Various: Quarantine processes in NSW

The Guardian: NSW hotel quarantine: who is exempt and who makes the rules?

https://www.theguardian.com/australia-news/2020/dec/21/nsw-hotel-quarantine-who-is-exempt-and-who-makes-the-rules

The Guardian: Complacency in Sydney hotel quarantine system could contribute to Covid outbreaks – guests

Australians returning from overseas have described weaknesses in Sydney’s hotel quarantine system which they fear could contribute to the spread of coronavirus.

The outbreak of the virus on Sydney’s northern beaches has prompted increased scrutiny of New South Wales’ hotel quarantine system after health authorities indicated the cluster may be linked to a returned US traveller.

The NSW chief medical officer, Dr Kerry Chant, said this week that health authorities believed a woman who returned from Los Angeles on 1 December and went into hotel quarantine may have been the source of the outbreak. Genome sequencing revealed the woman’s virus strain was a close match to the one which caused a lockdown of Sydney’s northern beaches days out from Christmas.

Chant has been at pains to stress that authorities were not certain of the link. While genome sequencing had shown that the two virus strains were “close”, she said on Monday, they were “not a perfect match”.

But many returned travellers who have recently been through the quarantine system say they would not be surprised by a breach of the system. While most of the people who spoke to the Guardian for this story said their overall impression of the state’s quarantine program was positive, others also identified possible gaps.

Kashi Somers, who returned to Sydney from New York City in early November, felt compelled to write to the NSW Health department after being “shocked” that the driver of her bus from the airport to the hotel was not wearing a mask.

In what she described as an “obvious and clear” potential for transmission, Somers said the unmasked driver was on the crowded bus for “at least two hours” while passengers were loaded on, driven to the Marriott hotel and began checking in.

“While we were driving I heard him talking on the phone [and] he was saying ‘oh yeah the bus has to get cleaned and then I’ll be home’,” Somers said.

“I remember thinking, ‘What? What does he mean he’s going home?’ He’s not wearing a mask, he’s crowded in here with us, he’s literally one of the only people who is a way for Covid to get into the population. I just remember thinking I don’t understand what the process is here. Why isn’t he staying here at the hotel with us?”

Returning from the US, Somers also described a jarring lack of concern among the officials she encountered while navigating the system, including ADF members incorrectly wearing masks. The bus driver, she said, had made an inappropriate joke about how tough quarantine could be.

“He like thought it was a lol of a lifetime [but] no one on the bus laughed at all. We’re all so, you know, traumatised by Covid coming from the US where literally thousands of people died every day.”

That experience was echoed by Noelle Faulkner, who returned to Sydney from the UK in November. Faulkner described the process of getting to the hotel from the airport as “pretty lax”.Advertisement

While her bus driver was separated from the passengers by a screen, he was also not wearing a mask. Other encounters during check-in gave her the impression of “environmental complacency” in the system.

“At the hotel, while we were waiting, this military guy was like motioning for me to stand closer so he could talk to me,” she said.

“It was just small talk, like ‘where’d you come from, how are you feeling’, I was like ‘dude I don’t want to talk to you’. The whole thing felt like there was a lot of complacency – you could really feel it.”

Faulkner tested positive for Covid-19 a few days into her stay in quarantine and was moved to one of the quarantine hotels operated by NSW Health. That process, she said, felt more secure.

“I was taken by one of the ambulance staff in patient transport. She was wearing full PPE and everything was covered in plastic. The whole van was basically wrapped in garbage bags,” she said.

Another woman who left a Sydney quarantine hotel this week said she was concerned a guard in the corridor didn’t wear a mask and chatted to guests through their open doors. But others who spoke to Guardian Australia for this story reported only positive experiences. Georgia Frances King returned from New York and said her quarantine had been “pretty great”.

“Everyone the entire time throughout the process was wearing masks,” she said.

“I was at the Marriott and someone from the police came on the bus and read us out all the details and the manager of the hotel came on, they were both wearing masks. Throughout the check-in process the staff, the army folks and the police folks were all wearing masks.”

Similarly, Shaffira Gayatri, who returned from Jakarta in September, said the overall experience had felt “as secure as the circumstances allowed”.

“In terms of getting to the hotel from the airport it was quite structured [and] pretty clear. The police and the army were also informative,” she said.

She did have one “confusing” encounter during her stay in quarantine, however. Early in her stay she had called hotel maintenance to fix her alarm clock. The hotel worker had arrived in full PPE. Realising the gravity of the situation, when the alarm clock broke a second time she called maintenance again but this time left it outside.

