PROFESSOR PAUL KELLY:
Thank you to my new interpreter next to me. Paul Kelly here, Deputy Chief Medical Officer, to talk through the issues of COVID-19 in Australia today. So I'm going to make three points before I go to questions.
The first is on the data. What do we know about the case numbers? So as of now we are at 6,875 cases cumulative from the beginning until now, and unfortunately almost 100 deaths. So 97 people have passed away and that is something that we hold close to our heart. There have been 26 new cases in the last 24 hours so that is a bit more than where we've been in most of the last couple of weeks, but it is explained by a couple of outbreaks that we're dealing with, our state colleagues are dealing with in Victoria and in New South Wales. Most of those cases are from those two outbreaks.
In terms of people right now in hospital we have 62, that's way less than it was even 2 weeks ago. In intensive care, 27 and on ventilators, 18. So remarkably small numbers and very encouraging in the way that we have managed to flatten that curve and to decrease the number of people therefore with severe illness. We have plenty of capacity in our health care system to deal with these matters now.
We know that we are still finding cases and we expect to find cases in the suppression phase. It's a thing that we will be continuing to report on cases as we change into the new phase of this response. And so to date we have had 688,000 tests in Australia, remaining with a very low positivity rate. And this is good news for us in terms of our confidence that we are finding the cases that are out there.
The second thing I want to talk about today is the app. So the app was launched just over 10 days ago now and I was told to me today that apparently this is the fastest that Australia has ever got to 5 million downloads of any app ever onto smart phones.
So, again, I think that is a remarkable statement about how the Australian public has listened to our appeal for this particular piece of the puzzle if you like, in terms of dealing with this issue of COVID-19 in Australia. It's important that we have as many people as possible downloading this app and now with over 5.1 million downloads that's a remarkable achievement. Now in terms of the app, we — it was launched on 26 April. We have been looking at that and gathering information about the app and how it is working and issues that people are finding with the app all through that period.
Every week we are, and continue to be, committed to improving that app. It is a silent auto update that will happen with people that have already downloaded it to improve its functionality, to improve any issues that come up in terms of security or privacy concerns, content changes and also the branding. They have been the clear things we have been concentrating on in this first 10 days. There have been — everyday there is something else that people say there are issues with the app and these are things that are all being taken on board and prioritised in terms of importance and where it is possible to fix them they will be fixed.
One of the issues that was raised actually at the Australian Health Protection Committee yesterday and from other sources is that there are some people with phones in Australia where the operating system is quite old and therefore this app, as many modern apps would not be compatible. But I can say, and I have looked into that today, that over 90 per cent of the market in Australia have operating systems which are compatible. So that means there are 10 per cent of phones which we may not be able to fix that issue. But at the moment there are 90 per cent of phones which could run this app and we certainly continue to encourage people to download the app and to register. It is completely voluntary and people that choose to do that are helping themselves, their families and the wider community in terms of the next steps.
So the last thing I want to just talk about in relation to those next steps is what do we know about the virus? We learn things every day. There are many of the best researchers in the world that are working in relation to COVID-19, gathering information from other countries as well as Australia, looking at treatments, looking at other ways of dealing with the virus in terms of hospitalisation and so forth, vaccines, new treatments and so on.
But today I just want to consider what do we know from the public health point of view? And so we know that this is an infectious disease, that is quite clear. It is a virus, it does spread from person-to-person and we know it is quite infectious. It is absolutely clear now that it is less infectious in children. Children are less likely to spread the virus between each other, or even from children to adults. They are also less likely to be infected and they are less likely to have severe infection and very, very rarely does that end up in intensive care and the more severe end of the spectrum. So children in general are not as much of an issue in terms of this virus. Most of that infectiousness happens in the first five days of people being sick. So for — mostly the infection is when someone is quite obviously sick, they know they are sick and they are transmitting it from person-to-person. Much less so before they get sick. So this is now quite clear.
We also know that this infection is more likely to spread in households. So it is between people living in the same house, for example, family members. And again from adult to adult rather than from child to adult. In terms of households, it is due to the close and prolonged proximity with someone that is infectious with others that are susceptible to the virus. So that household infectiousness is the most prominent one around the world but other settings where people can be inside for a prolonged period in close proximity, these are also risky issues. And much less so than outdoors for example. There has been one well-documented case of a stadium, a Champions League soccer match in northern Italy when Italy was right in the middle of their epidemic where there was an outbreak that came in that setting. But other than that, very little in relation to outdoors — people outdoors infecting each other.
