Date published: 
5 August 2020
Media event date: 
4 August 2020
Media type: 
Transcript
Audience: 
General public

NICK COATSWORTH:

As of 12 noon today, the reported number of cases in the previous 24 hours was 452. In New South Wales, 12 new cases of COVID-19 - one person in hotel quarantine, five people who had known contacts within known outbreaks, three people who had been interstate travellers and three people who are currently under investigation. In Victoria, 439 new cases reported. In South Australia, one new case reported, a person who was a locally acquired contact of a known individual with COVID-19. There have been 11 deaths from coronavirus disease overnight, taking the national figure to 232 people who have died in Australia from COVID-19. In intensive care at the moment, there are 44 people with COVID-19.

I wanted to discuss today the ongoing grave situation in Victorian aged care facilities. One that is being managed as a partnership between the federal and state governments and a number of institutions and individuals, and I wanted to take you through some of those, particularly the Victorian Aged Care Response Centre. The VACRC is bringing together some of Australia's best health service managers, best emergency planners, best people to work together with equally skilled and talented people in Victoria to make sure that aged care facilities are safe for those residents in Victoria that call those facilities home. There are Australian Medical Assistance team staff, some of Australia's best clinical leaders, who have been deployed overseas with me before and who are now using those skills on rapid decision-making and clinical leadership to really assist providers of aged care, more importantly aged care workers, who are working in very trying circumstances in Victoria at the moment and under a lot of pressure, helping them with understanding personal protective equipment and helping them provide care, helping them make decisions. Also, there are many nursing members of our nursing fraternity in Victoria, within the public and the private systems, who have been going out to individual aged care facilities to provide additional care, particularly in those facilities that have been more severely affected by the COVID-19 epidemic in aged care in Victoria. There are also nurses and doctors and other members of hospital staff in Victoria that have received aged care residents into their facilities and are caring for them in public or private hospitals, either because those residents are suffering from COVID-19 or because their care needs are such that they are more appropriately cared for in the short-term in the hospital, taking some pressure off the aged care facilities themselves. So what I hear when I talk to my colleagues down there, who are in the Aged Care Response Centre and also in hospitals, that this is a true partnership across the Federal and Victorian governments to gain control of this situation, to make sure the safety of residents in aged care facilities in Victoria are paramount, that the care that they are getting is exactly the standard that we would all expect for our parents or relatives in aged care facilities.

There have been Australian Medical Assistance Team members on the ground since last Thursday, working within the Aged Care Response Centre. As of yesterday, additional staff landed in Victoria, and now comprising five teams, which are working on rapid response into the most affected facilities to provide that immediate support. [Audio skip] …AUSMAT has become so well-known for around the nation. But the emphasis is that, whilst AUSMAT are a small number of staff, the partnership that's occurring between Victorian DHHS staff, between residential aged care providers and their staff, and the aged care managers from the Commonwealth, that is what is going to continue to bring this situation in aged care in Victoria under control. And I'd just like to pay tribute to everyone who's involved and acknowledge the residents of aged care facilities and their families who are also involved in making this response what it is.

QUESTION:

Today, Professor Murphy said before the COVID committee, he said it was a five-day delay between when St Basil's reported their first case and Commonwealth authorities were notified. How much difference does five days make in a pandemic like this? And what's the importance of people coming forward with those cases?

NICK COATSWORTH:

Well, the standard- it is important to come back to the standard here, and the standard that we set as a Commonwealth is that when there is a case in an aged care facility, that that case is reported straightaway. I think whether we're talking about an aged care facility or whether we're talking about a household outbreak, time matters. Time will always matter in COVID-19. And why does it matter? Because it allows people to be isolated. If you're in an aged care facility, to make sure that appropriate PPE is being used in caring for that individual. If you are in a household, making sure that household contacts are aware that they could become infected with COVID-19 and getting tested. So whichever way you cut it, time matters in COVID-19, and that's why we constantly have to review situations like this, find out why they happen, make sure they don't happen again.

QUESTION:

At the same hearing today, it was heard that Victorian health officials stopped using the COVIDSafe app at the onset of the second wave. Do you think this was a mistake? And could the cases across the state have been avoided if Victorians had used the tool like their New South Wales counterparts?

