Deputy Chief Medical Officer’s press conference about COVID-19 on 23 April 2020

Read the transcript of the 23 April 2020 press conference given by Dr Nick Coatsworth, Deputy Chief Medical Officer, about coronavirus (COVID-19).

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NICK COATSWORTH:  Good afternoon ladies and gentlemen and welcome to today’s COVID-19 update. To date, Australia has had 6661 confirmed cases of coronavirus, COVID-19. We've had- continue to have a low number over the past 24-hours of only 12 new cases diagnosed. Tragically 75 lives of Australians have been lost to coronavirus disease. We have performed 458,000 tests since the epidemic started in Australia. In terms of our current capacity to treat patients in need of critical care, we have 48 patients in intensive care units around Australia and 30 of those are on ventilators helping them breathe, and certainly that is a very challenging time for their friends and families, so we certainly acknowledge that today.       

I'd like to just reflect on a conversation I had today with all of the- many of the surgical sub-specialty heads, in association and collaboration with the President of the Royal Australasian College of Surgeons, Tony Sparnon. And that conversation was had in light of the recent government announcement to lift some the restrictions on elective surgery. I just wanted to pay tribute to that group in particular for their collaborative approach, across all the sectors that they deal with, an approach that has fundamentally been about the welfare of their patients and restoring a care in a safe and equitable way in this very challenging environment that we face ourselves in, looking to demonstrate to the public that our hospitals are safe places again, for elective surgery. So I would like to thank the Royal Australasian College of Surgeons in particularly, along with our anaesthetists and our operative nurses and the other peak groups that I have had the privilege of being able to discuss this really important policy change over the coming weeks.

I'd like to thank patients and families as well, who have been waiting for elective surgery for their patients. We will be moving together, slowly and cautiously over the next month, to look at the impact on our health system capacity, of reintroducing some level of elective surgery procedures. And we're going to be monitoring the impact of that, and one of the ways we are going to be monitoring that has been announced today by the Health Minister in a joint press release with myself. We have - and National Cabinet has agreed - that we require a real-time information system that we can monitor intensive care beds across the country. This is called the Critical Health Resource Information System, otherwise known as CHRIS. And that system is live now and there are many sites around Australia that are reporting. One of the unique aspects of that is that it will allow us to see how many patients in real-time have COVID-19, are on ventilators, importantly how many beds are available, how many beds are occupied by patients with COVID and also non-COVID related conditions. The reason why that is important is because as we move into resuming elective surgery, some patients well require intensive care after their surgery and we will be able to see what the impact of that policy change and that relief on the restrictions of elective surgery will be.

Also, that system will bring together public and private data reporting systems which makes it a very unique and novel system. I'd like to acknowledge the Victorian Government's support of this, Ambulance Victoria and in particular the Australian and New Zealand Intensive Care Society, all those groups and others have collaborated extraordinarily quickly to bring that up and running and online.

I will take some questions.

QUESTION:  There are reports emerging overseas that patients who have died from coronavirus have died because of blood clotting? Is that something that's been recorded here in Australia and that something that health authorities in Australia are looking into?

NICK COATSWORTH: I think as we learn more and more about coronavirus disease it's critical that we take these reports on board and use them to the best of our clinicians' ability to inform the treatment of patients in Australia. I'm not aware of that being a complication, clots in the legs going to the lungs are a known complication of people being unwell with sepsis and being in intensive care for a long period of time. So whether it is specifically due to coronavirus disease or just because of how unwell people get with it, I suspect we will get more of that information as time goes on.

QUESTION:  So I don't suppose you can tell us how many people who've died from coronavirus in Australia, died because of respiratory problems versus blood clotting?

NICK COATSWORTH: So we do have data collection systems for intensive care, as I've just mentioned, but there are also underpinning that, several centres, a smaller number, that contribute to overall intensive-care research, and the reasons why tragically people have died.

So that is not information that is obtained in real time as you can understand, it's different, it's not operational it's research-based. But that sort of information as and when it is researched and analysed would be presented by the researchers.

I might just take another quick question.

QUESTION:  Considering how low cases, new cases, are at the moment, how close are we to actually we to eradicating COVID-19 and is that now the aim rather than just suppression, that actual eradication?

NICK COATSWORTH: Well the aim as we have said is suppression. The reality is that we are doing an extraordinary job, we as the Australian community is doing an amazing job in that suppression strategy, to the extent that as you all know, there are some states that have reported zero new cases for several days now. So, eradication, which basically means that in a geographical area there are no reported cases or you have effectively eliminated coronavirus from a geographic area, could be an outcome of an excellent suppression strategy. The problem is, that we just have to acknowledge the non-immune state of the population, and the possibility as we have seen in north-west Tasmania, of how rapidly coronavirus can spread, and that might be in a healthcare facility or it might be within another part of the community where people are closely housed together. We have to be particularly attentive to our Indigenous communities in Australia. And so for all those reasons, I think we are on a strategy of suppression, a magnificent outcome would be geographic eradication in certain parts of Australia.

QUESTION: Is there a threshold at which point a suppression strategy becomes an eradication strategy? Is there kind of a levelling off? Or- what I'm taking from your question is that we'll always be on the suppression level especially because our non-immune communities like rural communities.

