Australia implemented international border restrictions early in the course of the pandemic in order to prevent the spread of COVID-19. From 28 March 2020 all returning travellers have been required to undertake 14 days of quarantine in a designated facility. Since then, some 130,000 international and domestic travellers have been quarantined slowing the spread of COVID-19 in Australia.
The review has examined quarantine systems and processes in all States and Territories except Victoria, met with relevant agencies and reviewed hotel quarantine arrangements and witnessed passenger arrivals. A model of good practice in an end to end quarantine system, together with the role of coordination of decision making, risk mitigation, community safety and patient care has been described.
Hotel quarantine is difficult to endure, particularly for vulnerable people. It is an expensive resource and requires a highly specialised workforce to support the system including clinical, welfare and security services in order to mitigate risk and discharge duty of care obligations. Infection prevention and control processes need to be tightly managed. Clear communication and decision making across agencies must be defined - including clear lines of accountability and risk ownership. Clinical and mental health support needs to be integrated within the system and should not rely on guests needing to reach out. Guests also need access to clear communication channels before they travel and timely review and appeals mechanisms.
States and Territories can improve hotel quarantine practices by adopting best practice. End to end assurance is necessary to ensure standards are maintained. With six months of quarantine experience and the likelihood that hotel quarantine will remain in place for some time, Australia’s one size fits all approach should be reconsidered to take account of greater knowledge of the virus, different prevalence in countries of origin of travellers, an understanding of how to incorporate risk-based approaches in system design and different models of quarantine made possible by new testing and monitoring arrangements. This will be essential to place quarantining arrangements on a more sustainable footing into the medium term.
In this context the review recommends:
- States and Territories should embed end-to-end assurance mechanisms and look to continuously improve hotel quarantine to ensure that it is delivered consistent with good practice.
- Information on the quarantine system should be easy to access by travellers in order to ensure their understanding of quarantine and to better psychologically prepare them for the experience. This should be provided across relevant Commonwealth/State and Territory websites.
- People in quarantine should have access to timely decision making and review processes, and complaints mechanisms including pathways for escalation.
- Options for new models of quarantine should be developed for consideration by National Cabinet including a risk assessment of these options and an analysis of traveler suitability.
- National Cabinet should consider exempting low risk cohorts, such as travellers from New Zealand, from mandatory quarantine.
- The Australian Government should consider a national facility for quarantine to be used for emergency situations, emergency evacuations or urgent scalability.