North Coast Public Health Director Paul Corben reflects on the challenges of COVID-19
A self-described “farm boy at heart”, Paul Corben gazed out at the cows in the paddock of his property near Port Macquarie, on the NSW mid north coast. Like most people during the height of the COVID-19 lockdown he was working from home, but the Director of North Coast Public Health was anything but under-utilised, not least because he was not long back from a period of extended leave.
“I began leave last November and by the time I returned at the end of March it seemed the whole world had changed,” Mr Corben told GP Speak.
“There has been nothing on the scale of this COVID-19 outbreak in the past century. For the public health network in NSW and Australia more widely this is the biggest thing in our lifetime.
“The fact is that we can’t lock the world down on a scale for COVID-19 to burn itself out, especially as we have relatively little idea of what’s happening in, say, Africa, or even as close to home as PNG.”
He continued, “Another challenge is that the information we have about this novel microbe is changing weekly, sometimes even daily… initially we were assuming that spreaders would be symptomatic, then we discovered the risks of asymptomatic transmission, and next the possibility of pre-symptomatic transmission.
“It’s an emerging knowledge base and with no vaccine on the immediate horizon the key public health measures are all the more important.”
The broader community has been encouragingly quick to embrace practices such as social distancing, handwashing, cough and sneeze protocols and even the somewhat problematical COVID-Safe phone app.
“It’s been pleasing to see the level of support by the public,” Mr Corben said.
“The challenge is from here on as the rules are relaxed… we must appropriately ease restrictions at the lower possible public health cost.”
In this age of COVID-19 the role of North Coast Public Health, whose network spans both the Northern NSW and the Mid North Coast Local Health Districts, is to “contain hot spots and minimise the virus’s spread, as well as working with primary care providers to identify and isolate any carriers, and identify the source of their infection.”
On the day of our interview no new cases of COVID-19 were identified on the North Coast. At 8 May 2020 there were 105 confirmed cases in the area (Tweed Heads to Port Macquarie) covered by the two LHDs. NSW totalled 3051 cases.
At face value, Paul Corben might seem like the farm boy he describes but he’s actually a numbers man.
Born in Sydney, he and his ten siblings moved north to a dairy farm outside Taree when their father embarked on a radical career change. Later he did a Bachelor of Science, majoring in agricultural economics, followed by a Masters. He’s currently undertaking a PhD, focusing on public health.
“I’m all about numbers,” he said, “so no chance of getting a photo in a lab wearing a white coat and holding test tubes. Epidemiology is one of the pillars of my discipline.”
Mr Corben moved into the public health field in 1992 during a decade-long spell with NSW Health in Sydney He moved back to the North Coast to lead a highly professional team addressing the region’s challenges, including the risk of diseases spread by fruit bats, mosquito borne viruses, the occurrence of serious communicable diseases such as pertussis and measles, and vaccination resistance in a number of regional locations.
However, nothing has happened on the scale of COVID-19, and Paul Corben suspects he may not be taking another holiday for some time: “Everyone’s travel plans are now on hold, and look likely to be for some time. I was lucky to have a break before all this started, now it’s just go-go-go, and we can only hope for a better ending.”
Addressing the key role of GPs amidst this crisis Mr Corben said practices have been doing a great job amidst rapidly changing circumstances, including patient confusion and the uptake of telehealth.
“It’s certainly important to encourage testing and referring patients if only the mildest of symptoms are detected. I think it’s important to remind patients that GPs are still open for business. This is a major concern, as recent figures [he’s a numbers man, remember] show that demand for GP services and ED attendances have dropped by 30 per cent in recent times.
“We don’t need people at home with crushing chest pain because they don’t want to overburden the system. It really is important to keep in touch with patients known to have chronic diseases.”
And so saying, he went back to looking at the cows, or perhaps to counting them, this being an irresistible habit.