AMA President Professor Steve Robson on ABC RN Drive - National Cabinet needs to release health advice on reduced isolation period

ANDY PARK:            Well, from next Friday, if you catch COVID - provided you don't have symptoms or work with vulnerable people in disability or aged care - you'll be able to come out of isolation after five days.

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JIM CHALMERS:      I think it's an important step which reflects the health advice that the Premiers and Chief Ministers and the Prime Minister received yesterday. That's the system working as it should be. Health officials, health experts briefing the leaders of our states and territories and the Leader of the Commonwealth and making sure that our settings are appropriate for the stage of the pandemic in which we find ourselves.

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ANDY PARK:            Those words from the Treasurer, Jim Chalmers, might be music to your ears as it might allow you to return to work faster if you do catch the virus. But the Australian Medical Association fears it will make labour shortages worse and have asked for the advice handed to the Government to be released publicly. Professor Steve Robson is the President of the AMA. Welcome back to RN Drive.

STEVE ROBSON:     Thank you very much for having me, Andy.

ANDY PARK:            The UK, US, most of Europe, even Israel have already dropped this seven-day isolation period. Did this decision really come as a surprise to you?

STEVE ROBSON:     I think the decision came as a surprise in the sense that the lessons that we've actually learned from overseas should be cautionary tales for us. And we were a little bit surprised. The data that we see suggests that as many as a third of people are potentially infectious on days six and seven, and if you're trying to manage a workplace shortage and sending infected people back into the workplace to infect their co-workers it’s potentially a problem. We've yet to see the advice that was provided. I guess at the moment we're being told that it reflected that, but we haven't seen it ourselves, so we're not sure.

ANDY PARK:            I take your point that the information, if it's in the public interest and I think we believe that it is, it should be released. However, wouldn't your argument be more fortified if you were able to connect labour shortages to the UK, US and Europe shortening of the isolation period? Do you know that is the effect?

STEVE ROBSON:     So a lot of the information that we have reflects the fact that there have been different rules, like a patchwork of different rules all over the world. And the one thing that's clear is that when these restrictions have been eased overseas, that there have been spikes in the amount of infection and they've put pressure on hospitals, they've put pressure on workforces.

            It's difficult to put one picture together because of the patchwork of different rules overseas. But what we've seen is worrying. And what we're saying, if these settings are going to change, and of course they're not changing, so people admit that in high risk settings they need to keep the seven days, we need to watch very closely and adjust the settings depending on what we see here in Australia.

ANDY PARK:            I mean, in my own anecdotal experience, I was certainly still infectious on this day seven and eight. Have you spoken to the Health Minister or the Chief Medical Officer about their reasoning? Have they offered any explanation beyond what was announced yesterday?

STEVE ROBSON:     No. We haven't heard anything from them. We've been asking these questions. We've certainly asked publicly as well and we've had little response. We're very keen to hear. We want to see the advice. If that is the advice they were given and they're following that, then it makes sense.

            But I think you have to understand that if they're trying to achieve a better workforce, then if you go about it in such a way that makes everything worse it's a potential problem. So we think there needs to be very, very close monitoring of what's happening from here, and no fear to readjust things if we find that, in fact, the new directions are having the opposite effect of what is the hoped-for result.

ANDY PARK:            You say close monitoring is a requirement. I was surprised that they didn't at least include a requirement for people to return a negative rapid antigen test before emerging from isolation. Why do you think that that was not a prerequisite?

STEVE ROBSON:     Well, again, there are lots of questions around the settings that are going to come into place from the end of next week. There's a lot of uncertainty. We think that employers around the country, healthcare workers who are just recovering from an absolutely horrific wave, need confidence that the Government is acting on the best health advice that they have to protect the country. Because I don't think we could cope with slipping back into the situation that we had over the last few months. It was exhausting for healthcare workers around the country and disruptive for people who couldn't access services and so on, Andy.

ANDY PARK:            So would you have been more likely to support this five-day isolation if they had insisted that RATs are a requirement?

STEVE ROBSON:     What we've said the whole time is that we would hope—we encourage—our political leaders to follow the health advice. And as you say, if you are going to shorten periods of isolation, then you need some sort of assurance that people, even if they have no symptoms or if they tell you they have no symptoms at all, at least we have some certainty that they are not infectious. And that is a surprising thing to us.

