Doorstop interview about coronavirus (COVID-19)
Read the transcript of a press conference with Professor Brendan Murphy, Chief Medical Officer, and the Minister for Health, the Hon. Greg about coronavirus (COVID-19).
Figures of the current numbers of which we are aware are 80,410 diagnoses – although we do expect newer figures as the afternoon progresses from China – and sadly, 2707 reported and confirmed deaths from the coronavirus.
In particular, we know that new cases have been reported in Austria, Switzerland, Croatia.
We have an unconfirmed report which we are seeking advice on of Brazil being included.
And as a consequence of increased numbers in Italy, where I think the latest figures we have are 323 cases and ten lives lost, primarily concentrated in northern Italy, the Australian Government, on medical advice, has lifted our travel advisory for northern Italy.
So just to repeat, the Australian Government, on medical advice, has lifted our travel advisory for northern Italy.
In particular, that is exercise a high degree of caution, Level 2 of our travel advisory, for the provinces of Lombardy and Veneto.
In addition, with regards to Iran, we already have higher levels of travel advisory for non-medical reasons, but we have issued additional advice with regards to exercising a high degree of caution in relation to any travel to Iran, where we’ve had an increase in the numbers and significantly high number of deaths, which, as the Chief Medical Officer indicated yesterday, may be a strong guide that the number of cases is greater than those that have been reported.
In regards to Australia, we still have had the 15 cases in the general population, and as the Prime Minister said yesterday, all have now cleared the virus and been discharged.
I can confirm that we have an eighth case from the Diamond Princess group that have been in quarantine.
It is a Victorian man. His partner had previously been diagnosed, so he had already been in quarantine as part of the Diamond Princess and already in isolation, having travelled to Victoria with his partner.
So, he could not have been in a more contained environment, but nevertheless, has now been confirmed.
And shortly before coming here, the director of the National Trauma Centre advised me that a further case is being investigated, but they are carrying out many tests on a routine basis.
And if that's either positive or negative, we’ll provide the answer once the testing has been.
But at the moment, there are eight cases confirmed from the Diamond Princess. All are well.
In relative terms, all are in a mild situation, on the advice that we have, and all are being well cared for.
So, those are the main things. Other than to make the point that, as discussed, The Australian Health Protection Principles Committee has developed the Australian health sector emergency response plan for COVID-19 on the weekend.
I met, via teleconference, with all of the state and territory health ministers, as well as the chief health officers.
We conducted a preparedness assessment, and I have to say that all of the states and territories are fully implementing and preparing for all of the elements of the plan.
So I want to thank them for their work. Brendan.
Thanks, Minister. So, as the Minister said, our major concern at the moment is the international situation in those countries which have significant outbreaks, and we’ve seen further growth in the Republic of Korea and in Italy, and obviously, that presents a risk to spread to other countries.
And our concern now is the number of countries outside of China making it more likely that we will have further outbreaks in Australia.
But as the Minister has also said, we are still contained in Australia.
We have no community transmission of this virus in Australia.
And that's a really important message for the public: that there is no reason to change anything you do, wear masks, or behave in a way that is different from normal.
But we are preparing. We are preparing because of the developing international scenario and we’re working very closely with the states and territories who run the public hospitals with primary care, general practices.
Aged care is a big part of our plan. And obviously, we are working on the basis of the plan the Minister talked about.
That plan has to be flexible. It has to be flexible because we don't know, if we do get further outbreaks here, what form that will take, how many people would be involved, how easily it would be contained, how easily we would be isolating people.
So the plan is very focused on flexible response, and it's also focused on proportionate response.
So, if we don't know what sort of severity this virus will have when it spreads into other countries, we’re getting a better picture at the moment.
We know that the majority of people who get COVID-19 have a very mild disease. That's the great majority of people.
But we also know that a small proportion do get severe disease and we have to be prepared for all eventualities and that preparation, which has really been going for years on the basis of our pandemic flu plans, which we've had for a long time.
