Date published: 
20 August 2020
Media event date: 
19 August 2020
Media type: 
Transcript
Audience: 
General public

NICK COATSWORTH:

To date we've diagnosed 23,993 cases of COVID-19 during the current pandemic in Australia. 228 of those were newly confirmed to 12 noon today. In New South Wales, there have been seven new cases reported. Two of those were overseas acquired in hotel quarantine, three were locally acquired and contacts of a confirmed case and two were locally acquired and the contact has not yet been identified. In Victoria, there have been 216 new cases reported. 47 of those were locally acquired and contacts of a confirmed case and 169 remain under investigation. In Western Australia, there were four new cases reported, all of those in hotel quarantine. And in Queensland, one new case reported, also in hotel quarantine.

There have been 12 deaths related to COVID-19 in the past 24 hours and 450 total deaths in Australia during the current epidemic. There are 694 people hospitalised and 52 of those hospitalised people with COVID-19 are in intensive care units.

There has been a lot of talk about vaccines today. The announcement by Prime Minister Scott Morrison and Chief Medical Officer of Australia Paul Kelly. So I wanted to try and get into the science behind some of these vaccines because we're hearing a lot about the names of the vaccines, viral vector vaccine from Oxford and something called a molecular clamp vaccine which is the technology that's proprietary to our own researchers at the University of Queensland. Both of those showing a lot of promise amongst a range of other candidate vaccines around the country.

So what do you have to do to get a vaccine? The vaccine has to be able to produce the immune response in the body, either through boosting antibody production which is one arm of the immune system, or activating what we call the cellular immune response, which is in another part of the immune system. The UQ vaccine technology, this molecular clamp vaccine is really interesting in that it uses- it targets what we call the fusion protein which every virus has to use, every envelope has to use to get into human cells. And of course to replicate the virus has to do that by entering into human cells. That doesn't matter what sort of virus it is. That's the way it does it. And so the virus fuses its membrane onto the host cell membrane, enters the cell and starts causing mischief and replicating. And it's those fusion proteins that mediate that. Now fusion proteins are a really good candidate to use for a vaccine because they're really, they generate quite a powerful immune response. The problem is, as researchers have found for many years, those proteins can actually change their shape or their confirmation, making it really hard to get a stable protein that actually gives you the right immune response.

So what have our researchers at the University of Queensland done? They've actually- and they've used a word that's evocative - molecular clamp - they've actually clamped these fusion proteins, these fusion proteins in a particular confirmation that results in the right immune response being generated. Now I'm going to have to apologise to them if I've explained that in any way, shape or form inaccurately, but it is complicated science. Science that's been generated and researched here in Australia with those vaccines in phase one studies at the moment.              

So that's a part of a protein and that's the part of the protein that forms the vaccine. What about the Oxford viral vector vaccine? That's called a viral vector vaccine and how is that different? Well, the viral vector as it sort of sounds, you get a virus which is not COVID-19, which isn't a virus that's going to affect humans by causing any disease. So in this case it's an adenovirus. You make sure it doesn't replicate inside cells, so it's a non-replicating viral vector. And then the genetic code of that virus is altered to end up producing an immune response akin to the immune response of COVID-19.              

Now why is that exciting and interesting? Because it doesn't just- in fact it stimulates less of the antibody type response and more of the cellular type immune response. And that really does have the potential to take harness the dual aspects of the immune system, antibody and cellular, to give you enough of an immune response to make you effectively immune to COVID-19.            

Now this is complicated stuff and I can tell you that even as an infectious disease physician, I find this technology and this science quite hard to unpick. I hope I've explained it as accurately as possible. But it also exemplifies the reason why we, as the Australian Government Department of Health, need to get the best people in Australia advising us on these complicated matters, where the virus is new, where the evidence is emerging. And so as was announced today, the Scientific and Technical Advisory Committee to Government on the COVID-19 vaccines contains some of Australia's most eminent scientists or vaccinologists, including an old colleague from the University of Western Australia, Associate Professor Chris Blyth and the current Deputy CHO of Victoria, Professor Allen Cheng. Both of whom are the co-chairs of the Australian Therapeutic Advisory Group on Immunisation or ATAGI. Alan Finkel is on that group, our Chief Scientist, who had such an important role during the first wave of the Australian epidemic in developing novel- in helping to develop novel ventilator manufacture in Australia and Larry Marshall, the CEO Chief Executive Officer of the CSIRO, amongst others.             

