Date published: 
30 April 2020
Media event date: 
29 April 2020
Media type: 
Transcript
Audience: 
General public

PROFESSOR PAUL KELLY:

There are 6,746 cases that have been diagnosed in Australia, and there has been an extra death, so we're up to 89 deaths today. We continue to test. Over 544,000 tests so far. And it's worthwhile considering where we are in Australia compared to the rest of the world right now. There was another milestone, I guess, overnight or yesterday where there is now over three million cases that have been diagnosed — about a third of those in the US — and over 200,000 deaths. An incredible figure when you think that the first cases we heard of were just in early January, only 4 months ago. So, we're continuing to do well in Australia. We're in that suppression phase and we have well and truly flattened that curve.

The second thing I'd like to talk about is the importance of partnerships. We are all in this together, that's been said many times before. And there was an announcement this morning by Minister Hunt about a very exciting partnership with Twiggy Forrest, one of Australia's richest men, but he has this philanthropic organisation, Minderoo — it's named after his family farm, I understand it, in Western Australia. And he, through that foundation, has made a partnership with a Chinese company which makes PCR tests, the diagnostic test that we have been using all along, those over 500,000 tests so far in Australia. But Twiggy Forrest, through this Minderoo Foundation, has now a secure supply line. That was a problem for us some months ago when we really needed to do a lot of laboratory testing. And now he has that and has an ability to have 10 million diagnostic tests, which is a remarkable change to where we were only a few weeks ago. So, those tests will be very important as we plot the way out of our current restrictions.

And the Prime Minister earlier today did talk about the date that he… will be when some decisions will be made, 11 May. So, we're on a countdown to lifting some of those restrictions. And so that laboratory testing component of the case finding ability will be a very important precedent to be able to lift those restrictions. As will indeed the low case numbers as we're continuing to see — under 20 again in the last 24 hours. And that third precedent that has been talked about of being able to respond to outbreaks if they occur into the future. And so that laboratory testing capability will be absolutely vital to not only find cases so that they can be quarantined, but also to deal with any outbreaks as they occur.

Because in this suppression phase, those outbreaks may occur. They may continue to occur. And finding them is not a failure of that particular approach, but indeed a success because the sooner we can find those outbreaks and make them as small as possible, the smaller number of people affected, the more likely it is that we'll be able to relieve those social distancing measures.

Another important component of that, and I'll stress that and I'm sure everyone will be stressing this aspect over the coming weeks, is the importance of the app which was announced on the weekend. We now have over 2.8 million people in Australia have downloaded the app. That's a remarkable statistic, that's over 10 per cent. So, the more people that can download the app, the more it's going to be successful in assisting our disease detectives to find the contacts of people, of cases as they are diagnosed.

The final thing I just want to talk about today is about the phase we're in. You might remember a few weeks ago, as we were on that very worrying upswing of the pandemic in Australia, where we were getting several hundred new cases of COVID-19 diagnosed every day. And at that time there was a lot of change, a lot of new things were announced. Premiers sometimes in different jurisdictions announcing slightly different social distancing measures, slightly different figures and so on. And so the word confusion was used a lot then. Confusing messages. And I've heard it again a lot over the last week or so. And that in one way is not surprising because we're on a new phase in this epidemic, a much less frightening phase, but a phase of change.

So over the next few weeks — and as we get closer to that 11 May target and after that as well — there will be many announcements about changes in the way that we'll be living our lives and hopefully getting back to some sort of new normality of living in a COVID safe society. So, there will be a lot of information. The information may be slightly different in different states. That is not a mixed message, that is a changed message. And we will, as we have always done, undertake to share those differences and share those announcements as soon as they come to be. And I'm sure across Australia, people will understand that.

So, one example is on schools. We're all committed, I'm sure, with slightly different approaches in different jurisdictions, to get the kids back into the classroom. That's a really vital thing to do for many reasons. We believe from the health side that it is safe to do so and that it is not putting teachers at risk either. But for a whole lot of other reasons it makes sense. And I'm sure teachers, parents and children themselves will agree that that is the best place for children to be learning and to get the best outcomes from that learning.

