Deputy Chief Medical Officer press conference about COVID-19 on 9 September 2020
Read the transcript of Deputy Chief Medical Officer Dr Nick Coatsworth's press conference about COVID-19 on 9 September 2020.
So we can provide some information about the latest vaccine developments that have been reported overnight related to the AstraZeneca Oxford vaccine. And I'll be also discussing contact tracing in Victoria and announcing a Federal Government initiative to support states and territories understand better the nature of healthcare worker infections in work, to provide even further protection to our healthcare workers who are working in this challenging period of the pandemic.
But first to the numbers, In the 24 hours to 12 noon today, there have been 93 new cases of COVID-19, taking the national total to 24,465. New South Wales reported nine new cases; one was overseas acquired, seven were locally acquired and were contacts of a confirmed case, one was locally acquired and the contact has not yet been identified. Today Victoria reported 76 new cases; 31 were locally acquired and were contacts of a confirmed case, and 45 remain under investigation. Queensland reported eight new cases today, all of which were locally acquired and contacts of a confirmed case. Sadly, there were eleven new deaths overnight due to COVID-19. There are 221 individuals hospitalised in Australia now with COVID-19, and I note that that's nearly half of the total that was reported compared to a week ago. So the number of hospitalised people with COVID-19 is markedly decreasing, which is great news.
To talk about vaccines. Many of you will be aware that the Oxford vaccine, which is one of the furthest advanced in the vaccine trials, the trial has been paused overnight. The Oxford vaccine is one of the candidate vaccines that Australia has been engaged and invested in with AstraZeneca with one of our advanced purchasing agreements. The other one of course being with our own University of Queensland and CSL. The Oxford vaccine is in phase three trials. That means that large numbers of people are now receiving the vaccine, and we're looking to see if that actually prevents them from getting COVID-19. And today, as I said, the trial was paused whilst an adverse event or medical event in one of the participants is investigated. And that person suffered, what would we be termed, a serious event that requires further investigation to determine whether it may have been related to the candidate COVID-19 vaccine. So to delve a bit deeper into that, all Vaccine trials, whether it's COVID-19 or any new vaccine that we develop, have built in rules, checks, and balances with regards to maintaining safety. They have such things called Data Safety Monitoring boards. And particularly for COVID-19, these boards have the best researchers, scientists, regulators, people who are used to being on these boards who oversee these trials and ensure that they're conducted in a very safe way. These trials have automatically triggered pausing rules built into them, and one of those is if there is an adverse effect or event, or a serious medical event in one of the participants undergoing the trials. A trial stopping for these reasons- a vaccine trial stopping for these reasons is in fact quite normal in routine vaccine development. So whilst we are in an unusual situation with COVID-19 being a new pandemic virus, the fact that a vaccine trial may pause because of an adverse event is not a new thing at all. Pauses are often short, in the matter of days sometimes. But we're not able to speculate on the effect of this particular pause because we simply don't have enough information at the moment from either the trial lists or AstraZeneca about the nature of the adverse event, and that's because it's being investigated.
We also have to remember that this particular trial involves someone getting a COVID vaccine and others within the trial getting a different sort of vaccine. So we're not even sure which of those vaccines this individual got. And finally, it's worth remembering that out of many thousands- 17,000 were the target enrolment, I think, of up to 50,000 people. With many thousands of people getting the vaccine, medical events can happen that are nothing to do with the vaccine. So all of these things are a possibility and we will get more information in due course. The really important thing though is that this is a vaccine that's being trialled by one of the world's leading universities, by some of the world's leading vaccine trialists, and the fact that we are hearing about it and I'm talking about it is testimony to the safety and the transparency, both of which are such critical principles as we continue the race towards an effective COVID-19 vaccine. So I look forward to being able to give further updates on that.
