http://www.australia.to/index.php?o...ola-roxon&catid=72:australian-news&Itemid=200
<snip first part about bombings in Indonesia>
LO: Well, let's talk about swine flu, you're heading the fight to bring it under control. Are you winning?
NR: Well, I think it's a very challenging situation. I think we have done well to slow the entry of the disease into the country, I think we've made the right decision about a month ago to move our efforts to protecting those who are most vulnerable, so identifying early and treating those who might have severe consequences from this disease and essentially that means the numbers will still continue to increase for the vast majority of people that will have a mild impact from this flu. But we now have 31 deaths. We currently have 194 people in hospital, more than a third of those are in intensive care, so it is a disease that is severe for some people and the real focus of our health system is making sure we identify those and provide the appropriate response and, I think which we're doing that, I don't think we should pretend that it's not going to continue to be difficult for some weeks and months to come.
LO: But we hear that the number of cases being diagnoseed in Victoria for example has dropped sharply. Does that mean that the threat is abating?
NR: I think it means that we may well have past the the peak in Victoria, it looks like we are coming to the peak in a number of other jurisdictions. With a highly contagious disease you would expect that to happen. Interestingly the number of cases are tracking not that differently from those in 2007, which was the worst seasonal flu that we've had in recent years, quite a long way in advance of last year's flu, but still broadly on track with that, so I think what we're seeing increasingly is a substitution of the swine flu instead of the seasonable flu rather than an additional burden. Admittedly some of the people affected by this flu seem to be having much more severe consequences and puts a different strain on our health system than the milder cases of seasonal flu might.
LO: I like to use this conversation to try to deal with some specific concerns about swine flu. Firstly obviously swine flu is putting a huge strain on our hospitals and health services and particularly intensive care units. I mean, is the system in danger of cracking and can anything be done to free up more resources?
NR: Well, I don't think it's in danger of cracking. I think it does put our health services under extreme pressure. All of our hospital services have winter plans, they know that they can expect to step up at this time. But ultimately I think we can always put more resources into our hospitals. It's something the Rudd government's been very proud to do in the last 18 months and we need to continue to invest in the system to make sure it can meet these peaks in demand.
LO: So would you expect elective surgery to suffer badly at the moment?
NR: No, I wouldn't expect it to suffer badly. I do think that there is the potential that some elective surgery might have to be delayed, each jurisdiction will need to make that decision and obviously we need the public to be understanding if that is necessary. But I think that, by and large, we've been told there won't be an impact. I've seen for example the Chief Health Officer in Victoria reported as saying that's not expected to be any impact, and they've obviously been through the worst of the situation to date, so I think that is telling.
LO: There are concerns that swine flu will be back next winter, possibly bigger and nastier than now. What are you doing to prepare for that?
NR: Well, lots of different things, obviously that is a risk, it's why we put an order in very early for a vaccine, which we hope will be available as early as October. Perhaps earlier than that. We are making sure that our normal support for protecting against seasonal flu is enhanced, for example, today we are announcing that the seasonal flu vaccine will be available free of charge to more than two million extra Australians, particularly pregnant and indigenous Australians. I think this whole situation with swine flu is reminding us that influenza is a serious disease, most people will get it quite mildly, but there are people that are vulnerable in our community and we need to protect against the harm that might be caused particularly for those people.
LO: So the swine flu epidemic is part of the reason you've decided to extent the seasonal flu vaccination programme next year?
NR: Well we decided to extend it because we received the medical advice that it was a targeted addition to our national immunisation programme that we should expand and I think that the swine flu has just reminded people of the very many numbers of people who can be affected by a serious strain of the flu. Of course, our scientists are working madly to see once a vaccine is produced for swine flu, maybe there'll be a combined vaccine for the seasonal flu next year, it's really too early for us to know. Obviously if there was, this extension would benefit more than an additional two million people, bringing it up to about 4 and a half million who get protection through that free vaccine programme.
LO: Trials of a vaccine will start in Adelaide next week, but as you say, it won't be available generally for three months. Why is that when in Britain they're rushing their swine flu vaccine into health centres now?
NR: Well, they are taking a different approach, they're not running human trials, as I understand it, they are using the trials for previous vaccines as the basis for a approving this. In Australia we have a system where we have those human trials to check that it's safe and effective. But I've made quite clear that if the intensity of the disease changes, if we get early results that makes it very clear that this vaccine is safe, I certainly would take advice to bring it on line more quickly if that were was appropriate.
LO: Now, pregnant women seem to be especially vulnerable to this disease. A key question, should pregnant women wear masks to try to avoid infection?
