PAUL KELLY: …20 days of no community transmission as at 12 midday today, and so that’s the headline good news. We should always remember what is happening in the rest of the world. This is a very unusual situation, to have no community transmission. Our current hospitalisation as of this morning was 10 cases in hospital. No one in ICU and no one ventilated. There hasn't been a death associated with acute COVID infection in Australia since 19 October. So contrast that with many countries that are still seeing tens, hundreds, thousands, even tens of thousands of deaths every day. This remains a major, major issue for the world. So our situation here in Australia remains very strong.
There has been a lot of discussion recently, and there should be, about our quarantine system. We have seen over the last few weeks, a number of incursions related to quarantine. The most recent one in the last couple of days in New South Wales, after that day 16 test of someone who had been in quarantine and been found to be negative twice in quarantine. So that is a new development. We have seen some cases of the variants of concern, both in several states now, related to hotel quarantine. We've also seen a community case in New Zealand of the South African related strain. So these are new developments in last week it National Cabinet, there was a specific discussion about hotel quarantine and what we should be doing to continually improve the quality of our already very high standard hotel quarantine. Again we need to put that in context. We’ve have had over 211,000 people that have come back to Australia since we introduced the hotel quarantine system in March last year. We’ve had thousands of cases of COVID in the hotel quarantine but very few cases that have leaked, if you like, out into the unity, whether that be workers within the quarantine system or indeed people that have left quarantine and developed the infection.
So we have a very good system. Can it be improved? Of course, all systems can be continuously improved. This is a complex end to end approach we have from when people plan to come back to Australia, going through the flights, arriving at the airports, going through the quarantine system, being safe in quarantine and then after people have left quarantine. And so National Cabinet discussed that. It was the AHPPC, the committee of chief health officers that I chair, have been given the task to relook at everything that we’re doing from end to end, as we have done all through the last several months to make sure that if there is anything we can think of to improve there, that we will do that. It will be based, as it always has been, on the best science available to us at the time. And so we’ve done many of those things in the past. In the last month, we’ve introduced that pre-flight testing, we’ve introduced mandating of masks on planes, mandating of masks in airports. We continue to look at the way that people are transported to quarantine hotels, we’re continuing to look to the procedures and the systems and the safety of our quarantine hotels. And as of this week, New South Wales has developed a post quarantine check-up including a day 16 test. So I've asked my New South Wales colleagues to give a proposal through to AHPPC and we will be looking at that later this week around that particular component but that is one of many things we’re looking it.
The other element of course which is related to that is the variants of concern, and so we've been charting that, very very carefully, not only from the international information but also here in Australia. So as of 5 February, we've now had 87 samples of the B117 strain which initially was found in the UK but is now found in many other countries around the world, in our hotel quarantine system. We’ve also had 18 samples of the B1351 strain originally found in South Africa and we know that that’s also spreading around the world. So there’s 80 countries across all six WHO regions have now had imported cases or community transmission of the B117 strain, and for the South African strain, 41 countries have reported that. So that is becoming the normal strain of the virus that is circulating around the world and we need to be prepared for those strains which are definitely more able to be transmitted between people, may be associated with more severity but that is still information we need to continue to watch carefully. And then the talk about how they may affect the vaccines.
And so just to talk briefly about our vaccine program, that’s all completely on track, an enormous amount of work done across the Australian Government with our state and territory colleagues. With GPs, pharmacies and others that will be delivering this. Our logistics are being worked through. We’re setting up our vaccine operations centre here in the Health Department to work through the scenarios of how we get those vaccines to where they need to be. We know the Pfizer vaccine has been approved by the TGA and we are looking very much towards a delivery of that in the coming weeks. And we are definitely on track to have those first vaccines being delivered by the end of February, as we've said, as the Prime Minister has announced.
