Coronavirus Victoria: Inquiry hears key evidence on hotel quarantine bungle
On Monday afternoon the question Victorian Premier Dan Andrews has dodged for weeks was answered, leaving another key riddle in its place.
For weeks, Victorian Premier Dan Andrews had declined to release the secret report by virus hunters into how many of the state’s COVID-19 cases were directly linked to returning travellers in the hotel quarantine scheme.
Even the state’s chief medical officer Brett Sutton insisted the research, funded by taxpayers, could not be released until it was considered by a judicial inquiry into the program.
“It’s not my genome sequencing data, it belongs to Peter Doherty Institute,’’ Professor Sutton said.
“It’s not my call to keep it under wraps. I don’t have an opinion on it. I’m very happy to speak about it if I’m asked about it in the judicial inquiry.”
On Monday afternoon, it was finally unveiled, along with the reasons why the Victorian Government may have wished it to remain under wraps as Melbourne was subjected to an unprecedented curfew and lockdown.
Victoria’s deadly second wave of COVID-19 that has infected thousands of Australians and killed over 100 people, can now be directly tracked back to a small group of returning travellers who entered hotel quarantine in May.
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WHAT IS GENOME RESEARCH?
Throughout the COVID-19 pandemic, genomic sequencing has been used alongside more traditional contact tracing and interviews with infected patients.
A genome is an organism’s complete set of genes or genetic material. Scientists can track the virus as it infects people through mutations in the virus.
Mutations in the genetic code of the virus “essentially act as a passport stamp” allowing scientists to trace back where the virus came from.
CAN SCIENTISTS LINK THE SECOND WAVE TO HOTEL QUARANTINE?
In his witness statement to the inquiry, the Doherty Institute’s infectious disease expert Ben Howden was at pains to make clear that while he could link “99 per cent” of cases to returning travellers he could not definitively blame hotel quarantine.
To do that, he needed to marry that genomic information with other contact tracing about the outbreak and interviews with infected people.
But Professor Howden noted the Victorian Health Department does have that information. Health officials are expected to give evidence on this issue next week.
In his statement, Professor Howden responded to a number of questions including the following:
– How many clusters and what proportion of cases were linked to quarantine travellers in the hotel quarantine program?
– What proportion of cases were linked to private security staff at those sites? What proportion of cases were linked to other staff in the hotel quarantine program? What were your findings in relation to onward transmission of infection from staff in the hotel quarantine program to persons in the community? Where did these cases occur?
– Based on these findings, to what extent was the increase in the spread of the COVID-19 virus in Victoria attributable to quarantined travellers or staff in the hotel quarantine program spreading the virus to the broader Victorian community?
– If that spread of the COVID-19 virus was attributable to quarantined travellers or staff in the hotel quarantine program, what do your findings suggest about whether the sources of that spread included all staff in all roles, at all sites – or whether the sources of spread were specific to: (a) certain individual quarantined travellers; (b) certain individual staff; (c) staff in specific roles (eg security staff); (d) staff at particular sites?
In response, Professor Howden said this was beyond the scope of the genomic testing alone.
“To answer each of the above questions in the terms asked requires the addition of epidemiological data,’’ he said.
“This epidemiological data is not held by the (Doherty Institute). I believe it is held by the Department.”
As a result, Professor Howden said he “does not and cannot make findings of the kind referred to in these questions.”
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MYSTERY REMAINS OVER HOW IT SPREAD
The crucial exchange shows the scientist saying the genomic research doesn’t tell you how the virus jumped from those returning travellers into the community.
Did security guards become infected and spread it to friends and families in Melbourne’s suburbs before they discovered they were infected?
Is it possible the travellers themselves spread it in the community when travelling to and from hotel quarantine?
And was the real ‘patient zero’ not a security guard employed by the Victorian Government but the night duty manager at the hotel?
As Victoria’s chief health officer Brett Sutton has previously said, the genomic testing reveals cases that are linked but not the sequence of infections.
“Sometimes the first case that’s notified to us is not the first case in an outbreak,” Professor Sutton said.
“Sometimes the first person who develops symptoms is not the first person who’s been exposed. So it is tricky in that regard.”
VIRUS HUNTERS’ SECRET REPORT
The infections are tracked in graphs that tell the story of how Melbourne’s COVID clusters were all but extinguished in May as the existing strains died out.
In one graph, the cases acquired from overseas are marked as orange dots. From a handful of orange cases in May, these then explode into a huge cloud of black dots in June, July and August of locally acquired cases.
“Network 1 (91 sequenced cases) was first identified in March and expanded rapidly throughout May. No further cases have been identified within this transmission network since 30 May 2020,” Professor Bowden wrote.
“There is no evidence of ongoing transmission of any other known genomic clusters within Victoria since this date.”
In other words, the virus was dying out. But in mid May, the virus comes roaring back.
“Network 2 (1705 sequenced cases) was first identified in mid-May in a group of returned travellers. Additional cases were identified within this transmission network throughout June and continuing into July,’’ he wrote.
“Of the 1837 cases diagnosed since 8 May 2020 where overseas acquisition was not suspected and with available sequence data, 1833 (99.8%) were identified within one of the three local transmission networks, or genomic cluster 45_A. “
WHO IS PATIENT ZERO?
Over the weekend, The Age reported that Victoria’s “patient zero” was a night duty manager at Melbourne’s Rydges on Swanston hotel, which was a quarantine hotel for returned overseas travellers.
But scientists say they cannot determine the sequence of who got infected first, simply that the infections are linked.
The Victorian Premier insisted on Friday that he still has no confirmation of who the “patient zero” was.
“I don’t have any advice about who that person might be,” Mr Andrews said.
“I think that whole notion that we could necessarily have, to that degree of certainty, clarity about one particular person, I don’t know the science would ever lead you to that. It could, but it may not.”
To that extent, the mysterious case of the night duty manager simply poses an alternative theory of how the virus got into the general community that does not involve security guards alone.
What is known is that security guards became infected after the night duty manager and that cluster was linked to returning travellers.
What isn’t known is how they were infected, whether some security guards were actually infected first but diagnosed after the night duty manager, or how the virus then spread in Melbourne’s north western suburbs.
It’s possible that the night duty manager became infected from contact with returning travellers. It’s also possible that the actual “patient zero” was still a security guard who got it from an overseas traveller who then infected the night duty manager
The fact that Victoria’s second wave of cases was linked to hotel quarantine has never been in doubt.
In a press release announcing the inquiry, the Victorian Government noted: “The chief health officer has advised the government that a number of cases of coronavirus in the community have been linked through genomic sequencing to an infection control breach in the hotel quarantine program.”
Victorian Opposition leader Michael O’Brien has repeatedly urged the Andrews Government to be “honest with Victorians and stop covering up the problems and mismanagement around hotel quarantine.”
“The Premier and his ministers are refusing to answer questions and continue to hide behind an inquiry rather than being upfront,’’ he said.
“The millions of Victorians locked up through no fault of their own, need the Premier to stop dodging questions and start giving answers.”
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