Topics: Coronavirus update; Commonwealth funding to provide 20,000 nurses with intensive care training; ICU capacity; quarantine measures
Well thank you everybody and welcome to the Frankston Hospital. I’m joined today by Felicity Topp, who is the CEO, who was herself a critical care nurse. Lori-Anne Sharp who is the Assistant National Secretary of the Australian Nursing and Midwifery Federation, and Ken Hambrecht, who is the head of Medcast, who are responsible for critical care training.
Today is about increasing the capacity of our ICUs around the country. It’s about ensuring that we have 20,000 existing nurses lifted in their capacity, so as they can begin training. They can help support the ICUs. They can lift their skills and lift their care.
And I want to start by acknowledging our extraordinary nurses around the country. They are on the frontline, along with our doctors and other health and medical staff, and they are literally saving lives and protecting lives. It builds on our announcement about capacity of two days ago, where the private hospitals were brought into the national battle against coronavirus.
And what we’ve done there is now being supplemented with boosting the staff and boosting the capabilities. And indeed, this hospital alone has seen 54 former ICU nursing staff from within the local community put their hands up and say, “we want to be part of the training”. And Felicity and her team, and we’re joined by Monique and Ross, two other nurses here in ICU who are doing an amazing job, taking care of patients now, taking care of patients in the future.
I want to do two things today – give you a brief national update on our containment efforts, and then talk about this capacity effort. Our national strategy is to bring the curve down, to reduce the number of the daily infection rate and the percentage increase, and to take a series of measures to do that, and at the same time, to increase the capacity of our hospitals and our primary care networks.
In terms of the latest available data, what we see is that two weeks ago we were having between 25 and 30 per cent daily increases. Then, it had dropped to the low teens over the last week and now, we’ve seen a number of days which have allowed us to say that we have dropped below the 10 per cent daily figure to single figures with regards to our daily increase in infections.
That means we are beginning to see early, cautious, but verifiable signs of flattening the curve. So, the curve is beginning to flatten. It’s not sustained yet. It hasn’t been consolidated. But those early, important signs are absolutely critical and they are a reflection of the four major measures that we are taking as a country.
Firstly, we have built a ring of steel around Australia through our borders, building on our natural advantages as a nation. That’s about limiting those that come in, buffering it with quarantine and isolation measures and preventing those from going out, who are Australian citizens, so as they don’t leave, seek to come back and potentially bring the virus with them unwittingly.
Secondly, there is testing. Now, as the Prime Minister has just announced, that over 261,000 tests. That represents, for the first time, any country that we are aware of with over 1,000 tests per 100,000 population and that is just an extraordinary effort by our medical professionals, by our supply chain management, by our pathologists, who are very courageous leaders, who are doing all of this work to save lives and protect lives.
That testing, which has seen an average of just below two per cent positive, means that we have one of the best analyses of the real rate of infection in the community. It then allows us to do the third thing, which is to contact trace, and our contact tracing means chasing down all of those who might have been at risk from exposure to a person who has the virus.
This is what’s allowed us to keep our loss of life down. And 23 lives lost is an agonising figure, but at well under one per cent of the known cases, it is one of the lowest rates in the world. Indeed, at this point, it is below half a per cent of the known cases. But we will keep an eternal vigilance.
And then the fourth measure is probably the most significant of all, it’s the social isolation, the distancing measures that are so hard for Australian families. But altogether, these are the things which are allowing us to see these early, significant signs of a moderation in infection rates and a flattening of the curve. That’s half of the equation.
The other half is about our capacity. Already, we’ve seen in primary care over 1.25 million telehealth consultations as we transform Medicare. We now have 10 years’ worth of work in 10 days. Our doctors and our patients, our nurses and our practice managers, are doing an amazing job, with over 1.25 million telehealth consultations.
Going forwards, we are expanding our care in aged care facilities, looking to roll out the flu vaccinations across those aged care facilities. And then thirdly, in our hospitals. We’ve already announced the partnership with the private hospitals, which brings over 30,000 beds, which represents a third of the ICU beds in the country, and brings 105,000 staff, and in particular 57,000 nurses, into the battle against coronavirus and supporting our health system.
