RUBY:

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

A leaked briefing from Victoria’s Chief Health Officer has contradicted public statements on contact tracing, and highlighted flaws with the privatised response to coronavirus in the state.

Osman Faruqi reported the story for The Saturday Paper and today, he details the extraordinary call, and what it means for Victoria’s roadmap out of the pandemic.

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OSMAN:

Last week, I got my hands on a tape of a briefing that Victoria's chief health officer, Professor Brett Sutton, gave to a couple of hundred doctors at the Royal Melbourne Hospital.

Archival Tape -- Brett Sutton

“Hello to everyone. I’d like to start with acknowledging the traditional owners of the land… “

OSMAN:

The call happened a few days ahead of the announcement made by the Victorian government on what the roadmap out of restrictions in the state look like.

Archival Tape -- Brett Sutton

“Look, I'm really here to be open to questions. I know people have lots of questions and perspectives about... “

OSMAN:

At the start of the call, Professor Sutton was repeating the same kind of points that he and Premier Daniel Andrews had been making in public for weeks. The restrictions that Victorians had been under were strict, but they were necessary.

Archival Tape -- Brett Sutton

“We’re all fed up. We've had weeks of significant constraints and they do touch on the most fundamental aspects of our lives…”

OSMAN:

But during a question and answer session with the doctors, Sutton sort of broke with what he and Andrews had previously been saying. He referred to a decision made by the Health Minister about swabbing hospital patients for Covid as a “Captain's Call”.

Archival Tape -- Brett Sutton

“So, look, it was really a ministerial call on the... on the pre surgical swabbing. So it'll be the minister's call on... on when that might wrap up.”

OSMAN:

And when he was asked about Victoria's contact tracing efforts, he became really direct.

Archival Tape -- Doctor on call

“Victoria’s contact tracing has been criticized in some circles and what needs to improve or needs to be done from now on?’

Archival Tape -- Brett Sutton

“Yeah, it was totally challenged. No question there. And, you know…”

OSMAN:

Basically, he was saying the tracing system just wasn't up to it.

Archival Tape -- Brett Sutton

“But even at lower numbers, there were some intrinsic challenges with contact tracing. We had some…”

OSMAN:

And he was being really specific. You know, he said this was partly down to old technology.

Archival Tape --

“We had some old systems. When we wanted to have surge support from all other jurisdictions, we had to go to a paper based system because we didn't have... “

OSMAN:

He also pointed to the other huge problem with the Victorian system, which everyone is really reluctant to talk about. And that's how much of the response has been handed over to private companies working in this complex way with the public sector.

Archival Tape -- Brett Sutton

“We've learned that a pathology system that is a hotchpotch of public and private pathology providers that are not able to be stewarded centrally is a challenge....”

OSMAN:

So - this was a really new, really honest assessment from the chief health officer about what has gone wrong.

RUBY:

Os - Lets talk about this call. I guess the first thing that stands out is how much it does contradict the public statements that have been made by the Victorian government about contact tracing. Tell me about how that tracing is actually working.

OSMAN:

Absolutely. We've seen the government run a really concerted defensive line on contact tracing in Victoria. Daniel Andrews in particular, has been adamant that Victoria's contact tracing team, its contact tracing efforts have been up to scratch. And that, you know, even if the system had been changed when the second wave kicked off, we wouldn't have seen any different results to what we're seeing now.

But I spoke to a lot of doctors for this story to get a sense of how exactly contact tracing works on the ground. So the doctors that I spoke to described a very, very, very complicated, very slow, very old fashioned process, which I have to admit, Ruby, when I heard I couldn't believe. I don't know was my naivety about how this stuff works. But I was shocked that in the context of a pandemic, things were moving so slowly. You know, one doctor said to me that even right now in the middle of Victoria's second wave, it was quicker to get a notification out about a gonorrhea case than it was to get notification out about a Covid-19 case.

And that's because the way the system works is when someone gets a Covid-19 test that's sent to a private pathology clinic which assesses it, they then give that result back to the clinic or the GP where the test was done. That GP doctor then has to call or fax that result to the Department.

They would then, and I've confirmed this from multiple doctors, use a pen and a pad to write down what that doctor was saying by hand. That would then be collated by another staffer in the department later in the day, be imported into a database. And that information would then be used by a separate contact tracer to call that case, to interview them, to find out where they'd been, who their close contacts were. That information would then be passed on to someone else who would then follow up and actually speak to their close contacts.

