Regarding the WA CHO's border closure comments reported yesterday, we now have a transcript, 20 pages:
https://www.parliament.wa.gov.au/Pa...B18D7C585D48258601002A5D8F/$file/09832545.pdf
And I have done my best to summarise just the bits that relate to border closures. I've already forgotten how this was first reported in the press, but this gives you a fairer idea of what actually happened. I've put page numbers in to allow for easy direct reference to the original transcript for fact checking/detail seeking.
CHO: DR Andrew Robertson, CHO Dept of Health WA
Dr Paul Armstrong Deputy CHO.
Chair: Janine Freeman
Deputy Chair: Zak Kirkup
Page 5 to 6
The Chair: Explain the 28 day zero community transmission?
CHO: It's based on two incubation periods. Makes sure we don't miss anyone. As we said to Federal Court, we believe they are highly effective in preventing imported cases to WA. But we continue to review to ensure they are appropriate and proportionate. As you know, we've made some exemptions and relaxed quarantine requirements, allowing people to quarantine at home.
The Chair: With six months in WA of no community transmission, how quick can we contact trace?
CHO: I'll defer to Dr Armstrong, but we're using updated software.
Page 7
Dr. Armstrong: We need good tools and good people to do good contact tracing. We have Salesforce based software, kept up to date in light of things learned during pandemic – we're confident it's fit for purpose.
Crucially, you can't let contract tracing get out of control. Our software (PHOCUS 2) is used in SA and New Zealand, and now Vic (replacing their paper system, which we never had in WA), and we're going to continue/upgrade in January, that process is underway.
The Chair: Will it integrate with WebPAS, the patient admin system?
Dr. A: Yes, thats key.
Chair: Is our tracing system different to NSW, the 'gold standard'?
Dr. A: I don't know if it's identical, but the principles as far as I know are the same – speed, accessibility and automation.
Page 8
Chair: What role if any is COVID App playing?
Dr. A: We've not had to use it.
ZRF Kirkup: On the evidence you gave to Federal Court; were you restricted in providing advice to opening to 'all states' or to 'no states'?
CHO: That's hard to answer, I'd have to go back to that. Most of the discussion was around other measures, like hotspots. The legal status of opening to some states but not others is outside my area. I could provide heath risk advice, but the legal matter is one for the Solicitor General.
ZRF Kirkup: So to clarify, the aspect of opening to all states or no states was reference to legal advice, not health advice?
CHO: Yes.
ZRK Kirkup: Have you considered other options other than simply closing WA borders? Travel bubble? Opening to certain states?
CHO: Yes, advice provided to the premier on Sept 25, which the premier made public. It included a list of options and risk of each.
ZRK Kirkup: Do you think it's achievable for all states to reach 28 days no community transmission?
CHO: Hard to say. Good progress made in NSW, even VIC is recovering well. It's possible to reach in one to two months, more like two, but my advice at the time is not predicated on borders being open to all states. Again, that's based on health advice, opening to individual states rather than all requires legal advice.
Page 9
Chair: and this is nothing new – the same advice presented 25 Sept and tabled in Parliment.
ZRF Kirkup: Has there ever been advice provided that other travel bubble or border controls could be maintained?
CHO: I provided early advice that could be considered including broadening exemption definitions and removing quarantine requirements for states with no community transmission.
ZRF Kirkup: I know you've provided this on Sept 25, but could you provide a brief summary of options given to govt earlier?
CHO: Obviously, we restricted Vic and NSW during their more recent outbreaks. And as the risk came down, we relaxed those extra restrictions. Beyond that, I've given broad guidance like business travel and family reunions, and removing quarantine requirements for states with zero community transmission – dependent on our confidence of the border arrangements within those states.
Page 10
ZRF Kirkup: So to clarify; the govt has been provided with options that suggest restrictions could be relaxed in certain circumstances, but it's up to the govt to decide to take your advice?
CHO: Yes.
Chair: In terms of being prepared, which is what we're here to talk about today, what current treatments and preparation have we done?
CHO: The ventilators we ordered have arrived having taken 3 – 6 months, also PPE, more beds and monitors. We've also been training up people.
