All right well today we are here to both announce the numbers to date of people
who have been screened and the outcomes of the screenings that have occurred for
coronavirus, novel coronavirus here in New South Wales, but also to hear about
some exciting news from Professor Dwyer who will talk to us address that in a
moment but first of all can I just indicate that the number of people
screened from the airport since the second of February,
are fourteen and a half thousand people have been screened. Of those numbers 57
people had symptoms that needed further testing, but I'm very pleased to say
every single person has shown negative result. We also have had of course the
four confirmed cases, they were much earlier in the piece and of those three
people have gone home and one remains in Westmead Hospital. Now that particular
person has had some very positive scientific results of the way he is
coping with the virus Professor Dwyer will tell us in more
detail but I just like to indicate that out of every negative come as a major
positive and this particular patient has shown a propensity to have the virus
much longer than the other three people and as a result our Public Health
pathology unit, that professor Dwyer represents, has been able to isolate the
virus and to actually do some further studies which have looked at the
variants and I understand they have been up to about eight separate variants that
have been looked at, two full genome sequencing and that's an incredible
outcome for us in terms of being able to help the World Health Organization come
to grips with how this particular virus can vary, particularly as it's a very
very new virus and I think before we ask Professor Dwyer to actually say a few
words, I'll ask our Chief Health Officer Dr. Chant to say a few words and then
we'll ask professor Dwyer to give us the expert views
these matters. Dr Chant. Thanks Minister. I'd just like to acknowledge the community's
response to date, very much appreciate that the testing numbers have continued
to climb reflecting the fact that people are hearing the message around coming
forward for testing, because at whilst we're in this phase of containment we
are attempting to find any cases in the community so we can put that public
health action around them, so thank you. I would also urge those returning
travelers from mainland China to ensure that you're complying with the
self-isolation procedures and to also be aware of the information on our website
that supports you identifying the sorts of activities you can undertake and
those that you cannot, so once again I'd also like to acknowledge the assistance
of the Chinese community in getting the messages out. Both our doctors in
that community, our Chinese medicine practitioners and also the broader
community response has been great, but again again can I reiterate there is no
place in New South Wales that I would have any qualms walking around with
myself or my family and I wouldn't be wearing a mask in public, so masks need
to be kept for those patients with symptoms, they're not required in the
general population, so thank you Minister. Professor , I'll ask Professor Dwyer
to actually address this in terms of the amazing research. As they say I mean
New South Wales has invested very heavily in our Public Health and
pathology and this is an incredible result, so I'll ask Professor Dwyer just
to take us through what exactly what is occured. Thank you very much Minister.
What we've done at the New South Wales health pathology laboratory at Westmead
Hospital is isolate the virus from a number of different patients including
the most ill patients and we've also sequenced the virus genome or genetic
material from those patients as well. The advantage of having the viral isolate, as
we call it, is that we can confirm that our tests are working well and we've
already done that we can also make a contribution in terms of understanding
how the virus is changing around the world and
how similar it is to other viruses around the world and so we put our
genetic sequences up on the World Health Organization site for people to compare.
Also by having an isolate we can help other laboratories in New South Wales
and elsewhere to develop the right sorts of tests and we also potentially can
help vaccine manufacturers and so on by providing viruses that they can then
work on, to hopefully, eventually develop a vaccine. You might like to tell us about
the size of the virus and the RNA These coronaviruses they're fairly large
viruses as RNA viruses go. RNA is important because they're the types of
viruses that vary the most of them may change from person to person,
a bit like what we see every year with influenza. The technical aspects of
generating the whole viral sequence from a patient is quite significant and I
think that's a tribute to the people in New South Wales health pathology and in
the research labs at Westmead their ability to do that has really been terrific.
Also perhaps a bit about the patient's being in the hospital
for a little longer and why that has helped us to look at the variants
of the of the virus as it sheds. Thank you so one of the things that we're now
seeing with this outbreak as it spreads around the world, particularly in China
but also exemplified by the patient that that's currently in Westmead Hospital is
that most people have a very mild illness we know that already, but a
proportion of people get sick a week or so into their clinical illness and
progress with severe lung disease and why that is, is a little bit uncertain,
one of the reasons for isolating the virus and indeed getting th e genetic
sequence is that we can study why some patients do badly and again this is a
focus of activity around the world and and I think we've made a contribution to that.
So any questions for
So in terms of the full genome of the virus and as I said it's quite a big
virus, there's over 50 of those now around the world and we've made a
contribution with a couple of those. There's only been one other in Australia
up until last week, then the two from New South Wales and there's some coming
in from Queensland, because they've got cases as well. But what you end up with
is a large collection of these moderated by the World Health Organization, that is
open access to researchers and diagnosticians to examine and improve
our both research and diagnostic testing.
So at the moment we do see, what we've seen in in our patients is some subtle
variations in the genetic sequence, whether this means anything clinically
is unknown, and again we're working to see whether that's going to be important.
One of the features is that as viruses move from animals into humans, they, as they
spread amongst humans as as far as is doing they may change and so surveying
for that sort of change at the genetic levels, absolutely crucial.
Look I don't have details on the individual patient that that's not appropriate, but
certainly the patient's been in hospital for a couple of weeks and has been
really well looked after on the clinical side, and is doing quite well, but we're
getting regular samples from that patient to monitor both the virus and
the clinical state.