Today, I want to announce that there are three measures that we are taking to boost workforce capacity in our hospitals even further. Firstly, we will, with Medcast that are here today, support and fund over 20,000 free treatments and free online courses to take existing nurses, to lift them to ICU capability.
Those will start in a few short days and that’s an extremely important measure. What Monique and Ross were saying to me, nurses with whom I was speaking just before, they are seeing a desire and a willingness and a great sense of spirit from our nurses who want to lift their skills and to support the existing ICU nurses.
This is what’s going to allow us to support those ventilators, which themselves will go from 2,200 to 4,400 and then to 7,500, to give us the capacity to meet even the most difficult of needs that we may face.
At the same time, in addition to those 20,000 new places which we’ll be supporting – and if more is needed, more will be provided – we are also supporting nurses, registered nurses, to come back into the workforce and we have seen, two days ago, Alison McMillan, the Chief Nursing and Midwifery Officer, announce that 1,000 nurses had already volunteered to come back. She’s just advised me that number has grown to 3,000 nurses and is growing each and every day.
So, our nurses are coming back in. Our existing nurses are seeking to increase their capacity. And on top of that, the Medical Board is working on mechanisms to help bring back doctors that have stepped out of the workforce, and we’ve seen a great interest in that.
And so, Professor Michael Kidd, Deputy Chief Medical Officer, and the Medical Board are working together. So, two things are happening. On the one hand, reducing the rate of infection, the first early signs of flattening the curve through the containment measures that we’re taking, and increasing capacity together.
I might invite Lori-Anne Sharp, from the Australian Nursing and Midwifery Federation to make some remarks and then Ken from Medcast.
These are extraordinary times during this global pandemic and obviously they require extraordinary measures. And we support the Commonwealth announcement today of the $4.1 million to 20,000 courses to upskill existing registered nurses in the workforce.
We hope that we don’t get to this measure, but we know that we need to be prepared. We’re seeing what’s happening to our international countries during this global pandemic and it’s very important that we increase the capacity of our intensive care beds and our intensive care workforce.
We also need to be reminded that nurses are doing an extraordinary job and we need the community support, and the best thing that everyone can do at this time is to stay home. We must do our very best at containing this virus.
We must also remember that those nurses, the 20,000 courses that are available, that this will be the individual registered nurse’s choice whether they uptake on this or not, and it will be available free to them. And we would seek support from their employer to do this during paid time.
So, we do welcome this measure by the Commonwealth. We are extraordinarily indebted to the work of what nurses and midwives and carers in aged care are doing at the moment, and we just encourage everyone to stay at home, to flatten the curve, and to reduce the burden on our healthcare system.
Thank you, Minister Hunt.
I’ll just correct one thing. I am Ken Hambrecht, the Principal Consultant of Critical Care Education Services, which is a part of the Medcast group.
And it’s been a whirlwind couple of weeks for our teams because we have been getting existing courseware online in manageable chunks so that nurses can move from the general ward area into the high dependency area, and then from the high dependency area into the critical care area, such as intensive care.
So, we’ve put together two courses – a high dependency nursing course, which is 13 hours of content, and then a critical care nursing course, which is 20 hours of content. And the aim is that nurses will be able to do modules within that course and then be supported by more experienced nurses in the workplace to actually go and be able to learn on the job.
So, if they’ve done the module on, let’s say, haemodynamic monitoring, they can then be introduced to the intricacies of that within the hospital setting. This course will be up and running by 9 April, and we’re pleased to say we’ve got strong interest in it already.
And I’d like to thank the Commonwealth Department of Health for their initiative in funding this course for 20,000 nurses to be upskilled to move into this area at this time.
Great. Thank you.
Now, we are going to take questions in an unusual way – over the telephone. I’ll start with the Melbourne crowd.
Hi, thanks very much, Minister. First of all, you’re talking about flattening the curve here. Do you think it’s a bit premature in Australia to be talking about flattening the curve, given that we’re about to go into winter and the flu season, which could create a massive spike in cases?
So, there are two different things here. Firstly, what we’re seeing- and I am being very cautious on this – is that our numbers have reduced from 25 to 30 per cent growth a day, to the low teens, down to, now, below 10 per cent.
