A leading infectious disease expert has warned Australian leaders to not become complacent to the risks around hotel quarantine, saying surging COVID cases worldwide should prompt a rethink of how we deal with returning travellers.
Medical experts are sounding alarm bells about the need to reform the system, even as NSW Premier Gladys Berejiklian – whose state is taking in by far the most returned Aussies – says she wants to “stick to what we know works”.
Following more breaches in hotel quarantine helping seed the South Australian outbreak, and well-documented errors in Victoria’s program, SA Labor leader Peter Malinauskas called for radical reform.
He proposed an “alternative model” where, instead of spending 14 days in a city hotel staffed by standard guards and workers, people would quarantine in less-populated areas inside specialised facilities.
Here are my remarks from my press conference at 9:30 this morning, calling for medi hotels in their current format to end, until there is a safer solution. You may note that not once do I attack Steven Marshall.
— Peter Malinauskas (@PMalinauskasMP) November 22, 2020
Several leading epidemiologists, including Philip Russo of the Australasian College for Infection Prevention and Control, and World Health Organisation adviser Professor Mary-Louise McLaws, also called for similar changes.
Associate Professor Russo told The Age it “makes logical sense”.
Infectious disease expert Bill Bowtell, adjunct professor at the University of NSW, told The New Daily the current lull in COVID cases in Australia was a chance to rethink the hotel quarantine scheme.
“The situation that emerged over the last nine months has evolved into this hotel quarantine, staffed by security guards and poorly trained, poorly paid people. It was an emergency phase, but the emergency phase is over,” Mr Bowtell said.
“As we go into 2021, quarantine and management of borders becomes pivotal to keeping [zero cases].”
Mr Bowtell was an architect of Australia’s response to the HIV AIDS crisis.
He has been an advocate for elimination of COVID in Australia, and wants international borders fiercely protected against virus risk.
But considering the surging cases overseas, especially in countries like the US and United Kingdom – where many Australians may be returning from – he said it was time to rethink quarantine plans.
“Our situation now is no longer appropriate. We see the holes in it. It’s ridiculous to blame low-paid, under-trained workers for breaches,” Mr Bowtell said.
“Blaming and shaming just guarantees the problem will spread. We need purpose-built or specially adapted buildings, permanent well-paid and well-trained staff with clinical supervision, and expanded to cope with a rising demand.”
With 628k worldwide cases per day and rising, keeping Covid out of Australia now requires purpose-built quarantine facilities, staffed by permanent, well-trained staff and clinicians able to handle greater numbers than presently. @abcnews @amapresident @MJA_Editor @smh
— Bill Bowtell AO (@billbowtell) November 20, 2020
The calls comes just days after the nation’s chief medical officer Professor Paul Kelly said hotel quarantine was the “major risk now of reintroduction of COVID-19” into Australia.
“When you think about what’s happening overseas, over 55 million cases now, enormous numbers in many countries and that is where Australians are coming back from,” Professor Kelly said.
The number of global infections is now close to 59 million. More Australians than ever are returning, as airport arrivals caps lift and more states take on more passenger loads.
New South Wales is taking the largest share of the returning traveller load.
Mr Bowtell didn’t back calls for isolating travellers in remote locations, but suggested – for example – people flying into Melbourne could be taken to less-populated centres like Bendigo or Ballarat.
He said surging virus cases overseas may encourage more Australians to come home, potentially bringing more virus.
“We have a stock of buildings like hotels or office buildings that could be adapted pretty easily, but the critical thing is the staffing has to be a public health requirement,” he said.
“It should be permanent, not outsourced. Investment in this is the most critical thing in keeping Australia virus free.
“Alternatives like home isolation, the sort that has collapsed in the UK, taking people on trust, ankle bracelets, none of that will be as effective as properly administered quarantine arrangements.”
But asked on Monday if Australia needed to rethink its hotel quarantine program in light of the breaches in Victoria and SA, Ms Berejiklian flatly rejected the notion.
“We’re always considering options, but we don’t believe at this stage that is a safe option,” the Premier said of calls to move quarantining travellers to less-populated areas.
“Given the quarantine system is working so well, we don’t want to jeopardise any of that … it’s important for us to stick to what we know works.”
Mr Bowtell accepted NSW’s system worked well, but said complacency mustn’t creep in.
“The system has to get better,” he warned.
“In a world where COVID is out of control, where we’ll have an increased demand for people to come in, we have to substantially upgrade the present system.”
SA Premier Steven Marshall said he was “disappointed” with the calls from Mr Malinauskas, saying it “makes no sense”.
The New Daily has contacted federal Health Minister Greg Hunt for comment.
Andrew Hayen, a Professor of Biostatistics at the University of Technology Sydney and former president of the Australasian Epidemiological Association, said hotel quarantine had “worked well” and that the costs of some changes proposed would be “massive”.
However, he told TND, the system “could be improved” with better COVID testing of hotel workers, and better working conditions.