Dr Finkel appeared this morning before the Inquiry into the Victorian Government’s COVID‐19 Contact Tracing System and Testing Regime and gave the following opening statement:

Thank you, Chair, and Members of the Committee, for the invitation to appear before the Inquiry today and for the opportunity to make this opening statement.

This Inquiry is investigating Victoria’s COVID-19 testing, contact tracing and outbreak management systems. These are crucially important capabilities in our battle against COVID-19, but their context is important.

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As you know, I chaired the National Contact Tracing Review adopted last Friday by National Cabinet. 

During our travels around Australia, my fellow panel members and I saw, in all states and territories, including Victoria, a well-established two stage response to COVID-19.

The first and most important stage is prevention. 

Prevention starts with the help of each and every member of the population. We are all familiar with the list: physical distancing, personal hygiene, staying away from work and gatherings if unwell, testing if symptomatic, and mask wearing where required.

Prevention continues with public health measures related to workplaces, institutions, venues and special circumstances. These include appropriately-managed access to aged care facilities; COVID Safety Plans in workplaces, schools, hospitals and restaurants; attendance limits at public events; and quarantine for international travellers and others at risk of having been exposed.

And finally, prevention depends on the authorities being well prepared.  Preparations that include an enduring commitment to public health so there are experts on hand at all times, appropriate emergency legislation ready to activate, clear lines of command, training programs for the public health workforce, stockpiles of personal protective equipment and training on how to use it.

But prevention is never perfect. The coronavirus that causes COVID-19 is an insidious enemy. It is driven by a biological determination to reproduce. To reproduce, it has to infect human beings and jump between them.

Despite vigilant efforts to contain it, we should not be surprised that the coronavirus will appear in our community from time to time, as we have seen in the last few days in Parafield, following nearly six months in South Australia without a case in the community,

When cases appear in our community, we depend on our second stage response: the combination of rapid testing, contact tracing and outbreak management systems.

These systems are powered by people and technology. Both are important, in that order.

Let’s start with people. They must be trained within the police force, emergency services and health departments. 

To run large numbers of tests, pathology labs require a skilled workforce, and the test sites need health administrators, nurses and doctors at the ready.

Prudent preparation for a sudden rise in cases requires that health departments train a surge workforce for contact tracing, to be held in reserve and called upon instantly if the case load soars.

To analyse the pattern of spread and the origin of the infection, we need trained epidemiologists and data analysts.

Let’s continue with technology. It can help at every phase.

Pop-up test sites initially used paper forms for collecting patient information and tracking the test sample. When the numbers are high, processing these paper forms leads to significant delays and the likelihood of data entry errors. A modern system based on digital data collection, and digitally tracking the data all the way through and into the contact tracing system, is much more efficient and less error prone.

For contact tracing, confirmed cases are allocated to a contact tracing officer to call the patient and interview them to identify their close contacts, and then alert those close contacts that they have been exposed and must start quarantine. The interviews often take up to an hour. Traditionally, the cases are allocated manually to the contact tracing officers, and the interview details are recorded on paper, then subsequently manually entered into a database to assist with follow up. This manual process works at low numbers but is easily overwhelmed when the case numbers are high. Moving to digital allocation of jobs, and digitally prompted and digitally recorded case interviews, is much more efficient and less error prone.

Speed is of the essence. 

Even at high case numbers, test results should be available within 24 hours of the COVID-19 test sample being collected.

Even at high case numbers, for positive test results, no more than 48 hours should pass between the time the test sample is collected and the close contacts of the confirmed case being told to quarantine.

If an outbreak occurs, the authorities must bring people and technology rapidly to the frontline in order to contain the outbreak.

I referred earlier to the coronavirus as an enemy. There is another less obvious enemy: complacency in the population or in the system, which if we are not careful will occur in times of low prevalence, such as we now have across Australia

We can overcome this enemy, too, by constant preparation, including frequent, consistent and clear communication with the public; appropriate preventative measures; continuous staff training and desktop simulations to test the system in peacetime.

Finally, we should appreciate the difference between risk minimisation and risk elimination. 

Risk minimisation means that we allow Australians to return home, while minimising risk through compulsory and well-managed quarantine measures.   Risk elimination means refusing entry to citizens waiting to come back to Australia.

Risk minimisation means an open economy where we work and travel even in the absence of a vaccine or therapeutic, while minimising risk through personal and workplace preventative measures. Risk elimination means wide area lockdowns with all their negative consequences.

I have no doubt that risk minimisation is the way to go: risk minimisation based on constant preparation, with trained workforces supported by modern technology to prevent outbreaks and to rapidly contain them, should they occur.

To conclude, let me say that from our review of all the states and territories in Australia, we saw that the people and systems are now in place to minimise risk while maintaining an active economy and community mobility.

Thank you.

 

More information about the Inquiry and transcripts of the hearings can be found here.