Date published: 
7 March 2020
Media type: 
Transcript
Audience: 
General public

PAUL KELLY:

Professor Paul Kelly, the Deputy Chief Medical Officer. So the situation continues to develop both internationally and here in Australia with a large number of cases. We've reached a watershed in a sense, over 100,000 cases worldwide now. Over 90 countries affected, with more than 3,000 getting close to 4,000 deaths around the world. So we're certainly seeing this COVID-19 problem spread and continue to cause some difficulties in many, many countries around the world. We're still seeing the major growth in numbers in what we're calling our high risk countries so China is getting less prominent but majority of cases are still from China. Iran continues to have a large epidemic and many deaths. The same in Italy, particularly northern Italy. And South Korea is the other place, which are doing a lot of testing, finding cases and also unfortunately people passing away. Here in Australia we've reached 70 in our numbers for cases, still only the two deaths. But we are still seeing people, mainly coming from travel from those high risk countries, but also an expanding number of countries. We've had a doctor in Victoria, coming back from the US for example, not on our high list countries at the moment. But it does demonstrate that the virus continues to spread and we need to be vigilant about people coming back from overseas.

We have those community based outbreaks in northern Sydney. They have been reported in the last few days, related to the aged care facility. As well as the doctor from Ryde hospital. So these things are becoming more complex but we're continuing to monitor the situation very closely with our state and territory colleagues. I've just come again from our daily Australian Health protection committee meeting, where we are discussing the issues on a daily basis. Yesterday I can report that we had two very good and constructive meetings. One with the aged care sector, the other with the primary care groups. So peak bodies and others in relation to GP's, practice nurses, the Pharmacy Guild and many others involved in primary care. That's led to a very good engagement and a commitment from all of us to work together on those two particular matters that are of great importance in this next phase of the COVID-19 issue here in Australia.

One of the clear messages that came particularly from the primary care group but also from aged care, was masks. We realised that personal protective equipment for our health care workforce and our aged care workforce is absolutely fundamental. We need to make sure that they are kept safe, so that they can provide the excellent care that they provide in those two sectors. We have our medical stockpile. It does include masks -surgical and P2 masks. I can announce today that we are releasing another 260,000 masks, surgical masks from our stockpile. They will be distributed as we've been doing since January in relation to masks supplies, through our Primary Health Networks, which cover every GP practice, every pharmacy and so forth around Australia. All of that primary care elements right throughout Australia. So those masks are on the move now, we've done a ring around of the Primary Health Networks today. I can say that they do have masks, GP's and others just need to ask and they will be provided. Now it's not an unlimited supply and so there will be other announcements in coming days in relation to our efforts to increase the supply of masks in Australia. But today I'm announcing that 260,000 masks will be released from the medical stockpile for use, immediately.

QUESTION: 

[Indistinct] the number of cases in Australia is that we've hit 70 there. How many of them are still I guess, current infections, compared to people who have been diagnosed with the coronavirus and have since recovered?

PAUL KELLY:

So there are 22 people that have recovered. So by recovery I would say we're talking about having had a positive test and then now a negative test, that's our definition of recovery. But I would say that most of the cases that we've had so far, are luckily at this point have been quite mild and so the symptoms have recovered much quicker. So we're really looking for that clearance laboratory test at the moment as being our definition of recovery, but I can say that almost all of the cases have recovered well. There have been unfortunately, these two deaths both quite elderly people. They, we know, are the high risk group for the severe end of the spectrum. And there have been and continue to be some cases that are more seriously affected. But the majority of people that we've had so far in Australia have been mild illnesses. This has been a similar pattern to the Australians who we know from the Diamond Princess, who were in Japan and in hospital in Japan. Most of those have recovered now or are recovering well and none of them are in serious condition.

QUESTION:

Just on the doctor in Victoria. Medical staff in Victoria have been advised that they don't need to be tested, if they have cold symptoms after they come back from the US. Following this diagnosis and the fact that this doctor has treated 70 aged care patients, will that be changed, should all doctors be tested if they have symptoms at all?

