Press Conference - Australian Parliament House, ACT

Transcript
29 Jul 2020
Prime Minister
E&OE

PRIME MINISTER: Good morning everyone. I’m joined by Professor Murphy this morning in his capacity as the Secretary of the Department of Health. The reason for that is as Secretary for the Department of Health that he is directly overseeing the operations of the Department and engaging with the Victorian Government in relation to the aged care issues currently that we are addressing in Victoria. Of course, Professor Kelly would normally join me on broader issues and will continue to do that in our normal updates and briefings, whether it be on National Cabinet or on broader reporting that we do on the pandemic. But given that Professor Murphy is the one directly responsible in his duties as Secretary for the Health Department, that's why he joins me here today. I just wanted to make that very clear. Everyone is doing a tremendous job amongst our CMO team, as they are in the Department of Health and as you know there are many challenges.

The situation that we have been facing, particularly in recent days and weeks in Victoria for aged care, has been very distressing. It is very distressing first and foremost to the families of those who have loved ones in aged care facilities. The most vulnerable in our community have always been our highest concern when it comes to managing the health issues associated with this pandemic. That has always been true for the elderly, but it has also been true for those who have many other comorbidities, those who are undergoing chemotherapy treatments, those in Indigenous communities and remote areas. We have always been aware of those who have been most vulnerable in our community and elderly persons, particularly those in facilities which these days, as we know, aged care has changed. It's one of the reasons why I called the Royal Commission into aged care because the nature and demands on our aged care services have changed. In many ways, aged care facilities in many instances have become a form of pre-palliative care in Australia. Many years ago it was quite different, but these days, particularly with the in-home aged care options that we are continuing to expand across the country, more Australians are choosing and it is a good choice to be able to make, to remain at home. But those who have moved into aged care facilities are often moved in at a much more advanced stage and all of us who have had to make those decisions in relation to loved ones understand that and so I think that attaches to it a particular sensitivity in the challenges we're now facing.

The challenges of dealing with aged care are not unique to Australia. Indeed, in every country in the world where there is sustained community transmission, it is inevitable that this will find its way into aged care facilities. When it rains, everyone gets wet. And that is what we're seeing with broad-based community transmission in Victoria. As the Premier rightly said, if you are ill, do not go to work. That is true if you work in a meat processing plant, it is true if you work in a chemist shop, it is true if you work in a restaurant, it is true if you're a journalist, a politician, whoever you may be, an aged care worker especially. We have, I think, over 750 healthcare workers in particular in Victoria who have been infected with COVID. This is the product of community transmission and whatever workplace it is, then workplaces are vulnerable and that's why the Victoria Government has rightly put in place the protections they have to try and protect against that workplace transmission.

Now, in relation to aged care facilities in Victoria, there are over 430 such facilities in Melbourne. It's a large number of facilities. We have seen some very distressing and concerning situations arise in a handful of those facilities. In facilities such as St Basil's, in facilities such as Epping Gardens where we have been working very consistently over recent days, in Kirkbrae. There are a range of other facilities where there have been COVID cases, around 13 that we are keeping a very close watch on. There are facilities outside of that list of 13 who are obviously in areas where there is community outbreak which we are also watching, but they are not what you'd call the critical list of facilities where we have a keen level of focus. So it's important to understand, because I can understand if people in Victoria or even elsewhere as they're seeing it unfold the very distressing stories out of St Basil's and the other facilities which have been affected most acutely, that they will have concerns about the facility where their family is. The good news is broadly across the aged care system in Victoria, we have been able together, working together with the Victorian Government, able to avoid those quite distressing scenes in the overwhelming majority of those facilities. But we will not be complacent about it and the establishment of the Victorian Aged Care Response Centre has been a key initiative to ensure that we continue to stay on top and hopefully ahead of any potential threats that may emerge in those facilities.

I'll ask Professor Murphy to speak to a number of those distressing cases. As I said yesterday when I was in Queensland before returning here yesterday, I want to be as up-front with you as we possibly can about what has occurred in these facilities. And I said the Royal Commission will have absolute ability to go into the intricacies of these issues, and I hope they do because all lessons always must be learnt. But in the meantime, happy for us to convey as much as we possibly can because I believe that can provide some assurance to the public that we are aware of the problems that have occurred and more importantly are taking actions to deal with those problems and to try to prevent them in the case of any outbreaks that may occur in the future in these facilities. But I do stress, the principal cause for transmission into aged care facilities has been through workforce transmission. It has principally come through the infection of staff, more broadly in the community, in many cases completely unaware of that infection and by the time they became aware of that infection, then obviously they'd been in those facilities. And that is true in many workplaces around Victoria. In the case of aged care, then obviously the consequences of that and implications are far more serious to those for whom they're providing care.

The actions that have been to principally address the disruption in workforce in these facilities. Where cases have been identified in facilities, there had been an immediate isolation of entire workforces in these places. Now, if you take out an entire workforce in a facility, that is going to have obvious impacts for the continuity of care and very distressing consequences have flown from that. They trouble me deeply, I know they would trouble the Premier equally deeply, our ministers for health, we are all very distressed by those events that took place in those few facilities that were affected in this way. And so it has been important in those cases to move as quickly as we can to get workforces into those places. Those workforces have been drawn from broader nursing staff but also, in particular, in the Epping Gardens centre, they were supported by the ADF and on one occasion arranged quite late in the evening. But going forward, the key actions that were necessary were to ensure the cessation of all unnecessary elective surgery and to free up the private and public nursing workforces to support those aged care facilities. The aged care facilities that are in the most distressed situation, you wouldn't describe as being in a normal aged care environment with residents. They have moved effectively into an in-patient care type facility, akin to what you would see in a hospital. And so that requires in many cases an even higher standard of nursing care in those places and so getting access to that private and public nursing workforce is a critical part of the solution to ensure we can move people quickly into those situations. So I welcome the decision of the Premier yesterday to make those decisions in relation to elective surgery. That is already making a very big impact and I want to thank, particularly, the hospitals that have been in the clusters of areas around where these facilities are in working so quickly with our team in the Victorian Aged Care Response Centre to be able to make those staffing available.

