Date published: 
5 June 2020
Media event date: 
4 June 2020
Media type: 
Transcript
Audience: 
General public

RAFAEL EPSTEIN:

Professor Paul Kelly, is Deputy Chief Medical Officer with the Federal Government. Thanks for joining us.

PAUL KELLY:

Hi Raf, how you going?

RAFAEL EPSTEIN:

Do you feel like you're making a lot of decisions without all the information?

PAUL KELLY:

That's the nature of a pandemic as you said in your promo. We had never heard of this virus. As it is, it hadn't been affecting humans to any great extent just over five months ago. So lots of things have been found out about the virus in the meantime but it's still early days. So- I had someone interview me this morning, he said well, do you get long term immunity from this virus? I said well we're not in anywhere near long term yet, so I can't answer that. So when we're starting to think about vaccination programs and so forth, which we'll hopefully be doing in the not too distant future, then that's absolutely a key question. Do you just get it once? Do you have to have it every year like a flu vaccine? Lots that is still unknown and yet we'd still have to make decisions about whether we would move ahead with a vaccination program or indeed with hydroxychloroquine as you've covered in the…

RAFAEL EPSTEIN:

[Talks over] I'll come to that.

PAUL KELLY:

…in the news. Yeah.

RAFAEL EPSTEIN:

Has your mind changed? Has your feeling about a vaccine changed, say in the last four, eight weeks, have you felt more or less confident about when a vaccine and if a vaccine is coming?

PAUL KELLY:

So I think it's still a long shot. I was speaking to daughter recently and she said, oh you know nothing important has happened in my life, you've had so many important things in your life and I just said, well I'm old. But you know, the vaccine, it's her generation's ‘moon shot’. If we get this right, starting from a base where we've never made a vaccine against coronaviruses successfully in humans. There are trials at the moment using absolutely innovative methods for creating vaccines, some of which would revolutionise the way we use vaccines if they're successful. But there's lots of ifs there. Am I feeling more confident? Yeah I am because there's now over a hundred vaccine candidates that are in various stages of clinical trials, some of them very early in animals. Others are going into phase one or phase two clinical trials. Some of them even more advanced than that. And that's incredibly fast to have got to that stage. So I'm more hopeful than I was eight weeks ago, that's true.

RAFAEL EPSTEIN:

How did you feel when you saw the protest in Sydney the other night?

PAUL KELLY:

So look, I think we're in this quite tricky moment in the pandemic in Australia. We see what's happening overseas, I mean the protests included in the US and terrible scenes there, but there is a lot of this- there's a lot to go under the- a lot of water to go under the bridge in relation to this pandemic globally. And we've seen many countries, almost all countries in the world, with very large numbers of cases still being diagnosed. We can feel a little bit precious here in Australia I think and rightly so that we can feel that we're in a very safe place at the moment. But we're now just reopening various things and getting back to some sort of COVID safe normal. While we're doing that it's really important that we consider those things that we talked about early on before we started closing down businesses and restaurants and et cetera, to kind of make and ask people stay at home.

RAFAEL EPSTEIN:

Can I be COVID safe at a protest? I'm going to wear a mask, I'm going to wear hand sanitiser, I'm going to try and keep my distance. Is that doable?

PAUL KELLY:

It possibly is, but I think it's going to be unlikely. And we know that this is a very infectious virus. One person with the virus in a large group, the larger the group, the larger the likelihood that there will be someone with the virus and the larger the likelihood that that will be spread to a large number of people.

RAFAEL EPSTEIN:

Singing and shouting overseas, that's proven to be a way to transmit. You do lots of breathing in and breathing out.

PAUL KELLY:

Yeah. And that's another thing with- back to your uncertainty issue that you've mentioned earlier. There is a famous choir outbreak in Washington State in the US where one person, a single person infected 86 per cent of the rest of the choir. So I think it was something like 60 people got infected, some people died, from one sick person. And that was- and we do speculate about singing, shouting, booing, I saw the other day as being a bad thing so if we do get crowds back to the AFL then please no booing. So it depends-

RAFAEL EPSTEIN:

[Talks over] Would you go to a protest? I mean I don't know what you feel passionately about but let's assume people go to a protest because they feel passionately about it, would you go to one?

