Deputy Chief Medical Officer press conference about COVID-19 on 2 September 2020

Read the transcript of Deputy Chief Medical Officer Dr Nick Coatsworth press conference about COVID-19 on 2 September 2020.

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NICK COATSWORTH:

In the 24 hours to 12 noon today, we have reported a total of 25,923 cases in COVID-19 during this pandemic in Australia; 109 of those were newly confirmed in the past 24 hours. New South Wales has reported 17 new cases. One was overseas acquired, 15 were locally acquired and contacts of confirmed cases and one was locally acquired and a contact has not yet been identified with one. Victoria reporter 90 new cases of COVID-19; 22 were locally acquired and contacts of confirmed cases, and 68 remain under investigation. Queensland has reported two new cases. Both of which were locally acquired and contacts of confirmed cases.

There have been six deaths overnight from COVID-19, bringing the national number of deaths due to COVID-19 to 663. At this point in time, there are 432 people hospitalised in the country, and 23 of those are in intensive care units.            

There's been a lot of discussion, particularly with some unseasonally warm weather over the past few days, of what the likely impact of warmer weather might be on COVID-19. There's been particular discussion about whether the virus might be less transmitted during the summer months as influenza would be. We have to be clear that we do not yet know the impact of the seasons on COVID-19. We absolutely cannot assume that because we're moving into the summer months, when other respiratory viruses traditionally decrease, that COVID-19 would also decrease. What we do know about summer, though, is that Australians will get outside. And they should, in the states where they're able to do so. And as restrictions are lifted in Victoria, so too will Victorians be able to get out and enjoy the warmer weather. But when people are getting outside, that means two important things that affect COVID-19 transmission. One is movement of people across cities, across states. And the second one is crowds, which we see frequently.              

So if we can't assume that COVID will be any less transmitted, we have to assume that that movement in crowds could potentially bring risk. And indeed, we have seen in the northern hemisphere COVID running rampant across many nations during the summer months as holidaymakers go to and from countries in Europe, bringing the disease back in to their own country and sparking new outbreaks of COVID-19. So the message is: as we move into the summer months, treat the summer with as much caution as you've treated winter. And that means keep physical distance. That means get tested if you're at all unwell. Don't go to a family gathering down at the beach if you're unwell or the kids are unwell. Stay at home and get yourself tested. Wear a mask if you're on public transport going to and from those areas. It's very hard to find a park in most of the beaches in Sydney, so a lot of people use the train and public transport; critically important to wear a mask as you're doing that. Excellent hand hygiene of course. And there has never been a better time to download the COVIDSafe app and have it active on your phone when you're highly likely to be around people who you don't know, at close distance for 15 minutes or more.           

Now I've got two journalists on the phone today and so I'll go to Dana first.

QUESTION:

Thanks, Dr Coatsworth. I just have a question about moving out of Stage 4 in Victoria. The National Cabinet approach has been to suppress the virus, not to try to eliminate it. Is that the AHPPC advice- is that still the official advice? Is that the way that Victoria should be moving out of restrictions?

NICK COATSWORTH:

Well, Dana, they're two different things. The first one, which is the National Cabinet and agreed AHPPC position, is for aggressive suppression of COVID-19. That hasn't changed. Several weeks ago, we discussed this again and reiterated, or gave clarity to what aggressive suppression means. And the target is no community transmission of COVID-19. Now, clearly that will not be the threshold that Victoria uses to determine how they lift their restrictions. But in terms of that decision-making, that will be very much the decision-making of the Victorian Chief Health Officer, Professor Brett Sutton, in conjunction with his Premier and Cabinet. I understand that's going to be articulated on Sunday. And the Australian Health Protection Principal Committee's role therein is to provide advice to Professor Sutton. Paul Kelly, of course, and Professor Sutton talk on a very regular basis about these sort of issues. So we have to separate- to conclude the response, we have to separate those two things. The aggressive suppression model, where we go for no community transmission, that's the end game. That's what all states and territories in Australia are aiming for. The road out of restrictions for Victoria will be based on different thresholds that they will no doubt articulate in the coming days.             

Rose?

QUESTION:

Thanks, Dr Coatsworth. I wanted to ask you whether you believe it's possible to adopt a national definition of a COVID-19 hotspot?

NICK COATSWORTH:

Well, it's certainly very challenging to adopt a national definition of a COVID hotspot, but it may well be something that we need to do. It's going to be discussed at National Cabinet this Friday, the importance of having a national definition of a hotspot. But if I can describe some of the AHPPC conversations on this matter, and some of the reasons why the hotspot definition is so difficult to come to. Firstly, you need to know why we're defining a hotspot. Is it about travel across interstate borders? Is it about the public health measures that an individual state is going to introduce in response to one, two, five, or 10 cases? There are different reasons why you might want to define a hotspot, and the reasons why you wanted to find the hotspot actually affects the definition. And that sounds a bit like a circular argument and that's because it is. You really have to take into account, not just the numbers, but also the circumstances surrounding COVID-19 cases. Are we talking about a densely populated urban area? Are we talking about a town of 10? Are we talking about a remote Indigenous community? All of those circumstances have very different sort of responses. However...

QUESTION:

[Interrupts] [Inaudible].

NICK COATSWORTH:

Oh yeah, go ahead. Go ahead.

QUESTION:

No, sorry. I was just going to follow up and say do you believe any definition should be used to determine who can travel intrastate or interstate?

NICK COATSWORTH:

Well, I believe that it's going to be critically important to have that discussion at National Cabinet, informed by the AHPPC discussions. We'll clearly be able to be a bit more- give a bit more fulsome response after the National Cabinet has occurred. The importance of having that discussion though is absolutely clear. Why do we want to have a definition of hotspot for the purposes of understanding movement across state borders? And that is so Australians can understand the circumstances under which borders may be opened and closed. Having said that, it is and always will be the position of the AHPPC that it's a matter for individual state chief health officers and their premiers, whether borders are open or closed.