The second area of response was to transfer patients - because they had become patients, in most cases - out of aged care facilities into both public and private hospitals. That has been an essential action, both to ensure that those Australians were getting the support and care they needed, but also that the facilities themselves could be brought back to a level of operations where the workforce could support it and that those who remain in those facilities could get the standard of care that we would all expect. So I thank the Premier also for his agreement to that step, working together to solve the problem. And that has also had a very significant impact. Last night, Professor Murphy can update you on this, but we had significant further transfers out of Epping Gardens, I understand, but there was also, I think, Wyndham Lodge as well, we had some transfers yesterday and a number of other facilities. That is relieving the pressure on those places and that is welcomed.

A third part of the response has been the calling in of AUSMAT teams. The first of those I anticipate to arrive tomorrow. Those teams, we hope, to get up to five within a reasonable period of time. They're teams of seven. They act as a first responder, if you like, into places that are going through a critical response need and to stabilise the situation and to provide not just the medical and clinical support but the leadership, medical leadership, that is required in those critical situations. And that is something they can supplement very, very effectively. And we welcome that support as well and that has been arranged, of course, by Minister Hunt to go in as part of that response. There is also the broader work which is being done on infection control. Professor Murphy can go through those figures, but some 150,000 aged care workers have been trained with those training modules that have been provided through the earlier response provided by the Commonwealth. It is also important that that will now be refreshed and part of the task that has been undertaken through the Victorian Aged Care Response Centre, led by Joe Buffone, has been to now coordinate teams to be going into facilities across Melbourne to ensure that we're getting compliance with infection control procedures. Part of the response team that has been going into places like St Basil's and others has also, in particular, in Epping Gardens today involves geriatricians as well as infection control specialists working together with senior nursing staff to ensure those facilities can be stabilised. St Basil's, I'm advised now, has been brought to a stable position and we're working very hard to ensure that Epping Gardens is in that position as quickly as possible.

The other critical part has been in communications and I want to commend Minister Colbeck for the work that he's been doing to ensure that we're getting as much communication to families as possible. As you know, there will be a principal point of contact for every resident with a family. And today, I'm advised that there will be outward calls to all of those family contacts in the Epping Gardens facility. That has already been done in relation to St Basil's and that is the practice that has been put in place. There is also a system that has been put in place where Services Australia is supporting the communication to families working with the nurses and others in the facilities who are providing those details to Services Australia so they can be communicated directly to families. It is our endeavour to contact families as often as possible to ensure they have the information of what is occurring with their loved ones.

I will leave it to Professor Murphy to go into more details of the response, but since returning yesterday, these are the things that have been put in place. I genuinely want to thank the Victorian Government for working with us to get these solutions in place. These are our shared responsibilities, as the Premier and I know. We have been in contact with each other this morning. We'll be speaking later today. We have been in regular contact over these issues and I want to assure Victorians, in particular, but Australians all around the country, premiers, chief ministers, myself, our officials, our teams are working together to just focus on the problem, to solve the problem, and to keep Australians safe. That's my sole objective.

Now, more broadly on the Victorian response, we continue to support that effort. The ADF obviously highly involved with that tasking and I can note today that the door knocking task that the ADF had been involved in will be expanded. That's proving to be very effective and so further resources are being directed towards that task. The testing regime in Victoria continues to run at a cracking pace and I commend them for the rollout of that program. Also I want to thank all states and territories. Last Friday, as I said to you, we agreed a national dashboard of key data that enables us to track even more closely the performance of all states and territories as they're going through their testing and their tracing regimes. Now, for many states and territories, we welcome the fact that they're entering zeros into those datasets and long may that be the case, but when those numbers move, it's important that we are able to identify those as early as possible. It is also pleasing to see that the outbreak in New South Wales has been contained. That has now been the case for many days and again I commend the New South Wales Government and the excellent tracing work they have been doing to stay on top of that. The response down in Batemans Bay has been particularly welcomed and I'm pleased to hear that the situation there has stabilised significantly and the broader cases that have been identified, they have moved on extremely fast to ensure that they can be contained.

Just finally, I just want to make a couple of points on the economic issues. It is clear that the Victorian wave that Australia is now experiencing, and that's how I honestly have to describe it. I mean, there's not a second wave that's going across the rest of the country, that is not occurring. There is a significant Victorian wave, but that Victorian wave is impacting the national economy more broadly. We're seeing that in the payroll data. That is the most, one of the most, timely datasets we see on employment. It is affecting other states. We're also seeing that on things like table bookings at restaurants and in states that aren't affected by COVID in the same way that Victoria has. So that's what I mean when I say Australia wins when Victoria wins. It's in the national interest, both from a health perspective and an economic perspective that we ensure that Victoria wins here and we're all backing Victoria to win and we're all putting everything we can behind Victoria to ensure they can do that and where we have shared responsibilities, we're working incredibly closely together.