NICK COATSWORTH: I suppose the best way to answer your question is: when does a suppression strategy become an eradication strategy, and that would be when the disease is eradicated in a geographic area.    

QUESTION:  Dr Coatsworth, your colleague, Professor Brendan Murphy, this morning told a Senate inquiry that small gatherings are being considered among some of the measures that might have restrictions eased in three weeks' time, but larger gatherings very much were not. Are we to take that to mean things like weddings and other major events indefinitely are long way off for Australia?

NICK COATSWORTH: Well, we've seen what happens when large numbers of adults gather together. There have been a number of major clusters that we're all aware of - some of those have been related to weddings. And so, the way to take things slowly is to increase numbers slowly, and so that is exactly what Professor Murphy said this morning. And you can infer from that that larger gatherings are a longer way off. That would include having crowds at sporting matches, for example, as well as weddings. But the number of people that we could have at events is something that would be considered quite rightly in the first tranche of restrictions.

QUESTION:  And he also implied that community sport is an area that have particular benefits, health wise, of mental health, to restarting as soon as possible. Would the AHPPC looking at giving very prescriptive instructions to sporting organisations of how to socially distance? How will they be assisted to apply those measures?

NICK COATSWORTH: Well, if we did take community sport as an example, then we would absolutely need to provide, I suspect, more detailed guidance. I think the guidance that we've provided at the moment is very clear, in terms of social distancing and individual cough hygiene, et cetera, that Australians know so well, and it is working. But similar to the advice that we've put out on schools, where there is a specific demand or need for advice, then the AHPPC is prepared to provide that advice in some degree of detail.

QUESTION: With the tracing app, the Prime Minister says he wants 40 per cent of the Australian population to download that app for it to be successful. Is that the sort of take-up rate that you would like to see? And if that doesn't happen, are health authorities looking at other methods of expanding contact tracing if the app isn't successful?

NICK COATSWORTH: Well, I think we just need to walk back to the purpose of app and consider what we have at the moment, which is an excellent and robust contact tracing mechanism that's done manually. But, you've got to remember that not everybody's memory is perfect for who they've been in contact with for the past 21 days-sorry, for the past 14 days. So, the app actually assists those disease detectives in determining who was at risk by effectively providing a memory aid so that no one is missed, so to speak.

Now, we also remember that that is data that is locally controlled on someone's mobile phone and is only released- so there's two levels of consent here. Firstly, someone has to download the app to participate. And secondly, if you are called by public health authorities to say you have COVID-19, you then have to release that local data to the state jurisdiction that's responsible to you. The Commonwealth will not be looking at that data at all. It'll be for state public health authorities.

So, in answer to your question about the 40 per cent, the more, the better. The more, the better. And I think that as we are able to explain to Australians the narrow scope of this, the very singular scope, and reassure them that every time someone comes to us and asks to put an ad in onto that app, the answer is no. And the Attorney-General, I think, was very clear this morning when he said the police would have no access to the data of this. And there have been requests, there have been requests to have added capability to the app and the answer has been absolutely consistent: this is for the disease detectives only.

QUESTION:  Is there a timeline or a date that you would like to see that 40 per cent target, or potentially more, achieved?

NICK COATSWORTH: I think we should see what happens with the rollout. But I have to say I am confident that just as Australians have adapted so well to COVID-19, this has been an astonishing behavioural change in a short period of time. I think they will also see the value of having this app as well.

QUESTION:  What would be the benefits of the World Health Organisation having similar powers to weapons inspectors and being able to basically go into a country uninvited? And how realistic is that actually happening?

NICK COATSWORTH: Well, the World Health Organisation has a really important role to play in assisting governments around the world in managing disease outbreaks. How that can be improved upon as a result of this particular pandemic is, as you know, going to be the subject of a lot of lessons learned, potentially inquiries as our Prime Minister has suggested.

So, I think we don't want to pre-empt what the results of those would be, except to say that we acknowledge the World Health Organisation has a really important role to play and we should consider whether its current structures and processes and rules are effective enough to pursue that role.

QUESTION:  The Home Affairs Minister today said that the Director-General of the World Health Organisation should resign. Do you- what do you make of that?

NICK COATSWORTH: I would make of that that there's a whole range of views in the community at the moment; that it reflects the deep concern that everybody has about this pandemic and the need to do as well as we can next time.

QUESTION: One of the problems Australian has had in terms of its own data on COVID is that it's a lot of overseas cases. There hasn't been enough in the community to really get a sense of how the virus spreads. Are we getting to a point yet where we can draw sound scientific conclusions from the cases we've had, or is that base number still too small?

NICK COATSWORTH: We're at the point where we can draw sound scientific conclusions about that. They- my understanding is that we will be able to share those at some point in the not too distant future. I'm afraid I don't know the exact date. But what I can tell you is the basic reproductive number, the R effective, is below one in every single jurisdiction at the moment except for Tasmania obviously because of the outbreak in northwest regional. And because of the amount of time that that's been the case, we can be confident with that result.

QUESTION: Just one more question. What's your response [indistinct] was given an exemption from quarantine laws [indistinct]? And is that appropriate?

NICK COATSWORTH: I'm afraid I'm not aware of what exactly happened in that scenario so I'm not able to comment on that.

I'll take one more question if there is one. I've exhausted you again. Okay. Thank you very much.


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