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