Date published: 
9 March 2020
Media type: 
Transcript
Audience: 
General public

ALI MOORE:

Well how clear are you about what to do to protect yourself against coronavirus.? Or what to do if you have a sniffle or a sore throat? Brendan Murphy is Australia's Chief Medical Officer and he joins us now. Brendan Murphy, welcome to the program.

BRENDAN MURPHY:

Good morning, Ali.

ALI MOORE:

If I can just start by dealing with the issue that's currently very much in the news. We just heard then that there's been a petition signed by thousands of people in favour of Dr Chris Higgins. From your point of view as Australia's Chief Medical Officer, did he do the wrong thing by going to work when he says he had what he calls a mild cold that it almost resolved itself?

BRENDAN MURPHY:

So Ali, I'm not aware of the details of what symptoms he had. So obviously, if somebody – in general terms, if somebody in a healthcare setting has an obvious flu-like illness with a temperature and symptoms, we always recommend that they don't go to work and certainly in the situation of this virus; that's an even stronger recommendation. But I know there's various stories about his symptoms and I'm not aware of the detail so I prefer not to get into the specifics of his case and – and that issue.

ALI MOORE:

I guess though it does go to the heart of he maintains that he didn't fulfil your criteria for testing. So who should get tested?

BRENDAN MURPHY:

So we're saying at the moment, that anybody, any return traveller who has acute respiratory symptoms so a cough, sore throat, fever, the sort of general flu and cold symptoms. If they've returned from anywhere really now because this virus is now in over – well over 100 countries and is growing in many places, we're suggesting that they should get tested. We're suggesting that anybody who has been in contact with a case of coronavirus or think they might have been in contact and anybody who is – we're also testing people with very severe and unusual pneumonia. We're not at this time suggesting that people in the general community who haven't travelled or haven't been in contact with suspected or confirmed cases should get tested. That may change if we get further community spread of the virus in Australia.

ALI MOORE:

And how long does it take to get those results?

BRENDAN MURPHY:

They are available the same day at the moment in the public health labs across the country and we are looking at expanding the testing capability. That's already happened in some states to the private labs. So the tests which were still only experimental in January are now well validated and performed pretty rapidly.

ALI MOORE:

So where does that sit with the 14-day isolation period?

BRENDAN MURPHY:

So the 14-day isolation period applies to people who have been in contact with a case. So somebody who has definitely had a close contact with someone who's proven to have the virus or for people who've come back to Australia from very high risk countries, in particular Iran is probably the highest risk at the moment, China and the Republic of Korea.

So we're asking those people to isolate at home for 14 days because as we've seen, we've had already 16 people from Iran, for example, who've returned and have developed the disease. So that's – that's – if you've come from a high risk country the idea of a quarantine is to make sure that you're not in contact with lots of people if you become infectious, if you do develop the virus. But most people, again, aren't being quarantined.

ALI MOORE:

That 14 days though as we were hearing earlier today from Sally McManus, it's a huge burden on people, particularly those who don't get sick leave and who can't work from home. And if the test results only take a day, why not just test these people?

BRENDAN MURPHY:       

Because you can't - test results won't tell you if you're incubating the virus unfortunately. The test …

ALI MOORE:

[Interrupts] So it only reads once you're symptomatic, does it?

BRENDAN MURPHY:

We think so or possibly in a day or so before you become symptomatic. We are and the whole world is now looking at whether that 14 day is too long a period the virus – the incubation period of the virus is probably more closer to a week rather than 14 days. The 14 days has a margin for error in it and we would like - most of the international community would like to see if we can safely reduce that period because it is an awfully long time and we agree with that.

ALI MOORE:

And in fact, there were some stories out of China and this is all part of the information slash misinformation that is swirling around, but there was a story that someone actually tested positive after 27 days. Has that been ruled out so that you know that it's no more than 14 days?

BRENDAN MURPHY:

Well … all of the group data suggests that the incubation period is more in the five to seven-day region. That – we've heard about that case, we don't quite know what that case means. It was an isolated case and there's really no good suggestion that if someone has been 14 days from a contact that they will become infectious. So we're pretty confident about that and I think, as I said, I think we might be able to reduce that 14 days at some stage.

