Informed, engaged communities for health

Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#BackToTheFire
#GiantSteps21
#Govern4Health
#HealthReImagined
#HearMe21
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
Croakey Professional Services
#BetterCareCOVID
#CommunityControl
ACSQHC series
Lowitja knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#JusticeCOVID
#LookingLocal
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
Croakey Professional Services archive
#bettercareseries
#CommunityControl Twitter Festival
ACSQHC series 2019
Croakey projects archive
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Naked Doctor
Poems of Public Health
Summer Reading 2016-2017
Summer Reading 2017-2018
The Koori Woman
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
#HealthElection16
Federal Budget 2009-2010
Federal Budget 2010
Federal Budget 2011
Federal Budget 2012-2013
Federal Budget 2013-14
Federal Budget 2014-15
Federal Budget 2015-16
Federal Budget 2016-17
Federal Budget 2017/18
Federal Budget 2018-19
Federal Election 2010
Federal Election 2013
Federal Election 2016
Federal Election 2019
NSW Election 2015
NSW Election 2019
NT Election 2016
Qld Election 2015
Victorian Election 2014
WA election 2021
Support non-profit public interest journalism
Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#BackToTheFire
#GiantSteps21
#Govern4Health
#HealthReImagined
#HearMe21
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
Croakey Professional Services
#BetterCareCOVID
#CommunityControl
ACSQHC series
Lowitja knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#JusticeCOVID
#LookingLocal
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
Croakey Professional Services archive
#bettercareseries
#CommunityControl Twitter Festival
ACSQHC series 2019
Croakey projects archive
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Naked Doctor
Poems of Public Health
Summer Reading 2016-2017
Summer Reading 2017-2018
The Koori Woman
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
#HealthElection16
Federal Budget 2009-2010
Federal Budget 2010
Federal Budget 2011
Federal Budget 2012-2013
Federal Budget 2013-14
Federal Budget 2014-15
Federal Budget 2015-16
Federal Budget 2016-17
Federal Budget 2017/18
Federal Budget 2018-19
Federal Election 2010
Federal Election 2013
Federal Election 2016
Federal Election 2019
NSW Election 2015
NSW Election 2019
NT Election 2016
Qld Election 2015
Victorian Election 2014
WA election 2021

Airborne transmission of COVID-19 and hotel quarantine – let’s stop going round in circles

Introduction by Croakey: Leading Australian public health specialist Dr Tarun Weeramanthri is urging Australia’s Infection Control Expert Group (ICEG) and the bodies it advises, including National Cabinet, to “stop dancing around the issue of airborne transmission” and its risks for hotel quarantine and Australia’s long-term management of the coronavirus pandemic.

His call for a fit-for-purpose quarantine system, including possible new or repurposed quarantine sites like Howard Springs in the Northern Territory or flagged private initiatives in Toowoomba and at Avalon Airport in Victoria, comes as Western Australia emerges at midnight from a three day snap lockdown sparked by transmission of COVID-19 in hotel quarantine in Perth.

Weeramanthri said:

If National Cabinet truly believes that vaccines are the answer and we will not need quarantine long-term, or that we will ultimately move to home quarantine arrangements, they should state that position clearly and table the supporting expert advice and plans for transition.”

Weeramanthri is President of the Public Health Association of Australia and is formerly the Chief Health Officer for the Northern Territory and Western Australia. Over the past year, he has worked with governments in WA, Victoria and South Australia as an advisor on the COVID-19 response, and with the Commonwealth Government as a panel member on the National Contact Tracing Review. In early 2021, he conducted an independent review of hotel quarantine arrangements in WA.

Saying airborne transmission is now the single biggest residual risk to Australia’s hotel quarantine system, he is urging ICEG, the Australian Health Protection Principal Committee (AHPPC), and National Cabinet to state their positions on key questions about airborne transmission which has caused much acrimony between academics and scientists in Australia and internationally.

Earlier today, in a stinging interview on ABC radio, Australian Medical Association WA president Dr Andrew Miller also called for hotel quarantine facilities that prevent airborne transmission of the virus, accusing authorities of being “grossly negligent” and breaching the human rights of “innocent people” who are infected with COVID-19 in hotel quarantine “because of denial of airborne problems”.


Tarun Weeramanthri writes:

Since November 2020, there have been 14 outbreaks of COVID-19 from hotel quarantine (HQ) across five states in Australia.

The public has got used to the following: short, sharp lockdowns; official bemusement about how the outbreak happened; a statement about how infectious the new variants are; announcement of a review; a reflection on how many people have gone through HQ, how few people overall have been infected, and how well current arrangements have served us; a comment about the unsuitability of older city hotels for quarantine; praise for the Howard Springs facility in the NT; and a commitment to further improvements.

