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‘Nervous’ wait for aerosol guidelines following another HQ leak


Matt Woodley


12/05/2021 4:54:16 PM

Consensus guidelines on face mask and eye protection against COVID are currently with ICEG for review.

Healthcare worker in full PPE at hotel quarantine.
Victorian healthcare workers at the Grand Hyatt hotel wearing PPE, including P2 respirators. (Image: AAP)

It has been confirmed that the first locally acquired COVID case in Victoria since February is the result of a hotel quarantine leak that occurred in Adelaide.
 
The man, who arrived in Melbourne after completing his quarantine in South Australia on 4 May, developed symptoms four days after his release, before being tested on 10 May and returning a positive result the following day.
 
Victorian Chief Health Officer (CHO) Professor Brett Sutton said on Tuesday it is ‘absolutely the case’ that the man in his 30s was infected while in hotel quarantine, a position supported by South Australia’s CHO Professor Nicolle Spurrier.
 
It is the 11th outbreak linked to hotel quarantine since December, and Professor Spurrier confirmed the most recent case likely occurred after a COVID-positive guest was placed in a room adjacent to the Victorian at the Playford Hotel.
 
‘I think it’s very evident now that the virus can be transferred through smaller droplets … and that these droplets may hang around in the air for a period of time,’ she told reporters.
 
According to Burnet Institute epidemiologist, Professor Mike Toole, the latest leak has placed even more importance on the upcoming release of new national guidelines that have been drafted by the Infection Protection and Control panel (IPC), which are expected to address the safeguards required to prevent airborne transmission of COVID-19.
 
The IPC was formed last September at the instruction of Federal Health Minister Greg Hunt after a spate of healthcare worker infections in Victoria, and comprises members from the National COVID-19 Clinical Evidence Taskforce (the Taskforce) and the Infection Control Expert Group (ICEG).

A Taskforce spokesperson told newsGP the final draft of the IPC face mask and eye protection consensus recommendations were approved by all 32 Steering Committee member organisations and have been with ICEG for consideration since 3 May.
 
Professor Toole told newsGP the number of leaks currently escaping hotel quarantine is ‘ridiculous’ and that more needs to be done to address holes in a number of states’ infection control procedures.
 
‘We are nervously waiting for ICEG’s response to these guidelines and to recommend changes in ventilation and PPE in quarantine hotels to the AHPPC [Australian Health Protection Principal Committee],’ he said.
 
‘I would hope that there is a sense of urgency because it’s an urgent problem.
 
‘I mean, just the past couple of weeks have been extraordinary. It seems like now we’re averaging two leaks a week.’
 
Enquiries to ICEG’s Co-Chair Professor Alison McMillian about the review process were forwarded to the Department of Health (DoH), which declined to provide an estimated timeline.
 
‘ICEG has received and is considering the consensus recommendations on IPC face masks and eye protection from the COVID Clinical Evidence Taskforce,’ a DoH spokesperson told newsGP.
 
‘As with all documents that ICEG is asked to review, these recommendations will be given thorough and appropriate consideration before a response is provided.’
 
Professor Toole said Victoria and South Australia have already taken steps to try and prevent airborne transmission by introducing ventilation audits of hotels used to house returned travellers and compulsory use of P2 respirators by hotel quarantine workers, but is concerned about the lack of progress in other states.
 
‘I’m not willing to say that in the community aerosols are the main route, but once you’ve addressed the other modes of transmission – droplets and fomite – as has been done in all quarantine hotels, well you’re just left with airborne transmission,’ he said.
 
‘And if you don’t address that, given the increasing number of infected returned travellers, these leaks are inevitable because nothing’s changing in four of the six states.
 
‘Northern Territory … clearly have the ideal facility. But until we can get those in the other states … then we’re stuck with this imperfect system.’
 
While ICEG is yet to recommend that Australia implement additional minimum standards to protect against aerosols, except under specific circumstances, the World Health Organization (WHO) and US Centers for Disease Control and Protection (CDC) have both recently updated their advice around this mode of transmission.
 
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