When
NSW Chief Medical Officer Dr. Kerry Chant appeared
before an Upper House Standing Committee inquiring
into the NSW Government’s Management of the COVID-19 Pandemic on
Tuesday 10 August 2021, she did so in company with Liberal MLA for
Wakehurst & NSW Minister for Health and Medical Research Brad
Hazzard.
It
was noticeable from the start of their joint appearance before the
Inquiry that
Hazzard was hostile to the existence of
this particular inquiry and suspicious of certain members
of the 8-member Committee.
"The
first speaker said this was not in some sort of—gotcha moment. And
all you are trying to do is carry-on like a—"
"...you
are just asking questions which are just aimed at just having a go."
"I actually thought it [giving evidence] was a ridiculous proposition..." [Brad Hazzard, NSW Minister for Health and Medical Research, 10 August 2021]
Equally, it was evident that Hazzard also intended to constrain the questioning of
and evidence
given by Dr. Chant.
He
reminded the Chair and Dr. Chant that she was unable to speak to the Inquiry as to the nature/content of
discussions held during crisis committee meetings or produce copies of
correspondence, reports or other written advice that Dr. Chant had given to
this committee because the crisis committee was a committee within
Cabinet.
Nevertheless
Dr. Chant did reveal that, 4
days after the NSW Delta Variant
Outbreak began, a birthday party at West
Hoxton attended by around 30 people was
underway and, although
in coming days 24
of the 30 guests were diagnosed
as infected with COVID-19, it was felt that infection spread had been contained early.
However,
although the party was broken up by NSW
Police and everyone was sent into home
isolation by NSW Health,
the containment door was never really locked and NSW Health failed to notice. Or if it did notice, failed to realise the full public health implications of a highly infectious new variant which might not act like the original virus or other known variants.
It
appears that the public health response to this super spreader birthday
party was the originating error which undid whatever effective infection containment had been
achieved in the first few weeks of the Delta Variant Outbreak,
because this particular infection focal point began cascading the virus through
south-west Sydney.
Becoming
a tipping point to a growing infection rate,
until the outbreak could not be contained within
Greater Sydney and began to infect regional
and rural New South Wales.
Cabinet crisis committee members might have received the first hint of a south-west Sydney containment issue by 29 June 2021 when it was discovered that at least 39-40 people had actually attended the West Hoxton birthday party and first contact and subsequent contact infections were still growing. Other COVID-19 infections which likely originated within that area 30-40 miles south-west of Sydney's CBD were still being reported on 4 July 2021.
Although concerns were growing of a possibly unknown transmission trail, there was not yet the political will to further extend the already expanded Greater Sydney lockdown or initiate a statewide hard lockdown.
The Berejiklian Coalition Government's approach to public health infectious disease control was not occurring in a vacuum. On 23 June 2021 a fellow Coalition Government leader, Liberal MP for Cook & Australian Prime Minister Scott Morrison, publicly endorsed the Premier Gladys Berejiklian's reluctance to lockdown hard and early:
“I
commend the New South Wales Premier for the way that she is handling
the outbreak in New South Wales, the fact that she hasn't gone to
lock down Australia's biggest city. She has taken, I think, the very
positive decision to keep Sydney open and to keep New South Wales
open for its residents and to continue to rely on what is Australia's
best contact-tracing system, the one in New South Wales.” [Prime Minister Scott Morrison in House of Representatives Hansard, 23 June 2021, p.44]
It
wasn’t until 25 June 2021 - 10 days after the West Hoxton super spreader party was held - that what might be described as a semi-hard lockdown began in Sydney's eastern and inner west suburbs. It seems at the time no-one had turned their minds to thoughts of possible further infection spread from West Hoxton deeper into Sydney's south-western suburbs.
On 25 June NSW Health reported that 20 of the 80 COVID-19 cases linked to the Bondi infection cluster were associated with the West Hoxton birthday party.
July 25th was Day 40 of the NSW Delta Variant Outbreak and 36 days after the West Hoxton party. The original figure of two people in the state with a locally acquired Delta Variant COVID-19 infection had risen to an est. 2,226 men, women and children with 8 deaths. On that day the records show 156 COVID-19 cases were in hospital, with 44 people in intensive care, 18 of whom require ventilation.
The next day that semi-hard lockdown grew to include all of Greater Sydney, as well as Wollongong, Blue Mountains and the Central Coast.
It wasn't until a tardy 56 days after that disastrous birthday party that a state-wide lockdown was imposed for 7 days.
At that point on Day 60 of the Delta Variant Outbreak data showed that, as of 8pm Saturday 14 August 2021, there had been 415 new locally acquired COVID-19 infections in the last 24 hours with 4 deaths and, the number of locally acquired COVID-19 infections since the 16 June beginning of the outbreak in NSW now totalled 7,745 people - inclusive of 47 deaths. In addition there were currently 381 COVID-19 cases admitted to NSW hospitals, with 62 people in intensive care, 24 of whom require ventilation.
COVID-19 infections caused by the SARS-CoV-2 Delta Variant continue to spread within the state population.
BACKGROUND
Uncorrected
Hansard,
excerpts of 10 August 2021 evidence before the New South Wales
Legislative Council Public
Accountability Committee of
Dr. KERRY
CHANT,
Chief Health Officer, and Deputy Secretary, Population and Public
Health, NSW Health, on former oath.
The
Hon. PENNY SHARPE: We are looking for the precise date. The nature in
which the advice was provided, we will ask you about a bit later, but
we are specifically asking for the date—two dates really—on which
your public health team started to prepare for the need to lock down
parts of Sydney and on what date you informed the Health Minister of
the need to do this?
