Australian Deputy Chief Medical Officer Paul Kelly made an announcement about questions and answers. (ABC)
Australian Deputy Chief Medical Officer Paul Kelly announced on Q + A that new protocols that determine who can be tested for COVID-19 will be announced in the coming days.
- The test criteria will shift from those who have recently traveled to others with symptoms
- Authorities urged to consider smartphone apps and open data to track the spread of coronavirus
- The deputy medical director denies that the main ICUs will soon be able to at the current rate of spread
Monday’s Q + A episode was dedicated to the discussion of the coronavirus crisis and featured ABC’s Dr. Norman Swan, Australian deputy chief medical officer, Professor Paul Kelly, and the leading infectious disease expert, Professor Sharon Lewin. As in the past few weeks, the episode was shot without a studio audience.
The government’s response to the coronavirus epidemic was put under a microscope when Senator Rex Patrick, the fourth Australian politician to have a confirmed case, appeared via video link.
The South Australian senator, quarantined over the past eight days, said that he was most likely infected by liberal Senator Andrew Bragg during an investigation into the Senate, in which Senator Bragg was showing flu-like symptoms.
Senator Patrick asked Professor Kelly why Senator Bragg could not have been tested earlier; the current testing regime limits the tests to those who have traveled abroad within 14 days of the onset of symptoms or come into contact with that person.
“He had flu-like symptoms but did not qualify for a COVID-19 test because he had not been in contact with anyone who was a known COVID-19 courier,” said Senator Patrick.
“A week later he realized others who had gone to a wedding he had been contracted with coronavirus, and at that point had qualified for a test.
“If he had been tested when he had symptoms for the first time, I would not have spent eight days working in the country of South Australia.
“Why are the test criteria so strict? Can you see how 10 minutes two weeks ago could have saved so much time and significantly reduced someone’s risk of infection?”
Professor Kelly initially rejected the application, saying that the marriage in question was a “super-spread” event and that the virus is more contagious than the flu.
But when host Hamish Macdonald pushed Professor Kelly to be more direct, his host announced that changes to the test protocol were imminent.
“We will remove the traveler component, but we are currently working on it,” said Kelly.
“There will be announcements about it in the coming days.”
Professor Kelly indicated that the authorities were investigating many measures in terms of how to respond to the current crisis.
Australia must “overcome the fear of data”
The show opened with Professor Kelly saying that health authorities in Australia “have been preparing for a pandemic like this for many years.”
It was a comment that soon returned to bite him.
After a spectator called to condemn what he considered lax control measures at Australian international airports, Singapore’s response was discussed.
There, the government is monitoring the movement of potential cases using a smartphone app with Bluetooth functionality.
Macdonald asked Professor Kelly: “Why aren’t monitoring and apps something you already have at your disposal?”
Professor Kelly said that apps were a tool available to the government, but were cut by dr. Swan.
“I’m sorry, do you already have that technology at your disposal?” Asked Dr. Swan.
“Well, we all have cell phones and location services are on cell phones – these are difficult decisions to make in terms of people’s privacy,” said Professor Kelly.
Dr. Swan was far less than satisfied.
“Paul, you didn’t introduce these technologies. Singapore has,” said Dr. Swan.
“You have had weeks to introduce these technologies and they have not yet been implemented.
“We should test every single person who comes out of one of these plans, because asymptomatic diffusion is what we have to worry about and at least you have a basis.
@QandA: Why aren’t Australian airports testing the temperatures of people arriving home from all parts of the world?
“You know if they get off the plane and are positive or not.
“The symptoms we have seen with Diamond Princess and South Korea are not a good sign of people who could spread the virus.
“Everyone who gets off an airplane or boat must be tested regardless of whether or not they have symptoms.”
Professor Kelly defended the trial measures and claimed to have done the job, especially when the Australians were returning from China because very few had proved positive.
It has been mentioned that in Taiwan they are also using smartphone apps to track data, including where people have been, and dr. Swan suggested that Australia forget about privacy issues and do the same.
“Taiwan’s big message is that they are shameless and embarrassed about the use of data, the linking of data and actually rather personal data for the public good,” he said.
“We are too nervous in Australia to connect, we connect some data but now we could take advantage of this opportunity to connect data on a large scale and be able to do something similar in Taiwan so we know what’s going on and we can actually measure things.
“We really have to overcome our fear of data.”
‘We are not in Italy’
Another key issue discussed was whether schools should be closed.
Prime Minister Scott Morrison has been against taking this step in recent days, despite having closed pubs, clubs and most of the places where people gather.
Professor Kelly said that if schools closed it would be “at least for the next six months, probably for the entire school year.”
Dr Swan said that modeling at Imperial College London shows that closing schools would help “flatten the curve”.
“Imperial College London Group found that closing schools … actually had the greatest effect,” said Dr. Swan.
The potential for “curve flattening” to relieve stress in Australia’s public health sector was another point of disagreement.
Dr. Swan said if the “hockey stick [trend line] it doesn’t change much … we will be out of ICU beds in New South Wales, Victoria will be behind us by April 10 “.
“And in that case, ICU doctors will face some very difficult decisions,” he said.
Asked if the prediction was accurate, Professor Kelly sifted through and said that ICUs could potentially triple their capacity.
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He pointed out that Australia had no comparison with Italy, which had more COVID-19 deaths than anywhere else, with 5,476.
“We also have strategies to reduce pressure on the hospital system in a broad sense, not just for intensive care units,” said Professor Kelly.
“We are not in Italy. I have seen some people say when they look at the curves of what Norman refers to, the epidemiological curve that we are two weeks behind Italy.
“We are not two weeks behind Italy.
“We have tested and found many other mild cases.
“Italy has mainly tested the top of the pyramid, the very serious cases that have entered the hospital. This is what their first 1,000 were.
“Our first 1,000 were primarily community cases. Mainly involved with travel from abroad. We have had only 20 people during this entire period who have been in intensive care.”
What about a vaccine?
Professor Lewin, who is a leading expert in infectious diseases and committed to working on vaccines, said that a COVID-19 vaccine could arrive in “12-18 months”, but hoped more that treatments could be developed sooner. .
“We haven’t talked much about the treatments in public and I think they can play a very important role while we wait for a vaccine,” said Professor Lewin.
“We don’t have a specific treatment for the virus.
“People improve on their own or improve because they receive supportive care in the hospital.
“If we had a treatment, an antiviral drug that blocked virus replication could potentially do two things: it could potentially improve the outcome – people don’t get sick and don’t die – or even reduce the transmission because most of the transmission of virus is related to the amount of virus present on board.
“Just recently, we learned about one drug in particular.
“It is an arthritis drug. A very small but widely tested study that shows that the drug has reduced the amount of virus that we could measure in someone’s swab.
“We can actually measure the quantity accurately, and it certainly has decreased with this particular arthritis drug.
“One thing we might see in the not-so-distant future is a great understanding of the drugs that block replication and which could have implications for both the clinical outcome and how contagious you are.
“I’m a little optimistic about it.”
The health department clarifies the comments
At the end of the episode, the Department of Health released a statement explaining Professor Kelly’s comments on the test protocols.
“As we learn more about the virus, we have continued to review the test criteria,” said a spokesman.
“In light of our stronger travel restrictions, attention logically shifts to the community with COVID-19 symptoms, in addition to returning travelers and close contacts in the cases.
“Professor Kelly has reported that the CDNA will change the testing guidelines for public health units in the near future.”