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]