ANDY PARK:            Isn't there evidence that does back up this reasoning, though? I mean, we know vaccinated people aren't as infectious after a few days and that infectious periods have shortened with every new variant. I mean, surely that needs to be taken into consideration?

STEVE ROBSON:     Well, that's not quite the evidence that we're seeing, and the newer papers that we have in our access—and maybe they've got some secret data that we're not familiar with—still show that as many as a quarter to a third of people, even if they're vaccinated, even if they have no symptoms, may be infectious, potentially, on those days six and seven. So that's why we're really keen to see the evidence on which they're basing their decisions.

ANDY PARK:            What are the politics of this? We know that the New South Wales Government, the New South Wales Premier was particularly strident for arguing for this- for the National Cabinet yesterday. What's your read of the politics of this?

STEVE ROBSON:     Well, our read is that there is a focus that's fairly short term on dealing with what businesses see as the issue of difficulties in the workforce. And I know this - in my own practice we've had staff members off in this situation and it is really difficult. But the thing that we don't want is for everything to be worse. And our position is that if you're going to make major policy changes like this, then you need to be absolutely sure that it's achieving what you want. If it is making things worse, then you need to be prepared to reverse course and return to safety. And we're yet to see how this is going to be managed.

ANDY PARK:            Of course, the change doesn't apply- doesn't, I should repeat, apply to vulnerable settings like aged and disability care. Clearly, that won't please the Health Services Union who were calling for it to be scrapped altogether earlier this week. Did that appeal surprise you?

STEVE ROBSON:     So I think one of the big issues that a lot of workers face is financial insecurity. And I know that with the drop in pandemic payments that's likely to be coming that people will be at a financial disadvantage if they have to isolate for longer. We understand that. And with inflation and other costs where they are, there's significant pressure for people to be able to earn money. That could be allayed by making sure that people who do have to isolate still have an income for those few days that they're isolating. And I think there are other mechanisms that could be used if people are worried about that financial impact.

ANDY PARK:            On RN Drive, you're with Andy Park. And if you've just tuned in, I'm talking with the president of the Australian Medical Association, Professor Steve Robson. As you've said before, you've called on governments to increase their vigilance in the wake of this decision. If that's not RAT tests, what does that actually mean? What would you like them to do?

STEVE ROBSON:     I think we'd like to see data on this. And of course, you're absolutely right that with changes in testing and so on, it's harder and harder to get data. But if you're making a big policy shift, then you need to make sure that you're achieving what you set out to achieve. And if we begin to find that there are much higher levels of people who are having to go back into isolation, that there are ongoing workplace shortages, or in fact that absences from work due to illness and other factors actually get worse after this, then people need to think very closely. So we're hoping that the Government has got a plan in place for this type of surveillance, Andy.

ANDY PARK:            What are the signs? Earlier you connected the five-day isolation period with an exacerbation of labour shortages. What are doctors and health professionals looking out for in terms of evidence that that might be the case?

STEVE ROBSON:     So I think there are a number of factors, and one may be—and I hope this won't happen as we come out of winter—there are increasing presentations to hospital, increasing pressures on health services. But one of the markers that we see in particular is people who are on furlough or sick in health services, and that causes enormous disruption for patients. If we begin to see that, that's often a marker of what's happening community-wide. That would be a tremendous concern and it would provoke a call for urgent action. So we're hoping that doesn't happen, but we need to see.

ANDY PARK:            Just lastly, the AMA is making representations to the Jobs Summit this week. You were part of a roundtable a few weeks ago as nurses go on strike in New South Wales today for the third time this year. What's the AMA hoping will come of the Summit for the health sector?

STEVE ROBSON:     I think the fact that we're seeing nurses who've been so under pressure, who have had such a massive burden placed on them over the last couple of years, as have doctors and other people involved in healthcare. The fact that negotiations on their workplace conditions have broken down to the point where they need to protest, that's a bad sign, and it tells us that their concerns are not being met. We'd like to hope that this can be sorted out. We don't think industrial action like this is great for the community. So if the Government can work to resolve this and deal with it, it would be great. But it's another sign of how much pressure the healthcare workforce has been under and how critical it is for us to have everybody healthy and well if we want a functioning health system.

ANDY PARK:            Professor Steve Robson, president of the AMA, appreciate your time tonight.

STEVE ROBSON:     It's a pleasure. Andy.