NICK COATSWORTH:
I can tell you today that there are 6613 cases of COVID-19 reported in Australia to date. Tragically 71 Australians have lost their lives to COVID-19. Globally there are just over 2.4 million cases. In the Australian context, we have conducted over 424,000 tests for COVID-19 to date. And most importantly, in the past 24 hours we have seen a further 26 cases, representing obviously a continued ongoing low level of reporting of cases, which demonstrates that the physical distancing measures that we have asked of Australians and Australians have really embraced are still paying dividends for us, and still keeping our numbers of COVID-19 very low indeed.
I wanted to make an observation from an experience, a personal experience, on the weekend, as I took my own family for some exercise around our suburb. And what I observed was Australians in pairs, in family groups, maintaining their physical distance but getting out for exercise. I observed some small businesses that were open, and I observed small businesses that had instituted some very practical and easy to follow measures to keep physical distance, and to help their customers adhere to the guidelines that we have asked them to do.
And that was such a comforting thing for me to see. And the reason it was comforting was because I know how hard it is now that we are approaching just over a month of these really stringent physical distancing measures, and restrictions that we've placed on our usual lifestyle. But to see people still adhering to those guidelines, to see small businesses assisting their customers, being quite creative about those processes. And I know that it's not just going on in Canberra, I know that it's going on around the whole country.
I would like to pay some attention as well to elective surgery. We know from the Prime Minister's statement last week that the physical distancing measures and the restrictions we have on place in our society are going to continue for another month, but there is something that may well change within that month, and that is the consideration for the reintroduction of elective surgery. And I know you've heard a lot about that over the week, the past weekend, in the media. Today, the Australian Health Protection Principal Committee continued its discussions on elective surgery, considering in some detail the sort of principles that may underlie what will be a very cautious and safe, but ultimately consumer and patient focused reintroduction of elective surgery into Australia, into the Australian health system, and certainly making recommendations for National Cabinet to decide – to focus on that in the coming days.
As part of that process, myself and colleagues within the department have also been engaging with a range of stakeholders around Australia, and I would like to particularly pay tribute to their universal commitment to consumer and patient safety during these difficult times and these challenging sort of policy decisions. In particular the College of Anaesthetists, the College of Surgeons, the Australian Medical Association, the Australian Private Hospital Association, just a few of the many stakeholders that have really proactively engaged with us with the principles of patient and staff safety fundamentally at the core of what they are recommending.
So, with that in mind, I am happy to open to questions.
QUESTION:
Just on the elective surgeries, how long can we expect before they resume, and what types of elective surgeries might be considered first? And just further to that, is it an issue of distributing some of the medical supplies that have been obtained by the Commonwealth among the states? And are those states prepared to resume those surgeries [inaudible]…
NICK COATSWORTH:
So, that was three questions in one. I'll try and deal with each of them. I think it's been clear from the commentary within the media but also from at ministerial level that this is not something we are going to sit on for many weeks. So, whilst I'm not going to pre-empt National Cabinet's decision, this is something that we recognise: there are Australians out there who are in pain, have disability, can't be in the workforce, need to take very potent pain medications that need their elective surgery done. Keeping in mind of course that there is still Category 1 and urgent Category 2 surgery taking place within Australia at the moment.
So, with regard to the specifics of timing and the nature of the procedure, that is also going to form part of National Cabinet discussions, so it's important that we don't pre-empt that. But the principles of having safe and cautious reintroduction of elective surgery are going to be paramount.
Leading to your third question, which was whether PPE availability is restricting expansion of elective surgery; it's not restricting expansion of elective surgery, but PPE availability is a key requirement, of course, for us to be able to perform elective surgery safely. Noting that the standard personal protective equipment for a surgical case is a surgical mask, generally a reusable surgical gown, gloves, and in some cases, eye protection. But now as a physician, I'm getting out of my [indistinct] rather than being a surgeon. So, I'll take the next question.
QUESTION:
Can I just clarify again on elective surgery – we don't want you to pre-empt what Cabinet says necessarily, but what's your recommendation about what should start first? For example, the AMA talks about low-risk high patient benefit. What is your recommendation from the AHPPC about what should be [indistinct] first, and is it in line with that AMA request?