But we won’t count it and bank it until it’s sustained over a longer period of time. Secondly, in terms of the flu, what we are seeing – and I did speak with Professor Michael Kidd shortly before talking with you, and he said that the expected arrival of significant flu would be in June. And so, that is why we are rolling out the flu vaccination.
We want people to pace it. Let’s focus on our elderly first and our health workers. But ring ahead, and make sure that you’ve got a booking. But at any time, over the course of the next month, that is a perfectly appropriate time to get that flu vaccination.
Next question, please.
So, moving on to the registered nurses and this extra training, why are we, in Australia, asking registered nurses to now be trained in intensive care?
So, we do expect that as numbers grow in Australia, that we will need additional support. As we expand the number of ICU and in particular, ventilated beds, then we move beyond our normal capacity.
And we’re able to draw in former ICU nurses – as I say, over 50 here, 54 at Frankston Hospital for example, have already put their hand up before this – but if we are doubling and then tripling and going close to quadrupling the number of ventilated beds, then we will need that additional staff.
But the staff are being amazing and flexible. They’re working more hours. Many part-timers are working full-time. Nurses are being upskilled and nurses are coming back into the workforce.
Sorry, just finding those questions, and how many nurses are you expecting will take up these new courses?
So, we’re fully expecting that all 20,000 places are likely to be filled. The nursing community, like- Australians as a whole have been magnificent. Australians, as a whole, have risen to this in terms of new business models, the practicing of isolation and distancing.
They’ve changed their lifestyles to protect and support each other, and our nurses are not just part of that; they are at the forefront of, what I would call, heroic leadership. And they are working hard, they are reskilling, they are increasing their hours, and they are increasing the re-entrance into the workforce.
As I say, two days ago, it was a thousand – that was the figure the Chief Nursing and Midwifery Officer had. Today, she’s just advised me that 3,000 nurses have volunteered and are in the process of returning to the workforce.
Also, just looking ahead towards the future of the battle with this. What provisions have been put in place in Australia, for sort of temporary or makeshift hospitals?
Well, I think what we have focused on is, by bringing the private hospital sector in, we have over 30,000 beds – 34,000 precisely. We have 105,000 staff and 57,000 nurses.
So, at this point, that meets all of our projections. And if more is required, then more will be done. But we believe that by the historic partnership with the private sector, which now becomes an integrated component of our public hospital networks across the country with all States and Territories coming on board.
Victoria has done a difficult and amazing job in striking those agreements. We believe that our hospital systems will, of themselves, meet the needs that we are projecting on even the most difficult of scenarios.
So, you don’t think there will be a need for any temporary or makeshift hospitals, then? We’ll be able to meet demand?
At this point, that’s our expectation. Correct.
Hold on, I’ll come to Canberra shortly. I’m just dealing with the Melbourne telephone.
I’ve got a few here. In terms of, you know, AHPRA’s sub-register during the pandemic, why is it so important for retired doctors, nurses, and midwives, and pharmacists also, to come back into the system? And you know, including final-year uni students coming in early. Why do we need that so much?
So, all of these measures are about boosting workforce numbers and boosting workforce capacity. And what we’re seeing is former nurses, former doctors, current nurses, current doctors, look at up-skilling. The College of Anaesthetists contacted me this week.
They are naturally trained to be able to expand their capacity to work when they are not doing operations into maintaining ventilator capacity and to assisting. And they are now working with the medical experts on what they can do in a similar way with nurses.
So, we’re seeing Australians volunteer in their community, but in the medical system as well.
Well that probably touches on, then – have you had many volunteers?
We’ve had tremendous volunteer support. Medical staff, allied health staff, nursing staff, doctors. And that is the spirit of Australia at its best.
So, these are the most difficult of times, but I honestly mean this – what I am seeing is the best of Australia at the worst of times.
I think one more from Melbourne and then I better turn to Canberra.
Yeah, we’ve got a few more to get through here. Just in terms of- are there any concerns around that, that these retired staff, given that some of them will be older members of the community, that they’re actually going to be potentially at greater risk of exposure to COVID-19?
So, these are all the considerations that are being focused on to make sure that quality is maintained and safety is maintained. And that’s why the Medical Board is working with Deputy Chief Medical Officer Michael Kidd. I might turn to Canberra for the time being. Dana?