Dr
CHANT: There was a progressive range of restrictions put in place and
on the twenty-fifth [June] we
briefed—we acted quickly. There were already preparatory orders
that had been previous orders that formed the basis of the
stay-at-home restrictions. On
that day, the Government responded to our initial request for
lockdown of the Waverley, Woollahra, Randwick, City of Sydney and
then quickly the escalating nature
justified locking down the remainder of Greater Sydney. The lockdown
did have effect in bringing the disease under control
in south-eastern Sydney quite quickly. Unfortunately, it was
unknown at the time that there was not containment of the West Hoxton
party. Obviously
more investigations will be done, genomic sequencing, and I have to
apologise to the Committee that I have not had the opportunity to go
back and look at all of that. But
there is concern that there was leakage at that point that was not
recognised at the time and then that led to establishment in
south-western Sydney. The
lockdown was less effective in south-western Sydney because of the
lower testing rates and the impacted community needed to be engaged
with. There were a number of challenges in seeing the same effect
that we were seeing in south-eastern Sydney in that area. There has
been a range of strategies put in place to work cooperatively with
the local communities.....
Dr
CHANT: Consistently public health has indicated the risk of seeding
regionally and we have done a lot of work to prevent that.
So there are
requirements around testing for people who are going to the regions.
We have certainly been doing a lot of messaging
and we have been looking at opportunities to provide feedback on
elements where the orders can be strengthened or clarified. As the
Minister has said, we are actually asking people to not try and look
for loopholes in the orders but rather to comply with the intent. We
also were aware that our regional communities require critical health
workers, other critical infrastructure workers—.....
Dr
CHANT: At every step of the way we looked at the exposures, whether
there were direct linkages, what were the risks, and made those
decisions about the actions that needed to be put in place. Obviously
with looking back there was a chain of transmission that was not
detected and that was also playing into the mind that we
needed to lock down. So all I can say is that we were looking closely
at the information available, working with our public health networks
and provided advice to government on a range of strategies. As
I said, the outbreak was actually brought under control in
south-eastern Sydney. It was really around when it got introduced
into south-western Sydney that we saw the escalating case numbers.
To be fair, it needed a different response in south-western
Sydney and there is a lot of focus on supporting communities in
south-western Sydney and understanding the disease…..
Dr
CHANT: The information was based on the best available evidence at
the time. Clearly the disease was not—initially they were very
linked cases and then other controls were put in place. Clearly the
lockdown was
recommended and enacted, and we did have success in bringing the
cases down. It was a seeding event into western Sydney that led to
those—....
Dr
CHANT: —West Hoxton, which was not recognised at the time. It was
thought that cluster had actually been identified very early but
there were issues around containment of that which were not
appreciated. Obviously, with the benefit of hindsight, there are
different decisions that can be made, but just be reassured that we
were looking very closely at all elements of the response in terms of
the recommendations to government about the controls at the time……
Dr
CHANT: There would have been a range of discussions with the
Minister, but the formal advice around going into lockdown was
provided on the dates when the lockdown was instituted.
As I said, everyone was looking at the data closely. I think
the key issue was the issue around the seeding event and whether it
was contained or not, which was not—initially, the West Hoxton
party was thought to have been well contained because it was picked
up quite quickly. With the benefit of hindsight, I think it is very
clear to see that there was a greater risk of the seeding event in
south-western Sydney than was appreciated at the time that emerged
and that led to the lockdown. The lockdown did have effect in
bringing down the numbers in south-western Sydney but was not as
effective in heeding the cluster growth in south-western Sydney.……
Dr
CHANT: Obviously in controlling case numbers we want to see the
effective reproductive [R] rate down beneath one. We want to
see declining numbers. Clearly there is no silver bullet for that but
what you want to do is make sure you have effective recognition of
cases and contacts and that good public health contact tracing…..
You
also want to limit the opportunity for people to mix and reduce
mobility. Things like mask-wearing can further mitigate that. Clearly
I want to see a range of actions taken that reduce the R effective
beneath one. As I said, we monitor those metrics but it is
complex because we are wanting people to behave. I should say that we
did observe that the community response to this outbreak was
different from the first wave and we did not see the same changes in
mobility patterns as we did with the first wave……
The
Hon. COURTNEY HOUSSOS: I understand. Dr Chant, if it does fall below
one, would that be then the basis for you recommending to loosen the
current restrictions, including the lockdown?
Dr
CHANT: No. I would like to see it go beneath one and then I would
like to see the case numbers continue to decline. I would like to see
us get down to very, very low levels of the virus and I would like to
see vaccine
coverage increase. They are my public health objectives that I would
like to see.
Dr
CHANT: If I could just comment on the Doherty report. I think what it
reflects is that we will need some level of restrictions as we
increase our vaccine coverage from that 70 to a higher percentage. We
will still need
restrictions. We will still need mask-wearing,
we will still need to have public
health contact tracing, we will still need to have a
range of measures. Obviously the higher we get our vaccine
coverage the better, but we will be responding to COVID. In the end
COVID will be an endemic disease. We are very privileged that we have
good vaccines that actually perform much better than the influenza
vaccines. I think it is very
important to know that
we are not talking about "a normal". We know that as
vaccine coverage goes up there will still need to be a range
of public health restrictions and measures in place as we work to get
that balance between societal, which is
a matter for government, and the public health outcome, which is
reducing the number of cases of COVID. [my yellow highlighting]
