Nick Coatsworth is happy to be called a straight-shooter but is cutting back his commentary on the Covid-19 pandemic before he gets stuck with a label he says doesn’t fit. 

The face of the nation’s vaccine roll-out recently saw himself dubbed ‘the former deputy chief medical officer turned outspoken critic of Covid-19 policy’ and did not like the description.  

‘That signals to me that I need to take a step back,’ he says.

Coatsworth, who held that official role for only six months from the early days of the pandemic, might be stepping back but he is not shutting up completely.

In a lengthy interview with Daily Mail Australia the 43-year-old describes what has worked best in the nation’s response to the virus, what could have been done better and where we are heading. 

He also slams the ‘loud voices’ he says are still scaring Australians who should by now be learning to live with Covid.  

Dr Nick Coatsworth is happy to be called a straight-shooter but is cutting back his commentary on the Covid-19 pandemic before he gets stuck being labelled as ‘the former deputy chief medical officer turned outspoken critic of Covid-19 policy’. He is pictured with wife Rebecca

Unlike some of the fearmongers he has railed against, the Sydney-born, Perth-raised father-of-three is an optimist. 'I think we're in a good spot in the pandemic compared to other nations,' Coatsworth says

Unlike some of the fearmongers he has railed against, the Sydney-born, Perth-raised father-of-three is an optimist. ‘I think we’re in a good spot in the pandemic compared to other nations,’ Coatsworth says

Coatsworth maintains restrictions should be removed as soon as they are not demonstrably necessary and will continue speaking out when an issue such as forcing children to wear masks at schools bothers him. 

‘My preference was always to look at the benefits and consequences of whatever restriction was brought in,’ he says. 

‘I’ve thought in general that we were too slow to realise the negative consequences of most of the restrictions.’ 

At heart, unlike some of the fearmongers he has railed against, the Sydney-born, Perth-raised doctor and father-of-three is an optimist. 

‘I think we’re in a good spot in the pandemic compared to other nations,’ he says. 

‘It’s difficult for people to see that because the Omicron BA.1 and BA.2 variants have actually caused a lot of disruption, but we’ve got short memories, I think.’

Case numbers might be high but the fact intensive care units were coping was more significant.

Coatsworth maintains restrictions should be removed as soon as they are not demonstrably necessary. He says the risk of contracting Covid outdoors was always small. Pedestrians are pictured in Melbourne in November last year

Coatsworth maintains restrictions should be removed as soon as they are not demonstrably necessary. He says the risk of contracting Covid outdoors was always small. Pedestrians are pictured in Melbourne in November last year

‘At the really pointy end, which I think is what we always have to bring it back to with the pandemic, is how much actual morbidity and mortality is this disease causing?’ he says.

‘It’s really quite small compared to the number of cases that there are in the community.’

You’ll get these little spikes of cases but the trend over time will be downwards towards eventually just low levels of circulating cases in the community 

Coatsworth notes almost 95 per cent of the population are now double-vaccinated and an ‘extraordinary number’ of people have infection-induced immunity.

‘I think that happening all at the same time will probably actually lead to a really big drop off in the cases,’ he says. ‘That’s the most likely thing.

‘You’ll get these little spikes of cases but the trend over time will be downwards towards eventually just low levels of circulating cases in the community.’

Coatsworth was appointed one of three new deputy chief medical officers under Dr Brendan Murphy in March 2020 during the early days of the pandemic. 

Coatsworth had extensive experience in disaster management, having previously volunteered with Médecins Sans Frontières (Doctors Without Borders) in Congo-Brazzaville, Chad and the Darfur region of Sudan

Coatsworth had extensive experience in disaster management, having previously volunteered with Médecins Sans Frontières (Doctors Without Borders) in Congo-Brazzaville, Chad and the Darfur region of Sudan

The consultant physician in infectious disease and respiratory medicine was seconded from Canberra Hospital where he was clinical director of medical services.

‘People often wonder where I got the job from and it was partly being in Canberra – I knew all the players around the table,’ he says. 

Coatsworth had previously volunteered with Médecins Sans Frontières (Doctors Without Borders) in Congo-Brazzaville, Chad and the Darfur region of Sudan.

He had also served as executive director of the National Critical Care and Trauma Response Centre in Darwin and led an Australian Medical Assistance Team to The Philippines in the wake of Typhoon Haiyan in 2013. 

