AMA Transcript - The latest local and international developments in the Ebola crisis

16 Oct 2014

Transcript: AMA President, A/Prof Brian Owler, Doorstop, 4 Treasury Place Melbourne, 16 October 2014

Subject: The latest local and international developments in the Ebola crisis

BRIAN OWLER: … to the WHO, there's an unprecedented humanitarian crisis. It's not just a medical emergency, it's a complete breakdown of society. The UN and WHO have said that we have a deadline of the next 60 days in which to effectively tackle this problem, though to tackle this problem will mean that we potentially will see 10,000 cases per week in West Africa. That means that the disease is likely to become endemic, and of course, for those nations and the surrounding nations, that is going to be an absolute catastrophe.

We do need an international response. People in West Africa, the WHO, the UN, have all said, yes, we need funds but yes, we also need health care workers. We need health care workers to provide support to patients, we need treatment centres built, we need medical supplies and equipment. And we have seen a response from the US, response from the UK, China and even Cuba and other nations as well.

What we have said is that we do have people in Australia that have gone to West Africa and are working there with organisations such as MSF and the Red Cross. We have asked the Australian Government to also step in and provide assistance. We do not want them to send people who do not want to go to West Africa, but we do know that there are people that are prepared to go, that are willing to volunteer and to go and do this dangerous work. I understand the Prime Minister's and the Minister for Health's reluctance to send people because they cannot guarantee their safety. If we could guarantee their safety, there would be no need to send people to this region. But there are people that are willing to go, to expose themselves to the risk of this disease, and I think that is something that is very admirable.

The worst thing we could do is have those people go unsupported, untrained, and unresourced. We want to make sure we give them every opportunity through the organisations such as MSF or Red Cross, but they are at capacity. And what we need to do is have the Australian Government with its AUSMAT teams - where there are volunteers that are ready to go and do that work - help train those people for that particular situation and go and do that work in West Africa. Unless we do that, as I said, we are going to see a humanitarian catastrophe that will not only affect West Africa but the rest of Africa, and potentially the world as well.

The potential impacts are already being seen in Europe and the United States. And that's the second issue, is that we have seen in Texas overnight a second health care worker that was involved in treating a patient in Texas contract Ebola. There are also concerns about whether that might have spread to other people in society because of her travel on an aircraft. The fact that a second health care worker in Texas contracted the disease is a matter for grave concern for the AMA because it means that their protocol in Texas, which we would expect would have the procedures and protocols not to have the disease contracted by health care workers, has failed. And the fact it's two healthcare workers, not just one, obviously means that there is a significant problem, obviously, in a First World nation.

In light of that, we have seen President Obama convene a meeting at the White House of experts to look at the United States' preparedness for Ebola in its response. We do have concerns about the preparedness of Australia. I know after speaking to people at various hospitals that they are doing the drills, they are using the appropriate equipment, they are looking at waste management and all of the other things that need to go along with that. But I think in light of the recent events in Texas, we need to review Australia's preparedness and to make sure we are prepared if we do happen to have a case of Ebola that develops here in Australia. Obviously, it remains unlikely that we will have a case, but it's certainly not impossible.

I am surprised that the Government, and particularly the Prime Minister and the Minister for Health, have not convened a meeting of experts to look at Australia's preparedness and its response both locally and also in terms of sending people to West Africa, using all of the expertise, all of the experts that we have in this nation, to actually address this issue. I know that the Chief Medical Officer has been working with his State counterparts to try and make sure the States are prepared but I think we need to have the same sort of leadership that President Obama is showing in the United States here in Australia, and I think this is the time that our Government, particularly the Prime Minister and the Minister for Health, need to step up and make sure that Australia is prepared for a case of Ebola in terms of its hospitals, but also to look at ways that we can address our international response and send people who are going to volunteer to do the work that we need in West Africa.

QUESTION: Have you spoken to any Australian medical personnel who want to volunteer but aren't allowed to go?

BRIAN OWLER: I have spoken to people that have returned from West Africa. We know there are people that are willing to go but Medecins Sans Frontieres, MSF, have said they are at capacity; they do not have the resources to send any other health care workers overseas. We have spoken to people who work for AUSMAT and there are people who don't want to go but there are certainly people that are keen and willing to go. That's the sort of work that they often train to do. It is dangerous and we acknowledge that - the gravity of the situation and the fact we can't guarantee their safety. But that is the point. Unless we actually respond and actually control this with a global effort, unfortunately the cases are going to spiral out of control. And at the end of the day, it is not just going to be West Africa that's affected but potentially countries such as Australia.

QUESTION: You said obviously that the two health workers in Dallas - our hospitals are doing drills as well, but do you think our hospitals could handle currently an outbreak of Ebola here?

