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The $2B Sydney lockdown: Quarantine transport once again in focus – News – The University of Sydney

Posted: July 5, 2021 at 1:51 am

In a December 2020 article for The Age, I called for a comprehensive review of quarantine transport in Australia. The Victorian COVID-19 Hotel Quarantine Inquiry omitted to provide any substantial focus on quarantine transporthigh risk, confined settings and a single point of failure in the quarantine system. Whilst recommendations were provided with respect to the transit of returned travellers, the transit of air crew, typically undertaken by ground transport companies under contract to airlines, was not afforded the same level of consideration.

Greater Sydney (including the Blue Mountains, Central Coast, Wollongong and Shellharbour) has commenced a 2-week lockdown costing the economy $143M per day, which led us to stand at the brink of a national outbreak (resulting in lockdowns in Darwin, Alice Springs, Perth, Brisbane, Gold Coast and Townsville, plus restrictions in other states/territories), due to the infection of an air crew ground transport worker with the Delta COVID-19 variant. Investigations have shown that the driver failed to wear a mask, whilst systemic issues surrounding daily testing and the failure to vaccinate (linked to deficiencies in the definition of border worker) continue to proliferate.

On 26 June 2021, NSW Health quietly updated its air transportation quarantine guidelines, but significant accountability and quality control questions remain. Continued quarantine failure also demands a rethink of our national priorities and our accepted approaches to risk mitigation.

The public deserves to know the regulatory and performance regime governing quarantine transport operators. Whilst returning travellers are transported by large bus and coach operators (e.g., ComfortDelGro, Kinetic) under contract to state governments, the transport of crew is more opaque and involves a relationship between airlines and small, private ground transport companies (e.g., Sydney Ground Transport, Legion Limousines). Any breach is of catastrophic consequence, as we are once again witnessing.

We need clarity in the chain of responsibility (and who forms this chain), based on principles of shared responsibility and accountability for ensuring all infection control measures are maintained. Questions remain over whether guidelines are legally enforceable, and whose role it is to monitor and police. Perhaps there should be separate accreditation requirements for quarantine operations too.

Quarantine transport operators must be sufficiently incentivised beyond the protection of personal health (which in a low COVID-19 risk environment like Australia is a difficult imperative). Contractual obligations should be independently vetted, whilst a stringent punishment and reward system could raise the stakes, with offending operators even named and shamed. Infection control breaches could also be grounds for the termination of employment as part of contract stipulations.[1]

An appropriately incentivised operator should go above and beyond to protect its employees and, by extension, the rest of the community. In Australia, we have seen a light-touch approach to personal protective equipment provision. The use of fit-tested P2/N95 masks, goggles, headwear and medical gowns in all high risk scenarios is a fail-safe solution. Retrofitting vehicles with physical barriers, and the use of anti-epidemic technologies such as anti-microbial coatings, and disinfection solutions like ultraviolet, fogging and nano-technologies can reduce error and inconsistency. These initiatives may be mandated or encouraged via appropriate market forces (operationalised through contract design).

Whilst technological solutions are important, they are only as effective as individuals personal responsibilities and behaviours. We have seen little invested by way of proper infection control training for frontline quarantine staff. Border workers could be trained in the same way medical staff are, plus given added directives such as the quarantining and disinfection of clothing and personal items to reduce the risk of spread to household contacts.

Focus should not only be on compliance but on building a zero-tolerance culture that stigmatises complacency and error. Total quality control and elements of the Six Sigma Doctrine have been effective in many sectors (e.g., manufacturing) in reducing the variance in outcomes. Pointing-and-calling, pioneered in the 1920s as a Japanese railway safety protocol, is a low-cost occupational safety strategy. Verbalising intended actions increases attention and awareness and has been found to reduce errors by 85%.

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The $2B Sydney lockdown: Quarantine transport once again in focus - News - The University of Sydney

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