I also welcome the announcement by APRA today, made before markets opened, which will ensure banks will have continued flexibility to be able to deal with the commitments that their clients have on their mortgages and business loans and things of that nature and I think that has shown a fleet-footedness by APRA in response to the crisis. Also, of interest, the Australian Office of Financial Management announced the syndication of a $15 billion, 50-year bond - sorry, 30-year bond. That is the second, I understand, of those 30-year bonds. One was done when I was Treasurer. They locked that in at some 1.9 percent. That means that we are changing the profile of our debt and ensuring that the interest costs on our debt, which have had to rise significantly, the amount of new issuances we have had have been at record levels, combined together with T-notes (Treasury notes), we’ve raised just some under $2 billion in recent months, $197.6 million to be exact, $132 million through bonds. These have been oversubscribed. That is an indication of the confidence that the world’s financial markets have in both how Australia is managing, I think, the COVID pandemic, but also the financial management of the country through this pandemic. And with that I'll pass you to Professor Murphy.

PROFESSOR BRENDAN MURPHY, SECRETARY OF THE DEPARTMENT OF HEALTH: Thank you Prime Minister. So in this evolving global pandemic with nearly 17 million reported cases and multiples of that unreported almost certainly, one of the key lessons is that where you have sustained, significant community transmission, there are tragedies in aged care. Aged care cannot be completely protected from sustained community transmission as we have seen in Victoria over recent weeks. Despite all the preparation, the infection control planning, the deployment of PPE, the pandemic and infection control plans that every facility has created, the restriction of visitors, the staff screening, all of those cannot protect against what the Prime Minister said was the inadvertent bringing into the facility of this virus.

One of the things we have all learned about this virus in the last six months is this terrible combination of a virus that can spread so easily in fit, young people, sometimes without any symptoms, and yet when it gets into our frail elderly people, it wreaks havoc. And it has a very significant death rate, fortunately some do recover and, but it is a very, very nasty virus with the elderly. We have always said from the beginning of this pandemic that we cannot completely protect our elderly unless we control community transmission.

So we do have outbreaks in 77 of our residential aged care facilities in Victoria. That is around about 10% of the 770 or thereabouts residential aged care facilities in that state. And given that there are 465 facilities in the outbreak hot zones, that in some respects shows just how well the others have done given the widespread community transmission that has occurred across that hot zone of the Melbourne metropolitan area and Mitchell Shire. Many facilities have protected their residents with extreme attention to detail and focus. It's not the fault that those facilities have outbreaks, that they have had cases introduced. We know that people, residents have often, families have said that sometimes they have observed breaches and we will look into any issues in the retrospective analysis of these significant outbreaks. But these incursions of this virus into facilities are essentially unavoidable. For most of those 77 facilities, there have only been one or two small cases. The public health response has been swift and prompt. Isolation, quarantining of contacts has brought the facility under very good and early control. In others, there have been substantial and bigger outbreaks. We have 13 facilities that we are keeping a very close eye on at the moment. Many with more than 20 cases. We now have across all of aged care, including homecare, 456 residents who are now Covid positive. That is still a relatively small proportion of the cases in Victoria but it is probably the highest concern group of people that are infected with this virus. There are also 381 staff who have now contracted Covid virus across the aged care sector. On top of that, there are many hundreds of hospital and healthcare workers who have also contracted coronavirus and there are also many hundreds, sorry, there are many hospital staff who have contracted, not hundreds but there are many hundreds of hospital staff who are in quarantine and isolation.

So the loss of staff with the virus, the loss of staff who are in quarantine, both in the aged care and hospital sector has put a huge strain on the workforce supply. It is essentially one workforce across health and aged care. That has been one of the most significant factors. The most tragic part of this aged care outbreak is that there have been 49 deaths in aged care. That is a terrible tragedy and there will be more. There will be more deaths with the number of aged care recipients that are infected. We know that, it is a certainty. We will see deaths every day and that is a tragedy. This virus, once it gets into many frail elderly people has an inevitable, fatal outcome in some cases. There is no effective treatment as we know, there are some treatments that can help a bit in some people, but essentially it has an inevitable outcome. We, our hearts go out to the families of those people who have lost their lives and to those families who will lose their loved ones in coming days and weeks. This is the concern above all that hits us in the health sector in this Covid pandemic. And that is one of the reasons why you have heard the Victorian Premier and the Chief Health Officer there talk to those younger and fitter people who aren't sick, who are spreading this virus in the community. That is the consequence of not doing the right thing if that is happening.

I will talk a little bit about two significant outbreaks. The first one that occupied us over many days last week and on the weekend was the St Basil's home for the aged. That, as the Prime Minister said, we had an event that we have not experienced before in the outbreak such as in New South Wales we had before, and the other outbreaks in Victoria where the nature of the outbreak was that the public health officials in Victoria decided that the entire staff of that facility should go into quarantine, management, staff, everyone - the whole staff. So we had to find, in partnership with Victoria, a new staff. new leadership. And that staff had to be found in a context where there essentially were no spare staff in Victoria because of the number of staff and contacts that were in quarantine and isolation. So it was very very difficult. Staff were found from all sorts of sources but they were not staff that knew this community and there is no doubt that there were, a very challenging situation and there were clearly deficiencies in care. Once those deficiencies in care became widely known to us last weekend, we immediately moved to decant residents from that facility. 64 have now been moved to hospital settings. There are 32 remaining. There is new management on site and all the reports are that this facility is now well-managed and care is good and we have that independently verified from a number of sources. But there were clearly deficiencies in care last week and stories which you will have heard reported and which troubled all of us about that. And obviously, the Minister for Aged Care, Minister Colbeck has undertaken to the families that we will do a review of that outbreak as we did in the two big outbreaks in New South Wales.

Our biggest concern at the moment is a facility in Epping; Epping Gardens. Again a facility where the great majority of the workforce had to go into quarantine. And a workforce had to be found very quickly. And that has been done with the huge support of the public hospitals in Victoria who also don't have any spare workforce but they have closed beds and wards and closed operating theatres with the elective surgery cancellation, and freed up their workforce to go out and support this facility. There are still issues in that facility. I understand that there are still concerns from families and staff. We are in the process of decanting a substantial number of those residents, up to 45 out of that facility. We are putting in some very senior workforce to cope with the loss of the many senior staff from that facility who unfortunately had to quarantine. We are very confident that we will have that facility stable like St Basil's in the next 24 hours.

