Purpose building quarantine facilities

With quarantine continuing to be a critical part of the Australian response to the COVID-19 pandemic, the Australian Government is working with the states and territories to purpose build quarantine accommodation hubs outside of major cities. A purpose-built facility will be located outside Melbourne’s CBD, to combat and protect the community from COVID-19, with dedicated quarantine and emergency response facilities also planned for the Northern Territory, Queensland and Western Australia. The NSW Government has expressed interest in its own dedicated quarantine facility and is expected to put a proposal together to the federal government.¹

Victoria’s new facility — the Centre for National Resilience in Melbourne — will be constructed in Mickleham, at the site of the existing animal quarantine facility, owned by the Australian Department of Agriculture. Construction is anticipated to begin in September 2021, with the first stage of the hub anticipated to be operational in early 2022.²

Experts in public health and infection control have informed the design of the new hub, which is based on the existing standalone facility currently operating at Howard Springs in the Northern Territory. With its cabin-style, outdoor accommodation, Howard Springs has been widely acknowledged as the safest and most functional design for quarantine in Australia.

The master plan for Victoria’s hub includes dedicated onsite services, including catering that is tailored to be delivered alongside strong infection control and prevention measures. The first stage of the hub will provide 500 beds, with a second stage doubling capacity a short time later. The design will allow for an increase in capacity up to 3000 beds, as part of a scalable build if a larger facility is determined to be required at any point.

While being used for the purpose of COVID-19, COVID-19 Quarantine Victoria will run the facility. The hub’s cabins will be relocatable so that they can be used for alternative and future needs, including ongoing quarantine arrangements, crisis accommodation and other emergencies.

The hub will have the following strict measures in place for safety, security and infection prevention and control:

• All staff will be vaccinated before they work at the quarantine facility.
• All staff will undertake daily health screening, COVID-19 tests and temperature checks. Staff will also be encouraged to get tested on their days off.
• Contact between staff and residents will be minimal. When required, all staff will follow strict procedures and be fitted and trained in full PPE, including N-95 masks.
• Staff will be solely deployed to the mandatory quarantine program — they will not work anywhere else.
• Staff will be provided with everything they need onsite, including all meals, and will not leave the facility during their shift.
• Access to the hub will be strictly controlled and enforced by Victoria Police and highly trained staff.

The hub’s cabins will be relocatable so that they can be used for alternative and future needs.

In addition to these measures, the hub’s design will support infection prevention and control, including: 

• Ventilation systems for accommodation facilities similar to healthcare settings to ensure that rooms are provided with a constant flow of filtered fresh air.
• Cabin-style accommodation with entry/exit points from dedicated decks, so the virus won’t spread through shared internal corridors.
• Multiple separate self-contained blocks of approximately 60 cabins to accommodate up to 250 residents in each block, with dedicated entry and exit points.
• Staff will work on the same block each shift, limiting opportunities for transmission across multiple areas of the site.
• Onsite central services, including catering, laundry and administration, will support operations and limit the movement of goods and materials offsite.
   

In a June article published in The Conversation, infection control experts Associate Professor Philip Russo, Director of Cabrini Monash University Department of Nursing Research, Monash University and Professor of Nursing Brett Mitchell described the factors that should be considered when designing purpose-built quarantine facilities.³

Minimise interactions between staff and residents

According to Associate Professor Russo and Professor Mitchell, the design of quarantine facilities should be simple, reduce interactions between staff and residents, and allow for self-contained units that have their own ventilation systems.

“We need to support and meet the medical needs of residents. However, where these or any other support services can be done remotely or through technology, this should be encouraged. By doing this, we reduce the number of staff at the facility,” they wrote.

“We also want to prevent residents from physically interacting with each other. These measures reduce the chance of being exposed to the virus, and spreading it. So in a dedicated new facility, we need to design to avoid these types of close contacts and to have clear separation of residents’ living quarters.”

Russo and Mitchell explained that a variety of living quarters, such as separate units or apartments, should be able to accommodate not just single people, but family groups as well, especially those with young children.

The authors stressed the importance of the units being easy to clean and wipe down, with hard surfaces like those seen in hospitals.

“We need a GP-type clinic on site. For example, there will be pregnant women who need antenatal check-ups and people with chronic diseases who need monitoring,” they said. “Then there should be protocols for transferring people to hospital, if they need higher levels of care.”

All staff working at the facility will need to be fully vaccinated, and healthcare workers — primarily nurses but also doctors — will need advanced skills in infection prevention and control. Security staff and cleaners will also need to be trained and tested in using PPE.

“Auditing and monitoring compliance with infection control measures, including cleaning, will be important,” said the authors, who also highlighted the importance of clear and consistent policies about infection control, testing and transfers of residents.

References

1. https://www.abc.net.au/news/2021-06-06/nsw-government-welcomes-federal-hotel-quarantine/100193822
2. https://www.vic.gov.au/victorian-quarantine-hub
3. https://theconversation.com/this-is-how-we-should-build-and-staff-victorias-new-quarantine-facility-say-two-infection-control-experts-162157

Images courtesy of the Victorian Government.