In terms of AstraZeneca, that is continuing to progress through the approvals process with the TGA. This is a very good vaccine, it’s very safe, and once it goes through those processes, of safety, quality and efficacy, we will be able to then look to rollout that vaccine as well, subject of course always to the TGA advice. In terms of the AstraZeneca vaccine in particular, in relation to reports around its effectiveness, particularly in relation to the South African variant of concern, I just want to make a very clear statement about people taking small amounts of information quickly, without looking at it carefully. And making conclusions. So at the moment, I can absolutely say, and this may change in future, and we will be nimble in the way we look at that information, and bring that into our planning, but at the moment, there is no evidence anywhere in the world that AstraZeneca’s effectiveness against severe infection is affected by any of these variants of concern. And that is the fact. What we have at the moment is a small group of people in a study, which has not yet peer-reviewed or published, in South Africa where there was an effect on the mild or moderate disease in relation to that variant of concern in that country. But there were no severe infections in any of the people that received the vaccine in regards to any of those types of the virus. So we don't have any information on that. We will obviously be looking at that carefully as time goes by and every day we get more information about that. We will be talking actually in the coming days with our UK counterparts, to really look carefully at what their experience is in relation to the very widespread use of AstraZeneca in that country across all age groups. So that will be helpful data for us in our planning in the coming weeks and months, and also for the TGA in their assessment.
So I’ll leave it there, and I’ll go to questions first in the room.
JOURNALIST QUESTION: Professor, when will the first Pfizer jabs actually be on the tarmac in Australia?
PAUL KELLY: So, I won’t go into great details there, and of course I- there’s always the caveat, they are- they do have to come from another country. And we heard this morning from the EU representative in Australia that they are definitely looking to allow that to happen, which was a very good news. And Pfizer, in our virtually constant discussions with them, also guarantee that they are on target to bring that to Australia in the coming weeks.
JOURNALIST QUESTION: [Inaudible question]
PAUL KELLY: Well, we- remember- if we work backwards from- we have told the Australian public, and the Prime Minister has on- has said this, and we are absolutely going by this timetable, we will have doses ready to be injected before the end of February. And I think I’ll just leave it at that.
JOURNALIST QUESTION: So, we know that when they get here, the TGA has to do the batch testing. How long do they need to do that, as in, [audio skip] backwards, what’s the latest they could arrive for [indistinct]… be able to start this month?
PAUL KELLY: Yeah, I’m not going to give you an exact date, but look, it’s a few days. It’s days rather than weeks to do that last piece of testing. And that’s important. That’s the final piece of the quality, and we would do the same with- when the AstraZeneca vaccines arrive from overseas, and we would need to do it again for the AstraZeneca product out of CSL.
JOURNALIST QUESTION: And once they’re actually on the tarmac, how long before [indistinct]… from there, do you think? So what’s the next step once they touch down?
PAUL KELLY: Well, they’ll touch down, and remember, the Pfizer vaccine needs to be kept very strictly at a -70 temperature, so there’s logistic exercises there. But we have our logistic partners in DHL and Linfox, so we’ll be doing the storage and the distribution in conjunction with Pfizer. And so they’ll arrive, they’ll be distributed, they have to go via the TGA for this final test, and then we’ll be working with the Pfizer hubs that we’ve- we’re setting up with the states and territories to get them to the place they need to be for the injections.
JOURNALIST QUESTION: My understanding was batch testing was actually being done overseas. So is there more batch testing to be done once they get here?
PAUL KELLY: Correct.
JOURNALIST QUESTION: Right. [Indistinct]… sorry [indistinct]…
JOURNALIST QUESTION: I was going to ask about something different, about- you talked about that- the AstraZeneca data with the South African strain, that being, a very small amount of data. We have more robust data about the Novavax vaccine and its efficacy, including against the South African strain and the UK strain. Have we considered waiting until the Novavax vaccine is available? I think in the past you’ve said that that could be a more long-term answer for the world, that vaccine.
PAUL KELLY: So, a couple of things I would say there about the vaccines. We need to and should and must use the vaccine we have. So we’ll be receiving the Pfizer vaccine in the coming weeks. We’ll be using that.
If- assuming that AstraZeneca gets through the final hurdles of the TGA process, we will be using that. When the Novavax vaccine goes through those processes, and they are several months behind those other two that I’ve mentioned, we’ll be using that. How they’re used together and so forth, this is emerging information we’ll look at. But I would imagine that the protein-based vaccines will be important longer term, as potentially others will be in relation- particularly in relation to the variants as we gather more information about that.
JOURNALIST QUESTION: So just to step back to Pfizer, so we are expecting 80,000 doses to be delivered straight up. So how soon before the next 80,000 will be delivered?
