A SENIOR Hunter doctor says increased testing and data about the location of Hunter coronavirus cases is needed as essential services, including power stations, plan for increasing coronavirus numbers where closing is not an option.
"I think we're not getting the kind of information we should be," said University of Newcastle school of medicine and public health Dr Benjamin Ewald as the number of confirmed coronavirus cases in the Hunter New England Health District increased to 72 on Tuesday.
The 72 cases are "widely scattered over Hunter New England" and "it's not that any area has not had a case", the health service's public health physician Dr David Durrheim said.
Dr Ewald joined other strong critics of the current testing regime, including ABC health commentator Dr Norman Swann, in arguing the extent of community transmission is not known. It is a particular issue in a region with two power stations and other essential services that cannot close, Dr Ewald said.
He argued a sentinel surveillance system of testing people in the Hunter with no risk factors at all would give a better indication of the extent of the coronavirus spread through the community, and particularly where there are significant concentrations of workers such as coal mines.
"If the objective of our current responses is to flatten the curve, the question is, are we flattening the curve in the Hunter? We don't know," Dr Ewald said.
Mining companies are screening employees by taking their temperatures but it does not pick up cases where people are infectious but have no symptoms. On Monday Senator Rex Patrick confirmed he had coronavirus but had no symptoms.
AGL said it is already "considering planning for the isolation of the site" at Liddell and Bayswater power stations if coronavirus numbers increase as expected.
"Isolation of the site" could include the possibility of workers being accommodated on the site, the Newcastle Herald understands. AGL did not respond to a specific question about such a proposal.
"Part of our preparation involves considering planning for the isolation of the site, and if this happens, we will be working closely with our employees and their families to ensure they know the care we will take in this situation," an AGL spokesperson said.
The company has directed all non-operational employees to work from home, has restricted access to control rooms and workshops, increased hygiene and site cleaning measures, and introduced social distancing measures to mitigate risks at the plant.
"We've also staggered meal breaks, separated the different shift teams coming on and off shifts, reduced the number of entry points to our site and restricted visitor and contractor access to the plants," the spokesperson said.
"We will continue to work with our people to keep the lights on during these unprecedented and uncertain times."
Dr Ewald said Hunter GPs needed local area-specific data about where coronavirus cases were to understand "what the local epidemiology is".
Doctors were also hampered by current rules restricting testing of suspected cases largely to where people had returned from overseas and were showing symptoms, or where they had been in contact with such cases and confirmed coronavirus cases.
Dr Ewald said sentinel surveillance testing of people with no symptoms or risk factors, which assesses the stability or change in coronavirus levels in a population, would give a clearer picture of the extent of the condition. The current regime means the health system and other essential services react to the coronavirus spread on an estimated 10-14 day delay.
"We need more release of local epidemiology and local results in a way we can understand what's going on in our own communities," Dr Ewald said.
He agreed with Dr Swann that the "asymptomatic spread" of coronavirus - the spread of the disease through communities where infectious people have no symptoms, is "what we should be worried about".
On Monday Australia's deputy chief medical officer Paul Kelly said testing guidelines would be changed this week. An additional 97,000 test kits arrived in Australia last week but doctors were still being advised to restrict their use.
"While the Government is working hard to source more supplies, it is important that we conserve the stocks we have so that we can respond no matter what happens overseas," Professor Kelly said.