Wider than that — and we've heard from Christine Morgan, the Mental Health Commissioner, today, talking about the mental health issues of this COVID crisis we've been in — and that mental health and wellbeing component of children is really an issue and we need to think more broadly than COVID-19 itself, but to those mental health matters for children and for their parents as we move to a more normal COVID free society. So, this is a time of very low cases; this is the time for kids to be getting back to school. So, I'm happy to take questions now. Thanks.

QUESTION:

What is your assessment, Professor Kelly, of the risk of a second wave of infections as we've seen in some other countries like Germany and Singapore? Especially as we move into winter and we look at starting to ease restrictions.

​​​​PROFESSOR PAUL KELLY:

So, the second wave, look, I'm sure will be a topic for quite some time. In one sense, we're victims of our success there to an extent. Because we've had so few people that have been diagnosed with COVID-19, and we are nowhere near that concept of herd immunity, so that would be one way of guarding against a second wave. We're definitely not looking to do that in Australia, as some other countries have either planned to do or have been forced to achieve through very large caseloads. We've seen what that has done in other parts of the world, some of the places that you've mentioned. So we won't be going to that.

A second wave is always possible and that's why those three precedents have been set by the Prime Minister before we lift those social distancing and social isolation rules about case finding, keeping the cases low if possible, if cases occur, finding them quickly, finding their contacts, quarantining them and decreasing the size of any outbreaks that we might have by having a very detailed and quick response. So if a second wave does occur we'll know about it quickly and we'll respond to it. Of course we're always looking for a vaccine to be developed, that will be some time away but that would be the way to guard against a second wave completely.

QUESTION:

Given the history of past pandemics, is a second wave something often harder to fight than the first wave?

PROFESSOR PAUL KELLY:

Not necessarily. Certainly if you look at past pandemics, you have to go back a ways. So thinking of the 1918–19 flu pandemic just after the Second World War, sorry First World War, there were a lot of reasons why that second wave was worse, which I don't think pertained to now. We are very prepared, much better prepared than we were then, in relation to what might happen in a second wave. And certainly that ability to do the laboratory testing as I said, rapidly and accurately, to be able to find cases, find their contacts, another reason to download the app, will really help us to fight a second wave. And I'm sure that there are many clinical trials going on with various treatments at the moment. So by the time — the longer we leave that second wave into the future the more likely it is we'll have successful treatments.

QUESTION:

Has contact tracing capacity increased to the point where it could handle a second wave in Australia?

PROFESSOR PAUL KELLY:

Yes, I believe it is. And again, the app is a good thing to download. Look the app doesn't replace good contact tracing. We have real expertise in Australia in relation to public health broadly and including contact tracing. Every state and territory has a very good unit and the heads of those units, the chief health officers, meet with us every day in the Australia Health Protection Committee. And in the larger states are public health units on a more regional basis. So that's all set up. The app is only a technological assistance to that expertise that's already there. So I'm very confident in our ability there.

QUESTION:

Professor Kelly, with the acquisition of the [indistinct] of these tests, how many tests therefore would you hope Australia is able to do on a daily or weekly basis, to be able to remove those restrictions and therefore how long can we expect that supply would last? Could it potentially mean we require more millions of tests in 6–12 months' time?

PROFESSOR PAUL KELLY:

So I think the plan from the Minderoo Foundation was to think about using those tests in the calendar year. I do want to stress though that the availability of the tests is not what will drive the testing. So over the last couple of weeks in the Australian Heath Protection Committee and here in the National Incident Room, we have been working up a very detailed surveillance plan about how we would use laboratory testing to measure what's happening out in the community, to be able to respond to outbreaks and so on. We have opened up the testing criteria now to anyone who has a respiratory illness. So coughing, shortness of breath, fever, these types of, or cough, these types of symptoms, anyone with those symptoms should be looking to get a COVID-19 test now. And expanding through that.

QUESTION:

[Indistinct] a number, how many would you would like to see in the Sentinel Program for example?

PROFESSOR PAUL KELLY:

Yeah, so the Sentinel Program is part of that and we'll be doing some cohort testing in high risk groups as well. And that plan will go to National Cabinet and there will be more detail about that later in the week. But just to say that we will be expanding on testing but we're not testing for testing's sake as it were. So I'm sure that's adequate supplies for what we're looking at.