PAUL KELLY:

So just to correct a couple of things there. The 70 people, that have all been contacted by the way through SMS, are not in aged care. They were people that had been most if not all of those were seen the GP setting. So they're not in that highest risk group. But there was some aged care people that potentially were exposed as well and they are being followed up. In terms of who should be tested, so our general principle for testing at the moment is people that are coming from the high risk or medium risk countries. And there is a list on our website in relation to that. But in the high risk group its: China, Iran, South Korea and Italy. And then there's a longer list of the medium risk countries. The US is not on that list, however, at this point, I think, now that we have over 90 countries with cases, anyone who returns from travelling should consider that, and it's a clinical decision really by the doctor. And some states are advising that specifically.

QUESTION:

And what's the thinking behind the advice to doctors who might have had casual contact with someone who's been exposed. I've seen some New South Wales guidelines that say, you can prepare food for a patient but you can't deliver the food to the patient if you're one of those doctors. What's the thinking behind that?

PAUL KELLY:

Probably not doctors, but aged care facility workers I think that would probably be the case. We've learned a lot from the Diamond Princess cruise ship. And so where that was very well handled in the beginning in terms of all of the patients being confined to cabins and so forth and that brought the issue in passengers under control. Unfortunately, the evidence is fairly strong now that crew delivering food and the trays themselves, from crew that were infected, prolonged and then increased the number of cases that were being found on that cruise ship. So we're taking, and this is a really important point, we're learning things about the virus every day and we're trying to use those lessons in the next phase. And the next phase is indeed, well in only one aged care facility so far, but this is something that we need to consider as we go forward.

QUESTION: 

The Victorian health minister in announcing that this doctor had been infected by the coronavirus said that she was flabbergasted, I think was the word that she used, that a doctor who had flu-like symptoms given the current situation had gone to work and had continued to treat patients. Do you share that sort of disappointment and if you can't get that message of self-isolation or reporting across to medical professionals, how hard is it telling the rest of the community to look out for those sorts of issues?

PAUL KELLY:

So our general theme and this is this is repeated every flu season is; don't soldier on, is a key component to this. If we're very clear about not only our own health but protecting others, then not going to work, or school, or university when you're sick and actively sick with a respiratory illness is a general principle. Washing your hands is a general principle. Both of those issues and cough etiquette, making sure you cough or sneeze into your elbow. General principles and we expect our healthcare workforce particularly to take those on board. Now I think we should be careful about blame games here. There are a lot of pressures on our workforce including not wanting to disappoint people that are booked in to see you. I presume that was the case with this particular doctor. So I'm not going to sort of go down the blame game but just to reinforce that issue for everybody in these circumstances as they come into winter and as the COVID-19 issue is upon us. It is particularly a message to healthcare workers and aged care workers. Take those messages seriously.

QUESTION:

Just on the second cruise ship that's in quarantine off the coast of California, there's four Australians trapped on board and President Trump he's sounding a little bit reluctant to bring those people to the mainland. We know that the virus spreads more quickly on cruise ships. At what point do you think would you be advising the government to be talking to the US about evacuating our citizens back to Australia?

PAUL KELLY:

Well so this is quite a different situation to what we found with the Diamond Princess in terms of the scale of the Australians on board. It appears much less this time around. So I'll be talking tomorrow as I do weekly with their American counterparts and we'll be getting the latest update in relation to this matter and I will be reinforcing that we all should learn from the Diamond Princess experience. And the Diamond Princess experience was pretty clear about what happened over time in relation to the spread of the virus and how difficult it is to run a quarantine station essentially on a ship. So I'm sure and I know that the people that will be giving advice to the American- to the US government and so their cruise liner itself that they do know those lessons and I'm sure they'll take them into account.

QUESTION:

Given how this this disease is spreading are there any new countries that you're concerned about? We've heard a lot about China of course Iran and South Korea having a travel ban put in place earlier in the week, Italy. Are there any other countries that are sounding alarm bells for you at the moment?

PAUL KELLY:

Well certainly Europe has a growing problem in multiple countries. Unlike the UK government include the UK and Europe, in this case. So UK again will be on this teleconference tomorrow morning. They- and I've spoken to them during the week - they are particularly concerned about the growth in cases there and mostly imported cases from other parts of the world. The Middle East is the other key hot-spot if you like at the moment. And then there are question marks that we have over countries that perhaps don't have as strong public health laboratory networks as the ones I've just mentioned. And so we're keeping a close eye on neighbours to our near north.

QUESTION:

Given the open borders in Europe does that make it more difficult to, when you do talk about travel restrictions here in Australia, being able to monitor the flow of people and stop any outbreak from Europe getting to Australian shores?

