WA Health told in March to move quarantine guests away from COVID-19 cases

Western Australia’s Department of Health was warned in March that hotel quarantine guests without COVID-19 should be moved away from neighbouring rooms where returned travellers had tested positive to the virus.

A Victorian man who spread the virus around Perth, sparking the city’s third lockdown, was not moved to a different room before completing his hotel quarantine at the Mercure Hotel on April 17 despite being in an adjoining room to another man who had recently returned from India and tested positive to the disease on April 13.

WA Health Minister Roger Cook says it is ‘unlikely’ any non-infected quarantine hotel guests are currently in neighbouring rooms to people with the virus.Credit: WAtoday

The opposition has criticised the government for dragging its feet on actioning the report’s recommendations prior to WA’s most recent hotel outbreak.

A final revised report by Glossop Consultancy, dated March 30 and made public on the Department of Health’s website on Tuesday, recommended guests opposite or next to a confirmed COVID-19 case “should be moved at least one room further away if at all possible”.

Three hotels — the Mercure, Four Points Sheraton, and Novotel Langley — were all identified as the riskiest for continued use in the the quarantine program because of the potential of airborne spread of COVID-19 from a ventilation perspective.

A summary of the report and other ventilation studies were provided on April 8 by the department to Chief Health Officer Andy Roberts, who made his own recommendations to Premier Mark McGowan and Health Minister Roger Cook on April 16 to stop using the Mercure to quarantine returned travellers.

A draft version of the Glossop report, prepared by occupational hygienist Laurie Glossop, was finished on March 8 and an initial final version three days later on March 11.

Glossop report recommendations for improving hotel quarantine

1. The hotels that have accommodation rooms at positive pressure to the corridors increases the risk of transmission via the inhalation pathway. If these hotels can have their ventilation system modified to change the pressure to negative or at least neutral this would lower the risk. This may not be possible at all hotels because of the design of the ventilation system. Whether extraction systems can be increased in airflow needs to be investigated.

2. Where positive room pressure for accommodation rooms in hotels cannot be altered, security guards are not to be located in a part of the corridor where there is minimal dilution of air coming from rooms with possible COVID-19 positive guests. The security guards may have to be moved further away from these rooms.

3. Guests in adjoining rooms or directly opposite to a confirmed COVID-19 positive guests should be moved at least one room further away if at all possible.

4. Security guards move as far as away as possible (current requirement is 2 metres) from rooms when doors are being opened to collect deliveries. This can be easily achieved when doors are knocked or telephone calls to rooms to say a delivery has been made.

5. It might be possible to install a supply air grill above the location of the guards. If the air coming through the grill is cooler than the corridor air it will act as an air curtain protecting the security guard. Laurie Glossop does not know how feasible this modification would be.

6. Rooms with COVID-19 positive guests could have the supply air reduced or exhaust air increased so the room could be made more negative pressure.

7. Rooms with COVID-19 positive guests could have a HEPA filter extraction machine installed in the room to reduce the viral load which could move into the corridors. These machines make some noise which guests might find annoying.

8. CCTV is another option where the security guard might not be able to directly see all the rooms, but could be notified from CCTV monitoring that someone has left a room. Another option is that simple sensors are used along the corridor which alarm when broken. These are readily available and are used in many shops and workplaces. Obviously, these would need to be turned off when deliveries are made. They may only be needed where there are emergency exits which cannot be monitored by security guards.

9. Another option is to not have guests in certain rooms because of security or poor ventilation in the corridor. This administrative control is relatively simple but does remove some rooms from being used for quarantining. The hotels with a red risk ranking might be amenable to this control. 

The report found some hotels relied on air escaping from guest rooms with positive pressure for ventilation.

“This substantially increases the risk of infection to those workers in the corridors and a small risk to guests when they open their entrance doors if there is a COVID positive guest on their level,” it said.

Dr Robertson confirmed on Monday there had been protocols in place to move non-infected guests away from COVID-19 positive rooms on April 13 but it had been focused on instances where several people in one room, like a family, had the virus.

The Chief Health Officer said the protocols would now require the movement of guests away from positive cases but prior to the Mercure cluster, they were only being applied to high-risk cases.

“We’ve done it on a case-by-case basis, we’ve been looking at where there have been a number of higher-risk groups so if we’ve had a family with a number of people within that family where there’s a higher viral load than we’d obviously move people from around that family,” Dr Robertson said.

“It really depends on the situation, and where they’re situated what they’re doing but certainly if we’ve felt there was a risk, we would look at moving them.”

Mr Cook on Tuesday said it was highly unlikely there was now any non-infected hotel quarantine guests in rooms next to people with the virus.

“When we have a positive case ... we then sit down with the floor plans, understand where those cases are in relation to other guests, we tend to leave positive cases in situ that is because to move them out of their rooms represents a risk, but we vacate to the best we can the other negative guests around that room,” he said.

“The pause that the lockdown represented was an was a important opportunity for our contact tracing teams to make sure that we can identify any close contacts, isolate them, get them tested. So it’s been successful exercise.

“Today’s zero number of positive cases in the community is obviously a very important signal that we are starting to get on top of this outbreak.”

Mr McGowan has raised concerns about a recent increase to active COVID-19 cases in hotel quarantine, with 28 currently in WA including two community cases.

The number of active cases throughout the state dropped to as low as three in March but had previous peaks of 32 in November, 57 in October, and 341 in April last year.

Mr Cook said the 28 were a large burden to have on the quarantine system.

“We clearly have to sort of keep an eye on where those positive cases are just to make sure the viral load is maintained at a manageable level,” he said.

Mr McGowan said a recent flight to WA on April 24 had brought in 78 travellers from India with four people having already tested positive for COVID-19.

Prime Minister Scott Morrison said on Tuesday Australia would be suspending flights from India until May 15.

He said there had been a concerning increase across the nation in the percentage of cases in hotel quarantine which had their origins in India.

Active COVID-19 cases in Australia have gone up from 31 in February to 256 on Tuesday.

WA opposition health spokeswoman Libby Mettam said in a statement hotel quarantine was still a weak link for the state.

“The state government was in possession of a report with detailed inadequacies at the Mercure Hotel weeks ago. The people and businesses of WA have now paid the price for the state government’s complacency,” she said.

“The McGowan government needs to work constructively to ensure their own failures in our hotel quarantine management are addressed so we can support stranded Western Australians who need to come home.

“Those returning also deserve to quarantine in an appropriate facility with confidence they will be safe and not exposed to the virus and the McGowan government must outline how it will deliver this in the best interests of our state.”