29 Oct 2020

Epidemiologists propose partial home quarantine for travellers entering New Zealand

10:29 am on 29 October 2020

A group of top epidemiologists are suggesting that people arriving from places with a low Covid-19 risk spend part of their quarantine at home.

An Auckland isolation hotel

File image. Photo: Alexia Russell

It is one of several recommendations the scientists - Professor Nick Wilson, Dr Jennifer Summers, Dr Amanda Kvalsvig, Professor Michael Baker - claim could strengthen the country's response to Covid-19.

The group says: "The latest scientific evidence for viral excretion should be reviewed to re-evaluate the optimal time in these facilities. The current 14-day period could then potentially be reduced for those who are willing to have some home quarantine with appropriate safeguards ... another week in home quarantine after leaving MIQ facilities could be considered.

"This period could also involve digital technologies to ensure adherence as used in some Asian jurisdictions. For example, Taiwan is able to closely monitor individuals quarantined at home through personal phones or government-provided phones."

Other suggestions include considering suspending travel from high-risk countries, pre-travel testing and quarantine for incoming travellers and changing MIQ facilities.

Professor Nick Wilson

Professor Nick Wilson. Photo: RNZ Insight / John Gerritsen

Wilson, a public health expert from the University of Otago, told Morning Report: "We did a systematic look at all the different aspects of border control and one of these is to look at the countries people are arriving from and potentially put bans in place for countries with uncontrolled spread such as the US, UK, India, Russia and so on.

"In contrast to that, we could actually stratify countries which are very low risk and these could be places like Australia, Taiwan, Pacific Islands. And for those places, people could have a different type of quarantine arrangement.

"Maybe a week in a proper facility and maybe a week or two in home quarantine where they have more freedoms but also with digital technology to ensure they adhere to quarantine...

"There's a cost benefit of having more people use home quarantine and the evidence so far ... is that it can be done at quite a safe level.

"But it would still need to be done extremely carefully and it should in our view be backed up by other things to reduce the risk at the border such as pre-flight testing, actually redesigning some of our quarantine facilities ... maybe even moving quarantine facilities out of Auckland to reduce the risk of outbreaks spreading into the Auckland community, our biggest city."

Taiwan also used hefty fines to enforce the need to remain at home during quarantine, he said.

"There could also be screening systems so people who are not thought to be suitable for this type of home quarantine arrangement - if they have no suitable place to go to, or there has been difficulties with them."

Border controls - including preventing people returning from certain countries, had to be reconsidered because incursions were a "heavy burden" on the country, Wilson said.

"Our government needs to balance to rights of people to return ... with the rights of protecting New Zealanders from outbreaks and that's particularly protecting the most vulnerable... there is a real case for this type of so called right to return to be reviewed in extreme pandemic situations."

We need to move away from a one-size-fits-all approach, Wilson said.

"This is an ongoing, high risk situation, and there is no room for complacency at any level. It really is a time, with the new government, to take a serious look at doing things at the best possible level in all these possible domains."

Other measures recommended by the group:

  • Enhance mask use on flights by incoming travellers
  • Review domestic transport of incoming travellers to MIQ facilities
  • Review mechanisms of viral spread in MIQ facilities
  • Review risk management of international air crew
  • Review risk management of international shipping crew
  • Review role of imported cargo
  • Review routine testing of border workers / MIQ facility workers
  • Review health monitoring of close contacts of those in high-risk border-associated occupations
  • Implement wastewater surveillance for the pandemic virus in cities
  • Enhance year-round respiratory disease surveillance in the community
  • Implement improved digital technologies to supplement manual contact tracing
  • Revise the alert level system
  • Rapidly publish reports of border incursions/failures and breaches of MIQ

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