PAUL KELLY: The contract we have with Pfizer is that we will have now 20 million doses between now and the end of the year. They will be coming regularly, and there will be a weekly delivery is what we are aiming for. That's assuming no disruption to supply, and the airbridge and so forth, but we will be expecting to receive them every week, we will be starting to vaccinate within a few days of them being available, and then that will continue.
JOURNALIST QUESTION: And so when you say vaccinated within a few days of availability, do you mean within a few days of delivery? So once they’d actually touched down on the tarmac, jabs should be in arms a few days later?
PAUL KELLY: There is that quality step, remember. So once that quality hurdle has been finalised, then shortly after that, we’ll be looking to start vaccination by the end of the month. I’m not going to go into any further detail.
JOURNALIST QUESTION: With the 80,000 doses that come in [indistinct]… Professor Murphy has said because it’s obviously two doses and he said we won’t start something we can’t finish. So does that mean that first rollout will be 40,000 people [indistinct]… as do you keep the doses [indistinct] to make sure that that can be finished off? How does that work?
PAUL KELLY: Well, certainly we do, but both the AstraZeneca and Pfizer vaccines are a two-dose schedule, so we need to make sure that we have enough for that. We don't want a lot of vaccines sitting out in warehouses, so we will be looking to rollout particularly for those most- those priority populations that people will know about now, as soon as we can. But then on the third week we’ll be going back to the same population, those same people, to give them their second dose. Particularly with the Pfizer, that’s really important, that three-week interval. We will await the TGA advice in relation to AstraZeneca, but some of the information that has been coming up in the last few weeks is that it may actually be a longer interval for that second dose. I’m going to go to the phone to give a chance, as there’s some other people there. So I’ll go to Paul Osborne from AAP.
JOURNALIST QUESTION: Thank you. I've got two questions. The first is as part of your review work, is any work being done to start recording the details of Australians who have COVID shots overseas? And I ask because it could be useful in knowing not only how many doses we need here but also down the track, when we're looking at policies such as shortening quarantine periods and things like that.
PAUL KELLY: Well certainly, there’s a lot of work that’s being done with our overseas partners in relation to vaccine certificates and the like. So proof of vaccination will be an important component of that. But look, at the moment we have a laser-like focus on commencing the Australian program for people that are in Australia, and that includes all Australians in Australia, but in fact anyone who’s in Australia will be eligible to be vaccinated. So that's our main aim at the moment, and that overseas component will come along as an important issue later. At the moment, just to reiterate, there's no- we’re not looking to change our two-week hotel quarantine procedures.
JOURNALIST QUESTION: A second unrelated question. Is it true that vaccines such as Moderna can be more easily modified to deal with variance? Apparently the genetic information can be more easily rewritten and revised than the other types of vaccines.
PAUL KELLY: So what we've seen in the last year since we’ve started on this what I’ve called before a moonshot to find at least one vaccine that works against COVID, the first ever to be used in humans successfully. We’re now in this extraordinary position where we have multiple vaccines that have been shown to work. And under- with several different platforms, including two very innovative platforms. One of those is the MRNA vaccines. They were unheard of a year ago in terms of humans and certainly an unproven technology. The second one is the viral vector vaccines, that’s the AstraZeneca. So the MRNA is Pfizer and Moderna and others. AstraZeneca, the Russian Sputnik V vaccine is another viral vector vaccine. And then there’s the more traditional ones like protein vaccines, Novavax being one of those examples. And other even more traditional vaccines like the Chinese ones, which are an inactivated virus, for example. So the more traditional methods, one of the issues with those are they do take a long time to change and to modify. The great advantage of both the MRNA and also the viral vector vaccines is they can be done more rapidly. Essentially they’re the same use of an RNA molecule but a different way of delivering it. The issue though is that it’s one thing to change the vaccine. There’s another issue to make 9 billion of them. And so if we're going to vaccinate the whole world, it's going to take time. And so, yes, it's an advantage to be able to change the vaccine quickly, but you still have those issues of being able to get an adequate supply and going through regulatory processes which I would imagine will be easier second time around, but that’ll be for the regulatory authorities to consider. I’ll just go to Tamsin now at The Herald Sun.
