Date published: 
10 September 2020
Media event date: 
8 September 2020
Media type: 
Transcript
Audience: 
General public

NICK COATSWORTH:

Good afternoon, everybody. It's Dr Nick Coatsworth with today's national COVID-19 update. In the past 24 hours to 12 noon today, we've had 66 newly confirmed cases of COVID-19, taking the national total to 26,374. In New South Wales, we had nine new cases; three of those were overseas acquired in hotel quarantine. Five were locally acquired and were contacts of a confirmed case. And one was locally acquired, and the contact has not yet been identified. In Queensland, one new case was recorded, which was overseas acquired. Victoria had 55 new cases; 31 of those were locally acquired and were contacts of confirmed cases or in a known outbreak, and 24 remain under investigation. In Western Australia, there was one new case recorded. The total number of hospitalised individuals is 264. In ICU, there are 29 people. And there were eight new deaths, sadly, overnight, all reported in Victoria, taking the national number of people who have lost their lives to COVID-19 to 770.           

I'd like to focus again, as we have done so many occasions during this COVID-19 pandemic, on our mental health as a community, and particularly the mental health of Australians living in Victoria, in both metropolitan Melbourne and regional Victoria. I wanted to outline some of the things that the Federal Government is doing in the mental health space, many of those in partnerships with the Victorian Government. And then go through a little bit of advice on how we might tackle mental health in our own families and some concrete advice on what you can do if you're feeling particularly anxious or under stress or strain because of the restrictions in Victoria, or you observe a friend or a family member who is undergoing similar psychological stress.            

So, the Government has funded 10 additional Medicare-subsidised psychological therapy sessions, in addition to those who have already used their 10 Better Access sessions in the calendar year. That's 20 sessions for a calendar year, and being in touch with someone who is a qualified clinical psychologist is a really important way to assist with mental health. We've of course had some significant investments in digital supports, including $12 million additional funding to ensure that people in Victoria can access 24/7 mental health support such as through Beyond Blue, Lifeline, and Kids Helpline. We funded an additional $5 million to enhance digital and phone services for specific groups who would be experiencing challenges with the COVID-19 restrictions in Victoria where physical isolation at home can worsen their mental health issues. And more recently, and importantly, coming into R U OK? Day on Thursday, next week, the $26.9 million investment in 15 dedicated mental health clinics across Victoria goes live. And that will be a very important access point for people suffering from psychological distress due to the restrictions.

But what can you do at home? What can you do yourself or with friends and family? There's a series of things that can really assist during lock down, and as one of my close friends and colleagues today said in Melbourne, it's very difficult for us in areas of Australia that aren't under restrictions to really understand exactly what people are going through. But my advice to you is this: make sure you're staying connected with friends and family. If you're feeling isolated, take what can sometimes be a difficult step to reach out and maintain those important connections of friendship and family. Put some structure into your day. Whether you set aside dedicated time for housework, make sure you then have some downtime after that where you are doing something that you enjoy to do- enjoy doing - a hobby. Set yourself achievable goals. One of the simplest things you can do in the morning - and this was said to me once a leadership seminar by someone who is a very good leader - is make your bed. It sounds so simple, but if you get into some structure and routine for the next two weeks while the restrictions are still in place- the Stage 4 restriction still in place in Metro Melbourne and the surrounds, those sort of achievable goals and structure can be very important to keep you on track. But if you are feeling, what we would call, dark and down, or thinking about behaviour- doing things that may be dangerous, to yourself even, then Beyond Blue, Kids Helpline and Lifeline are your immediate supports. Going to websites such as Head to Health, to get an idea about where the best help for you might be, and your general practitioner is really important. And if there is a psychiatric emergency in your family, then importantly, accessing emergency department services is critical.           

So, I hope that helps over the coming weeks. It's not going to be easy. It wasn't easy hearing the extension of the restrictions on Sunday, but we can assure you from the Federal Government point of view that that was done by the Victorian Government based on their modelling to make sure that this is the safest exit from restrictions that they can possibly do. And I'll take some questions. Tamsin.

QUESTION:

This week, we've heard about the gold standard of contact tracing in New South Wales. That seems a bit like an abstract concept for some people. What's the difference specifically between the way that contact tracing is being done in New South Wales and in other states like Victoria?