NR: Well, I know there were some early comments from some obstetricians saying that that might be a good idea, but a clarifying statement was put out to say that the masks are really most effective for people who have a disease, for them to wear a mask not to spread it to others. I think that pregnant women, late in their pregnancy, need to be aware that this is a flu that has a particular impact for respiratory diseases, so if late in your pregnancy, when there's already significant pressure on a mother's lungs, this is a disease that can have complications, but I think being careful, following the normal procedures of keeping yourself away from those who are sick, personal hygiene, washing your hands, etc, is really the most effective way to prevent getting this illness and very importantly getting help early if you do have any flu-like symptoms. We know that Tamiflu is a safe and effective treatment for women who are pregnant and might have the flu, so there are options available to be able to be treated if you're pregnant and do get this disease.
LO: Well, you say that Tamiflu is safe, but there is argument, I mean some doctors recommend it, others are worried that it could be dangerous and have complications. I mean, how confident is the government that there are no risks to pregnant women from Tamiflu?
NR: Well, look, obviously I wouldn't like to provide advice to each individual pregnant woman, they should get that advice from their GP or their obstetrician. But I have clear advice that in general terms and provided of course by our health officials that Tamiflu is safe in most circumstances for pregnant women to use and clearly it's one of the things that's been shown to be effective to reduce the impact of this disease if you're at risk of a severe outcome.
LO: There's also debate over whether Tamiflu and the other anti-viral drug Relenza are being prescribed too liberally, are the governments expert advisors worryed that the swine flu virus could develop resistance to these drugs?
NR: I think we always have to be aware that there is a risk of resistance developing. We know that our seasonable flu, for example, in the northern hemisphere fear this year was resistance to Tamiflu. All of the tests done to date in Australia have shown that the current strain of swine flu in Australia is responsive to Tamiflu. There have been three isolated cases overseas where they seem to no longer be resistant to Tamiflu, which is a worry, but Rilenza, the other drug, has been proved to be effective. We have to keep monitoring that, we have to keep sharing information around the world, but there's very isolated evidence at the moment that it's becoming resistant. But I do agree with doctors that we have to be careful not to over prescribe this medication, it's why we're urging people, the vast majority who have mild symptoms, not to take Tamiflu unless they are in a vulnerable category and unless their doctor recommends that it's necessary.
LO: Minister, we thank you.
NR: It's a pleasure.
<snip first part about bombings in Indonesia>
LO: Well, let's talk about swine flu, you're heading the fight to bring it under control. Are you winning?
NR: Well, I think it's a very challenging situation. I think we have done well to slow the entry of the disease into the country, I think we've made the right decision about a month ago to move our efforts to protecting those who are most vulnerable, so identifying early and treating those who might have severe consequences from this disease and essentially that means the numbers will still continue to increase for the vast majority of people that will have a mild impact from this flu. But we now have 31 deaths. We currently have 194 people in hospital, more than a third of those are in intensive care, so it is a disease that is severe for some people and the real focus of our health system is making sure we identify those and provide the appropriate response and, I think which we're doing that, I don't think we should pretend that it's not going to continue to be difficult for some weeks and months to come.
LO: But we hear that the number of cases being diagnoseed in Victoria for example has dropped sharply. Does that mean that the threat is abating?
NR: I think it means that we may well have past the the peak in Victoria, it looks like we are coming to the peak in a number of other jurisdictions. With a highly contagious disease you would expect that to happen. Interestingly the number of cases are tracking not that differently from those in 2007, which was the worst seasonal flu that we've had in recent years, quite a long way in advance of last year's flu, but still broadly on track with that, so I think what we're seeing increasingly is a substitution of the swine flu instead of the seasonable flu rather than an additional burden. Admittedly some of the people affected by this flu seem to be having much more severe consequences and puts a different strain on our health system than the milder cases of seasonal flu might.
LO: I like to use this conversation to try to deal with some specific concerns about swine flu. Firstly obviously swine flu is putting a huge strain on our hospitals and health services and particularly intensive care units. I mean, is the system in danger of cracking and can anything be done to free up more resources?
NR: Well, I don't think it's in danger of cracking. I think it does put our health services under extreme pressure. All of our hospital services have winter plans, they know that they can expect to step up at this time. But ultimately I think we can always put more resources into our hospitals. It's something the Rudd government's been very proud to do in the last 18 months and we need to continue to invest in the system to make sure it can meet these peaks in demand.
LO: So would you expect elective surgery to suffer badly at the moment?
