RUBY:

From Schwartz Media I’m Ruby Jones, this is 7am.

Medical experts say that the government’s slow response to the coronavirus outbreak has left Australia exposed, and a lack of resources could make the crisis worse.

Today - Mike Seccombe on the challenge our country and health system is facing.

We’re covering the coronavirus everyday this week on the show.

This is part 2: what the government did wrong.

Mike, Bill Bowtell has been a leading critic of the government’s response to Coronavirus, you spoke to him for your story in The Saturday Paper… can you tell me a little bit about that phone call?

MIKE:

Well, Bill is an adjunct professor at the Kirby Institute for Infection and Immunity at the University of NSW. And he was the architect of Australia’s response to the AIDS epidemic several decades ago and our response was world-leading at the time. So he knows quite a bit about the insidious way in which mass diseases spread.

RUBY:

Mike Seccombe is The Saturday Paper’s national correspondent.

MIKE:

So anyway, I rang him on monday morning, and before i could even ask a question, in fact I didn't even have anytime to turn on the tape for the first part, he went so quickly.

Archival Tape - Bill Bowtell:

“The facts of the matter are, they were warned 12 weeks ago by WHO and others what was coming.”

MIKE:

“They” by which he meant the government..They did not accumulate test kits. They did not accumulate the necessary emergency equipment.

Archival Tape - Bill Bowtell:

“They did not undertake a public education campaign.”

MIKE:

They gave no money to science, no money to the WHO.

Archival Tape - Bill Bowtell:

“No money to research, no money to the International Vaccine Initiative.They did nothing! They diligently did not do anything. I am deeply frightened.”

RUBY:

So what Bill Bowtell is saying to you is that the Australian government spent months watching the coronavirus crisis escalate elsewhere in the world... before it arrived here… but did basically nothing about that...

MIKE:

That's exactly right. And an Australian slow reaction is all the more unforgivable for that. We were granted largely due to good luck and our geographical isolation. The luxury of time to watch and learn.

I mean we were slow learners. And now the spread of the disease is showing up not only the deficiencies in our short term response, but also some deficiencies, its showing up pre-existing shortcomings in Australia’s healthcare system.

RUBY:

When did we start to see the government respond in a serious way to coronavirus?

MIKE:

Well, with the exception of the travel bans, first on China, then on South Korea, Iran, and then way, way too late on Italy. The first real indication that the government was getting serious didn't come until February 27, when Scott Morrison held a joint media conference with the health minister, Greg Hunt, and the deputy chief medical officer, Paul Kelly, to announce the activation of the so-called Coronavirus Emergency Response Plan.

Archival Tape - Scott Morrison:

“Earlier today the national security committee met for three hours to consider the next round of advice and information we’ve been receiving in relation to the coronavirus.”

MIKE:

At that point, I should add that there were still just a handful of cases in Australia and all of those cases had come here from abroad.

So anyway, they had this big presser in the prime minister's courtyard during which I counted. They said the word plan 32 times.

Archival Tape - Scott Morrison:

“You can be assured that the constant management of that plan and the constant communication is a key part of the plan itself.”

MIKE:

But the plan in reality was more of a blueprint for bureaucratic consultation.

Archival Tape - Scott Morrison:

“The thing about this plan and as Dr Murphy reminded us this morning, the key to plans such as this is, is they need to be flexible.”

MIKE:

There were no concrete actions mentioned. None of the three men and I think this is important, even uttered the words hygiene or hand-washing or social distancing.

Archival Tape - Scott Morrison:

“The key message that I really want to get across to Australians today is because of the actions we've taken on the coronavirus, we’ve got ahead, we intend to stay ahead and together we will get through this, thank you very much.”

MIKE:

So, it was a big event that produced not much.

RUBY:

Mike, there’s been a lot of confusion about what people should do, especially around testing. Can you talk me through where that confusion originated?

MIKE:

Well, for a start, there was a lot of confused information going out at various press conferences a couple of weeks ago. For example, Greg Hunt, the health minister, publicly said if in doubt, get yourself tested.

Archival Tape - Greg Hunt:

“That's the important message, we would rather, even though it can be a stress on the system, we would rather we over test rather than under test.”

MIKE:

And this was followed, of course, by a run of people seeking tests lined up outside hospitals and such like.

And then a couple of days later, the chief medical officer, Brendan Murphy, rather tactfully referred to, quote, some confusion, unquote, and countermanded what Hunt had had to say.

Archival Tape - Brendan Murphy:

“At the moment we are not recommending general members of the community with acute respiratory symptoms, colds, flus and the like be tested.”

MIKE:

So that's one example of mixed messaging. Then there's another one that was that was conveyed to me by the president of the A.M.A. in South Australia, where early in the piece there was signage produced by the federal and some state health authorities, which was intended to go up in doctors' windows, and it was wrong, and potentially disastrously so.

The messaging was that the people who thought they might have the disease should, quote, tell staff immediately upon entering a surge surgery if they thought they were a risk. Well, that was completely wrong.

The South Australian signage said, do not enter. Instead, go home and call your doctor and wait for advice.

So we basically spent the first phase of the outbreak unnecessarily delaying our response. Then in the second phase, our messaging was mixed and confused.

And now all of that is compounding with a bigger problem, which is a lack of resources in our health system to deal with the crisis.

RUBY:

We’ll be back in a moment

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RUBY:

Mike we're talking about Australia’s response to Coronavirus. The virus is well and truly here now. What is the state of our health system, and will it cope?

