Covid-19: Mysterious cluster in Brisbane a warning to stop using hotels for managed isolation, experts say

Australian health authorities have evacuated a Queensland hotel and are considering alternative isolation facilities – including mining camps – following an outbreak of the highly contagious UK strain of Covid-19, prompting questions about New Zealand’s response.

On Wednesday 129 hotel guests were transferred from the Hotel Grand Chancellor in Brisbane to an undisclosed facility and required to isolate for another 14 days after six previously identified cases from the hotel were found to be linked.

Australian-based New Zealand epidemiologist professor Tony Blakely said the guests were moved from the building because the cause of the outbreak had not been confirmed.

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The further isolation was needed because they could have been exposed to the virus through the hotel’s ventilation system.

The Queensland Health Department is investigating how the virus was transmitted, and there is no evidence the cases had been in contact with each other.

Premier Annastacia Palaszczuk said on Thursday “all options” for alternative isolation facilities were being considered, including mining camps.

Jono Searle/Getty Images

Queensland Premier Annastacia Palaszczuk said she would look at “all options” for alternatives to hotels for MIQ – including mining camps.

The case highlighted the difficulty of using hotels for managed isolation and quarantine (MIQ) in the wake of a much more contagious UK Covid-19 strain, and should be a warning for the New Zealand government, Blakely said.

New Zealand is believed to have 19 cases of the new UK variant in its isolation hotels.

Blakely suggested ventilation systems at all MIQ hotels should be checked to reduce the risk of cross-contamination between rooms.

Better quality checking was also needed for both Australian and New Zealand MIQ operations, including regular inspections and incident reporting processes for staff and guests.

“We don’t have eyes on, or eyes in, quarantine to really know what’s happening – nobody does.”

Associate Professor Nick Wilson believes purpose-built quarantine facilities should be built.

Ministry of Health director of public health Dr Caroline McElnay said the ministry continued to monitor research and developments internationally, particularly around the UK strain.

“The layered protections within managed isolation and quarantine facilities give us assurance that collectively we limit the risk of spread to the community.”

These include tests for people from the UK and US on arrival, as well as on day three and day 12, and restricting them to their rooms until a negative test is returned.

From January 15, returnees from the US and UK will need a negative pre-departure test or medical certificate prior to travel.

McElnay said an increase in Covid-19 cases was to be expected “given case numbers globally are continuing to increase”.

University of Otago associate professor of public health Nick Wilson – who was supported by epidemiologist Professor Michael Baker – said hotels were not designed for infection control due to problems with shared spaces and ventilation.

Wilson

suggested there should be purpose-built facilities for quarantine, moving MIQs out of Auckland, and having people quarantine at a military base such as Ōhakea, or even at home with strict controls.

He said there had been eight border failures identified since early August, with seven probably associated with failures at MIQ facilities – showing officials need to be “taking seriously” the risk of further incursions.

He said the future looked “pretty grim” for new pandemics, and “a sensible country would have a built facility ready to go for quarantine and isolation”.

Fiona Goodall/Getty Images

If New Zealand saw an influx of positive cases at the border, an existing managed isolation facility could be transformed into a quarantine facility. (File photo)

The “next best option” would be to move MIQ facilities out of Auckland, protecting the “key economic centre”, or reserving Auckland-based facilities for low-risk travellers such as those from Australia.

Wilson said using hotels was a “false economy when a failure can lead to a lockdown” in Auckland, costing millions of dollars.

Head of MIQ, Brigadier Jim Bliss, said he was “extremely proud of our MIQ facilities, and Kiwis should be too.”

Bliss was confident in MIQ staff and systems, and was proud of its “model of continual improvement”, pointing to the recent introduction of day-zero testing in response to the new strains.

“Our priority is the safety of returnees, staff and the New Zealand community.”

Moving facilities would be a decision for Cabinet but would need consideration of limited suitable facilities in locations where there was also a hospital facility and transport hubs nearby, Bliss said.

Covid-19 Response Minister Chris Hipkins said shifting facilities into more remote locations such as a military base would require up to 4000 MIQ staff to willingly move there to work.

Housing them would also create “significant logistical problems”.

“The Government does not believe it is a feasible option for these reasons.”

DAVID WHITE/STUFF

Some experts believe dedicated coronavirus quarantine centres, such as this one set up in Whangaparāoa north of Auckland last year, should be used instead of hotels.

Wilson questioned what it would take to trigger a review or shake-up of the MIQ system, saying it needed a “shock to its senses”.

He said he would “sleep easier at night” if the vaccine roll-out was fast-tracked for border workers, reducing the risk of them becoming infected and spreading the virus to the community, but health officials have remained stedfast about the April timeline.

Wilson and Baker have also suggested the Government eliminates shared-space use in MIQ facilities, at least until people return a negative first test result, or use home quarantine with digital tracking, similar to that in Taiwan and South Korea.

Microbiologist Dr Siouxsie Wiles said it was “not uncommon” for viruses to spread through ventilation systems, but she had not seen any evidence of Covid-19 being transmitted that way.

“It’s airborne so it’s a possibility.”

STACY SQUIRES/Stuff

There a currently no plans to open new managed isolation or quarantine facilities, MIQ authorities say. (File photo)

A recent study of nine Covid-19 infected people in three separate flats in a high-rise building in Guangzhou, China found the virus outbreak may have been transmitted via faecal aerosol transmission through bathrooms connected by drainage pipes.

Wiles said the UK variant was no different in the way it was transmitted but could infect a larger number of people.

She said a lack of vigilance in following level one guidelines, including using the contact tracing app and staying home when sick, was the greatest threat for a community outbreak.

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