PAUL KELLY:

That's certainly a challenge. There is open borders throughout Europe and it's a very large population. Interestingly for those that are interested in numbers. Iceland has one of the highest rates by population. So very few cases but it's a very small country. And so it's popping up in all sorts of surprising places. In fact, we've had one imported case that had travelled from Iceland through the UK and back through the Middle East. So where they actually picked it up. Hard to tell. But it's a bit of trivia for today.

QUESTION:

Can I just ask about New South Wales where we have an escalating number of cases. Are we past containment in New South Wales?

PAUL KELLY:

No, we're certainly looking at continuing containment and continuing to actively look for, find cases and their contacts and to isolate them as quickly as possible to decrease further spread into the community. We have had some community based cases now which don't have a direct travel link that's to be expected but minimise for as long as possible.

QUESTION:

Have you had any further discussions with Indonesia. They've got four confirmed cases now but experts believe that there would be much more and there’s a bit of panic spreading through the population. Is Australia is assisting with their efforts?

PAUL KELLY:

So we're certainly in close contact with Indonesia and they have laboratory testing capability. How much they're using that is really a matter for the Indonesian Government and we've offered support and we'll continue to offer support and assistance in regard to that. I know that the World Health Organisation has also done the same through their country office. And so we'll be continuing to monitor that situation very closely. We've had one returned traveller from Indonesia who went via Singapore. So again it's very difficult to tell where these things have started from but that's certainly something that we're looking at very closely.

QUESTION:

So someone returned from Indonesia has the virus. Is there a point at which with if the Indonesian government doesn't start reporting more- a larger number of test tests of their population should we think about travel restrictions with Indonesia?

PAUL KELLY:

We're not at that point yet and there are many people that go to Indonesia from Australia and have foreign holidays and we're not looking to restrict that in any way nor to restrict people coming from Indonesia at this point.

QUESTION:

A lot's been made in the past week or so of people stockpiling toilet paper, putting that to one side, because we're quite aware of what your views are on that and those of your colleagues it's unnecessary. Are you hearing reports talking to people like the Pharmacy Guild or pharmacies around the country people also stockpiling prescription medications or more over-the-counter medications.

PAUL KELLY:

So we're doing we're very actively looking both internationally and locally in relation to us as suppliers of pharmaceutical products and medical devices and spare parts for medical devices all of these things. We have very close links of course through the Therapeutic Goods Administration, part of the Department of Health. So they have had a teleconference. I think the day before yesterday with their counterparts in the US the UK and Europe around this matter. We are linked in with the World Health Organization who is also looking at these matters in relation to essential drugs. And at the moment at that point both internationally and in Australia there are no issues with shortages of any of the vital drugs that we need. So that's the first good point. That doesn't mean that they might not be shortages of supply in your particular pharmacy. And this brings back the toilet paper. You can actually make a shortage very quickly by people hoarding and please do not do this with any goods but particularly with pharmaceutical products. So I think that's a that's a key but good news story, that at the moment where we're well supplied. We're looking actively as to whether we need to be thinking about stockpiling some of these drugs in our national medical stockpile. That's certainly an active consideration at the moment but at this stage there are no shortages.

QUESTION:

What sort of drugs would they be that you're considering adding to that stockpile?

PAUL KELLY:

So mostly antibiotics and potential antivirals, although as we know there is no specific antiviral agent which has been used to any useful way against COVID-19 at this point. There are clinical trials we know of in China and elsewhere in relation to use of particular drugs in particular circumstances. But at the moment there's nothing that's been proved to be effective. So this is a major issue for us to find those materials.

QUESTION:

Given the virus has spread, do you think it's unusual that there are no confirmed cases in the ACT. And do you expect that it's possible it's here already but hasn't been confirmed.

PAUL KELLY:

So I know the ACT has very good laboratory network and is testing people. So far, all negative. The ACT is a small jurisdiction and so it's not surprising that they might be the last to get this although there is a lot of international travel through and to the ACT but generally not directly. So people found on the border at the place of first stepping on Australian soil are likely to be diagnosed there rather than the ACT at the moment. So yes, no cases yet but they're part of the National Planning and we meet with Karen Coleman the Chief Health Officer in the ACT every day on our AHPPC teleconferences.

