that we're going to see COVID now and into the future. I remember about a year ago talking to you about having probably 2 or 3 waves of COVID during 2023. This is the third wave and continuing into this year.

ORITI: I mean, what I'm trying to get my head around is if JN1, as you say, there's no evidence that suggests it's more severe. So if it doesn't cause more severe disease, why are we seeing those hospital admissions in Australia rising, as you say, particularly in the eastern states?

KELLY: Well, that's just related to the large numbers of cases, I think, in the community. I think we- you'll remember, you know, this time last year people were reporting their rapid antigen tests through to health departments, and they were being recorded.

ORITI: Yeah.

KELLY: When- that's not the case anymore. So when you look at the official figures of cases, that reflects what's happening in the community and it's helpful for monitoring, but it's not the total story. So there is definitely more cases in the community than are being officially reported.

ORITI: [Interrupts] Is that part of the issue- just on that, it does seem like such a long time ago we were all, you know, reporting the antigen tests. I mean, comprehensive COVID data really has become a thing of the past it seems. Do you feel as though we've lost track of community transmission in a way, Paul Kelly?

KELLY: I don't think we've- I don’t think it's true to say we've lost track. I think that we- you will remember we had, you know, a lot of discussion almost 18 months ago now about- or sort of September of 2022 about, you know, treating COVID more like other infectious diseases. So it is- we are monitoring it like we do with other infectious diseases. We don't know, you know, how many- absolutely how many flu cases there are in the community every winter. But we do know when flu starts. We do know when it gets worse. And all of those monitoring things that we have, particularly for severe disease, are continuing and we're watching those very closely. So I don't think it's- you know, we are we are continuing to watch. We don't know every single case, but it's not absolutely necessary to do that. You do know when-  you do need to know when there's a change, and we're monitoring that, you know, as we've picked up the JN1 issue quite early. That was something we picked up in early December, particularly in Victoria and we've been monitoring that as well.

ORITI: And obviously, we'll continue to see, you know, sub-sub-sub-sub variants, or however many times you said sub there, this is going to continue. But with JN1 and the rising hospitalisations, you know, back in October, you made the comment- you made that declaration that COVID is no longer a public health emergency, or I think the words were no longer a communicable disease incident of national significance. Do you stand by that now in light of these rising hospitalisations?

KELLY: I do, because, you know, the hospitalisation- remember that as people come into hospital, they are tested. You know, I had to have some- something- a small procedure in November. And, you know, I was tested twice. I wasn't there because of COVID and ended up being negative, but- so some people that come into hospital are tested, but they're not there due to their COVID, if that makes sense. But that aside, there are people that are sick from this virus as has been the case all throughout. But we're not seeing the kind of, you know, huge disruption to the community or to health services, or that very, you know, massive severe disease and death that we were seeing earlier in the pandemic. And that's mainly due to hybrid immunity that we have at the moment from previous infection, but crucially, from our high vaccination rates.

And you mentioned that the vaccination rates could be improved and that they are being improved in the two weeks before Christmas, and that this will be in the- in our monthly report nationally will be published today demonstrates that that rate of vaccine did increase, particularly in older people and including in aged care. So I think that's heading in the right direction, and I would encourage anyone listening that is eligible for a booster to go and get one.

ORITI: Kenny, I want to ask you about that now. Let's turn our attention to the boosters. A month ago, we actually reported on this story. Two new boosters became available for Australians. Are you confident they're effective against J.N1?

KELLY: Yes, they are effective against J.N1 and all other variants that are currently circulating. So this was a shift in the vaccines from both Pfizer and Moderna, reflecting the change in the virus over recent- over the last year. Of course, you can't do that on a real time basis like we do with flu vaccine. We do change that every year on the basis of what's circulating at the time. But then it takes time to make these vaccines. So these are XBB vaccines, which are closely related. They’re still Omicron and they still- the tests we've had both here in Australia and elsewhere is that it works against J.N1 as well.

ORITI: Are you concerned about the uptake though? I mentioned those figures in the introduction there. You did express some optimism a moment ago, but sent that message for people to go and get their boosters. I mean, it's clear a lot of people are not. A lot of people say: I've had my three or my four. That's it, I'm done for now. Are you concerned about that, that our immunity will wane over time? And we're going to continue to see more variants.

KELLY: Yeah. Look, I think one of the reasons why we're seeing a wave now and the previous waves is a waning of immunity. Of course, anyone that gets COVID now are protected from that- from the first three doses. And we have very high rates of three doses of vaccine, so they will get a boost to their immunity from this latest wave. I am concerned about the- those that are more vulnerable to severe disease – so that's people who are over the age of 75 in particular. And so the ATAGI advice at the moment is that they should be getting an extra dose, and that includes those in aged care.

The reality is, though, Thomas, as you've mentioned, that people are kind of sick of it. They feel that they're relatively protected. Their lived experience of COVID now is nowhere near as severe for most people compared with earlier in the in the pandemic, but it is still a serious issue for those that are more vulnerable to severe disease. And they definitely should be getting a vaccine along the lines of the ATAGI advice right now. There'll be more advice later in the year for the ongoing COVID vaccination program, and we'll obviously be talking about that at the appropriate time.

ORITI: Yeah, because I was going to ask, because the Department of Health website says: if you've already received your recommended doses in 2023, you don't need any other doses and should wait until new advice is provided. So you're saying we'll be expecting that advice later this year? Is that right?

KELLY: Yes. I think we certainly will want that before winter. I think we need to as similar- as countries like Australia in other parts of the world – the UK, thinking of the UK, US and Europe, for example – they're starting to get more into a pre-winter top up idea, if they’re- and there's a bit of different views there in different countries as to who should get a top up. But an annual booster or something like that might be where we go. But of course we'll be guided by the ATAGI advice, and they in turn will be guided by the best evidence at the time.

So for the moment, you're right. The people under the age of 75, there's no- if you've had a vaccine, and there's a lot that didn't during 2023, they shouldn't be getting another boost at this stage. But if you haven't had a 2023 booster, you can get one. For those over 75, it's highly recommended that they get a second booster, and for 65 to 74, that's a matter to discuss with your GP, including those with other high risk illnesses younger than that.

ORITI: We're almost out of time, but what if you're not? What if you're in your 30s, 40s? Happy, healthy – you're saying I could go and get the booster now. Is your advice they should? If they haven't got comorbidities and they're in a younger age group, should you just go out and get it?

KELLY: Look, I think that's a personal choice issue, if people- and it depends on how people are feeling about their own personal risk. In reality, people at that younger age group are not at- are no longer at risk of severe disease from- severe complications from COVID, really, in the majority. So it's a risk benefit equation people should consider. The other thing I'd say, though, Thomas, is those that are eligible in that higher risk group for antiviral treatments, they should have that plan with their GP, get a test and get a prescription. There was 93,000 people had antiviral treatment in December, which was the highest through the whole year. So that's encouraging that that’s- people are taking that advice. It also reflects what we were talking about before. That's a very key statistic we look at for what's actually happening in the community. It's sometimes more helpful than the actual- the voluntary information in that way.

ORITI: Yeah. Professor, look, thank you very much for giving us the time, I appreciate it. Take care.

KELLY: You’re welcome. Thanks, Thomas.

ORITI: Professor Paul Kelly joining us there, Australia's Chief Medical Officer.



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