So these are now strengthening our resolve in terms of our general principles as to how we are going to look at reopening society, reopening the economy in a COVID-safe way. Those issues of it being an infectious disease, mainly an issue within households or close contact and prolonged contact. So these are matters that will certainly guide the principles that we will be putting to the National Cabinet for their consideration on Friday and there will be further announcements at that time by the Prime Minister and the Chief Medical Officer in relation to the next steps on the way out, if you might think of it that way, in terms of reopening the economy and society in a safe way.
So I'm happy to take questions now.
QUESTION:
Professor Kelly, if I can ask you on the app, why is it the state health departments and territory health departments don't have access to the data yet, can you explain that?
PROFESSOR PAUL KELLY:
So we launched the app on 26 April so about 10 days ago now, with a view that it would be ready to be completely and fully operational at the time when society will be starting to open up again and be ready for people to be circulating more, to be therefore at more risk of spreading the infection or indeed having the infection transmitted to themselves. So it was a deliberate thing to launch the app, to get people to download it — over 5 million now — to work on any little bugs that might have been there, to fix those and crucially to get the legislation sorted and that will be going to parliament next week in relation to privacy and security issues to give Australians that reassurance that things will be used properly and only for that very specific issue of assisting with the contact tracing.
So that final step, which will be completed by the end of this week, will be having very detailed and very clear collaboration with the state and territory public health officials that they will only use it for that purpose, that information, and that information. And that information just as a reminder, is very minimal. It is name, phone number, post code and age range. That is all it is going to have. But it will be ready to go for next week.
QUESTION:
There's been a study out of the United States that has identified a new strain of the coronavirus. It's become dominant since February and emerged in Europe and became more contagious than the first strain. Is that the strain that's been in Australia and has the disease — the virus — become more transmissible since it first emerged out of Wuhan?
PROFESSOR PAUL KELLY:
So, there certainly has been a study of the virus around the world from the beginning and they've shown actually that the virus is very stable compared with when it was first found in China. And so, whilst there are some minor changes throughout that time, it's actually remarkable that things have remained pretty stable in fact. So there are recognised slightly different strains but they are not that different from previous ones. Whether they're more transmissible or not, that's a typical thing that happens to this type of virus that's spread from animals to become transmissible between humans, that it does become generally more transmissible over time and less severe over time. Of course, we're really looking for that second part as well if that's the case.
QUESTION:
The new strain that emerged in February, is that the one that you believe is in Australia?
PROFESSOR PAUL KELLY:
So, it's the coronavirus that we've seen, it's been pretty stable throughout. We're doing our own genetic examination of that, genome analysis. And so, at the moment, as I say, there are slight differences but essentially it's the same as the one that we saw the first time and our first cases in late January, which came directly from Wuhan.
QUESTION:
Professor Kelly, considering these outbreaks in New South Wales and Victoria, how confident are you that we are still heading in the right direction? And how difficult is it to quickly get on top of outbreaks like those ones?
PROFESSOR PAUL KELLY:
Yeah. So there are, as I said, two current outbreaks. One — they've both been widely reported. One in an aged care facility in western Sydney, Newmarch residential aged care facility, and the second one is in a meatworks in western Melbourne, the Cedar meatworks.
So, we always learn a lot from outbreaks in terms of new infections like this COVID-19 virus, and I have full confidence in my state and territory colleagues, who I meet every single day in AHPPC, that they know what they're doing. They get on top of these things as quickly as they can. But both of those outbreaks have been quite complex within an aged care facility and has spread very rapidly as we've seen, and unfortunately, a number of deaths from that particular outbreak because of the vulnerability of the residents. But that continues to be a concern, but very close cooperation between the Australian Government, the Aged Care Quality and Safety Commissioner, New South Wales Health and their local authorities in western Sydney as well as Aspen Medical. So, they're getting on top of that and I'm sure that's something that will continue to be difficult, but they are doing a good job.
The second one is the meatworks, again, that's been going for some weeks now and almost 50 cases, as I understand it. Again, a difficult workplace. There have been large outbreaks in similar workplaces in the US. A recent report just on Monday this week demonstrated some of the very similar issues that we are finding in western Sydney in relation to a meatworks. Its people who have worked very closely together for safety and other reasons. There are many people in a confined area. And so again, as I said in the beginning, the general principle that if you are indoors, close to other people and there's someone who's infectious, the likelihood that that will spread is quite high. And so, these are matters that will continue. And as we look to open up society, we will expect to see other outbreaks and the important thing is that we will need to be able to get on top of them quickly and I have, as I said, great confidence in my state and territory colleagues in doing that exact work.