NICK COATSWORTH:
The recommendation of low-risk high benefit procedure is a very good recommendation and principle as to how we should approach elective surgery resumption. We agree with that.
QUESTION:
[Inaudible]… AHPPC also considering what's been discussed in the last week with regards to low-risk but high value workplaces that might be able to resume first, as we come out of these restrictions? Are specific industries being considered?
NICK COATSWORTH:
The absolute focus at the moment, as I've said, because the Prime Minister has been very clear how long the restrictions are going to be in place for. So, the focus at the moment is about us building confidence in the health system by looking at elective surgery resumption, and that's going to be really important for Australians to see that hospitals are safe places to go to for your surgery. So, that is the main focus of the AHPPC's work at the moment.
QUESTION:
We're seeing overseas some countries turning away from sort of point-of-care tests and others, finger prick blood tests, the UK for example thinking they're not as reliable to determine if someone has or hasn't had coronavirus. Is that thinking, in terms of what Australia's looking at, changed at all? Or are we still testing those couple of point-of-care tests that we got in a couple of weeks ago?
NICK COATSWORTH:
So, the national strategy for looking for COVID-19 in the community when there are very low levels is something that the AHPPC is developing at the moment. It is not based around point-of-care testing, it is based around widespread application of what we call and what you know now as PCR-based testing.
QUESTION:
Stuart Robert says even if 1 per cent of Australians signed up to the mobile contact tracing app, it's better than nothing. How effective would it be if 1 per cent of Australians signed up for the app?
NICK COATSWORTH:
Well, I think we need to take it back to the principle of the app and the principle of how we determine our contact. We have a very well-oiled machine at the moment which is about people calling Australians, and determining whether they have been contacts. And what the app will do is just provide an added layer, if you want, the icing on the cake, to enable more, a greater percentage of people to work out whether they're at risk or not. And that's the purpose of the app. So it is the case that if you put the app out and even if only 1 per cent of the population take it up, that it will be more useful than if no one takes it up. So I agree completely with what the minister has said.
QUESTION:
So is the app that necessary then? We're asking Australians to give up potentially significant privacy concerns to sign up to this app. If it's just the icing on the cake is that sacrifice worth it?
NICK COATSWORTH:
Well I think that we think that, we think that Australians will come with us on this. That's the first thing to say. They will see the inherent value in having a mechanism that helps those disease detectives do their work. So I think the question referred to would one per cent be useful? It would be more useful than zero per cent but we think there's going – that Australians will embrace this. And the reason we think so is because we've been very clear in what the app is about. This is not a geo location app for example. This is about letting those disease detectives know who someone has been in contact with for greater than 15 minutes, basically to help with our memory if you will, because we can't remember everyone that we've been in contact with for more than 15 minutes.
There are legitimate privacy concerns but the narrow scope of this app and the serious consultations that we're having with those who represent privacy concerns in Australia, is going to make sure that those are well addressed.
QUESTION:
Dr Coatsworth, your colleague Professor Murphy last week flagged that national guidelines around how would you report and consider someone as being recovered from coronavirus were being developed. Are you able to provide an update on that? New South Wales for example is still reporting the exact same number of recovered cases now for the last 12 days. They're obviously not at a point where they're actively or accurately collecting that data. What's the latest on that?
NICK COATSWORTH:
Well look, it is important for us to report the number of patients that have recovered from coronavirus. You can imagine that the priority of course, particularly in the jurisdictions where there are still low levels of community transmission, certainly not zero cases, that the priority is towards actually identifying those contacts, identifying the contact chains and interrupting those. So as that gets easier to do then we will move towards more frequent reporting of the statistic that you've mentioned.
QUESTION:
Sorry, does that mean we're missing the opportunity to actually collect data that might be able to tell us what the recovery time is for different age groups or people with different underlying conditions if we're not collecting that from the start?
NICK COATSWORTH:
Well the data is being collected but as you've quite rightly pointed out the time taken to recover, who is actually recovering quicker, that's actually a longer process to determine that sort of information and process it than it is to simply say, we have this many cases at one time.
QUESTION:
South Australia is conducting asymptomatic testing now. Will the AHPPC move towards that as their general advice do you think given the number of cases in the large number of cases that are now being conducted?
