Deputy Chief Medical Officer's interview on ABC News Radio's The Ticket on 12 April 2020
Read the transcript of Deputy Chief Medical Officer Professor Michael Kidd's interview with Tracey Holmes on ABC News Radio's The Ticket about coronavirus (COVID-19).
TRACEY HOLMES: Hello. Welcome to an ABC NewsRadio special presentation. I'm Tracey Holmes. For the next half hour, Australia's Deputy Chief Medical Officer Professor Michael Kidd will be on the line answering your coronavirus questions that have been posted on Twitter and Facebook during the day. Thank you for the many hundreds of very good questions you've posted, we'll do our best to get through as many as we can. Professor Kidd, welcome.
MICHAEL KIDD: Hi Tracey and thanks for the opportunity and thank you for all the great questions people have sent in.
TRACEY HOLMES: Yeah. They've been fabulous and let's try and get through as many as we can. I'm going to start with a Twitter question from Simon W(*). Given the strict rules around eligibility for testing, how likely is it that coronavirus is actually much more prevalent in the community than the statistics indicate?
MICHAEL KIDD: Yeah. Thank you. That's a great question and I think the- well the answer is that we don't believe that there- that we're missing a lot of positive cases with the testing which is underway. Australia's testing is very targeted but it's targeted on the areas where we know we're most likely to be picking up cases. Australia's actually conducted 330,000 tests since the beginning of the pandemic. We've picked up just over 6000 positive cases from those 330,000 tests. So we have a very high number of negative tests compared to the number of positive tests coming through.
We do have increased testing occurring in situations where we know that there's more likelihood that people may have contracted the coronavirus and that's particularly around contacts of people who have come into the country and we've seen that with the cruise ships, for example, but also around the clusters that we've seen of infections occurring in the country. And we've seen some very high profile events, for example, the wedding where a large number of people were infected and then the state health authorities went out and tested large numbers of people who'd been guests at the wedding and the contacts of people who'd been guests at the wedding and so forth until we believe that we picked up all the people who were positive.
TRACEY HOLMES: Alright. Murray Emerton(*) asks on Facebook, after a vaccine has come out, will immuno suppressed e.g. lupus patients or rheumatoid arthritis patients on pharmaceuticals be safe or will they always have to be careful in the future of catching coronavirus because of their ongoing condition?
MICHAEL KIDD: Yes. Look, there's a lot of queries around the vaccines and what's going to happen with vaccines, and it's still very early in the development of vaccines. We have to remember that we've only been sharing our planet with this virus over the last three to four months. So there is still a huge amount that we are learning about the coronavirus and still a lot that we're learning about how it manifests when people develop the COVID-19 infection.
Fortunately, some of the world's greatest minds including great health and medical researchers here in Australia are really devoting their time and energy to the whole issue about whether we can develop an effective vaccine which is going to be safe and which is going to be able to be produced in very large numbers and shared not only across Australia but also with populations all around the world.
The issue about people who are immune compromised is a really important issue and it depends on the type of vaccine which is eventually developed. People who are immune compromised are unable to be vaccinated against live attenuated vaccines but they are able to be vaccinated with other vaccines. So it really depends on what comes forward. But as I say, it's still very early in the development phases of seeing whether we actually get a vaccine and if we do, who's going to be able to use it and how it's going to be managed safely.
TRACEY HOLMES: This is from Alison(*). Why hasn't Australia encouraged the wearing of masks? And a lot of other people have been asking that as well. She says even fabric or non-medical PPE ones would surely be helpful even if just to stop people touching their faces.
MICHAEL KIDD: Yeah. So at the moment, in Australia, we have low community transmission of the coronavirus and so there is no recommendation at the moment for people wearing masks when they go out in public. For example, people going to see their GP or going to the pharmacy or going to do the shopping. And I accept that it can be a bit confusing because we look at other countries, particularly countries where there is high prevalence in the community and a lot of local transmission occurring, and you see lots of people wearing masks in the media reports but that's not necessary in Australia at this time.
We have, along with the rest of the world, had very serious concerns about shortages of masks, particularly with surgical masks which people use in healthcare settings and so our use of masks has been restricted to people working in healthcare settings and people working with patients or with clients who are especially vulnerable if they were to be infected with COVID-19.
