Before today’s hearing gets underway, I just want to place this extraordinary moment from yday on the timeline. Brendan Murphy, now Health secretary, tries to whisper an answer to his deputy in front of a mic, gets caught, acts surprised then stares blankly into space.

OK, so senior counsel Peter Rozen is making submissions to the #agedcareRC. After this week's evidence he says "we will be submitting that it was not well prepared."

"Because the risk of an outbreak of COVID-19 in an aged care home is
extremely high, even with low rates of community transmission there
needed to be a planned proportionate response to protect the elderly frail in the nursing homes." There wasn't.

"None of the problems that have been associated with the response of the aged care sector to Covid-19 were unforeseeable." None of them.

Rozen is referring back to SA's chief health officer Professor Nicola Spurrier and the principles that underpin public health. "The principle is enshrined in the public health legislation of the states and territories," he says. This is key re: hospital transfers issue.

"The approach is concerned as much with the clinical needs of the resident as it is with what Professor McLaws described as the negative residents' right to remain negative." That is the crux of the hospital issue. Negative residents have the ~right~ to be kept safe from Covid-19

Rozen now makes the point that while the fed govt's overarching emergency response plan for the health sector, a 56 page document, mentions aged care but does not detail what to do. "It is a plan, it's just not an aged care plan," Rozen says.

The above plan was February. The next one, which purports to deal specifically with aged care from the CDNA, was released on March 13. This, Rozen notes, was adapted from an existing plan for responses to influenza outbreaks in nursing homes.

"This derivation of the document may partly explain why some aged care
providers may have thought that their existing influenza plans would hold them in good stead for COVID-19 only to find that they left them woefully unprepared," Rozen says.

"Remarkably the first two versions (of the CDNA doc) made no mention of the Federal Government having a role in the system, that it funds to the total exclusion of the states," Rozen says. Bingo.

Now after Newmarch House and Dorothy Henderson Lodge outbreaks, the commonwealth developed a joint protocol with the NSW state government about what to do in event of an outbreak. No such protocol exists with any other state.

Regarding the above specifically, Rozen says: "It is unacceptable that such arrangements were not in place in February. It's unforgiveable that they are not in place in August. The virus is not a fair fighter. It doesn't wait until the bell rings."

On June 26, the royal commission asked the aged care quality and safety commission to supply "any pandemic plan" or "risk-based framework" for dealing with Covid-19 in the sector. One of them is a widely availably risk pyramid. You can Google it.

"Whatever else may be said about the documents they are not the comprehensive plan of a regulator facing the COVID-19 pandemic," Rozen says.

Rozen notes that a credentialed infectious control expert was on the ground at Dorothy Henderson Lodge on Day 1. This made an enormous difference to containing the outbreak. There are 66 such experts across Australia.

Rozen asks the obvious question: why the hell didn't the commonwealth use them? "To be blunt, what could be more important to the nation right now than to deploy these experts to help our floundering aged care sector respond to this pandemic?"

"Commissioners, there is reason to think that in the crucial months between the Newmarch House outbreak in April and mid June a degree
of self-congratulation and even hubris was displayed by the Commonwealth." Ouch. True.

"Perhaps, Commissioners, that is the ultimate lesson. When it comes to the health and safety of our residents in nursing homes we can't afford to take any risks at all," Rozen says. And with that, his oral submissions are finished.

I'm just going through the rest of the tendered evidence at #agedcareRC I didn't get time to read this week and this is chilling. On April 20 the aged care regulator's general manager Anne Wunsch made these notes about Newmarch House situation.

Keep in mind, at least 3 residents had already died. The rest were being forced into "hospital in the home". One was in actual hospital and discussion turned to whether they should "remain in hospital or return to service." One doctor said no. "Newmarch is an unsafe environment."

Three days later, she notes this terrifying stat. And on the SAME day, almost two weeks into the outbreak, they start using N95 masks instead of basic surgical masks. Gowns still being rationed.

Wow. Just wow. The one Covid-positive resident hospitalised from Newmarch House was in hospital not because of the infection but because of a broken ankle. Per this email from Dept Health official on April 29.

Another resident from Newmarch (who did ~not~ have Covid-19) was in hospital for unrelated reasons. Again, they decided to keep them in hospital "until it is safe to return to the service." Repeatedly we are told it was not safe. But the other residents were never moved out.

Weeks after the 19th resident at Newmarch died, federal and NSW officials joined a call with 120 others in the sector to agree on a protocol for Covid-19 in aged care. "People keep forgetting there were a lot of good outcomes at Newmarch," they were told. https://www.thesaturdaypaper.com.au/news/politics/2020/08/15/exclusive-the-phone-call-that-denied-elderly-patients-access-hospital

Fed aged care commissioner was on this call. Sector leaders, incl. those with clinical quals, begged her and C'wlth officials to listen and look at int'l evidence. She reminded them “that they are responsible for infection control under the Aged Care Act”. https://www.thesaturdaypaper.com.au/news/politics/2020/08/15/exclusive-the-phone-call-that-denied-elderly-patients-access-hospital

Anyway, please read this if you can. From start to finish. This June 10 call is the ground zero for what we have now seen in Victoria, where more than 1000 residents have been infected and Australia's aged care Covid-19 aged care deaths went from 20 to 70 per cent of all deaths.