There are 11 other facilities with significant sized outbreaks as the Prime Minister has said. Many of those facilities have quite large numbers of cases. But they are managing extremely well. Some of them have, they have all co-horted those residents, lessons we learnt from Newmarch House and Dorothy Henderson Lodge in New South Wales. So some of them have a floor of positive and some have a floor of negative. They are being supported by their local hospitals and they are being brought in to, with nursing staff, infectious diseases physicians, public health physicians and as the Prime Minister said, they are setting up a hospital in the home type environment in the residential aged care facilities. Many of those facilities have also decanted staff to private hospitals in significant numbers when they feel like the load on the facility, or that those residents need hospital care. On no occasion has there been a situation in Victoria where a doctor or a clinical staff member feels that someone would benefit from hospital care when that hasn’t been provided. But given that the events of the last few days, we have spent a lot of time with the Victorian Department of Health, working out ways to ensure that these sort of staffing shortages don't ever happen again. And we have now got a very strong agreement that priority will be given to meeting the staffing needs of every residential aged care facility with public hospital staff. They are the only staff at the moment we have left, we're looking at trying to bring in from interstate, additional nurses and trying to recruit new personal care workers from nursing students and other sources. But at the moment, the only staff that are available when there are mass quarantines of staff are the hospital workforce. And I can say with incredible gratitude to my colleagues who run the hospitals in Victoria, how much they have stood up and provided senior nurses, teams of nurses to go into facilities where there are staff shortages, where staff are in isolation or in quarantine, and step in and fill the gap and provide that leadership. We have seen that in several facilities over the last 24 hours and we have a guarantee now that this will happen and we will make sure that at no stage do we get a staffing situation which leads to those significant deficiencies in care.

We also have, with a very welcome announcement of the Victorian government, the cessation of non-urgent, elective surgery. We are freeing up significant private hospital capacity across Victoria and we will continue to transfer residents with Covid, or with high care needs from those facilities where it is seen necessary to make the care environment safe. You can make the care environment safe as we have seen in St Basil's at the moment. There are still some positive cases there, but things are stable and good by all accounts. So there are many other things we are doing. As the Prime Minister and Minister Hunt have said, we have set up a joint Victorian and Commonwealth government aged care response Centre where we now have a number of senior clinical staff, infection control, geriatrics, senior nursing staff, to respond to these issues, to rapidly deploy to a facility that has any issues. We have set up a workforce agency which will recruit staff from interstate, fly in some nurses from other states, create a new pool of nurses to help, and personal care workers to help support these facilities. We are also going to deploy a range of infection control enhancements. As the Prime Minister said, there was extensive training in infection control but when you're busy, things can slip and you need to have people coming in to supervise and ensure that you are doing the right thing. As Minister Hunt announced, we are also deploying face shields. Staff in residential aged care facilities are now wearing masks routinely but if we can put face shields on top, that provides additional protections, stops people touching their mask, and ensures that people are much more aware of infection control practices. We will be also making sure that every facility is visited by an infection control expert that can ensure that the training is up-to-date and that people are refreshed in that way. We are very, very keen to make sure that those facilities that don't have outbreaks continue their excellent protection and practice and we want to help bolster them. It has been very difficult for families because they have been generally prevented, except in limited circumstances, from visiting, but we have to keep anyone unnecessary out of these facilities to protect the residents.

Finally, I wouldn't be, it would be remiss of me not to say that the most important thing we can do to solve the residential aged care outbreak in Victoria is to control that community transmission. So to all of my fellow Victorians, and I am a Victorian at heart, please do what your Premier and Chief Health Officer is saying. Please keep that movement to an absolute minimum. Please do what you're being asked to do. Do it for your elderly, fellow Victorians because it is the community transmission that has caused this problem.

Thank you Prime Minister.

PRIME MINISTER: Thanks, Brendan.

JOURNALIST: Dan Andrews said yesterday that he wouldn’t let his own mother into some of these aged care facilities, now given they’re regulated by the feds, how do you respond to his quite emotive criticisms of your government’s handling of these aged care facilities, and is there blame shifting going on?

PRIME MINISTER: I am not interested in any of that. What I'm interested in and I know what the Premier is interested in, is us working together to solve the problem. And the reports of, I think these things about how the Premier and I are working together are greatly exaggerated. The Premier and I enjoy a very good working relationship. We enjoy a high level of respect for each other and the responsibilities we each have. And we will continue to conduct those responsibilities as the public would expect us to do, and in fact as each of us would expect us to do. And I said earlier, that all of us, many of us I should say, have had to make decisions about our elderly loved ones who have gone into aged care. And it is an even harder decision these days because we know that, in many cases if not most, we are making decisions about placing our elderly loved ones into pre-palliative care. And that was certainly the case with my own father last year. And they are difficult decisions because you're coming to terms with what you know is the situation. And so I completely understand the emotion that is around this issue. We saw this with Minister Hunt yesterday, and I understand the emotion of whether it is the Premier or anyone else about these issues and that’s why I think we have to deal with them sensitively, which is what we are seeking to do. It’s why I’m so appreciative of some of the heroics of the nurses and nurses aides and assistants of some of those working in the most affected facilities is truly extraordinary. Whether it was the ADF nurses that went in at 11pm the other night into what was one of the most challenging circumstances they have certainly faced. Or whether it was those who just bravely got out of bed each day and said I'm going back to work today. I say thank you to them. They have concerns and we want to allay those concerns, particularly with the practices that Professor Murphy has outlined today. Whether that is in the provision of PPE equipment, and the additional support going into infection control, to assure the aged care workforce that they can get to work, they shouldn't go if they are not well, obviously. But those protections can be in place and that is what the Premier and I are keen to, I think, reinforce. The entire system depends on that operating effectively. The aged care system has challenges in it because of what I have said before. That is why I called a Royal Commission into Aged Care. I'm not naive to those challenges, and the significant demands that are going to be placed on the Commonwealth to respond to those. Already we have made some significant responses when it comes to in-home aged care places, and in the budget we will be making more. But what I am keen to stress today is the context and the context is that out of more than 430 aged care services and facilities in Melbourne, we have got some very serious and acute conditions in 3, arguably 4, and that includes previously Monash, which we had to completely transfer people out of. In the hundreds of other facilities around the state, particularly in the metropolitan area, then they have been managing extremely well. And so I would point to that experience to calm people's concerns and certainly to not add to the, any exaggeration of how that relationship is proceeding. The relationship is a very strong one. We have worked together for some period of time now and that working relationship undoubtedly will continue to serve both Victorians and Australians I think hopefully well.

