Standing by for the start of @AMA_NSW Covid-19 briefing with Health Minister @BradHazzard and Chief Health Officer Dr Kerry Chant.

Present on the panel: Brad Hazzard, AMA President, Nigel Lyons, Richard Griffiths.

BH notes that this has been a challenging time; started early January. Notes his remit as state health minister, primarily hospitals. Thanks everyone for efforts so far.

First q: AMA objective includes that HCW will be protected. Can the ministry indicate how safety objectives will be achieved. BH: agrees that HCWs should be safe, that should get all PPE that is needed. However PPE is challenging across the world. Many meeting about the PPE issue

BH: notes that obtaining PPE is challenging, as it was during bushfires. Notes much goodwill, but little clarity at the moment around how PPE will be distributed between the responsible organisations.Root is worldwide shortage of PPE.Notes NSW ministry will be doing all possible.

Notes multi-agency efforts re procurement. All avenues being explored. Lyons: aware PPE is a major issue for clinicians in NSW Health. Notes CEC guidelines which are now updates. However, clinicians note that some don't apply this consistently, this can create confusion.

Lyons says efforts to improve information sharing of stock documentation, and usage. Urges appropriate us of PPE, in order to keep safe over next weeks and months. BH: notes that frontline staff express concerns about lack of transparency from their hospital executives.

BH says has asked Ministry to improve transparency and communication to frontline workers. HCWs should not be worried about lack of information, this can and should be addressed.

Lyons notes numbers of HCW's who have tested positive. Some at work, some not. Data collection to inform risk of workplace acquired covid. Rates of infection overall have decreased (48 cases last 24 hours, total 734 in NSW) many are overseas acquired, or from a known person.

Lyons notes lower numbers of patients admitted to ICU or needing ventilation compared to our international colleagues. BH: dramatic drop in short period of time, hopes this continues, frontline staff credited for large numbers of tests (127,000 tests cf Victoria 30,000).

Q: concern about regional HCWs and patients following bushfires, what will ministry do in regional areas. BH: cordons have been assessed as a solution, but not used yet as not deemed effective and mixed communities; PPE/staffing/education of regional area HCWs

Lyons says each LHD well advanced in planning. Pleasing that currently most regional areas have had low rates of infection so far. Notes concern about Easter travel to regions: people must stay at home, police will enforce. Notes ICU network supports rural/regional/city.

Lyons: ICU modelling says that if current trends continue for 7 - 10 days of low rates of ICU, and slowing infection - that services won't be overwhelmed.

Audience q; elective surgery Cat 3; when will this recommence? BH: These pts needed to be delayed in public and private; not able to currently give a clear answer on this - quite a long way away, could be 6 months or longer. No one knows.

BH: notes that some clinicians have moved patients from Cat 3 to Cat 2 - hopes that these have been based on clinical need.

Audience Q given community transmission, should we test more? BH: Shortage of testing kits is a serious issue worldwide, need to ration tests. If had more tests, would test more; some pockets are testing more. No easy answer.

Audience Q re collaboration of public and private anaesthetists re training and transparency re PPE stocks. Concern about contract arrangement between public and private hospitals, will there be enough PPE sharing?

BH says this public/private concern is valid. A new team is being created as an interface between the public and private health systems. Little insight between the systems currently. Lyons says part of agreement is that pvt inventory potentially avail for public.

Lyons says hopefully won't need private section for covid patients, but if needed, agreement will include that HCWs have same standard of PPE as in public. BH: notes that this is a new arrangement, and details are emerging, designed to keep private hospitals open.

BH has a shout out to the wonderful @FionaDavies8.

Question about medical students as a potential workforce. BH: no current plan for students to be 'frontline'. They might be involved in other tasks as supervision if they agree. Need to protect, but also this is a very rare medical event, this is living history (not a nice part).

Q about guidance for safest available Telehealth. BH says frontline staff might not feel that hospital management is listening, that they're not empowered. Worries about lines of communication. Notes emergency physician rang him as minister directly re 2 face shields left.

BH says to use Telehealth as needed. Caller says hospital execs in public hospitals have told doctors to not use it. Caller wants statewide guidance to decrease confusion. BH says will follow up this hospital.

Q is there support measures for Au manufacturers of PPE/testing. BH = yes, huge efforts.

(BH leaving, has health ministers meeting now, says thank you for all work doing now and future and involvement in AMA, keep safe).

Q about workforce surge plan.
LHDs have had to plan for doubling ICUs. Scenario planning for more than this, if we have the international experience (although lets hope not). Surge plans quantify extra activity, trigger points to enact strategies etc.

Q about 2021 recruitment for specialist training positions.
Richard: Currently stakeholder conversations are occurring. Challenging year. Talking with colleges re exams and intakes. No firm plan yet, but will be shared when finalised. Goal is to not adversely impact trainees.

Q - current numbers are small compared to other countries. Won't we therefore drop restrictions if numbers continue to drop in a week or two? Lyons says we are all hoping for that; however given absence of vaccine only way to avoid overwhelming system is to continue.

Caller says but won't we turn into NZ in a week or two, with a chance of elimination? Lyons says the advice is that we are not able to eliminate it in the community now, that to release restrictions is high risk, may be dangerous.

Q about indemnity of specialists in private hospitals, treating public patients, particularly if working out of scope.

Lyons says that if public patients are contracted to private patients, TMF will cover (even those who only work in private), including out of scope issues.

Q: is there a 'rule' about level of seniority of HCWs who treat covid patients in emergency departments.

Lyons: no rule, however in general, minimise staff contact, tend to use senior colleagues. (Our intubation team exists exclusively of consultant anaesthetists).

That's a wrap. Thank you @AMA_NSW and panel.