Date published: 
22 September 2020
Media event date: 
21 September 2020
Media type: 
Transcript
Audience: 
General public

NICK COATSWORTH:

Good afternoon everybody. Dr Nick Coatsworth with today's national update on COVID-19. To the 24 hours to 12 noon today, we've had a total of 26,912 cases of COVID-19 in Australia, an increase of only 16 newly confirmed cases in the past 24 hours. New South Wales reported four new cases, three were overseas required and those people were in hotel quarantine, and one person had locally acquired COVID-19, it was a contact of a confirmed case. Queensland reported one case of COVID-19, and that person was in hotel quarantine, and Victoria reported 11 new cases, five were locally acquired and contacts of a confirmed case. And six people's COVID-19 cases remain under investigation. Sadly, there were two new deaths overnight, both reported in Victoria, taking the total number of deaths from COVID-19 to 851.           

These are very pleasing results from Victoria overnight, and just a testimony to the immense effort of Victorians both in rural and regional Victoria, particularly in Melbourne, and it surrounds those Australians who have been under a very restricted way of life for many weeks now. We would encourage Victorians to keep up the good work. There is still some way to go, as your government and health services plan the roadmap out. It is of course pleasing when we see numbers so close to single digits, and the control that that implies that will be able to keep COVID-19 under control. This light at the end of the tunnel is getting closer every day. We would, as we always do, ask for your patience. It is clear that the Victorian public health unit, Professor Brett Sutton and his colleagues are taking these numbers into account as they plan further lifting of restrictions, but that patience as always is required.           

I wanted to also welcome the announcement of additional funding yesterday from the Federal Government, to additional vaccine research in Australia at the University of Melbourne and the University of Sydney. We're investing in new technologies that are not yet under development in Australia, including the so-called mRNA technology, which is one of the United States' based candidate vaccines, and also another protein subunit vaccine. We have- this is in addition to the over $1 billion investment in securing the Oxford vaccine that AstraZeneca is producing, and the letter of intent for production of the University of Queensland vaccine. So that sort of investment demonstrates the broad range of vaccine opportunities that Australia has, at its disposal, and also a recognition that COVID-19 vaccine technology is going to need to continue to be developed, to continue to be improved, throughout 2021 and beyond.           

Finally, I'd just like to note, being a father of three myself of course, that there are school holidays coming up. And around the rest of Australia, what that means, and indeed regional Victoria, what that is going to mean is movement. And we know where there is movement, there is potential movement of COVID-19. So, when you are out on your school holidays, make sure to remember the COVID three: keep your distance, wash your hands, don't interact with others if you are unwell. Work out where the nearest COVID testing facility is for your particular holiday destination, and if you are sick on that day that you have leave out of your major capital city, don't be the one that takes COVID-19 into regional communities in Australia. This is the new normal for us. We need to be exceptionally cautious; we need to get our lives back on track and enjoy the school holidays, and do what Australians do in the spring school holidays, but we also need to do it especially in a COVID safe way.           

I've got some in the room and some on the phone, so I will just go to Tamsin to start with?

QUESTION:

Yeah. Obviously, really exciting numbers coming out of Victoria at the moment so it's a lot of hope. We're hearing that potentially some of the roadmap out will be sped up slightly with numbers coming down faster than had been predicted. What's your understanding of where we are at in comparison with the Victorian roadmap and getting any indications that Victoria is going to be out of restrictions earlier?

NICK COATSWORTH:

Well, I think once again where the numbers are encouraging, we still have to see what they do in the coming days. Certainly, if they continue down into single digit territory, there is no doubt that they will be provoking some thought on behalf of the Victorian Government about the roadmap and when restrictions can be lifted. But I just wanted to- we do have to note the sound of caution here. And that is simply to say that the effort that Victorians have gone to so far, the incredible effort, could easily be undone. And we don't want that to happen. We want those decisions to be made with caution and safety in mind, and we are confident that the Victorian public health unit is doing that and we are providing advice as well, through the AHPCC. And that the Victorian public health unit has learnt so much, and demonstrated improvements in the test, trace, isolate system that can give Victorians competence of that extra firepower to be able to keep COVID-19 under control into next year.