David?

JOURNALIST: Why is it only today that some of this federal intervention is happening? Why wasn’t it not coming forward at the National Cabinet meeting on Friday? This crisis has been weeks in the making in aged care. Have you acted too slowly on this?

PRIME MINISTER: Well David, you must have missed the announcement that was made on Friday made about the establishment of the Victorian aged care response centre. That is what Professor Kelly announced from that very platform, that was one of the measures that were put in place because of the need to bring together the joint response. What had occurred over the weekend, in particular, which rapidly escalated the situation in a number of these facilities as I said was the complete withdrawal of the workforce. That is not something that happened in Newmarch in New South Wales. This was a new situation, that had not been anticipated or foreshadowed at a state level or considered at a federal level, that an entire staff of an entire facility where there had been a significant Covid outbreak would be completely removed. Effectively almost immediately. And so that placed an incredible strain on getting the continuity of care, staff that had to be drawn from not the usual sources, at different levels of training. Doing the best they possibly can, could under the circumstances but it is very distressing what those events lead to. And so what you are seeing David is that these circumstances that we are facing, constantly change. And they present new challenges. The challenges that we have in Victoria are very different to those that we experienced In Newmarch. In Newmarch, the majority of the staff were able to be retained in the facility to ensure that there was a continued continuity of care in those places. There was not broad based community transmission that led to what occurred in Newmarch. In Victoria, there has been and that means that more facilities are at risk and the fact that more facilities have not resulted in the circumstances we have seen in these, this small number of facilities in Victoria is welcome news, and encouraging news that by and large across the vast majority, the overwhelming majority of facilities, that those protections have proved sufficient to date, but we are not complacent about it and that is why we are taking the additional measures now. So we will continue to make the response, we will continue to respond to the cases that present, and we will continue to work together to get the right response.

We’ll come back over here to Andrew, and then Phil.

JOURNALIST: Professor Murphy, welcome back, I bet you’ve missed it. Can I ask you to update us on the ICU capacity down in Victoria and what thinking there might be or what planning there might be to boost that from other states and territories, perhaps by transferring patients? And Prime Minister can I also ask one about pandemic leave? Clearly you have resolved the issue in aged care but extending pandemic leave to others to ensure they aren't at work if they are told to be isolated. Can I ask that one as well?

PROFESSOR BRENDAN MURPHY, SECRETARY OF THE DEPARTMENT OF HEALTH: So I haven’t got the actual data on ICU capacity, but we are very comfortable with that situation at the moment. The outbreak in Victoria has seen some hundreds of people in hospital but ICU occupancy is still well within its base and we have already substantial plans to expand ICU capacity in the public and private hospital system in Victoria. I don't think there would be any foreseeable need in the next - unless we had a very significant increase in the number of severe cases - to do that. This is one of the challenges at the moment in Victoria is that we have seen this problem in aged care but the hospital system has otherwise been coping very well. We can get back to you on the current data today on the ICU capacity. I have come prepared for aged care but all of our reports are that we are very comfortable with the ICU capacity in Victoria at the moment and with the already planned expansion capacity. There is a lot of potential expansion. That is not a current concern. Obviously we are watching it carefully.

PRIME MINISTER: I think that’s one of the biggest differences between now dealing with this Victorian wave and when we were dealing with the broader first national wave is the concerns we had in those in that first few months was we had to build up those ICU capabilities and not only is there that capability in Victoria that has been built up but obviously around the rest of the country. As you say, you can put a respirator on a plane and you can move it between states very quickly. So that is I think a welcome assurance to people that we have a much higher level of confidence today than we had back in April and March when it came to those issues. On the issue of pandemic leave, it is a matter I have discussed with the Minister for Industrial Relations and as you know there are ongoing discussions between the government, employer groups and employees about a range of issues around managing the pandemic. And that will be one of them.

JOURNALIST: PM, you spoke about the effect of Victoria on the economy more broadly. Until the Victorian outbreak, we were sort of on track to reopen a large amount of the domestic economy by now, mid to late July. Can you even estimate or guess when we might reach that point that we were supposed to be at now given what is happening in Victoria, at what stage we might get to having all the borders open and most of our commerce…?

