KYLIE GILLIES:
Well as coronavirus infections top half a million globally, numbers on our shores have reached over 2,900. Australians are starting to adapt to life under new government regulations, but are we doing enough?
LARRY EMDUR:
For more, we're lucky to be joined by — live by Deputy Chief Medical Officer Nick Coatsworth in Canberra. Lucky because he is such a busy man. We appreciate your time this morning. You've worked in some of the most vulnerable areas in the world in disaster relief, helping with disease control efforts. How does the current coronavirus pandemic compare, would you say?
DR NICK COATSWORTH:
Well, thanks, Larry. I mean, this is unlike anything I've seen before, and I think all of my colleagues around the world and Australia would agree with me. I mean, the images that we're getting out of nations like Italy and the United States are horrifying.
The important thing to remember, as many of your report has just pointed out, is the differences between the United States health system and the Australian health system. I've been working in the Australian health system up until a week ago at Canberra Hospital, we are very well prepared, and I know people are working very, very hard. The sheer amount of human capital that is devoted to this in Australia at the moment is absolutely astonishing.
KYLIE GILLIES:
That is reassuring to hear. You mentioned those horrific scenes in Italy. Is there a fear we are headed in that same direction?
DR NICK COATSWORTH:
Kylie, I think is a natural fear that we want to avoid that, really at any cost possible. Which is why the intensive care doctors that I've talked to on a daily basis are doubling their capacity around the country, which is why at the Melbourne Convention Centre is being set aside as a potential COVID-19 hospital. These are preparations that we have to have.
But it's about stopping us getting there, and that is where every Australian has a role. As I've said yesterday, the virus is not a long jumper. If you keep your social distancing measures away, 1.5 minutes away from people, the virus can't get to you, and the virus cannot survive you washing your hands.
So the best thing about this difficult situation is when we see that curve flatten, and we will see it flatten, every Australian will know that they have contributed to that.
LARRY EMDUR:
Okay. Well said. Now, new rapid testing has come into place. And previously, the lab testing could be more than a day, new technologies says it can test in about 15 minutes. So how will this help slow the spread of the virus?
DR NICK COATSWORTH:
Now Larry, we've got to be a little bit qualified about that. Some of this rapid testing involves what we call antibody testing, and that testing, whilst being very rapid test, it doesn't give you a great idea of what's happening when the patient first gets unwell. So you could do one of those tests of day one of symptoms and a patient would be negative.
So the DNA tests that we use — we call them PCRs, and they're the ones being used in hospital at the moment — they do take several hours to come back, and we are facing difficulties in supply chain with the reagents at the moment to make those function.
But despite all that, we are the highest testing country in the world. And if you look at the US, you do two tests, you get one positive. You look in Australia, we're doing on average 100 tests and you're getting between 1 and 2 positive.
So the burden of disease at the moment is far less. We can't be complacent at all, and I think today you will see that several premiers and the Prime Minister will not be complacent in the measures that they implement, but in terms of the testing that we're doing, we're doing a very good job at the moment.
There will be more rapid PCR tests coming on the market in April, and that will be able to give us a really good idea of the testing environment and what's going on in the community.
KYLIE GILLIES:
Dr Coatsworth, I think what can be a little bit scary is that we're told to stay home if we're unwell. But there are people who have COVID-19, who are positive with zero symptoms. In fact, some very high profile people in the community. So what do you do about that?
DR NICK COATSWORTH:
That is a really challenging problem, Kylie. What I would say, though, is the ability to transmit the virus increases the worse your symptoms get. So for someone who doesn't have any symptoms, there's not going to be as much virus in their respiratory tract. It's going to be more difficult.
As you get more sick, you get more virus around, and certainly, the people with very severe pneumonia who go into hospital, that's why we have to protect our health care workers so much, because when they cough, a whole heap of virus gets out onto the surfaces around them. So while it is a concern that you can have this so-called asymptomatic transmission, it's not the major way that it is transmitted.
KYLIE GILLIES:
Okay. That is interesting, first time I've heard that.
LARRY EMDUR:
There's this race run around the world to find a vaccine and find it quickly. A tuberculosis vaccine already in use in Australia could soon be trailed with Australian health care workers. Could this be the breakthrough; do you think?