JOURNALIST QUESTION: Thanks, Professor. I also have two questions if that's alright, but on the same topic. We've heard a lot about hotel quarantine over the past few weeks, people saying that potentially we should be quarantining people away from large population centres and instead having centres in the regions. I'm just wondering if you could outline some of the reasons that we haven’t done that already and what are some of the difficulties of a plan like that.
PAUL KELLY: So, if people cast their mind back to about a year ago, we did do that. We did have our first case- our first quarantine system was actually in Christmas Island, when we evacuated people from Wuhan. We learned a lot from that process, but one of the major things was the problems of having such a remote setting for quarantine. And as we've gone through that process now, with, as I said, over 200,000 people coming back, people who are coming back, particularly the most vulnerable that have registered with the Department of Foreign Affairs because of their vulnerability, needing to come back for multiple reasons, is they come back because they have other issues. So, we've seen mental health issues, we’ve seen severe other physical issues like end-stage cancer, people about to give birth. All sorts of reasons why you actually need good care on-site and also an ability to be able to get people to hospital if they’re needed or to arrange- to access a range of services, which are more available in our capital cities.
The second thing I would say is that one of the most risky times of transmission during that end to end phase of what we call hotel quarantine is actually the transport from the airport to the actual facility. And so, the longer that is, the more risk there is. So there's a range of issues there. We've looked at what, if any, other suitable accommodation may be available outside of the capital of cities, and we've looked in great detail at for example, the Gladstone proposal, which was put forward by the Queensland Premier recently. There was one on the table that was discussed briefly at National Cabinet around a proposal in Toowoomba. So there's two options. We have the Howard Springs facility. It's on the edge of Darwin. It's not very far from Darwin, really, but it is in a more rural area. So we've looked closely at that. At the time when we started the hotel quarantine system, our hotels were lying empty, essentially because of the limitation in travel and so that played into it.
But I’d just like to stress that this is really a very good system that has had some issues recently, which we're addressing, as I said, and looking at ways of continuously improving the quality. But it has worked well and will continue to work well and be able to deal with those other issues that I mentioned.
And your second question, Tamsin.
JOURNALIST QUESTION: Thanks. Also just wondering, Daniel Andrews today, in his press conference, said that the Victorian hotel quarantine system was at a higher standard than that of New South Wales. Is anyone state doing better on hotel margins? What are the differences?
PAUL KELLY: So I don't think I would get into state rivalries, but I would say that we have learnt a lot as a nation about hotel quarantine. The Victorians have the advantage, of course, of having had a royal commission or a special commission into their hotel quarantine issues from the middle of last year, and they've certainly had to and have addressed some of the issues that were highlighted in that time. All of the states have been examined under the Halton review. Jane Halton, the previous department secretary here in the Department of Health in Canberra, she's gone to every state and territory and looked closely at all of those arrangements and given advice. But beyond those things, we're continuing to look at what has happened over the last several months and to learn from those things. And some have been some very specific and unintended or imagined issues that have been addressed and corrected, and there's others that we discussed at AHPPC yesterday and put on the table. Let's look at this, let's look at that. Under testing, whilst people are in quarantine in terms of the returnees themselves or the staff, both in fact, what can we do around the hierarchy of infection prevention and control, should we be looking more closely at other elements about the movement to and from quarantine, where people should be housed if they're positive, those sorts of things. So we'll continue to do that work.
JOURNALIST QUESTION: Thanks Professor. On a number of occasions now, you've had to defend the efficacy of the vaccines that we are getting. A Lot of that seems to be down to confusion around the goal in that it's about reducing mortality and serious illness more so than contracting the virus. Can you explain for Australians, is it likely that they have to accept that they will possibly get COVID even after having the vaccine but the actual benefit is that they won't die? Do you think that that understanding of efficacy could be better explained, given people repeatedly raised concerns of AstraZeneca?
PAUL KELLY: That's a great question. Thanks, Clare. So, look, the initial… what we're initially trying to do for the vaccine rollout, I think, has been very clear, but if we need to make it clearer, we'll continue to say this. We are looking to protect those who are most vulnerable. And by that, I mean those who are most likely to be exposed to the disease, or once exposed and infected, most likely to have severe illness. And so they are- that is our fundamental first task of the strategy that we've undertaken. So that’s how we've come up with our priority populations. So we are going out absolutely at the start to vaccinating anyone who is involved with our quarantine process and thinking about that as end to end. So people who are aircrew, people that are at the airport, people that are involved in our hotel quarantine system, because they are the ones that are, at the moment, the most likely to be exposed. Then, we work through with frontline health care workers. We work with those that are in aged care or those that care for them, on the basis, again, that they’re most likely to be exposed and or most likely to be severely affected. So that is our aim first up.