NICK COATSWORTH:

Well, the importance of the COVIDSafe app is that it provides an extra layer of protection. It needs to be integrated into the workflow of a public health unit. And we've been very clear from the start when we rolled out COVIDSafe app that the control of COVIDSafe and how it would be used would be with the individual public health units. COVIDSafe was actually being used at the start of their second wave. Brett Sutton was very clear with that on a number of his press conferences. It is the case that in the intervening period, the COVIDSafe app stopped being used. We are- we have discussed this with the Victorian Public Health Unit, and like a lot of their systems and processes, which they're looking at forensically now, which I might add is a very challenging to do when you're getting 400, 500 cases a day. But it's our understanding that it's now being reintegrated into their workflow.

With regard to New South Wales and how they've been using COVIDSafe, the app is clearly having an important effect. I mean, not only did it identify some unknown contacts, 544 of them in fact, it actually identified an entire exposure event at one particular club in the New South Wales. It wouldn't have otherwise been found. So, I think that demonstrates the utility of the app.

Going on to the other part of your question, would it have made a difference? I think one of the challenges early on in the Victorian outbreak was that these were largely situations that were going on within households, very large households, but nonetheless, households who are very aware of who they'd interacted with. So, the Victorian public health officials weren't getting a lot of return from using COVIDSafe simply because this was an outbreak in a part of the community that didn't have a particularly high download rate of the app, and when they did download it, it just wasn't revealing the contacts.

QUESTION:

[Indistinct] how long they stopped using the app for in Victoria?

NICK COATSWORTH:

I don't have that information today.

QUESTION:

Just continuing on that, when did the conversation with DHHS take place with regards to resuming using the app? I understand they've given a commitment to go back to it after New South Wales' success. What is your understanding of that commitment? And more broadly, are you concerned that this is a tool at their disposal that they chose not to use when- it may not have solved every case but could've at least surely helped some?

NICK COATSWORTH:

Well, I wasn't the person that had direct conversations with the Victorian DHHS. So, I sought clarification myself yesterday that was within their workflow. And to the point of where we think the locus of control should be, we've been very clear with COVIDSafe that we want the locus of control to be with the public health official. Public health officials in Australia, by rights of the Constitution, sit within state health departments. So, it's absolutely important to keep that as the number one principle. It's the reason why we're not keen on going to the Google, Apple app, for example. We want to keep that control with individual public health units.

I think what the current situation has demonstrated though, that appropriately integrated into the workflow of the public health unit, that COVIDSafe can make a material contribution to controlling an outbreak. But independently of me or the public health units, what message do we have to send to Australians, and that is COVIDSafe will only be of material benefit if it's downloaded on your phone and if it's active. So, that's the message from me today. We know there's been 6.81 million downloads. That means nothing if the app's not still on your phone or if it's not activated. So, I would strongly encourage Australians to look at that data out of New South Wales and recognise the importance of COVIDSafe app, not to solve the entire problem but to be a significant and material contribution to contact tracing.

QUESTION:

Can I just ask- Professor Kelly on Thursday said that when people move, the virus moves. I mean, do you concur with that? And if so, isn't that a premise for border restrictions being a really good way to prevent this virus moving across the country?

NICK COATSWORTH:

Well, we absolutely concur with the premise that when people move, the virus moves. The border restrictions, as you know, that's a matter for state and territory governments. At some point, it's clear that when the virus reaches a certain level, you have to put restrictions. Whether it's around the city, whether it's around the state, those restrictions are designed to restrict movement, and that's exactly the result of some of the border restrictions at the moment.

QUESTION:

So if we stop people from moving across the country, like, just following that logic to its logical end, that it would prevent the virus, that's the premise of the- of what Professor Kelly was saying on Thursday, that's what you're saying you concur with. Doesn't that, you know, speak for itself regarding states putting in place border restrictions?

NICK COATSWORTH:

Not entirely. And the reason for that is that when border restrictions become a proportionate response depends on the magnitude of an outbreak in a given state and whether the receiving state feels as though that represents a risk to their population.

QUESTION:

Dr Coatsworth, what's the risk of Victorians who fly in to Sydney getting a cab to then go to their location to self-isolate? That transmission risk from the person coming from the airport, from Victoria, then spending time in an Uber or a cab, what is the transmission risk there?