They've been modified for this virus and we are now doing sector specific responses, predicting a range of scenarios.
And sometimes, you hear lots of speculation in the media about various scenarios and numbers.
We don't know what scenarios will eventuate but our plan has to be such that we are ready for whatever happens.
I know you have produced a plan (inaudible) this is quite interesting reading.
In some senses, it’s quite shocking. But can you take us through, if a pandemic is declared – and it’s not that this would be a matter for WHO to decide – but if it is declared, can you take viewers, listeners, readers through what would happen in Australia from enhanced screening, social distancing and the like?
PROFESSOR BRENDAN MURPHY:
Sure. So, if a pandemic is declared, but we are in containment in Australia, we will just continue what we're doing now. It's just a label.
A pandemic is a label that simply says that there’s sustained community transmission in several countries.
We are already preparing for the eventuality that we have further outbreaks in Australia should they happen. So that's what the preparation is about.
So, declaring a pandemic doesn’t change what we do.
What changes what we do is if we get further outbreaks in Australia and work out where they area and how we deal with them, how we contain them and the size of those outbreaks, and then we bring into play those aspects of this plan that are relevant to the circumstances at the time.
So declaring a pandemic doesn't really change what we're doing at all.
More cases in Australia, community transmission in Australia, definitely changes (inaudible).
(Inaudible) if you did have the instances of more transmission here in Australia.
PROFESSOR BRENDAN MURPHY:
Well, again, it would depend on the circumstances. If it’s a small outbreak, we would move quickly to contain it as we have already.
So the relevant public health unit would do contact tracing, we would isolate the people and try and prevent further spread.
If you had much bigger spread, you change your response, and the plan deals with that.
So, you're then moved into a phase where you're not trying to fully contain but you’re trying to limit the speed of transmission. So all of those eventualities are predicted in the plan.
Further to that, with this plan, it’s talking about the potential of school closures or workplace closures. What’s the threshold for that to occur, and would that be nationwide, just in certain areas?
PROFESSOR BRENDAN MURPHY:
Again, as I said at the start, this is a flexible plan. It depends on the circumstances at the time.
So, if you had an outbreak in a particular city or state, you might- that got to a certain size, you might then close the schools.
You might change the configuration of the hospitals to deal with that.
If it’s in several cities and states, you do it according to the local needs at the time.
And that’s what we have learnt from repeated flu pandemics, is you have to adapt the response according to the circumstances almost on a daily basis.
Minister, can I ask you- Minister and Chief Medical Officer, can I ask you about aged care? You mentioned it briefly, Professor.
We've seen oversees the impact that this virus can have on the elderly. What measures are you taking in relation to aged care homes to try and prevent this spreading, particularly among those vulnerable people? And is that an area of risk?
So, we know that COVID-19, in particular coronavirus, as with flu, particularly affects the elderly, and it affects them because obviously their immune system can be weaker. So that has been one of our primary areas of focus in dealing with the states.
We've been working to make sure that they have primary care facilities.
The Department of Health has been in direct contact with aged care facilities and what we are focusing on at the moment is a number of things.
Firstly, that there are the containment processes to help prevent in terms of the safety; the processes with regards to hygiene at present.
Secondly, that if there were an outbreak there’s an awareness and the ability to identify, isolate and then ensure that the other residents are safe.
And so, that's been one of our highest priorities because it is an area where we know that with the flu season in Australia, that has not uniquely, but overwhelmingly had its most significant impacts on our older population.
Mr Murphy, I know it's difficult question, but conceivably how long could this crisis continue? Should we be preparing for months or weeks or.
PROFESSOR BRENDAN MURPHY:
Again, very hard to speculate. And one of the things that we would be very focused on if we got an outbreak in Australia is trying to slow the pace of development by containing cases, isolating, because a slowly evolving outbreak has much less pressure on the system.
Even though it might have a longer impact, it is much easier to handle.