PRIME MINISTER: Not at this stage Phil, with the status of the Victorian waive. I'm significantly encouraged by what we have seen in New South Wales. Where there has been a real test of the system with a number of outbreaks and the capability to get on top of those quickly should give all of the country great encouragement, that it is not an inevitable consequence that where there are outbreaks, it can result where, sadly the Victorian situation has come to. That's not a criticism, that’s, they’re just an observation of facts. So I think that is encouraging. It says that, yes, we can get on top of this when it occurs. So you know, there are a couple of cases in Queensland today. And a school has been closed for a short period of time to deal with that. I have a lot of confidence as expressed to me by the Chief Medical Officer this morning, the Acting Chief Medical Officer Professor Kelly about the response to that situation and the readiness of their tracing capabilities in Queensland. So I think once we get a better read on where these numbers are in Victoria and hopefully we will see better numbers from Victoria today but we don’t know. But what I do know Phil, and I have got another meeting with that group of what was known as First Movers later today, is that a number of those are facing similar challenges to Australia. A lot of countries that went through that first period, as successfully or almost as successfully as Australia is now seeing this again. So this is not unique to Australia. But you know, I was at Walker Seafoods, a visit I made yesterday, it was tremendously encouraging because it just showed a business that was adapting and changing their business model, making use of the supports that were available to make decisions, keep people in work, grow their business get themselves out of it and when businesses are doing that and governments are doing what governments are doing, then it is my hope that we can have a better read on that in about a month from now. But I think any time before that, I mean, that’s I think a cautious estimate - a month from now, if we get a better read on that in the next couple of weeks then I will be the first to celebrate that.

Mark?

JOURNALIST: A couple of matters for Professor Murphy. Professor, it is reported this morning that you made a direct request to the Victorian government last week to further restrict elective surgery to free up nursing staff for these aged care facilities and that when that hadn't been done by Sunday, you are said to have been shocked that that was the case. The Victorian Government says the first communication they had with you about this matter was on Sunday and you didn't make any direct request. The first direct request came from the Prime Minister in a text message on Monday. Can you clarify those events please for the record? And secondly, the operators of Epping Gardens have distributed a memo to resident’s families saying that they wanted to transfer the elderly residents to state run hospitals and the Federal Department resisted that. Can you clarify that for us please?

PROFESSOR BRENDAN MURPHY, SECRETARY OF THE DEPARTMENT OF HEALTH: So the, I have no evidence that the federal Department has resisted that at all. The Federal Department has been cooperating with the Victorian Department to find private hospital beds as quickly as possible, and we are in the process of transferring a significant number of residents. We have got to obviously comply with the residents wishes and their concerns. I have been in discussion with the Victorians authorities about elective surgery and I first discussed it with a senior official in the Victorian health department I think on the 15th July wondering what they were doing with elective surgery. I have had many informal discussions with people late last week, certainly on the weekend on Sunday I did say that this has become really crucial that this is stopped now and I did make a very formal request. But we have been discussing this over, late last week and on the weekend. So I think it is a bit of a storm in a teacup. They did, they had a Cabinet meeting and they have made a decision and that is the most important thing.

JOURNALIST: Prime Minister, WA Premier, Mark McGowan has said he won't be lifting the state's borders until he can be confident there is no community transmission in the Eastern States. Clearly there still is widespread community transmission in the situation in Victoria, given this and given the fact that you have said part of your suppression strategy, the goal is no community transmissions. Why is the Federal Government supporting Clive Palmer in his High Court challenge against WA’s hard border?

PRIME MINISTER: Let me be clear, we are not supporting Clive Palmer. An action has been brought in relation to the WA border. It goes to quite serious constitutional issues which the Commonwealth could not be silent about and my concern is that it is highly likely that the constitutional position that is being reviewed in this case will not fall in the Western Australian Government's favour. And what I am keen to do is to engage with the Western Australian Government to ensure that we can have appropriate health protections for the people of Western Australia to ensure that there is not transmission from areas associated with outbreaks, that was the basis of a position that I have been consistently putting to Premiers. It is absolutely critical that we do not get transference out of outbreak areas. That is our Government's policy. And so my fear is, is that if an all or nothing approach is taken to the border question, then that will not serve the people of any state well. And so I would welcome the opportunity to come to a position where we can address the genuine concerns that people might have in any other state, but particularly in Western Australia, to ensure that they are covered off and that is my only real objective here. The constitutional position is one that provides for there to be free movement of Australians across borders, that’s what a Federation is, and that that free movement should not be prevented. There are much more broader consequences of this case that go beyond specifically the pandemic and that is why the Commonwealth responsibly has to be able to put the responsible constitutional position. This is not done in aid of Mr Palmer in any way shape or form, in no way at all. I warned the states and territories that if they make arbitrary positions on borders that they are likely to find themselves in this situation, that someone is likely to bring a case and that this may well crystallise a constitutional position that would not be to their advantage so as I think the Finance Minister and our Senior West Australian has made the point in the West today, very keen to engage in a way with the Western Australian Government that protects the health of Western Australians and protects the health of Australia and the prosperity of Australia and so we are not seeking any sort of conflict here, whatsoever. We would like to have a very productive outcome here but I fear a sort of an all or nothing approach on the case is not the best way forward here because I think the constitutional position is fairly clear. Now it is not for me to bush lawyer that. I'm not a lawyer let alone a bush lawyer so, that is the advice I have from the Attorney-General, who is also a Western Australian. So I'm concerned about the sort of combative way that this is unfolding in Western Australia and I would like to find a much more productive way forward.

JOURNALIST: One of the consequences on your role as PM, of COVID, has been your ability to travel overseas to meet global leaders. We obviously know that is incredibly expensive and we've seen that virtual summits have been quite effective in the interim. After the crisis, do you intend to travel normally, or do you think that virtual summits will be a part of the future?