So there are many things that vaccine manufacturers need. Two important ones
are the genetic sequence of the virus because they want to know how different
is this virus from other ones in, elsewhere in China or in other parts of
the world, the second thing they need is to be able to grow the virus so they can
see how it behaves in people or in cells that are infected, and we do this for
example each year with influenza we grow up the virus we work with a W.H.O. to
examine them. So you need both the the isolate of the virus and the genetic
sequence.
So there's one sequence that's come from Victoria, there's now a couple of
sequences from New South Wales and I believe there's a couple of sequences
from Queensland as well coming online.
I don't have the clinical details of the patient, but in general most of them
been reasonably well, actually, and that's one of the features of the the corona
virus infection for most people it's a mild disease, but for people who've got
underlying significant health problems or of a certain age then they're the
ones who run into trouble clinically.
They're going to a global bank that that's run by the World Health
Organization and they're up there for people to analyse it's always been an
open access approach, which i think is super important and I think this is
actually development since the old SARS days where people pass a little bit more
hidden about information. I think people now are much better about
sharing this sort of information and that's sort of underpins whatever we do
in our laboratories.
So we've always known in our infection control and prevention advice from the
get-go was promised on the fact that it was spread by droplet transmission and
also potentially the airborne transmission. The distinction is when
it's likely to be spread in an airborne way. So Professor Dwyer can comment
but, when someone's more you all they're likely to have more virus and then when
they're coughing lots that there is a component of that that it's both
droplet and aerosol. There'd be certain circumstances some procedures that we do
on people like nebulisers clearly are aerosol generating and in times like
this we actually move, switch, use the opportunity to switch clinicians from
doing sort of nebuliser or aerosol aerosolised generating procedures to
using spacers and other ways of administering some medications, just to
minimise the amount of airborne transmission routes. so in summary we've always known
that a component of transmission could be by the airborne route. There are some
particular things that we do, either sick patients coughing, or when we put an
airway down someone's neck or when we do certain things that are going to induce
them to cough, that we know there's a higher proportion of airborne
transmission or likelihood of that compared to the droplet, but the
precautions that we've had from the beginning recognised, have always
recognised those various components. Did you want to say anything.
There's a discussion about the different ways of spreading the virus but really
the most important way is when people are symptomatic, when they're coughing
and spluttering and sneezing and have the runny nose and of course the sicker
they are the more likely they are to have a high viral load in their clinical
samples, so yes, we talk about what a-symptomatic shedding and and that may
well have a role but the the overall in thing is really how sick people are when
they when they come to medical attention. So could I just add something you notice
this we do need to emphasise that out of 14 and a half thousand people that were
screened for a 14 and a half thousand people have come through our airports
since the second at February only 57 showed any flu-like symptoms and they
were screened and there was absolutely zero of those people who had coronavirus
so the precautions that we're taking here in New South Wales are really
working and as Dr. Chant said we are very safe to go walking around in our
community I would encourage everybody to get out there and enjoy New South Wales,
particularly if the rain stops we do need to get out there and realise that
our economy also needs to be supported. Can I also add that the New South Wales
pathology where Dr Dwyer comes from in terms of his working life is doing
major work not only for New South Wales but also for Christmas Island. They've
been doing testing for Christmas Island, in fact one of our pathologists New South
Wales pathologists he's on Christmas Island working there and I think the
numbers are that there have been about five who have been tested from Christmas
Island, again the good news is zero, zero coronavirus, so at this stage it's
looking very positive and I would encourage people to understand that
being sensible yes, if you happen to have some symptoms and you've been in there
near China or come from China then get it checked out but other than that we're
doing very well
I'm sorry you'd have to ask this the Australian Minister
for that Greg Hunt, I don't know the answer to that, you wanted to ask Dr.
Chant something else? Dr. Chant.
I suspect it's a combination of the fact that we have taken a broad range of
actions which is really attempted to both reduce the travel from that from
the affected country which is mainland China we have also asked people to come
forward to testing and regardless of that we've also asked people to take
precautions like self isolation. So I think it's a reflection that the public
health measures have been effective. I think we are very watchful as I sort of
said you said from you the beginning we need to be watchful about what is
occurring outside our borders and that we're very connected
internationally. The questions will be, you know, how China is managing and
China's doing an amazing range of public health measures in order to dampen down
infections. We're watching those data change but also the region just keeping
an eye on whether we're seeing cases in in other parts of the region or other
parts of the world. All of those, that information, as well as better
understanding the severity profile. This has really been a very important period
for us to learn more about this and I think at the first conference I sort of
told you what we knew at that time but I'm really pleased to see that our
knowledge has actually very much increased even I think the three weeks
since we've been meeting and I suspect in the coming weeks you know we've had
virus isolated, we understand a bit more about the genetic variability of a virus,
we understand a little bit more about its infectiousness, we understand about
they've particularly for the cases that have been diagnosed that have traveled
from China, the world is sort of looking at those cases and sharing data about
the experience with those cases. this will all put us in a good position to
make the best Public Health decisions going forward, but that needs to be
continually modified depending on what's happening in China what is happening in
the world and what our experience locally is.
They may be like all things I've sort of highlighted that, it's got to be the
right set of measures at the right time and we've got to be watchful about the
changing circumstance both in China and globally I've emphasised before that the
Australian health protection principle committee is meeting regularly to
consider this and we're actually having quite a large meeting on Thursday to
look at all, with with additional experts, to look at all of the data to formulate
our thinking and advice to government. All right I think that's good thank you
very much and thanks for everybody again attending appreciate that, thank you.
Thank you. Thank you. Thank you. Thank you