This is all really important as a point of contact tracing is to try and identify who the close contacts of Covid-positive case are, as soon as possible, so you can isolate them, test them and make sure they aren't spreading the virus to anyone else inadvertently.

RUBY:

Mm, so a lot of room for error in that process and also just not much speed.

OSMAN:

That's right. The main issue there is that the process was very, very slow because it relied on outdated technology. There was also a lot of room for error. You can imagine when doctors are making phone calls to people and those phone calls are being transcribed. You end up with things like names being spelt wrong, addresses being spelt wrong, numbers not being communicated properly. So that leads to a situation where people who've got the virus or who are there close contacts are just not able to be contacted.

You've also got a situation and Victoria's quite unique in this regard where the system was very, very centralized. You know, I spoke to some doctors who said that when they called the contact tracing team, they didn't even know suburbs in Melbourne where the hotspots were occurring.

RUBY:

Os, I think the big question here is how significant were all of these failures with contact tracing in terms of the bigger picture, in terms of the severity of the second wave in Victoria.

OSMAN:

Yeah, so despite what the Premier has been saying on this publicly, all the frontline doctors I spoke to who were involved in contact tracing back in June, July when the second wave kicked off, said that it is the key reason why Victoria's outbreak became as bad as it did.

Archival Tape -- Doctor

“They were hammered. I mean, I have no nothing but praise for the people on the end of the phone. But they were completely pasted. They're completely banged into the ground because it was so hard to get any congruent support for them…”

OSMAN:

You know, one doctor said to me that, you know, it was hoped hotel quarantine breaches were how it got into the community. But the slowdown in contact tracing is how it's spread so fast. The failure of the Department to contact trace is why the second wave got out of control

Archival Tape -- Doctor

“The running into the ground, the public health response in the state of Victoria led to a situation where the public health response could not match what was needed “

OSMAN:

And I think that's something that the government has been really reluctant to acknowledge. But it's something that doctors have been pulling their hair out because they have been begging for changes to the system for months.

RUBY:

We’ll be back in a moment.

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RUBY:

Os - another challenge for Victoria’s contact tracing efforts, which Brett Sutton pointed to in that call, is the fact that key health services are privately run. So who is actually doing the contact tracing in Victoria?

OSMAN:

So this is another area where Victoria has really stood out compared to other states. And... and that's how much of the public health services that have been operating since the pandemic kicked off in March have been privatized to private companies, management consultants and...and other health services.

Since March, Victoria has issued 85 separate contracts related to Covid-19 public health work to private companies. The total value of those contracts is over 116 million dollars, and more than half of that has been spent on outsourcing the basic work of contact tracing. That's things like call centers, people to do the data analytics, software companies to build analytic dashboards and management consults to glue the whole thing together.

And that's a huge contrast to what we saw in other states and territories. New South Wales, for example. It also obviously was hit by the pandemic.

Archival Tape -- Newsreader

“A southwest Sydney pub is tonight a makeshift clinic with hundreds of anxious locals lining up to be tested…”

OSMAN:

And it’s public health teams did their best to manage that.

Archival Tape -- Newsreader

“Patient zero has been identified as a freight worker that travelled from Melbourne to Sydney on the 30th of June…”

OSMAN:

And when they needed extra support, they didn't turn to the private sector. They didn't outsource that. They brought in staff from other areas of the public service, people that were familiar with the processes of government, that knew how the systems worked.

Archival Tape -- Health Official

“And this is so important that we get that contact tracing, we can clamp down so we can keep our economy strong in NSW. So we need people participating in that testing regime…”

OSMAN:

When it needed extra support, they turned to the Australian Defense Force. So it was essentially all kept in-house by the New South Wales government. In Victoria, the opposite happened.

RUBY:

And so what would actually at this point be needed to make contact tracing work within the department in Victoria?

OSMAN:

I think to answer that question, you have to really go back to what Victoria's public health team looked like before the pandemic hit.

The Age newspaper has previously reported that there were internal government documents that showed that before the pandemic hit, Victoria had the lowest resourced public health team in the country. And even if you doubled its size, you still would have the least resource team in terms of public health officers per head. And that meant that when the pandemic hit, we just had 14 people.

RUBY:

Sorry, you're saying there were only 14 people, in all of contact tracing.

