Press conference with Chief Medical Officer Paul Kelly and Minister Mark Butler
Read the transcript of the press conference with Chief Medical Officer Paul Kelly and Minister Mark Butler on Tuesday 19 July 2022.
PRESS CONFERENCE, PARLIAMENT HOUSE
TUESDAY, 19 JULY 2022
SUBJECTS: Omnicron; vaccines; third and fourth doses; provisional approval for Moderna for very young children; boosters; flu; aged care; masks; Pfizer; pressure on hospitals.
MARK BUTLER, MINISTER FOR HEALTH AND AGED CARE: Thanks for coming in this afternoon. I wanted to provide an update on this third Omicron wave that Australia is grappling with right across the country. And also provide some advice about a development from the TGA in relation to a vaccine for under-fives. And also for the Chief Medical Officer, who's been good enough to join us here today, to run through a statement that he has already circulated to members of the press here today - and we'll be publishing immediately after this - pulling together a range of pieces of advice the Chief Health Officers, individually and together, have released over recent days, but particularly setting out some of the actions that members of the community, individuals, and business can take to moderate the size and the impact of this third wave. As I've said, and certainly the Chief Medical Officer has said on a number of occasions in recent days, this third Omicron wave for 2022 is proving to be a very, very significant one. There were 300,000 cases or thereabouts reported over the last seven days. And I think the CMO and I are pretty confident that the real number is likely to be more than double that. We are seeing hundreds and hundreds of thousands of Australians infected every single week in this wave. As of today, there are more than 5,200 Australians in hospital with COVID. That number has increased very dramatically over recent weeks. Over the last month or so, it’s gone from something under 3,000 to over 5,000. People will recall that in January, that first Omicron wave, the BA.1 wave in January saw hospitalisations reach about this number - about 5,200 to 5,300. It's important to point out during that wave, Western Australia effectively had zero hospitalisations, their border was still closed. They weren't hit by the BA.1 wave. So, we're not entirely comparing apples with apples there but what is clear is that hospitalisations are almost certain to increase further from where they are today over coming weeks. The other difference, obviously, between the situation we've confronted today and in January, is that hospitals are also grappling with flu, a range of other respiratory illnesses, and the usual surge in hospital activity that we see during winter. Our government is committed to doing everything possible to get Australia through this winter safely and healthily. Already, we have extended our support to state governments for COVID related hospital activity, which was due to expire in September for the remainder of this year. A matter agreed between the Prime Minister, the Premiers, and the Chief Ministers at their first National Cabinet meeting several weeks ago. We've also rolled out an information campaign continuing to reinforce the importance of boosters and the CMO will have more to say about that very shortly. We've also expanded access to the fourth dose of the vaccine for over 50-year-olds on a strong recommendation from the Technical Advisory Group on Immunisation, or ATAGI, and making it available to all Australians aged over 30. And finally, but certainly not least, we've also on a Commonwealth application or submission, we've substantially expanded access to the highly effective antiviral medicines that were listed over recent months on the PBS but up until very recently, were largely sitting on shelves gathering dust rather than out in the community preventing the severe disease, which we know is just so important. And already, those actions are having an effect. Just over the past seven days, more than 550,000 Australians have received their fourth dose, the overwhelming bulk of those over the age of 50, particularly between the ages of 50 and 65, which was the new target group by ATAGI. I cannot stress the importance of booster doses enough. Two doses of COVID vaccines just are not enough to provide you with full protection, particularly against these Omicron subvariants. There are still more than five million Australians for whom it has been at least six months since they had their second dose of COVID vaccine but have not yet had a third dose. And over the last seven days, only 50,000 or so Australians received their third dose. The third dose rate just isn't shifting fast enough. And I strongly urge people who are eligible for a third dose but have not yet had it to go out and get that booster. It will provide you with extra protection, particularly against the possibility of severe disease. Also, I can report the prescription rates for those antiviral medicines have increased sharply in just the very short time since the Pharmaceutical Benefits Advisory Committee expanded the eligibility and provided that every Australian 70 and over will be able to have access to these highly effective vaccines and people over the age of 50, who have two risk factors are also eligible for it. I'm really hopeful to see those rates of prescription continuing to increase. They will have a dramatic effect on hospitalisation numbers if we're able to continue to expand that number. And early on in my time as the Minister, I and my Ministerial colleague, Anika Wells stressed that we needed to do more to lift the rate of fourth dose vaccination in aged care facilities at the time, in spite of the fact that the fourth dose had been available for some months, only about 52 percent of eligible residents in aged care had received their fourth dose. In just those few weeks since I made that statement, I'm pleased to say that that rate is now up to 76 percent. This will have a dramatic impact on the protection of our most vulnerable members of the community -residents of aged care facilities. Now over the last week, particularly on Friday, I think the Health Protection Committee, made up of all of the Chief Health Officers of the jurisdictions, issued advice about not just what government can do, but what individual members of the community and business