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#162 Praise for the Victorian response to the COVID-19 pandemic


 

14 May 2020

AMA Victoria President, Associate Professor Julian Rait, was invited to make a statement at the Public Accounts and Estimates Inquiry into the Victorian Government's Response to the COVID-19 Pandemic. On behalf of our members, this was his statement delivered on Tuesday 12 May:

Thank you for the opportunity to appear before the Committee today. First, it is important to note, and as you’re well aware, the COVID-19 pandemic is not over and continuing vigilance is essential.

Populations who have dealt with pandemics in the past have experienced waves. Even the most accomplished public health physicians during past pandemics have been tempted (or pressured) to loosen restrictions and produced resurgent disease. 

Similarly, the COVID-19 pandemic may take many months and years to play out. There will undoubtedly be comprehensive reviews and inquiries conducted in the fullness of time that can take into account the whole story, the whole picture, looking at the lasting effects of decisions made and comparing the efforts of countries globally. 

It is important to acknowledge that Victoria has taken steps so far that have successfully minimised the transmission of COVID-19 and the State Government should be applauded for these efforts.

The Victorian State Government should be commended for a number of strong decisions it has made and robust actions that have been taken to help us avoid the types of tragic situations we have seen in other parts of the world – where there have been high rates of death and illness; especially in vulnerable groups such as the elderly.

Some of the decisions which have had a positive impact include:

There have been a few issues and AMA Victoria has been publicly vocal about these. We have made known our concerns about a lack of personal protective equipment (PPE) for frontline health workers and a continuing issue with fair distribution across the state. This has been one of the most important issues for our members and a significant source of stress for them.

Another issue has related to general practitioners, who obviously play an important role in managing a pandemic. There has been a lack of a two-way dialogue and strong relationship between the State Government and general practitioners – and indeed, a lack of support from the State Government over many years – although there is an attempt to improve the lines of communication. In a pandemic, we see that disconnect and stress play out very clearly, whereby GPs are ignored or excluded from our disaster preparedness.

In Victoria, there have been some issues with our devolved public hospital system. Public hospitals are their own masters, to a large degree, with their own boards positioned at ‘arm’s length’ from the government – rather than being line-managed by government.

There is a conversation to be had around whether the devolved system serves us well in a pandemic and whether the Department of Health and Human Services (and especially Safer Care Victoria) should have a more active role to play so that, for example, we might have more transparency from public hospitals; a fairer and more equitable distribution of PPE between various public hospitals; and more consistent application of processes and guidelines – such as for PPE use and training.

As we begin to lift restrictions, Victoria appears to be taking a very conservative approach. AMA Victoria has no opinion on this either way – as long as the State Government continues to be guided by its Chief Health Officer. The Chief Health Officer’s expertise and advice should continue to be respected by all parties. At times, his decisions might appear more conservative than other states and we need to accept that we have our own local conditions to take into account. Over the course of this pandemic, there will continue to be circumstances where we need to make different decisions or take a slightly different course.

Moving forward, there are a number of issues we will need to deal with and the way specific outbreaks are contained and managed will be paramount. There is a lot riding on how well our public health teams can continue to detect cases and finesse their methods of containment. Public health teams will face a lot of pressure to act quickly and effectively and a culture of blame and finger-pointing will be unhelpful in achieving this and we all play a part in that – the media, advocacy groups, political parties and the broader public.

That is not to say, that we should not question decisions or actions or provide constructive criticism, but we should be wary of applying retrospective bias to outbreaks and we should seek to understand the facts. Many things are clear and straightforward in hindsight.

We will need to support the public health teams to be transparent in their decision-making. They should also be given time to apply their learnings and finesse their approaches as we slowly lift restrictions and learn how best to manage the outbreaks that will inevitably occur. Rigorous and extensive testing will also be of high importance.

AMA Victoria is also very concerned about the secondary effects of COVID-19. As a result of widespread avoidance of care and under-utilisation of healthcare, we are expecting a high number of non-COVID-19 related illnesses that may come to light later on and we need to prepare the system for this.

We are also very concerned about other secondary effects of the pandemic – such as rises in alcohol consumption, mental health issues and of course, as we’ve seen, a rise in domestic violence, as reported by Victoria Police. 

Thank you.

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