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SA Health boss worried about under-reporting of COVID cases

Health authorities don’t really know how many South Australians have COVID and believe that many cases are going unreported, the SA Health CEO admits.

Feb 07, 2022, updated Feb 07, 2022
SA Health boss Dr Chris McGowan. Photo: Tony Lewis/InDaily

SA Health boss Dr Chris McGowan. Photo: Tony Lewis/InDaily

Giving evidence to parliament’s budget and finance committee this morning, SA Health chief executive Dr Chris McGowan said the number of daily cases reported by authorities was not a true picture of how many South Australians were actually infected.

SA Best MLC Frank Pangallo asked McGowan: “Is it correct you really don’t know how many positive cases are out there and many are going unreported?”

McGowan said it was “an important question” and “the short story is yes”.

“What we call the ascertainment rate, which is the rate of positive cases that actually exist in the community that we are able to ascertain are in fact positive cases, is a challenge for all the jurisdictions,” he said.

“The way we keep an eye on that is look at all the cases that go to SA Pathology… it’s about 6000 tests a day give or take… that ascertainment rate if it’s much above five per cent then we do believe there is an under-ascertainment.

“I think if I remember this morning it was about 9 per cent or 10 per cent so there is an under-ascertainment of that.”

McGowan said that’s why authorities were recommending people with symptoms to get PCR-tested, rather than relying on rapid antigen tests, because PCR tests were more accurate.

“The short answer to your question is yes we do worry about under-ascertainment somewhat,” he said.

“That’s partially underpinning the decision of the chief public health officer and the police commissioner to move back towards our preference of PCR for symptomatic patients.”

McGowan also said it was a “fundamentally important thing for our community” for people to get their booster, if due.

Pangallo asked McGowan if SA authorities were going to consider a similar scheme carried out on the Gold Coast last week, where Queensland health authorities conducted random testing of people and found significantly high rates of people who were unaware they had COVID.

“It wouldn’t surprise me if the team are planning to do that,” McGowan said.

“We do continue to be worried about under-ascertainment.

“No jurisdiction in the world is fully confident of all the numbers that are out there, that’s just a fact.

“But whether it’s ten per cent or whether it’s 80 per cent of ascertainment we don’t know.”

McGowan said part of the problem was a perception that Omicron was not a serious variant and people were not rushing to get tested or have their booster shot.

“That’s my operating hypothesis, that people are saying this is mild, just a cold or a flu-like thing and I don’t have to go and get boosted,” he said.

“I make two comments on that – it often is, it clearly is a disease that compared to Delta is less severe and you’re less likely to end up in hospital but you still can and we are having deaths every day of people.

“Not all of them older people and not that an older person dying is any less tragic than a younger person dying… there are younger people who are getting not only severely ill but evolving into long COVID and that can be very disabling.

“Yes I do think people’s perception that it is a less risky disease is contributing towards a lower vaccination rate.”

Authorities are concerned that more than 410,000 South Australians eligible for their booster have not yet received it.

McGowan reiterated the message that people should get their booster “if not for their own sake but for the sake of the community and those that they love”.

Pangallo asked McGowan if authorities would consider changing the definition of being fully vaccinated against COVID from two doses to three, if people continued to resist getting boosted.

“I believe this is a question that’s at the forefront of the minds of ATAGI (Australian Technical Advisory Group on Immunisation) giving advice to national cabinet,” McGowan said.

“I would welcome it.

“I think in fact for Omicron unless you have the third dose you are not really protected. You might be protected in terms of the severity of the disease but you are certainly not protected in terms of catching it and passing it on.

“Unless you’ve had a third boost you are much much more susceptible to catching Omicron and giving it to your loved ones.”

Pangallo asked McGowan if authorities were planning for a new COVID-19 variant to emerge by winter.

McGowan said officials were “staying alert”.

“We can only watch and monitor,” he said.

The Health boss said the other “big threat” that authorities were worried about for winter was flu.

“As you know we haven’t had flu for a couple of years… so we’ve got a population that largely hasn’t been exposed to flu for a few years,” he said.

“That’s usually a precursor to a fairly significant flu season.

“I’m hoping that the heightened awareness people have about masks and social distancing and all these things will contribute to some mitigation of that.”

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