You have to remember that masks are mainly to protect the environment from the wearer. So people wearing masks or people who may be symptomatic rather than people who are not symptomatic or are not- have not been in contact with COVID-19. The other challenge with wearing masks is using them appropriately and what we've seen in other parts of the world is people using masks that then they, they put their hands on the mask and then they scratch their eyes which is a terrible thing to do because if someone's coughed on your mask and then you scratch your eye, you could actually be infecting yourself which is not is not a good thing.
And many of the masks which are being developed in other parts of the world are cloth masks or cotton masks and these become very damp very quickly when people wear them. And you know, these may become a mainstay especially in low income countries where there are huge populations and there's not access to surgical masks to protect healthcare workers and to protect vulnerable people. But we're not in that situation here in Australia at the moment.
TRACEY HOLMES: Leanne O'Grady(*) says why don't we just close the borders to the entire country and stop anyone coming in for a few months so that we can get on with our normal life here without restrictions?
MICHAEL KIDD: Well we have closed our borders, of course. That's a decision which was made by the National Cabinet and the Prime Minister and our borders now are only open to Australians coming home. And we have a number of air flights coming in from different parts of the world bringing especially young Australians home to sit out the pandemic with members of their families. Of course, anybody arriving in Australia over recent days is required to be quarantined in a hotel under supervision for 14 days and- so that we can make sure that anyone who's coming into the country, if they're already been infected with the coronavirus that we pick that up and that they are not going to be transmitting the virus to other people.
MICHAEL KIDD: We've just had overnight a number of Australians repatriated from South America who were on a cruise ship - yes, another cruise ship - where there were high numbers of people with the coronavirus. And those people are now all in quarantine for the 14 days, and anyone who gets sick will be looked after by our health service. So, we are closing- our borders are closed. New infections are only coming in with Australians and they're being very, very closely and appropriately managed. The issue about how long the borders stay closed of course is the question which nobody knows the answer to at the moment. And it really depends on what happens with this pandemic and what happens around the world.
But at the moment we still have cases occurring in Australia - we have less than 100 cases being picked up each day over the last few days but that still indicates that transmission is continuing. And of course amongst those cases some people are getting very unwell, ending up in hospital, ending up in intensive care and tragically, small numbers of people are still dying. So, even though our borders are closed, it's not the time to lift the measures that we've got in place.
TRACEY HOLMES: Oliver Janneck(*) says: are there any tests being developed that produce results within minutes? Will we start doing drive through testing as we've seen in some other nations?
MICHAEL KIDD: Yes. So these are what we call point of care testing which enables a test to be done and carried out while you're sitting there and to give the results within a short period of time. At the moment the most efficient tests we have the tests are the test where someone has a nasal swab, and throat swab, and that's sent off to a laboratory, and then people go into isolation in their own homes and they wait for the results. And depending on where you are in the country, it can take us from up to one day or for a few days if you're in rural or remote areas, before people are getting a result. There's research going on around these more rapid point of care tests to see if they're going to be appropriate for more widespread use around Australia, and hopefully, we'll start to see some of these being released more widely- wide used over the coming weeks.
TRACEY HOLMES: We've got a special presentation here on ABC News Radio, joined by Professor Michael Kidd, Australia's Deputy Chief Medical Officer answering your questions which have been posted on Twitter and Facebook. This is a really important one I think, Professor, because I've heard this issue be raised in other countries as well in growing numbers. It's from Geraldine Madrel(*). She says: can you please ask what procedures have been put in place for a person with intellectual disabilities being hospitalised? Can a carer be present at all times, especially if the person is non-verbal? I'd really appreciate knowing this because it could happen and it would reduce my anxiety as I worry about this scenario. There's nothing in the media about people with disabilities and COVID-19, and I'm also aware that this is an issue for minorities and Indigenous people who don't speak English.