So it's critically important we get the best advice from the best people in Australia. And that's replicated in all of the government committees that advise the Department of Health and advise our ministers and our Prime Minister. The Australian Health Principal Committee that you've heard so much about, comprising the chief health officers of every state and territory with decades of cumulative experience in health. The Communicable Diseases Network of Australia, comprising Australians leading public health physicians in the communicable diseases branches of health state health authority. And our Infection Control Expert Group, with our leading infection control physicians. This is a committee that even I'm not on because I'm not an infection control expert. I'm an infectious disease physician. And I want to share with you today the confidence that I have when I see my colleagues on those committees working to interpret the evidence, the emerging evidence and give us expert opinion that guides our response to COVID-19.           

And with that I'll take some questions. Tamsin?

QUESTION:

If and when we do get a vaccine, what kinds of protocols would need to be in place to ensure that when people are entering a venue or any other high risk setting, actually was vaccinated?

NICK COATSWORTH:

Well Tamsin, I'm not sure we're considering that at this point. I mean, the most important priority for Australia is to secure the capacity to manufacture the vaccine, to secure an agreement to do so which clearly we have secured with AstraZeneca today. And then the important thing is to be very clear with the Australian public about the importance of getting vaccinated. So the rates of flu vaccination this year have been astonishing, really. I have never seen them in my practicing career, they've been so high. So there is a significant demand we anticipate for the vaccine in Australia. And we anticipate that the uptakes are going to be good. So in terms of those more forcing type mechanisms or immune passports or things like that, these are not things that are currently being discussed, but I'm sure they will be part of the agenda of the scientific and technical advisory committee.

Claire.

QUESTION:

Dr Coatsworth, just to change slightly to aged care, what advice is the AHPPC are currently preparing for National Cabinet this Friday with regards to the states undertaking audits of their capability to then report back I assume. What is the plan there with that process?

NICK COATSWORTH:

Well, Claire, as you know, we can't discuss the detail of the National Cabinet submission. But it is well known that National Cabinet has asked the Australian Health Protection Principal Committee to report back on exactly the learnings from the Victorian Aged Care Response Centre and the principles of how the Federal Government and the State health authorities, as well as the aged care regulator and the providers themselves, will respond to any further outbreaks of COVID-19 in residential aged care in those states that don't currently have outbreaks. So that is building on the existing plans that the Communicable Disease Network of Australia made for residential aged care facilities, but most particularly, incorporating the learnings of how to manage multiple outbreaks - as you know up to 120 now in Melbourne in residential aged care facilities - and taking those learnings nationally.         

Anna.

QUESTION:

Doctor, in terms of remote Aboriginal communities, something which has been [indistinct] over the last 24 hours, what's the currents restriction, if any, on entry to remote Aboriginal communities? And do you [indistinct] know if any that are still locked off from the rest of Australia?

NICK COATSWORTH:

So, Anna, I hope my answer is contemporary. My understanding is that there aren't any communities that are under the biosecurity zones that were enforced during the first wave. I understood they were all- that those restrictions were all raised. But to an extent, I'm going to have to take that question on notice.

QUESTION:

And just a follow up on that, what would be the advice, and there is some material on the website for people who might be now travelling more freely to more remote areas, about how they should be interacting and behaving in order to not only social distance but try to protect those communities?

NICK COATSWORTH:

So I think the most important protection is - for example, the Northern Territory, I was looking up the restrictions myself yesterday. That if you're from a declared hot spot, which the Northern Territory makes very clear where those hotspots are, then you need to quarantine for 14 days. And the NT has a significant number of people in quarantine in Howard Springs to that end. So those sort of cross-border movement restrictions are at the moment one of our most important barriers towards infection in our remote north-west, north-east, and far north communities. Specific advice to individuals of course: don't try and get to a remote community if you've been in a hot spot area or you've been in Victoria where there have been some notable instances where people have tried to do that, and they've felt the full force of the law accordingly. And finally, just the standard message that if you are at all unwell, even if you don't have COVID, if you bring in a respiratory virus into a community and cause a flu outbreak or you cause an RSV outbreak, or anything like that, there's a whole cascade of effects for that community about needing to get tested, and so on and so forth that would be undesirable. People do have to be very cautious if they're visiting our remote communities. But at the same time, those communities do have visitors. They do need visitors at the moment and that's also important to keep the connection with Darwin and the rest of the regional centres.