As this flows through and later in the year, we’ll be looking to offer the vaccine to everyone in Australia that wants a vaccine, and I really encourage everyone to consider taking a vaccine when it becomes available for you. I certainly will be. My colleagues will be when our turn comes. And so that's when we can start to think about how that plays out into decreasing the virus spreading in the community. But it's mostly about severe disease right now. That's why the efficacy of the AstraZeneca vaccine and the Pfizer vaccine against severe illness and death, which is both very, very high, approaching 100 per cent, is enormously good news.
In terms of what that might do in ways of us getting back to some sort of post-COVID normality or COVID normality, this was raised in the press conference after National Cabinet on Friday, where exactly those issues that you've raised there, Clare, were mentioned. And that's why Phil Gaetjens, who's the Secretary of the Department of Premier- of Prime Minister and Cabinet here in Canberra, together with his colleagues in other states and territories, with medical advice from the AHPPC, with economic advice through Treasury, the Treasurer- Treasury Department and others, will be really examining what it looks like in Australia later on this year when we've got a good vaccine rollout and just trying to get back to some sort of new normal, if you like. But that new normal will almost certainly mean that we will have virus circulating in Australia. But if we can protect people from the disease, that is the main aim at the moment, in terms of preventing people going to hospital, preventing people going to intensive care and preventing death.
JOURNALIST QUESTION: Ah, yes. Sorry. Just quickly, it was also mentioned that Pfizer would be giving us an update on the longer-term delivery of the vaccine by the middle of this month. Are we still waiting for that? What’s the status on when will find out beyond the 80,000 doses what the schedule is?
PAUL KELLY: So they've certainly committed to those extra doses that were announced last week. So 20 million by the end of the year. How that plays out after those initial four to six weeks, I'm not sure that we have that yet. It does, of course, depend on the global demand, et cetera, and their ability to keep up with that demand, which is a challenge, a good challenge to have of course. There are now millions of millions, tens of millions even of people around the world who have received their vaccinations. So in one sense, that's good. But they have guaranteed that they will supply us and there will be more details once we start to roll out how that how that works for both the- for the Pfizer doses. The AstraZeneca, we do expect an early delivery from overseas, but then backed up quickly from next month with our locally grown supply through CSL.
JOURNALIST QUESTION: Hi Professor Kelly. I understand there's no evidence that the AstraZeneca vaccine isn’t effective on the severe cases of the virus, but what about mild and moderate cases? Is there evidence that the vaccine offers minimal protection against mild and moderate cases of variants of COVID-19 – the South African variant, for example – and is that concerning? And if it’s not concerning, has South Africa acted prematurely here?
PAUL KELLY: So, look, I won't talk for the South African authorities. They'll need to make their decision on the basis of the information they have, but particularly what they are trying to achieve through their own vaccination program. I just stress again that we're looking to prevent severe disease. There's no evidence that there is an issue with severe disease in relation to that variant or other variants at this moment. And so, they've acted on that information. It's become widely available, of course; all information we take into account. But our aim at the moment is not about mild and moderate disease. It's about severe disease. And so, we will continue to push ahead. I’d just say, though, that our initial strategy, based on getting as many people vaccinated as possible, starting with those most vulnerable groups, is only the start of this. We may find that all of the vaccines have issues either with the variants of concern or they only last for a limited period in terms of their effectiveness. Now, we don't know that because there's just no one in the world that has had two doses of Pfizer or Moderna or AstraZeneca or any of the other vaccines for more than a few months. So, we just did not know yet about that. We do not know certain issues in relation to particular subgroups of the population. So, I'm often asked about pregnant women, people- women that are breastfeeding, people with particular immune suppression and so forth. These are things that we'll need to keep looking at carefully over the coming months and even years. So, I think there's lots of information. We take it all on board, but we are continuing in our process through that program.
JOURNALIST QUESTION: Yeah, I have a follow up to that. In terms of advising, we've heard in committees that pregnant women, for example, are being advised to talk to their GP, but if the nation’s medical experts don't have a decision or a direction in terms of whether these women who are pregnant, for example, should be getting the jab, how could a GP be able to provide that information or be able to assist there?