QUESTION:

Just on Victoria as well, has the AHPCC ever given consideration to the impact of curfew on spread of the virus? Has that been something that you've believed would be beneficial or- what's the AHPPC [indistinct]?

NICK COATSWORTH:

Well, the curfew was obviously designed with an intent in mind, and that was to restrict movement which, as I said previously in the press conference, is part of the key way- is the key way that COVID-19 spreads around. But as a public health measure, it was never debated or discussed within the AHPCC itself. I will just go to the phone then I will come back to the room. We might start with Matt.

QUESTION:

Thank you for that. Just sort of building on what you were saying there about the hard work that Victorians have done could easily be undone, and your warning there to members of the public who are- could be going on holidays during the school holidays, travelling around a bit more; are you concerned that we might be experiencing a bit of a lull at the moment, and as soon as people do start to travel around more, when restrictions are lifted between places like the ACT and Queensland and South Australia, that we could start to see clusters popping up again? And how fearful are you that there could be a sense of complacency and that people might stop being as diligent as they have been in abiding by the rules put in place?

NICK COATSWORTH:

Well, Matt, it's always going to be a balance. We're clearly looking at numbers within seven out of the eight jurisdictions in Australia that do allow movement within states, from urban to regional areas, from Sydney down to the South Coast, or indeed from Canberra to the South Coast on school holidays. So, there would be no point at the moment in restricting that sort of movement because the numbers would simply not favour that as a proportionate response. But, as I have said on more than one occasion, you know, government, the AHPCC, we can't do this on our own. So, with those numbers being low, the obvious way to keep them low, but to keep our school holidays as close to how they usually are, is to be as safe and COVID safe as possible, and that's going to be a responsibility for everybody. And it will be a responsibility as we lift state borders as well. There's the opportunity now for residents of the ACT to go to South Australia. Don't get on that plane if you're unwell or at all feeling unwell. I think you can get your money back these days if you're crook and you don't get on the flight. You're doing the whole community a favour. So, the licence to move is not a licence to move unsafely.

We might go to Dana.

QUESTION:

Thanks Dr Coatsworth. I've actually got two questions. The first one is about the Centers for Disease Control in the United States, the news overnight that they're saying airborne transmission is one of the main ways that COVID is spread. The AHPCC's still says this is not a significant factor. I was just wondering what the Americans are seeing that the Infection Control Expert Group that advises to you is not.

NICK COATSWORTH:

Thanks Dana. So, I have seen the Center for Disease Control recommendations, and my reading of that, in fact I think the wording is fairly clear, that there is an increase in what we call aerosolisation. And what they have suggested is that the main mode of transmission is aerosol transmission, which is not quite airborne transmission in the purest sense of the word. But what does that mean for Australian national guidance? Basically, it has always been the case that Australian guidance, US guidance, European guidance has recognised that aerosols are produced by someone who has COVID-19, and that they can be inhaled by someone in close proximity, and can be a form of transmission. So, as I'm speaking to people now in this press conference, about this far away at least, my speech is creating aerosols, and that aerosol can contain COVID-19.           

Whether it is the main mode of transmission or not, is one of the issues that is currently under debate, and we have seen that there has been a shift from the Center of Disease Control. I didn't see the references that were published on the website that they are using to base their decision. It is the position of other major organisations, our own Australian Health Protection Principle Committee, the European CDC, Public Health England, that the main mode of transmission is contact in droplet, and there is an increasing recognition that aerosols have a role. Now, what has Australia done about that? Well, during the Victorian second wave, the guidance on when to use N95 masks, which are the ones that protect you from transmission of airborne infectious disease, was expanded, such that any patient within a hospital in Victoria at the moment, either suspected the so-called SCOVID or COVID positive patients are being treated by practitioners using a N95 mask, and that was an important step recognising that role of aerosols.      

