Extract from The Guardian
Experts say the current system is bound to leak and might be unsustainable in the face of more transmissible strains such as Delta.
There have been as many Covid leaks from hotel quarantine recorded in the past three months as there were last year.
Last modified on Mon 12 Jul 2021 03.32 AEST
Breaches of Australia’s quarantine system have substantially increased this year, with data showing there have been as many leaks recorded in the past three months as there were last year.
There have been up to 30 breaches – where a community case of Covid has been traced back to an infection in quarantine – since the system was established in March last year for Australian citizens and permanent residents returning home. Twenty of those occurred this year.
Experts say that the current system is “bound” to leak and that quarantining in hotels might be unsustainable in the face of more transmissible strains like Delta.
“Our quarantine system has to dramatically improve,” says Dr Driss Ait Ouakrim, an epidemiologist at the University of Melbourne.
“There’s now a large consensus [that] quarantine in hotels is an inadequate and in fact dangerous approach. It was a good quick and dirty solution in April 2020, but since then we have seen and suffered from the limitations of such a system.”
Since the beginning of May, seven of the 12 leaks were identified to have had the Delta strain of Covid-19.
The data from CovidLive.com.au includes a couple of breaches linked to flight crew and those from ships early in the pandemic. It also includes cases that have not been epidemiologically linked to hotel quarantine. The rules around flight crew quarantine are not consistent between states, and often depend on where the flights originated.
There have also been leaks at other points in the system. Three of the New South Wales leaks are linked to transport – one each in June, January and December.
Last week a luggage handler at Brisbane international airport also tested positive, which we didn’t include in our count.
“The current Covid-19 quarantine system, which relies largely on [the] use of dedicated hotels and newly recruited staff, is bound to continue to leak Covid cases in the community on occasions,” says Maximilian de Courten, professor at Victoria University and director of the Mitchell Institute.
This is due to the fact the virus can infect people days before they show symptoms, and that neither our hotels nor even all of our hospitals were built for containing Covid-19.
Further, quarantine staff are hard to protect, de Courten says, because “they have to go home after their shifts, potentially carrying the virus to their close contacts.”
Arrivals haven’t significantly increased
The Delta strain of the virus has been at least partially blamed for the recent slashing of the cap on international arrivals. The states that have taken the most international arrivals – New South Wales, Queensland and Victoria – have had the most quarantine breaches.
However, Guardian Australia analysis of the data shows that the number of overseas-infected Covid cases actually peaked last year. Overseas infections have remained relatively stable over the past few months, even as breaches have increased.
The introduction of measures such as mandatory testing before international flights in January has likely reduced the number of overseas infected cases.
After accounting for the New Zealand travel bubble – which did not require arrivals to quarantine in Australia – there has not been a significant increase in arrivals to put pressure on the system.
Different Covid variants
Many viruses mutate over time, including Covid-19. This has made it hard to “get better” at quarantine, as the challenge has not remained the same. Our efforts to contain the virus may also be selecting for features that make it harder to contain.
“Restricting replication of the virus (its ultimate goal) through certain measures (like wearing protective gear and isolating incoming travellers in hotel rooms) will give an advantage to those virus mutations which can successfully overcome such barriers by, for example, travelling longer distances in smaller particles (aerosols) and/or staying longer in the air etc,” says de Courten.
“Hence over time, it is likely that new variants emerge being harder to contain with the same level of [quarantine] effort. And the current increasing Delta variant may be such an example.
“A similar escape from the existing quarantine procedures can happen if new virus variants infect people for a relatively longer time, and therefore can infect a larger number of contacts.
“This would then result that longer quarantine periods might be needed for individuals infected with such a variant.”
What are the alternatives?
The federal government has backed a 1,000 bed purpose-built quarantine facility in Melbourne’s north and is in talks to build similar accommodation for overseas arrivals in Western Australia and Queensland.
There will also be a trial of home quarantine in South Australia for people returning from low-risk countries. A date has yet to be set for the start of the trial.
Dr Ait Ouakrim says purpose-built facilities should be used for unvaccinated travellers from high-risk countries where the pandemic is not under control.
“We could then use [hotel quarantine] for low-risk travellers. We could even have fully vaccinated people quarantining at home until they receive a negative test (this regimen is applied in Victoria to people returning from orange zones in other states).”
Professor de Courten says improving quarantine starts with training and vaccinating every person in the quarantine system – including not just those that come into contact with potential cases, but their close contacts too.
We should then move quarantine to remote locations, although there aren’t yet sufficient places, and some travellers will need the medical services only found in cities.
Finally, we need to make “the existing (imperfect) quarantine system acceptable” through more vaccinations, rapid testing and contact tracing.
“But in my opinion these measures work only on a small scale and alone cannot be ‘the’ answer on how Australia deals with incoming Covid,” he says.
“It was a good strategy during the first 6-12 months for Australia, giving us time, but it is not a solution, nor sufficient for now and in the foreseeable future. We need a better/more comprehensive approach to Covid.”
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