TRANSCRIPT LEGISLATIVE COUNCIL LEGAL AND SOCIAL ISSUES COMMITTEE Inquiry into the Victorian Government’s COVID-19 contact tracing system and testing regime Melbourne—Wednesday, 18 November 2020 (via videoconference) MEMBERS Ms Fiona Patten—Chair Ms Tania Maxwell Dr Tien Kieu—Deputy Chair Mr Craig Ondarchie Ms Jane Garrett Ms Kaushaliya Vaghela Ms Wendy Lovell PARTICIPATING MEMBERS Dr Matthew Bach Mr David Limbrick Ms Melina Bath Mr Edward O’Donohue Mr Rodney Barton Mr Tim Quilty Ms Georgie Crozier Dr Samantha Ratnam Dr Catherine Cumming Ms Harriet Shing Mr Enver Erdogan Mr Lee Tarlamis Mr Stuart Grimley Ms Sheena Watt Necessary corrections to be notified to executive officer of committee Wednesday, 18 November 2020 Legislative Council Legal and Social Issues Committee 65 WITNESSES Ms Fiona Brew, Chief Executive, Colac Area Health, and Associate Professor Daniel O’Brien, Deputy Director, Department of Infectious Diseases, Barwon Health. The CHAIR: Good afternoon. Welcome back. This afternoon we are now joined by Ms Fiona Brew, who is the Chief Executive of Colac Area Health, and Associate Professor Daniel O’Brien, who is the Deputy Director of the Department of Infectious Diseases at Barwon Health. Thank you both very much for joining us this afternoon. On the committee today we have Deputy Chair Dr Tien Kieu, Ms Georgie Crozier, Ms Kaushaliya Vaghela, Dr Matthew Bach and, as I mentioned, I am Fiona Patten, the Chair of the committee. I will just let you know that all evidence taken at this hearing is protected by parliamentary privilege, and that is provided by our Constitution Act but also by the standing orders of the Legislative Council. This means that any information that you provide during this hearing is protected by law; however, any comments repeated outside the hearing may not have the same protection. Any deliberately false evidence or misleading of the committee could be considered contempt of Parliament. As you are aware, this is being broadcast, but it is also being recorded. We will be sending you a proof transcript of today, and I will encourage you two to check that when you have time to make sure that we have not misrepresented you. We welcome you to make some making remarks. Fiona, I believe you have a presentation to start us off with. Ms BREW: Thank you, Chair and committee, for the opportunity of actually participating in the public hearing today. Visual presentation. The CHAIR: Thanks, Fiona. Ms BREW: I am just checking that you can see that. The CHAIR: Indeed we can. Thank you. Ms BREW: Fantastic. I am going to start and just talk about our preparedness, which commenced in January of this year. Typically we had a health service response in preparing ourselves internally. But being a rural hospital, we also work very closely with our GPs, and in fact they are the predominance of our workforce. So in liaison with our general practitioners—and we have two predominant practices here—it was identified fairly early that they did not have the capacity to assist with testing, and part of that was because of their own comorbidities and also from infrastructure. So indeed we actually set up a clinic in February sometime. The other thing that we did was really value community engagement, and that is probably not a surprise when you think about the size of our organisation and our town being somewhat 12 000 to 13 000 people. In March of this year I was actually approached by a CEO of a major national business here and we did convene a meeting at the local football oval, and a number of community leaders actually attended. We also had local media involved in that, being both radio and print. At that meeting we really decided that we needed to have a health promotion approach or public health messaging. We actually developed a campaign, and our campaign slogan was Keep Colac Safe. Everything hung off that in our communication with business leaders and with our community so people could actually identify with it. We also had a communication strategy, and I will not open that link, but that is included for members to open offline. Part of that communication strategy was recognising that not people of authority but people of influence were participating in vignettes and key messages to the community. Also when we did have our outbreak we changed our messaging, and our campaign became Let’s Get Back to None. We changed our messaging at different times. One of the other things is that we had Father’s Day and we said, ‘The best gift you can give your father is to stay at home’. So we were responsive to what was happening within the community at the time. From a COVID service response our primary role was testing, and we had a very agile testing model. We worked with Barwon Health, but they indeed led the contact tracing as the public health unit, and monitoring was in collaboration with Barwon Health. So although the majority of that role was with Barwon Health, we certainly had input into that process. And accommodation and social support was provided through Colac, but in the early days it was in partnership with Timboon hospital. Wednesday, 18 November 2020 Legislative Council Legal and Social Issues Committee 66 Assoc. Prof. O’BRIEN: I am just going to take over here and describe the actual outbreaks just so you can familiarise yourselves a little bit with them. Thanks again to the Chair and committee members for allowing me to present to the parliamentary inquiry. Colac was affected by two major outbreaks. The first one was in mid-July. It occurred coincidentally at about the same time that the Barwon Health contact tracing, management and monitoring unit was set up. It involved quite a number of cases in the end, with 104 confirmed cases that were contact traced and monitored, 335 primary close contacts and also quite a number of secondary household and workplace contacts. It predominantly involved the abattoir in Colac, the Australian Lamb Company abattoir, and in the end there were 67 cases in staff and 15 cases in household contacts of staff. It was quite a complex outbreak, however. Firstly, it involved a very high-risk setting. We know that abattoirs are a high-risk setting. There is a huge risk for amplification and spread of the virus very rapidly in these settings, and by the time the outbreak was detected it had already spread across multiple production lines, shifts and different areas in the facility. But it also involved many challenges, which included a culturally and linguistically diverse workforce, many of whom shared accommodation, and being a large employer in the town it really had an impact on many other parts of the town, including local schools, early learning centres and such things as gyms and other community services. Finally, the other thing that complicated it was that by the time the outbreak was detected there was already evidence of unlinked community transmissions, so it had actually spread outside the workplace and those close contacts. In the end there were 23 non-ALC staff or contact cases, indicating further transmission outside ALC. But despite the of complexity of the outbreak, the size of the outbreak and the fact that it was reasonably established once detected, it was still completely controlled within four weeks and no further cases were detected after that. Just to give you an idea of how, I think, effective this was, if you look at the estimated risk of the number of cases that a person transmits to, it is thought to be about 2½ per person. If you look at the 67 cases in the ALC company, you would have expected maybe 160 or 170 household contacts or other contacts infected, and in fact only 15 were. That is probably a more than 80 per cent reduction in the estimated potential number of cases, so I think considering the significant complexity and size of the outbreak that that was an excellent outcome. Now, that outcome was not only through all the great management of the local and Barwon Health teams, as well as Colac, and also DHHS but I think the Colac community performed an amazing role in really addressing what needed to be done and really taking on this outbreak and doing something about it. So I think it was a great effort by the community. But despite all that effort, within really another six weeks unfortunately they were faced with another outbreak. This was imported from metropolitan Melbourne, so it had no relationship at all to the first outbreak. And it ended up involving 39 confirmed cases that required again contact tracing and monitoring, 576 primary close contacts but also as well further secondary and household contacts. Once again it was really very complex and involved at least five workplaces, an early learning centre and some very complex households and had spread into social networks. So it was certainly a major threat to the Colac community, but once again with the response of the management teams and the Colac community there was in fact no unlinked community transmission at all detected from this outbreak, and within two weeks the outbreak was under control with no further cases—so, once again, I think a really excellent outcome. Ms BREW: For the outbreak management Colac Area Health had an incident management team, and that was actually stood up in January of this year. Obviously the frequency it met changed over time and on what the needs were. We were also part of the emergency management team that was established in Colac, and my role was as a member of that team.