July 12, 2022
THOMAS ORITI: In a bid to relieve pressure on hospitals across the country, millions of Australians are now eligible for COVID antiviral drugs under the Pharmaceutical Benefits Scheme and more Australians are also now eligible for a fourth COVID vaccine. These changes this week, we presented them to you yesterday morning. As a result, an additional seven and a half million Australians may get another booster as new Omicron subvariants lead to higher case numbers across the country. With more, we are now joined by Chief Medical Officer Professor Paul Kelly. Professor, hello and thank you for your time. Antiviral drugs first of all, can I ask you about them. What exactly are they and how do they prevent COVID from getting worse?
PROFESSOR PAUL KELLY, CHIEF PHYSICIAN: We now have a range of treatments for COVID. Over the last year or so we’ve had treatments that usually required intravenous use, so that must be mostly in hospitals. Whereas at the beginning of the year, we introduced two oral treatments which can therefore of course be taken at home and very early in the course of treatment, therefore as soon as possible after the diagnosis.
But they are there under the Pharmaceutical Benefits Scheme, so available to GPs to prescribe on prescription and to be supplied by pharmacies in the usual way for several months. What has happened over the past few days and announced by Minister Butler on Sunday is an expansion of availability and eligibility for these treatments, which should make it much easier for people to get prescribed and , second, to start these drugs early.
So the key point for listeners today, Thomas, is if you’re in those high-risk groups of people over 70, people over 50 with two risk factors, the range of those you can get information from the website or from a normal doctor, and aborigines and torres strait islanders over the age of 30 with two risk factors are now all eligible for these oral medications. And now is the time to go talk to your regular health care provider about this availability. So you have a treatment plan in case you develop COVID over the coming weeks and months.
ORITI: Is there a reason why eligibility only extends if they are effective? Is it a supply problem?
KELY: No, there is plenty of supply. We sometimes hear reports that some pharmacies don’t have it on their shelves the same day, but they can get it very quickly and we work closely with Pharmacy Guild pharmacies about this supply from actual pharmacies . But there’s plenty of supply in the country, so that’s not a problem. The main question is really what the evidence shows about their effectiveness. They are very effective in reducing the risk of death, serious illness and hospitalization for those most at risk. Recognizing that most people who have had COVID so far and will have it in the future have relatively mild illness, but some people are at higher risk of severe illness and that’s what these treatments are for . People over 70 are most at risk, people over 50 with two or more risk factors, and slightly younger Aboriginal and Torres Strait Islander people with these risk factors are at higher risk.
ORITI: Sure, and check the website for this list of chronic conditions, if you’re eligible. I just want to go to the reminder, sorry to interrupt you. Can you explain, I’m just interested in the definitions here. Can you explain to us why the fourth shot is now accessible to people over 30 but only recommended for people over 50? Again, we hear that supply is not an issue. So what’s the difference there?
KELY: Supply is not a problem. We have a lot of vaccines right now. This is again based on evidence and effectiveness and we rely, as we have since the start of the pandemic, certainly since the start of the vaccine in early 2021, on our ATAGI group, that is say the Australian Technical Advisory Group on Immunization which advises the health Minister, Minister Butler and they had a discussion with him early last week, told them what we expected in terms of epidemiology. There is the new wave starting in Australia with the BA.4 and BA.5 sub-variants of Omicron. And they took that into account with this change in their advice. We know, again, that the people most at risk of getting severe COVID are people over 70 but, and in this case over 50, we know that a fourth dose will improve the chances of have a milder disease. illness and not end up in the hospital and so that’s where this strong recommendation came from. But also in the context where many people feel they want to have this extra protection, there is certainly no harm.
ORITI: But that was my question. Sorry to interrupt, but is the difference there, there’s no concern about a higher risk profile for someone under 50 if you get that fourth shot, is there? These are only questions about its effectiveness, if it is worth getting it.
KELY: It is definitely worth it and I will encourage people to consider getting vaccinated in this 30-49 age group. It has not gone below thirty years because there are recognized side effects in young people, which has been taken into account in this recommendation. Let’s say a slight increase in protection for 30 to 49 year olds and a much larger increase in protection for the over 50s and certainly the over 65s. And again, I encourage everyone, well everyone in Australia, to reflect on where they are with their vaccination journey right now and to go and make that appointment to get the vaccine that is due to them and do it now.
ORITI: Can I just ask because I have heard reviews. I just want to ask you one. Professor Adrian Esterman, epidemiologist from the University of South Australia. I mean, he expressed concern right now about the government messaging on COVID. He even accused the government of essentially giving up on telling people about the current risks of the virus or the benefits of the fourth dose. What would you say to people who think not enough is being done or maybe there are mixed messages because you might have people in the 30 to 49 age bracket thinking, well wait you say i can choose to get but you don’t recommend me to get it. Are you concerned that there will be a bit of confusion among young people wondering whether they should receive the fourth dose?
KELY: I certainly encourage anyone who is confused to review the information we have on our website or to consult their regular healthcare professional and someone you trust for this information. Then, like I said, for that younger age group, it’s available, if you want to get it, it’s available. For people over 50, definitely encourage taking that fourth dose as soon as possible or the third dose if you are up to it. We still have, as you know, Thomas, about 30% of Australians who are due for their third dose, haven’t come forward for it. I can absolutely say that two doses of vaccine is not enough to protect you optimally against the Omicron variant of COVID-19 and the newer variants that are coming are more transmissible and potentially, this vaccine can save you from serious illness. So I strongly encourage anyone who needs another shot to make that appointment today.
ORITI: While we have you here at last, Professor Paul Kelly. We were talking with a virologist from Johns Hopkins University in Baltimore about an hour ago on the program and he said that in the United States they’re watching what’s going on here closely because it might spell out what’s going get there in the fall in the northern hemisphere. What is your message to other international health experts now that we are well and truly in winter?
KELY: They are watching very closely. In fact, I had another very good discussion with my counterpart in the United States as well as in the United Kingdom, New Zealand and Canada last week in the northern hemisphere. They are watching very closely what is happening here and in New Zealand in terms of fighting influenza and RSV and other winter viruses as well as COVID. We are the first two countries in the world to really face this after two years without the flu. So they think a lot about what they should do to prepare for winter. They’re looking, for example, at some of the new hybrid vaccines that have been produced for COVID that aren’t available yet, but might be available in time for their winter push. So these are the COVID vaccines that would include both the original virus, which is the vaccine we used during this time, as well as a range of other options in terms of the Omicron variant. So they are certainly very concerned about our experience with the flu, which seems to be calming down a bit at the moment. But the good news is that our flu vaccine seems to have matched up well with what’s been circulating. So they are very keen to know more about it and we continue to discuss it.
ORITI: Paul Kelly, thank you very much for giving us your time. Appreciate it.
KELY: You’re welcome, thank you Tom.
ORITI: This is Professor Paul Kelly, the chief medical officer.