PAUL KELLY:

Not at the moment. No. I have done in the past and look, black lives do matter and I really feel strongly about that. But would I be going to a protest this week? I would not and certainly not in Melbourne because unfortunately that's where we are still getting cases in the community. In the whole of Australia, it's looking pretty good. In Melbourne it's looking pretty good too, but there are cases we've seen the occasional clusters starting up, that Cedar Meats, in relation to the hotel quarantine at Rydges on Swanston Street - I think I've stayed there actually - and others…

RAFAEL EPSTEIN:

[Talks over] Some others.

PAUL KELLY:

…and the [indistinct] family. Yeah.

RAFAEL EPSTEIN:

But isn't that because - let me switch my attention to Victoria - isn't that because we're doing more testing and really extensive testing?

PAUL KELLY:

Yeah I think that's absolutely part of it and look, you know, finding cases is at this stage in the pandemic should not at all be seen as a failure. That's actually a success. Obviously we want to get to a time where we're not finding any even if we're doing lots of testing. But at the moment lots of testing, finding cases quickly, identifying their contexts quickly and getting both of those groups to isolate so that they don't spread to other members of the community, that's the key part.

And so the app, by the way, is another thing to consider. There's 6.2 million people in Australia have downloaded it but we need more. So I definitely would say if you haven't downloaded the app please do so.

RAFAEL EPSTEIN:

Paul Kelly is the Deputy Chief Medical Officer with the Commonwealth so he's one of those top doctors advising the Federal Government. Of course he and people like Professor Brett Sutton all sit on that committee advising governments.

Paul Kelly, the hydroxychloroquine trial, let's take the politics of President Trump away from it. There was a study that led the World Health Organisation to pause a lot of trials. That study was published in The Lancet, one of the best medical journals in the world, but it was a dodgy study. How unusual is it for a dodgy study to get published?

PAUL KELLY:

It's- even in the best journals, it happens from time to time. And it's an intriguing thing. So this is back to that uncertainty question you asked. So, there's a lot of research going on. We're discovering a lot of new information about this virus every day. It's absolutely crucial that decision-makers or those that are advising them, like Brett and I, are appraised of that information. And so, what's happened in this- what I've called the social media epidemic or pandemic is- I'm not alone in that. I didn't make it up, I don't think. But there's- that rapidity of information is really, really important but there are some key elements in terms of scientific and medical knowledge, is that it should be contested. It should be checked carefully. And I think sometimes, in this last few months, this is not the first time I've seen things that probably wouldn't in other times have been published.

RAFAEL EPSTEIN:

[Interrupts] So you're saying there's so much pressure there that's leading to mistakes even in a journal like The Lancet.

PAUL KELLY:

Yeah. I think the pressure to publish. And look, this- if this one was actually true, then, as we've seen, the World Health Organization made the decision immediately to suspend their trials on the basis of that. So, finding- their findings- the main findings, so your listeners know, the main findings they had in that paper, which was based on over 90,000 patients around the world, different countries, different hospitals, they found that using hydroxychloroquine in various ways increased mortality. So it increased the risk of death. So that's a pretty important finding.

The problem is that underlying that is some very suspect methodology. There were some information there which was purported to have come from five anonymous Australian hospitals and…

RAFAEL EPSTEIN:

[Interrupts] Did that raise some real alarm bells amongst the researchers?

PAUL KELLY:

Yeah. We did the maths and we realised that that can't be right. That number of cases hadn't been diagnosed in Australia in that time period and those number of deaths hadn't happened in any- right throughout the country. So, it was implausible that that could happen in five hospitals. Other people have raised that too so…

RAFAEL EPSTEIN:

[Talks over] Do you think that people- sorry to interrupt, Paul Kelly, but do you think…

PAUL KELLY:

That's alright.

RAFAEL EPSTEIN:

…it will damage people's trust in science? I mean, I've done- I've actually done, as a reporter, stories in the past about, you know, sometimes dodgy stuff gets through even through peer review. But does the fact that it happens in a high-profile way, does that damage the trust people might have in the science, do you think?