QUESTION:

Just on the Newmarch Nursing Home series of deaths that we've seen in recent days, why is it that these elderly patients are dying in hospital and they haven't been perhaps transferred to an ICU to be placed on a respirator?

PROFESSOR PAUL KELLY:

So my understanding is most of them have actually died, passed away in the actual aged care facility. I don't know the details and wouldn't go into the details. Obviously I'm very sad for the loss of themselves and the family. But my understanding is that that was their wish, that that would happen. And most of the people that have died in that and the other aged care facilities that we've had outbreaks, are very elderly and that's a decision they've made. So of course ICU, we have tripled the capacity of ICU, that's one thing we've been able to do that no other country in the world has had that opportunity, other than perhaps New Zealand, by flattening the curve to allow us to get that time to increase our capacity. So it is certainly not a capacity issue. If people would need ICU and they wanted that care, then that would have been arranged.

But I'd say one other thing about Newmarch: it's an extensive outbreak and it really demonstrates how quickly in those vulnerable groups things can change. So on a good day as we've had in the last 24 hours, 19 cases can very quickly get into the many more than that. That's why we have to really protect those vulnerable people but also have the testing capability to be able to find cases when they occur and hopefully prevent it getting into aged care facilities.

QUESTION:

Are there lessons to be — sorry to interrupt — anything to be learnt from that case? Given that there has been such a big outbreak [indistinct]?

PROFESSOR PAUL KELLY:

Yes, certainly people, if anyone is working in an aged care facility or a healthcare worker, really taking even the most minor symptoms to get tested. And it's certainly not a blame game at all. The circumstances of that particular case will come out in time. But in general terms for those of us that care for vulnerable people, really taking that seriously and thinking through getting testing early. Even the most mild symptoms can be quite infectious, as we've found in this case when we're dealing with vulnerable people.

QUESTION:

Just back to the issue of schools, the Victorian Chief Medical Officer does seem to be giving different advice to the Premier than the AHPPC advice on schools. Are they seeing different information or what's the reason for that?

PROFESSOR PAUL KELLY:

So, Brett Sutton, the Chief Health Officer as he is actually down in Victoria, is on our daily meetings and we talk about this a lot. And I'd just go back to the first principles. The first principle one is there is very little COVID-19 circulating in the community at the moment. But it's not zero. So there is still a risk out there in the community and I can understand the reluctance in the part of some of the states where there are more cases than others, and so Victoria is one of those. Second of all, we all agree, we absolutely all agree that the best place for kids to be is in the classroom when that is safe to do so. Now Victoria will make their decision on that basis and Premier Andrews has talked about going a little bit slower than other states. That's his prerogative. He's the elected representative in Victoria. So, the advice is the same. The interpretation of that advice might be slightly different depending on local circumstances.

QUESTION:

Just on the Group of Eight academics are talking about pushing for an elimination strategy, is it worth keeping lockdowns in place a bit longer, until [indistinct] actually eliminate the virus and potentially [indistinct]?

PROFESSOR PAUL KELLY:

So, the Group of Eight universities, off their own bat, they put together a group of experts to actually come up with some advice to government and we welcome that advice. It's a very detailed report that was released, I think, today, but we’ve seen it a couple of days ago. Very helpful information. But in general terms, in line of what we've been advising government from the AHPPC, and in that document, they do talk about the three main potential strategies. One of them herd immunity. We talked about that one already. We're not doing that one. That's essentially way too many cases, too many deaths. We decided early on that that would not be Australia's way. And that leaves us with two.

The suppression strategy, which we're currently on, which means let's make a balance between the effects of COVID-19 directly on one hand and the other health, economic, social effects of the quite stringent measures that you'd have to put in place to eliminate the virus altogether — so it's a balanced argument — and then look for those outbreaks and stop those quickly when and if they occur in that suppression strategy.