QUESTION:

When it comes to international travel restarting again, whatever point that might be, would there be any health advice or medical advice in terms of whether proof of vaccination should be sort of part of an Australian citizen being granted access to a country to ensure that Australia does remain COVID-free while the rest of the world's still recovering from the virus?

NICK COATSWORTH:

So I think that's probably a similar sort of answer to Tamsin's question, in that that probably is a bridge too far in terms of our thinking at the moment. The state of the epidemic around the world and in Australia means that international travel is not at the forefront of our minds at the moment. Though, clearly we do have the International Students Pilot Program planning to be started, and that would likely be started before a vaccine became available.

QUESTION:

Paul Kelly has said that this vaccine that was announced today was just the first of multiple that the Government will be announcing. How many others are being worked through at the moment, and do you think some of those have as much potential as this one?

NICK COATSWORTH:

I think we're aware, as you are, that there are at least, I think it's six candidate vaccines that are moving towards phase three trials. So the producers of all those vaccines will- some of the major producers will be approached. In terms of the absolute number that we're approaching, I don't have that on hand. But you can be assured that where there is a credible possibility of a vaccine being produced, that we're engaging in the same way as so many other countries have engaged. Noting of course that our position and our message worldwide is that whoever gets to that successful vaccine first, that should be made available to all countries: low, middle, high-income countries. And that we all have a duty to support, particularly the distribution and access of vaccine around the world, and particularly not just in high-income countries, which is why Australia's provided a letter of commitment to the COVAX vaccination facility.

I'll just take Josh first, and then Dana. And then come back to the floor.

QUESTION:

Yeah, thanks, doctor. Just a quick one on the vaccine. There has been some [indistinct] today about the difference between a letter of intent to get a vaccine versus the deal to get a vaccine. I realise this might be more of a political question or a matter of semantics. But realistically, what does today's announcement really mean? How meaningful of a step is it practically? And if it all does goes well and all the boxes are ticked, how many steps are there before this vaccine would actually be rolled out?

NICK COATSWORTH:

Well, Josh, I think it's an important question actually. What does this letter of intent actually mean? The answer really is the ability of Australia to be able to produce a licensed vaccine in the country, is the way I understand it. And having that critical first step, as it relates to the Oxford vaccine, which is clearly one of the most promising vaccine candidates and why we've engaged first with AstraZeneca. So that is why the media release today was done with colleagues from CSL, and noting that we really do have, not just some serious research power, but some serious manufacturing capability in Australia through that particularly successful Australian company. Dana?

QUESTION:

Thanks, Dr Coatsworth. The PM said today that all options would be on the table when it comes to encouraging people to accept a vaccine once we do have an approved COVID-19 vaccine. And Professor Kelly talked about linking it to programs. The PM's mentioned many times about the no jab, no pay policy. What types of things could the vaccine be linked to? Are we talking about people not being allowed to go to restaurants and bars? Or would people not be able to attend schools or catch public transport? How broadly could the restrictions apply?

NICK COATSWORTH:

So once again, I'll just take a step back and say that we have spoken about vaccines so much this year, that Australians have gone through so much pain with restrictions and stage four and three restrictions in Victoria at the moment. At the same time, we've had record influenza vaccine uptake. And so the first step is going to be, is never the stick. The first step is always engaging with Australians, with the community, doing some of that complicated explaining that I've attempted to do today. But really reassure Australians that the vaccine, that we eventually get is safe, it's effective, and when we roll it out we monitor it, just as we do the new strain influenza vaccines every year through our really robust regulatory system. And it's that confidence that's going to get the bulk of Australians getting vaccinated. I have absolutely no doubt about that. But there will be strong, I suspect the majority of Australians will get vaccinated and there will be a strong public view that those who choose not to get vaccinated need to, there needs to be some sort of incentive stick perhaps, through the currents programmes, including No Jab, No Pay, to make that happen. So I think that is a very reasonable interpretation of what the PM had to say today. Again, looking at specific things like not being able to go into restaurants, not being able to travel internationally, not being able to catch public transport or more broadly having what in the olden days would have been a yellow fever vaccination certificate, these are clearly policy decisions that need, will be discussed. But there's no current mechanism to enforce that sort of thing at the moment.