So, that's a long answer but I wanted to make sure that people were very clear, that both the Infection Control Expert Group, the AHPCC, and federal and state health departments have all recognised the important and growing role of aerosols in the transmission of COVID-19. We continue to look at the evidence on a daily basis.           

You've got a second question, Dana?

QUESTION:

Yes, thanks doctor. It's sort of a related question. So, the latest AHPPC guidance on PPE states that fit testing is the minimum standard for each occasion of use of a P2 or N95 mask and that these [indistinct] are not protective if they don't fit properly. It also says that fit testing of all healthcare workers who may need to use one of these masks will be difficult to accomplish due to limited supplies and range of types or sizes available. We've been told throughout this pandemic that the Federal Government has plenty of PPE; now it turns out that we don't even have enough of the right masks for healthcare workers to access ones that fit them properly. What's the AHPPC advice to the Government now on procurement and manufacturing of these masks to ensure that we do have adequate supply?

NICK COATSWORTH:

Well, thanks, Dana. There's a number of elements to that question. The first one is I just need to point out that the minimum standard recommended under national guidance is in fact a fit check. And although it's challenging to explain in a press conference, I'm going to have a go because it's important. A fit check, otherwise known in the US as a seal check, when you put on an N95 mask, you make sure that it's adequately moulded around your face and that you can't feel obvious air leaks either- usually around the chin or up around the bridge of the nose. Easy for people with glasses, of course, because they'll fog up. Now, that is the minimum standard, and that is what anyone must do before they go into a room someone's with suspect COVID-19 in Victoria or COVID-positive in Victoria at the moment. That has always been the minimum national standard. A fit test is different. A fit test works out what mask is best for you as an individual, noting that blokes with beards have to shave to wear an N95 mask. A fit test is something that's commonly performed by an infection control practitioner or an occupational medicine specialist and actually uses a machine to determine how much leak is around a particular mask. So they're two different things, and the fit test was acknowledged and is acknowledged by European CDC, even a US CDC as a challenging policy tool to be able to roll out during a pandemic. In Australia, only South Australia had respiratory protection programs and fit testing prior to this pandemic, and now most jurisdictions, I understand, are considering fit testing programs, and Victoria announced theirs last week. We welcome that announcement. It's absolutely critical.           

To move to the second part of your question, in terms of supply of N95 masks and what is actually available on the market. The commercial market at the moment is robust for N95 masks. Whether you're an aged care provider, whether you're a state health service or a private hospital, you should be able to access a range of different N95 types, some of those now being produced in Australia, and prior to this pandemic no N95 masks were produced in Australia. They are now produced in a range of different sizes and shapes, and there are sufficient masks for fit testing programmes to be undertaken by jurisdictions. So the last thing I'd say is that there are still, however, some very popular masks such as some of the 3M series that are still difficult to get on the national market. So the important thing for any fit testing program is range of masks and sizes of masks and that they should be sufficiently commercially available in Australia at this point in time for employers to start respiratory protection programs.           

I would just move- I think there's one more person on the call.

QUESTION:

Yes.

NICK COATSWORTH:

Yes, go ahead. Who’s that? Paul.

QUESTION:

It's- sorry, it's Paul Osborne from AAP. Just wondering how concerned you are about the drop off in testing rates. By my calculations they're down about 30 per cent over the last three weeks. And do you have any theories on why it is actually happening, whether it's [audio skip] or particular demographics or what the situation is there?

