Coronavirus: Meet the people behind the Hunter's successful response to COVID-19

They have been the faces in the media, the puppeteers ensuring our hospitals were ready to cope, and the calm, reassuring voices keeping us informed so we could protect ourselves, our families, and our community.

They called the shots. They endured long days, and sleepless nights.

But the efforts of Dr David Durrheim, Dr Paul Craven, Elizabeth Grist and Michael DiRienzo have paid off.

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The Hunter has no active cases of COVID-19. And if an outbreak occurred now, the Hunter's hospitals are ready, and its staff are on guard.

But the region's success, to date, had taken a "village".

It had taken the support and flexibility of Hunter New England's 17,000 staff members across its 39 facilities.

And it had taken the compliance of the Hunter community to follow the public health measures to reduce the spread of COVID-19.

Dr Durrheim said he had lost count of the number of times he had told people to wash their hands thoroughly, and stand back, since the coronavirus arrived in the Hunter in early March.

"I said a lot of things repeatedly, and people have been amazing," he said.

"It is horrible if you give a message that you know is critical and people don't respond.

"But the people of the Hunter have been amazing. The fact that people did stay at home, and keep their distance, is really encouraging.

"It could have been very different."

As people began to feel scared, anxious and worried about the threat of the virus, Dr Durrheim said honesty and transparency in their public health messages had been key - giving people up-to-date, evidence-based information as soon as it was available.

"Old" public health measures had been rolled out in the absence of a vaccine or effective anti-virals.

"Quite soon we realised we were facing a once-in-a-century pandemic," he said. "We didn't know what the outcomes would be, but we could see and learn from what was happening in other countries.

"We realised that most of the spread was through droplets, so there were measures that we knew very well, simple measures, that would work. And they worked extremely well to really suppress the virus in Australia.

"The government responded appropriately - a little later than I would have liked when it came to closing international borders, but they did close the borders. That gave us an opportunity to really hunt down the virus, and track down the close contacts and get them to isolate.

"If we didn't get it right, if we didn't do what we needed to do, you could see it was very obvious that people would die.

"We had to put in every effort we could to save lives."

Dr Durrheim said he had an "unbelievably wonderful" team behind him in public health - doctors, epidemiologists, nurses and clinicians - who realised the scale of the risk and were prepared to do whatever they could to respond.

But even so, particularly in mid-March and most of April, he got little sleep.

Dr Durrheim had been involved in large responses to cholera outbreaks, Congo fever and Ebola, as well as the H1N1 flu pandemic in 2009.

But all of his previous public health experiences paled in comparison to COVID-19.

The sheer global scale of it. The relative severity of the disease. Its ease of transmissibility, and its fatality rate.

"I must admit, my own hours were unhealthy, I believe," he said.

"Because of the fascination, and the evolving science, one would go to bed and try to get some sleep. But then a couple of hours later, one's mind was too active - so you'd spend the time reading what was in The Lancet or New England Journal of Medicine before getting back into the workplace.

"But the drivers were just so strong. I mean, people's lives were imminently at risk, so you wanted to do everything you possibly could. This was the pandemic of the century. The last one like it was the Spanish flu in 1918/1919."

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The Hunter's COVID-19 response team had prepared for the worst, and hoped for the best.

"And so far, we have got the best, I wouldn't want to be in any other country in the world at the moment," Dr Durrheim said. "But we are not out of the woods yet.

"We can't afford to relax our guard, we have to be ready to respond to this virus, and hopefully buy enough time for us to see a safe and effective vaccine ready for general use in the population."

EVERY day for the past 138 days, Dr Paul Craven has received a "situation report" as the nominated medical controller for the Hunter's COVID-19 response.

And for 138 days, he had been preparing and enacting plans, trying to be ready for every possible scenario, including deaths.

Now, cautiously optimistic, he is proud to be implementing the region's recovery plans.

Up until Easter, Dr Craven was working every day of the week, including weekends.

There was much to do, in little time.

"We just didn't stop," he said. "There were some extremely long days at the beginning.

"A lot of us believed we were on a similar curve to what was happening in Europe, which we had seen become overwhelmed.

"We wanted to be able to manage, to have the ventilators and the beds and the PPE, to help us see these sick patients.

"But we always knew the best thing we could do is try to prevent it spreading in the first place... Although we worked over Easter, it felt like the first time we could have a bit of a breather. It was a tipping point.

"By then we could see we had been doing a great job - and that is 17,000 people doing a great job," he said. "Every single staff member had a role. We all worked on this together."

There was a plan for every hospital, every ward, every staff member.

"The pandemic around the world has shown us what will happen if we don't act quickly," Dr Craven said. "If we didn't over-react, and if we weren't quick, within days we could have been as bad as Europe. That's the truth.

"It is the best over-reaction we have ever done."

AS the number of COVID-19 cases looked likely to rise from a trickle to a roar, the information from the State Health Emergency Operations Centre was coming through "thick and fast" to Elizabeth Grist - the district's Health Service Functional Area Coordinator.

High on the chain of command, Ms Grist provided leadership and direction in unprecedented times.

"Very quickly we realised this could be really difficult and really dreadful, so we needed to put measures in place quickly, and we did."

Ms Grist worked alongside Dr Craven to prepare the workforce, and the region's hospitals, for a large outbreak.

They looked at logistics, establishing screening clinics, and strategies to train and up-skill staff.

They looked at bed numbers, and intensive care capacities. They bought extra equipment - including ventilators, and sought locally-manufactured personal protective equipment (PPE) due to a worldwide shortage.

"It was a massive undertaking when I look back. I'm quite in awe of everything everyone has done. It has been a huge operation," she said. "I did feel the weight of responsibility. I worried for our staff. We were seeing everything that was on TV from Italy and across the world.

"But it really does take a village. Everyone played their part and worked together beautifully - all of the 17,000 Hunter New England Health staff, from the frontline to administration to contact tracing.

"The cleaners were vital - everything had to be cleaned so thoroughly. They were such a vital cog in the wheel, and I don't know that everyone fully appreciates that.

"Everyone worked beautifully together.

"Their hard work, their dedication, and their resilience has protected the community, and should be celebrated by everyone."

Ms Grist said COVID-19 had not taken hold in Australia, NSW and the Hunter as it had in other countries because of the measures that were put in place.

"Even now people say, 'It never happened and now the country is in recession'," she said.

"But the reason it didn't happen was because of the measures that were put in place, and put in place so well.

"This could be a totally different conversation in Australia now if those measure weren't put in place.

"We are still seeing dreadful outbreaks across the world. In Australia, we have done an incredible job, but we need to keep on doing a good job."

Hunter New England Health chief executive Michael DiRienzo said they had always had strategies in place should something like COVID-19 occur, and his team had responded "extraordinarily well".

"I am extremely proud," he said. "There was an enormous amount of work, but they did a really good job in maintaining a sense of confidence, stability, and giving the necessary support to allow our frontline clinicians to become confident about what might have been ahead."

Mr DiRienzo said from as early as January, clinicians had become aware of the looming threat of COVID-19.

"Through their overseas networks of colleagues, we were getting information quite early," he said. "They were telling our clinicians that this was not influenza, that this was something serious. That it was highly contagious, and we needed to be prepared."

He said non-urgent elective surgeries had been cancelled while case numbers were escalating, but now the Hunter's hospitals were focused on getting back to "100 per cent".