Date published: 
27 July 2020
Media type: 
Transcript
Audience: 
General public

NICK COATSWORTH:

I’m providing the daily update on COVID-19 in Australia. To date we have diagnosed 14,403 cases of COVID-19 during this pandemic. In the past 24 hours to 12 noon today, there have been an additional 475 cases diagnosed. In New South Wales, there have been 14 additional cases, three of those related to hotel quarantine. Ten have known links to existing clusters of COVID-19 within New South Wales, and one case is a locally acquired case of COVID-19 whose contact is not yet identified. Victoria today reported 459 additional cases. Eighty-two of those were known contacts of people with COVID-19, and 377 remain under investigation. There are 241 people nationally who are hospitalised with COVID-19, and 41 are in intensive care units. One hundred and fifty-five people have lost their lives to coronavirus disease. Ten additional Australians overnight lost their lives to COVID-19.

The situation, of course, in Victoria has us all deeply concerned. The numbers continue to fluctuate in the 300s and 400s. Today a number of 459, which not quite approaching the peak, but certainly close to the 490 that we saw several days ago. What isn't happening, of course, is that those numbers are not doubling on a week by week basis. That we have reached a relatively steady state, for the moment, of numbers between about 350 and 450 per day. This certainly reflects the effect of some of the initial restrictions that have been brought in, and we need to keep in mind, of course, that we're only two weeks from the Stage 3 restrictions, just over two weeks since they were brought in, and of course the mandatory mask-wearing policy in Greater Melbourne and Mitchell Shire, which was implemented some five days ago.

So whilst we are deeply concerned, we are obviously watching the numbers with interest. This is a truly national effort. We have the Australian Defence Force, which has made a significant contribution at the request of the Victorian Government, with over 1400 ADF personnel in Victoria at this point in time, assisting with a range of activities. Their contact tracing has been ramped up to extraordinary levels, both within the Victorian Department of Health and Human Services but assisted remotely by colleagues and public health officials around the country. And additionally, we are- we know that if additional resources are required from the ADF to the Victorian Government, that they are available, that additional ADF resources are available if Victoria needs them.

I want to dwell on the situation in aged care, which is obviously occupying our minds, the minds of families of those who have loved ones in aged care within Victoria at the moment.

The Minister for Health Minister Hunt and the Minister for Aged Care Minister Colbeck announced yesterday the Victorian aged care response centre, which builds on many weeks of collaboration between the Commonwealth Department of Health and various other organisations to formalise a response centre dealing specifically with aged care and the challenges that several aged care centres are meeting against COVID-19 at the moment. This announcement is in clear response to the gravity of the situation, particularly in a number of- smaller number of aged care facilities with many, many cases of COVID-19, where we need to work hard to bring things under control as quickly as possible. That is a broad range collaboration, led by the Commonwealth Department of Health and Emergency Management Australia, which of course is housed within the Department of Home Affairs, a close collaboration between the Commonwealth and our Victorian colleagues in Emergency Management Victoria and the Department of Health and Human Services. With assistance from the Australian Defence Force, with leadership, as well, from the Aged Care Quality and Safety Commission and the Commissioner, Janet Anderson, and of course, in partnership with the aged care providers in Victoria and with families of those and of aged care residents themselves.

This is a challenge that we all need to work together to meet quickly, for the safety of those who are vulnerable and dependent on care within aged care facilities in Victoria. There have been calls, of course, in some- from some sectors of the community for all residents in very affected aged care facilities to be removed. One of the things that I've learnt as a clinician and assisting with the response as Deputy Chief Medical Officer is that every single outbreak is different in regards to COVID-19. That it affects different facilities in different sort of ways when we're talking about aged care. And as anyone, like myself, who’s had a relative in residential aged care in Australia – my father was in three aged care institutions – they're all very different. And if I reflect back on where dad was, I could quickly appreciate that COVID-19 would behave very differently in those institutions, based on the number of people who were together in rooms, based on the number of single rooms there might be, based on the level of acuity of care for those aged care residents, some of whom have very advanced dementia and behavioural issues as well as other care needs. And so what that means is that it's very difficult to apply blanket approaches across different facilities. They require an individualised response. They require a coordinated response where we can, as with the Victorian aged care centre, make sure that the right decisions are made for each individual aged care unit. And then of course, decisions need to be made for individual aged care residents, both those whom are COVID-19 positive and others who may be suffering because of their high care needs and the effects that the work force disruption is having on them. The important thing to note there is that decision-making for individual aged care residents is a shared decision between themselves, if they're able to make it, their families, and of course healthcare practitioners. And those aged care residents who do suffer from- who are suffering from COVID-19, who require hospitalisation, will of course be hospitalised. But that decision needs to be made by the treating clinicians. Every aged care resident in Australia has their own general practitioner, be intimately involved in those decisions, the receiving doctors at the hospital, the wishes of the aged care resident and the families. And I wanted to make that clear today because it is important that people understand that there is no blanket approach, that these approaches need to be tailored, individualised, and effective.

