Friday, 19 February 2021

Some Reflections on Quarantine

 

Medical staff in Surry Hills, NSW, 1919. Pic courtesy NSW Archives

By now, every state in the commonwealth, with the exception of the Northern Territory has had to resort to at least one snap lockdown because of failures in the hotel quarantine system.

This system works most of the time, but when it breaks down, the results are not pretty, from the point of view of both health and economic outcomes.

Quarantine was used extensively in the Spanish Flu pandemic of 1918, and to a large extent, it did help Australia to get through the episode with a much lower infection rate than many other countries at the time.

Historical accounts describe two different programmes, one maritime and the other land, the first apparently much more successful than the second. The land quarantine camps (as they were called) were set up adjacent to state borders, whereas the maritime stations were set up near embarkation points in the major cities.

All states had quarantine stations (North Head in New South Wales, Port Nepean in Victoria, Bruny Island in Tasmania, Torrens Island in South Australia, Woodman Point in Western Australia, and Lytton in Brisbane) but many more were planned in case numbers overwhelmed their capacity. In due course, temporary quarantine stations and influenza hospitals were set up to handle the increasing volume of affected Australians.1

The maritime stations were apparently relatively effective, but the state border stations were not. People frequently bought their way out or escaped because it was easy to do so. The maritime stations were often set up offshore or in inaccessible locations, so escape was often impossible. These places weren't remote, but they were designed in 1918 to be inaccessible.

Perhaps we can learn from history. Scattered throughout the country are a number of mothballed commonwealth owned and run facilities, mostly detention centres. they include Baxter IRPC* (Cultana SA), Christmas Island IRPC, Curtin IRPC (Curtin WA), Howard Springs Quarantine Facility (NT), Inverbrackie APD# (Woodside SA), and Leonora APD (WA). There are also facilities at Port Augusta and Port Hedland.

What they have in common with the quarantine centres used in 1916 is their inaccessibility.

Christmas Island (which cost the Australian taxpayer $180 million to be reopened when the medical evacuation legislation was passed by parliament) is almost empty. Currently, it houses a family of four from Sri Lanka, although was used briefly to quarantine repatriated Australians last year.  

Most of these facilities use pre-fabricated structures and resemble mining camps in that they consist of separate buildings that don't share ventilation and air-conditioning systems, unlike hotel accommodation currently used for quarantine in our state capitals. Virologists are telling us that self-contained and spread accommodation is much better at preventing the spread of virus than your typical multi-storeyed city hotel. 

Most are located close to airbases with runways of sufficient length to cater for international flights. All are self-contained with catering and laundry facilities attached.

The ADF has currently a strength of just over 85000 full-time personnel and active reservists across the three services. 

Combining personnel, these locations, and a realistic allocation from the defence budget, a number of these centres could be set up as quarantine facilities. They could be staffed with soldiers, sailors and airmen/women, who might be happy to work a FIFO stint for a limited specified period. Infantry soldiers (for example) might be grateful for beds and air-conditioning. Who knows - down the track, personnel who served in these locations could be rewarded with a special Covid medal, similar to that awarded to peacekeepers. I'm only half-joking.

The risk of staff working multiple jobs and locations would be eliminated, and the possibly infected travellers would be housed a long way from major population centres, not smack in the middle of them as currently arranged.

Those in quarantine would probably prefer a self-contained demountable to stuffy hotel rooms with balcony and corridor access off-limits. After all, if you're going to be stuck in quarantine for a fortnight, whether you're in a metropolitan hotel, or a donga in the bush is neither here nor there.

And breaches of security protocols amongst staff (the major cause of the transmitted infections) are probably a bit more unlikely in a military environment than a civilian one. There's always the threat of an A4.

This notion has already taken wings with a couple of entrepreneurs (Wagner in Toowoomba, and Fox at Tullamarine) which strongly suggests that it's feasible.

Strangely, immigration and quarantine are commonwealth responsibilities, but they have been duck-shoved, on this occasion, to the states. Using commonwealth facilities and personnel would put this process in the hands of the level of government responsible.

Anything has to be an improvement on lightning lockdowns.

*Immigration Reception and Processing Centre

#Alternative Place of Detention

1. The Navy and the 1918-19 Flu Epidemic, by Greg Swinden


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