Today's hotel inquiry hearing is under way. You can watch it live, below:
Latest updates
And that's it from Dr van Diemen. Thanks for following in what has been a huge day. So huge the inquiry couldn't find time for Jason Helps and Andrea Spiteri from the DHHS.
They're expected to be up tomorrow afternoon. From 10am, we'll hear from Victoria Police Chief Commissioner Shane Patton and his predecessor Graham Ashton.
Keep an eye on theage.com.au this evening for all the latest.
Dr van Diemen has been pressed on who was responsible for the implementation of infection control measures in hotel quarantine.
In cross-examination led by Arthur Moses SC, the lawyer for Unified Security, Dr van Diemen said the responsibility was with the emergency operations centre. This centre was made up of a number of representatives from different departments and agencies.
Arthur Moses SC is acting for Unified Security.
"Is that a serious answer?" Mr Moses asked.
Dr van Diemen said didn't go into granular details such as who might have been responsible on the floors at each hotel.
A plan outlining who was in charge, and shown to the inquiry, noted the Health Department Commander in charge of COVID-19 accommodation had responsibility for a "safe environment at all times."
Dr van Diemen said "everybody has responsibility in some way, shape or form".
"Are you trying to blame others?" Mr Moses asked.
"I'm not trying to blame anybody," Dr van Diemen replied.
She said a large number of small actions or decisions undertaken by a large number of people was behind the outbreaks in the hotels in Victoria.
"I don't believe that any one individual is responsible for what occurred," she said.
Earlier, Professor Brett Sutton said his team gave advice about infection control measures and it was up those managing hotel quarantine to implement.
Health officers Australia-wide endorsed the continued use of hotel quarantine for international arrivals to Australia in June, the inquiry heard.
Then-Chief Medical Officer Professor Brendan Murphy chairing a meeting with state and territory Chief Health Officers on March 16, when Australia was still figuring out the virus.Credit:Alex Ellinghausen
The Australian Health Protection Principal Committee, made up of the chief health officers from the state and territories jurisdictions, agreed hotel quarantine had been a key part of Australia's success in responding to coronavirus, the lawyer for Health Department Claire Harris QC read to the inquiry.
The AHPPC also considered home quarantine as another option in its June 26 statement.
There was not enough data to warrant diminishing the use of hotel quarantine, Ms Harris read to the inquiry.
Dr van Diemen also said some people were allowed out of hotel quarantine while still awaiting test results.
This was based on a risk assessment of people showing no signs of COVID-19 and only in a small number of instances, she said.
Dr Annaliese van Diemen
She said anyone who was released - if, for example, they were late into their quarantine and showing no symptoms - had an appropriate location to continue their isolation.
Dr van Diemen said it was determined in these cases that they were most likely non-infectious.
They were getting "daily calls" to ensure they were maintaining their isolation, she said.
She added that only people showing symptoms were getting tested prior to early May.
Earlier today, Counsel assisting the inquiry Ben Ihle cited an example of a person who completed quarantine at the Stamford Plaza and then tested positive for COVID-19.
Professor Brett Sutton, who was being cross-examined in the first session, said "that is potentially the case; they would have been questioned as to whether they had any symptoms and would have been released."
"I think that has become part of the reflections on strengthening the testing regiment in hotel quarantine for that very purpose," he said.
Dr van Diemen has addressed the decision to allow COVID positive people to leave hotel quarantine at the end of their 14 day detention.
In the first few weeks of the program, which began in late March, people who didn't display symptoms of coronavirus were not tested.
The Rydges on SwanstonCredit:Penny Stephens
Before early May, no asymptomatic cases were tested.
However, people were getting released from quarantine at the end of their 14 days even if they had tested positive, so long as they had a safe place to isolate and were cooperative.
"That was an incentive to ensure that people did report when they had symptoms and ensure that a test was undertaken," she said.
She said she didn't want people to refuse to have a test because they knew they would be kept in quarantine.
The new measure to detain people for a further 10 days for refusing to a test in quarantine was introduced in late June, about the time international arrivals to Victoria were suspended, effectively putting an end to the hotel quarantine program.