And with that in mind I'll take questions. Tamsin.

QUESTION:

Just on the aged care situation in Victoria, last week Alison McMillan visited one of the sites that have had particular issues, and she said she heard of cases where workers there had tested positive, but they’d been entirely asymptomatic. What's your understanding of asymptomatic cases in Victoria at the moment? And what’s the current advice on their ability to have or spread the virus?

NICK COATSWORTH:

Alison McMillan, as you know, is the Chief Nursing and Midwifery Officer. She’s been taking an absolutely key role in this, both- Alison has extensive emergency management experience and of course is one of our country's leading nurses, in fact, the leading nurse of the country. Alison’s comments there reflect the fact that COVID-19 has a known pre-symptomatic period. That for 48 hours at least before someone starts to develop symptoms, they are able to have virus within their upper respiratory tract and transmit it to people. That makes it a very challenging situation where you've got a workforce that absolutely has to be at work, to care for these individuals but may well be incubating the virus, may well be in a pre-symptomatic phase. So whilst we don't have data specifically on the number of people who are asymptomatic, it is certainly a challenge of COVID-19 and one of the reasons why when we look at the numbers and say there are over 500 individuals affected with COVID-19 in aged care in Victoria, that it's about 260 of those are residents themselves and 260 of those are staff. So a very challenging situation.

QUESTION:

The cases in Victoria today, 377 under investigation. That's about 80 per cent of today's cases. Overall they've got about 3000 under investigation. What is the impact if those cases aren't traced within 24-48 hours? What is the window? And presumably of those 3000, many have surpassed that window. What's the risk that there is now a lot more exponential growth of this virus in the community to come?

NICK COATSWORTH:

So, I think it reflects a few things. You spoke of the- when we say on a daily basis now, that there's a significant number of cases in Victoria under investigation. Then in the ensuing days, the contact tracers down there are trying to make those links between the various outbreaks. And as we've heard from Professor Sutton, I believe there's over 100 separate outbreaks and clusters down in Victoria at the moment, so that is a very challenging job indeed. It's certainly not to say that those 377 haven't been contacted. It's been very clear in the past few days and indeed weeks that the focus has been making sure that people who are diagnosed are contacted on the day of diagnosis. And that is absolutely critical, and I think one of the things we've heard which has been very encouraging, there have- there are challenges in calling people and getting in touch with them. Sometimes they may not answer the phone, and of course now we know that if people don't answer their phone, they will be contacted in person. And the ADF is supporting us with that. So in actual fact, the most important thing is once you get a diagnosis, someone is aware of that diagnosis and then they isolate.

Then, as you say, it is desirable to be able to trace the contacts as quick as possible. And it certainly does have an effect when that contact tracing takes a few days or potentially you can't find the links. So the tighter the contact tracing is, the easier you- the quicker you get on top of these transmission chains. I think the reality in Victoria at the moment, what we're seeing with the increased emphasis on contact tracing, the literally thousands of people who are involved around Australia, and what we will see is these numbers come under control, those contact tracing times will come down, and it’ll be easier to find those contacts in the quickest possible time. But there's no point in saying it's not a challenge. It is a challenge when you get to these numbers, and it is something that would challenge any jurisdiction in Australia, which is exactly why we're offering the extensive support that we are to Victoria.

QUESTION:

One of the things that National Cabinet agreed to on Friday was a more centralised, open, transparent, sharing of information data beyond case numbers. What data will be now shared between the states and the Commonwealth more freely? And isn't that implicitly saying that that information wasn't being shared potentially in the case of Victoria and it would have been more valuable had it been made open to other states earlier?

