PROFESSOR BRENDAN MURPHY:
At the outset I should say that this is a rapidly evolving situation. There have been significant developments over the last three or four days and we are updating our advice and analysis on a daily basis in partnership with the World Health Organization and very importantly in the Commonwealth in partnership with our state and territory health officials who have the primary health response in the public health arena.
So while our concern has been heightened in the last three or four days, I would like to start by assuring the Australian public that there is no need for alarm, and the risk to the Australian public from this novel virus remains relatively low, although we do need to keep a precautionary and active surveillance of the situation.
Coronaviruses are ubiquitous. They're present in – there are a number of them present in humans and in lots of animals. In fact, some of the common cold are caused by coronaviruses. But we do know that coronaviruses from animal species can sometimes mutate and cross into human and causing new infections and two coronaviruses that did that in recent memory were the MERS and the SARS virus, which obviously means that we are always concerned about the emergence of a new coronavirus infecting humans. And that's why we and all the international community take this development seriously.
This novel virus was first detected in the city of Wuhan in China, over a month ago. There are now more than 220 confirmed cases. The vast majority have been in that city of Wuhan, in a relatively small area of that city. There have been three deaths confirmed so far in those cases. Six cases have been detected in other parts of the world, in other parts of China, in Shenzhen, Beijing, also in Japan and South Korea and Thailand. The great majority of those people have reported a travel history from Wuhan. So we still believe that Wuhan remains the major source of this infection.
Since last week, we've had more than 130 new cases confirmed by the Chinese authorities. Generally, in people with previously unexplained pneumonia and it's important to note that most of – many of those cases were cases from some time ago and it's just updating the surveillance data, particularly for people who had unexplained pneumonia. All of the cases so far have been in adults. There haven't been any children infected.
What we do know is that whilst we have over 220 confirmed cases, that's likely to be a significant underestimation because there are a significant number of mild cases and mild cases often in these outbreaks often go undetected and the modelling suggests that there could be many more than those 220 cases when we finally get a true picture of their epidemiology.
A number of clinical symptoms have been reported. The most consistent is high fever. Nearly every patient who's been confirmed with this disease has had a high fever, but other respiratory symptoms – such cough, breathlessness and sore throat – have also been reported in some cases.
As I've said, there have been three deaths, and there have been a number of – a smaller number of clinically severe cases, often in people with associated comorbidities or other medical conditions. However, we don't yet know enough about whether this disease is as serious as some other diseases in the past. We simply haven't got the data to assess the clinical severity of this disease and that will emerge as we get more data over the coming days and weeks.
The World Health Organization is now reporting limited human-to-human transmission and this is a development over the last three or four days, whereas as of late last week, there was no confirmed reports of human-to-human transmission. But now, there are cases who do have the disease that haven't had contact with the seafood market in Wuhan that was thought to be the primary source and overnight we have heard reports from China that there have been cases of infection of health care workers, which would be pretty conclusive evidence that there is some human-to-human transmission. But yet again, we don't know what is the risk of human transmission, how easily this virus is transmitted from human-to-human versus from animal to humans and again that data will evolve over the next few days and weeks.
In response to this significant development over the weekend, and because Australia has significant numbers of international travellers from Wuhan and from China, we are putting in place some additional proportionate border measures. In particular, these measures relate to the three direct flights a week from Wuhan to Sydney. Each of these flights will now be met by our border security and biosecurity staff and New South Wales Health. They will be providing to all the passengers an information pamphlet in English and Mandarin, outlining the symptoms this disease might deliver and asking them to identify themselves at the border if anyone has a fever or any of the symptoms that suspect that they might have this disease. And then if they are suspected of having this condition, New South Wales Health will follow up as per our normal border security and biosecurity protocols.
We will also be putting information in place at all other ports of entry, warning people about this disease and alerting them that if they do develop symptoms on arrival or after arrival, that they should seek medical attention. And obviously, we'll be doing some specific communications in the Chinese media to target the Chinese-speaking population, who are clearly of significant interest to us.
No international travellers have yet been confirmed as having this coronavirus in Australia and we already have well-established existing biosecurity measures at the border, where airlines are required – and have been for many years – to declare any ill passengers on board and we have protocols for assessing those passengers at the border.
