Failure at a federal level to acknowledge COVID-19 is transmitted through the air has been putting the community at risk, senior scientists, health and safety experts and doctors have told the ABC.
- The ICEG will be updating its advice on the airborne nature of COVID-19
- Senior atmospheric and aerosol scientists say there is no doubt COVID-19 is transmitted through the air
- Breaches in Australia’s hotel quarantine system have led to at least three community outbreaks
Leading scientists said the virus could be leaking through our border controls because authorities have not put in place precautions that provide the greatest possible protection from airborne transmission.
In recent days, the Federal Government’s health advisors have considered updating their advice on the airborne nature of the virus, the ABC can reveal.
The Infection Control Experts Group (ICEG) met on Wednesday this week, for the first time in 2021.
Professor Lyn Gilbert said the group would “be updating advice”, particularly in light of the arrival of the highly transmissible UK COVID-19 variant.
“The ICEG has always acknowledged that SARS-CoV-2 can spread via aerosol transmission under [some] conditions, but evidence suggested that this was relatively uncommon,” she said.
The group will soon send its updated advice to the chief medical officers across the country.
Previous advice excluded COVID-19 airborne spread in hotel quarantine
The ICEG recognises the possibility COVID-19 can spread through the air in “clinical settings”, such as when a patient is being intubated.
But the group, which advises health authorities on infection control, has not acknowledged it could be a problem elsewhere in the community, including in hotel quarantine.
Occupational Hygienist Kate Cole, who assesses workplace environmental risk, said that narrow definition was not strong enough.
She said the group needed to acknowledge people infected with coronavirus can contaminate the air indoors.
“Aerosols that emit when we cough or breathe or talk actually stay in the air and then move by air currents in the space we occupy,” she said.
“Because we haven’t, as a country, acknowledged airborne transmission outside of those incredibly narrowly defined areas … we’re leaving ourselves open to the continued outbreaks from hotel quarantine, which arguably could be stopped in its tracks.”
Professor Lidia Morawska, an aerosol physicist, said allowing coronavirus to spread through the air in our quarantine system was the chink in our armour.
“It gets into the air and the majority of the particles carrying the virus in the air are sufficiently small that they can float in the air for a sufficiently long time to be inhaled by others.”
Most of the outbreaks in the past few months have originated in hotels, which Professor Morawska described as “very dangerous”.
She would like to see federal health authorities take control of the situation by getting hotels to guard against airborne transmission.
“There should be national guidelines, standards about this, and all the facilities, all the hotels should adhere to this,” she said.
Australia’s mandated 14-day hotel quarantine period is among the strictest COVID-19 border policies in the world, and protocols for those arriving are very tough, but there are renewed calls for a focus on the personal protective equipment (PPE) of hotel and border workers.
For every 191 cases of COVID-19 found in hotel quarantine, one escapes into the community
Since the start of November until Thursday night, Australia’s hotel quarantine system had caught 765 positive cases of COVID-19.
That’s more than 10 a day.
From those cases, only four have infected a person outside of quarantine, with just three leading to outbreaks in the community.
A driver in NSW tested positive after transporting international travellers to hotel quarantine, which led to the Berala cluster in which tens of thousands of people went into lockdown.
In Brisbane, a cleaner at a quarantine hotel, her partner and several Australians returning home tested positive for the more virulent UK variant of COVID-19, leading to a snap lockdown across the city and 129 people being evacuated from the hotel.
South Australia was thrown into lockdown after a cleaner and two security guards at a quarantine hotel tested positive and were linked to the Parafield cluster, in which 33 people caught the virus.
A genetic study in NSW showed a worker at a quarantine hotel in Darling Harbour caught the virus from an airline crew staying there, but she did not infect anyone else.
And earlier last year, breaches in hotel quarantine led to Victoria’s second wave.
So, the hotel quarantine system is doing its job as Australia’s primary defence against COVID-19, but experts say it can still be strengthened.
Paul Glasziou, head of Bond University’s Institute for Evidence-Based Healthcare, said three infections spreading from 765 patients was not a bad result.
With an increasing number of people arriving at hotel quarantine carrying the more contagious UK strain of the virus, plugging the leaks in the system is more important than ever.
He said Australia’s border control and quarantine systems had improved, but it would be more difficult to control an outbreak if the new strain began spreading in the community.
“The response might be a bit harder than we’ve seen so far because of the increased transmissibility,” he said.
Medical-grade equipment needed for every COVID-19 case in quarantine
Since the early hotel quarantine breaches, the governments tightened up the system, introducing measures such as daily saliva testing of hotel workers and drivers and testing people for COVID-19 before they get on a plane to Australia.
But scientists said the leaks would continue unless everyone encountering a possible positive case was given medical-grade PPE, to stop them breathing in the virus.
That meant face coverings such as proper-fitting P2 and N95 masks, like those used in hospitals, on construction sites and to avoid breathing in fumes like smoke.
Ms Cole said only the proper equipment would keep people safe from becoming infected with an airborne virus.
“The minimum level that we would want to see is an N95 or P2 respirator because that’s protecting against aerosol spread or airborne transmission of COVID-19, which we know to be of a concern,” she said.
“And we also want to see a review of the ventilation of those facilities.”
While Australia’s hotel quarantine system is one of the strictest in the world, there are other countries that do more to prevent returning citizens from spreading the virus.
In South Korea, passengers are tested outdoors rather than indoors and drivers are separated by plastic screens from people who are possibly infectious.
Professor Morawska said Australia would have significantly fewer COVID-19 cases if the ICEG acknowledged the virus could be transmitted through the air outside of clinical settings.
Atmospheric chemist Robyn Schofield agreed, saying: “it is airborne.”
Professor Schofield from the University of Melbourne said the expert group advising the government did not appear to be considering the latest science which shows COVID-19 spreading through the air.
“It does seem to be out of step with what the Centres for Disease Control, and the US [are] saying, what many of the other countries around the world are doing,” she said.
On Thursday, a group of doctors wrote to health authorities in Queensland calling on the Government to include workplace health and safety experts, ventilation experts and aerosol scientists in assessing problems with hotel quarantine in that state.
“We believe experts from these three fields have an important role to play in elucidating the cause of viral spread both within the hotel, and in future planning for all hotel quarantine around Australia, and could piece together an important piece of this puzzle for the nation,” the letter read.
Experts hope the issue of stopping the virus spreading through the air is firmly on the agenda when National Cabinet meets on January 22.