can do to mitigate and moderate the size and the impact of this wave. And as I said, the Chief Medical Officer has issued a statement reinforcing those messages. I'm going to hand over to Professor Kelly shortly to run through that statement. But before I do that, I also want to announce that today, the TGA, the Therapeutic Goods Administration, has granted provisional approval to the Moderna vaccine for very young children aged six months to five years of age - the one sort of age cohort that up until now has not been covered by a COVID vaccine. I want to stress very strongly that this is just the first step in a process of making available to parents for their youngest children a potential COVID vaccine. This is a very, very new product. But as I think I've said on this podium before, it was only first approved by the FDA in the United States a matter of weeks ago and has only been rolling out to children of that age in the US over a few weeks. Having been approved provisionally by the TGA, this vaccine now needs to go to the Technical Advisory Group on Immunisations, which I think people now know very well as ATAGI for their approval or otherwise for this vaccine to be administered to very young children of that age. Until that point, this is simply not a vaccine that would be available to those children. Also, if ATAGI does approve that vaccine to children of that group or a cohort within that age group, then supply of that vaccine also still needs to be arranged. I want to stress again that there is very limited supply of this Moderna product, which is a different product to the products made available to other age cohorts - a very limited supply of this Moderna product across the world, and as you can imagine, there is fierce competition by countries in North America, Europe and other parts of the world to get their hands on this very limited supply. I've reported before that my department is in active negotiations right now with Moderna for Australia to secure as many doses as we possibly can from this very limited global supply. And those negotiations are continuing. I want to stress that in spite of this good news that TGA has been able to approve this Moderna product for under five-year-olds. There is no action yet that can be taken by parents or should be taken to seek to make an appointment or otherwise, there are still a number of steps yet that need to be secured before we are in a position to make available this vaccine to parents and their very young children. If I had a message to parents of children under the age of five today, it is to consider getting your child vaccinated for flu. Our vaccination rates for influenza for under five-year-olds are lagging where they historically have been at this point in the flu season. They are lagging quite considerably. As we know, through tragic experience, children under the age of five and particularly children under the age of two are a very high-risk category for influenza. About 1,300 Australians have been hospitalized this flu season so far for influenza, and almost 6 in 10 of those, more than 700 of them have been children under the age of 16. So, my message to parents of children particularly under the age of five – it’s go out, make an appointment today for your young child aged between six months and five years old, make an appointment for them to get their free flu vaccine. It's a very important protection for some of our youngest kids. With those few words, happy to take questions later. But before I do that, I might hand it over to the Chief Medical Officer to run through his statement.
PAUL KELLY, CHIEF MEDICAL OFFICER: Thank you Minister. And as the Minister has said, there's a statement that's been released under my name today which really summarises the advice that I've given to Minister Butler, and also his colleagues and other Health Ministers around Australia and National Cabinet on Saturday, charting out what I believe is happening in Australia at the moment and what is likely to happen over the next month or six weeks. Essentially my message today is that there is a new variant of COVID-19 - it is circulating in the community and it poses a significant new threat. The reason for that is because it's much more infectious than earlier variants. This is the BA.5 variant and BA.4 to a certain extent. And it's also very good at escaping immunity, whether that is from previous infection. So, you can get reinfected with this with this particular variant, or from vaccination. So, whilst vaccination, as the Minister has said, continues to offer very good protection against severe disease and death - and I would reiterate what the Minister said, absolutely to go and get that third dose if you're due, or get that fourth dose if you are now eligible. But those vaccines do not stop the transmission of this virus. And this variant is unusual in that case. What we do collectively today and what we've in fact, already started to do in the last couple of weeks, will change what happens in the future. We need to do that collectively to slow the spread of the virus, as well as to protect the vulnerable and to protect our health systems, which as the Minister has said, are already under strain. All of the recent changes that have been made - the AHPPC statement that was mentioned by the Minister particularly around mask wearing, about working with employers and the community, around work from home options, for example. The fourth dose or third dose of vaccine, the increased availability of the antivirals, all of these things together will help to protect the vulnerable, and to slow the spread. And both of those things are important right now. We know that wearing masks do reduce the spread and protect yourself or protect others. If you're away from home and indoors in a crowded place. I really, very strongly suggest that you do wear masks. I'm wearing a mask, now, you will notice the Minister is wearing a mask as well. This is our leadership role for the community. This will not be forever. But for the next few weeks, this is the way we can actually influence the spread of the virus, protect vulnerable people in our community, and also protect our healthcare systems, which are already under strain. There's more in the statement. But for the interest of time, I'll leave it there. Happy to take questions as well.