All this plays out first at a state level, but the problem is that there are serious discordant elements in the national conversation, and we are failing to learn from each other’s experiences, and move forward as a country.

The biggest problem is the failure to accept and simply state what is now obvious from the science and first-hand analysis of the cases – the significance of airborne transmission generally, and in the HQ environment specifically.

Recent editorials in the Lancet and the Medical Journal of Australia state the case for airborne transmission simply and clearly.

Over the last year, Australian states and territories have set up their HQ systems and dealt effectively with the risk of close-range droplet transmission and indirect transmission from environmental contamination.

Hundreds of thousands of people have gone through the HQ system successfully as a result, and thanks are due to the hard work of all HQ staff.

However, I believe that the single biggest residual risk is now from airborne transmission, made possible by poor ventilation in closed hotel environments.

I stated this in my recent independent review of HQ arrangements in WA. Indeed, if you read other published reviews from South Australia, Queensland and Victoria closely, you will find no convincing evidence to support any other form of transmission as the source of recent outbreaks.

The second discordant element is the finger-pointing between states and territories on the one hand, and the Commonwealth on the other, about responsibility for HQ.

Most recently, WA Premier Mark McGowan firmly reminded the Commonwealth that under section 51 of the Constitution, quarantine is a Commonwealth responsibility.

Prime Minister Scott Morrison stated after National Cabinet last week that the states had agreed a year ago to take responsibility for HQ, and that it was a matter for ‘state public health acts’.

Headlines have sharpened in the last few days (‘COVID Hotel Blame Game’, The Sunday Times, 25 April 2021), but the public could reasonably conclude it is a shared responsibility.

Acrimonious divides

These discordant elements have prevented a thorough co-operative reset of quarantine arrangements as the global context has changed, vaccines have come into play, and the Australian public has come to expect and demand no community transmission, a basically unrestricted lifestyle and the prospect of a resumption of normal travel.

Vaccines are seen as the way out of the pandemic, and the vaccine rollout prioritised. National Cabinet is on a ‘war footing’ with respect to vaccines but has failed to maintain a similar level of urgency with respect to quarantine.

Since the national review of hotel quarantine was released in October 2020 (the Halton Review), states and territories have essentially been left to go it alone.

For many months, there has been an acrimonious divide between academics as to the position of the Infection Control Expert Group (ICEG), and their views on the relative contribution of droplet vs. aerosol transmission in the community.

Contrary views are expressed not just by respected academics, but also increasingly by national health professional groups and influential commentators each time an outbreak occurs.

In October 2020, ICEG released a statement on transmission of SARS-CoV-2, which acknowledged the potential for aerosol transmission in certain settings, particularly in poorly ventilated indoor environments.

Listening to the ICEG Chair, Lyn Gilbert, interviewed on radio in February 2021, I believe that there is substantial agreement between the opposing camps, and a consensus is possible as to appropriate risk mitigation in HQ sites.

Stop dancing around

But the ICEG needs to now update and state its position publicly with specific reference to HQ, given the number of academic articles supporting airborne transmission in recent months, and in light of the recent reviews and ventilation assessments.

Without such a statement, ICEG and the government authorities they advise, risk being left isolated in a minority position, outside the bulk of mainstream independent scientific advice, which has been convinced about the significance of airborne transmission in HQ for many months.

Our health advice and expert committee system has served us very well so far in Australia, and we do not want to see a split into different camps, as seen in the UK with the formation of an ‘independent SAGE’ group separate to the official Scientific Advisory Group for Emergencies (SAGE). Contestability and transparency of advice should form part of the expert committee process, not be separate from it.

The Australian Health Protection Principal Committee (AHPPC) needs to seek such advice from ICEG and come to a clear position on airborne transmission in HQ, and minimum criteria or standards for ventilation and PPE.

In the AHPPC statement of 14 April on Continuous Learning in Managed Quarantine for International Arrivals, there is no mention of ventilation and the specifics of personal protective equipment (PPE) are not addressed. It is time to stop dancing around the issue of airborne transmission.

National Cabinet must seek consensus

In public policy terms, all major crises are a test for the Federation. National Cabinet is an interesting innovation, not foreseen in the Constitution.

Its initial promise in March 2020 was of a ‘strong spirit of unity and cooperation.’ It has engendered public support and trust from its ability to negotiate the interests of all jurisdictions, to deliver pragmatic public safety and wellbeing outcomes in the national interest, and to consider both lives and livelihoods.