So, the modellers can give you predictions that could go from a few months to several months, and what we don't know- there is always a possibility with a new virus that it could persist and come back on a seasonal basis. These things we don't know.
So Minister, as part of your planning or preparedness on this, have you considered the possibility you might have to cancel events that have major crowds like the AFL?
So, the possibility of events is always there, but that is a last resort.
And so, the way we think of this is as rings of containment.
And so, there’s a very well thought through plan which we've enacted in relation to those community transmission cases, and I think that is important to recognise: that at this point, although we are not immune to the virus, we are well prepared.
We are as well-prepared as anybody. And we've implemented that already.
And so, the idea of rings of containment is with individuals, families or affected units, and if we can contain those, then we can limit the impact.
So, what we've done, as you would hope that a government would do, is to prepare for all eventualities.
But so far, in Australia, we have contained the virus on the official medical advice of the AHPPC, but this plan is about saying: we're not immune but we are as well-prepared as anybody in the world.
I just wanted to ask about the travel advice for South Korea and Japan.
Will you look at updating that, and are you concerned about how the Japanese authorities let people off the Diamond Princess and onto the train system?
PROFESSOR BRENDAN MURPHY:
So, the travel advice has been upgraded to Level 2 at the moment, and that, whilst we're watching, both those countries are trying very hard to contain their outbreaks.
The South Korean one is particularly in two cities, which they have put very significant measures in place.
We will be considering the situation, as we will be today, at HPPC, and we do every day, but at the moment there’s no proposal to increase the travel advice.
In Japan, I've been asked to comment many times about the Diamond Princess. I wasn't there. I don't know what happened there, but what we do know is that eight of the people who came to Australia from that cruise ship have developed the virus. So there is some concern.
Some of those were contacts and they wouldn't have been let off the ship.
But there is concern that some of the people who might have got off the ship could have been incubating the virus.
We haven't seen evidence of significant further outbreaks in the Japanese community, so we're watching that situation.
What about the Olympics? Are you assessing whether it’s safe for Australian athletes to travel to the Olympic Games?
So, our first priority, not just for the general population but of course with the athletes themselves, is the health and safety of the athletes.
Secondly, however, the Olympics are some roughly five months away, and so assessments will be made closer to the time.
And that would involve first and foremost Japanese health authorities and the IOC, but we would be part of that.
And so, rule number 1: Safety, care, protection of our athletes.
But, at the moment, our travel advisory is very, very clear. It's a Level 2. It's not at a Level 3 or 4. If that needs to change, we have done it without fear or favour no matter what the circumstances or the country involved, as you’ve seen overnight.
However, our message to the athletes is: we will put your health and safety first, but for the moment, just keep training because our hope is that there is a very fruitful Olympics ahead of you.
But if there is any risk, they will be the first to know, and we are in constant contact with Australian sports authorities.
Two questions. One is: what is your assessment of the likelihood that the virus is actually here already, given the experience overseas, where it takes a critical mass, as it were, before we actually start to test regularly in the wider community?
I might give Brendan that one.
The other question is: what is your assessment of the safety of allowing university students into the community if that decision is taken under the self-isolation? What kind of likelihood is there of some (inaudible)?
PROFESSOR BRENDAN MURPHY:
So, the risk that there is the virus in the community at the moment, it's always a possibility, but we have tested several thousand people.
We've had a very advanced testing program and our doctors and hospitals around the country have had a low threshold for testing anyone who's had a relevant travel history, and we haven't found anybody except those 15 original Hubei cases and the eight cases from the Diamond Princess.
That's not to say that someone who’s come originally from China through another country isn't here already, and we are always on the lookout for that.
And anyone who's got an unusual pneumonia in a hospital is now being tested.
But we haven't seen any evidence of that. I think the sense- and AHPPC is going to consider the student issue later today.
I think the feeling is that provinces outside of Hubei and China are seemingly more under control, but we have to be very confident about the data before we accept that.
So, if there's any more relaxation it would be very gentle and under the supervision of the state public health authorities, but that's a decision for the Government to make, on the medical advice, would be that we should be fairly cautious at the moment.