JOURNALIST: Minister, you both walked in with masks today. I know you are strongly encouraging it but do mask mandates need to be reinstated and should that be uniform across the states given the transmissibility of this new variant?
BUTLER: I might start with that. And the CMO can add. But the CMO statement reflects the advice that was issued only on Friday in writing by all of the Chief Health Officers across the country, all the jurisdictional Chief Health Officers, who strongly encourage the community to wear a mask in indoor spaces, particularly crowded indoor spaces where there's not the ability to socially distance. And I think that is really the position as we move into this phase of the pandemic - providing members of the community with very clear information about what they can do to protect themselves and to minimise the size and the impact of this wave.
JOURNALIST: Does it need to be mandated?
BUTLER: That is not the advice that was issued by the Chief Health Officers last week.
JOURNALIST: We're talking about protecting the vulnerable. We're talking about I guess ADF in aged care homes in this Surge Workforce Program. The numbers I think - there's over 1,518 staff currently being deployed to aged care homes, but the aged care sector is saying they actually need more surge workforce, want more surge workforce. So, can you kind of explain, I guess, what the bottleneck is here? Is it that there's not enough ADF staff that have been assigned to this program? Is it that the sector isn't requesting enough people? Is it that they don't know they can still request staff? And one for the Professor if I could - in your statement you talk about forecasts? What sort of forecasted numbers are you looking at over the next couple of months or a couple of weeks around this winter surge of cases?
BUTLER: I'll deal with the aged care question first. You're right that over recent months there has been a mix of reliance on the Department Surge Workforce, which is where nurses and personal care workers are contracted or engaged by the Department to be provided to aged care facilities who need them. And just last week, I think about 1,900 shifts in the aged care sector were worked or were filled by nurses and PCAs from the Department Surge Workforce. And that's higher than the peak we've got to in the January wave. So, I'm very pleased that element of the Department's actions is working well. We're looking at ways in which we can expand that. We're also in discussions with the ADF which had been starting to roll down its presence in aged care facilities. It's obviously got a range of other pieces of work it needs to do. It responded remarkably well, magnificently well to the recent floods, for example. We're talking to the ADF still right now about what ability they have to continue to contribute - to continue to support members in aged care as well and obviously talking to the sector. We'll have more to say about that shortly.
JOURNALIST: Just to clarify, you talk about scaling down the ADF. Does that mean that it will continue to scale down? While the other program will boost?
BUTLER: Well, we're certainly going to continue to try to see our surge workforce capacity increase, it's running at a higher rate than it was in January but where the department is now talking to the ADF about whether there is additional capacity the ADF has - recognising that they have other jobs they need to do as well but where there is some additional capacity, they're able to contribute to the aged care sector. Those discussions are active right now.
KELLY: Yes, so all of my advice has always been the case for the last two and a half years and the same with my colleagues in the states and territories - is based on the best science and the best medical advice that we have at the time. There are a range of things we look at to give that advice. We know how Omicron works. We've been through two waves already. This is the third one. We can look back to January and give us some sense about what that does in terms of hospitalisations, ICU admissions and the like. We know from other countries, for example, the UK has gone through a BA.4 and a BA.5 surge in recent times, and South Africa and other countries, and see how that has worked. And we know the real data which we've talked about already today - that we are in the 5000s in terms of hospitalisations for the first time since around early February. So those are things. We also have forecasting which we've had from our modellers that have provided that weekly, for many, many weeks. I think we're up to report 151 now, and so we do look at that every week. But these are predictions. To give a number - an actual number to that would be false, I think because it's a prediction. We don't know exactly what it will be. What we do know, and this is where their forecasting leads, and what I shared with Ministers over the last few days, is that we can predict reasonably well up to four weeks from now. And in every state and territory, the number of cases according to those predictions are continuing to rise. So, we're at the start of this wave, not the end. We know that that is associated with hospitalisations, and that what happens in the future really, very much depends on what we do today. And what we've done in the last two weeks. The increase in vaccination, the increase in the protections in aged care, in particular around treatments and the vaccination. The increase in mask use, the increasing choices that people are making, not to say this is an individual responsibility, but it's a combined community effort that we need to put in place for the next few weeks. And that will make a big difference in that number, whatever we get to.