Thanks, Minister. I just wanted to ask you about the modelling behind the Government’s response. Professor Paul Kelly said the other day that release of modelling in the interest of transparency. And he’s now backtracked on that this morning.
Did you or your office ask him not to release the modelling?
Look, with respect, both of those presumptions are incorrect. Firstly, the Prime Minister and Professor Kelly held a press conference, I think, a week and a half ago, where the modelling was provided. So, there’s a presumption behind that which is incorrect.
There was both a mitigated and an unmitigated scenario, and I believe your paper ran the results on the front page. The next thing is that Professor Kelly is leading an epidemiology workshop in the coming days, where we’re getting input, particularly off the back of the data, the cases, everything we’re seeing, from experts around the country, which will allow for the next round of modelling to be done.
And when that’s complete, that will be provided. So, what’s happening now is that we’re getting modelling input, which will come from experts around the country, the workshop that Professor Kelly is leading. And as we’ve done with the first round, that will be provided once it’s been assessed and completed.
Next question. Tamsin?
It’s actually Clare from the Daily Tele.
That’s okay. I’m just wondering if you could speak to the capacity that we have to cope with coronavirus in regional centres. In particular, New South Wales yesterday had its first death outside the city, in Orange.
A lot of these hospitals have ICUs. Does that mean that they are able to cope with severe coronavirus cases? And on top of that, in terms of the increased capacity that we’re getting extra ventilators and things like that?
How will that be distributed, in terms of, will a lot of regional hospitals be getting a boost, or will it just be targeted if there is a significant outbreak in a certain area?
Yeah. Very important question about regional capacity. Now, one of the things that’s occurring is, again, in regional Australia, we’re seeing people come back into the workforce. But in particular, as we’ve commissioned 5,500 ventilators through ResMed – and ResMed’s making these in Australia so we’re very confident about the production lines on that front.
That is more than the 7,500 we need, and a big part of that is to make sure that we have distributions through regional Australia. We won’t always know where an outbreak or a particular case might occur, so it’s providing that additional capacity, not just in the cities, but particularly for regional Australia, which is why we have over-ordered, compared with our expectations of even the highest of needs, because there is this question about making sure that we have care, protection and equity for regional Australians through the hospitals within their systems.
Next? Is Tamsin there?
Yes. Hi, Minister Hunt. Just in relation to the overseas arrivals coming in, since the measures were put in place to go into hotels around the country.
I was just wondering, of those cases- or how many people have been put into hotels so far since that’s been introduced? And of those people, how many of our new cases are being made up of those people and what was the testing like?
So, it’s a question about overseas arrivals. I’ll have to refer that one, I apologise, to Border Force and Home Affairs. It is one of our containment measures. So, when I talk about containment and bringing the curve down, the ring of steel around Australia is a critical part of that. I know this has been a very difficult situation.
I know that there are some thousands that have been put into quarantine in hotel accommodation. They can be very difficult for families, frustrating, and so we are making sure that they are all being taking care of. On the specific question of numbers however, I’ll respectfully refer that to Border Force, which will have those details. Then I might-
Minister, Clare again, can I just quickly ask one extra question? We just saw additional social distancing measures we’ve seen – particularly in backpackers and youth hostels – where obviously now these young travellers can’t go out, go anywhere except for essential reasons.
Would it be better potentially for their health if they were able to go back home?
Look, I understand that AHPPC or the medical expert panel is considering issues such as hostels to make sure that we have the best possible and the safest arrangements for everybody.
Overall, I will say this – and I’ll have to conclude here and I apologise for those that haven’t had a chance to put their questions – that Australians are incredibly receptive, responsive and doing the right thing.
Australians are responding magnificently in their approach to self-isolation and social distancing. That is helping us to make these early signs of progress. We are ahead of where I had hoped we might be. We are doing better than our best expectations.
But we are still seeing the fact that infection continues to grow, albeit at a slower rate, and that’s why, right now, the steps that we all take together will save lives and protect lives.
And that’s why today, this announcement about bringing more nurses back into the system and expanding the capacity of our ICUs is also about increasing the capacity whilst we decrease the numbers and help in those first early signs of flattening the curve.
Thank you very much, everybody.