NICK COATSWORTH:

Okay. So, we have heard the term gold standard in contact tracing used, and I think we should just take a step back to the principles of contact tracing, which- and the principles of contact tracing are no different from any jurisdiction: New South Wales, Victoria, anywhere else in Australia. And rather than concentrating on the difference- any differences between the two, it's really about outcomes. And the outcomes are very clear in the pandemic health intelligence plan. What you want to do is find the cases, so you stop the infectious person being in the community and put them in isolation, and you then want to find the contacts of those cases so that if they become infectious, they'll be- they'll do so in quarantine. And then it's all about a timing issue. So the longer you have infectious people within the community, the more likely you are to have your basic reproductive number above one, and to have those outbreaks get out of control. So, when we say gold standard, what we're really referring to is the shortest time possible between a person getting symptoms and the whole contact tracing process being wound up, the case being closed by the disease detectives. What we've seen in Victoria is a recognition that when the outbreak gets to a certain level, those times start to stretch out. And that's not just the contact tracers, that's the testing processes, how you get information to the contact tracers, and then the interviews afterwards. So all those processes are being streamlined. We've heard from the Premier Daniel Andrews and Professor Brett Sutton on how that's being done. We've had it reported in the last Pandemic Health Intelligence Plan that in Victoria, 99 per cent of cases are now being notified within 48 hours of a specimen being taken, which is a critical metric, and one that the other jurisdictions are achieving at 100 per cent. But gee, 99 per cent is pretty good coming from where things were only a few weeks ago.

So to circle back, really, it's about having the processes in place within your public health response, that that time between when somebody's first symptomatic and when they are put into isolation, and the contact tracing interview is complete is as short as possible.

QUESTION:

On the actual method though, what's the actual difference between what New South Wales is doing versus what Victoria doing? Like, on an actual, methodical, sort of logistical basis. How are they actually different? Or are they the same process?

NICK COATSWORTH:

Well that's- I've explained the method that you go through, and that's the basic public health outbreak response. So the method is always the same. Now, when variability might come in, when you're talking about resources, when you're talking about whether the response is centralised or decentralised. I think we heard today from Victoria a very, very positive move to put regional public health units. The success of the Barwon health team who are contact tracing- started contact tracing several weeks ago now but helped bring the Geelong outbreak under control. So there are differences in how that method is applied, and the resources behind that. But I think we can very confident from what we've heard from Victoria that they are learning the lessons - both from New South Wales and their own experience - to make sure that they can control COVID-19 at low numbers into the future. Claire.

QUESTION:

To change subject: on aged care, the Commonwealth's regulator is still consistently getting complaints relating to COVID-19 as recently as August. Are you concerned the issues remain across the country and that there are clearly worried families who are going into aged care homes, and concerned about what they are seeing? Do you think that the regulator should therefore be stepping up visits to follow-up on each and every one of those complaints?

NICK COATSWORTH:

Well I think the first thing to be said is, I'm very glad that families are finding a voice. They should, it's an important part of holding providers, of any description, and also government to account, so that's the first thing to say.           

The second thing is that, the AHPCC and the aged care division of the Department of Health are investing significant time and effort with the jurisdictions in ensuring that there is a model that can be replicated, based on the Victorian Aged Care Response Centre in any state or territory in response to an outbreak. And then even down to an individual aged care facility. Obviously, you don't need a Victorian Aged Care Response Centre for a single outbreak in a facility but that those foundation stones are there, that if there's some early signs that things are getting out of control in the aged care sector, that there is a rapid support mechanism for the Federal Government to work together with the states.

QUESTION:

[Indistinct] I understand works being done to digitalise some of the contact tracing processing in Victoria? Just wondering if you could speak to the benefit of moving from some of the paper based systems to more digital based systems, including use of text messages to contact Victorians if they've been somewhere where there's been a COVID case.

NICK COATSWORTH:

Well I think that the focus quite rightly of the Victorian Public Health Unit is to examine that entirety of the contact tracing- the public health response from testing through to concluding the contact tracing interview, and trying to make those as efficient as possible. And clearly if you've got a paper-based system there are certain efficiencies that you will get from digitalising those. And the Chief scientist, Alan Finkel, we're aware has been working closely alongside colleagues within- senior colleagues within DHHS to ensure that where a process can be digitalised, it is. But digitalising a process is not the be all and end all, there are other things around that including making sure that the appropriate seniority of public health physician is overseeing the outbreak investigations. Which is another element that's being looked at.

QUESTION:

Can I just get one on the vaccine? The CSL and AstraZeneca said yesterday that it could take until September next year or longer for the full [indistinct] of those 80 odd million doses to actually be made. How will the Health Department sort of manage the rollout of a vaccine over the course of nine - or possibly further - months? I think you said a previous one of these conferences that people like the elderly or people who are sick would be prioritised with those first couple of million. But for the rest of those doses, how will that sort of process be rolled out over many months?