Just as significantly, Coatsworth had recent experience as a frontline clinical physician. 

It also helped that he knew Professor Paul Kelly, who later replaced Murphy as chief medical officer, through the Trauma Response Centre.

Some restrictions including curfews, particularly those enforced in Victoria, served no useful purpose. 'Taping up the playgrounds was just bizarre,' Coatsworth says. A playground is pictured taped-off at Flagstaff in Melbourne

Some restrictions including curfews, particularly those enforced in Victoria, served no useful purpose. ‘Taping up the playgrounds was just bizarre,’ Coatsworth says. A playground is pictured taped-off at Flagstaff in Melbourne

Coatsworth studied medicine at the University of Western Australia where he met his future wife Rebecca Pearson, now a lung transplant physician, while dissecting foetal frogs. ‘It’s not the most romantic,’ he says.

The young doctor did his internship at Royal Perth Hospital then returned to Sydney where he worked at Royal North Shore Hospital before heading to Darwin. 

I was confident that we were doing our best but I certainly wasn’t confident about what would happen 

Coatsworth and Pearson got together about seven years after they met and moved to Canberra when their two daughters and one son were aged one, five and three respectively. [They are turning seven, nine and 11 this year]. 

The first major government response to Covid was to shut international borders, which Coatsworth says bought valuable time to plan for the coming pandemic. 

‘I was confident that we were doing our best but I certainly wasn’t confident about what would happen,’ he says.

Early priorities were securing personal protective equipment, ensuring intensive care bed capacity, and procuring and making ventilators. 

Coatsworth says Australians should '100 per cent' be proud of how they have managed Covid-19. 'It was a joint effort between government, health care workers and the community. What it actually proves is Australia is not as polarised as everybody thinks it is'

Coatsworth says Australians should ‘100 per cent’ be proud of how they have managed Covid-19. ‘It was a joint effort between government, health care workers and the community. What it actually proves is Australia is not as polarised as everybody thinks it is’

‘It was all pretty united in the first six months,’ Coatsworth says. ‘I think national cabinet was working, the states and territories were doing things in a broadly consistent way. 

‘And then when it started to fracture and different states started doing different things it started getting quite confusing.’ 

Coatsworth’s initial contract was for three months, later extended to six months, but he stayed on as a part-time adviser for another year. 

He became a familiar face to most Australians from press conferences, television interviews and advertising campaigns but still thinks there was a lack of communication about where Covid was headed. 

Coatsworth says it should have been made clearer that cases would eventually rise and there would be significant numbers of deaths but the health system could deliver care to those who needed it. 

‘That was the message that we needed to shift to in early 2021, to kind of prepare people,’ he says. 

Coatsworth says the best thing Australia has done in its fight against Covid is getting the vaccination rate to 95 per cent. 'That's an extraordinary number,' he says. Wearing masks was important, 'when we didn't know much about the virus'

Coatsworth says the best thing Australia has done in its fight against Covid is getting the vaccination rate to 95 per cent. ‘That’s an extraordinary number,’ he says. Wearing masks was important, ‘when we didn’t know much about the virus’

‘But unfortunately there was always a very loud group that thought Covid should be eliminated at all costs and I think that did hold us back a bit.’

The ‘inevitable’ happened when the Delta strain hit. 

Coatsworth is scathing of those who discouraged the take up of the AstraZeneca vaccine when it was linked to a tiny proportion of complications.  

There were lives lost because of that anti AstraZeneca message. No question about it 

‘When the Delta wave came through it had the biggest impact on the people who had been eligible for AstraZeneca but had chosen not to get it,’ he says. 

‘There were lives lost because of that anti AstraZeneca message. No question about it.’

Coatsworth says once the Pfizer vaccine became available residents of New South Wales and Victoria began getting the jab at an extraordinary rate.

‘I still think that’s the case that no other jurisdiction in the world did it as quickly.’

Coatsworth’s philosophy is that no policy was necessarily wrong at the start and that most measures were worth trying. 

Coatsworth is sure the number of Covid cases has been understated and the only way to get an accurate figure would be to take blood from a sample of the population. Sydneysiders are pictured exercising at Bondi as restrictions were eased in September last year

Coatsworth is sure the number of Covid cases has been understated and the only way to get an accurate figure would be to take blood from a sample of the population. Sydneysiders are pictured exercising at Bondi as restrictions were eased in September last year

‘Most of us were pretty convinced that we needed the restrictions at the start,’ he says. ‘All the measures that we took were reasonable. 