PAUL KELLY:

Well, it could. And certainly, colleagues have written to the editor of The Lancet sort of suggesting that they need to reconsider that and hopefully withdraw that paper. But- and- but mostly, that's not the case. Mostly, it is believable and we- and- but it's contestable. So we've seen that paper, there's other papers that have suggested that hydroxychloroquine is useful. It's an open question and so we want to get as much information as we can and- so the message to your listeners is: you shouldn't be taking hydroxychloroquine unless you've been- you are a part of a clinical trial in Australia under those strict circumstances that that occurs, and under the direction of your medical practitioner.

RAFAEL EPSTEIN:

Do you think we are going to know soon how many of us have had it? I know there's- you're going to be looking at people who've given blood at the Red Cross and those sorts of things. Are we going to know soon how many of us have been exposed to the virus, how many of us have had it?

PAUL KELLY:

So, yeah. So you're referring there to what we call zero surveillance studies. So that's looking at how many people in the population might have developed antibodies against the virus. I say it like that because as I said, we're not sure about whether those antibodies are actually protective in any way. So immunity may- is a different question. But we can do things like examine blood that's been taken, been donated, say, sometime last year and then doing it again over the last few months and compare that to see the proportion of people that have antibodies. There are other ways of doing that as well, various surveys that we're considering throughout the wider community.

They will tell us. I would be very surprised if it's a high number. We haven't had many cases. So even in those places that we've seen those terrible scenes on the television, say, from New York, from northern Italy and China early on, Wuhan back in January - it seems a long time ago...

RAFAEL EPSTEIN:

Most people haven't had it there, have they?

PAUL KELLY:

No. It's still only under 20 per cent. Even with those scenes of the hospitals overflowing, ICUs having to decide who should get a ventilator, all that sort of stuff, which we haven't got anywhere near doing in Australia, it's only about 20 per cent. So 80 per cent of people are still susceptible. That's why we're concerned about second waves and that sort of thing.

RAFAEL EPSTEIN:

Can I ask a final question? Just come back to the protests, if people go - you're advising them not to go- should you wear a mask?

PAUL KELLY:

Yeah. Masks are an interesting thing. Look, I mean, I think, like with all of these issues of decreasing risk, the easiest way to avoid becoming infected by- from COVID, by being part of a protest is to not be part of a protest. So that would be the first thing. The second thing, if you absolutely need to go - I would reiterate there's many ways of protesting other than gathering in a group - is to keep your distance. And certainly for anyone who's sick, they should definitely not consider going because it puts others at risk. The last bastion of protection could be a mask but it's certainly not our thought that you should be wearing a mask in public like that.

So, I think don't go. Definitely don't go if you're sick. And if you are in a group, keep your distance. That's the standard that we're keeping and I'm sure Professor Sutton would agree.

RAFAEL EPSTEIN:

Feel free not to answer this question, so I'm just giving you that get out…

PAUL KELLY:

Okay.

RAFAEL EPSTEIN:

Do you want to tell us what protest you went to? You said you've been to a protest.

PAUL KELLY:

Ah, well, that was many years ago when I was a member of an organisation called the- called- it's a long time ago, I can't even remember what it was called. But it was something like ‘doctors in nuclear disarmament’. So, it was back in the 1980s, I was a medical student and I was in a protest in Perth being watched.

RAFAEL EPSTEIN:

Fantastic.

PAUL KELLY:

But there I was, [indistinct] when I was young.

RAFAEL EPSTEIN:

[Talks over] So that was anti-American forces coming here or anti-Australia getting into nuclear weapons or nuclear power?

PAUL KELLY:

It was about- it was a nuclear protest back at the time but mostly about the disarmament of the superpowers, not naming one in particular.

RAFAEL EPSTEIN:

Understood. Thanks so much for your time. Appreciate it and appreciate your work as well.

PAUL KELLY:

You're welcome.

RAFAEL EPSTEIN:

Professor Paul Kelly, Deputy Chief Medical Officer.

It's just fascinating having people who make decisions who are just unbelievably and blatantly frank and honest. I'm not saying politicians aren't. Politicians have a different job. I understand why they answer questions the way they do. I think it's defensible sometimes the way they answer questions the way they do, but it is amazing to have people making significant decisions being so unbelievably frank and honest.

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