Medical graduate helps chart our way out of COVID-19

27/07/2020 | 5 mins
3D retro effect of Dr Nick Coates, Deputy Chief Medical Officer of Australia

While he may feel he was lucky to be “in the right place at the right time”, there’s no doubt that the skills and experience gained from working in some of the world’s most vulnerable and war-torn countries helped UWA medicine graduate Nick Coatsworth secure the role of Deputy Chief Medical Officer of Australia shortly after COVID-19 was declared a pandemic.

An infectious diseases and respiratory medicine specialist at Canberra Hospital and Australian National University academic, Dr Coatsworth (MBBS 2002) was appointed in late March as one of four deputies to Chief Medical Officer Brendan Murphy, joining fellow UWA medicine graduate Dr Paul Kelly (MBBS 1984) on the front line of the country’s medical response team to the COVID-19 pandemic.

When Uniview first spoke to Dr Coatsworth in early April, he had hit the ground running, juggling meetings, webinars and regular media interviews on prime time television.

“It’s very difficult to sleep with all the stuff that’s buzzing through your mind,” Dr Coatsworth said. “There’s such an enormous amount of work to be done in our complicated health system.

“I feel like an interloper coming in halfway through. Brendan Murphy and Paul Kelly – their stamina is just astonishing. Any time I feel tired I just look at those two and think ‘buckle up Nick’.”

As the only hospital-based practising clinician in the team of deputies, his role has involved dealing with hospitals and health services.

“The Commonwealth traditionally doesn’t have a strong role in the hospital sector and yet during a time of crisis we are and should be expected to have some sort of overarching view on that,” he said.

While most of us would find working as Director of Infectious Diseases at Canberra Hospital and lecturing in medicine at the Australian National University more than enough, Dr Coatsworth is also undertaking a part-time PhD on the topic of how infectious diseases affect foreign policy. He already has a Masters in International Public Health from the University of Sydney.

But the PhD has been put on hold for now, while he tackles the real thing.

During his stint with Médecins Sans Frontières, Dr Coatsworth worked in Congo-Brazzaville, Chad and the Darfur region of Sudan – some of the poorest countries in the world crippled by conflict and disease – providing valuable experience for his current role.

“It’s about being able to make commonsense, fast decisions which is an asset; and if you’ve worked in emergencies – not that people who haven’t worked in emergencies can’t do that – it’s just that the level of comfort that you have in this rapidly changing environment is improved.

“You’re comfortable making those quick decisions that have big implications and that’s the real key. Obviously they still have to be considered and evidence-based but the amount of time you have to actually do the reflection is brief.”

“It’s more complex charting your way out than your way in… We now have to work out how to get out in the right way.”

Dr Nick Coatsworth, Deputy Chief Medical Officer of Australia
Dr Nick Coatsworth



When we caught up with Dr Coatsworth again in late May, he said while the pace of decision-making had slowed down a little as the nation moved into a recovery phase, the decisions that needed to be made were more difficult.

“It’s more complex charting your way out than your way in,” he said. “It’s one thing to be able to shut everything down, and you have choices about what you need to shut down, but by and large it’s a fairly uniform thing.

“But on the way out there’s a whole range of societal considerations that you need to look into and then plan what is a commonsense approach out.”

This approach revolved around a cautious and staggered response to avoid having to shut down again.

“But also you need to balance that with the fact that we’re in an extraordinarily good position and can afford to lift restrictions far quicker than any of us really thought would be possible. Anything that we put a restriction on, we now have to work out how to get out in the right way.”

On the subject of a COVID-19 vaccine, Dr Coatsworth said anything was possible but pointed out that smallpox was the only disease that had been successfully eradicated from the world with a vaccine.

“The transmission dynamics of COVID-19 certainly don’t favour the production of a vaccine like the measles vaccine where you can have very few cases, provided your coverage is high — I’m not sure COVID-19 is going to be in the same category,” he said.

“You’ve got the influenza vaccine which has to be done every year and then you’ve got the possibility of no vaccine; so between those possibilities I really think it’s anyone’s guess as to what we end up with here.”

On a positive note, Dr Coatsworth pointed out that a record of more than 7.39 million doses of seasonal flu vaccines had been administered Australia-wide to date in 2020, which was 4.7 million higher than the same period last year.

With so many resources around the world being directed towards a COVID-19 vaccine, it was more likely that a vaccine would be found than during previous pandemics such as SARS and MERS, he said.

When asked about the question of opening Australia’s interstate borders, Dr Coatsworth said it was hard to label any issue a uniquely state issue during a global pandemic.

“We really do need to have a national position on the issue of suppression versus elimination and the reason for that is because that substantively affects what we do with our international borders.”

Dr Coatsworth said he had fond memories of his time as a medicine student at UWA and always looked forward to coming home.

“Both Paul Kelly and myself are proud Western Australians,” he said. “I’ve always said there are two things WA does really well: mining and medicine.”

“When I first came to work over east, people in the health system were really happy to take on UWA medicine graduates because they were well-regarded.”

Since being appointed a Deputy Chief Medical Officer Dr Coatsworth said he had received many messages of support from his fellow graduates.

“One of the best things about being in the job is that a lot of old mates from uni have contacted me, which has been really positive. I would love to come back and visit family and friends once those borders are open and it’s great that people have continued to get in touch with me.”

Read all of this winter's Uniview magazine [PDF, 2.8MB]. 

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