‘But because they represented an infringement on human rights they needed almost a weekly reconsideration.’ 

Coatsworth says the ‘default position’ was to bring in restrictions first and worry later about civil liberties, when the reverse should have happened. 

Some restrictions including curfews, particularly those enforced in Victoria, served no useful purpose. ‘Taping up the playgrounds was just bizarre,’ Coatsworth says. 

‘The idea that being outdoors was ever any risk to anybody was an example of how we went too far with our restrictions.’ 

Coatsworth says vaccine mandates were ‘very important early on’ to drive uptake but have passed their usefulness. 

‘There’s very few people who are likely to change their minds now because of the mandates,’ he says.

Coatsworth came to his Covid role with experience in disaster management but not of the magnitude of Covid. ‘We kind of fooled ourselves into thinking we could sneak through and that was actually never going to be the case,’ he says

Wearing masks was also important, ‘when we didn’t know much about the virus and may still be important if we have a more lethal variant.’

Lockdowns, because of their mental health consequences, ‘probably caused more harm than good’, Coatsworth says.

He also believes working from home now serves no purpose from a public health perspective. 

I think for the people who are concerned about coming back to work we just need to reassure them 

‘I think there’s stuff to be said about work-life balance, giving people the opportunity to have days at home,’ he says. 

‘But I think for the people who are concerned about coming back to work we just need to reassure them.’

Internal border closures should have had an exemption process that allowed people with good reasons to travel the opportunity to do so. 

‘It’s not enough to stand in front of a press conference and say “these decisions are heartbreaking” when you’re stopping someone from seeing a loved pass away,’ Coatsworth says. 

Coatsworth's views are at odds with some more risk-averse commentators such as the ABC's Dr Norman Swan (above) and former Australian Medical Association president Kerryn Phelps who favour restrictions

Coatsworth’s views are at odds with some more risk-averse commentators such as the ABC’s Dr Norman Swan (above) and former Australian Medical Association president Kerryn Phelps who favour restrictions

‘I find it hard to describe those decisions in polite terms. I mean, we’re bloody Australians.’ 

Closing the nation’s borders was the right thing to do at the time but caused the same unnecessary hardships as shutting off states. 

‘As an Australian citizen overseas, what on earth does citizenship mean if you can’t get home?’ Coatsworth says. ‘I think the right decision at the start but it set us off on a path that left us closed for far too long.’

As an Australian citizen overseas, what on earth does citizenship mean if you can’t get home? 

Coatsworth agrees with vaccinating children aged five to 12 but does not think there will be much difference in disease severity in a vaccinated person and an unvaccinated child.

‘I have no problem that our child vaccination rates are sitting between 55 and 60 per cent,’ he says. ‘I don’t think that’s a major public health issue.’

Coatsworth reckons a fourth dose of vaccine is right for those with compromised immunity, and is probably worthwhile for those over 65.

‘For people under 65 unless they’ve got some pretty severe condition I reckon three doses is fine,’ he says.

Coatsworth became a familiar face to most Australians from press conferences, television interviews and advertising campaigns but still thinks there was a lack of communication about where Covid was headed

Coatsworth became a familiar face to most Australians from press conferences, television interviews and advertising campaigns but still thinks there was a lack of communication about where Covid was headed

Coatsworth’s views are at odds with some more risk-averse commentators such as the ABC’s Dr Norman Swan and former Australian Medical Association president Kerryn Phelps who favour restrictions. 

‘The problem is that group is loud and it’s influential,’ he says. ‘It’s a bit exhausting really. 

‘I thought it’d be all done and dusted by now – not the pandemic – but this bloody argument. 

‘It’s bad for the punters as well. No one wants to see duelling experts, but then you have a choice. Do you shut up and let them run the narrative?’

The emergence of an unexpected Covid variant which was highly transmissible and lethal across age groups would be the worst future scenario but was ‘very unlikely’, Coatsworth says.

Internal border closures should have had an exemption process that allowed people with good reasons to travel the opportunity to do so, Coatsworth says. Police are pictured stopping drivers at a Western Australian checkpoint in April 2020

Internal border closures should have had an exemption process that allowed people with good reasons to travel the opportunity to do so, Coatsworth says. Police are pictured stopping drivers at a Western Australian checkpoint in April 2020

He does not like to use the terms winning or losing when it comes to Covid-19. 