NICK COATSWORTH:

No, I don't think it's fair to suggest that National Cabinet agreeing to a set of standards implies that that information wasn't being shared with the AHPPC prior. We've been in long discussions, and Professor Sutton and his colleagues give us extensive information about the situation in Victoria, including their challenges with regard to contact tracing and other things. This is how we've known that we've needed to be able to support them. So certainly, those numbers now, those new key performance indicators which are part of the Pandemic Health Intelligence Plan, will be very important to be able to assess response. They will indeed involve things like the time taken between someone getting a test and to have been reported. That- all- any particular delay or time period between when a COVID-positive patient has their test and when they’re fully contact traced, that’s the sort of metric that we want to see reported, so we can work out that it’s as short as possible. And that’s how we know three key things, about COVID-19. We want to get to a point where we know where COVID-19 is in Australia, why it’s there, and what we’re going to do about it. And as long as we can report against those metrics, we’ll be able to work that out.

QUESTION:

What’s the current advice from the AHPPC on how to define a close contact? Is it just someone who’s physically been close to that person? Say, they were working a shift together, something like that, or could potentially an aged care worker at a facility testing positive then deem that entire facility a close contact and all of those cases should isolate?

NICK COATSWORTH:

So, there’s a base level of definition of close contact, which is 15 minutes of face-to-face contact or two hours of more prolonged contact. Now, in practice, what’s going on in pla- in areas where there’s more likely to have been transmission, like aged care facilities, like the Crossroads Hotel, that the public health officials, if they deem it appropriate, will be more conservative with that definition. So a shorter contact might be used to define someone who might need a test or might need to isolate. And you've seen with New South Wales’ public health response to the Crossroads Hotel, for example, that they've been- they've got the base definition of what a close contact is, but then they may go beyond that and say, well, anyone who's been in this facility between Date X and Date Y, we require you to get a test and we require you to isolate. So there’s the base level, as per the Communicable Disease Network of Australia guidance, and then there's individual Public Health Unit discretion to go even further than that.

QUESTION:

Is the AHPPC continually reviewing international borders? And is there any indication that it’s likely the travel ban- you’ll recommend the travel ban be lifted by 1 January of this year- of 2021, sorry?

NICK COATSWORTH:

Well, we are asked to look ahead a lot with COVID-19. 1 January seems almost a lifetime away, doesn't it? With what's going on with COVID-9 on a daily basis at the moment. But it is fair to say that the AHPPC is absolutely discussing international travel and borders. It would be- you know, it's important for us with that medium-term look at COVID-19 and where it's going to consider in particular the trans-Tasman bubble and what the requirements would have to be on both sides of the Tasman to be able to open that. So, whilst it is with the situation as we have in Australia at the moment not on the cards in the short term, it is definitely something we're still discussing.

And I might take a few questions on the phones, and then I'll come back to you. So, Dana.

QUESTION:

Thanks, Dr Coatsworth. I've got a couple of questions about aged care. The Federal Government announced a week ago that there’d be workforce funding support to the sector, including to ensure that employers can cover any additional entitlements, so that workers can be restricted to a single site. I'm just wondering when we can expect to see the details of that and see it actually rolled out. And also the [indistinct] issue of residents not being transferred to hospital. Is there a plan underway to set up a standalone facility just for aged care residents who are COVID-positive to be treated? Thanks.

NICK COATSWORTH:

