Learning fast lessons saves lives in coronavirus battle

It cannot be happening again — surely? It might be. Victoria’s second wave of COVID-19, sparked largely by security bungles at quarantine hotels Rydges on Swanston and the Stamford Plaza in Melbourne in May and early June, has cost 219 lives since July 5. That includes a record daily toll of 19 deaths reported on Monday, a spike that took the national coronavirus toll past 300. Victoria has 7869 active cases of the virus and the state’s current lockdowns are costing the national economy about $12bn, 400,000 jobs and incalculable personal hardships.

The Andrews government, to its shame, does not appear to have learned the lessons of the hotel debacle, which is now the subject of an inquiry headed by retired judge Jennifer Coate. On its opening day, senior counsel assisting, Tony Neal QC, said “it might even be that every case of COVID-19 in Victoria in recent weeks could be sourced to the hotel quarantine program”. Against that background, on Tuesday’s front page Victorian editor Damon Johnston reveals that two more COVID-19 hotels in Melbourne — the Brady and the Grand Chancellor — are beset with big problems involving security, infection control and tensions between medical staff, police and Victorian Department of Health and Human Services officials.

On the day the world officially passed 20 million COVID infections, including five million in the US, the bright spot in Victoria was that new cases totalled 322, the lowest increase for weeks. If the state is at a crossroads, neither the Andrews government nor any other state or territory or Canberra can afford to ignore the hard lessons of past mistakes. Such lessons abound, unfortunately, not only within Victoria’s hotel quarantine programs but also in the problematic, resource-strapped aged-care sector, whose frail residents and their anxious families have borne much of the loss and emotional brunt of the pandemic.

Lessons should have been learned early in phase one of the coronavirus outbreak at Anglicare’s Newmarch House nursing home near Penrith in Sydney’s west. There, 19 residents died after contracting the virus while in care. On Monday, the aged-care royal commission heard that NSW Health Department officials were concerned about setting a precedent if they transferred all COVID-positive nursing home residents for treatment. As Stephen Lunn reports, commonwealth and state officials were sharply at odds about how to treat Newmarch House residents who contracted the virus in the early days of the cluster.

In hindsight, mistakes across the sector have been legion. Little was done to prevent disaster being repeated at more than 100 nursing homes in Victoria, in which 1000 residents have been diagnosed with COVID and 168 people have died. The toll was a “human tragedy”, counsel assisting the aged-care commission Peter Rozen QC said. His description of the virus as “the greatest challenge the Australian aged-care sector has ever faced” is correct.

Problems aired before the commission included the fact neither the federal Department of Health nor the aged-care regulator developed a COVID-19 plan for the sector. That was despite the fact from the outset it was recognised that recipients of aged-care services were a high-risk group. Nor did the Australian Health Protection Principal Committee, the joint state-federal body that is the main source of advice about COVID-19, have any advice for the sector about coronavirus between June 19 and August 3. During that crucial six weeks, Mr Rozen said, the number of new daily infections in Victoria grew from 25 to 413. No advice was provided, for example, Mr Rozen said, about how the sector should respond to the risk posed by aged-care workers who might be COVID-19 positive yet asymptomatic, especially those working in multiple facilities. In a sector that relies on part-time and casual staff, such workers were always likely to be infection carriers.

The aged-care royal commission, its recommendations and their implementation will be a lengthy process and far broader than the COVID-19 crisis. Immediate lessons about the sector’s main shortcomings in managing coronavirus, however, need to be taken on board. If heartbreaking scenes such as those at Newmarch House and St Basil’s Greek Orthodox home for the aged at Fawkner, in Melbourne’s north, are to be avoided, health authorities and the sector need to prepare for the possibility of future outbreaks. Evidence to a Senate committee scrutinising the Morrison government’s response to the pandemic shows the aged-care watchdog knew there had been an outbreak at St Basil’s but took four days to inform the Health Department. Coronavirus protocols, which stipulate aged-care homes must notify federal authorities, as well as the state public health unit, within 30 minutes of learning of an infection, should always be followed. With Australia’s COVID toll increasing by more than 100 in less than 10 days, Deputy Chief Medical Officer Michael Kidd has warned more people will die because of COVID’s “devastating effect” on aged-care facilities.

Current problems in Melbourne’s quarantine hotels also will erode public confidence. An infected guest refusing to stay in her room, hotel staff at risk of infection and understandably anxious, and close contacts between infected guests are a potentially lethal mix. Until mistakes are avoided, ongoing COVID-19 waves remain a serious risk.