DR NICK COATSWORTH:
I'm sure it will be something that is worthwhile looking at. My colleague, Nigel Curtis, down in Victoria has started looking at this and the idea is the tuberculosis vaccines, when they trialled it the early trials, the people who got the vaccine had less respiratory viruses, and that's — you know, this is what we're doing, looking back to very old scientific literature to try and find the answers.
This will not cure coronavirus. The BCG will not stop someone getting coronavirus, but I suspect what it might do is decrease the number and severity of the cases. That is what is hoped and that is a theory behind what Professor Curtis is looking at as we speak.
KYLIE GILLIES:
Yeah. And that's a 100-year-old vaccine, so it's incredible, isn't it? A lot of variety of other treatments we heard talked about are arthritis drugs, malaria drugs, is there one that is more promising than others?
DR NICK COATSWORTH:
No, there's nothing that's sort of come out as a silver bullet yet, Kylie, and we're actually waiting for some of the data out of China and we've got our own trials for this particular arthritis drug which is also an anti-malarial, it's called Hydroxychloroquine and there's trials that are starting in Australia at the moment to work out exactly how effective that drug is going to be.
There's old HIV drugs, but there's also newer drugs, one called Remdesivir that has been trialled in the United States at the moment. So every mind that can possibly be turned to this globally is being turned towards therapeutics and also in months, hopefully, six months rather than 12 months, a vaccine against coronavirus.
LARRY EMDUR:
We're all addicted to looking at these graphs and these curve and statistics show we could be days away from having more COVID-19 cases than our hospital system can handle. What measures are in place to make sure that we don't run out of ICU beds and ventilators if the need arises?
DR NICK COATSWORTH:
Well Larry, I'm not sure we are days away of being overwhelmed in a hospital sense. Obviously, that's what we want to avoid, but the rate of hospitalisation at the moment is far less than 10% and we only have around 20 patients in our ICUs around the country and we usually have 2,000 ICU beds. So we can double the intensive care unit capacity already, and we can look at increased measures by procuring more ventilators, which the Health Minister has announced.
So all those things are going on at the moment. Converting different parts of the hospital into expanded ICUs and the intensive care doctors looking at least 200 per cent increase in ICU capacity to meet the demands.
So the idea, of course, is not to get there. But if the worst comes to pass and we do head in that direction, I'm really confident – I talk to intensive care doctors every day, they are doing their utmost to make sure we have enough resources to cope with this if it happens.
KYLIE GILLIES:
Doctor, the weather is about to turn, it always does around about Easter time, doesn't it? It starts to get colder. We're heading into the flu season. Does the change of season — does that have — does that all go, you know, not so well for the future of this COVID-19? Does the weather make any difference?
DR NICK COATSWORTH:
I'm not sure what the weather's going to do to COVID-19 itself. Obviously, we're entering flu season and that's probably one of the biggest messages we have to get out there at the moment to the public is get your flu vaccination.
Certainly, to all my health care worker colleagues, we need close to 100% of healthcare workers getting the — their influenza vaccination this year because what we don't want is coronavirus and a bad flu season. We don't have a vaccine for coronavirus, but we definitely have a vaccine for influenza and the Government will be making that available in early April.
LARRY EMDUR:
Doctor, as we wrap it up, you've been moving around like the rest of us this morning. You've walked out your door, you may be held your car keys, you've gone through an office door, you've pushed a lift, maybe you've got a cup of coffee. How are you feeling about moving around and keeping safe?
DR NICK COATSWORTH:
Well, I'm feeling pretty confident, Larry, because when I see what my fellow Australians are doing and fellow co-workers, they're by and large doing the right thing, but it's not by and large, we need everyone to be doing the right thing with washing their hands frequently before they touch surfaces, by keeping their distance, don't have 5 people or 10 people crammed into a lift, all those sort of things.
This it's unlike anything we've seen before, because it's not just Government and doctors and nurses that are going to fix this. It's each and every one of us, so if we can see each other doing the right thing, if we can call each other out even if we are not, then that will be a really important thing for us to do.
KYLIE GILLIES:
All right. Thank you so much. That's good advice to end on. Deputy Chief Medical Officer Dr Nick Coatsworth, thank you for your time this morning.
LARRY EMDUR:
Thanks, Nick.
DR NICK COATSWORTH:
Thank you.
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