BRIAN OWLER: I certainly know that there are designated centres in each of the capital cities that could handle a case of Ebola, but I would expect that there are many hospitals around the world at this moment looking at what's happened in Texas, and looking at the fact that two health care workers have become infected, to make sure they review their procedures and protocols. It's not just about having the right personal protective equipment. It is about doing the drills with the nurses to make sure you have the number of people that you need to make sure that there are no breaches in protocol. The best equipment is quite clumsy and is quite cumbersome to wear; they need to be trained and drilled at not just wearing it but putting it on and take it off. Cleaners in the hospital need to know the right procedures to clean the room and how they're going to be protected. How to respond in terms of waste management? What's the response at the front door in the emergency department? How is the rest of the hospital handled, the rest of the intensive care units handled, in terms of if there is a case that is isolated in one of our hospitals?

Now, I know we have facilities, isolation rooms, to actually treat this very type of infection. And I do have confidence and I know that people are putting in a lot of effort but we need to make sure there is consistency across the nation and that people right throughout the health care system, not just nurses or doctors, but everyone involved that's involved in healthcare, knows how to tackle this problem.

QUESTION: If hospitals are currently now having to review the practices that are in place in light of the second health worker in Texas, isn't that a sign the hospital has been previously unprepared?

BRIAN OWLER: No, I think they are prepared in the best knowledge that they've had and people are now scratching their heads. Dallas, Texas, is a First World facility and you would expect that - or, you would not expect that two health care workers would become affected by Ebola by treating a patient with Ebola. So I think, in light of that, people need to review the way that they are conducting management. Obviously, people are going to be looking closely at the way the treatment was conducted in Dallas to make sure that the procedures are up to scratch. And I think it is timely that we review our preparedness and make sure every State is prepared for the way that this is going to be conducted should a case of Ebola appear on our shores.

QUESTION: Does this reinforce the Government's stance, though? If people have come back to the US, they don't know how it got past the health precautions, doesn't that reinforce our government's decision not to send people in case we get it back and we can't control it?

BRIAN OWLER: Well, I think the problem is, though, that unless we actually tackle the problem at its source, we are not going to see the problem go away. And what we're actually seeing, if we - if this disease becomes truly endemic in the population of West Africa, not only will it wipe out millions of lives but - and, in fact, the CDC has predicted 1.4 million cases - not only will it affect large numbers of people but it has the ability to spread through other countries in Africa, potentially to Europe and other countries around the world.

Now, the last thing we want to do is to make people panic or fearful but I think we need to have a very considered approach in terms of Australia's role in treating this particular problem and its global response. I don't think it is the time to put our heads in the sand and suggest that Australia should shut its doors and just pretend the problem is a West African problem and let other nations handle the problem by themselves. As we have seen, the United States has committed 3000 people at the moment, it may commit more in the future, to go to West Africa, not to just provide health care but logistics and treatment centres. We have seen the UK sending 750 people, including health care workers, to Sierra Leone. They are building a 12-bed treatment facility on the outskirts of Freetown that will be devoted to the treatment of international health care workers. We're even seeing China and Cuba are sending people as well.

I think we need to look at our role of the expertise we have. We clearly had people that are willing to go. We're not suggesting that anyone that doesn't want to go and do this work be sent, but we do know that we have the capacity for people that are actually able to go and do this work. They need to be properly resourced, properly supported, by our government.

QUESTION: Are you satisfied with the Australian Government's response? The Prime Minister said Australia's done a lot of Ebola - spent $18 million. Is that proportionate to a threat as large as this?

BRIAN OWLER: No, I don't think it is proportionate. And as I've said, funding is one aspect of this but what we know and what the people on the ground in West Africa are saying is that we actually need people to go there and to do the work. We need to make sure that we get people into treatment centres. We've got to have people build those treatment centres. Have people making sure they educate the public. We need public health experts helping their society. It is a complete breakdown of society in West Africa. I mean, there are literally, without exaggeration at all, people dying in the streets and unless we actually have people there going and doing the work on the ground, that situation is only going to get worse. So $18 million, I accept that it is a significant amount of money but in terms of the proportion of the response we are seeing, I think it is inadequate.

Now, I don't want to downplay the issues associated with Iraq and Syria. They are very significant issues with ISIS, but we are seeing at least half a billion dollars in terms of our military effort per year going in to treating that on a humanitarian and security basis, and I think we need to be thinking about this type of problem, not just a local health problem of West Africa but an international global emergency, a problem not only in terms of the humanitarian crisis, which should be sufficient on its own, but a potential security problem for the rest of the world and an economic problem. And that's the sort of way that we should be thinking about that, and I think if we are looking at the amount of resource and energy that we are putting in to other areas overseas, I think we can up Australia's efforts.


16 October 2014


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