A number of potential passengers have been assessed by state health authorities but there have been no confirmed cases of this disease. We have the diagnostic capability in our laboratories to diagnose this condition and we are well prepared in our public health system and all of our state and territory health services have the facilities to diagnose, treat and isolate any patients who might have this suspected disease. So as I said at the outset, this is a rapidly emerging situation, there is not a cause for alarm but we are watching it very closely and we will obviously be providing regular updates to the media. And I'm happy to take any questions.
QUESTION:
Has there been consideration at this point to expand [indistinct]… they've being screened as they come in? [Indistinct]…
PROFESSOR BRENDAN MURPHY:
We will be looking, as I said we'll be providing information to all flights at the border but that will be general information. In terms of meeting specific flights it's obviously very easy for the direct flights, we're doing some careful modelling to see if there are any other flights from China that have a high proportion of Wuhan origin passengers and we may consider expanding that too. But we have to do the analysis to find out where they come from because there are apparently 160 flights from China a week and obviously flights from China could come via other ports a well. So it's a very complicated process.
I think the important thing to remember is this border screening; you cannot absolutely prevent entry into the country of a disease like this. The incubation period is probably about a week, many people who are incubating will be completely A-symptomatic and without any symptoms or fever. So the purpose of borders, border measures is to identify those people that we can where there's a high risk and to ensure that people with a high risk know about it and get attention. But there is no perfect way of preventing entry into the country if this disease becomes much bigger, we need to respond to it as we always do.
QUESTION:
Is the analysis being done quickly so that [indistinct]…
PROFESSOR BRENDAN MURPHY:
Yes, that analysis is being done quickly, yeah. But at the moment the intention is to put in place these additional border measures at Sydney Airport from tomorrow when the next flight is due in.
QUESTION:
Is there any advice –
PROFESSOR BRENDAN MURPHY:
[Interrupts] From Thursday, sorry.
QUESTION:
Is there any advice for Australians not to travel to [indistinct]…
PROFESSOR BRENDAN MURPHY:
At the moment we are working with the Department of Foreign Affairs and Trade on consideration of updating the travel advice. The World Health Organization is still not recommending any travel advisory. We think as the evolving situation requires there should be some specific advice, certainly about what you do in Wuhan and we are discussing with the Department of Foreign Affairs whether we should change the advice more generally.
QUESTION:
It’s, I know you sort of mentioned Australia will be ready for this and we have sort of seen this out of China pictures that we have to start wearing contamination suits and some sort of breathing apparatus. So, is Australia prepared for that if this does land on our doorstep?
PROFESSOR BRENDAN MURPHY:
Absolutely. Every, every one of our state and territory health departments has a designated containment facility with negative pressure ventilation, all of those protective equipment and they have well established protocols to transport a suspected person from the airport to that facility and look after them. We are rated extremely highly internationally on our capacity to deal with that, we're well prepared.
QUESTION:
Do any specific measures happen now with a few possible… [indistinct] across the country about their protocols? Did, there were issues that happened.
PROFESSOR BRENDAN MURPHY:
Sure. So we are, we have provided broad information to all health professionals and hospitals a week ago and we're now updating that and we'll be rapidly communicating the new information over the next couple of days to every health professional in the country. GPs often will be the people who might see people first, but obviously to all of the health departments so they're aware of this condition.
QUESTION:
Is this a degree, it's just advice about the condition and protocols meant to happen [indistinct…] gaps in certain hospitals like how they deal with [indistinct] –
PROFESSOR BRENDAN MURPHY:
Yeah. I think every hospital – we've had lots of experience with this in the past. We've had the flu pandemic, we've had Ebola – we were prepared for Ebola. So most of our hospitals, our emergency departments, our state public health departments are well prepared with protocols. But obviously we need to make sure that they're up to date and revised and that everyone is aware of this. So, we're a very well prepared country to deal with a new, emerging infectious disease.
QUESTION:
Are the screening measures [indistinct] rise, are people self-reporting?
PROFESSOR BRENDAN MURPHY:
Yes. Self-reporting symptoms, fevers, cough and the like. You might be leading to questions of whether we should go back to scanning for temperatures and things at the border. The evidence suggests that – certainly our evidence in the flu pandemic – suggests that that was ineffective. It missed a large number of cases, as I said cases that may be incubating or afebrile and it often leads to a false sense of security. It's not an effective mechanism and all of the public health advice that we've had, we had a meeting of all of our senior public health experts yesterday and we don't believe that is an appropriate measure and that it is helpful.