So I’ll just make two points in response to that. I think it’s a very important question.
Firstly, as Brendan says, there have been several thousand, I’m advised over 3000 tests, conducted in Australia, of which only 15 in the general population have come back as positive, all the rest have been negative.
And those figures will be updated within the next 48 hours by the states and territories, who are carrying out that testing.
So there’s been much more testing, I think, than has been necessarily understood until now.
And that's fine. We would rather over test than under test.
And wherever there is information, our job is to share it, to provide it, and all of this has been in the context of acting early, acting hard.
And that principle was one that we established in the NSC right from the outset, and the declaration of coronavirus as a disease of human pandemic potential on 21 January, was one of the first in the world.
And that then followed with the plan which was put already in place with regards to the National Incident Centre, the National Medical Stockpile, the National Trauma Centre, the daily meetings of AHPPC, and all of the other steps. So, they’ve come together on that front.
Professor, should any hospital in Australia that doesn't have a permanent isolation facility now be putting in place a temporary one?
And if I could ask one more question, what sort of outbreak size would you need to see in a city such as Sydney before its schools would need to be closed down?
PROFESSOR BRENDAN MURPHY:
I think- it’s very difficult to speculate in terms of number.
Every hospital has some form of process for isolation. There are some that have much more sophisticated isolation.
Every state and territory health system has one or more hospitals that are designated high containment facilities.
But every other hospital does have standard policies and practice for what we call barrier nursing or using PPE or isolation. So they all have those policies.
Obviously, they are all brushing them off now and making sure that they’ve got the right equipment.
I don't think you can put a number on what size of an outbreak would lead to school closures.
It depends where it is; depends how localised it is. So I think getting speculative about numbers isn’t really helpful at this stage.
So one last- Andrew.
Just on the quarantine powers. This state’s long ago seeded quarantine powers to the Commonwealth.
Can you confirm, and I think we heard some of this discussion on Q&A the other night that Australia does have, the Commonwealth does have power to forcibly quarantine people, forcibly?
And also, and I wanted to ask you, Brendan Murphy, just about child care. Like, child care obviously – aged care, child care – they’re both critical infrastructures-
Actually, both the States and the Commonwealth have power.
The triggering of the Bio Security Act with the Chief Medical Officer's declaration brought that into being.
But the states themselves have their own bio security arrangements and, for example, they have been monitoring the home isolation. And they have powers if they need them. We have powers if we need them.
PROFESSOR BRENDAN MURPHY:
So, one of the interesting things about this virus is the very small number of children that appear to have been infected, certainly in the Chinese experience.
Now, that either means that children aren't particularly susceptible, or that if they are, they’re getting such mild disease that it’s not been detected.
Whatever the reason is, that's a good thing, and we haven't seen a lot of evidence of-certainly, we haven't seen evidence of severe infection to any significant extent in children.
But we're still learning about this virus.
And clearly though, if there’s evidence of transmission amongst children; children are in influenza the super-spreaders.
They’re the people who often spread the virus more, so you would be very cautious about containing situations where children might spread it.
But the good news so far is that it doesn't seem to be a major child predilection.
Just on a separate health issue, Minister. You may have a view, Professor. On the baboons, there’s been a lot mirth about the escaped baboons. But actually, a lot of people I think have been surprised, and in some cases upset to learn we’re still doing medical research on primates.
Why is that still a necessity in this country?
So, other than the story as reported through the ABC, which was where I learned about the baboons, I don't have any extra information. I have to say, my heart was with the baboons. And so, beyond.
The male one in particular?
They operated as a modern relationship. And I'm fine with that.
Having said that, though, more generally, let me finish with this point that I understand this can be a stressful and a concerning time for many in the community.
The reality is, at this point, we are contained in Australia. There are no leave passes though.
In a global situation we’re not immune, but we are as well-prepared, as well prepared as any country. And in the end, we will get through this.