So with regard to the workforce and when we might actually commence funding for aged care workers only to be able to work in one sort of area, and I'll just reiterate that policy: that we want to- there is a lot of travel for individual aged care workers between facilities, just, to be honest, as there is with many doctors and nurses as they work in different healthcare facilities. And what we want to do is try and minimise that, because obviously an infected individual who may or may not be aware that they're symptomatic going from one facility to another is likely to spread the virus. I'm afraid that I'll have to take that question on notice with regard to when that will actually be implemented, and we'll make sure we let you know. With the second question, opening a standard facility is certainly an option. I think one of the things we have to recognise, though, is that people who are in aged care –  as I said, my father was in aged care before he passed away – have a range of really high care needs and that setting up a standalone facility, while possible, would be a challenge. We have standing facilities, and they are our hospitals. So there have already been situations where, at least in one particular aged care facility in Essendon several weeks ago now, it was deemed more appropriate, because of the care needs of those individuals who had cognitive problems, had dementia and cognitive problems, that the majority of those, if not all, as I recall, were moved to a public hospital setting. At the moment – in fact I was speaking this afternoon to one of my clinical colleagues who's been involved with this – there are a number of residents with COVID-19 who are being transferred to private hospitals. So again, that critical partnership that we've had underpinned by the National Viability Guarantee between the Commonwealth, state healthcare services, and private hospitals being enacted to solve this new problem, this new challenge that we have to meet down in Victoria with the aged care sector. So that's the strategy at the moment to utilise private facilities both if COVID-19 positive patients need admission, that could be to a public facility or a private facility, but also as a means of taking patients who aren't necessarily COVID-positive but have very high care needs to help decant a facility and improve the work demands on workforce. So, that's quite a nice way to wrap up what the Victorian aged care- or one of the tasks of the Victorian aged care response centre going forward.

Now, Tim, I think you're on the phone too.

QUESTION:

Yes. Dr Coatsworth, two questions with regard to the COVIDSafe app. First, of the thousands of people now tracked to have the virus in this country, can you tell us- do you know how many were using the COVIDSafe app? Do you know what percentage- in what percentage of cases the COVIDSafe app worked? And if you don't know, can you tell us why not? And one other thing, can I ask you do you continue to support the COVIDSafe app as a better alternative for the job than the Google Apple app?

NICK COATSWORTH:

Well, thank you, Tim, and thanks for the opportunity to address those issues. I mean, the one- I can tell you why we're not always aware of the statistics – because we're not allowed to know – certainly not allowed to know how many people have downloaded the app. In terms of how many times contact tracers have used the app and have found people who are COVID-positive who have the app on their phone, that information is available. It has been reflected or provided by the Victorian Health Department, by the New South Wales Health Department as well. I don't have those numbers on hand at the moment. I understand- I think in Victoria's case, it's been over 100. But I think the question more broadly is, on how many occasions has it actually found contacts that would not have otherwise been found by the manual contact tracers themselves? Certainly, the situation at the moment in New South Wales is such that the contact tracers are able to determine quite effectively the number of contacts that people have had.

Your second question about whether I support the COVIDSafe app, and unfortunately you won't be able to see this, but what I'm showing Australians is the COVIDSafe app on my phone – active and no further action required. I have an iPhone, not an android. I'm confident with the performance of the COVIDSafe app. I'm not too worried about the battery life issues, and I have it running on my phone in the background. I think it's a very straightforward thing for Australians to do, and indeed close to 7 million Australians have downloaded the app.

What would be immensely of benefit to Australia and to the public health response is that people activate it on their phone. It's one thing, of course, to have downloaded it; it also needs to be activated. And the final point that I would say, Tim – in fact I might make two: the first one is that independent modelling commissioned by- that was that was undertaken by the Sax Institute has demonstrated the potential efficacy of the COVIDSafe app, depending on the number of people who have it active at any one time in Australia. The Gapple alternative, Google Apple, or Gapple as it's fondly termed, unfortunately takes the locus of the control away from the contact tracer. And anyone who's looked at the Google Apple alternative will realise that it requires an individual to be contact- to- it gets an SMS or a notification if they've been in contact with someone who's been diagnosed with the virus, and then that individual has to contact the contact tracer. That is the reverse of how the COVIDSafe app was designed and engineered. Why did we design and engineer the COVIDSafe app as we did? Because we want to put the contact tracer at the front and centre of that process. I'm not sure any public health department in Australia at the moment wants random calls from people who have received a notification from Google or Apple on their phone. That is the current position of the Commonwealth Department of Health with regards to the Google and Apple offering. Of course, we're prepared to see how it runs around the world and see how effective it is. But our decision at the moment stays firm that we support the use of the COVIDSafe app, that we're using the COVIDSafe app, and that we encourage Australians to download and activate it.

And I think there was one more person on the phone.

QUESTION:

Hi, Dr Coatsworth, Steph from the ABC…

NICK COATSWORTH:

Hi, Steph.

QUESTION:

…today’s been- hello. Today’s been the deadliest day in Australia since the pandemic began. Has the AHPPC discussed providing specific further federal support to Victoria? And if so, what is that support beyond ADF support?