“But he just like casually knocked on the door, he wasn’t in PPE, and then afterwards he asked to come into the room. I tried to maintain distance from him and made sure I wore a mask but I was confused at the time because it felt inconsistent,” she said.Advertisement

While it’s still unclear whether the northern beaches outbreak was a result of a breach in the quarantine system, it has prompted health authorities to retrace their steps. On Monday, Chant said that drivers, hotel cleaners and health workers who came in contact with the woman suspected of being the source had been interviewed and tested.

“We’ve gone back and reviewed all the CCTV footage around this individual,” she said.

“We’ve tested cleaners at the hotel. We’ve tested people who transported her when the person went to a health facility. We’ve looked at anyone who may have come in contact with her – even if they were wearing PPE.”

But if the outbreak was the result of a breach of hotel quarantine, it would not be unique. Since two security guards working at the Marriott hotel tested positive for the virus in August, a number of health and hotel employees have been infected following contact with returned travellers.

At the beginning of December, a woman who worked as a cleaner at the Novotel and Ibis hotels at Darling Harbour tested positive. Last week, a van driver who shuttled airline crew between Sydney airport and their accommodation also caught the virus.

Then, in the latest apparent breach, the NSW premier, Gladys Berejiklian, revealed on Tuesday that a nurse who worked in the hotel quarantine system had tested positive after she helped transport a symptomatic family of three who had arrived from the US.

The woman was one of the eight new cases reported on Tuesday after a record 44,466 tests were conducted in the 24 hours to 8pm on Monday and the only one not linked to the Avalon cluster.

The NSW government has consistently defended the system, saying some breaches are inevitable in a program of its size and scope.

“It is important that we make sure the end-to-end process of people returning from overseas protects the broader community spread [but] I don’t think any system can ever guarantee that we won’t have transmission events,” Chant said on Tuesday.

“Similar [locations] elsewhere such as New Zealand have had a number of incursion events as well. It is also about how you surveil, pick them up and respond to them that is important. I think it’s inevitable that these issues will arise. We try as best we can to minimise them but it is about the response and the actions of individuals coming through.”

The Australian: NSW hotel quarantine at issue in exposures

A healthcare worker suspected of contracting COVID-19 through the NSW hotel quarantine program has become the third case of exposure arising out of contact with overseas travellers in the past month, raising concerns on the integrity of the regime.

The nurse’s infection was detected among eight fresh cases of the virus recorded in the 24 hours to 8pm on Monday, with investigations continuing into whether her illness could be linked to an overseas strain of the virus or one identified locally.

Officials said further information on the matter would be provided on Wednesday morning when further COVID-19 data would be released ahead of a decision about whether or not to ease restrictions on the northern beaches.

It is believed the nurse, from western Sydney, contracted the virus while transporting a family from the airport to their quarantine location. They were symptomatic for the virus at the time of their contact.

On December 2, a cleaner who had worked at the Novotel and the Ibis at Darling Harbour tested positive to the virus.

Two weeks later, a bus driver shuttling flight crews from the airport to their hotel locations tested positive.

Officials said neither the cleaner nor the bus driver had passed on the virus to their close contacts, and neither case had been linked to the outbreak that emerged at Avalon.

NSW Premier Gladys Berejiklian said such leakage was to be expected from time to time when workers were so closely exposed to overseas travellers and aircrew.

Ms Berejiklian defended the breaches by pointing to the high number of people who had ­successfully isolated within Sydney’s hotel quarantine program.

“I don’t think any system can ever guarantee that we won’t have transmission events,” Ms Berejiklian said.

“I think it’s inevitable these ­issues will arise.

“We try as best we can to minimise them but it is about the response and actions of individuals coming through.”

Last week, the NSW government said it would be strengthening some aspects of its quarantine program by limiting the number of hotels that could be used by aircrews flying into Sydney.

These rules, which see crew members restricted to quarantining in two hotels near the airport, came into effect on Tuesday.

Previously, these airline workers were housed across up to 26 hotels, Ms Berejiklian said. They had also been able to apply for exemptions that would enable them to self-isolate at locations of their choice.

Figures obtained by The Australian show NSW has taken 89,574 returning travellers into hotel quarantine since March 28, amounting to more than half of the 175,854 returning travellers that have arrived in Australia.

It has also taken more interstate residents than any other jurisdiction, with the cumulative interstate figure now sitting at 42,084.

Health officials remain uncertain as to the cause of the latest outbreak on Sydney’s northern beaches although genomic testing has linked some infections to a virus strain detected in a woman travelling from the US on December 1.

NSW Chief Health Officer Kerry Chant said on Monday this testing was not a “perfect match”.

However, it gave officials a line of inquiry to follow, along with a working theory of how the virus mysteriously emerged in the northern beaches suburb of ­Avalon.

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