With regard to contact tracing, there's been a lot of discussion in the past few days about what contact- constitutes the gold standard of contact tracing. The comparisons inevitably between Victoria, and New South Wales, and Queensland as they all attempt to control their virus in epidemics that are very unique in their own ways from different state to different state. I wanted to focus on the outcomes that we, at the Federal Department of Health, in collaboration with the Chief Health Officers have agreed on, in initially the Pandemic Health Intelligence Plan, which came out several months ago. And they are that all cases of COVID-19 are notified- that are notified to the public health unit are contacted within 24 hours. That all new cases of COVID-19 have their contact tracing interview by the disease detective completed within 24 hours. And that the close contacts of that individual with covered 19 are quarantined within 48 hours. So these are the metrics that every single public health unit are aiming for. And what is exceptionally pleasing about the way Victoria has been able to respond to their very challenging outbreak is the fact that now, even with 76 cases in a day, that they are able to achieve those key performance indicators, if you like, well in excess of 95 per cent of the time. And that is precisely what's going to assist Victoria in controlling lower numbers of COVID-19 as the epidemic recedes and lift their restrictions in due course.
The three key elements that we've seen announced by the Premier and the Chief Health Officer in Victoria are of course a digitalisation process for the contact tracing, the decentralisation of the disease detectives and public health units themselves out into the suburbs, out into the regions of Victoria, and the high level delegation, including Commonwealth representatives, the Chief Scientist, and senior bureaucrats from the Department of Health and Human Services going to going to New South Wales to make sure that they have learned the lessons to improve the contact tracing system.
Now finally, and most importantly, I'd like to talk about healthcare worker infections. Now that we've seen the second wave in Victoria, we've seen a large number of healthcare and residential aged care workers get infected. And what I'd like to say to you today is that over 3,300 healthcare and residential aged care workers becoming infected is not an acceptable figure, for any government; either the Victorian Government, the Commonwealth Government. And it's incumbent on all of us to do what we can to understand more about the nature of those infections, so we can protect our healthcare workers during this pandemic. COVID-19 is with us for the foreseeable future. Our healthcare workers deserve the best protection. The reasons for their infection are many and varied, and differ from infection to infection. From touching contaminated surfaces, from close contact with an infected colleague in tea rooms, from contamination whilst taking off PPE, from prolonged contact with patients. Added to this is the nature of COVID-19, which we're learning more about, and in particular the nature of COVID-19 aerosols and the extent to which our recommendations need to change to include the use of particular filter respirators, so-called P2 or N95 masks. And those recommendations have changed during the pandemic and during Victoria's second wave. Leading Australia's guidelines development is the Infection Control Expert Group. These are leaders and practitioners of infection control; many of whom who have been practicing infection control space for over two or three decades. These are nurses and doctors who practice within our hospitals, who understand infection prevention control. I'm pleased to be able to tell you today that the AHPPC reiterated its support for this key advisory body last Thursday.
So I'd like to announce three things on behalf of the Commonwealth today. The first is that there will be a partnership between the Infection Control Expert Group or ICEG and the National COVID Evidence Taskforce, both key committees and both key organs of our response to COVID-19. This will bring together our infection prevention and control experts with other senior clinicians around the country, senior clinicians and nurses around the country, to discuss, debate, to analyse the evidence on key questions related to infection control in COVID-19. The National COVID Evidence Taskforce of course provides our clinical guidelines and has done under a partnership between the Commonwealth and Victorian governments as well as other philanthropic funders.
The second announcement I can make today is that the Australian Health Protection Principle Committee, the AHPPC, has endorsed an expansion of national healthcare worker surveillance in the national notifiable diseases system. And while states and territories have been collecting this data, this expansion will provide national level, a national level snapshot of the types of healthcare workers who are getting infected and the settings in which they are getting infected. And that's going to be critical to be able to help states and territories target their interventions and work out where deep dive investigations need to take place.
Finally, there is a new network of epidemiologists, of disease detectives called COVID-Net that is funded by the Commonwealth Department of Health, embedded within states and territories and is available on request to assist a state or territory in investigating any sort of outbreak but in particular, outbreaks involving healthcare workers. And COVID-Net will also gather and analyse the data that is collected under the expanded surveillance program so that we fully understand or understand better the nature of healthcare worker infections.
Finally, can I pay tribute to the Australian Medical Association, in particular, its president Omar Khorshid, the new President of the federal Australian Medical Association, for their advocacy in this space, not just for its members who are largely doctors, but also for nurses, also for residential aged care workers. And I'm pleased to be able to tell you today that the press release from Minister Hunt is a joint press release with the Federal President of the AMA as we work together on reducing the risk of healthcare worker infection in this country.