QUESTION:

Dr Coatsworth, the states that have extended or maintained border closures keep saying - the premiers keep saying it's based on medical advice but with the exception of Victoria, it does appear that they're pursuing strategies of elimination, using the use of any COVID to keep their borders closed. Are you satisfied with the medical advice as it's being explained by those individual states or like the Prime Minister would you like to see more information and detail tail behind those decisions?

NICK COATSWORTH:

Well, I think we've always encouraged around the AHPPC as much transparency in decision-making as is available. I can assure you all the chief health officers provide that. That said, it is clear and it is clear to Australians now that those border decisions are made by state premiers and health ministers on advice of their chief health officers. And that it's particularly important that those decisions are justified not just to the people of that state, I think that we've seen very clearly in the past few weeks the significant effect that border closures have on people living on the wrong side of the border. And I can tell you, when I worked in Lismore for example in 2004, it was, we would always send our patients to John Flynn Hospital on the Gold Coast Private Hospital, and then probably to the new Gold Coast University Hospital. So this is, it's not just a question of being able to switch that off, of course, because these border towns actually depend on cross-border healthcare and they haven't depended on it for 10 or 20 years, they've depended on it for 50 years. The same for the South Australian border. So what I would simply say to conclude that question is it's a general principle of medicine when you're implementing - when you're doing anything to treat a problem is first do no harm. That has to be a consideration as well, equally with border closures.

QUESTION:

After elderly, healthcare worker and other vulnerable groups, what other groups of people would the government be looking to try and vaccinate first. Would it be fair to say that [indistinct] towards the end of the vaccination process?

NICK COATSWORTH:

I think beyond saying that they're during a pandemic, and where the vaccine is not going to be available, may not be available to all Australians at once, it may be. But that there would be a prioritisation system. You've outlined two of the groups in elderly Australians. I would add in people who have co-morbid conditions, by which I mean, multiple health conditions. We know that leads to severe COVID-19 and potentially death. And of course the principle of reciprocity where people are putting themselves at risk on the front-line, healthcare workers, residential aged care worker, disability workers, there are - there are many people who may fit into that priority category. Clearly, though, that is going to be the job of some of the committees that I've just mentioned to decide that. If and when it is decided it will be clearly indicated to the Australian public, with a rational as to why. But at this point those decisions have not been made and I guess appropriately so given we're not even at the manufacturing stage of the vaccine yet.

So two more questions.

QUESTION:

You mentioned the influenza vaccine has had a strong take up this year. Australians obviously comfortable with it, it's been around for a long time. Is there a way that [indistinct] professional or government may need to deal with vaccine hesitation in terms of when a new vaccine comes to market, people might not want to jump, [indistinct] they might not jump in immediately, but waiting to see how other people may react.

NICK COATSWORTH:

So I think that's a really important observation that people are comfortable with the influenza vaccine and we're talking about a novel virus with a novel vaccine. What can we do to maintain, to increase confidence and decrease vaccine hesitancy? Having - being able to communicate the research results of the phase one and two trials, so they're the safety trials, and those results have been excellent in terms of safety profile for these candidate vaccines, including the Oxford vaccine. That's an important thing to remember, that we've gone through the safety trials. When we get into the phase three trials where there's many, many more people, tens of thousands of people now, you get even more safety data. That needs to be clearly communicated to the public. And then what we've got, what you get after that, when the general public starts getting jabbed, is what we call the post marketing data and that's where our robust regulation and systems come in, regulatory systems come in, to make sure if there are unexpected post marketing side effects of this drug, that they're found out immediately. And there are good reporting mechanisms in Australia based on years of having a really robust vaccine strategy.

Last one.

QUESTION:

There have been some discussions today about whether or not the curfew in Melbourne is necessary and some people were fined for going to get takeaway after 8:00pm. Is there any medical reason to put in place a curfew because of coronavirus?

NICK COATSWORTH:

I think the short answer is there is a medical reason to do whatever you can to reduce mixing. As Paul Kelly's fond of saying, the virus doesn't move, people move. And so if there - there was clearly information available to the Victorian Government that suggested that, shall I say, after dark movement was a problem and they instituted a policy response to that. Every time you see one of these things, it can be safely assumed that it's actually in response to some sort of public health issue that is trying to be addressed. In this case, movement, most recently in New South Wales, restrictions in schools, on choirs and sport and that sort of thing. This is because these issues are coming up. And restrictions need to be placed in to resolve them.

Thank you.

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