Date published: 
31 August 2020
Media event date: 
28 August 2020
Media type: 
Transcript
Audience: 
General public

NICK COATSWORTH:

...In the 24 hours to 12 noon today, we have had 131 new cases of COVID-19 diagnosed, bringing the national total to 25,448 since the pandemic began. There have been 13 new cases diagnosed in NSW. One was overseas acquired, eight of those were locally acquired and contacts of confirmed cases. Four were locally acquired and the contact has not been identified. 113 cases were diagnosed in Victoria, 79 of those are under investigation and 34 of those were locally acquired and contacts of confirmed cases. There were two new cases in Western Australia, both of whom were overseas travellers returning, and Queensland had three new cases diagnosed today, which I understand are under investigation. There have been 12 additional deaths overnight and the national number of deaths moves to 583. 543 people are hospitalised with COVID-19 and 35 of those are in intensive care units.

I wanted to give an update today on a partnership funded by the Federal Government, the Victorian Government and private philanthropy. It started in March of this year, and it's called the National COVID Evidence Taskforce [sic]. This is a coalition of 30 peak health professional bodies that are brought together by the COVID Evidence Taskforce, and they discuss, debate the evidence that is emerging about COVID-19 therapies around the world. This is based on a 5-year-old project called the National Living Guidelines Consortium [sic], and the principle is quite a unique one internationally. Guidelines usually take many years to be agreed upon, five, 10 years, and by the time the guideline comes out, many clinicians will know that it's out of date. But the living guidelines model upon which the National COVID Evidence Taskforce is based, provides quite literally up to the minute guidance for clinicians around Australia who are treating COVID-19.

And how does it do that? Well, it reviews daily the evidence that is coming in about new treatments, and we know that there are many, many hundreds of treatments that are being tested around the world. It is a very significant task to be able to do that. And then provides a weekly summary to clinicians around Australia, focusing on particular aspects of COVID-19 treatment that require updating. So, my understanding from the group base down in Victoria is that there are 200 individual clinicians contributing over 360 work hours in total every week to that effort to give Australians the best- Australian clinicians the best guidance possible.

So, for example, if you're in general practice at the moment and you've got a COVID positive patient and you want to understand the treatments available for non-hospitalised patients with COVID-19, you can go to the COVID Evidence Taskforce webpage. If you Google COVID Evidence, it'll come up as the first hit, and that will give you the information. Similarly, for a hospital clinician, if you're treating a hospitalised patient with COVID-19, you can have a look at the evidence. And if you're a patient or a consumer and you want to know about the treatment and the evidence based behind them, then it is written in a very accessible way, it's a very easy website to follow and I'd strongly encourage Australians to have a look at that.

Now, I've got two journalists on the phone today. The floor is yours guys, so Clare, I'll start with you.

QUESTION:

Thanks Dr Coatsworth. I have two question. Firstly, in relation to a government MP, Craig Kelly, who sought to discredit the health experts that are consulting on treatment and vaccines and is still pushing hydroxychloroquine as a solution or treatment for COVID. Are you concerned about him using his social media platform in Parliament to promote those views against the scientific advice? And secondly, we've heard today, of course, of the mother from Ballina who lost one of her unborn twins, in what seems to be some confusion around border exemptions. You actually worked at the Lismore Hospital. What- as far as your concern from a federal health point of view, has gone wrong here and what do you think needs to happen to make sure that never happens again?

NICK COATSWORTH:

With regards to the comments made in Parliament on hydroxychloroquine, I think Australians are very clear which Kelly should be listened to in COVID-19, and that is Paul Kelly. And Paul Kelly, like myself, like all clinicians around Australia, understand that regrettably hydroxychloroquine is not effective for COVID-19. And whilst I understand why there are many Australians out there looking for a solution, we have solutions come across a desk literally every day and have to work out whether they are or they aren't effective. I believe we have tons of hydroxychloroquine in this country which was really generously donated by Clive Palmer early on in the pandemic where there was a possibility that hydroxychloroquine would be useful. Now, there are no circumstances where we as government or clinicians would sit on several tonnes' worth of hydroxychloroquine in the national medical stockpile if it were useful for COVID-19; we would be giving it to patients right now but unfortunately it's not. The trials are clear on that and in fact the World Health Organization pulled hydroxychloroquine from one of its trial arms because the evidence was so clear that it was not effective. Now, that doesn't happen very often, and it only happens when it is clear there is no benefit at all from the treatment. So, regrettably, hydroxychloroquine is not the answer.

We are looking through National COVID Evidence Taskforce, of course, for the optimum treatments for people with COVID-19 so we understand clearly the evidence for Remdesivir, we understand clearly the evidence for Dexamethasone. Our intensive care doctors actually produce data every week to help each other around the country through a database called SPRINT-SARI, S-A-R-I. And that actually means that we've got the best evidence to guide the treatment at the moment, and that- we'll continue to communicate that to the Australian people.

