PATRICIA KARVELAS:
Recapping our top story: face masks will be compulsory for every Victorian from Monday after the state recorded 723 coronavirus infections, the highest number since the pandemic began. For more on this, I'm joined by the Deputy Chief Medical Officer, Dr Nick Coatsworth.
Dr Coatsworth, thank you so much for joining us. What is happening in Victoria?
NICK COATSWORTH:
Well, Patricia, the numbers today are serious. They've got all our attention around Australia. What's going on is that there's deeply embedded community transmission within greater Melbourne and Mitchell Shire, and what we're finding is that's creating a very different epidemic to the first wave. The second wave now deeply within suburbs, where there are a lot of essential workers. And so, people who work in aged care, people who work in healthcare, in food distribution, in construction. And so some of the movement restrictions that have been put in place, whilst it's decreasing movement overall in Melbourne and Mitchell Shire, perhaps isn't having as rapid effect as the movement restrictions in the first wave.
PATRICIA KARVELAS:
The deaths connected to aged care facilities keep rising. Should any resident who's diagnosed with corona be either moved to hospital immediately or treated by registered nurse only?
NICK COATSWORTH:
Well, Patricia, I can tell you, having had my father in aged care, in three residential aged care facilities, the facilities themselves are vastly different, both in terms of their layout, their staffing, their ability to care for patients on site, to do what we call cohorting patients with COVID-19. And so, that decision making has to be about the patients' welfare. Of course, this is their home for these individuals. So these people, these Australians, they would being taken out of their home. That has to be the right thing for them. And of course, the clinical condition has to dictate that, how sick they are.
And what I can tell you is that for those most affected aged care facilities, that the central hospitals that service them, have been partnering with the Victorian Aged Care Response Centre to make sure that that level of assessment is at the highest possible level for a medical specialist to decide whether a resident stays in their home in an aged care facility or whether they got to hospital.
PATRICIA KARVELAS:
We hear some facilities have enough PPE while workers at other facilities say they're not getting it fast enough. Where's the truth in this? I mean, is it true that some aged care facilities are just not getting the PPE they need?
NICK COATSWORTH:
Well Patricia, from our side, the National Medical Stockpile has sufficient personal protective equipment for residential aged care facilities, for hospitals in Victoria. We know the Victorian Government, the aged care providers, can do their own procurement, and we know that global supply chains, whilst not perfect, are in much better shape than they were during the first wave. But it is absolutely critical that if people are experiencing personal protective equipment shortages, that they are reported through the management, and also that our operations, say the Victorian Aged Care Response Centre, obviously, has people dedicated to personal protective equipment, two logisticians who could facilitate getting PPE to where it's needed the quickest.
PATRICIA KARVELAS:
Okay. So, is PPE the most important thing to stopping outbreaks in aged care?
NICK COATSWORTH:
Well it's such a multiple pronged process, Patricia. I mean, personal protective equipment is critically important to protect staff and allow them to deliver care to residents, often who have high care needs. But it's not the only thing, of course. We need to make sure the people who are working in residential aged care facilities are getting tested when they're unwell. We need to make sure that there's a robust public health response that can make good decisions about whether to lay staff off or not. Of course, some of the issues that happened last week were because entire shifts were sent home from work, and that is challenging for any aged care facility to deal with. So, as a composite, all those different things are going to be important in getting this under control.
But the most important thing of course is getting those numbers down in the broader community, because until we do that, it will still be a risk for residential aged care facilities.
PATRICIA KARVELAS:
In terms of the deaths that we should expect in coming days, Brendan Murphy told us we need to expect that yesterday, and he's now the head of of course health federally for the Commonwealth Government. How many deaths should we expect? I know it's a crude question, but every day, are we just going to see rising numbers of people dying in Victoria? Is that something that we have to expect for the coming months?
NICK COATSWORTH:
Well, the tragic thing about this virus is that it affects the elderly so severely. It does have a very high death rate in the elderly. And when we have these high numbers within the community, when we have incursions of COVID-19 into residential aged care, or even people who are at over 60- over 70 who are living in their own homes and they're not in residential aged care, they are at risk. So, this is something we can expect. What I do know is that the doctors down there - many of whom are my colleagues - and the nurses in the hospitals are doing their best to give the best possible care that we can. We have traditionally in Australia, so far in the pandemic, had lower mortality rates, lower death rates across all age groups. But that statistic doesn't make any difference of course to friends or family who tragically lose loved ones to COVID-19.
