Experts warn Australia needs to reset hotel quarantine while India flights are paused

Experts warn Australia must use the next three weeks without flights from India to reset the fragmented national hotel quarantine program and acknowledge that airborne transmission between rooms is a risk.

Prime Minister Scott Morrison announced Australia would pause all direct flights from India until May 15 as that country grapples with a wave of COVID-19 cases. Australia will also urgently send millions of pieces of personal protective equipment and 500 non-invasive ventilators to India, as well as 100 oxygen concentrators, tanks and consumables.

Prime Minister Scott Morrison and Foreign Minister Marise Payne announce a pause on direct flights from India to Australia.Credit: Rhett Wyman

The decision to temporarily stop flights was based on health advice prompted by an increase in the number of coronavirus cases among people in hotel quarantine and the high proportion of those originating in India. In the past week, the number of quarantine cases jumped from 90 to 143.

In the Howard Springs facility in the Northern Territory, where people on repatriation flights are quarantining, 95 per cent of cases are among arrivals from India. The Institute for Health Metrics and Evaluation estimates India will hit a peak of 13,300 deaths a day in mid-May, when Australia is due to re-evaluate the flight ban.

“It’s important to take this pause to enable those quarantine facilities, particularly in the Northern Territory, to be able to work through the system and return to lower levels [of positive cases],” Mr Morrison said on Tuesday afternoon.

Public Health Association of Australia president, Adjunct Professor Tarun Weeramanthri, said it was crucial during the pause to reset the country’s quarantine system.

“Currently the arrangements are fragmented, in terms of each state and territory running it with different standards and practices,” he said.

One key improvement would be explicitly acknowledging the risk of airborne transmission in quarantine hotels.

“The biggest risk is airborne transmission underpinned by poor ventilation, so we must look at that risk and mitigate that risk as best we can,” Professor Weeramanthri said.

Australian Medical Association president Dr Omar Khorshid said while COVID-19 was mostly spread through droplets, it was clear that in some situations – including in Western Australia’s recent quarantine outbreak – aerosol spread also occurred.

“The AMA has repeatedly called for urgent national action on airborne transmission in hotel quarantine,” Dr Khorshid said. “The pause in flights from India gives us the chance to revisit the settings and have a cohesive national approach.”

The Infection Control Expert Group, which advises the Australian Health Protection Principal Committee, must make a decision on the risk of airborne transmission in hotels before arrivals from India resume, Professor Weeramanthri said.

But Chief Medical Officer Paul Kelly said the idea the country’s top medical experts were denying that aerosol transmission occurred was “ridiculous and false”.

“Aerosols do play an important role in transmission,” Professor Kelly told a parliamentary COVID-19 committee on Tuesday evening. “But, I would say that [is] unusual. That is not the usual way that the virus is spread.”

Over the past 24 hours, India recorded 323,144 new cases and a further 2771 fatalities, with overrun hospitals turning away patients due to a shortage of beds and oxygen supplies.

As the epidemic in India grows, transiting flights from that country through Doha, Singapore, Dubai and Kuala Lumpur have been paused by those countries. Eight repatriation flights Australia’s Department of Foreign Affairs and Trade planned to run during May have been postponed.

When direct flights to Australia resume, all passengers will be required to return both a negative COVID nasal swab and a negative rapid antigen test before departure.

There are more than 9000 Australians in India who are registered with DFAT as wanting to return home, with 650 classed as vulnerable. That number is expected to increase in the coming days.

Mr Morrison said the government recognised the significant difficulties stranded Australians faced and would seek to resume repatriation flights as soon as possible.

“These are Australians and Australian residents who need our help and we intend to make sure we are able to restore flights ... and that those repatriating flights focus on the most vulnerable,” he said.

“We don’t think the answer is to forsake those Australians in India and just shut them off, as some seem to suggest.”

Opposition leader Anthony Albanese said pausing flights from India meant thousands of citizens and permanent residents were now “trapped” and quarantine must be improved.

“The Morrison government has failed to provide a national quarantine system. If hotels aren’t suitable, they need to build an alternative,” he said on Twitter.

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