NICK COATSWORTH:

I think quantifying individual transmission risk is a really difficult thing to do. If we take a step back and look at a few things, the first thing is, don't travel if you're unwell. The second thing is when you arrive in Sydney, it should only be, as I understand it, under specific exemption at the moment. Beyond that, there was a very extensive press conference delivered by Kerry Chant and Minister Hazzard today at Sydney Airport, and I would refer viewers to that because it's got a very detailed synopsis of how New South Wales is dealing with Melbourne-Sydney travel.

QUESTION:

Dr Coatsworth, there's been a few significant outbreaks in hospitals across Melbourne. What work is AHPPC doing in terms of looking at those outbreaks? And have you identified any issues in the use of PPE, either in the past or currently, in Melbourne hospitals?

NICK COATSWORTH:

So, that's a very broad question regarding the number- and really speaks to the number of healthcare worker infections that have been diagnosed amongst hospital healthcare workers, but also residential aged care workers. The- when you have a large community outbreak, it creates almost triple risk for a healthcare worker. It's risk of acquiring in the community, from friends or family. It's risk of acquiring from other staff in the tearoom. But it's also risk of acquiring from patients, and we need to be able to address those, and to some extent, only the second or third are things that we can actually intervene in. The first, reducing community transmission, that's Stage 4 restrictions. The other two, we do need to look very carefully at healthcare worker infections to determine whether there's been any breach in PPE, if PPE's been put on or off correctly, and I think the most pertinent discussion at the moment is where and when P2/N95 respirators should be used.

Now, the AHPPC has, through its infection control expert group, has had a consistent position for some time now that the routine care of COVID-positive patients can be performed with a surgical mask, and not an N95. I have been in personal discussions with the Chief Medical Officer of Victoria, and I know there have been a number of healthcare worker infections where there has been concern that appropriate PPE has been used, and yet the virus is still being contracted. That alone does not constitute an in-depth investigation, but it is of concern, and so the Victorian DHHS, last Friday, I believe, went to more widespread use of P2/N95 respirators within their clinical(*) facilities, namely hospitals. That has certainly provoked, or we had in train already, discussions at the AHPPC, and we are looking, and have done yesterday and today, specifically on P2/N95 mask use, and when we have the final position on the N95 use from the AHPPC, I'll be able to discuss it with you.

QUESTION:

Queensland Health put out a statement last night. They said that they'd asked the AHPPC to look into travel exemptions for people after someone allegedly used forged documents to enter Queensland and get around some of the quarantine issues. Regardless of that issue itself, what advice- or what's the AHPPC looking at in terms of domestic travel? They said that you'd be providing advice to National Cabinet. When are you planning on doing that?

NICK COATSWORTH:

So I think, again, moving back to the principle, there is, no matter whether we close every border in the country, there is still going to be people who need to find exemptions to travel, who require exemptions to travel. There are still going to have to be systems in place to enable some degree of transnational travel, or indeed international travel coming into the country. What's important, though, is that National Cabinet, through AHPPC, have a truly composite view of all the exemptions that we have at the moment. Making sure that any potential loopholes are closed, of course, but substantively, once the exemption has been decided on, at the AHPPC level as a principle, it is then up to the state and territory to actually implement that. And so where there have been people who have appeared to have been able to get through these exemptions, as they have been recently in New South Wales and Queensland, that would be absolutely a matter for the state and territory to get on top of. I'll take one more.

QUESTION:

A senate committee this morning has heard that under a third of aged care workers have now completed the Government's coronavirus infection training. Do you think that's good enough? Would you like to see a greater uptake of these training modules?

NICK COATSWORTH:

So, we've had a substantial number of people completely control training, but it is clear that infection control needs to be front and centre of protecting our aged care residents in Australia. So we will be working hard to increase that number. We will be working hard to review the training. I reviewed it myself last week. So it is absolutely essential that adequate PPE training is provided to aged care staff. This is not just a responsibility of government, of course. But a knowledge about how to practise basic infection control is something that all providers need to consider. Remembering, of course, that every year there are outbreaks of a respiratory virus in aged care facilities in Australia. Influenza. So to think that it is suddenly important for all aged care workers to have infection control training because of COVID-19, whilst that is absolutely critical, it's [audio skip] that their staff are well-trained. Thank you.      

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