MICHAEL KIDD: Yes. No, it is a really important question and a concerning question for everybody who's concerned about their loved ones - particularly loved ones who are elderly, loved ones who have a disability, loved ones who may be vulnerable in other ways. The Australian Government has established an advisory group, a disability advisory group - involving people with disability, carers of people with disability and research experts from across the country - to inform the national response to make sure that what we're doing takes into consideration the needs of people with disabilities from across the country, and also to make sure that the voice of people with disability is being heard in the development of national policies. And that's very important and that's been established over the last couple of weeks.
I think the specific question which is being asked is if I have a family member with intellectual disability and has to go into hospital for something related to COVID-19, or for non-COVID-19 issues, is the family member able to accompany that person? And the answer at the moment is, yes. And- but if the person being admitted to hospital is either diagnosed with COVID-19 or suspected to have COVID-19 then all the appropriate precautions and protection is going to need to be adopted by the caregiver as well as by the healthcare providers who are providing care to that person.
I think that it's also really important, Tracey, many people of course have loved ones who are in residential aged care facilities and many of the facilities have gone into lockdown and mum, or dad, or grandma, or grandpa are there on their own and people are worried about connecting with them.
I know many facilities are allowing very small numbers of visitors to come in - people are obviously being screened before they come into the facility because we don't want people from outside introducing the coronavirus into our communities where there are very vulnerable people. The visitors who come in are being restricted just to visit their loved one in their room, making sure that there's no interaction with other residents or with other visitors. So, these measures are being put in place to protect the most vulnerable people in our society and- but also to make sure that we are still able to reach out to those that we love and care about, and are able to still have those connections which we need.
I know that many people are connecting of course with loved ones who are in their own homes, people who are maybe frail and elderly or have a disability, and we're doing that through other technology. And so, either using the telephone regularly to connect, or when people have access to various video applications on phones to be able to actually see each other and reach out. And that's been of course very important for many families over this long Easter weekend.
TRACEY HOLMES: Professor, Joanna(*) says: A German study looked at the number of asymptomatic people with antibodies in an area and concluded the death rate is about 0.4 per cent. With the number of new cases so low and hospitals far from overwhelmed; should we be moving to a controlled herd immunity programme, keeping the most vulnerable safe? And following on from Joanna's question a lot of people are asking if restrictions should be reviewed once we see a persistent reduction in new cases, as we're seeing now?
MICHAEL KIDD: Okay so if I can deal with those one at a time because there's quite a few questions in that one. So, the first one is this issue about herd immunity. So herd immunity is when a very significant number of people in a population get exposed to an infectious agent and experience the illness - and in some people that will be mild, in other people that will be more severe. And then after a time you end up with large numbers of people who are immune to that particular agent and you are less likely to get outbreaks.
What we know of course in our immunisation programs - our national immunisation programs, our childhood immunisation programs - are all around creating herd immunity. Unfortunately, with the coronavirus; if we were to attempt herd immunity what we would end up with is still a very large number of people getting very severely unwell and ending up in hospital, ending up on intensive care units, on ventilators and a very large number of people would die. So we are not going down a herd immunity approach in Australia.
And we've seen the consequences of countries which were quite late in instituting the sort of measures that we have in Australia and the very large numbers of people who were dying - we've seen the impact in New York; we've seen what's happening in the UK with nearly a thousand people dying every day over the last few days; we've seen what's happened in Italy and Spain, Germany and other countries. And those countries have not adopted a herd immunity approach, by they've, you know, they've gone into lockdown - they're trying to protect their most vulnerable members of their population. But the virus is continuing to spread and cause large numbers of people to lose their lives, which is absolutely tragic.
So yeah, herd immunity is not on the cards at this time for the coronavirus. What we're attempting to do is to reduce the number of people who get exposed and to drive down the number of new infections. And, as that happens, then to look and see what may occur in the weeks ahead with the restrictions in place. You're going to have to repeat the other parts of the question [indistinct].
TRACEY HOLMES: I, actually I think we'll move on because some of what's been asked is going be covered in some of the other questions. Gunjan Pande(*) says: how do we know that when symptoms of an infected person disappear she or he is not also an asymptomatic carrier anymore? Could this be a mistake that we're making?
