Virus risk Australia might have to take
Coronavirus cases linked to hotel quarantine have again highlighted the potential for leakage of the virus into the community but pressure is mounting on the Federal Government to consider other forms of isolating people.
Experts are now raising the possibility of shorter quarantine periods or quarantine at home as options, especially for those coming from low-risk countries, which could provide a much needed economic boost.
Australia's hotel quarantine program has been at capacity all year with around 30,000 people still unable to get home from overseas. Some of them have been in limbo for months.
The Federal Government has said the priority is getting Australians home but it's been a slow process due to the caps on hotel quarantine in each state.
One mother-of-two Desalyn Bowyer, 40 has been separated from her children in Australia for nearly 10 months after moving to Hong Kong for work in December last year.
"Why are we being put in a hotel when I could be at home spending time with my children?" Ms Bowyer told Sky News.
"We're armed with so much technology these days, I actually don't believe that hotel quarantine is the right approach," she said.
"I hold an Australian passport, I'm an Australian citizen and we're always meant to be welcomed home and that isn't the case right now."
As the pandemic stretches on, states are also becoming more concerned about economic recovery.
This week Charles Darwin University became the first university in Australia to welcome international students into the country, after agreeing to shell out almost $160,000 for 63 students to quarantine in the Northern Territory.
Federal Education Minister Dan Tehan has confirmed that the NT, South Australia and New South Wales would all be submitting plans to restart international student programs in 2021.
Last month NSW Premier Gladys Berejiklian said she wanted state, which already accommodates the most returned travellers, to use a third of its hotel quarantine slots to bring in international students, skilled migrants and specialist workers, ideally starting in January.
"We would like to start that as soon as we can in the new year but obviously that's up to the federal government to let us do that," Ms Berejiklian told The Sun-Herald.
The move would be a lifeline to the university sector, which relies heavily on international students and has mostly not been eligible for government payments including JobKeeper.
Melbourne University epidemiologist Professor Tony Blakely told news.com.au that he hoped there would be a change in policy next year to allow more international students in Australia.
He is one of a number of experts who believe the government needs to look at alternatives to hotel quarantine.
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A model released by the Burnet Institute in Melbourne last month suggested reducing quarantine to seven days would provide a $66 billion economic boost, without increasing the risk of virus transmission if travel volumes remained stable, the Australian Financial Review reported.
However, if more travellers are to be brought into Australia without an increase to hotel quarantine caps, other alternatives need to be considered.
SHORTER QUARANTINE PERIODS
This week US health officials at the Centers for Disease Control and Prevention (CDC) shortened the recommended quarantine period for Americans travelling during the Christmas period to as little as seven days if people get tested.
It comes after the UK announced new rules to begin on December 15 that will allow overseas travellers to leave quarantine six days after arrival.
People will be able to halve their quarantine period if they pay between £65 and £120 ($AU118 and $AU217) for a COVID test after five days. Results would likely be known within 24 to 48 hours so they could be released six days after arrival if the test is negative.
Prof Blakely said a five-day quarantine period would be a dangerous policy for Australia to adopt but it could be applied to certain low-risk countries.
"If someone is coming from China as an international student to study in Melbourne, it makes perfect sense," he said.
He said China's infection rates were 0.01 per cent of places like the UK and US and even if they were 10 times higher than what's been reported, they would still be lower.
China is currently recording less than 100 cases a day in a country of 1.4 billion people.
Other countries like South Korea, Singapore, Taiwan and the Pacific Islands also had very low rates of infection so a shorter quarantine period from these countries could also make sense.
NSW Premier Gladys Berejiklian does not support a shorter quarantine period but has said authorities were weighing up whether to allow home quarantine.
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Most of the coronavirus infections in quarantine are being detected on day 10, with people normally tested on day two and day 10.
"Victoria wasn't testing on day 10 and that could be part of the reason why it got away from them down there," Ms Berejiklian said.
"I feel we're much better off keeping the 14-day quarantine. If you really go below that point you're risking the whole system."
QUARANTINE AT HOME
Countries like South Korea allow returned travellers to quarantine at home if they test negative to the coronavirus on arrival but they have to wear a wrist band that uses GPS to monitor their movements.
Australian National University Associate Professor of Infectious Diseases Sanjaya Senanayake told news.com.au that non-hotel quarantine should be considered.