OSMAN:

That's correct. There were only 14 people in the entire Victorian contact tracing team before the pandemic hit.

And it makes sense when you understand that, why we needed to upgrade it as fast as possible. And it makes sense why the government turned to the private sector to do that. But I think what...what doctors have been saying, what epidemiologists have been saying for months now, is that we can't just rely on these makeshift short term solutions.

And they've also been very, very clear. We're starting to see the government do this. Is that the contact tracing system, the public health system more broadly should be devolved. And the government announced that it would be modeling itself more closely on the New South Wales public health model by devolving some tracing efforts to first regional hubs. There are now five hubs in regional Victoria that it'll be utilizing local knowledge to conduct contact tracing. And as of last week, the government announced that they'd be expanding that to suburban areas as. Well, so we're starting to see some of this stuff happen, but it's still happening in a very ad hoc way.

RUBY:

Os, how important is contact tracing to Victoria's pathway out of lockdown?

OSMAN:

It's actually one of the most important factors at the moment. You know, the roadmap that was released by the Premier relied very heavily on modeling that had been conducted on behalf of the government. And one of the inputs into that model was Victoria's contact tracing efforts. The modelers were asked to see what would happen if Victoria eased restrictions. And the government said, well, we can't ease restrictions yet because under the current framework, that would mean we'd bounce back and face a third wave. But that assumption relied on the slower, less efficient efforts of contact traces, of... of that model of contact tracing.

So even some of the modelers, Professor Tony Blakely, who's an epidemiologist is one of them, has said himself that if Victoria was able to fix its contact tracing, if it was able to upgrade its contact tracing capacity, Victoria could emerge from restrictions faster and still not risk entering a third wave and having to deal with another lockdown.

So contact tracing isn't just something that is about, you know, showing off who's got the best system. It's now a key part of ensuring that Victoria has a public health team strong enough to withstand any easing of restrictions.

RUBY:

Hmm and what did Brett Sutton say about the way out of all of this on that leaked call?

OSMAN:

What Brett Sutton said to the doctors on that call a couple of weeks ago was that there is a need to upgrade public health and contact tracing in Victoria, not just to deal with the current pandemic, but to deal with all the challenges that the country and the state is going to face over the next few years and decades. You know, he pointed to potential flu pandemics in the future. He talked about the risk from bushfires.

Archival Tape -- Brett Sutton

“It’ll be floods and droughts and food borne illness and all of the corollaries of climate change that are only going to become more significant threats…”

OSMAN:

Contact tracing might only have become a popular buzzword now. But all of those problems rely on public health teams and on contact traces to resolve.

Archival Tape -- Brett Sutton

“I think we need to design a system that can respond to pandemics early and robustly because they are going to be part and parcel of our lives going forward.”

OSMAN:

So there is a deep, deep need. And Brett Sutton was articulating this to have a well resourced and functional system to deal with all of these challenges in the future.

Archival Tape -- Brett Sutton

“I do think if it’s shown us anything, you know this is a multi-multi-multi-billion dollar cost to Australia, it’s a small investment to make in public health…”

RUBY:

And so Os, is that happening? Is this the Victorian government investing in fixing this?

OSMAN:

Well, look, we're seeing signs that the government is attempting to respond to these concerns that doctors have been raising. I think the question is, will these short term solutions, whether that's bringing on a company like IBM to use artificial intelligence to, you know, review the contact tracing work, whether that's hiring call centers for six months at a time that might help us get through this pandemic. But it doesn't really solve the bigger problem of the future.

That's going to require much more investment and much more strategic thinking around building up the public sector rather than throwing a Hail Mary pass to the private sector to get us out of a relatively short term crisis.

RUBY:

Os, thank you so much for your time today.

OSMAN:

Thanks heaps, Ruby.

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RUBY:

Also in the news today…

Restrictions across Victoria will be eased slightly from today, as the state begins its gradual roadmap out of the stage four lockdown.

People living alone will be allowed to have one other person in their home, and exercise will be allowed for up to two hours, split over a maximum of two sessions.

Households, or groups of two, can also spend time outside for social interaction.

The curfew will now apply from 9pm and playground and outdoor fitness equipment will reopen.

In regional Victoria, groups of up to 5 will be able to gather outdoors.

And Oxford University has announced it will resume a trial for a coronavirus vaccine it is developing.

The late-stage trials of the experimental vaccine were suspended last week following a reported side-effect in a UK patient.

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