And after that rather lengthy talk, I can take some questions.
Dr Coatsworth, with regards to the pausing of the vaccine trial, obviously, we've said that this is standard and we could be back on track within days, but is it also a stark reminder that it could be sometime before we find a vaccine, if at all? And do you think it should prompt a rethink on a rhetoric around not removing restrictions and other issues until a vaccine is found?
Well Claire, I think probably both things are true. That it is going to potentially just be a few days, but it is equally a reminder that the vaccine development process can be fraught. At this point, we don't know enough to say that the vaccine- this particular vaccine is under a cloud; I don't think it is. And what I've explained today of course is that these sort of measures, these automatic pauses, because of serious adverse events, do happen as sort of a matter of course during vaccine trials. So, I think the rhetoric, if you will, needs to be that this is a really good example of an accelerated process that has not led to any sort of diminution or decrease in the focus on quality and safety as we search for a vaccine.
Dr Coatsworth, The New York Times reports that the problem in the vaccine trial was that a person suffered from transverse myelitis. Regardless of whether or not that is the case, can you explain what transverse myelitis is and what effect it has on a person?
I can. So, transverse myelitis is a condition where there's inflammation in the spinal cord at a particular level, and it can cause any range of problems further down from where that spinal cord level is. Bladder and bowel dysfunction. In its worst case, paralysis. It can be temporary or it can have lasting effects. I too have seen those reports from The New York Times. I think one of the most important things is to remember that many thousands of cases of transverse would occur in Australia and around the world every year that have nothing to do with vaccines. But nonetheless, it is- if true, it is something that needs to be investigated. But the most important thing is that we wait for the trials at Oxford to give us the information, which I'm sure they will in the coming days.
Dr Coatsworth, just in regards again to the pausing of the trial, depending on how serious or the impact it has on the AstraZeneca trial, could this mean that the Queensland researchers working on the [indistinct] end up sort of being [indistinct] and having this alternative vaccine if AstraZeneca fails. Is the Queensland vaccine sort of waiting in the wings to potentially be the next prime candidate for a vaccine? And are there any lessons that future researchers could learn here?
Well we've invested our first two advance purchase agreements with two different technologies very deliberately, but that doesn't mean that we're not considering the alternative technologies as well. There are, as you know, four different technologies available to construct this vaccine and over 160 potential candidates; some more advanced than the others. I wouldn't compare this as though we're going- this is our backup option for- with the UQ vaccine. We're very confident with the quality of the research at University of Queensland just as we are with the quality of the research at Oxford.
With regard to lessons learned, I think- I doubt that there are lessons learned, to be honest, because these trials are following exactly the same sort of trial methodology, and that involves the data safety monitoring boards. That involves systems and processes that these vaccine trials are very, very used to. So whilst I'm sure the researchers at UQ will be watching with interest, as we all are, to see what the outcome of this pause is, they will be proceeding with their trials. Of course, the Oxford vaccine is at a more advanced stage in the trials than the UK vaccine. The UQ vaccine is in Phase 1, where they're testing the safety and the antibody levels produced, and the Oxford trials are Phase 3 of course, where they're testing whether it actually stops you getting the virus.
Dr Coatsworth, what's the threshold not just for this trial, but any vaccine trial, and if we can walk away and that it's not worth pursuing any further? And if it did come to that with AstraZeneca, how would that impact the deal that we've made, the money that's on the table, to buy that vaccine?
Well Claire, with regard to the first one, I think the first part of that question, it's very hard for us to say whether a single adverse event in the trial that we're anywhere near the point of that trial actually stopping or that there might be a cloud over that vaccine. As I said, this sort of event happens very frequently in vaccine trials. The reason we are hearing about it is because clearly there's a lot of scrutiny over the COVID vaccine, and clearly the researchers at Oxford and the company itself are keen on being as open and transparent as possible. With regard to what would happen to our deals or whether we would walk away or so on and so forth, I don't think we're even close to thinking about that sort of thing with this single event.
Just on another topic, the advice you gave yesterday as making your bed as helpful routine advice has taken off on social media, some different views. What do you make of the reaction that this comment has received? And do you have any other advice for helping to maintain a routine during lockdown?