JOURNALIST: Minister, are you at all concerned with the ability for hospital systems to cope with the record volume of patients with COVID-19. Do you think they have enough resources?
BUTLER: We're obviously talking at a range of different levels with states all the time. I only had a virtual meeting with my Health Minister colleagues on Sunday afternoon. We're having another meeting, I think on Thursday, where we're certainly at the ministerial level, staying in very close contact about the capacity of systems at all levels to deal with this third wave. I know the Chief Medical Officer is in constant contact with his equivalents as well as our departmental officials. As I said, we extended our support through the rest of the year. And we're staying in close contact about what else we can do to provide states with that support. Obviously, these hospitalisation numbers are deeply concerning. As I said, in addition to all of the other pressures that hospitals face over the course of winter, the hospitalisation rate has increased sharply over the last several weeks. I'm pleased to say that the admission rate to intensive care units has not increased as sharply. That's been a much slower increase. We're still at probably only about half the ICU admission rate we saw in January, although hospitalisation numbers are at about the same rate. ICU admissions were at about half that rate because there was still a greater presence of the Delta variant back then which was a more severe variant of COVID. So yes, we're all concerned about it. None more so than State Health Ministers who are responsible for the operation of their hospital systems. We're staying in very close contact at all levels, Ministerial, Departmental and the Chief Health Officers.
JOURNALIST: Minister, on the vaccine contract review that you announced a few weeks ago - do you have any updates on how that's progressing and when a report is due?
BUTLER: No, I don't have anything new to say about that except that Jane Halton is doing her work. As I said at the time I announced it - I would ask her to be able to provide a report as soon as she possibly could. I wanted that measured in weeks, not months, but most importantly I want her to be able to do the work thoroughly. So, she is not only looking at the fitness for purpose of our existing procurement arrangements over the course of this year and into next, but also looking at the changing landscape. I've talked already about the vaccine for under-fives for which we did not have a procurement arrangement because it didn't exist. Also, the new variant-based vaccines of which there are a couple already going through regulatory approval processes here in Australia and elsewhere in the world. And there is, as has been canvassed a bit publicly over the last several days, the question of surplus supply in areas as well that I've asked Ms. Halton to provide us with some advice about.
JOURNALIST: On the children's vaccines, you said the supplies aren’t available at this stage yet. Do you have any idea of when we will start seeing substantial supplies? And can you explain to us why it's so difficult to obtain these at this point? Obviously, it's one company making them - isn't it just a smaller dose of the current vaccine that we use for adults?
BUTLER: I'll have a go and the CMO might want to provide some more technical detail. This is a very new vaccine. As I said, it was only approved by the FDA very late in June in the US and started to roll out shortly after that. It is a different dose. It's a different vial. So, it requires a whole new manufacturing operation. And as I said, there were really no countries that had procurement arrangements for that vaccine either. So, from a very quick start, you'll see countries in North America and Western Europe and here in Australia, looking at trying to secure suppliers pretty quickly of this vaccine at a time when there is a pretty limited number of doses on the global market. We're all negotiating pretty furiously with Moderna for that supply. As well as that, of course, I think I've indicated that Pfizer also has a product for six months to four-year-olds. I think theirs has been granted approval to submit an application to the TGA - it hasn't yet done that - we expect that to happen pretty shortly. And then there'll be a TGA approval process for that vaccine. And we're obviously also talking to Pfizer about securing supplies of their version, in the event that it's approved.
JOURNALIST: Is there an ETA as to when we'll actually get supplies here or were you hoping to be in the next two months, three months? Do you have a timeframe?
