Deputy Chief Medical Officer interview on ABC Radio Adelaide on 4 June 2020

Read the transcript of Deputy Chief Medical Officer Professor Paul Kelly's interview on 4 June 2020 on ABC Radio Adelaide about coronavirus (COVID-19).

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SONYA FELDHOFF:

Paul Kelly is the Deputy Chief Medical Officer of Australia. Thank you for your time, Paul.

PAUL KELLY:

Hi Sonya, how are you?

SONYA FELDHOFF:

Yeah, really good to have you. Thanks for your time. First of all, what is the actual figure of how many Australians have downloaded COVIDSafe app as of today?

PAUL KELLY:

Well, people are still downloading it every day, so at 6.30 this morning I can say it was 6,201,718, to be exact. So there would be more since then. We're very encouraged by the number of people that very rapidly downloaded it early on, and that's continuing. It's slowed down a bit. But I still believe that it is an important component of our response and our preparedness going forward.

SONYA FELDHOFF:

Is it as an important of our way out of this as it was touted a few weeks ago? Does it remain that?

PAUL KELLY:

Look, I think it does. I think people- we can't be put into a false sense of security right now. And South Australia has done really well, and your chief health officer there, Nicola, is a great leader. But the fact that we haven't had many cases in the last few weeks doesn't mean we're out of the woods completely. If you look at the rest of the world, this is still a very live issue. Thousands and thousands of people every day are contracting the virus. Hundreds of people are dying in countries that are very similar to us.

 So, we have done well up to now. Our borders are closed to the outside world, but that doesn't mean we're immune to the virus. So whilst- this is kind of a backstop for us. It's part of that contact tracing exercise that we will do with every single case if they come back, and this will definitely help.

SONYA FELDHOFF:

Have we used the- has anyone used the app to-

PAUL KELLY:

[Interrupts] Yeah.

SONYA FELDHOFF:

We know of one occasion. Has it been any more than one?

PAUL KELLY:

Yeah, it's been used a few times. But I think it was one of those things that happens, isn't it, when you make great plans and then you get something exactly ready to go, and then it's exactly at the same time when all the cases disappear. So, we haven't really had all that many cases in the community, to be honest. Most of the new cases in the week since the app has been functional were ones that have come across the borders; so, people who have come from overseas and gone immediately into quarantine. They don't have the app and they don't need it because they're not really in contact with anyone for those weeks when- those two weeks when they're likely to come down with the infection. So, there was definitely one that was well publicised in Victoria. There was another one in New South Wales. And on both occasions, that was helpful to that contract tracing, which is still mostly a manual process, but this is definitely a good aid to that.

SONYA FELDHOFF:

There might be somebody who'd say: look, I can count them on one hand, that doesn't sound like it's as useful as it might be. Are we judging it in the wrong way, perhaps?

PAUL KELLY:

Yeah, look, I think we'd- let's think where we were a couple of months ago with up to 400 cases a day around Australia being diagnosed. It would've been enormously helpful then. We didn't have it then, but if we ever got back to that sort of position, it would be absolutely vital. The manual process of contact tracing is extremely labour intensive, it takes a long time. And every moment that you don't have that information and getting that to the person- to people who have been exposed to the virus and could therefore be themselves infecting others, is a crucial component of the control in terms of public health, but also to individuals who may have been affected. So, it'll be useful at some point if the virus comes back.

SONYA FELDHOFF:

Alright. If we're talking about the importance of that spread across the country for those of us using the COVIDSafe app, there were questions at the time about its ability to work on certain phones or how functional it was on certain phones. Have those issues been tidied up?

PAUL KELLY:

They've been tidied up, they haven't been completely resolved. So, there was a couple of issues there and I think I've spoken to others on radio in Adelaide about this. One was in relation to older phones and older operating systems on either Android or Apple phones, and that's true. That's been improved. We think about 90 per cent of mobile phone users would be able to download the app and it would work now, so that's improved from earlier. But it's not 100 per cent, and this is the same with any app, really. The more modern the app, the more modern the operating system needs to be. So, we've made some modifications to expand that, but we can't promise that every ancient Nokia or something will be able to download this app. It just won't be able to. But majority of people it does.

