An Open Letter to the Hon. Sarah Courtney MP - from Tasmanian GPs
- Emily Isham
- Closed on
- Target:
- Tasmanian Health Minister, the Hon. Sarah Courtney MP
- Region:
- Australia
- Website:
- medium.com
Thank you so much for signing the open letter to our Tasmanian Health Minister requesting restricted travel into the state and consideration of closing schools and universities - despite this being a controversial topic. There are many opposing views, but the WHO's executive director has advised fast, decisive action and closing chains of transmission when dealing specifically with COVID-19. Despite the AHPPC's advice being otherwise, my understanding is that, with no knowledge of current community transmission, we don't know when it will reach schools, and allowing asymptomatic carriers to transmit to each other leads to greater likelihood of the virus being carried to numerous homes and vulnerable / at-risk populations. WHO this morning have advised to "not gather in groups more than 10", and, combined with the federal government's advice to "practise social distancing" (which is not possible at schools, especially at primary level), I still think heeding this advice would involve closing schools / universities, despite all the consequences.
The Hon. Sarah Courtney, MP Minister for Health
15 March 2020
Dear Minister,
RE: COVID-19 Pandemic, Containment measures in Tasmania.
I write to you, on behalf of General Practitioners in Tasmania, with regards to the current Coronavirus pandemic that has reached Australia, and now Tasmania. It seems that there is consensus amongst the medical community that the appropriate action to take in this setting is to immediately undertake widespread measures to reduce the rate of transmission of this virus within the wider Australian population, and more specifically within the Tasmanian community. Evidence for this comes in the form of an increasing number of cancelled medical conferences, educational events and medical specialty fellowship exams across the country, based on sound medical analysis by the boards of various specialties and the medical reports coming from experts and professionals in other countries who are currently battling a significant COVID-19 burden. We are fortunate to be in the position where we can learn from what other countries have done, and what has happened in countries where they haven’t used conservative measures earlier. This unfolding healthcare situation is causing enormous concern amongst all of the medical community, including hospitalists, intensivists and GPs on the frontline.
I am dismayed at the seeming disconnect between the actions being taken within the medical community and the recommendation for actions being passed on to the general population. If widespread isolation and social distancing measures are truly what is urgently required to allow a temporised assessment and management plan for the Coronavirus outbreak within Australian borders (as we have been advised time and time again), then surely we should be making this clearer to the general public right now. Although we have just heard our Prime Minister advise social distancing, we are still allowing schools and universities to remain open – a mixed message, and one that is resulting in more fear and confusion amongst parents, who are making decisions for themselves about whether to opt in or opt out.
With this in mind, I ask that you re-think your current recommendations to the general Tasmanian population and consider instituting more conservative measures with regards to public event cancellation (even when <500 in attendance) and social distancing immediately to curb the spread of such a contagious and severe disease. We should immediately recommend a 3-4 week closure of schools, cultural and religious places (including places of worship), gyms and leisure centres, pubs, bars, theatres, cinemas and concert halls.
Of course we’re particularly concerned in Tasmania given we are an island with limited health services and an already-overstretched hospital system. We need to take aggressive steps to limit spread now. We have the potential to reduce the disease burden NOW by severely restricting entry into the state to essential travel and residents. Travellers might be unknowing carriers as they travel in, and given we’re not testing the wider community (as you’re aware, GPs have been restricted in swabbing), and the incubation period is 2-14 days, we really don’t know the level of community spread at this stage. It would just take one case wandering into a nursing home to start a cluster and put a whole vulnerable population (and their healthcare workers) at great risk – as we’ve seen at Life Care in Seattle.
We, as GPs, will start being exposed, with no knowledge, more and more commonly, and we then pose great risk to any following patients who are elderly, immunosuppressed or suffer comorbidities. We also then start diminishing our necessary healthcare workforce because, once we are exposed, we have to put ourselves in home isolation for a period of time – not to mention posing increased risk to our families and vulnerable around us.
Restricting our incoming travellers would allow a steady declaration of cases of COVID-19 to present to hospitals and fever clinics as their symptomatic phase develops, without completely overwhelming the strained system. They could then be tested as per protocols, keeping in mind the pressure on the supply of laboratory testing equipment. Numbers of confirmed cases could then be firmly established and their progress tracked by our public health team, allowing for clearer guidance for ongoing quarantine requirements. Other people with flu-like illnesses, but without the relevant travel histories to countries affected by Coronavirus, would also be able to be assessed and managed appropriately and calmly during this period.
I realise, of course, that on a population health level, drastic interventions need to result in larger outcomes to prove their worth, and given the low number of confirmed cases (6) in Tasmania currently, it does not seem like school/university closure and restricted travel are warranted yet. And I am aware that such interventions would come with significant economic consequences. However, our state’s healthcare system is facing an impending disaster, and at an individual level it is extremely concerning that new cases could be traveling in by the day, and schools could be propagating it – without our knowledge. We cannot confirm that there is no community spread currently in Tasmania.
Ms Courtney, this is your career-defining moment. We call on the state government to make Tasmania an example of bold leadership and excellence in pandemic management.
Yours faithfully,
Dr Emily Isham MBBS BMedSci DRANZCOG FRACGP MIPH
GP, Hobart, Tasmania
Tasmanian GPs are very concerned that not enough is being done to reduce the COVID-19 burden in Tasmania, before there is rapid community transmission. We need to close Tasmanian borders, given the increasing community spread in NSW and Victoria, and given the uncertainty around whether there is community transmission in Tasmania (as we GPs are restricted in testing). We need to close schools and universities to disseminate these 'mass gatherings' before the virus is transmitted more widely throughout the community, and then back to homes and more vulnerable populations. We call on the state government to make Tasmania an example of bold leadership and excellence in pandemic management.
The An Open Letter to the Hon. Sarah Courtney MP - from Tasmanian GPs petition to Tasmanian Health Minister, the Hon. Sarah Courtney MP was written by Emily Isham and is in the category Health at GoPetition.