At the moment, its relative silence on HQ is telling, and it risks a quiet default to a lowest common denominator position, with each jurisdiction having an effective veto on national policy.

That is understandable from a state or Commonwealth sovereignty perspective, but the public can and should demand more effort to achieve consensus on key public health issues that require national action, coordination and planning.

Border controls and quarantine of international arrivals are inseparable in practice, and will be needed for years to come, with or without complete and effective vaccine coverage.

Completion of the global vaccine rollout will take till at least 2023, and as long as the virus is replicating and transmitting anywhere in the world, there is a chance of new vaccine-resistant variants emerging.

Key questions for key bodies

So, what can be done to end this circular and unproductive conversation, and allow us to move ahead as a country?

What is needed are straight answers to three simple yes/no questions from the three most important committees tasked with national quarantine policy in Australia.

The three committees are ICEG, AHPPC and National Cabinet. Remember, ICEG reports to AHPPC, which is a subcommittee of National Cabinet. All of them have been debating these matters for over a year.

The hierarchy of committees makes it crystal clear that National Cabinet is ultimately accountable. It is next due to meet on Friday 30 April 2021, a watershed day for national quarantine policy.

To ICEG: do you believe that airborne transmission is now the most likely form of transmission of COVID-19 in HQ in Australia, given the risks from droplet and environmental contamination are largely now eliminated with standard protocols and good practice?

If so, what updated guidance can you provide to reduce the risk of airborne transmission further in the HQ environment?

To AHPPC: do you agree that minimum national ventilation criteria or standards would be helpful for all HQ sites across Australia?

If so, will each state and territory release the ventilation audits from your HQ sites, so as to inform the development of such criteria or standards?

To National Cabinet: can you agree and state publicly that quarantine is effectively a shared responsibility between the Commonwealth, states and territories, and that you will work cooperatively to plan a fit-for-purpose quarantine system in Australia?

If so, will you, as a group, endorse an assessment of possible new quarantine sites, both Commonwealth and state-owned, in each state and territory against agreed criteria (e.g. proximity to health facilities, guest capacity, ventilation adequacy, capital and maintenance costs etc.)?

Such an assessment could cover both existing facilities and greenfield sites and include previously flagged initiatives in Toowoomba (Queensland) and Avalon Airport (Victoria). A comprehensive, transparent and independent assessment could take weeks to months to complete, which provides even more reason to start this process now.

The ultimate goal should be to expand high quality quarantine systems in Australia, not to completely replace HQ.

We will likely always need, in my view, a balance of HQ with other dedicated quarantine facilities, but they all should meet agreed national criteria or standards.

If National Cabinet truly believes that vaccines are the answer and we will not need quarantine long-term, or that we will ultimately move to home quarantine arrangements, they should state that position clearly and table the supporting expert advice and plans for transition.

Goals for the future

Australia will need to deal with the challenge of COVID-19 variants of concern as they emerge. However infectious a variant is, strict borders and high-quality HQ provide our best means of defence against community transmission.

But if quarantine is suboptimal, especially with respect to ventilation, a more infectious variant will find its way through. The preferred long-term answer, for both lives and livelihoods, is to provide expanded and sustained high quality quarantine in Australia, not restrict incoming numbers and impose recurrent lockdowns.

In the meantime, existing HQ systems need to be continuously improved based on risk assessments contained in the multiple state reviews and following the ‘Hierarchy of Controls’ framework endorsed by AHPPC.

Vaccination is obviously a key control measure as is suitable PPE, which I have not discussed in detail here, as the choice of PPE follows acceptance, or not, of the importance of airborne transmission.

In the longer term, we need to redesign and expand the quarantine system for international travellers in Australia, so it can achieve two distinct goals.

Firstly, to reduce the risk of transmission of COVID-19 into the community, and the avoidance of lockdowns. Secondly, to provide an opportunity to support the return of Australians living abroad, seasonal workers, international students, and business visitors, who are prepared to undergo and pay for quarantine. The costs of repeated lockdowns, and the damage to community confidence, are almost certainly greater than the costs of an optimal quarantine system.


See previous Croakey articles on the COVID-19 pandemic.

Support our public interest journalism, for health.

Subscribe

Donate

Other ways to support.

Related Posts

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Search by: Categories or tags

Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#BackToTheFire
#GiantSteps21
#Govern4Health
#HealthReImagined
#HearMe21
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
Croakey Professional Services
#BetterCareCOVID
#CommunityControl
ACSQHC series
Healthdirect Australia series 2019
Lowitja knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#JusticeCOVID
#LookingLocal
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
Testing Croakey News category 1
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018