 The other element that was- has been discussed at length is for the different operating systems on Android phones, we're very happy that that's working extremely well on Android phones. For Apple phones, there has been some issues again that has been improved, but really, for most phones it does work, and will be there to be used if we get large outbreaks again.

SONYA FELDHOFF:

So, when we talk about the Apple phones and the issues associated with that, can you clarify because one of the confusing parts of this was about whether the COVIDSafe app needed to be open and operating in the foreground or whether it was sufficient for it to be operating in the background?

PAUL KELLY:

Yes, so look, I'd just say- I'll put my cards on the table, I'm not an IT geek, I'm a public health physician, so I'll try to explain it. Hopefully that's helpful in layman person's terms. But my understanding is that the crucial component for all operating systems is the Bluetooth that needs to be operating. And then the app itself can be in the background or the foreground. It's certainly- for Apple phones, apparently, bringing it to the foreground every so often is a good thing and that does improve the functionality. But there's really no need to do anything particularly manual. Once it's been downloaded, it will start working and we'll store that information that will only be used if and when it's necessary to use it. But having the Bluetooth operating and on the phone is an important component.

SONYA FELDHOFF:

It's 28 minutes to three here on ABC Radio Adelaide, South Australia and Broken Hill. My guest Deputy Chief Medical Officer here in Australia, Paul Kelly. Paul talking with us about the COVIDSafe app; is it still the crucial part, crucial key in our road to recovery from the from the pandemic? So as the Deputy Chief Medical Officer, when you get the information from a COVIDSafe app, and we've only had to do that on a handful of occasions, what are you seeing there, Paul?

PAUL KELLY:

So, I'd firstly point out that I don't get to see it at all. I'm a Commonwealth employee and so the way we've really dealt with the security and the privacy components of this is absolutely crucial. So, the only person that can see this information is the person that's doing the contact tracing exercise in the states or the territories. So, the public health officer that's engaged with a particular case, and phoning their contacts to see if they're well, and to advise them to isolate themselves if that's necessary. So what they get in those circumstances is a very small component of the data. It's basically when you download the app you have your name or a name, your phone number obviously, mobile phone number, a post code of where you are living and your age range. They're the four things. The age range is important because of that if there was a large number of contacts for example, in the contact tracing exercise, it's fairly typical to contact the most vulnerable people first. So if there was someone in their sixties or seventies or eighties, they would probably be rung first before a whole range of people that might be younger because of their vulnerability to the disease.

SONYA FELDHOFF:

Is it your understanding that anybody you come in contact with will be on that list and you will see the accumulated time or will you only be added to that list if you top the 15 minutes within 1.5 metres?

PAUL KELLY:

Yeah, so the list is only those- the parameters that have been set is for 15 minutes, 15 minutes of contact within 1.5 metres. So that would be the only ones that would be there and provided to the contact tracing officer.

SONYA FELDHOFF:

Paul, if you were to - and I don't know how you rank this - but I mean, is the COVIDSafe app a key part of this or just an additional tool? Because at the moment we've been doing this all with manual contact tracing. What does the COVIDSafe app add to this and how relevant is that to the whole overall picture?

PAUL KELLY:

So it adds two things. It adds the repetitivity of the information being available to be used. So rather than going through what can be sometimes quite a laborious, manual process of asking people where have you been, when did you get sick, where have you been during that period, what about 48 hours before that, where did you go then, who were you involved with, who were you close to for more than 15 minutes. For some - for those of us that have made- for people that have been staying at home mainly and have just been with their family, that's a fairly easy answer. If you're catching public transport for more than 15 minutes and then going into town and then working with a whole bunch of people or for example, in a retail store interacting with a large number of people through the day, that won't be all that easy to remember. In fact, it might be impossible to remember because you just don't know who all those people are. That's the crucial breadth of contacts, that we'll be able to have that information from the app. That's a game changer. And as we go forward and open up society more, if there is- if the virus is reintroduced into the community and starts to spread in the community - and that's still a possibility - then this will be really crucial to be able to get on top of those outbreaks quickly.

SONYA FELDHOFF:

But it's at this stage we've got 6 million having downloaded it and we can't even be sure that all of those still have it or are operating it correctly is my understanding. I mean they may not have registered once they downloaded it. At best we've got - when you consider our total population - 25 per cent, is that right? I'm hoping- I shouldn't do maths on air.

