Nebuliser device may be behind COVID-19 spread at Holiday Inn, Sutton says

The two latest cases at the Holiday Inn are a returned traveller, who tested positive to the virus after finishing her 14-day quarantine period, and a food and beverage worker.

Chief Health Officer Brett Sutton said health authorities are working on the hypothesis that those cases are all linked to the use of a nebuliser.

“That medical device is called the nebuliser and it vaporises medication or liquid into a fine mist and if that’s breathed in – especially when it is used as medication and someone is infectious or later tests positive – that [can transmit] the virus and that mist can then be suspended in the air with very, very fine aerosolised particles,” he said.

Holiday Inn workers’ close contacts test negative

The food and beverage worker tested negative at the end of her last shift on February 4, but developed symptoms two days later. On February 8, she was advised she was a “primary close contact” of a positive case at the Holiday Inn was required to get tested and isolate.

“She got tested on the morning of the ninth and returned a positive result,” Premier Daniel Andrews said.

Five of the woman’s 13 social and household contacts have so far tested negative.

Three cases have now emerged at the Holiday Inn in less than a week, while five have been detected in less than a fortnight across three Victorian quarantine hotels. Three are confirmed to be the more infectious British variant of COVID-19.

More than 950 hotel quarantine workers across the state’s program are now in isolation after being identified as close contacts of the three Holiday Inn cases, as well as the COVID-infected support officer from the Grand Hyatt and a guest at the Park Royal.

Guests at the Holiday Inn started being transferred to the Pullman Hotel on Tuesday night.

COVID-19 Quarantine Victoria, the government agency overseeing the quarantine program, said 48 residents at the Holiday Inn are being considered primary close contacts to the most recent cases.

Any guests who were due to leave quarantine in the next three days will be required to stay at least another three days.

“We understand this will be difficult news to receive and will do everything we can to ensure the health and wellbeing of these residents are supported during their new quarantine period,” the agency said in a statement.

“The transfer of the residents will be sequenced and coordinated, and there will be careful management of infection prevention and control measures.”

As well as this cohort of guests, anyone who undertook quarantine at the Holiday Inn in the past week is also being considered a close contact.

“All staff and residents at the hotel during the exposure period of January 27 and February 9 are considered primary close contacts and need to quarantine,” the agency said.

A source in the hotel program, who is not authorised to speak publicly about the matter, said the hotel would be closed for at least a week as the ventilation system in the hotel is reviewed.

The state government suspects airborne transmission of the virus has occurred inside the hotel.

The government has been preparing to open two additional quarantine hotels in recent weeks as Victoria is set to take hundreds more international arrivals this month. Capacity in these new hotels could make up for the lost capacity caused by the closure of the Holiday Inn.

Callers to radio station 3AW described seeing guests at the Holiday Inn being escorted out of the hotel on Wednesday morning.

A caller identified as David said he saw guests leaving the building one-by-one. “[They’re] walking them out one-by-one with the police obviously around and the medical workers escorting them out to the bus, so they’re definitely unloading the hotel,” he said.

Brisbane’s Hotel Grand Chancellor, which operated as a quarantine facility, was evacuated in mid-January after a casual cleaner tested positive for the highly infectious UK strain of the virus. Six cases were linked to a cluster traced to the seventh floor of the hotel.

All guests at the Grand Chancellor were evacuated individually in ambulances to another quarantine hotel and where they were required to restart their 14-day quarantine period.

“We moved each room in their own ambulance. We didn’t mix people. That’s why it took so long,” Queensland Chief Health Officer Jeannette Young said at the time.

Australian Medical Association president Julian Rait has called for the state government to release the results of an audit of the ventilation system in the Holiday Inn before it started housing high-risk returned travellers.

Professor Rait said serious questions remained about whether an adequate examination of the facility was undertaken before the COVID-19 outbreak emerged this week.

“I’d like to see the original audit to demonstrate if it was safe to use in the first place,” Professor Rait said. “We need to see if they have done this, and if not, we need to be asking why not?

“There have been three cases on one floor. One case is unfortunate, but two or three cases is careless.”

Two schools closed, new exposure sites in Sunbury

Text messages, seen by The Age, informed parents that Salesian College and nearby St Anne’s Primary School would be closed to students and staff on Wednesday as a coronavirus precaution.

The Health Department updated its list of exposure sites late on Tuesday night with seven venues in Sunbury, including Cellarbrations and several stores in the Sunbury Square Shopping Centre.

Anyone at those venues at the specified times must get tested and isolate for 14 days, regardless of their test result.

In a late Tuesday afternoon press conference, Victoria’s Chief Health Officer Brett Sutton said it was likely that the two new cases at the Holiday Inn were a result of transmission inside the hotel as they were on the same floor.

“At the moment [the investigation] is absolutely focused on that floor and all the individuals who have been on that floor – staff or residents – are going to be in quarantine and will go through the testing process,” Professor Sutton said.

“If there is any indication that the risk extends beyond that floor, then it is an option for us to close the hotel need be.”

Doctor floats caravan parks as an alternative to hotels

Dr Michelle Ananda-Rajah, an infectious diseases physician at Monash University said it was crucial to understand whether the latest cases in quarantine were instances of a “slow-burning” virus with long incubation periods, or whether people were actually catching the virus in the hotels.

“We’ve known for a long time, that COVID can be spread through fine aerosols, which basically accumulate in the air, remain suspended for hours,” she told Melbourne radio station 3AW on Wednesday morning.

“The issue though is that we haven’t really seen this addressed in any meaningful way by any level of government.

“It’s been discussed and floated people have talked about it and then danced around it but there really hasn’t been any meaningful interventions put in place to mitigate this risk.”

Dr Ananda-Rajah said she was opposed to extending the period of quarantine for overseas arrivals if it was found that new strains of the virus had longer incubation periods.

“If you go to Hong Kong, you have to quarantine for 21 days. And that’s been in place for quite some time there now there. [But] there are real humanitarian issues at play here as well,” she said.

“I don’t like the idea of putting people into hotel quarantine I think that no, there’s a real dark underbelly to all of this, which is the mental health effects on confining people in closed spaces with no access to fresh air.“

The doctor said she had even been mulling on the novel idea of housing quarantine cases at caravan parks, instead of hotels.

“I’ve been thinking to myself whether caravan parks might work. At least people would then get access to fresh air,” she said.

Berejiklian says Andrews “pretty good at spin”

Meanwhile, interstate tensions over standards in hotel quarantine have resurfaced.

NSW Premier Gladys Berejiklian took a swipe at Victorian Premier Daniel Andrews after he claimed Victoria had “higher standards” in quarantine hotels than NSW on Tuesday.

“I can foreshadow for you that we’re not going to anywhere near the capacity NSW has, we will have less capacity because we have a different model and I believe higher standards,” Mr Andrews said on Tuesday.

Speaking to Sydney radio station 2GB on Wednesday morning, Ms Berejiklian said her Victorian counterpart was “pretty good at spin”.

“He’s pretty good at spin and that’s all I’ll say. I think the people of NSW don’t want me to lower myself to those sorts of statements.”

The NSW Premier said she believed the success of a state’s hotel quarantine system should be measured by how many Australians have been returned home while keeping the community safe.

“All I know is that NSW has welcomed more than half the Aussies coming back home: when other states were in lockdown or refused to take people or weren’t able, we’ve done that on behalf of the states,” she said, adding that she did not believe any state’s system was perfect.

“Is the system in NSW perfect? No. And I would never boast about it.”

with Mary Ward