MIKE:

First of all, let's not sound too alarmist. I mean, Australia has a generally strong health system, but there are some critical weaknesses relevant to this crisis. The OECD data shows that we are well down the list, about halfway down the list of advanced countries in terms of the number of hospital beds that we have.

So we have about 3.8 per 1000 of population, which is about the same as Norway. A little ahead of Italy and Spain, but it's way behind Japan and South Korea, which have nearly four times as many beds.

So the truth here is that our our hospitals are pushed to their limits even by a moderately severe flu season. I spoke to Vlado Perkovic, the dean of medicine at University of New South Wales. You know, he just put it very bluntly.

Archival Tape - Vlado Perkovic:

“Our hospital system runs very lean that runs with them with no regular surge capacity.”

MIKE:

And that means that we're exposed to any sort of event that leads to a large increase in resource requirements and people turning up at hospitals.

Archival Tape - Vlado Perkovic:

“So there's no doubt that that will challenge us and challenge our health system.”

MIKE:

And that's where we are now.

Archival Tape - Vlado Perkovic:

“There are many people who are still complacent, and if we don't get over that complacency and realise that every single person has to take this seriously we run the risk of heading for the catastrophic scenes we’ve seen in other parts of the world.”

RUBY:

And so, Mike, other measures that we can take to improve our health capacity than at least in the short term.

MIKE:

Well, there are some. There's been much publicity about plans to increase the number of ICU beds, of which there are only about 2200 in the country at the moment, I might say - by canceling elective surgery. But Stephen Duckett, the health program director at the Grattan Institute, suggests that won't help a whole lot. And the reason for that is that if we start canceling elective surgery, it won't make a big difference to ICU because very few elective surgery patients take up ICU beds because by and large, they are otherwise pretty healthy. I mean that's why it's elective surgery.

RUBY:

Ok so with a potential surge in people needing to be hospitalised, experts are saying we don’t have enough beds?

MIKE:

We don't have enough beds. In the case of even a, you know, a moderate outbreak of this thing in Australia, we're going to be really overstretched. I mean, that's what Duckett said. He said it won't be enough.

You can move on the elective patients, but it still won't be enough. So that's one factor. The other factor is a demographic one, which is that over the past two decades in this country, we've been ageing at a tremendous rate.

The number of people aged over 85, which, you know, all the stats show us as the group most at risk from coronavirus because it's a disease that overwhelmingly affects the elderly. The number of people over 85 has increased by one hundred seventeen point one per cent over the past 20 years. That's three times the rate of general population growth.

So if you add that in with the fact that our hospitals have not been terribly well resourced, it's no surprise that the Australian Institute of Health and Welfare in a report last year found that the increase in public hospitalisations was three times the rate over the past five years at which new public hospital beds were being added to the system.

RUBY:

So what does that actually mean practically, Mike?

MIKE:

Well practically what that means is that the system was already under great stress because the resourcing wasn't keeping up with demand. And now demand is about to escalate dramatically.

RUBY:

Mike, given how stretched the health system already is, and the pressure it’s about to come under, what are the lessons that we can learn right now?

MIKE:

Well, one would seem to be that we need to put more into hospital beds.

There's another one, of course, here, which is we need to be more self-sufficient in crucial medical gear. I mean, at the moment, you know, half the world's facemasks come from Wuhan. Reagents for testing come from Italy. Test kits come from the United States I mean, this is part of globalisation and it's the same problem that's afflicting a lot of sectors of the economy in this crisis. Is that supply chains can break down. So you actually need a much greater domestic resource to draw on in these areas.

And then apart from that, the big thing, which is the thing that goes to the general public rather than the hospitals and the health experts, and that can be summed up in two words, which are hygiene and distancing.

Dr. Perkovic noted that the number of confirmed cases in this country had quadrupled in the week to last Wednesday, which is when I spoke to him and he issued a dire warning. He said it will probably be 2000 next week and the week after that, 8000. And if we don't take this seriously, it could potentially be 32000 a week after that.

Archival Tape - Vlado Perkovic:

“So that's when you know, a hospital system would be really overwhelmed. I think what that tells us is the time that complacency is passed.”

MIKE:

Which takes us back, I guess, to where we started with Bill Bowtell. Had the government acted sooner and more decisively, those figures could have been very different.

RUBY:

Mike, thanks for taking the time to talk to me today.

MIKE:

Thank you for the call.

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RUBY:

And as the government imposed shutdown of thousands of pubs, clubs and restaurants took effect yesterday, the economic impact of the coronavirus pandemic became bleakly apparent.

Thousands of newly unemployed Australians lined up at Centrelink offices across the country hoping to register for welfare payments. The demand for government support was so large it crashed the MyGov website. The government services minister Stuart Robert initially blamed a cyberattack for the website being offline, before correcting the record to admit it was a capacity issue.

More than 55,000 Australians tried to access the website at the same time. Labor has criticised the government for not providing more staff to process claims.

And nearly 50 people who disembarked from the Ruby Princess cruise ship in Sydney have tested positive for coronavirus. The cruise ship was carrying nearly 3000 passengers, all of whom were allowed to disembark despite a number of people on board showing symptoms of the virus.

And the Australian sharemarket lost $100 billion in value on Monday. The Reserve Bank has announced it will spend another $4 billion buying government bonds, after making a record bond purchase last Friday.

I’m Ruby Jones, this is 7am. See you tomorrow.