ALI MOORE:

Do you have any sense of what timing that might be? And I suppose I ask that question because of what's already happened in Hobart. Are you concerned that the incident in Hobart is not going to be an isolated one?

BRENDAN MURPHY:

No. It was very – it's very unfortunate when people who, you know, who are under investigation, who may be a suspect case don't adhere to the request to isolate. The vast majority of Australian citizens or anyone in the world will follow advice but we do find some people who have ignored it and that's very, very disappointing.

ALI MOORE:

Very disappointing. But I'm sure that you would understand some of the stresses on people who are casual workers and have no financial backup.

BRENDAN MURPHY:

Exactly and I think – I think we do – we do have – if this becomes a – you know, there's widespread isolation then I think we do have to consider those issues and Government's looking at all of those issues. I think it is true though that if we did develop wider spread community transmission in Australia, we would be less likely to be quarantining contacts and more focused on isolating people who actually have the disease itself.

ALI MOORE:

I know that there's been a lot said about wearing masks as well, that if you think that you're contagious, then you should wear a mask. But if you're well, there's no reason you should, it's not going to have any effect. But that said, if you're travelling on an aeroplane, are the rules different?

BRENDAN MURPHY:

Well, certainly wearing a mask walking down the streets of Melbourne makes no sense at all because there's no evidence of community transmission generally except in Australia – except in that small pocket in North Sydney where that nursing home case was. That's the only community transmission we've seen.

It is true that because of the wide international travel spreads that there might be a bit more sense in wearing a mask if you were travelling, particularly to a high risk country such as Italy or some countries with large cases. But there really is not a lot of evidence. It's more important to be wearing a mask when you're in – when you're clearly in contact with someone who has the disease. But I could understand why people on a plane might feel more inclined to do so. I'm certainly very opposed to people wearing them in the general community.

ALI MOORE:

You'd wear one on a plane if you could get one of course. [Laughs]

BRENDAN MURPHY:

Well, I think mask supply is a big issue internationally. The biggest manufacturing country for masks is China and they're certainly – the manufacturing has been reduced. They're now gearing up again. The Australian Government is very aggressively buying masks at the moment, we're – Government is very keen to make sure we have enough masks to meet our eventualities – and we do have masks in our stockpile and we are releasing them judiciously to those areas of the health sector which need them – we obviously have to be careful about rationing that supply. We don't want them wasted. But we do have masks.

ALI MOORE:

You're listening to Australia's Chief Medical Officer Brendan Murphy at 9.15 here on ABC Radio Melbourne.

Just before I take a couple of listener questions on the calls, there is a text here, I can just clarify with you, Brendan Murphy. Should all overseas travellers isolate?

BRENDAN MURPHY:

Not. No. No. Only – what we're saying is if you've come back from high risk countries – that's China, Iran and the Republic of Korea, South Korea – we want you to isolate at home for 14 days. If you've come back from other countries and begin, depending a bit on the risk, but Italy's probably the next highest, we are suggesting that if you - we would prefer you not to work in the health care industry, if you're in a high risk sector, if you've come back from Italy or the other high risk countries. But at the moment, we're not saying that anyone who's come back from other countries should isolate. We're suggesting that you should just be aware of your symptoms and make sure you don't develop – if you develop cough or fever or sore throat, go and get tested. But we're not saying you should isolate unless you've come back from those high risk countries: China, Iran and Republic of Korea.

ALI MOORE:

Sharon has joined us from Geelong. Hi, Sharon. What's your question?

CALLER SHARON:

G'day Ali, Dr Murphy. Simple question. Is there a test for retrospectively? I asked this question because family arrived back from Southeast Asia in early January. Adult daughter was extremely ill with all of the symptoms that you're talking about for three weeks or so; went through her family and they tried to stay away from everyone for a while. But we're just wondering whether she would have any antibodies that would show that she actually had COVID-19?

ALI MOORE:

Yeah. Good question, Sharon. I'll put that to Dr Murphy.

BRENDAN MURPHY:

A very good question actually, and the answer is not yet but soon. So, there are a number of labs who are developing these antibody tests that will be able to look for antibodies. Westmead in Sydney have got a prototype test. I think the Doherty Institute in Melbourne have one too. There's not one that's been validated and widely used. I'd be surprised if – because in early January, the cases were nearly all just in China. So unless you'd been to China, it's probably unlikely. But we will have a test that will be able to do antibody assessments fairly soon. And that will be very important to actually detect how many people have had this virus and have not known it because we do know that a lot of people have very, very mild disease and may not have even noticed it.