QUESTION:
Professor Kelly, just on the meatworks still in Victoria, it's come to light overnight that the first case was 5 weeks before this cluster, per se, was identified. In other situations, say when someone contracts the virus at a school, everyone is told which school it is and the state health authorities are quite forthcoming with that information. Whereas in this facility and other workplaces, we haven't seen that transparency even when it's been asked of those authorities. What kind of discussion has the AHPPC been having around the importance of transparency in these situations and what- you said there's learnings from each of those clusters, what specifically has the AHPPC learnt from the meatworks?
PROFESSOR PAUL KELLY:
So, yes. So, the meatworks firstly, I think it was 3 weeks not 5 weeks, and it wasn't the first case that they actually linked specifically to the meatworks, as I understand it. But in any case, it is very transparent now about where that outbreak is and they've taken specific action, including closing the meatworks for a period of time. These things evolve. It's not always clear when — in a contact tracing exercise where those links are occurring.
Certainly firstly, with the first case, it's quite common to not make that link immediately but only the second and third and so forth as the story is gathered by the contact tracers. These are very expert people, but it does take time. It's again a reason why we want the app. Having a number of contacts with something in common quickly is how we start — the disease detectives start to get to the bottom of these cases and to make those linkages and then to put in the public health action to deal with the issue. It's very similar to a criminal investigation. You don't expect everything to come out in the first few minutes or few hours or even days. Sometimes it can be quite complex. I don't believe and I don't accept the premise that Victorian DHS- DHHS hid this in any way. They've certainly been very transparent and very open about the issues that they're facing.
In terms of what we've learnt from this particular outbreak, it's similar in the US. So, my understanding is that this — and this is not necessarily just this particular workplace but there are a number of workplaces around Australia where there are disincentives for people to stay at home when they are sick. And so, that can be financial. It can be a workplace culture. There are a whole range of reasons why this might be the case. But I just want to absolutely make this very clear — and this is the case with both of those two outbreaks at the moment — is that people coming to work when they're sick put others at risk, and we really, all of us, need to take that new way of thinking about going to work, not soldiering on when you have symptoms that might be COVID-19. It's absolutely crucial in terms of protecting your work colleagues and the wider community as we go forward in this COVID-safe way.
QUESTION:
Of the 5 million people that have downloaded the app, how many people have successfully registered and how many have it on regularly? And can the AHPPC give advice at the National Cabinet, make a decision about easing restrictions if we don't have that information of how successfully it's being used?
PROFESSOR PAUL KELLY:
So, I mean, I think for this one the proof of the pudding will be in the eating. And so, I think the success, whilst the metrics you've raised are important, I think it's actually the usefulness of that information and the timeliness of that information being released to the public health authorities which will be the number one thing that we'll be able to have, that confidence that the app is working and assisting us in our work. I can say that the majority of people that have downloaded the app, that app is working, and as — they have registered, but I don't have the actual details with me. I can't give you that number, sorry.
QUESTION:
Professor Kelly, can I ask you, when it comes to lifting of restrictions or recommending that some restrictions be lifted, what's the strategy behind the path forward? Say, if you lift something and get a small number of cases or a number of cases, do you shut everything down again? Is there a cap of cases you set before you then increase restrictions again?
PROFESSOR PAUL KELLY:
So, last week at National Cabinet, we presented from the AHPPC our pandemic intelligence plan, which is basically — that was something we've worked up as a group to look at what are the metrics indeed that would lead us to think that we're going well or we're not. And so, there's quite a lot of detail in that. It's now been published and I'd encourage you all to have a look at that. But in general terms, it's the issues that we've been raising for some weeks now: The effective R number, keeping that less than 1 — that's a very important component to say that on average a person who has the infection is infecting less than 1 person extra. That obviously will show that overtime we are on top of the epidemic but also overtime will disappear altogether. So that's one of them.
I think growth rate or the opposite of the growth rate of the infections, which is virtually zero at the moment as a percentage, keeping that low as well. The actual numbers, we expect that they will rise. That's something we will take into account. And finally, it's that evidence that we are getting on top of outbreaks if they are occurring. So, there are a number of metrics in that plan that looks at, for example, how long it takes to find a case and to make sure they're isolated.
QUESTION:
So what — when do you lockdown again? Is there a certain number of cases you have [indistinct]?
PROFESSOR PAUL KELLY:
So it's a combination of all those things demonstrating that we're on top of the epidemic but also, that at a very local level perhaps that the health care is not being overwhelmed. So those 2 things together are really crucial. So I can't give an actual exact number because it will depend on circumstances. I think we've seen a good example of how things may proceed in a rural area in north-western Tasmania. So, that wasn't actually a lot of cases at the start but it was a sudden increase in cases. It was health care workers, which made it more complicated, and we needed to not only shut a couple of — Tasmanian Health did a couple of hospitals and then the aged care facility got involved. So it became complex like that, but that led to very strict action in terms of lockdowns, if you like, and in the quarantine of large numbers of people. So, I think that's a way that we'll go forward but we'll have further details about that in the coming days.