QUESTION:
You mentioned a number of significant developments and one of them you touched on before – the human to human transfer. Any others that [indistinct] know?
PROFESSOR BRENDAN MURPHY:
Well I think that the detection of cases in other parts of China, in Beijing and other – another city, that is, again, we're still not entirely sure whether they have all been derived from Wuhan or whether there are – there has been transmission in any place other than Wuhan. That's obviously a really important issue to be resolved over the next few days.
QUESTION:
United States took up screening measures quite quickly and we're – ours is starting on Thursday. Is there any reason – was there – is there a delay, was there any reason for that delay?
PROFESSOR BRENDAN MURPHY:
We believe that the time – we met, had an urgent meeting yesterday on the basis of the new development over the last weekend. We believe that the measures we've taken place – we have undertaken are proportionate to the evolving data at the time we took them. The United States have taken a much more precautionary approach but again, they're only screening three of their 400 airports.
QUESTION:
You mentioned before there was significant media interest in this. Do you reckon there's a risk that this kind of gets a bit overplayed by the media?
PROFESSOR BRENDAN MURPHY:
There's always a risk with a new and emerging infection. People get frightened and there is often media hype. And that's why I think it's really important to reassure the public that we are well prepared in this country to respond to these issues. And as I said, we still don't quite know what the severity of this disease is. We do know that there are number of quite mild cases, many people have recovered fully and many people have been treated just like a bad cold. So we don't quite know what- how serious the disease is, how it's going to spread or what the developments will be. We just have to keep a watching brief, but at the moment, please be reassured and we'll be doing everything we can to detect any cases that come in and to respond.
QUESTION:
Is there anything people can do to protect themselves while travelling in particular?
PROFESSOR BRENDAN MURPHY:
Well, I think anyone who was going to Wuhan should definitely avoid any live – any markets, particularly where there are live animals because we – there's no definite proof of the animal source of this virus at the moment but it seems extremely likely that it's come from an animal source. And the great majority of the initial cases were associated with people who'd visited or worked at a seafood market that also had a lot of live animals. It's unlikely that the virus came from seafood, it's more likely that it came from animals. So- and obviously if they thought they'd come in contact with anyone with unexplained pneumonia or fever, to be aware and to seek medical attention.
QUESTION:
Just on another issue – have you seen a spike in deaths attributable to smoke inhalation in Australia because of the bushfire season?
PROFESSOR BRENDAN MURPHY:
We haven't seen a spike in deaths. We have – some states have reported higher increase of presentation at the Emergency Department with exacerbation of asthma and respiratory disease but that data is fairly patchy. There's no – certainly no evidence related to increased mortality at this time.
QUESTION:
On that, does this call – does the bushfire smoke that's been hanging over a lot of the major cities, does that call for a bit of a reform of national guidelines around smoke in workplaces and things like that?
PROFESSOR BRENDAN MURPHY:
Well I think we – as my colleague Professor Kelly who's here with us today who's been responding to the bushfire issue has said, there's a lot we don't know about bushfire smoke. I think – and that the reporting of the fine particulate matter by states and territories, we're trying to get national consistency on that, we're trying to – the government's recently announced some research funding to do more research into the long term impacts of exposure to bushfire smoke. We don't know whether there are any long term impacts. We know that in situations where there's prolonged air pollution there are adverse effects of long exposure to small particulate matter pollution. But there really isn't a lot of data on bushfires and it's an evolving area.
QUESTION:
We heard reports of hospitals, including birthing suites, being filled with smoke. Given that [indistinct] hospitals can be quite vulnerable, is there – does these buildings need to be redesigned to make sure that people are not going to be effected by [indistinct]…?
PROFESSOR BRENDAN MURPHY:
Yeah. I mean, that's – most modern hospitals would have pretty good air control systems that should prevent that. And I think newly designed hospitals would have air handling systems that would prevent that happening. But there may be some older hospitals that still have air intakes that can do that [indistinct].
Any other – no other questions? Well thank you again very much for your attention today and we will certainly be providing regular updates.
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