‘Sentinel surveillance’ key to easing lockdown

Aggressive testing of vulnerable community groups is vital if authorities are to ease lockdown restrictions.

Medics perform COVID-19 tests at a drive-through COVID-19 testing center on Bondi Beach. Picture AFP.

Australia must move towards a ­system of so-called “sentinel surveillance’’ — aggressive testing of vulnerable community groups, such as prisoners or aged-care residents — if authorities are to ease lockdown restrictions imposed to control the spread of COVID-19.

Greg Dore of Sydney’s Kirby Institute said it was increasingly clear that the rate of community transmission of the coronavirus was low and no longer made sense to speak of locations such as the eastern suburbs of Sydney as “hot spots’’ of infection.

“Case numbers are down everywhere, including in the eastern suburbs,’’ Professor Dore said.

“I’m not sure I would describe them as current hot spots given that very few cases are being diagnosed in the whole of NSW, including the eastern suburbs.’’

The comments came as the NSW Corrections Department confirmed it was preparing to begin blanket coronavirus testing of all new inmates in a bid to prevent the disease from entering the NSW prison system.

‘’The network will soon introduce testing for all individuals ­entering custody as part of NSW Health’s plans to undertake sentinel surveillance in the broader community to help identify the rate of infection,’’ a spokeswoman for NSW Justice Health said.

“Any inmate identified as a suspected COVID-19 case is being immediately provided a surgical mask and isolated in a separate cell for testing, treatment and close monitoring.’’

Professor Dore, an infectious diseases physician at St Vincent’s Hospital, which services Sydney’s eastern suburbs, the epicentre of the initial outbreak, said elimination of COVID-19 from Australia was a real possibility, albeit an ­unlikely one.

He said Australia had “definitely not overreacted’’ in its ­response to the virus, and backed the Morrison government’s plan to begin easing restrictions around mid-May. “Clearly there’s a spectrum of views around this in terms of levels of restrictions, but I think the government’s mostly got it right to date,’’ he said.

“So I’m happy to back the ­people advising the government going forward.’’

Professor Dore said the impetus now must be towards sentinel surveillance, where testing was conducted more randomly on people with no symptoms but who were members of a group in which the disease could spread quickly.

“People who are homeless, people who are incarcerated in prison, people in aged-care facilities obviously,’’ Professor Dore said. “These are settings (where) in other countries we know the virus has been rapidly transmitted.’’

NSW Corrections boss Peter Severin told The Australian all new prisoners were required to quarantine for 14 days before joining the general population. ­“Initially we weren’t testing them much,’’ he said. “Justice Health is now significantly increasing testing for that population.’’

NSW Corrections has also deployed thermal scanners and hand-held thermometers to monitor for symptoms of coronavirus.

Prison bosses have also set aside 2.5 per cent of the system’s overall capacity to house prisoners ill with coronavirus who don’t ­require hospital care.

The specialist areas will be self-contained units capable of housing maximum-security inmates. The measures are an ­attempt to keep prisoners out of the public hospital system, thereby reducing the pressure on critical care ­resources.

“Hopefully we’ll never have to use it, but we want to be prepared,’’ Mr Severin said.