BUTLER: We're in active negotiations with Moderna. Now we have been for some weeks. I think I first met with Moderna about this at least a couple of weeks ago. I think as soon as the US FDA approval was granted. So those negotiations have been going on for some weeks. It's not just the legal technicalities of that negotiation it’s really the reality of the global supply that Moderna is trying to satisfy a whole bunch of different potential customers. But I hope to be able to have some more to say about that in the near future. I really just want to stress though, for parents of children this age that, although the TGA has granted provisional approval of this vaccine, there is no action for you to take yet. There are still a number of hurdles to jump through, not least of which is supply of something which is highly sought after on the global market.
BUTLER: Sorry, did you have anything you wanted to add about that?
KELLY: The antigen itself is the same, but it's a much, much smaller dose. And it's as the Minister said, it's a completely different vial. It's different in the constituents. So, it has to go through that process itself and it's not as simple unfortunately as just diluting one of the adult doses.
JOURNALIST: On that, given the situation we face ourselves in at the moment with those surplus vaccines that we've actually already purchased. Is that the consideration of the sort of negotiations you're going through now, in not over ordering?
BUTLER: Yes, I can say in the broadest possible terms. Obviously, I don't want to go into the details of the negotiations we're having. But the point you make is obviously a factor in our minds as we approach those negotiations and also something that Ms Halton is considering her review.
JOURNALIST: When do you expect the TGA to make a decision on Moderna’s Omicron specific booster?
BUTLER: I don't have a specific date for that, as I think I've indicated that that is under consideration right now - and the TGA really has just worked magnificently right through this pandemic as well as all of the usual work that they have to undertake to continue the supply of good quality medicines to Australia. They've done all of this work on vaccines and antiviral treatments in really good time compared to all of its equivalents across the world. I want to make sure that TGA understands it should do its work thoroughly, according to the best possible timeframes it comes up with. I would have thought we'd expect that in the reasonably near future but that's really a matter for TGA.
KELLY: Minister, can I just say, it’s really important, we both said it today that the best thing you can do to protect yourself at the moment is to have the vaccine that's available. And my colleague in Victoria, I'll quote him - Brett Sutton, “the best vaccine you can get is the one that's available today”, and that's still the case. So, for anyone who might be considering waiting for these other vaccines, don't wait. With this wave, we want everyone to get that third or fourth dose, whichever one you're due for now – now.
JOURNALIST: And just one more, I think you've kind of touched on it but when you get COVID with this latest wave, how long are you immune for before you can get it again?
KELLY: This was something that was covered in the AHPPC statement recently about a change in advice there. Again, it's based on the science we know about this - we know enough about this new variant that the reinfection is much more possible than previously and earlier than we previously thought and so that is the appropriate advice about one month or more after your previous infection, you may have COVID again, and so go and get that test. In terms of what happens with this particular variant and how that might protect against the next variant, because there will be a next variant - that's pure speculation, I can't tell but I do know that the BA.4 and the BA.5 variants can escape that immunity from previous infection. Either Omicron or one of the other ones prior to that.
JOURNALIST: I think about two weeks ago, you launched a new advertising campaign around the antivirals and the vaccines as well and I think National Cabinet agreed that the States would run their own campaigns around mask wearing but if I'm correct. With the reiteration of this advice today, will we see it as a further revitalisation of that campaign or renewed, pushing out of that campaign, can you kind of run us through what that looks like at the moment and what it was reaching?
BUTLER: Yes, a few weeks ago. I can't quite remember the precise date. But a few weeks ago, I announced the launch of our winter campaign - particularly focused on booster doses. But generally on a range of other behaviours that will help you protect yourself against COVID. And that's been rolling out over recent weeks. We decided not to release a campaign on antivirals until such time as we had the expanded access. We didn't want to roll a campaign out and have a whole lot of people find that they had to jump through a whole lot of very difficult eligibility hoops. So having done that now, I have asked my Department to finalise, in the very near future an information campaign to promote awareness among the community about the access to these treatments and how effective they can be particularly for older Australians or Australians who might have other health issues in preventing severe disease. Since the decision of the Pharmaceutical Benefits Advisory Committee was accepted by the Government early last week, we’re already rolling out very substantial communications to General Practitioners in particular, so that they are aware of the changes - webinars through the Deputy Chief Medical Officer Professor Michael Kidd – direct communications. But there will be a broader information campaign on antivirals to the community in the near future. As for other advice, we can provide to the community around some of the measures that Professor Kelly has outlined. We remain very open to continuing to review the range of our communication activities to the community and make sure that they're up to date. Thanks, everyone.