NICK COATSWORTH:

Well I think as you say, there is a concept of prioritisation when a vaccine is not immediately available to the whole population. But that's exactly why we have Australian Therapeutic Advisory Group on Immunisation, another of those committees that has been around for a couple of decades a bit like AHPCC. But we're going to be hearing about ATAGI a lot more in the coming months. And ATAGI and our scientific and technical advisory group, within the vaccination division of the department, and bringing together community stakeholders and professional groups, we are all looking at those prioritisation issues. So it's not the point where I can definitively say what that priority list is but when it is available, and it depends of course on when the vaccine becomes available, how much of it we have and how effective the vaccine is, then we will make sure that we explain it very clearly to the Australian public what that priority is based on.

QUESTION:

Dr Coatsworth, for boarding school students, there isn't a single postcode or health district in regional New South Wales that comes close to the Commonwealth definition of a hotspot. But there are students who are looking to return home for the holidays next week unable to do so without isolating. What work is being done by the AHPCC to come up with a model that would allow exemptions universally for these students rather than on just border town hotspot- travel bubbles rather, which exist at the moment between Queensland and New South Wales?

NICK COATSWORTH:

Well I think the point you bring up Claire, is a really important one and just reflects the challenges that rural Australia is experiencing when the outbreaks are largely confined to cities. Whilst the AHPPC is not taking a view at the moment on that particular jurisdictional issue which applies to New South Wales, it does emphasise the need for a nationally consistent definition of a hotspot and that's under ongoing discussion at the AHPPC.

QUESTION:

Has the AHPPC received the detailed modelling that was used to underpin the roadmap to recovery for Victoria? And I was just wondering on the thresholds that have been put in place for the roadmap outlined on Sunday, if you had an opinion on those? [indistinct] erased potentially if say contact tracing improves over the next few weeks?

NICK COATSWORTH:

Well with regard to the modelling that underpins this, we had a discussion with Professor Sutton and Professor Cheng yesterday about the roadmap method at AHPPC. We've had individual discussions with colleagues about the modelling and we look forward to receiving more data including a full brief of the assumptions underpinning that modelling in due course. The actual thresholds that have been set, there's been a lot of debate about those. Whether they're too conservative, whether they've extended their restrictions times out too far. And I think what I've taken away from discussions with Victorian colleagues is that they are more than prepared to look at the timelines and revisit them. Whether in response to their clearly improved public health response capability, they take the view that they could take [audio skip] cases per day, average cases per day. I'm sure they will have a look at that in the coming weeks. But it's not something we've heard yet.

QUESTION:

On a different sort of topic. There's been talk I guess amongst some commentators and some media [indistinct] and that sort of thing, talking about I guess COVID deaths. And there's this line going around, people saying that people are dying with COVID not from COVID. Looking I guess on the statistics saying that only 80 per cent of people are actually as that with the only cause of death or [indistinct]. Could you sort of speak to that I guess? You know obviously a lot of the comorbidities people do have are things like asthma or diabetes which aren't necessarily fatal conditions. What would you say to people who have been trying to downplay how difficult and how just dangerous this disease is?

NICK COATSWORTH:

I mean it's a really good question and there's been a lot of discussion about how we're classifying COVID related deaths. I remember as a junior doctor trying to do the death certificates, it's not always an easy thing when someone who has, say influenza to take another respiratory viral disease, dies of a heart attack and then trying to decide which one you put when you know that the influenza probably had something to do with the heart attack. So it's not always easy to classify those deaths. I don't by any stretch of the imagination think it's a reason to underplay the severe impact that COVID has on people with comorbid conditions. So that that is the problem with COVID. As soon as you start having one, two, three or more other health conditions, your likelihood of having a fatal outcome with or from COVID is increased. And that's why we have to take these control measures.

Maybe one more question.

QUESTION:

The AHPPC noted the agricultural code that was put forward last week. Five states have now signed onto it. From that epidemiological point of view, would you like to see Queensland sign up to that code, given again it's dealing with regional areas without any coronavirus transmission?

NICK COATSWORTH:

Well look, the agricultural code as you say was noted by the AHPPC. It's actually something that's being discussed and put forward by the Department of Agriculture and discussed with individual departments of agriculture around the country. So I'll have to leave it leave it to them.           

Thank you very much.

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