The second question regarding the young mother who lost one of her twins, I'm not familiar with the circumstances of that case but there are few things that are more tragic in life than losing a child in the womb. So, my condolences to the mother, to the family. The specific circumstances, as I said, I'm not aware of so it's very hard to comment how much of an issue the border was. We've got to remember that the chief health officers around the country take these decisions on board as very, very seriously. They are very, very aware of the effects of placing restrictions have within those border communities, and my understanding is that there are exemptions, very clear medical exemptions for individuals. That is at the forefront of chief health officers' minds. These issues are discussed at the AHPPC but more importantly of course, because we're talking about two states and a state border, they are discussed regularly between the chief health officers of New South Wales and Queensland, the health ministers, the premiers. Despite what is a tragic case today, if I can provide some reassurance that the healthcare of people on border towns is at the forefront of the minds of both the Office of the Chief Medical Officer and also the chief health officers around the country. Jane.

QUESTION: 

Hello Dr Coatsworth. Thank you for the presser today. I'm just wondering if you can shed some light on the discussions that are being had around the AHPPC table regarding hotspots. I know that a decision hasn't yet been made, but can you tell us what kind of factors you're weighing when you're trying to give advice to a premier as to how to declare a hotspot, like number of cases, community transmission? What are the sort of factors you're weighing?

NICK COATSWORTH:

Yes, I can, Jane. So, the issue of what is defined as a hotspot is both an important one now and going forward in this pandemic. But if I can outline some of the challenges in defining what a hotspot might be, you know, we've clearly got three different pandemics going on in the country at the moment. We've got Victoria, which is really pleasingly, after a really difficult time, coming down off its second wave. We've got the next two most popular states, New South Wales and Queensland, doing their best with their public health units to avoid a second wave. Then we've got the ACT, Tasmania, South Australia, Northern Territory and Western Australia with no community transmission at all. So, with that in mind, it is actually a challenge to come up with a definition of a hotspot.

And the other thing that we have to remember, of course, is that if we are to come up with that definition, what are we going to use that definition for? That said, it's been- it is recognised around the table that we need to continue to discuss and debate these things. I'm aware of the PM's comments this morning about the necessity to have a definite- clear definition of a hotspot going forward, and I'm also conscious that that's going to be a discussion at National Cabinet. So, I hope I've given enough sort of general information, but it is obviously an issue of significant national interest and the premiers and the PM will be discussing it next Friday.

QUESTION:

And if I could just ask a follow-up, Dr Coatsworth, do you agree with the PM's assertion that, until we have a vaccine, there's no concept in Australia of having zero risk from COVID. You know, you look at WA right now with the hard border closure, there's no COVID there, but at some point, all the states need to recognise that there is no future in which we are at zero risk.

NICK COATSWORTH:

I think it's not simply me agreeing with the Prime Minister; I think every chief health officer agrees with that as well. I mean, nobody seriously thinks that there's zero risk. And, indeed, we also need to see how safe and effective a vaccine actually is before we know what that impact is. So, I do think we're all firmly on the same page there. Clare, did you have another question? No? Okay. One more, Jane, if you like or otherwise we'll-

QUESTION:

No. Sorry. Yes, I did.

NICK COATSWORTH:

Oh, you did? Go ahead.

QUESTION:

Yeah. Just following on with what the hotspot- the advice that would then link to the border decisions, is it the AHPPC's expectation that if you are able to come up with some mechanism to define a hotspot, that if a state health officer was to diverge from complying with that, they would have to be public and transparent in the regions behind that, or are you confident that whatever you come up with, there will be no disputes and no issues that we've seen in the past with borders and state health officers diverging from the consensus opinion of the AHPPC?

NICK COATSWORTH:

Well, there's a lot of elements to the question, but I think the first and most important is, as I said in my response to Jane's question, it's critically important to decide why we're going to classify somewhere as a hotspot. Is it purely about a border issue? Is it about what a state is going to do internally, if it declares a hotspot in a certain area? Is it about what two states- the relationship that two states are going to have with each other? So, those- as I've said, those elements are complex; they're not straightforward. But in terms of transparency of decision-making, I think that the chief health officers, where they've had make decisions for their own states in conjunction with their first ministers, have absolutely accepted the need for transparency - not just accepted the need but have been transparent around those decisions and why are they being made. And those decisions are communicated to us at the AHPPC and I'm sure they're communicated around the table at National Cabinet as well. So, I think, taking a step back and looking at the principle, transparency and understanding about decisions that are made by states that affect the rest of Australia, whether it's borders or any other decision, is critically important. And one more if Jane wants to ask one.

QUESTION:

I have exhausted my list but thank you.

NICK COATSWORTH:

Okay. Thank you both for joining and thanks everybody.

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