ALI MOORE:

And indeed another question on the text line: can you be reinfected?

BRENDAN MURPHY:

Again, we don't really know. There's been some – one suggestion again from China that someone might have been reinfected. It's unusual with a virus – if you've had a virus and cleared it with your immune system to be reinfected. That's a question that we really need to work out with future information. That would be a relevant issue if this virus becomes endemic. Sometimes, flu viruses that come in a pandemic, then can become what we call endemic and keep coming back in the community. And it depends a little bit on whether the virus might mutate a bit and so that the immune protection isn't as strong. So we don't really know the answer to that yet.

ALI MOORE:

Gerard in Avoca. Hi, Gerard.

CALLER GERARD:

Hello, Ali.

ALI MOORE:

What's your question?

CALLER GERARD:

Well, my question is that the doctor has added more confusion by saying that naming China and South Korea and Iran, and leaving out Italy, which is the hottest spot on the planet, but then mentioning Italy in the other parts of his advice. There's no way that we're not protecting Italy for the Grand Prix, otherwise they would be on the isolation list. You know –

ALI MOORE:

[Interrupts] Gerard, let's put that question to Dr Murphy. A lot of people are actually concerned about that here in Melbourne.

BRENDAN MURPHY:

Sure. So Italy, the Government seriously considered putting in travel bans as we have for Korea, for China and for Iran. It's very difficult to put in travel bans in those formal quarantine periods for Italy, partly because Italy has porous borders. And at the time, when the travel bans were introduced for Iran and the Republic of Korea and China, the cases in the Republic of Korea and Iran seemed to be much greater. Italy has very enhanced border screening, so the Government has put processes at the border so that everyone coming from Italy now has to have health checks and have information provided at the border.

So, Italy has also now completely locked down the northern part of the country in the same way that China did for Hubei province. So they're not letting anybody out of the infected zone. So, it's certainly –

ALI MOORE:

[Interrupts] But that's actually only really created more concern here, hasn't it? I mean, the fact that China introduced isolation for an entire province didn't stop us banning people from China. So…

BRENDAN MURPHY:

Well, I think the problem was that, at that time, there were a large number of cases outside of Hubei province in the other provinces of China. At this time, the Italian outbreak does seem to be largely confined to those northern zones. So, we are obviously very concerned about Italy and – at the moment, though, because the cases are in significant numbers in now many, many countries – as I said, over 106 countries – we know we can't really just put bans in place for an increasing number of countries. We just have to be focused on making sure that all returned travellers, if they come back, are focused on their health and if they have symptoms, get tested. That's the most important thing. They can't isolate the [indistinct] forever…

ALI MOORE:

[Talks over] The entire community. No.

BRENDAN MURPHY:

…Yeah.

ALI MOORE:

And just a final question, Brendan Murphy.  Would you feel comfortable going to the Grand Prix? Would you feel comfortable jumping on a plane from Canberra to Sydney? Would you be comfortable going to the movies?

BRENDAN MURPHY:

I jump on planes three or four times a week with full confidence at the moment. I would go to the Grand Prix. I would go to the movies. We don't believe that, at the moment, there's material risk in going to public gatherings in Australia, but we are saying that if you returned from a high risk country, we would like you not to attend public gatherings. And anybody who has any flu-like symptoms, particularly if they're a return traveller or unwell, please keep away from public gatherings. That's the best way to protect people.

The other thing that we're also saying is that this is a really good opportunity for everyone in the community to practice good personal hygiene. A good chance to focus on handwashing. A good chance – if you're unwell, stay away from work and keep away from close contacts with people and practice good cough etiquette, and all of those sort of things that we've talked about for years. But they can really help in the prevention of transmission of a virus, any virus.

ALI MOORE:

Absolutely. Brendan Murphy, thank you very much for talking to us.

BRENDAN MURPHY:

Thank you.

ALI MOORE:

Brendan Murphy, Australia's Chief Medical Officer there. And of course, if you want more information, the ABC – you may have already listened to it – it's launched a Coronacast podcast with our very own Dr Norman Swan, and that's also giving some of the latest information on the virus.

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