TRACY GRIMSHAW:
Dr Nick Coatsworth is Deputy Chief Medical Officer. I spoke to him late today.
[Excerpt]
Dr Coatsworth, thank you for your time. For Victorians struggling with these restrictions, why didn't Stage 3 work?
NICK COATSWORTH:
Well, that's a really important question to answer, Tracy. Essentially, we had widespread community transmission across a number of different settings, many different outbreaks in Victoria. So, it was a very different outbreak to the first wave. And what that meant was, that whilst the movement restrictions of Stage 3 were essentially working, they were dropping the basic reproductive number to around about one. But what that meant was that we kept seeing the same numbers every day, between 400, 500, 600 and even up to 700 cases. And what that does is it puts immense strain on your public health system, your contact tracing system, on your hospital system; strain that can't be sustained in the medium term. So, whilst the movement restrictions in Stage 3 were working in some sense, they weren't working hard enough and they weren't working quick enough. Which is exactly why the Victorian Premier has asked Victorians to go that extra mile, that substantial extra mile, that the Stage 4 restrictions will impose.
TRACY GRIMSHAW:
Was non-compliance with Stage 3 a significant factor, because, I guess, if people were reluctant to comply with easier restrictions, surely there's a greater chance they will rebel against tougher restrictions?
NICK COATSWORTH:
I think non-compliance was part of the story, but I think understanding the reasons for that non-compliance were even more important. We heard a variety of things, both through our own channels, through the Victorian Premier, people who simply weren't complying because they didn't believe that they should comply. That's obviously not acceptable. People not complying because they had other reasons like financial hardship, people who had to go to work, people who perhaps weren't even offered sick leave. There were a variety of reasons. Now, what the Stage 4 restrictions are going to do is get things under control as quick as possible, so this pain can be as short as possible for Victorians, and we can demonstrate that we, not just flatten the curve, but start to bend it down the other side again.
TRACY GRIMSHAW:
Given that we've gone into Stage 4 lockdown at between 400 and 700 cases a day, is six weeks a realistic timeframe for this to last? Because New Zealand went into this kind of hard lockdown when they were only getting 90 cases a day, and I'm pretty sure they- weren't they in lockdown for four to six weeks as well?
NICK COATSWORTH:
Well, I think six weeks is as very reasonable timeframe to provide to Victorians as an expectation in that we've got movement down, as I said, to a certain level at Stage 3. And now we just need to push that curve over the edge and start to reduce cases. Now, if we get the basic reproductive number down well below one through these restrictions, we will see the numbers come down quite substantially.
TRACY GRIMSHAW:
So, on your analysis of data, what is the significant driver of this transmission? What is the driver behind all of these decisions that we have heard today?
NICK COATSWORTH:
Well, from what we've heard from the Victorian Chief Health Officer, who informs us on a daily basis, there's two elements to this. There's a series of major outbreaks that have occurred in suburbs and workplaces. But on the other side, there are also a significant number of unlinked cases. So, there's two issues at play here. There's how to get those larger outbreaks under control, how to perhaps restrict those workplaces and no longer have the outbreaks in there. But also - and this is Stage 4 restrictions come in - really snuff out those chains of transmission that have been driven by the unlinked cases of COVID-19 within the community.
TRACY GRIMSHAW:
On the issue of unlinked cases, how significant do you believe asymptomatic cases are with this kind of uncontrolled community transmission? Is it time to just start just start blanket blitzing testing, you know, office buildings and communities, and schools to try and root out these asymptomatic cases?
NICK COATSWORTH:
Well, in fact, we've done that Tracy through the Victorian testing blitz. You'll remember they've gone through an extraordinary number of cases. In fact, Victoria is one of the highest testing places in the world at the moment. And finding cases that are truly asymptomatic is actually not that common. What we're most worried about is the pre-symptomatic, where you've got a day or two where we know people are shedding virus, we know they're infective, but they don't know because they haven't had their symptoms. And they're the sort of people that you will find if you go in hard and look for people without symptoms. Now, I can tell you where that's going on. That's precisely the strategy that's being used in New South Wales at the moment to shut down their chains of transmission. I think in Victoria where we've got so many cases at the moment, it's very important that we follow the public health advice, which remains: anybody with mild symptoms to get themselves tested.
TRACY GRIMSHAW:
When hotel quarantine has been so pivotal to containing this virus, why are consular staff allowed an exemption to fly in from overseas, then travel domestically to their home state, then quarantine at home, as this infected Queenslander did on Friday. Surely that's a massive loophole.
NICK COATSWORTH:
Well, Tracy, the quarantine is clearly one of our most important measures, particularly international quarantine. The AHPPC is certainly aware of that case. We're at this moment discussing the various exemptions that are in place to make sure we can tighten up those loopholes as and where they exist. And the preference is to have people quarantine at the port of entry.
TRACY GRIMSHAW:
Are you getting to a point where you think that we can't afford these exemptions now?
NICK COATSWORTH:
Well, I think to be able to function as a nation, to a point we have to have exemptions. I mean, we're talking about diplomatic travel. That's a well-known exemption for a variety of things around the world. I mean, we're talking about international cargo coming into the country, international shipping cargo. So, these exemptions have to exist. But it's important that the systems, the processes around those exemptions are robust enough to detect the cases when they came in. I would note that that particular case was in fact detected. So at some level, the system was working.
TRACY GRIMSHAW:
But other people had been exposed potentially on that domestic flight.
NICK COATSWORTH:
There are certainly people who we are contact tracing on that domestic flight, yes.
TRACY GRIMSHAW:
For months we were being told that masks were not necessary, that they didn't protect you from getting the virus, they protected you from spreading the virus if indeed you were infected. Now we're all being told- certainly in Victoria, Victorians are being told to wear masks and increasingly so in New South Wales. That's confusing messaging, isn't it?
NICK COATSWORTH:
It can be confusing, but I think if I can simplify it for the audience, the best value for masks is to stop the person who's infected with COVID-19 from transmitting it to another person. That is where the best evidence is for mask use. But equally, when you're in an area where there's high community transmission, there is some value of having that mask on yourself if you're COVID-free to stop yourself from getting it.
TRACY GRIMSHAW:
It's been suggested by some eminent frontline healthcare workers that you've changed your view on masks because, initially, you didn't think that the virus was spread- you thought initially the virus was spread by droplets, and now you're increasing of view that it is spread by very fine particles in the air. Is that the case? Have you changed your view?
NICK COATSWORTH:
Well, I think what we can all agree on is that there's a continuum between what comes out of your mouth, and the size of the virus particles, from those that are in droplets which tend to really not spread that far, and then you can detect the virus in airborne particles, we know that.
TRACY GRIMSHAW:
Some people will really struggle with these lockdowns. I'm thinking about sole parents, I'm thinking about sole occupants in homes who can barely leave home now. What help is available to them, and what do you suggest they do to cope?
NICK COATSWORTH:
Well, I acknowledge how difficult this is going to be. We all have neighbours. We know if there's people around us who are isolated. We should be checking in on them. In terms of people's mental health, that is a significant concern and I would urge people to go to the health.gov.au website, and to head to health. But the most important thing is for people who are struggling to reach out to their general practitioners via telehealth who can put them in touch with people who can help them here and now.
TRACY GRIMSHAW:
Alright. Thank you for your time.
NICK COATSWORTH:
Thank you Tracy.
[End of excerpt]
TRACY GRIMSHAW:
Deputy Chief Medical Officer, Dr Nick Coatsworth.
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