NR: No, I wouldn't expect it to suffer badly. I do think that there is the potential that some elective surgery might have to be delayed, each jurisdiction will need to make that decision and obviously we need the public to be understanding if that is necessary. But I think that, by and large, we've been told there won't be an impact. I've seen for example the Chief Health Officer in Victoria reported as saying that's not expected to be any impact, and they've obviously been through the worst of the situation to date, so I think that is telling.
LO: There are concerns that swine flu will be back next winter, possibly bigger and nastier than now. What are you doing to prepare for that?
NR: Well, lots of different things, obviously that is a risk, it's why we put an order in very early for a vaccine, which we hope will be available as early as October. Perhaps earlier than that. We are making sure that our normal support for protecting against seasonal flu is enhanced, for example, today we are announcing that the seasonal flu vaccine will be available free of charge to more than two million extra Australians, particularly pregnant and indigenous Australians. I think this whole situation with swine flu is reminding us that influenza is a serious disease, most people will get it quite mildly, but there are people that are vulnerable in our community and we need to protect against the harm that might be caused particularly for those people.
LO: So the swine flu epidemic is part of the reason you've decided to extent the seasonal flu vaccination programme next year?
NR: Well we decided to extend it because we received the medical advice that it was a targeted addition to our national immunisation programme that we should expand and I think that the swine flu has just reminded people of the very many numbers of people who can be affected by a serious strain of the flu. Of course, our scientists are working madly to see once a vaccine is produced for swine flu, maybe there'll be a combined vaccine for the seasonal flu next year, it's really too early for us to know. Obviously if there was, this extension would benefit more than an additional two million people, bringing it up to about 4 and a half million who get protection through that free vaccine programme.
LO: Trials of a vaccine will start in Adelaide next week, but as you say, it won't be available generally for three months. Why is that when in Britain they're rushing their swine flu vaccine into health centres now?
NR: Well, they are taking a different approach, they're not running human trials, as I understand it, they are using the trials for previous vaccines as the basis for a approving this. In Australia we have a system where we have those human trials to check that it's safe and effective. But I've made quite clear that if the intensity of the disease changes, if we get early results that makes it very clear that this vaccine is safe, I certainly would take advice to bring it on line more quickly if that were was appropriate.
LO: Now, pregnant women seem to be especially vulnerable to this disease. A key question, should pregnant women wear masks to try to avoid infection?
NR: Well, I know there were some early comments from some obstetricians saying that that might be a good idea, but a clarifying statement was put out to say that the masks are really most effective for people who have a disease, for them to wear a mask not to spread it to others. I think that pregnant women, late in their pregnancy, need to be aware that this is a flu that has a particular impact for respiratory diseases, so if late in your pregnancy, when there's already significant pressure on a mother's lungs, this is a disease that can have complications, but I think being careful, following the normal procedures of keeping yourself away from those who are sick, personal hygiene, washing your hands, etc, is really the most effective way to prevent getting this illness and very importantly getting help early if you do have any flu-like symptoms. We know that Tamiflu is a safe and effective treatment for women who are pregnant and might have the flu, so there are options available to be able to be treated if you're pregnant and do get this disease.
LO: Well, you say that Tamiflu is safe, but there is argument, I mean some doctors recommend it, others are worried that it could be dangerous and have complications. I mean, how confident is the government that there are no risks to pregnant women from Tamiflu?
NR: Well, look, obviously I wouldn't like to provide advice to each individual pregnant woman, they should get that advice from their GP or their obstetrician. But I have clear advice that in general terms and provided of course by our health officials that Tamiflu is safe in most circumstances for pregnant women to use and clearly it's one of the things that's been shown to be effective to reduce the impact of this disease if you're at risk of a severe outcome.
LO: There's also debate over whether Tamiflu and the other anti-viral drug Relenza are being prescribed too liberally, are the governments expert advisors worryed that the swine flu virus could develop resistance to these drugs?
NR: I think we always have to be aware that there is a risk of resistance developing. We know that our seasonable flu, for example, in the northern hemisphere fear this year was resistance to Tamiflu. All of the tests done to date in Australia have shown that the current strain of swine flu in Australia is responsive to Tamiflu. There have been three isolated cases overseas where they seem to no longer be resistant to Tamiflu, which is a worry, but Rilenza, the other drug, has been proved to be effective. We have to keep monitoring that, we have to keep sharing information around the world, but there's very isolated evidence at the moment that it's becoming resistant. But I do agree with doctors that we have to be careful not to over prescribe this medication, it's why we're urging people, the vast majority who have mild symptoms, not to take Tamiflu unless they are in a vulnerable category and unless their doctor recommends that it's necessary.
LO: Minister, we thank you.
NR: It's a pleasure.