"Yes we do need hotel quarantine, particularly for high risk individuals but I think for low risk individuals, non-hotel quarantine with surveillance such as a wrist band and app - these sorts of things should be considered," he said.
However, the limitations of the system were highlighted in Hong Kong recently, which has stopped its own home quarantine program.
Until last month, Hong Kong allowed returned travellers to quarantine at home if they wore a wrist band that linked to their home wi-fi and alerted authorities if the signal dropped out.
But this system was abandoned after a number of new coronavirus cases were identified in the city.
"We wanted to tighten the quarantine measures due to the worsening COVID-19 situation globally," Centre for Health Protection head of the communicable disease branch Dr Chuang Shuk-kwan said.
"In the past, there were a few cases who infected other family members while they were quarantining at home."
SEPARATE QUARANTINE FACILITIES
The recent outbreak in South Australia raised the question of whether people should be quarantined in specialist facilities outside of major cities, to minimise the risk to large populations if the virus does leak out of hotels.
News.com.au readers were also supportive of this approach with 63 per cent of the 30,000 votes in an online poll favouring the development of national quarantine facilities.
Prof Blakely said there were good arguments for this approach, especially at the beginning of the pandemic, but he doesn't believe this will happen now with a possible vaccine on the horizon.
"The vaccine is getting closer and the cost effectiveness of shifting quarantine, as well as the transition risk probably means it won't happen," he said.
He said CBD hotels, where most people are quarantining, now appeared to have their systems working so there was a risk to disrupting this if the system had to be shifted to different facilities.
Prof Blakely believes that as long as security and other staff were being paid well enough so they didn't have to take second jobs, it is a manageable situation.
GLOBAL SPIKE IS A THREAT
Hopes for a change to quarantine measures may be hampered by a concerning spike in cases in overseas cases, particularly in the United States and parts of Europe, which are entering winter.
Epidemiologist Mary-Louise McLaws, who is an adviser to the World Health Organisation, said Australia's hotel quarantine program was about to be "really tested".
"There will be the occasional incident as hotels are not purpose built for quarantine," Ms McLaws told the ABC last month.
After more than 20 days of no new cases of community transmission, NSW this week identified a coronavirus case in one of its hotel quarantine workers.
The cleaner caught the virus from someone staying at the hotel but doesn't seem to have passed on the infection so far.
The good news is that the Australia's success in controlling the virus and the re-opening of state borders will see more quarantine spaces available for returning travellers.
Prior to Victoria's second wave around 7700 returning Aussies per week were being quarantined and this will be restored to around the same level once Victoria begins taking overseas travellers again from Monday, December 7.
Victoria will initially take around 160 passengers a day, which is still less than half of the 3000 a week NSW is taking.
However, the Northern Territory has also announced the cap on arrivals at the Howard Springs quarantine facility near Darwin will double from 500 to 1000 people a fortnight, and Tasmania has also begun taking 450 arrivals a week.
Other states have also agreed to accept more people, including Western Australia, which will take an extra 140 per week and Queensland will take an extra 150 per week. South Australia has also resumed taking around 600 arrivals per week after its recent outbreak.
Even with these boosted numbers it may be a struggle to get all Australians back in the country before Christmas.
Prime Minister Scott Morrison said just under 27,000 had been wanting to return to Australia in September and since then around 35,000 had arrived, but there were now around 36,000 more wanting to come back.
He has made it clear that it was the government's priority is to get these Australians home despite requests to take international students or other overseas travellers.
"We simply cannot do that because our priority is to get Australians home," he said.
Mr Morrison said last month that the National Cabinet had considered the possibility of home quarantine but "we're not convinced at this point that we can take those risks and that the systems can be certain".
He pointed to the elevated number of cases overseas.
"We don't think at this stage we can move toward anything like that," the PM told 3AW's Neil Mitchell.
"There are already some exemptions that are provided in all states and territories that sort of deal with specific circumstances. But that's only where they can meet the high standards expected of quarantine that is applied in a hotel setting.
"But let's not kid ourselves that those are foolproof either. And that's why the outbreak containment, the tracing, the COVIDSafe behaviours, the wearing of masks, all of these things are very important to ensure we stay on top of it."
Since the start of the pandemic around 400,000 Australians have returned home.
Originally published as Virus risk Australia might have to take