For good health
From paediatrics to public health and pandemics, Professor Spurrier's passion for keeping people well
On the wall of Professor Nicola聽Spurrier鈥檚 office above Hindmarsh聽Square is an instructional poster聽that once belonged to her father聽Dr Evan Ross Smith (Clinical Microbiologist,聽成人大片 and RAH).聽鈥淲ASH YOUR HANDS / BEFORE聽HANDLING FOOD / AFTER VISITING聽THE TOILET / AFTER A CLEANING聽SESSION鈥.
The modern relevance, of course, is not聽lost on Professor Spurrier, an alumna and a聽Professor of Public Health at the University聽of Adelaide. 鈥淥ne of the things I like about public health is聽that it can be a really simple intervention that聽impacts the lives of a huge number of people,鈥欌櫬爏he said. 鈥淭he very nature of public health is that it can聽be invisible. The reason that people can turn聽on water in South Australia and it comes out聽clean is because of public health. The reason聽that we don鈥檛 have sewage running down our聽main roads is because of public health. These聽are the things that people really take聽for granted.聽Public health is such a rewarding area of聽 medicine.聽It鈥檚 a small specialty, there鈥檚 not聽many people and we could do with some聽more, and the pandemic has really shown聽us that."
鈥淏ut when I think about the patient it鈥檚聽actually the whole population. What鈥檚聽driving me is to improve the health of that聽whole community.鈥澛Professor Spurrier
Now Chief Public Health Officer for South聽Australia 鈥 and lauded on social media as聽鈥楽aint Nicola鈥 for her role in keeping South聽Australians safe during the COVID-19聽pandemic 鈥 Professor Spurrier had originally聽trained in paediatrics after graduating from聽the 成人大片.
鈥淟ike many people in medicine, I do come聽from a family of doctors and, probably what聽was more influential, there were female聽doctors in my family as well,鈥欌 she said. 鈥淢y mother is a pathologist and I had an聽aunt who was a paediatrician鈥 I really felt an聽affinity for children. I remember writing in a聽grade seven English essay that I was intending聽to be a paediatrician."
鈥淢y father was an infectious disease physician and he taught medical students. And so, when I started at the 成人大片鈥檚 Medical School 鈥 pointing out聽my sister got in the year before 鈥 it would be mum, dad and the two girls driving into Adelaide all together. I think those years at medical school were聽just wonderful.鈥
Professor Spurrier made the decision to practice dual specialities in paediatrics 鈥 in which she trained at the Women鈥檚 and Children鈥檚 Hospital 鈥 and public health following a fortuitous meeting with Australian epidemiologist Professor Fiona Stanley. 鈥淪he gave a lecture to the paediatric registrars about evidence-based medicine and was talking about preventing things happening and not just assuming that everybody had to get sick, and it was from that point that I decided I wanted to look at how I could prevent people getting ill and not just treating people who ended up in hospital.鈥
A PhD at the 成人大片 鈥 on parental management of childhood asthma 鈥 was followed by a ten year appointment as a Clinical Academic at Flinders University鈥檚 Department of Paediatrics and Child Health. 聽An opportunity arose in 2008 to take up a consultant position as the Department of Health's Public Health Physician.
聽鈥淧eople don鈥檛 want their loved ones to get聽sick. So not only are we talking about a聽whole population, but we鈥檙e looking at all聽the policies, interventions, whether that鈥檚聽immunisation or whether that鈥檚 looking at聽the changes of law around termination of聽pregnancy, all of these things prevent people聽getting sick,鈥欌 Professor Spurrier said.
While the state had a pandemic plan before聽any of us had even heard of COVID-19,聽Professor Spurrier admits it鈥檚 impossible to be聽100% sure of what lies ahead at the beginning聽of an outbreak. 鈥淲hile we were somewhat prepared and聽we thought about pandemics and we had聽a pandemic preparedness plan and such,聽nobody in the world really envisaged how聽huge it was going to be,鈥欌 she said. 鈥淏ut we had a very insightful video lecture聽from Dr Bruce Aylward leading the聽World Health Organization's investigation聽into China. And he said to us, 鈥楧o not聽underestimate this virus. It is terrible. And聽if you can do something about stopping it聽getting in, do everything you possibly can鈥. And then we were starting to get text聽messages from colleagues, ICU to ICU, from聽Italy saying, 鈥楾his is like the apocalypse. Don鈥檛聽underestimate this. This is absolutely terrible鈥.聽So, we went on and did something about it,鈥澛爏aid Professor Spurrier.
Well used to media after more than a year of聽press conferences, Professor Spurrier said the聽public鈥檚 impression of her confidence in the聽face of the pandemic was a true reflection of聽what she felt during this time. 鈥淚 can鈥檛 say I鈥檝e been scared (during the聽pandemic). I had real confidence that the聽hospital system would have an ability to聽deal with patients. I had real confidence in聽the South Australian government that we聽would manage it together, and I had a lot of聽confidence in the community that we would聽get through it.鈥
And those ever-present critics who think,聽despite it all, that local public health responses聽were too restrictive? 鈥淭here鈥檚 a very cute little cartoon of Pooh and聽Piglet,鈥欌 Professor Spurrier said. 鈥淧iglet says to Pooh, 鈥楶ooh, how will we聽know if our pandemic plan is working?鈥 And聽Pooh says to Piglet, 鈥楤ecause they鈥檒l all say聽we overreacted鈥. And Piglet says, 鈥楽o, does聽that mean when we鈥檙e right, everyone will say聽we鈥檙e wrong?鈥 And Pooh said, 鈥榃elcome to聽public health, Piglet鈥.
鈥淏ut I think people will learn from this. I think聽the world will learn from this. And there are聽things we might want to keep for the future.聽The improvement in people鈥檚 hand hygiene,聽not going to work when you鈥檙e sick, getting聽tested if you鈥檙e ill, staying away from other聽people. Those sorts of things have resulted in,聽not only a reduction in COVID-19, but also a reduction in other respiratory illnesses."
Story by Elisa Black
Photos by Meaghan Coles