The third one is an elimination strategy. That's something that New Zealand went down that line. Some other countries have suggested that’s maybe where they're heading as well. When you look at where New Zealand is now, they've started to release their social distancing measures this week, which basically aligns them with where Australia is. And we've had a very similar experience in terms of the number of cases that we've had and the number of cases we're continuing to have. So, we're not, at this stage, pursuing an elimination strategy but we welcome the [indistinct] advice on that.

QUESTION:

Professor Kelly, just on schools again, research released this week by the Federal Government [indistinct] universities around the country show that if kids are away from school longer, it detailed a series of issues that they would have to their education but also to their health. Some say it would be detrimental to their physical health and also to their mental wellbeing. And we're seeing different states bring back schools in different grades, and also within certain states, say Victoria, we may soon see that a lot of private schools come back but public schools remain closed until at least next term. What would be your health concern, from your medical perspective, on having a disparity between the rate at which schools come back and the effect that would have in the disparity of education on the children?

PROFESSOR PAUL KELLY:

Yeah. So, as I've answered in the previous question, Victoria will have to make their own decision in relation to their schools that they run. There has been a lot of discussion with the independent sector and the Catholic sector as well about that and there is federal funding that goes to those schools, so we have some influence there. Look, as I said before, I think everyone agrees the best place for kids for all sorts of reasons — their educational outcome, their mental health and wellbeing, their social development, their physical development — the best place for them to be during those school years is in the classroom and being with their friends and getting the best outcomes. And we believe from a health perspective that is now safe for that to occur. Different states will make their own decisions in relation to their own schools that they run. Victoria is a little bit different from others and ACT is a bit different from others as well.

Have you got a question there?

QUESTION: 

Just got one from Nick McCallum from Seven.

PROFESSOR PAUL KELLY:

Yeah. Hi, Nick.

QUESTION:

Professor, thank you for this. I just wanted to know how closely your office, the federal medical office, is working with the AFL in particular and the NRL in helping them jump through all the hoops to make sure they can get their competition back up and running. Are you working very closely with them?

PROFESSOR PAUL KELLY:

Yes. We are working with the AFL, NRL and other codes and specifically with the Australian Institute of Sport. It's done a very great — thank you to Dr David Hughes, who's done excellent work with a team there at AIS, to look more broadly not just at the elite level of sport, but to community sport and Olympic sports and so on about what would be a safe transition back to sporting codes, including the elite ones — AFL, NRL and others. So, we had a detailed discussion about that today in AHPPC and there will be advice going to the National Cabinet on Friday with some general principles and some advice on those matters.

QUESTION:

Yeah. And how important, I suppose, is the opening of the interstate borders, specifically with the AFL? How important is the opening of the interstate borders and what are you advising on that at the moment?

PROFESSOR PAUL KELLY:

Well, both the AFL and the NRL and other codes, so netball, would be the same and the rugby union and other sporting organisations at the elite level are national competitions, and so or at least several states involved. So, those internal borders in Australia will be an issue that will have to be dealt with in relation to that. As it stands at the moment, if the Dockers, my team, came over from WA to play at the MCG or wherever a crowd-free event may occur, when they went back to WA they'd have to serve two weeks of quarantine. So that would be difficult. So I think there'll obviously have to be discussions at the state level about those matters if these competitions were to proceed.

QUESTION:

The Prime Minister said today while international travel was a long way off, he hoped there would be a point that Australians could travel within the country. In terms of the contact tracing capacity, are you confident and are there measures in place for potentially interstate sharing of information? So if someone is travelling or a holiday in another jurisdiction, that that contact tracing could happen as quickly?

PROFESSOR PAUL KELLY:

So, it's a very good question. So that happens now. Some years ago, we developed a legal framework of data sharing between states in relation to infectious disease outbreaks. And so those same things would pertain, wherever that information about contacts came from, whether it was from the app or from the more traditional way of asking those questions. So on a very specific way that they would occur, if I was in Queensland and I became a contact of a case in Queensland, and I had the app — as I do, and I hope all you do — and the contacts also had the app, then that information would go to Queensland as the place where the case was, with that contact information including my mobile phone number and I'd be contacted.