PRIME MINISTER: I hope they, virtual summits, are part of the future. I think there has rarely been a more frenetic period in which an Australian Prime Minister has engaged with other leaders, particularly as we have been dealing with the pandemic matters and most of my recent calls have particular been going to the issue of accessing vaccines and their production and things of that nature and we have another set of those calls later today. But the traditional method of leaders coming together also cannot be underestimated. I mean I don’t think it is a question of either or, I look forward to a time where you can do both. I note that European leaders now are starting to get back to face-to-face meetings under controlled circumstances, I indeed hope to be part of a series of those meetings in Washington later next month. But that is still scheduled to proceed and I'm looking forward to attending that and intend to, should it go forward. So look I think you have got to get the balance of both of them together but I think there has been, I mean just, I think this morning there was a meeting of the Canadian Deputy Prime Minister and our Deputy Prime Minister on these issues and once again the Canadian Government have been very complimentary of Australia’s approach to the pandemic. A lot of countries have looked to see what we have done here. You know we mark ourselves very hard in Australia, and we should. We should mark ourselves very hard when it comes to the care of the most vulnerable in our community and particularly the elderly. We should mark ourselves hard and so we should be concerned about the distressing circumstances that have unfolded in Victoria and that is a good thing, but we also need to understand that you are better being in Australia than anywhere else at the moment.

Kieran?

JOURNALIST: Queenslanders have declared Sydney, hot spot, the entire Sydney region a hot spot, so from Saturday residents from Sydney will be blocked from travelling to Queensland after two returned travellers tested positive. What is your reaction to that? And another question just on AUSMIN and China because Secretary Pompeo in the last few days has said that democracies like ours need to try and induce change within the Communist Party leadership. Is that a reasonable proposition? Would you get on board with that?

PRIME MINISTER: I think it is wise to ensure that there is no transfer of people from outbreak parts of the country to those where there isn’t an outbreak. That is as true from ensuring that there is no transfer from someone in a suburb of Sydney to another suburb of Sydney, to another state or territory. I think it's important to sort of put borders aside when it comes to those things. If you are not in an outbreak zone, well you don’t want people moving to where you are and otherwise you end up in the situation that we have ended up in broader Metropolitan Victoria. So I think that is very sensible that you limit movement of people out of outbreak zones and I support that very strongly. That is the basis of the position I have been advancing to the states and territories from the very outset. I talked about the need for testing, tracing and managing outbreaks. That is how you manage the pandemic and you keep your economy running. Now, on the broader issue of the AUSMIN meetings which have been very successful in Washington and these are good opportunities, as the G7-plus as it effectively will be when it  meets hopefully later next month, and other meetings of that nature, these are great opportunities for like-minded liberal democracies of developed economies to come together and share common views about how we work with each other, how we develop our economies and how we work together to promote peace and stability globally and particularly in the Indo-Pacific region and that has been the focus of these talks that we have had with AUSMIN on this occasion in Washington. And so I would agree that the more that like-minded liberal democracies, particularly those developed economies, but broader than that. The participation, I think, of India in these discussions which both Prime Minister Modi and I were able to attend in France last year, this is very helpful. The like-minded partnership that has increased, which is strengthening between Japan, Australia, the United States and India, not just on economic issues but broader strategic issues, I think contributes to a strategic balance in the Indo-Pacific which promotes peace and stability, which is what we want. We want a successful Indo-Pacific prosperous region. We want China's economy to be strong and successful. We want Malaysia 's economy to be strong, we want Indonesia’s, we want Australia’s, we want Japan’s, Korea’s, Myanmar’s, we want all of these places to be strong and for that to happen it has to occur on the basis of a stable balance within the region and I think the cooperative way which like-minded developed economies, liberal democracies are coming together, I see as a very positive force of peace and stability.

I suspect Chris has a question along similar lines.

JOURNALIST: You answered so magnificently I’ll move on. You mentioned the 30-year bond issue. There has been a lot of talk recently about modern monetary policy essentially so the government can borrow from itself forever. Are you compelled by that idea?

PRIME MINISTER: No.

Paul, you have been very patient.

JOURNALIST: Yeah, on pandemic leave, when did you ask the Industrial Relations Minister to consult on that issue? Does that indicate now you are inclined to provide it and why now when unions have asked for this for months?

PRIME MINISTER: I've spoken about that in recent days.

JOURNALIST: Can I ask, Senator Holly Hughes attended one of the COVID implicated Sydney restaurants and has chosen not to self-isolate, I understand.

PRIME MINISTER: I'm not aware of the circumstances of that so I can’t really comment on it.

JOURNALIST: How is the staffer forced to self-isolate?

PRIME MINISTER: I suspect he's been giving Netflix a pretty good workout. Hopefully he is doing a lot of work on other briefs and things of that nature which I suspect he more likely is. But I think what that demonstrated was the rapid nature of response of the New South Wales tracing effort. He was contacted very readily and I was informed on that on Sunday evening and immediately made the decision that he obviously would not be travelling the next day when I was going to Queensland and, sorry, on Tuesday when we were going to Queensland. And then we took the appropriate advice from the Acting Chief Medical Officer about how that was managed. As you probably observed, we are a bit more strict on how we practice social distancing than clearly the Press Gallery is today and as they are on most occasions when we’re standing out here. But we do follow that and I want to thank, particularly, my staff and the medical support I’ve provided and my own doctor here in Canberra who takes regular checks on me and that’s practiced pretty significantly here to ensure that I do not provide (inaudible) just the once.

JOURNALIST: Prime Minister, are we in danger of being caught in a pre-election vortex with the Trump administration…

PRIME MINISTER: Sorry, I couldn’t quite hear you.

JOURNALIST: Are we in danger of being caught in the pre-election politics in the United States? Is that why we are slightly at odds on some points in that AUSMIN letter and not as strong as the United States had hoped?

