PETER STEFANOVIC:
Well, as it turns out, joining us now is the Deputy Chief Medical Officer Nick Coatsworth. Nick, good to see you. Thanks for joining us. So first of all, can you answer that question that we just posed then. If those changes were made earlier, do you think it would have prevented that second outbreak?
NICK COATSWORTH:
Well it's very hard to apply what we call in the medical world the retrospectoscope to do these things, Pete. And I think what we do know and what is certain is that it's very hard to change your strategy when you're at 800 cases a day. But what is welcome and what we've been assisting the Victorian Public Health Unit with changes very early on now in the post peak phase where the curve is coming down and we're trying to get to a point where there can be control at the low numbers; the sort of control that we're seeing in New South Wales at the moment.
But it is true to say, of course, that at some point along that epidemic curve, as it ramped up, control was lost. It is equally true to say that once control is lost by any public health unit, that time taken between someone getting symptoms and someone getting isolated nor their contacts quarantined, that will start to extend for any public health unit in the country. And that's why it's so important to keep the numbers under control.
PETER STEFANOVIC:
Control lost because the system wasn't up to scratch. Is that how you would put it?
NICK COATSWORTH:
I'm not sure that's how I would put it but in any- in any system, if control is lost, you have to understand why and you have to make changes and it would be the expectation of the Victoria- not just Victorian people but all Australians, that the Victorian public health response was reformed in some way. And I think we can welcome what we're seeing at the moment; particularly that collaboration between Victoria and New South Wales, as the senior bureaucrats and the Chief Scientist go to Sydney to discuss the contact tracing methods.
PETER STEFANOVIC:
The fact that Victoria is finally overhauling its contract [sic] tracing method though, isn't it too late for that? I mean we are months into the pandemic.
NICK COATSWORTH:
Well it's never too late to have an intervention that you know is going to make a difference. And certainly, we could continue under with the systems that were in place prior in Victoria and it is a common question. We- we received it for aged care, the Victorians are receiving it for contact tracing but we have to work with the realities and the reality is that the epidemic happened and there were cases up to 700 a day. And I think we can be assured by what the Victorian Government is doing that that will markedly decrease the risk of that happening again.
PETER STEFANOVIC:
So what would they be looking at? You've got these health officials, these government representatives that are now moving from Victoria, they're going to New South Wales and they're going to watch how New South Wales is doing things to triple check - they're the words that the Victorian Premier is using.
So what would they be trying to learn that they don't know already? What would they be looking at in the hope of taking back to Victoria?
NICK COATSWORTH:
So there's potential delays at every point from when someone gets a symptom of COVID-19 to when the case interview is completed.
That person is isolated and their contacts are quarantined. That's- that's a consistent process nationally. But the- each step along that way is dependent on what you have in your state. Is it a paper-based system, is it an electronic system do you have a very rapid notification system from when the lab gets the result and when the disease detective gets the result? How quickly are the disease detectives getting to those positive results and letting the person who's affected know?
So there's three points at which your system could start to blow out in terms of the time that it's taking. And every day that you don't isolate someone is- decreases the effectiveness of your contact tracing. That's- that we know clearly. And that's why speed is of the essence and every step along that process has to be analysed, work out how it can be tightened up.
PETER STEFANOVIC:
Nick, I've got to ask you about this breaking news that's come from AstraZeneca this morning just in the past hour or so. It turns out that someone involved in that trial has had a negative reaction or has had some kind of reaction that has caused the study to be placed on hold. First of all, can I ask what your reaction to that is?
NICK COATSWORTH:
Well in some respects, Pete, I think this is a- this is a very positive thing because it shows that despite the accelerated vaccine development, safety is the priority of the clinical trialists, the investigators and indeed the company AstraZeneca. What this likely means, and like you, I don't have the full details at the moment, is that a reaction that would be classified not as a minor reaction but as something more severe has occurred in someone who has received the vaccine.
That doesn't at this point mean that it was the vaccine. But it does mean that it has to be investigated and presumably means that there's going to be no further vaccinations until that investigation takes place and from what we understand from the company this morning, and this will develop during the day, we'll have more information. But this is certainly not something that means the Oxford vaccine is off the table and we want to stress that.
But also, it sort of exemplifies that we don't put all our eggs in one basket and like many governments around the world, there are several candidate vaccines that we've invested in as the Australian Government, knowing that not all of them will get through. But at this point in time, we don't have any more information about the Oxford vaccine and this would be an appropriate step that AstraZeneca's taken.
PETER STEFANOVIC:
What sort of a delay might we be looking at here?
NICK COATSWORTH:
It depends entirely what the investigation finds so it's very hard to tell. I think we've also heard from the trialists and the company that they will make sure that any delay is as short as possible. But we just really need to work out first what the reaction was and hear a bit more from the trialists in the company later on today.
PETER STEFANOVIC:
Does the company inform its buyers such as Australia or any other country who might be interested in the vaccine or did you find out through the media this morning, Nick.
NICK COATSWORTH:
Well it wouldn't be appropriate to go out to say the buyers before you went out to the public. I think this is a demonstration of the transparency that that AstraZeneca and the Oxford trialists show. This is the sort of transparency that the Australian Department of Health and Government has been calling for, for a long, long time because we all need to know and we all need to know at the same time and I'd anticipate that any further releases will be public and will be as transparent as they have been so far.
PETER STEFANOVIC:
So just to clarify, the negative reactions in trials is common, as far as you can tell?
NICK COATSWORTH:
Well look, negative- minor reactions are common. So pain around the injection site, a little bit fatigued for the day or so after a vaccination, that would not stop a clinical trial clearly because you know we often get that with the flu jab. But this will be a more substantial reaction than that. I'm not sure exactly what reaction it was and hasten to say that we're not sure that it was related to the vaccine yet. But in all prudence and because they've got to focus on safety, the trialists have taken that decision today.
PETER STEFANOVIC:
Are you worried- I mean I'm aware and you've said that you don't have all the details at the moment. So I certainly appreciate that but from what you can tell so far, is this something that you're worried about?
NICK COATSWORTH:
With the information that I've got at the moment, Peter, I'm not- I'm not worried about it but it is something that we're clearly interested in in the Department of Health and we look forward to receiving more information.
PETER STEFANOVIC:
Okay. Deputy Chief Medical Officer Nick Coatsworth, as always, appreciate your time this morning and bringing us up to speed.
NICK COATSWORTH:
Thanks, Pete.
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