PAUL KELLY: So, it's a very good point, I think- so, this goes into the same issue I was just talking about there, where we are going through all of the processes to make sure that the TGA regulatory advice and our expert committees like the Australian Technical Advisory Group on Immunisation are looking at all these- all of this information and giving direct and clear advice to our practitioners that are actually giving the vaccine, whether that's GPs or pharmacists or nurses in certain circumstances. But they can't give advice if they don't have the information, so they can give a balanced view and they will do about that. We can talk about what has happened after the regulatory decisions have been made in other countries, and indeed, eventually in Australia, and look at the real world experience. And the real world experience, for example, in Israel, where they have now vaccinated a large proportion of their population, that's how they've been handling it. They've had a- left it to an individual choice for pregnant women in those circumstances on the balance of risk versus benefit. And so, the risk of getting COVID-19 in Australia at the moment is obviously much lower than it is in Israel. And so perhaps the sensible thing would be to wait, but that could change. So, that's the sort of discussion that would be had with your usual practitioner rather than an absence of advice, if that makes sense.
I'll just go to the room for the last two questions.
JOURNALIST QUESTION: Professor, the AMA says pharmacies should be excluded from the roll out because they're not equipped to deal with adverse reactions. What's your reaction to that?
PAUL KELLY: So, the AMA represents doctors and that's the important thing to consider. We've made a decision to look at the widest access we can for this vaccine. Pharmacists have been vaccinating in all states and territories now for some years, at least some of the vaccination programmes. And so, they are experienced. I would say that pharmacists won't be joining the roll out until later in the year. And by that stage, we'll have a much better understanding of all of those matters, including the risk of side effects that there have been. And there were early reports from the UK, I think even on the first day when they started with their Pfizer vaccine roll out, about allergic reactions. As time has progressed, that is actually extremely rare, about 11 per million. So it’s not a big deal. But it is certainly- that safety component is an important thing to consider.
JOURNALIST QUESTION: We've talked in the past about, I guess, the vaccine portfolio that we’ve had in Australia, signed up for specific vaccines before we knew any of the efficacy data, anything like that. If we were to then- now, there’s a lot more data out there, say, go to Moderna or go to another company and try and get them on our portfolio, would that cost us significantly more money because that data's out there now?
PAUL KELLY: So, the main issue is supply. And so, we made our decisions - and Moderna was on the table, there is a potential, and we decided to go for one mRNA candidate, which ended up being Pfizer. That's the company that we have the relationship with. And as we say, within the coming weeks, we'll be expecting those first doses to arrive. Very exciting. We did the same with AstraZeneca, one of those viral vector vaccines. We had two protein vaccines. The UQ one, for unfortunate reasons, is not going ahead. But certainly the Novavax one, we're very excited about.
So, there’s our free. We’re also part of the COVAX facility. We can look to get other vaccines through that, including Moderna. Actually, they're part of that. But, you know, I think- my own view is COVAX is mostly, there for our neighbouring countries that we're also supporting. This is a global pandemic. We need a global roll out of vaccines and that's going to help protect Australia as well. I'll leave it there.
JOURNALIST QUESTION: [Inaudible]… Wollongong case? Is it possible- [indistinct] appears that was transmitted in the hotel [indistinct] likely to be one of the bearings?
PAUL KELLY: So, the case in Wollongong is one of the- this was someone who was tested on day 16 after they arrived back in Australia, gone through the hotel quarantine process, had two negative tests during that and was sent to the community. New South Wales this week has developed a system for following up everyone after they've gone- left the quarantine process and advising people to get a test even if they're asymptomatic. This is the case in Wollongong. Came out positive, but my understanding is there's still three options there. It's either a false positive. It could be a very long incubation period. It would be very long, but it's possible that they had carried it right through quarantine without being picked up. Or that there was some infection during the quarantine period. All of those three things are possible and it's still under investigation. So, I can't give any further details there.
JOURNALIST QUESTION: With that in mind, is it likely that the medical experts panel will recommend extending quarantine to 16 days?
PAUL KELLY: That's not currently on the table, no. Okay. Thanks everyone on the phone and thanks for those in the room.
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