QUESTION:

And how would you personally define a hotspot at the moment?

NICK COATSWORTH:

Well I'm part of the AHPPC, so my personal opinion on hotspot doesn't actually matter too much. And I take a step back and just reiterate my previous response to the question, which is the definition of hotspot depends on why we want to define a hotspot and what response that's going to give. And as I said, we'll be able to more fully discuss these matters once the discussion at National Cabinet has taken place.

QUESTION:

Okay. But it sounds like you're not overly optimistic that there can be a national set of rules or a national definition on a hotspot agreed to on Friday.

NICK COATSWORTH:

I wouldn't say that at all. I'm always an optimist. And… but this is a decision of national significance, and appropriately, our national leaders will be discussing it on Friday.

And I've got another question on the phone.

QUESTION:

In person. Thanks for making the effort to come down. I've just got a written question.

NICK COATSWORTH:

Yes.

QUESTION:

Is the public well aware of the [indistinct] by the pharmaceutical companies to find a vaccination for this COVID-19? Just wondering, is there any research by the Government or established groups for examining changes to lifestyle which would maintain or improve the average person's immune competency and resistance to the virus?

NICK COATSWORTH:

Sorry, could you just repeat that last bit of the question?

QUESTION:

I'm just wondering if there's any government or establishment research focus for examining changes to lifestyle, which would maintain or improve the average person's immune competency or resistance to the virus?

NICK COATSWORTH:

I think I understand the question, being is there any- are there any general measures that we can do that are being researched that are going to boost our immune system? And I think we are absolutely confident that being as healthy as you possibly can be is your best protection against COVID-19, getting severe COVID-19. So, it's… we don't really need to do too much research into that. We know that things like quitting smoking are going to be an excellent and important thing to do. That's self-evident. Losing weight is going to be important. The general measures of having a balanced diet. If you have any co-morbid conditions, and when I say co-morbid, that means any other health conditions - so diabetes, high blood pressure, heart disease - the most important thing you can do at the moment is discuss with your GP about how you get those in the top control that you possibly can.

And all those measures, all those measures are going to help with your natural immunity and help you if you get COVID-19. Of course, what they don't do is actually stop you from acquiring it and the way you do that is by keeping physical distance, avoiding people, getting tested if you're unwell, washing your hands, wearing a mask, all of those things. So, first thing to do is stay healthy; second thing to do is avoid getting it.

QUESTION:

Yeah. Is there any research being done people who have contracted it and not gotten sick? Like, what makes them different, that's all? Is there any research going into that study as well?

NICK COATSWORTH:

Is there any research into- so that would be case control studies where you look at people who contracted the disease and compared them with people that haven't. Most of those studies would look at particular risk factors for acquiring COVID-19 but severe disease. That's usually where the comparison lies, and that's how we know that people who are older and who have more of those added health conditions are at risk of more severe disease.            

Now, I'll just go back to Dana in case she's got one other question.

QUESTION:

No, I think you covered it. Thanks, doctor.

NICK COATSWORTH:

Okay. And Rose?

QUESTION:

Dr Coatsworth, I wondered whether you think mystery cases are more important to focus on when defining a hotspot as opposed to those cases with known sources? And what sort of parameters you're looking at when coming up with possible definitions?

NICK COATSWORTH:

Yeah. So that answer, we can say a definite yes to. That it is of more concern when you have mystery cases, where you can't establish where the chain of transmission is, than it is where you have cases where you're clearly able to work out the chains of transmission. And you can look at the example of Batemans Bay Soldiers Club down in New South Wales, where they were able to get on top of that by identifying all the transmission links. And then, because people were then isolated, the transmission in the south-east of New South Wales effectively stopped. So it is the case that mystery cases, even at low numbers, are of concern.            

Just to finish off on the answer of that question, how do we actually establish if a mystery case has a link? Well, you've got to look at the contacts of that particular case for the 14 days prior. You would typically, and this is being done in New South Wales and likely also in Victoria, you would test those contacts - what we call the upstream contacts - even if they're not symptomatic. Often, we would ask them to be tested, both with the nasal swab and potentially with a blood test to see if they've got any antibodies. And the last thing which has proved to be very, very useful and it's not something that we would have ever been able to be used in the early part of the 21st century, it's a new technology called genomics, where we're actually able to map the sequence, the genetic sequence of the virus, and then use that with our public health knowledge to form those links. But the short answer to your question is yes.

QUESTION:

And does it make sense medically to restrict someone's movement if they have been in a hotspot, and a hotspot as defined nationally across the country?

NICK COATSWORTH:

Well, again, that speaks to my previous answer of what the hotspot definition is for. Let's look at a concrete example in New South Wales at the moment, which is where you have cases within specific suburbs or, say, the Tattersalls gymnasium, that you define that as a place where you want to do increased testing, where you want to test asymptomatic people, where you want people to have been to a certain area, a certain club or a gym, to actually isolate themselves for 14 days. So that is a form of movement restriction within a city, where you're asking people to isolate who have been to that venue. But you can see the difference between that and then making the decision that an entire state border needs to be closed.           

So, it's a very, it's a very complicated definition, the one of hotspots, and it will continue to be applied in different ways by the chief health officers, necessarily because the circumstances of each particular outbreak differ so much from state to state and region to region.

QUESTION:

Just one-

QUESTION:

Thank you.

NICK COATSWORTH:

That'll be it. Okay. Great. Thanks very much. Cheers.

QUESTION:

No more questions?

NICK COATSWORTH:

No more questions. Thank you.

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