MICHAEL KIDD: Yes. This is, again, part of the challenge that we have in our experience with this virus is so short, and so we are continuing to learn more and more about the virus. So once people have been infected and have recovered and are now asymptomatic, they are what we call recovered and we have a few thousand people in Australia now who have recovered from COVID-19. And what we hope is that these people will now no longer be at risk of further infection and we hope that these people will no longer be shedding the virus and at risk of causing other people to be infected.
But, as I say, we are still very early in our understanding of this virus. So some of these assumptions may prove not to be the case and that's why so much research is being carried out, both in Australia and around the world. There have been some reports in the media over the last few days from South Korea, that some people who had been infected were now no longer with symptoms, were still being shown to have evidence of traces of the virus. Now, whether this means that they are infectious or whether this is just part of having some traces of the viruses, is not clinically significant - we just don't know. So this is where much of the research is being carried out.
But what it means is that even though people have may have had the virus, and are only small numbers of course in Australia - a couple of thousand out of 25 million - those people will still need, at the moment, to be doing the same things that everybody else is doing with regard to physical distancing and hygiene, making sure that you're not at risk of transmitting anything to anybody else.
TRACEY HOLMES: Our guest this evening is Professor Michael Kidd, Australia's Deputy Chief Medical Officer, answering your questions posted on social media throughout the day. Melinda Paw(*) says: I've read reports that vitamin D levels play a part in outcomes of COVID-19 patients. Could our success thus far be due to our outdoor lifestyle and having just come out of summer? If so, should governments wind back the restrictions on outdoor exercising and sport?
MICHAEL KIDD: Look there are a lot of theories out there about what's going to have impacts on the health and wellbeing of each individual? What's going to have an impact on whether people are more or less at risk of contracting the coronavirus? What may or may not have an impact once people have been affected- infected on the natural course of the, of the disease? And, you know, it reminds me Tracy of the early days of HIV - before we had effective treatments - where every month or so there'd be some new idea about things which might have an impact or may not. Some of which proved to be helpful, many of which proved not to actually produce any useful outcomes.
Well rather than something once a month, what we're seeing is several things coming forward each day as people around the world look at possibilities. And many of the ideas of course are being researched and there are trials underway across Australia looking at a number of different measures. There's a trial in South Australia looking at the BCG vaccine, which is used for tuberculosis, to see if this might be something which is helpful - there's lots of different ideas out there.
The issue about summer is an interesting one. There was a theory right at the outset that maybe while the northern hemisphere was in the depths of winter - when the virus first appeared at the end of December - that perhaps people in warm climates were not going to be affected by the corona virus. Well as we've seen with the spread to countries all around the world, that's not the case. So the virus is just as dangerous in warm countries, countries which are coming out of summer, as it is in countries which are in winter when this first appeared.
The challenge though that we've got as winter approaches in Australia, and in other countries in the southern hemisphere, is that winter is the time when we see the influenza season occurring. And that's why the Australian Government is so keen that all people who are vulnerable to influenza get vaccinated and that the rest of the population seriously considers getting vaccinated against influenza this year as well, so that we can avoid having a terrible influenza season at the same time that we have COVID-19. What we can't afford is to have a double whammy, if you like, of lots of people getting sick with either COVID-19 or influenza ending up in hospital, ending up in intensive care units. This would double the risk of overwhelming our hospital systems.
TRACEY HOLMES: Paula McMahon(*) says are the healthcare workers who are testing positive directly nursing COVID-19 patients or are they inadvertently exposed? She says we had a recent case in a non-acute setting and multiple staff were exposed and have been isolated. The only staff member still able to work ignored government policy and wore a mask and gloves while attending patients. We don't feel safe at work, and worse still, we feel like we're putting our loved ones at risk at home.
MICHAEL KIDD: Yes. So the issue, obviously health care workers in a pandemic, are one of the groups which are most at risk of being infected with the infectious agent. And so it's very important that we're doing all we can to protect our doctors, and nurses, our allied health professionals, but also everybody who's working in health care settings. The people delivering meals, the people who are cleaning, the people working in administrative roles as well, because everybody is in an environment where there are likely to be more people who are positive for the virus. The protection which is required is what we call the personal protective equipment. This is the masks, but also gowns, gloves, goggles and other equipment to protect people when they're working with patients who have been diagnosed with the coronavirus or who we have a high index of suspicion may be infected with the coronavirus.