PRIME MINISTER: Australia sets its foreign policy on our own national interests and while we have the deepest and most lasting friendships and alliances with the United States, that doesn’t mean we always share every view to its minute detail and there is often a difference in nuance or emphasis or timing and on occasion in substance. And part of that is because our economic composition and relationship with our region is different to the United States and so those economic issuances will be different. But there is no doubt about the core of that friendship and that partnership or about its objective. Now, we are both passionate, vibrant liberal democracies and thank God for that. And that means that in the seasonal politics, which is the electoral cycle, as is occurring wonderfully in New Zealand as well and many other democracies around the world, there will be elements of politics that comes into that. We see that in our own domestic situation, there are some state governments going into elections and there others that are not and that influences the policy and political debate here in Australia as well and I think we are all capable of separating those issues and I have no doubt in the engagements I have with leaders around our region that we can factor out what is the noise of politics and be able to focus clearly on the issues of substance.

JOURNALIST: Your Government has commissioned reports following the outbreaks at Dorothy Henderson Lodge and also at Newmarch House, why haven’t those reports been made public yet? Have they not been finished or are you looking at them internally and just to Professor Murphy, you have today said that you are going to be sending infectious disease experts into all the aged care facilities. Why was that not done until now, given the deadly impacts we have already seen?

PRIME MINISTER: I’ll ask Brendan to update on both of those.

PROFESSOR BRENDAN MURPHY, SECRETARY OF THE DEPARTMENT OF HEALTH: The Newmarch report is not completed yet. The Dorothy Henderson Lodge report has been provided to the Royal Commission. That will make it in the public domain because the Royal Commission into aged care has had a significant interest in these aged care outbreaks. So that will be published on the Royal Commission website. But the Newmarch report isn’t even completed yet. So that study is still going on.

JOURNALIST: (Inaudible)

PROFESSOR BRENDAN MURPHY, SECRETARY OF THE DEPARTMENT OF HEALTH: Well, there’s… you do not do these reviews until things are completely settled down and there is a calm. You don't do a review when things are still active. So the Newmarch review was a very long and complex process and it obviously had to be done remotely because people were in different states. So it has taken about three or four weeks and it is being written up at the moment. It will also be provided to the Royal Commission and it will also come into the public domain. The lessons we've talked about on many occasions. The lessons are that you need to cohort people, you need to obviously do communications. Newmarch, the most important lesson was communication with families was the biggest breakdown. The care and the infection control was strong. One of the lessons that Newmarch was bringing in very good infection control experts, which New South Wales Health did, and having really good PPE. So in terms of the Victorian infection control, there has been a lot of infection control training already. There was lots done early in the pandemic, there were roadshows, there were online modules, facilities did their own. What we are now saying is that we have freed up some workforce with the cancellation of elective surgery of some experienced theatre nurses, so that we have got a larger pool of people who can go out and just repeat the training that people have had already.

PRIME MINISTER: We have time for two more. One and two.

JOURNALIST: Given, following up on the pandemic leave, given the urgency of the situation in Victoria, can we expect to see something on that sooner than the October Budget and have you looked at the cost of not doing it, the cost to the broader community and not just the actual dollar cost of doing it?

PRIME MINISTER: Those discussions are continuing and when they are completed we will make some announcements.

JOURNALIST: Sorry, just deflation, first time in 22 years. Is that a good thing or bad thing for households?

PRIME MINISTER: Well, look, these most recent numbers are, I think, quite unique to the rather extraordinary circumstances we find ourselves in. What I know is good for Australia is people getting back into work and what I know is good for Australia is business having the confidence to open their doors again and what I know is good for Australia is that when there are more people in work, then that is providing the revenue to support the essential services that Australians rely on. We're going to see lots of numbers that will be interpreted many different ways and I'm not going to provide a commentary on that. A good example is a point I was making last week and this is the issue of unemployment. Now, for a long time we have always looked at the headline or the published rate of unemployment, measured rate of unemployment, as being the key indicator of unemployment in what is happening in the economy. Now, we know that is not the case in this pandemic. The measured unemployment rate understates the amount of unemployment that we are seeing in our economy at the moment and what we have occurring at the moment is we have the effective rate of unemployment actually falling while the measured rate of unemployment is rising. And I'm sure that some will take the opportunity to pick their figure, as to make whatever case they would like to make. But why the effective rate of unemployment is so important is it takes into account those you may have gone out of the workforce but in ordinary cases would still be in it, those who are working zero hours but may not be considered unemployed. I think we have to have a real, honest understanding of what's going on with unemployment in this country and that is why the Treasury have advised and we agree that the effective rate of unemployment is the right way to assess where the labour market is at the moment. And what is concerning to me is, more concerning to me, I must say, is the payroll data which shows that the Victorian wave is having this broader impact on the national economy and is in some cases slowing and in other cases reversing the upward trend that we were seeing in employment in the country. That is of great concern to me and so, you know, inflation traditionally shows a level of activity in the economy, a letter of positive, in acceptable bounds, of positive tension in the economy and clearly, the impact of the pandemic which has produced the COVID recession is having a negative impact on the economy and I think everybody understands that. So what do you do about it? What you do about it is get Australians back into jobs. You provide JobKeeper, you provide JobSeeker, you provide cash flow support, you give the instant asset write off, you do HomeBuilder, which is proving to be a great, a tremendous success, you provide support to the entertainment industry, you go and get films to come and base in Australia, you put $1 billion into skills training and create 340,000 places and support 180,000 apprentices. That is what you do and that is what we are doing and in the Budget there will be more. But for now, we are now focused on delivering the supports which are keeping people in jobs and keeping people in business and we are focusing on the health of the pandemic so we are saving lives and we’re saving livelihoods. Thank you all very much.