PAUL KELLY:

So we estimated there's a bit over 16 million adults with mobile phones in Australia. So six divided by 16 - I shouldn't do the maths on air either - but it's certainly over a third and getting up towards that 40 per cent. And look, the 40 per cent was something we're certainly aiming for. I've seen other estimates of what would be a useful number which is less than that. But we're approaching that and as I said other people are downloading it every day. That number is - as far as I know - is actually the registrations as well as the downloads.

SONYA FELDHOFF:

Oh okay.

PAUL KELLY:

So it's a great number. Yeah of course, people can remove it from their phone. I hope they haven't. They can you know, that might be possible. But look I really believe that - this is my belief all the way through this - is Australian people have been extraordinarily- they've listened to the advice and that's from the Prime Minister all the way down throughout society. And I'd be absolutely convinced if we did start to see - let's hope we don't - but if we did start to see large outbreaks occurring around Australia, that people would rush and put that app on, they would really see the value of it and whilst we haven't been able to demonstrate that so much so far that that's just the nature of the way that the pandemic has proceeded. So yeah.

SONYA FELDHOFF:

Paul Kelly, when we first heard about this app, and it was certainly a big push by the Prime Minister from a political point of view, we don't hear that quite so much several weeks later. Has there been a change in the direction that that advice is going as far as you're aware of?

PAUL KELLY:

No, no not really. I mean so we advised the Prime Minister, myself and Brendan Murphy meet with him at least weekly, sometimes more frequently than that. So we're still providing advice in general about the pandemic and the app is still there as a component of it. It's one of the components and at the moment not as crucial as we had thought it might be a few weeks ago, but that's just because we're not seeing very many cases in the community. The theory behind how it would work if we were seeing more cases is absolutely sound and the applicability of the app to the issue of contact tracing remains absolutely our advice.

SONYA FELDHOFF:

Okay but potentially our health success has been the downfall of the app in a way.

PAUL KELLY:

Well yeah but see that's a good [indistinct].

SONYA FELDHOFF:

It's a good outcome.

PAUL KELLY:

Yeah.

SONYA FELDHOFF:

Yeah, yeah. Hey look I'm getting a couple of questions here that may not be your concern given you are a medical officer than an IT person but do you mind if I throw them out to see if you know the answers to them?

PAUL KELLY:

Sure.

SONYA FELDHOFF:

Okay. First of all, do you know if the source code was released?

PAUL KELLY:

Yes. It was released on 8 May.

SONYA FELDHOFF:

Okay. A couple of people are asking why does the app keep switching off?

PAUL KELLY:

Yeah. So I think I think that relates to the reminders that come through every so often to make sure you switch it on. I think that that's about bringing it to the foreground, I think, I'm not I'm not an IT specialist. But that's- it stays on all the way through but I think it's actually just opening it up and then for the Apple phones in particular that brings that app to the foreground and does then improve the functionality. But it still works even the background of Apple phones.

SONYA FELDHOFF:

Do you know if it works on smartwatches?

PAUL KELLY:

Not yet. That's something we're considering for future updates. But at the moment, it doesn't.

SONYA FELDHOFF:

Do you know if it stops running when other apps are running?

PAUL KELLY:

It doesn't stop running but for the- and on the Android phones, it's not a problem, but for the Apple, if it's in the background, the functionality is not quite as strong as it would otherwise be. But it's certainly still running and it does work.

SONYA FELDHOFF:

Now, I'm speaking with Paul Kelly, the Deputy Chief Medical Officer. We have got him on here to talk about the app, but a couple of other questions are coming in and Paul has made it clear that he's happy to answer those questions. We have a couple more minutes with him. If you've got a question, give us a ring now, 1300-222-891 or you can text us on 0467-922-891. We'll get to as many as we can in that time.

Jenny took her son in to get a COVID test this week because he had a cold. She says it was quite a difficult process for her son who is autistic. And she says she understands why her son needs to get tested, but if she needs to get him tested every time he has a runny nose, she's saying it's going to be a really difficult winter for her family. Is the advice still to get tested if you're showing any signs of coronavirus every time?

