Dr Chris Zappala - COVID-19 and mental health

ASHLEIGH GILLON:           The mental health impact of coronavirus restrictions will also be considered at a National Cabinet meeting tomorrow. New research is showing today that suicide rates could jump by 50 per cent due to the pandemic and actually outnumber deaths from COVID-19 by up to 10 times.

Joining us live now is Chris Zappala, he's the Vice-President of the Australian Medical Association. Appreciate your time. We have seen this research out today suggesting that the mental health impact is very serious. We've seen this report out from the University of Sydney in particular, suggesting that young people are mainly going to be affected, that there could be an increase of 25 per cent in suicides - that means we're looking at between an extra 750 and 1500 suicides annually. The data does, I know, take a while to come out on that front, but what are you hearing from GPs working on the frontline on this issue? Have we actually already seen a spike in suicides during the pandemic?

CHRIS ZAPPALA:                Thankfully, we haven't yet seen a spike in suicides that's noticeable, but we must predict that with the circumstances that exist - particularly for young people at the moment who are particularly vulnerable and more likely to be out of work, with all those obvious social stresses and financial stresses - that there is going to be an increase.

And what we would like to see happen is a recognition that this is as important as organising PPE and thinking about treatments of coronavirus, that we have to make sure that there are community-based, GP-centred practices that are going to help people access care and get those pathways in place. So they can see a mental health nurse, see a psychiatrist, or psychologist, or whatever it's going to be - that this will happen. We were worried about youth suicide and mental health before, and we need to be more worried about it now going forward with coronavirus.

ASHLEIGH GILLON:           I see the AMA is cautioning National Cabinet ahead of its meeting tomorrow against feeling pressure to rush into lifting restrictions. How worried are you and your colleagues around the country about a second wave of the virus sweeping Australia as we see some of these restrictions start to be lifted?

CHRIS ZAPPALA:                There is a degree of worry about that happening. The issue is not so much around the pace or magnitude of lifting restrictions - clearly we're going to do that in a very careful and measured way - but it's important that all of those personal behaviours that we've changed over the last month or so remain in place. So even if we go back in to shops, even if we are allowed back into restaurants, venues, we still must observe social distancing and hygiene, et cetera, et cetera, and of course, be a party to extensive testing and contact tracing, including the app.

So, in other words, how ever these restrictions are very carefully lifted - and clearly it needs to be careful - all those other behaviours and measures must stay in place - we must continue to play our part going forward. Because this is not going to be something that goes away in the next month or two, we've got a little while to run yet, so those measures need to stay in place.

ASHLEIGH GILLON:           It's clear today that all the States and Territories are going to have different rules in place for this weekend. Obviously, Mother's Day is on Sunday, a time when families would like to be able to gather together. Victorian Premier, Dan Andrews, said today at a news conference that even if restrictions were lifted in Victoria - and he's suggesting they won't be by Sunday - he said that even if he was able to visit his elderly mother on Sunday that he wouldn't be doing so - he thinks it's still too risky. What's your advice to families, particularly in New South Wales and Victoria where we have seen community transmission, who might be wondering, well, should I see my elderly family members on Mother's Day if the restrictions in my State are lifted and I'm able to do so?

CHRIS ZAPPALA:    Well, it is really important we stay connected with family and friends, and that's of course one of our defences against mental health illness that we were just referring to before. So I think everyone just has to exercise common sense and caution, and of course if you are at possibly an increased risk of respiratory illness, then you can't go anywhere - you just stay put at home and isolate yourself. We're relaxed about each State doing this in their own way in a gentle progressive way.

But within the laws and restrictions, if there is capacity to go visiting, then that's okay. But of course, fully making sure everyone is well and still maintaining all of those physical distancing, hand hygiene rules. So in other words, if we play it safe every step of the way and remain within the restrictions, then we're okay.

There are still, of course, those Zoom-type options for families, and they need to be explored as well. But definitely staying connected - very, very important, we would encourage families to make an effort to continue to do that well.

ASHLEIGH GILLON:           Chris, researchers are warning today that COVID-19 is already starting to mutate - we know, of course, viruses do do that. But what does that mean in the hunt for an effective vaccine to combat coronavirus?

CHRIS ZAPPALA:                 I think the honest answer is we don't know. Remember that viruses mutate, particularly coronaviruses, mutate frequently. So that's something that we've observed in many coronaviruses over time. Often, and in the huge majority of cases, it doesn't change the complexion of the illness or significantly change the disease. Of course, that propensity does exist, but equally, there might be a mutation that makes the virus less infectious or less virulent. So, on the whole, we shouldn't be overly worried about these mutations. They do have a potential impact on vaccine discovery and vaccine development, of course, but that's one of the challenges, and why we keep saying, hey listen, a vaccine might be a little way off, there are stable parts of the virus - for example, the receptor binding domains and parts of these RNA code - and these may offer the solutions for a vaccine. So we just need to let the research happen and not be overly distracted by the possibility of mutation - which is probably not going to have any difference - and crack on with all of those social measures that we've mentioned in the hope that we do hit on a vaccine sooner rather than later.

ASHLEIGH GILLON:           Dr Zappala, the Vice President of the Australian Medical Association. Appreciate you joining us with your insights. Thanks so much.

7 May 2020

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