QUESTION:

There's a push on in the United States to develop a permanent pandemic department and there would be a secretary of pandemic, et cetera. The Minister this morning said we do have a permanent pandemic body in Australia already. Could you just give us a little bit more information of what that permanent pandemic kind of agency is?

PROFESSOR PAUL KELLY:

So it's the Australian Health Protection Committee, that you've heard of a lot. I'm a member. It's chaired by Brendan Murphy, the Chief Medical Officer. Has the chief health officers of all the states and territories. And under that committee, there is a range of other expert committees that give detailed and very specific advice to that committee. So that's the standing committee. We have that all the time.

QUESTION:

Is there a need for kind of a permanent pandemic body? Basically we've already got that structure?

PROFESSOR PAUL KELLY:

Yes, I believe we do. There have been calls in the past to set up something like the CDC or Centres for Disease Control in Australia so that we can be like the US. I think it's interesting that the US is now talking about setting up something which they've already got. So I think we have that structure at the federal level and it’s mirrored in each of the states and territories. There is expertise in each of the states and territories, and we have a virtual centre, if you like.

QUESTION:

Back on the NRL, there's a lot of confusion as to how the games will start up again. Can you give us any indication about what the committee has been thinking regarding, like, can the games start up again in a safe way? Is that realistic?

PROFESSOR PAUL KELLY:

So I'm not going to pre-empt the discussion that will happen at the National Cabinet on Friday, but there were a range of, there's a framework that we've developed, which I think can work for community, sport, and for the other codes. The elite level will have to think of specific other things related to, for example, if they had someone who did become COVID-19 positive in a team, having had an extremely contact sport engagement during the time of infectivity, and NRL or both NRL and AFL both are contact sports. So that would be an issue for the sport itself in terms of what would happen for that team or the team that they played. So those are specific issues. But in a general sense, what we would need to work through with the codes, and with anywhere that sport was being recommenced, is to have a very detailed plan about that, and hygiene measures and so forth to minimise any problems.

QUESTION: 

Are you talking directly to the codes? [Indistinct] chief medical officers [indistinct]?

PROFESSOR PAUL KELLY:

So, yes, I haven't spoken to all of the codes. I did speak to one of the CEOs in recent days. But other members of the committee have spoken directly with the other codes.

QUESTION:

Do you have updated numbers on hospital admissions and ICU?

PROFESSOR PAUL KELLY:

Yes. I think I do. Let me just see. So hospitalised, and this is as of this morning, it would be slightly updated now, but it's 104 total hospitalised as of this morning. 40 of those in ICU, and 26 intensive care with ventilation. So well below the 7,000 limit.

QUESTION:

[Inaudible] The World Health Organization last week came out and said there was no evidence that people could catch the virus twice, but I understand that some people who have left South Australian borders have been told that if they have already had coronavirus and then come back into the state, that they're not required to do the mandatory two weeks of self-isolation. What's the understanding in Australia about that at the moment? Because that seems to somewhat contradict what the World Health Organisation has said.

PROFESSOR PAUL KELLY:

So the World Health Organization came up with a couple of statements which were slightly contradictory last week. So the one you mentioned, but also that they were commenting on the concept of this immune passport. So they also said that there was no strong evidence yet of long-term immunity after you've had a case of the virus. So those two things are still uncertainties about COVID-19, and we're continuing to learn things every day. But in terms of South Australia's own stance, you'd need to ask them about that. I'm not sure how they work their quarantine.

QUESTION:

What's the AHPPC advice for states at the moment on [indistinct]?

PROFESSOR PAUL KELLY:

So our general census is you get it once and you don't get it again. But how long that immunity lasts is not certain. And indeed, the serological testing of antibody response does not, and the WHO is quite clear on this as well, those tests don't necessarily say you're immune. So yes, it seems possible that you can get it again but rarely, and then that long term immunity question is obviously an important one when we start talking about a vaccine development. If we can't make an effective immunity against this virus, then a vaccine won't work either. So that's a crucial question, there are now over a hundred vaccine candidates that are being tested around the world, mostly on phase 1 testing or animal testing. So those sort of questions will be absolutely crucial in the development of a vaccine which we are hoping for, will happen over the next months and into next year.

 Okay, thank you very much.

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