The federal government must step in and take over management of hotel quarantine or risk further coronavirus lockdowns, a leading health expert has warned.
Former World Health Organisation epidemiologist and chair of epidemiology at the University of South Australia Adrian Esterman told The New Daily that quarantine bungles in multiple states showed it was time for the federal government to step in.
At the moment our quarantine systems are working like a sieve,” Professor Esterman said.
“It is a national responsibility to guard international borders. It could be done really well. It’s just a matter of if the government has enough willpower.”
The warning follows Queensland Premier Annastacia Palaszczuk saying she is considering using mining camps to quarantine international travellers to reduce the risk of outbreaks in densely populated areas.
Ms Palaszczuk said she would raise the matter with the federal government when national cabinet meets next Friday.
“We are going to look at all options and one of those options is to look at some of the mining camps that we have in Queensland,” she said on Thursday.
The move has prompted heated debate between the states over whether hotel quarantine should be moved to remote locations, with some health experts criticising the piecemeal approach and calling for it be handled by the federal government.
New South Wales Health Minister Brad Hazzard said it would not make sense for the government to move its quarantine program outside of Sydney.
“We’ve had more than 114,000 people go through our hotel quarantine system … it would not be logical for, on the basis of three incidents in the last year, to move our base of operations out of Sydney,” Mr Hazzard said.
On Wednesday the Hotel Grand Chancellor in Brisbane was evacuated and shut down after a spread of the UK variant on its seventh floor.
An investigation is under way into what caused the cluster that has so far infected four other returned travellers, as well as a hotel cleaner and her partner.
More than 220 staff at the hotel are being tested and isolated, together with 147 former guests.
On Thursday, Queensland’s chief health officer Jeannette Young said she had “very little concern” that the UK variant had spread in the community.
Brisbane was last week placed in a three-day lockdown due to concerns over how infectious the UK strain is.
Quarantine system ‘reactive’, ‘not forward-thinking’
A national review of hotel quarantine in October recommended that a national facility be set up “to provide surge capacity”.
The review recommended several options for national quarantine hubs including the Howard Springs facility in the Northern Territory, which was at the time only being used for domestic quarantine, Learmonth RAAF base in WA, and immigration detention centres.
Professor Esterman said it would cost a lot of money to set up these facilities, but not as much as lockdowns.
“Two or three days of lockdown cost billions of dollars. And by doing it properly, you lessen the chance of COVID-19 escaping.”
Australia needs a co-ordinated hotel quarantine system that is ahead of the game and not merely “reactive” to blunders, he said.
Pre-departure testing and testing on arrival – they’ve only just decided to do it now? Why weren’t they doing it months ago?’’ Professor Esterman said.
“Daily testing of staff, they’re only just doing that now. This is all reactive and not forward-thinking.”
Every time SARS-CoV-2 escapes hotel quarantine there are calls to overhaul the system as cities are sent into lockdown, borders closed and travellers left in limbo.
Many health experts have called for facilities to be moved out of cities.
But Deakin University chair of epidemiology Catherine Bennett said remote facilities come with their own challenges.
Access to acute care for COVID-19 and other patients, and the ability for the coronavirus to infect more people during longer transfers are the major concerns.
If you have the right facility, and it is out of the city but not too far from the airport, and is purpose-built, it works,” Professor Bennett said.
“But elsewhere the additional problems and challenges outweigh the benefits.”
Locations such as Christmas Island, which housed repatriated Australians from Wuhan in February last year, have been proposed as an alternative.
South Australian Labor leader Peter Malinauskas suggested the immigration detention centre be used as a quarantine facility in the wake of Adelaide’s lockdown bungle.
But Professor Bennett said it would be difficult to limit the spread within the facility if you had a constant stream of potentially positive passengers.
“It is essentially opening up a potential corridor of transmission. It is built for people who are able to mix,” she said.
“You have to think about keeping them separate, not allowing them to mix, redeveloping the facility to work.”
Professor Bennett said the key change governments should be considering was to opt for facilities that allow air and exercise, as many returning travellers could be forced to quarantine for several weeks.
“If someone doesn’t test positive until day 11 they will have to stay for another 14 days,” she said.
“You could be having people there for four weeks if it is a parent or child who tests positive at different times.”
Professor Bennett said facilities to accommodate longer stays would be better.
“Having settings that have better access to a kitchen, so they can cook food, is a consideration, and fresh air.”