Dr van Diemen signed off on about 20,000 orders to detain international arrivals in quarantine in Victoria.
It was a decision that weighed heavily on her, she told the inquiry.
Dr Annaliese van Diemen
Dr van Diemen had the job of signing off on the notices given to each person arriving in Victoria from overseas, requiring them to be detained in a hotel for 14 days.
She had to take into account public health factors along with people's human and legal rights.
The inquiry has heard more than 20,000 people went through the hotel quarantine program from the end of March until July.
Dr van Dieman is now getting asked about the hotel quarantine exemption for air crew. She said it was a national exemption and Victoria signed up to it.
People who breached isolation orders weren't issued with $20,000 fines despite admitting they had broken the rules, the inquiry has heard.
This has come up in the questioning of Dr van Diemen, which has focused on the decision to set-up hotel quarantine.
Dr Annaliese van Diemen said positive cases were still "out and about" in early stages of the pandemic.
She said she considered home quarantine, rather than quarantine in the hotels, but she agreed with the requirement from the National Cabinet for hotel quarantine from the end of March.
Dr van Diemen said the $20,000 fine that could be issued to people who breached home quarantine didn't appear to deter a "large number of people from breaching that order" at the time.
She told the inquiry COVID-19 cases told contact tracers they had been "out and about in public places when they were under a quarantine order and should have been just at home."
The chair of the inquiry, former judge Jennifer Coate, asked if those people were fined.
"At the time, they were not, they were not fined," Dr van Diemen said.
She said there was a balance between fining people and maintaining trust and people's willingness to provide honest answers to contact tracers about where they'd been and who'd they'd been in contact with to "manage the public health risk."
"It was decided not to [fine] at that point in time, but as we have learned further...some of those processes have changed," Dr van Diemen said.
Dr van Diemen said she called for a clinically-based health expert to be embedded in the hotel quarantine operation.
She agreed with counsel assisting the inquiry, Ben Ihle, that the lack of oversight from the public health team meant that adherence to infection control in the hotels was lost.
The public health team didn't know protective gear and social distancing was not being adhered to by workers in the hotels, the inquiry heard.
"That was something that came to your attention only after the outbreaks had occurred wasn't it?" Mr Ihle asked.
"Yes," Dr van Diemen replied.
Dr van Diemen has acknowledged hotel quarantine was run more as a logistics or compliance exercise, rather than a health program.
She said clinically trained personnel should have had more of a role in overseeing the program and on the ground at the hotel sites.
Dr Annaliese van Diemen giving evidence at today's inquiry
Dr van Diemen said her opinion was made "in retrospect and we know a lot more now."
The inquiry has heard the Health Department had one full-time infection control consultant.
The consultant was shared across the department and the MDU - the Microbiological Diagnostic Unit.
Dr van Diemen said they were primarily employed for public health elements of infection control - not for hospitals - and primarily assisted with outbreak investigations and other infection control breaches in the community.
Dr van Diemen says she also endorsed an email from another senior public health official that warned of risk to the health and safety of people detained in hotel quarantine.
We heard about the email earlier. It was sent in early April by Dr Finn Romanes, who was the Deputy Public Health Commander, to the state controller running the COVID-19 pandemic response.
Victoria's former Deputy Chief Health Officer Annaliese van DiemenCredit:Paul Jeffers
Dr Romanes called for an urgent review in the governance of hotel quarantine, which needed a clear leader and direct line of accountability to the Deputy Chief Health Officer, Dr van Diemen.
That resulted in the creation of a public health liaison position to work in Operation Soteria, set up to oversee the program.
Dr van Diemen said she agreed with what Dr Romanes raised.
"I think we were all acutely aware whilst fully supporting the need for quarantine of returned travellers, we were also aware that we were detaining people and there were inherent risks...that we needed to be cognisant of," she said.
Dr van Diemen has also acknowledged hotel quarantine was initially geared too far towards "logistics and compliance" instead of health.
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2020-09-16 07:10:00Z
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