‘Whilst I wouldn’t say winning or losing I would say we’ve put ourselves in a better position that most other nations,’ he says. ‘That’s how you’ve got to see it.

‘It’s a pandemic. We were never going to get through this with no deaths, no work force shortages, no supply chain disruptions. That’s just magical thinking.’ 

Coatsworth says Australians should ‘100 per cent’ be proud of how they have managed Covid-19.

‘It was a joint effort between government, health care workers and the community. What it actually proves is Australia is not as polarised as everybody thinks it is.’

After his secondment to the Department of Health ended Coatsworth went back to Canberra Hospital as the executive director of clinical services. 

Closing the nation's borders was the right thing to do at the time but caused the same unnecessary hardships as shutting off states. Returning international travellers are pictured at Perth Airport in March this year

Closing the nation’s borders was the right thing to do at the time but caused the same unnecessary hardships as shutting off states. Returning international travellers are pictured at Perth Airport in March this year

He is now completing a PhD on health in foreign policy at Australian National University where he also lectures, and offering the occasional Covid commentary. 

‘I’m trying to do it less and less,’ he says. ‘I’m more and more conscious that I should be doing less and less. I’m not in government. I don’t hold an official position.’ 

But it is hard to say nothing when someone with a loud voice says something with which he strongly disagrees.

‘I suppose the best thing is to ignore them and just try to run a middle narrative, that’s probably the best thing to do,’ Coatsworth says. 

‘Sometimes my personality gets in the way. I get a bit fed up and have a crack. 

‘The one thing I just can’t sort of let go of is the kids in masks thing. That’s probably the only thing I’m going to stay very vocal about. I’m so convinced that that’s the wrong policy.’

Priority in the fight against Covid must be protecting the vulnerable

Coatsworth contracted Covid about six weeks ago. 'I think I was like everyone I was quite surprised by the fatigue that gets you for a couple of days,' he says. 'But the recovery was very quick and I haven't had an ill effects from it'

Coatsworth contracted Covid about six weeks ago. ‘I think I was like everyone I was quite surprised by the fatigue that gets you for a couple of days,’ he says. ‘But the recovery was very quick and I haven’t had an ill effects from it’

Nick Coatsworth says the priority in managing Covid-19 must be on protecting and treating the most vulnerable. To do that, we have to recognise who falls into that group.

The infectious disease specialist says that goal is made harder due to comments from ‘medical leaders who don’t hold official positions’. 

‘They’ve got loud voices and they still suggest that everyone’s at risk essentially,’ he says. 

Coatsworth names ABC commentator Norman Swan, former Australian Medical Association president Kerryn Phelps and Professor Brendan Crabb of the Burnet Institute. 

‘In my view from just having come off call at the hospital a week ago the number of truly vulnerable people from Covid now is much, much smaller after the vaccination,’ he says. 

Coatsworth believes the medical community needs to better communicate to those who are still most vulnerable that they can be treated if they get Covid.

‘I think there’s probably more people in the community that feel vulnerable than are actually vulnerable, if that makes sense.’

‘And we’ve got to change that because people can’t live in fear when they needn’t.’

‘We’ve got to reassure them and say we can care for you, we’ve got a great health system and we can we will give you the best care if you get sick.’

Coatsworth says he has fully vaccinated patients who have no risk factors other than being over 65 who still don’t want to go to a shopping centre. 

‘Now that they’ve been vaccinated they don’t need to lock themselves away from society,’ he says. 

‘The number of people who are actually vulnerable is getting smaller and smaller and smaller the longer we go through the pandemic.’

Coatsworth says the genuinely vulnerable are those who have poor immune systems such as patients with leukemia or who have had lung transplants.

‘We talk about obesity and diabetes as being risk factors but really now you’re talking people who are severely obese with very poorly controlled diabetes, they’re the ones that are risk. 

‘If you’ve got a few extra kilos on and you’ve got a bit of diabetes, you’re not at the same risk now that you’re vaccinated that you were two years ago. 

‘So we’ve got to define the vulnerability better and in that narrow group of people who are vulnerable really make sure that they get the right messages about how to protect themselves.’



Source link