QUESTION:
Is there any medical basis for the Victorian Government telling kids not to go to school?
PROFESSOR PAUL KELLY:
You'd need to ask the Victorian Government about their way of-
QUESTION:
[Interrupts] Given you're across the disease and you're giving medical advice, is there, in your view, any medical basis for the Victorian Government to make that call?
PROFESSOR PAUL KELLY:
Yeah. So, we live in a federation. The Victorian Government of course has their ability and their responsibility to the Victorian population to make decisions of that nature. I will go back to what we know about the virus. We know it's infectious. We know it's particularly infectious amongst adults. It's not so infectious amongst children. It's not so severe in children. And I believe strongly that all states should be taking into account the local epidemiology of the disease in their case and making evidence-based decisions. But how those decisions actually play out in each jurisdiction is their responsibility and I'll let you ask their premier about that.
QUESTION:
On Friday, Scott Morrison said that 11 of 15 pre-conditions to ease restrictions have been met. We've spoken about the app already but can you confirm that the other ones have been ticked off or where are they up to?
PROFESSOR PAUL KELLY:
Yes. They've been progressed. It's not for me to tick off, it'll get ticked off by the National Cabinet — in a good way. So, we'll let them make that assessment. But yeah, those 15 really are in 3 major tranches. One is about our ability to find cases and that's continuing to be very good and that's pretty much there. The second one was about tracing contacts and you've mentioned the app was the one thing which wasn't fully dealt with the last time that — looked at it last week. And the third one is really what we've just been talking about in relation to our response to outbreaks. The National Cabinet did want us to consider that a bit more, to look at what we've learnt in the outbreaks in particular institutions, what about geographic areas and what would be the triggers to change those sort of things in response to outbreaks, including, if necessary, a reversal of some of the relaxing of some of the restrictions as we have it now. So, look, that's one that we will be taking on Friday to them for — with further details.
QUESTION:
Given the progress that has been made on those — and we're only a couple of days away from Friday now — can you give us any idea of the types of restrictions that you'd be recommending that can be eased?
PROFESSOR PAUL KELLY:
So we've got a very large document looking at great detail at all sorts of sectors, as we did on the way in when we were seeing — and it seems a long time ago now, but when we were seeing large numbers of cases being diagnosed in Australia and increasing every day in that concern that we had that led to the restrictions that we were currently facing. So we've reversed that to look at what would be the opportunities to open various parts of the economy and society again. And so, I won't go into details about those. It's a decision for National Cabinet but they've seen a draft of that and they gave us some more feedback after yesterday's meeting and we had another long session at the Australian Health Protection Committee today and nutted out those things. But there's a few things that the Prime Minister spoke about yesterday, general principles if you like, that this will be gradual; that some things will open, others not. It will be scaled so that risk of increasing the number of cases is minimised whilst giving the maximum benefit to the economy and to normalisation of society. So that's the general gist of it.
And the final thing, which is very important, is that individual jurisdictions will be able to and they need to make their own decisions on the basis of their own local data and circumstances. And so, those things will be obvious when the actual list of what's open and what isn't and to what extent is talked about on Friday, if National Cabinet is ready to do that. Last question.
QUESTION:
Professor Kelly, just on Newmarch House, is there medical advice to suggest that a government intervention against the owners will be required? Are you satisfied that the measures taken there are being appropriately handled, given how long this outbreak has been going, how many people have now died and how many people have been affected?
PROFESSOR PAUL KELLY:
So, aged care facility is very difficult and we've said all along that the most vulnerable members of society are those older people. We've found that with evidence all around the world as people over the age of 65 with chronic diseases, people over the age of 70, particularly over the age of 80, particularly over the age of 90, when they get this infection, it's bad news. And so, we've certainly seen that in relation to Newmarch. And I think important to note, very few other large outbreaks in Australia in aged care facilities, very different from other countries. And so, the one other facility, the Dorothy Henderson Lodge, and this one really are the only 2 large outbreaks we've had so far and that's a remarkable credit to the sector looking after these people in these difficult circumstances.
QUESTION:
Just say something about the handling at this particular centre, though.
PROFESSOR PAUL KELLY:
Look, there's a range of matters and I'm sure that that will become clearer how these things have worked over time. But I think, at the moment, the most important thing is we assist and we all work together as well as we can to make sure that we get the best result for the people that are living there and indeed the staff, some of whom have also been sick.
So thank you for your questions.
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