NICK COATSWORTH:

Well, Steph, I think what we're seeing at the moment was with the Victorian aged care response centre is a very specific and tangible example of the discussions at the highest level, both within the AHPPC and the highest levels within the Victorian Health Departments and Commonwealth Health Department as well as between first ministers, the Prime Minister and Minister Hunt. So, this is the example of how we're providing more resources into managing the situation down in Victoria to minimise the impact on patients and families to get the situation in aged care under control. As I said at the start of the press conference, there is a standing offer for additional ADF support for Victoria, and the Victorian Government, the Premier, is aware of that offer, and we're confident we'll take that up if required. The Victorian aged care operation centre, of course, has some of Australia's leading emergency managers. I mentioned Alison McMillan by name, Joe Buffone from Emergency Management Australia, both close colleagues of mine, the leaders of Emergency Management Victoria, and, of course, the interventions of Janet Anderson to ensure quality and safety in aged care facilities. So this is a particularly strong response, and that is the additional response that has been discussed at the AHPPC.

And I'll take two more questions from Tamzin and Claire.

QUESTION:

Today, or over the weekend, there’s been a particularly… some would say ridiculous video that’s emerged out of Victoria, someone abusing Bunnings staff because they’d asked this woman why she wasn’t wearing a mask, and she was saying she was going to sue them. We’ve seen other examples of people abusing police officers about- when they were asked about not wearing masks and also moving across Victoria. What would be your advice to those people who think they’re above these public health orders? And what’s the importance of people actually following the rules on this?

NICK COATSWORTH:

Well, I'd say that this is the same standard that we would apply to people seeking treatment in our hospitals, which is that any sort of abuse is intolerable and completely unacceptable, particularly to those retail staff at places like Bunnings who are just seeking to be COVID-safe and to align- to obey the law. So that sort of behaviour has to stop. We acknowledge- I acknowledge that wearing a mask can be difficult. There are- it may take a while to get used to. But in all seriousness, it is just having a mask on, and we have provided a variety of ways, whether- you can buy them at the chemist, you can buy them at Bunnings, you can make your own cloth masks. There are a variety of ways to make sure that you've got a face covering. And then the why underneath all of that. Well, all we have to do is to see the numbers in Victoria to understand the why. That whilst mask wearing is part of a suite of measures, firstly you would have to ask why that individual was out of their house, because they're not supposed to be. Secondly, we understand that social distancing and testing is important, but if the icing on the cake is to wear masks and cut that transmission rate down so Victorians can get on that other side of the curve as quickly as possible, then it is critically important that all individuals in Greater Melbourne and Mitchell Shire do exactly that. So, whilst I understand it can be a difficult thing to get used to, the idea that it's some sort of imposition on someone's freedom or individual rights, I'm not sure I can be convinced of that. Claire.

QUESTION:

On New South Wales, it's now been just over two weeks since the Crossroads Hotel cluster. The state still only has cases in the low teens, and almost all of them are getting connected to clusters. Are you now confident in saying the state has avoided a Victorian-style second wave? And if not, how long do you want to wait to be able- and what results would you want to see to be able to make that call?

NICK COATSWORTH:

Well, I think we'd take our lead from Dr Kerry Chant on these things, of course, the New South Wales Chief Health Officer. I think that we're confident when we can say we know where COVID is, why it's there, and what we're going to do about it. And there still remain some unlinked cases of community transmission, and whilst that number remains small, whenever you do see unlinked cases, it implies that there may be transmission chains where people may have had minimal symptoms, they may not have been tested. What this absolutely means is that when New South Wales Health get out there and say, okay, for this particular area, say it's Harris Park, I understand today, to really strongly encourage all individuals there who have any sort of symptoms at all to get themselves tested. And that's the way that we will get things under control. But I think at this point in time, their response has been magnificent, but of course, it’s very draining, it takes a lot of effort, and it's going to have to continue over the coming days.

QUESTION:

Nick, should the Black Lives Matter protests go ahead on Tuesday in Sydney? A big one scheduled for there, thousands of people, all in close proximity. What’s your view on that?

NICK COATSWORTH:

Well, I mean, the view- our view on that is that certainly any sort of mass gathering in the current climate is likely to be a risk. I understand the matter’s before the courts at the moment, so I might leave it at that. Okay. Thank you very much.

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