The real issues of how the failure of the Victorian hotel quarantine program became the SOURCE of the State’s lethal second wave of Covid-19 infections have been lost.
Political and media attention has been diverted to a witch-hunt for who took a decision to use private security contractors to enforce quarantine directions in the hotels. That no-one in the government or bureaucracy appears to be able to say who took the decision, or when or why it was taken is an abject failure in public accountability, but an answer to those questions would not explain the failure itself! Nor is “use the ADF” an answer to anything, let alone everything.
It was always likely that some returning travellers carried the virus – that’s why they were quarantined! The questions that need answers are therefore:
1. What testing was done to identify who had the virus and who did not, to ensure the clinically competent isolation of positive cases and hence to protect not only the community but also all staff and fellow quarantinees?
2. What level of training, PPE and other resources were needed and provided to all staff to prevent infection – hotel workers, clinical staff, and security/enforcement staff alike?
3. What were the supervision arrangements and were there clear chains of command at each quarantine facility?
4. What measures were in place to identify staff who predictably might become infected, to care for them, and isolate them to prevent further spread?
These are questions about an effective quarantine system and are very similar to those that have had to be asked and answered in other health settings. They apply regardless of what security staff were used in any settings.
The last of these questions overlaps with the second key issue: what were the VECTORS that led to the devastating spread of the virus into the community, and in particular its deadly spread through our aged care system? Here, the main questions seem to go to:
a. the adequacy and targetting of our testing and contact tracing systems;
b. the timing and nature of community control measures;
c. the diversity and breadth our public health communication systems;
d. aged care workforce issues; and
e. the preparedness, and particularly the infection control systems of our aged care facilities.
Both sets of issues reveal a further array of concerning administrative governance questions at both Commonwealth and State levels:
i. What were the procedures for continuous, expert observation, reporting, and evaluation which might have exposed and addressed each point of failure?
ii. Where was the professionalism, courage, and openness among public service leadership which could have encouraged the exposure, review, and correction of mistakes ?
iii. When it seems clear that some more junior public servants and health professionals identified failures quite early in the quarantine program, what is it in current public sector culture and structure that meant that their concerns were not heard and acted upon?
I hope the Victorian Board of Inquiry will go to the first set of broader issues about the quarantine failure. It would be another failure of public policy if similar scrutiny is not applied to questions about the vectors of the second wave, and notably by the Commonwealth to the aged care disaster it neither averted nor managed. No-one seems to be keen to ask this second set of questions about the aged care tragedy nor those about administrative governance.
Terry Laidler is a Melbourne psychologist and former ABC Radio 3LO Melbourne drive-time host.