QUESTION:

Should pharmacists be imposing pack limits on people who are buying up medicines just make sure that people won't be adversely affected by not being able to get their hands on what they need?

PAUL KELLY:

At the moment, no need. But that's certainly something that we're considering. On the other hand, we are considering ways that we can assist people with chronic diseases and who are on long term and multiple prescription medicines, ways of them to actually get extra scripts because we want to keep them away from people that might have COVID-19. They're the ones that are at highest risk for severe end of the illness. So this is something we've discussed very actively yesterday at this workshops that I mentioned.

QUESTION:

You mentioned we foreshadowed further announcements in coming days about protective equipment. There has been discussion about the number of masks that are in Australia. The fact that many of them are made in China. What sort of measures would you have to start looking at, is it boosting local production of those things or finding other countries to import them from?

PAUL KELLY:

So we've had discussions about this over the last week or more and there's been announcements by Minister Hunt and even the Prime Minister around boosting local production for example and working with the Victorian Government where our single supplier at the moment, who do manufacture masks in Australia, to increase their production through that facility. And you're quite right the global supply is disrupted in relation to personal protective equipment broadly including masks. And much of that production, as indeed much of the production for the world's other goods, are in China. And ironically for the masks in Wuhan itself the epicentre of this particular COVID-19 problem. So supplies are disrupted. Demand, not surprisingly, globally is increased. And the same in Australia. So it is a worldwide phenomenon and Australia is doing what we need to do to ensure supplies within our own country.

QUESTION:

I understand the Chinese government has taken control of some factories in China to ramp up production of masks. Are they cooperating with the international community in terms of distributing those masks or are they sort of supplying them domestically as a priority?

PAUL KELLY:

So I'm not aware of the situation in China. We have been in very active discussions though with Taiwan. And in Taiwan they certainly are ramping up production and we are in active discussions with them in relation to the precursors of the raw materials if you like for mask production. So they can honour the contracts to our single supplier here in Australia. So we're looking at a range of ways through a whole of government approach at the national level and also the states and territories. We talked about this today at the AHPPC teleconference to make sure we were really coordinated in relation to increasing the supply of masks in Australia.

QUESTION:

In the longer term, do you expect COVID-19 to become endemic in Australia and something that we have to learn to live with?

PAUL KELLY:

There's a range of possibilities that might take place with this virus. We may bring it under control and eradicate it completely. That's still something we're looking to do. It's looking less likely that that will be the case. We may have a limited number of cases in Australia and that's again something we're really working hard to do but may not happen. We may have a large outbreak and it goes away after winter. It may become endemic so something that we will find comes back each winter for example. All of these things are possible. It's widely been discussed and examined around the world. I think the issue we've got at the moment is indeed that it's winter in the northern hemisphere and when you look at those hot spots on the map they are all in the northern hemisphere. Where they are going to finish there their flu season and their winter season soon. So we'll get some forewarning about what that does in relation to climactic conditions. At the same time the southern hemisphere of course will be entering into our winter season and it remains to be seen how that will play out.

QUESTION:

Just on yesterday's meeting with the GPs. When are you expecting the new Medicare items to be announced so that they can bill patients who they talk to over Skype time at home.

PAUL KELLY:

So certainly that was an active and lively discussion yesterday with the GP's and other primary care professionals. And so there will be announcements about that in the coming days but certainly we gained a lot of information and opinion and important views from people at the coalface yesterday. And that's certainly been taken into account how we can scale up for this problem if indeed it becomes a large outbreak here in Australia.

QUESTION:

And given the ability of doctors to spread the disease. How crucial is that kind of ability to do Telehealth to containing the spread?

PAUL KELLY:

So I think Telehealth has a number of advantages. One is the one you mentioned but the others side that particularly for those who have chronic disease and therefore- or the elderly - and are therefore at that highest risk of getting the more serious end of the spectrum of this disease. And just remembering that 80 per cent of cases will be mild and probably don't need to see a doctor at all, once we have a large number of cases if that occurs. And then there's the protection of the health staff themselves but it will also importantly minimise the use of personal protective equipment. You cannot catch this virus over a Telehealth consultation. And so that certainly from a public health point of view and decreasing the numbers of cases that may be found in the community. That's an important consideration as well. Okay, thanks a lot. Thanks for coming.

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