NICK COATSWORTH:
Yeah. So the move with individual jurisdictions to expand their testing guidance has been completely endorsed by the AHPPC as something that individual jurisdictions are able to do and it's not just South Australia. I'm aware of a number of jurisdictions. The reason that the AHPPC hasn't come out explicitly in that regard is that we're looking at the National Surveillance Strategy at the moment and that will be a statement that's actually presented to the national cabinet. So those jurisdictions where there is very low or in some cases no cases being reported at the moment, are logically going towards looking for the so-called asymptomatic cases.
QUESTION:
Are you able to say in a broad sense how many tests there are available to be used in Australia at the moment nationally?
NICK COATSWORTH:
I think beyond saying that we've got one of the most successful testing regimens in the world, and that we've had over 424,000 tests being conducted and that there's going to be a significant increase in the testing capacity in the coming weeks. That's about all the information that we can give you at the moment.
QUESTION:
New Zealand has just announced that it will move back from stage four to stage three within the next week or so. Do you envision Australia after the month timeline the Prime Minister has outlined, moving from stage three to a clearly defined stage two level of restrictions?
NICK COATSWORTH:
Well those are the sort of the decisions that will be made through AHPPC to the national cabinet in a month's time and as we know with coronavirus, although we're doing very well, we have to see what's happening on a week by week basis. So it's important not to get too far ahead of ourselves on that.
QUESTION:
Security guards at Canberra Hospital at the moment don't wear PPE for some of their role which does involve going to the Covid ward I understand. They do wear a mask and gloves when they're helping transfer patients. Does more need to be done in terms of protecting other frontline workers like security guards who are having really close contact with Covid patients including in the lift area of a hospital?
NICK COATSWORTH:
So I think it's important: every hospital is different. Every hospital is structured differently. So commenting on an individual hospital is a very challenging thing so we need to walk it back to the general principles. And the general principle is that personal protective equipment is actually the last line in your workplace health and safety hierarchy of mitigating risk.
So the first line is making sure your procedures and processes within the hospital are sufficient, that you identify patients who potentially have Covid, that they are in an appropriate location within the hospital and then that appropriate personal protective equipment is provided to all people who are interacting with suspected or positive Covid patients.
QUESTION:
So then, just sorry to clarify that will there come a point if there are more Covid cases coming into hospitals that potentially security guards helping transfer the patients, standing in the lift with the patients, or other workers like cleaners could end up wearing full PPE do you think?
NICK COATSWORTH:
Well the National guidance on PPE has been updated and discussed by the Australian Health Protection Principle Committee and will be going to national cabinet this week. So we'll have some very clear guidance on how that has been updated. And the sort of healthcare workers for whom we recommend personal protective equipment.
QUESTION:
We've heard a bit about how challenging the global environment is to secure some of this medical equipment. And how has Australia done it? We seem to have gone from a position where there was a great shortage to now we're in a pretty strong one. Has it been very difficult to negotiate in that environment?
NICK COATSWORTH:
So I think every nation is finding it challenging at the moment. There's obviously a supply demand issue whereby we have kept a demand on the personal protective equipment relatively low because our cases have been low. So when we're able to announce that 60 million masks have entered into the national stockpile we are able to distribute 11.5 million out into the community, we're doing so into a community where the prevalence of COVID-19, the rates of COVID-19 are very low. So we're getting a lot in, we're putting sufficient out. And so even those supply chains are an issue, we're getting enough in for the stockpile at the moment. And we've got entire working groups within the Department of Industry, Department of Health, a very senior level that have contributed to keeping that supply chain open. We've also got a lot of Australian businesses, philanthropists and notable Australians that have assisted us and so that the fact that we have been successful I think is something to celebrate. One more question.
QUESTION:
Is there an update to provide in relation to remote Indigenous communities and the potential quarantine arrangements that could be in place? I understand Defence has been involved in potentially setting up some isolated areas where older people could be moved close to their communities. Can you explain what is being done?
NICK COATSWORTH:
So that is being considered by the AHPPC tomorrow and there is actually going to be a specific statement on that by a colleague of mine that I'd like them to make if that's okay.
Thank you.
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