Healthcare workers themselves, if they do contract the coronavirus, and in some cases we've seen health care workers who 've become infected we believe through the workplace, but in other cases we've seen health care workers who may have been infected through other mechanisms, through social events, through other contacts which may have occurred. But health care workers just like anybody else who is either diagnosed as positive for the virus or is going through testing for the virus need to be in isolation and they need to be away from all other people. There's no excuse for anybody who might be either infected or at risk of having been infected continuing to be in any workplace.
TRACEY HOLMES: Our next question's a very practical one, and I think somebody who's at home and looking after the family and trying to stay as healthy and fit as possible. Louise Gomes(*) says is there a safe way to prepare salad greens? Can you contract COVID-19 from consuming raw vegetables that are washed in water only?
MICHAEL KIDD: Yeah. This is a real concern. I know of many people, it's when you go out shopping and buy produce which may have been touched by other people before it's been picked up and put in your shopping bag. Is- does that potentially pose any risk to you, and the same with packaged goods. You may pick up something and have somebody else been touching that as well. Now of course, this is not new with coronavirus. When we get our produce home, we wash our produce and we do that because we don't know who may have not washed their hands after being to the bathroom, or whatever else before touching the produce that we're buying.
Most important thing when you come home from shopping is that the first thing you do, you put your bags down and you wash your own hands, and you sing Happy Birthday twice while you're washing your hands very thoroughly. And then you go into your kitchen and you wash the produce that you've bought. It is safe to wash your produce in running water. And because the virus is unlikely to last on produce, a lot of people also then proceed to wipe down, particularly the packaged goods which they've bought in plastic packaging, and so forth to- and wipe that down with disinfectant or whatever sanitiser people are using just to be sure that there's no potential residual on the packaged goods.
It's very, very unlikely that people would be picking up coronavirus from produce or from packaged goods that they're purchasing while they're doing their shopping. But a lot of people are being very cautious just in case.
TRACEY HOLMES: Barbara Peleg(*) says why are we still getting new confirmed cases from the Ruby Princess 18 or 19 days after it docked, when the incubation or the self-isolation period is only 14 days?
MICHAEL KIDD: Yeah that's a very important and valid question. What we're seeing with the Ruby Princess is that some people of course were infected and asymptomatic when they left the ship. Some of those people go home, they go home with their partner who may not have been infected. They become symptomatic and then their partner may become- may be infected days later. So I think this is explaining some of the spread in time that we're seeing in cases related to the Ruby Princess. It's probably transmission that's occurring from passenger to passenger, even though people may be in isolation in their own homes. The state and territory health departments are doing a spectacular job in following up all the people who are on the Ruby Princess and carrying out monitoring and where appropriate, testing of all the people who were onboard that particular cruise ship.
TRACEY HOLMES: And Linda Ellor(*), when do you think elective surgeries will start again?
MICHAEL KIDD: Well surgery of course is continuing, and important surgery continues to take place. And actually this is probably the best time for people to be having surgery while our hospitals are reasonably quiet. We've ramped up our capacity in case we get lots of cases. But in many places, hospitals around the country, the hospitals are actually quite quiet at the moment. We worry that this may be the calm before the storm. We hope the storm doesn't hit in Australia but we're very well prepared. Elective surgery is continuing, particularly for surgery which is investigating important conditions. For example, if someone is told that they may be at risk of a diagnosis of cancer, surgery is continuing. But a lot of surgeries, for example, cataract surgery, knee and hip replacement surgery, those types of elective surgeries have been put on hold for the moment while we make sure that we're not having lots of people in our hospitals and our hospitals are prepared for what may happen in the weeks ahead.
TRACEY HOLMES: Professor, I'm on here for the next two and a half hours. I reckon I could keep going with questions and we still wouldn't have enough time. But the half hour is complete. Thank you so much for giving up so much of your time today.
MICHAEL KIDD: It's my pleasure Tracey, and thanks to everyone who sent in the questions and thanks for the great work you're doing, keeping [indistinct] informed.
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