PATRICIA KARVELAS:
This evening the World Health Organisation is meeting in Geneva to decide if coronavirus should be declared an international public health emergency. Seven Australians have contracted the virus and dozens of others are being tested across the country. Two Australian citizens in China have also been infected with coronavirus. The global death toll is now 170. It's been more than 24 hours since the Government said it would evacuate some of the hundreds of Australians stranded in China to Christmas Islands[sic] with details emerging about just how cost-spread will work.
It's a rapidly evolving situation and to tell us more Deputy Chief Medical Officer Professor Paul Kelly joins me now. Professor Paul Kelly, welcome.
PROFESSOR PAUL KELLY:
Hi, Patricia.
PATRICIA KARVELAS:
The World Health Organisation is meeting in a few hours. Do you expect they may declare this an international emergency?
PROFESSOR PAUL KELLY:
Well the – they have very specific criteria for what they call a public health emergency of international concern. This is under the International Health Regulations to which Australia is a signatory and most other countries are – including, crucially, China – and their criteria are really twofold; a new or emerging infection that is spreading beyond a single nation's border and causing public health concern. I think this definitely qualifies.
PATRICIA KARVELAS:
Yeah. It sounds, based on that criteria, to have met the criteria. Now, they have debated whether to declare it a public health emergency of international concern two times last week. We've seen this virus rapidly develop since then, haven't we? But they didn't make that decision. Why were they reluctant?
PROFESSOR PAUL KELLY:
Well look, I wasn't in the room for their deliberations obviously but I think it is – things have emerged very quickly. So a month ago we had the first information that there was something happening in China; it was very few cases; it was in a single city. And since then it has mainly stayed in that city and that Province of, Hubei Province of China, it has spread to other parts of China and now to over 10 countries around the world. But of the almost 8000 cases now, almost all of those are still in China and almost all of those in China are still in Hubei province.
So a week ago things were very different. There was just the start of a couple of cases internationally, still working out the virus – how serious it was how easily it could be transmitted from person to person – and some of those things in the last week have become more clear and more concerning.
PATRICIA KARVELAS:
There are reports from other news organisations reporting the virus has broken out of the Hubei Province and that all of China is now infected. What do you know about that?
PROFESSOR PAUL KELLY:
Well we only know what we've heard from China through official sources but also a range of unofficial sources that we are, you know, monitoring – media and so forth, even social media, so you have to take these things with somewhat of a grain of salt. But it does point to having patients in other parts of China, that's true. But again the majority of the cases so far reported by the Chinese authorities are in Hubei Province.
PATRICIA KARVELAS:
In the case of a declaration, what sort of processes and rules does that change? And how would that affect us here in Australia?
PROFESSOR PAUL KELLY:
Well from the Australian situation – and this is where the International Health Regulations are very clear – sovereign states and countries, as in Australia, can make their own rules and their own approaches to these sort of things. What it does do though – and so short answer to your question is it won't change much about what we're doing in Australia – what it does do though is it does ramp up the international collaboration and frees up some funds to particular things like vaccine research and so forth and those would be very welcome. And we're very well placed here in Australia with some of the best facilities and scientists to work with international colleagues on looking for better diagnostic tests, being involved with clinical trials of treatment and also development of vaccines.
PATRICIA KARVELAS:
In Darwin the AUSMAT team from the National Critical Care and Trauma Response Centre will oversee medical staff at Christmas Island. We've heard that they're ready to go. What measures are in place to stop them contracting the virus?
PROFESSOR PAUL KELLY:
Well so we know a lot about this virus now and we know how to protect health care workers in particular from the virus, and they'll be taking those precautions. I think it should be, it's very important for listeners to know that there are – the Chinese authorities themselves have very strict exit screening so no one will be exiting Hubei Province in particular if they have symptoms. They'll be taken away from that place and put into hospital for further testing. So the people that will be on the plane will be without symptoms –
PATRICIA KARVELAS:
[Interrupts] But isn't part of – sorry to interrupt, I don't mean to sound rude – but isn't part of the issue that people are now spreading this? Well there are some cases before symptoms show up?
PROFESSOR PAUL KELLY:
Yeah, this is something that's emerged in the last 48 hours – particularly in information that has been shared with us from Germany – where it does appear now likely that, I would say, in very rare occasions that people that did not have symptoms can actually transmit the virus. But I think for most cases it would be when people are already sick.
PATRICIA KARVELAS:
So in terms of Christmas Island and preventing an outbreak there, how does that work? Explain to me how you quarantine people at Christmas Island and ensure that if one person does develop coronavirus, it doesn't spread?