- other discussion-
Page 12
ZRF Kirkup: The WA perspective is hard state borders remain until 28 days passes without community transmission. SA has gone 69 days, Tas 152 days, NT 193 days, ACT 97 days without transmission. I imagine the govt will respond to it's own health advice here, can you foresee the travel advice being changed to open up to those states?
CHO: Yes certainly. We continue to review epidemiology and border controls. But the focus is on the safety of WA.
Page 13
CHO continues: We need to be aware of our susceptibility within WA because very few restrictions apply here – it makes WA more vulnerable. We also need to consider the border controls of a state we might open up to – you could have people go from Melb to Adelaide, then fly to Perth.
ZRF Kirkup: Are you confident in any of the other states to manage these concerns of epidemiology and border controls?
CHO: Epidemiology, yes, all except NSW and Vic. Maybe opening up to some jurisdictions but not others is a possibility, and that will be considered in any future advice.
Page 14
Chair: Because of the susceptibility you mention, would a lockdown like the first round be the response to a potential outbreak? Are we assuming WA is a susceptible community?
CHO: Yes. The lockdown and measures would vary depending on outbreak severity and circumstances.
ZRF Kirkup: Currently people from WA could freely travel to other states based on the health advice, yes?
CHO: Yes, always have been – no restrictions ever applied to leaving WA, only on returning. I provided other options which could be considered to govt on Sept 25, including travel to other states without community spread, SA, Tas, NT, ACT and QLD.
Page 15
ZRF Kirkup: Does health advice take into account on social mobility or mental health?
CHO: It's a consideration, but there are going to be mental health impacts either way – like those from a prolonged lockdown in Vic, and delays for cancer screening treatments. We also appreciate mental heath impact from separated families. We've provided exemptions for border crossing when people have needed medical care.
The Chair: The Mental Health Commissioners have said they want mental health and social and economic issues on an equal and integrated footing with health impact. Is that considered when framing your health advice?
Page 16
CHO: One of the problems is its hard to quantify what the impact actually is. Its easier to quantify in a lockdown situation, but not easy to quantify impact of closed borders.
ZRF Kirkup: Is it fair to say that because we have de-restricted so much, we have boxed ourselves in to having to keep the hard border?
Chair: You're saying its a choice between restrictions or border?
ZRF Kirkup: Yes
CHO: It's a tightrope we walk here. My job is to assess whats best for health and safety of WA community, and that will vary over time. During Vic's 2nd wave, no one wanted us to open borders. Obviously, that risk has substantially decreased. It may come to the stage where we feel the risk is low enough to open to certain states- that's part of ongoing consideration.
ZRF Kirkup: So the govt has an opportunity now to open up travel arrangements based on your advice?
The Chair: The advice provided which was tabled 26 Sept.
ZRF Kirkup: and possibly before.
CHO: And in future as well.
ZRF Kirkup: It's only interesting to me, Dr Robertson, because the Premier has stated the 'all or nothing' approach with borders was based on health advice. But there's an option for selected states and territories.
CHO: We will always look at options going forward, but there is a legal element to that and other things for the govt to consider as well. But from a health point of view, I provide the advice.
Page 17
ZRF Kirkup: So it's not 'all or nothing'? There are nuaced approaches which could be taken, but the premier has suggested it's all or nothing based on your advice.
Chair: The health advice. I'll help here because that is an all-or-nothing answer he's asking from you. The advice handed down 26 Sept was based on risk assessment, which takes into account susceptibility because of WA's removal of restrictions.
CHO: correct.
ZRF Kirkup: So we can't remove border restrictions because we eased other restrictions so much.
Chair: It's not an all or nothing question. You don't have to answer that, CHO. If Kirkup wants to ask the premier that, he can.
ZRF Kirkup: it was based on health advice. If the health advice indicated we can ease restrictions, or we could soften the border, or there could be a mix, it seems there is an option provided to the government where the border could be softened with some changes in restrictions.
CHO: It's a sliding scale of risk – and we need to see where we are on that scale. And I provide advice on that.
ZRF Kirkup: Which you've done previously.
CHO: yes.
The Chair: I want to raise type 2 diabetes as one of the commodities.... (fin)
) before they can move across the border anyway!