Well look, thanks for asking that, because it did take off on social media, and what I make of that is that there are a lot of people who are very frustrated in Melbourne about being locked down, and that many of them saw that advice as trivialising their experience. It wasn't intended to do that at all. What I might say as well is that that may have been helped full advice for a lot of people four or six weeks ago, and for a lot of people it's not that helpful now, because they are really feeling it in terms of mental health- in terms of their mental health and the psychological effect that that's happening- that it's having. So what to do? So of course the comment was not simply about making a bed. It was about having small rituals during the day, which is known to be an important thing when you're under stress and the rest of the world seems chaotic. Make your world the best that you can control as controlled as possible and get the small wins during the day. But if that's not enough, then one of the most important things is to get out there and avail yourself of those clinical psychology appointments. There's ten that are funded under Medicare and we've funded another 10.
There are 15 general practices that are going to be specifically looking at mental health and providing mental health support under a government program, joint program with the Victorian Government. And that starts next week on Monday. And if people are having serious mental health effects, of course Lifeline, Beyondblue, Kids Help Line, but also if necessary the emergency department. So I think all those things are critically important. And I might just go to the phone and then I can come back to the room. Who's on the phone? I'll take Jade first.
Hello. Yes. Thank you.
Yes, go ahead, Jade.
Sorry. Is Australia seeking more information on what has happened in the Oxford trial or are you just waiting for them to provide that? And do you think that hope to having a vaccine available here by early next year is now looking too optimistic?
Well I mean, clearly the Oxford trials and AstraZeneca has been very forthcoming with their information. We don't think particularly that we deserve the information any quicker than anyone else around the world and we have every expectation that we'll receive it in a timely fashion from them. And no, I don't think we can make any comments at the moment about whether this is likely to delay the Phase 3 trials, whether it's going to stop for several weeks any further vaccinations. It is just- it's just too early at the moment. But no doubt we'll have more to say on that in the coming days. And was it Sylvia? From SBS?
Dr Coatsworth. And given the AstraZeneca-Oxford vaccine hold, should the government must now be actively pursuing other vaccine candidates that are also in advanced stages?
Well the Government's constantly monitoring other candidate options. And whilst these are the two that we've got advance manufacturing agreements with, there's certainly no focus on those two, no pause in our desire to look at other potential candidates. So we constantly get updates, for example, at the Australian Health Protection Principle Committee on the status of vaccine. The vaccines of Vaccine Group Australia Therapeutics Guidance Group, the ATAGI group on vaccines constantly looking at the status of other vaccines. And if we have further things to announce about other agreements that will happen in due course, but we're by no means closed to considering other agreements with other vaccine producers. We're also of course part of the COVACS initiative, which is committed to making any successful vaccine available to essentially every member of in the world, every person in the world, in both developing and developed countries, and I think being part of that initiative which I understand has been signed up to by over 70 countries, sponsored of course by GAVI and CEPI, two of the leading vaccine non-government organisations in the world. Being part of that initiative puts us in a very strong position as well. And I'll just go back to the room for a couple more questions.
Was it enough that Queensland would be granting exemptions to boarding school students from ACT and New South Wales in areas with no active COVID cases so kids can come home from boarding school in Queensland without having to isolate on the way back. Obviously a welcome development it comes just days after the state said that it would never consider such a move. Are you concerned that with individual jurisdictions moving backwards and forwards like this that it will have a prolonged mental health impact on the people that are affected, and contribute further to restriction and lockdown fatigue. Would you like to see a more standardised approach to these issues in the future?
Well I think it's okay to change one's mind as government in response to some clear needs for teenage students in boarding schools wanting to go back and not have to isolate before seeing their families. So as you say, I welcome, we would all welcome that. As parents, we would welcome that. The borders, the reality of the borders is that they are a means of controlling movement. And we know that movement can spread the virus, but they are obviously a very challenging thing to manage. And every time you put in some sort of intervention like this, there are consequences, whether they are for people with health issues, whether they are for agricultural workers, whether they are for boarding school students which have been the three main groups that we've been discussing, but certainly not limited to that. And so I think we just need to be mindful that if these are going to be used, then it will increase the regulatory burden on state governments in providing exemptions and there will be many, many groups that will ask for exemptions.
Okay. Thank you all very much.
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