NICK COATSWORTH:

Well, Paul, I think we've all expressed concern about the decrease in testing rates. After all, the strategy is to detect people who have symptoms of the- of COVID-19, and then you find your clusters, and the clusters can be sorted out before they turn into outbreaks. So we can only ask Australians with even the most minimal of symptoms, even if you think you've got high fever, if you haven't had a COVID-19 check, you need to go and get tested. With regard to how public health units are actually targeting their testing, they're very aware of the need occasionally to do what we call asymptomatic testing, which has been discussed here before, where certain groups of people who are showing no symptoms at all but have been designated as close contacts of people with COVID-19 are encouraged to go and get tests. And that's an important tool as well. How do we lift testing rates? It's actually going to be a challenge because we're moving into the months of the year where there's less respiratory virus. There've only been 36 deaths from influenza this year, and so it's challenging to get people to get out and get tested if they're not exhibiting symptoms. So I think- to sum up I think there's going to be a natural decrease in the number of tests being done because of less respiratory symptoms, but just a big caution that just because we're entering the summer months, this will have no impact on our risk of COVID-19. We just saw the first and second waves in the northern hemisphere taking place during the summer months, and so we can't at all be complacent.

QUESTION:

And just a follow-up, is it possible that the drop in testing rates was actually skewing the number of positive cases that we're seeing?

NICK COATSWORTH:

As in the number of- drop in numbers might be masking a true number of undetected cases out there?

QUESTION:

Correct.

NICK COATSWORTH:

Well, the percentage positivity has stayed the same, even in Victoria, which only, I think, recorded 7000 tests, and those numbers are getting quite low now. So I don't think it's going to be masking a large number of undetected cases. What I do know, though, is that there's a big focus in the local gov- affected local government areas in Victoria around Casey, where they've had the most recent cluster, and so a large number of those tests will be being conducted in those pop up clinics, which should be of some reassurance. And I'll just go back to the room, and if you like to stay on the line, I can offer you a couple more questions as well. Yes, Tamsin.

QUESTION:

Great, thank you. If as part of the contact tracing interview someone was to reveal that they'd breached a public health order, should that person be fined? Or are you worried that that would have an adverse impact on people telling the truth during those important interviews?

NICK COATSWORTH:

Well, I think the principle is that we want to do things that are going to encourage people to be as open as possible. And so no matter what reason you may have for wanting to conceal information to a public health official, please don't do it, because it has some very widespread implications for your community. With regard to enforcement, that is a difficult question, and it needs to be one that I think is made on a case by case basis. And we've seen in Victoria, clearly, the decision was made with certain members of households not to fine them because they were forthcoming with information. And for that particular case with that particular information available to the Victorian health authorities, that is the decision that they made. So I think you can expect to see some variability with that. There's- but fundamentally that will be a matter for the state who's enforcing the fine.

QUESTION:

At the start of the pandemic, when the national restrictions came in we heard that it was hard to tell which of the restrictions [indistinct]… successful in suppressing the virus because they'd come in all so quickly at the same time. Given that it was a more staggered approach in Victoria for the second wave, is there anything that we've learnt about what works and what doesn't and what could be implemented moving forward, specifically looking at Victoria?

NICK COATSWORTH:

Well, I think- we've learnt a lot of things, but I don't think we've come to the conclusion about which of the measures is likely to give you the biggest bang for your buck. In particular, the particular example is the masks. It's very difficult to unpack the effect of mandatory mask use, although undoubtedly there was an effect. So were the numbers to increase, certainly in states like New South Wales and Queensland or anywhere around Australia, I think the threshold for implementing mandatory community masks is going to be a lot lower now as a result of the Victorian experience. But in terms of the staggering of restrictions, I think we understand that households are a major focus of infection. And as you've seen with the Victorian road map and most other states and territories will put in restrictions on household numbers as one of the early interventions. So they're two examples of things that we've learnt. There are others. And I'll just go back very quickly to see if either- Matt, do you have another question before we finish up?

QUESTION:

No, thank you.

NICK COATSWORTH:

Dana, did you have another question?         

Dana might have hopped off the line. And Paul, did you want another question?

QUESTION:

No, I'm fine, thanks.

NICK COATSWORTH:

Okay. Good. Well, thank you very much, and we'll look forward to updating you later on in the week. Thank you.

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