PROFESSOR PAUL KELLY:
So this is something that will need to be looked at carefully and I don't want to pre-empt either the AUSMAT group that will be overseeing the medical care, or indeed Department of Home Affairs who will be responsible for the actual running of the Centre on Christmas Island. But look, there are very well worked out methods for isolating people and for looking to prevent further spread of a virus. And we've, as I say, in the last few weeks and particularly in the last week we've got more and more information and understanding of how to do it with this particular virus.
PATRICIA KARVELAS:
And in terms of the emergency flight home for instance – what kind of risks does that pose for somebody who may be asymptomatic but carry the virus? Or somebody who develops symptoms on the flight for the others?
PROFESSOR PAUL KELLY:
We've been asked to advise Qantas who, hopefully, will be the carrier to assist in this effort about safety for their staff, also for medical – designated and dedicated medical staff, health staff that will be on the flight, and for the people that are being moved from Hubei Province. And again, just saying that none of them will be sick when they come onto the flight. It's a relatively short flight. There's always the possibility that someone could become sick on the flight but there's very specific infection control information and advice that's been given to all involved, today actually.
PATRICIA KARVELAS:
And just in terms of understanding the way quarantine works – sorry to ask you some simple questions, but I do think there's a lot of uncertainty or confusion about some of these things. We know that, for instance, there's a lockdown in Brisbane of a soccer team. But at the same time – and that's in a hotel – others who are coming from Hubei will have to go to Christmas Island. When you're being quarantined in a hotel does that not pose risks for others in the hotel? How does that work? And why the inconsistency?
PROFESSOR PAUL KELLY:
I can see that it could be seen as being inconsistent but really what we're doing in both places is the same. So we'll be using masks where that's a reliable way of either stopping someone with the infection transmitting it to another person, or receiving the infection from another person. But again I'd really stress that it's only close, very close contact for a prolonged period which is really of concern. And for those that do not have symptoms we're taking an abundance of caution there in terms of our approach.
So really the risk to people who are – from people that are not actively sick and coughing and sneezing and so forth to other people is very small. And by use of masks and other personal protective equipment, and just judicious being away from people that may be spreading the virus, these are the ways that we- the standard ways of using isolation for this type of infection.
PATRICIA KARVELAS:
And how about pilots and staff involved in flying into China? How do you protect those people who are trying to do a good thing but of course may be concerned about the risks to them?
PROFESSOR PAUL KELLY:
So the pilots and others in the – on the flight deck, that's relatively easy. All modern aircraft have a completely different circulation of air in the cockpit. So as long as they don't leave the cockpit they won't be exposed. But if they did really need to leave the cockpit then the advice would be to wear a mask. Similarly, with the staff on board we have quite specific ways of dealing with that, but including the use of masks and or gloves when required.
PATRICIA KARVELAS:
If you're just tuning in, Professor Paul Kelly is my guest. He's the Deputy Chief Medical Officer and I am taking a bit of his time just to clarify some of these things.
We've learned today that a man who had the virus in Melbourne travelled on a flight to the Gold Coast; does that indicate this virus really could stretch out pretty quickly? I mean what does it mean for the people on the flights? I know that those people on that Tiger Air flight would be pretty concerned - what's the risk to them?
PROFESSOR PAUL KELLY:
So the risk is certainly there and in those circumstances we are doing very careful tracing of potential contacts for any of the cases. But I will stress to you and your listeners that we, at this stage, still only have seven. All of those cases – so two in Victoria and one in Queensland and the rest in New South Wales at this point – are stable. Several of them have a very mild illness in fact.
And that's the important thing with this new virus, there is a wide spectrum of disease. Yes, there has been a death rate. Yes, some people have got very severely sick. But many people are only mildly ill and I suspect that there is a lot of people without symptoms that just have not received the tests.
PATRICIA KARVELAS:
Professor Kelly, you're the incoming Chief Medical Officer for the country. You're going to be stepping into this important role of advising Australia. How are you feeling about that after witnessing how quickly things have been developing with coronavirus?
PROFESSOR PAUL KELLY:
Patricia, this is something I'm certainly ready for and I'm very privileged to be asked to come on in acting arrangements. And this is the sort of thing that I've trained for and had experience in for many years.
PATRICIA KARVELAS:
Thank you so much for your time.
PROFESSOR PAUL KELLY:
You're welcome.
PATRICIA KARVELAS:
Professor Paul Kelly is the Deputy Chief Medical Officer and incoming Chief Medical Officer.
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