Zero-case status is the best COVID-19 option for Australia – And that means stronger controls over international arrivals (Part 2 of 2)Sep 16, 2020
To achieve and continue with zero-case status we need to minimise the risk there will be a major breach in our current systems for quarantining international arrivals.
How many new infections are arriving from overseas?
New Zealand is an excellent case study for Australia because of the early success they had against COVID-19 and the determination they show to control it.
By August 9 New Zealand had achieved 100 days without community transmission of the coronavirus. Two days later, matters went awry when an Auckland family of four tested positive. A breach of their international quarantine system is believed to be the most likely source.
New Zealand’s previous last case of community transmission dated back to the 22 May 2020. Since early June to mid-August they had around 70 overseas arrivals classified as COVID-19 overseas acquired, an average of one a day. The 70 included 6 infections via the USA, 6 via Hong Kong, 11 via UAE, 21 via Australia (possibly in transit) and 23 via India. Infected individuals end up in quarantine with the other 270 who arrive (on average) from overseas each day. They are quarantined for a fortnight, meaning a rolling total of around 4,000 at any one time, with about 14 in their midst with the virus. In fact, on the 22 August they had 5,506 in managed quarantine.
Was it inevitable that the virus would get loose into the New Zealand community due to a breach in quarantine?
Australian data is not so readily available. Using Department of Health fortnightly reports we estimate for June and July combined, Australia had approximately 450 COVID-19 infected international arrivals. That averaged around 7.5 per day. We have no data on the country of COVID-19 acquisition for these arrivals and whether they were Australian citizens or non-citizens.
This table summarises provisional ABS data on the number of international arrivals (citizens and non-citizens). We will concentrate on June and July 2020, but the other columns provide useful comparisons.
|All arrivals – State or Territory of clearance – provisional estimates (Source: ABS) |
|State of Clearance||Jul-19||May-20||Jun-20||Jul-20||Jun-20 to Jul-20
|Jul-19 to Jul-20
The average daily number of international arrivals for June and July combined was about 720. This means an average of about 1 in 100 infected arrivals (higher than the 1 in 270 for New Zealand). Assuming similar patterns since, we estimate that with a 14-day stay this means there is a rolling total of around 10,000 in hotel quarantine at any one time, about 100 of whom arrived infected.
The provisional data for June and July 2020 combined show that of the total of 44,050 arrivals from overseas, 24,800 were Australian citizens returning, though it is not known in which country they embarked or spent most of their time. The other 19,250 arrivals were non-citizens, including 1,430 from the UK, 1,810 from China, 1,020 from the USA, 1,850 from India, 580 from Pakistan, 510 the Philippines and 410 Indonesia.
On this we note certain inconsistencies from the federal government. By the 11 March, non-Australians from Italy, South Korea, Iran and China were not allowed into Australia within 14 days of them leaving those countries. On that date, Italy had less than 13,000 cases, South Korea less than 8,000 cases, Iran 9,000 and China about 81,000 (though eventually only reaching around 85,000). Yet we – like New Zealand – are currently allowing arrivals from hotspot countries or regions with much worse records: the UK currently with over 390,000 COVID-19 cases, US over 6 million, India over 4.5 million and Pakistan close to 300,000. Not to mention other countries on their second waves.
Why we need to move quarantining away from our cities
With it being carried out in CBD hotels, it is just a matter of time before any of the states receiving overseas arrivals go from zero cases to multiple cases, and we might have another Victoria on our hands.
Are the consequences worth it?
All international arrivals should be isolated geographically away from population centres, such as when Australians were flown from Wuhan to Exmouth in WA and then on to Christmas Island and passengers from the Diamond Princess were flown direct to Darwin for quarantine in the NT. There are various immigration detention and quarantine centres and other suitable remote facilities around the country.
We need to apply the “pub test” to arrivals, whether Australian citizens or not. Thus, flying into Australia starts with a trip to the airport in a major foreign city, like London, Delhi or New York. This is followed by check-in queues, escalators and lifts, immigration queues, security checks, airport lounges, boarding and sitting in planes, stopovers requiring similar activities, and disembarkation in Australia. All that is before reaching a quarantine hotel.
Thus, if you had the virus before departure, how many would you have infected on your travels? And if you didn’t start with the virus, what is the chance you have picked it up by the time you reach your hotel? And what is the chance someone at the hotel – hotel and security staff, your fellow “guests” and the medical staff who will treat you – will catch the virus as a result? And then what is the chance someone will take it into the community?
These chance factors are of course unquantifiable. But risk clearly exists at multiple points. The risk might be miniscule, but the consequences are gargantuan.
If international arrivals can’t be geographically isolated from population centres, then international arrivals have to be cut back significantly.
For those stranded overseas, what is more important are those of us already here who – like them – can’t see our families and who can’t find a job. Get Australia in order and then people can return to a country where their families are still alive and where there are jobs for the taking. A positive spin-off of remote quarantining could be lifting the arrival cap numbers. However, more arrivals almost certainly mean more infections, and lifting the cap in the current system would only add to the risk of leakage from quarantine.
Which model will Australia end up with?
As the pandemic has progressed, Scott Morrison’s overall control has been diminished as state leaders have increasingly defied or ignored him.
His response has often been erratic, straw-clutching and coercive: ‘off to the rugby’, ‘open the schools’, ‘open the state borders’, ‘the CovidSafe tracking app’, ‘supporting Clive Palmer v WA’, ‘the vaccine(s) just around the corner’ and ‘open the state borders’ again.
Worryingly, most recently we have his promotion of NSW’s “suppression” model over the community “elimination” model everywhere else.
The Premier of NSW seems to be saying that “zero-cases is impossible” – even while other states and territories have been there for months. The New Zealand PM, within hours of the August 11 cluster appearing, put Auckland into Level 3 lockdown and the rest of the country into Level 2.
Five jurisdictions out of eight with community elimination is an amazing result by any measure, worldwide. With some luck, despite being pushed in another direction by our PM and his senior ministers, all of our eight states and territories and New Zealand will achieve zero-case status and our whole country can live in peace until the COVID-19 problem is solved, albeit with a little bit less wealth.
The PM can help out by concentrating on the role where he made his name. That is, by introducing controls on our international borders to minimise unwanted consequences from overseas arrivals and by making widespread use of our extensive immigration and refugee detention facilities.
Robin Boyle lectured in statistics at Deakin University and preceding institutes for three decades until 2009. His academic background in mathematics, economics and finance, as well as statistics, led him to developing teaching software in those areas and to be widely sought after as a textbook author.