PAUL KELLY:

Yeah. Look, certainly, that is a trick. For any child, it would be difficult, and for someone with autism, I can imagine it would be particularly stressful for the family as well as the person. So, I certainly hear what they're saying.

The advice is still if people have symptoms is to get it tested. There's two reasons for that. One is we really want to make sure that we're not missing someone out in the community that could rapidly start off another outbreak. And so that's, from the public health point of view, absolutely crucial. So we did over 33,000 tests in Australia yesterday and virtually none of them were positive, but we want to continue to test as many as we can. And we know that people that have symptoms are the ones that are most likely to be positive. So that would be the best use of that test and best chance of finding a random individual with COVID who may be spreading it quietly and silently and not to their knowledge in the community.

SONYA FELDHOFF:

So sadly for Jenny, yes, the answer- the advice is.

PAUL KELLY:

I think the answer is yes. Sorry, that was a long answer…

SONYA FELDHOFF:

{Talks over] No.

PAUL KELLY:

…to a very short question.

SONYA FELDHOFF:

No, no, no. Not at all, Paul. Happy- yeah.

The other question I have before me is that we often hear our Chief Public Medical Officer saying people are now COVID-free, those who've had the disease, but it seems that they are often still having the impacts of COVID on their health. What sort of long-term impacts do we know at this point are a result of COVID-19?

PAUL KELLY:

Yeah. So, we're learning a lot about COVID-19 all around the world, given that we knew nothing about it in December last year. So, very rapid upswing in what we know. But there's still a lot we don't know.

In terms of being COVID-free, that refers to the laboratory tests that's done to diagnose and then in some cases- not all but in some cases to demonstrate that that virus is no longer present, and either through a lab test or from monitoring of symptoms. So, the symptoms of a cold-like illness or a flu-like illness, shortness of breath and coughs and sniffles, et cetera. There are other effects though that aren't the flu-like symptoms that we know with COVID and it certainly can affect other parts of the body, and whether that leads to long-term damage is still to remain. We don't- we're only five months into this. So, what things look- what people look like a year after they've had COVID, we haven't got to that point yet…

SONYA FELDHOFF:

I know.

PAUL KELLY:

So it's a tricky one to answer but it certainly does affect the blood vessels. It can affect the heart. It can be a multi-organ disease of great severity. And we've seen hundreds of thousands of people die all around the world. Here in Australia, only 102, so we're doing very well.

SONYA FELDHOFF:

Yeah. But it does seem like a tornado that whipped through and leaves devastation in its path in some cases.

PAUL KELLY:

Yes it does. And certainly when you see the numbers of cases in the US, for example, or many parts of Europe, we certainly feel for them and now in many other parts of the world, Brazil, Russia, many parts of South America.

SONYA FELDHOFF:

Brian has a final question for you. We hear about the symptom of COVID-19 is a cough. He says: is the first symptom a dry cough or a wet cough? Does it matter?

PAUL KELLY:

I'd keep it a cough.

SONYA FELDHOFF:

Yeah.

PAUL KELLY:

If you've developed a cough and it's a recent development, then that- you should consider getting tested. A cough with shortness of breath and fever, definitely starting to get more likely. But to be honest, in South Australia, because you've had so few cases for some time now, it's probably going to be something else, but you should get tested anyway just in case.

SONYA FELDHOFF:

Well, on that note, one of our texters says: surely, officials are satisfied now that there are no more cases left in South Australia after all this time without a case. Can we be that certain?

PAUL KELLY:

No certainty in this- with this virus. I think- yes, as I said, South Australia, NT, WA, if you are there- those places in particular and here and in Canberra as well, in the ACT, we haven't had a case for a month. So, the chances that it's circulating out there silently is unlikely. But look, we can't be absolutely certain. This virus is very infectious. It can be infectious even when you don't have any symptoms. And so, the chances of eliminating it completely is very, very unlikely without a vaccine. And eventually, we're going to have to think about opening our international borders and then… The rest of the world is continuing to see lots of cases so we'll have to remain vigilant for some time yet.

SONYA FELDHOFF:

Paul, you've been incredibly generous. Thank you so much for your time today.

PAUL KELLY:

You're welcome. Nice to talk to you, Sonya.

SONYA FELDHOFF:

The Deputy Chief Medical Officer Paul Kelly.

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