PATRICIA KARVELAS:
There are lots of cases within workplaces. Does this mean that the public health message isn't working? The Premier, Daniel Andrews, telling a really disturbing story today about somebody who was at work after they tested positive for COVID-19. This isn't someone just with symptoms, they have been told they have COVID-19 and they're at work.
NICK COATSWORTH:
I mean, these are disturbing stories in as much as that is how it spreads, when your restrictions are in place and apparently they're not working because there's these instances of people who do still turn up the work. But the answer to that question of course is to work out why that's the case. There are reasons why people have to keep going to work. To earn a crust, because they're in financial hardship, because they're in casual employment, all sorts of reasons like that that need to be assessed and we need to try and find something as a government to help people to get the message to stay at home. One of the important things of course though, is that this doesn't go away if we all go to work if we've got COVID-19. So any hardship that we're feeling at the moment is going to be magnified many fold if we don't get this epidemic under control. And that's where we can all play a part.
PATRICIA KARVELAS:
I know your job is to give the health advice, but there is an intersection between behaviour, incentives, sticks. We all know this. So do we need paid pandemic leave at a sort of national level, to ensure that there's no maybe, that everyone is sure that they should stay home, because they know they'll be financially covered.
NICK COATSWORTH:
Well, I think the role of health in this is to point out, first establish the amount, or the proportion, or extent to which this is actually going on. If it's isolated cases, then you don't need a national policy to affect that. If it's a substantial proportion of why this epidemic is spreading, then we need to make that clear to government, and then the arms of government that would deal with that, treasury, industrial relations, et cetera, would need to consider the appropriate response.
PATRICIA KARVELAS:
[Talks over] And has that case been made?
NICK COATSWORTH:
Well as I said, an isolated case, whilst it's an important message to get across from Premier Andrews today, does not the policy make. But definitely it's a consideration that we need to find a way to keep people who are not in secure employment, who have a driver to go and work when they're infected or waiting for a test, we need to consider how we can minimise that.
PATRICIA KARVELAS:
Borders were a big issue. They were all meant to open up in July and hasn't the world changed since that road map was first devised, really dramatically. Queensland are shutting their border to greater Sydney tonight. 18 new cases were confirmed in New South Wales today. Is that kind of move necessary to try and contain this?
NICK COATSWORTH:
Well I think the first thing to say is that no chief health officer or premier wants to see what is going on in their state, what is going on in Victoria happening in their state. So they have to make decisions that are- that they deem to be in their state's interest. Of course, when those decisions are made, we discuss them at the Australian Health Protection Principal Committee. We consider what affect that will have on the spread of the pandemic. In New South Wales at the moment though, we can be confident that the New South Wales public health unit is able to track and trace the COVID-19 cases. There were six unlinked cases today of course, but that just means that the disease detectives need a little bit more time to link all the cases. Up until today, all the cases, 100 or so cases in the past week, had been linked to outbreaks. And so as long as you know where COVID is, who has got it, and what we're going to do about it, then we consider things under control.
PATRICIA KARVELAS:
Just ending where we started on this number, 723 cases today - is that the high mark? Or could we expect even higher case numbers in coming days?
NICK COATSWORTH:
Well, Patricia, it's bouncing around so much. So 723 is a record, clearly. When you add it on to yesterday's total of just 290, it certainly doesn't sound too bad over two days. I would anticipate this is going to bounce up and down for a few days before we see a trend. And the trend that we want to see of course is down. And we're going to see that because the effect of mandatory mask use will start to become more apparent over the next week and we're confident that that will assist things. And the extra measures that Premier Andrews has suggested today will have an important effect in regional areas of Victoria.
PATRICIA KARVELAS:
Should we get to the point where the whole country is wearing masks?
NICK COATSWORTH:
It will be difficult to reach that point in places like the Northern Territory and Western Australia at the moment. But I think what you see is as the epidemic spreads and as we're less confident about where community transmission is, then the mask- the mandatory mask policy will be implemented and has been done in regional Victoria as of this Sunday. In New South Wales, it's strongly recommended that if you can't socially distance you wear a mask. And I'm sure Queensland in the early phases of locking down these cases in South East Queensland at the moment, is considering this also.
PATRICIA KARVELAS:
Thank you so much for joining us.
NICK COATSWORTH:
Thank you.
PATRICIA KARVELAS:
That's Dr Coatsworth, the Deputy Chief Medical Officer, Nick Coatsworth joining us there.
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