Hotel quarantine: how secure is the system?

With hotel quarantine forming a crucial line of defence against variants of SARS-CoV-2, just how watertight is the system?

A 14-day period of mandatory hotel quarantine was introduced in March 2020 for those entering Australia from overseas. Since then, the suitability of hotels as quarantine facilities has been called into question, with concern growing over airborne transmission, more infectious strains of COVID-19 and several reports of breaches. With every hotel posing a different set-up and unique challenges, what can be done to make the system safer for guests and staff?

Many health experts are calling for the establishment of national standards for hotel quarantine facilities, to address the problem of continual breaches. In an opinion piece published in the Australian Financial Review, Professor Mike Toole from the Burnett Institute expressed his concern regarding the failure to do everything possible to ensure better control of air quality and aerosol transmission in quarantine hotels. With evidence that the virus can escape from a room into a corridor and even into other rooms via aerosol transmission, many health experts are calling for higher-grade, standardised PPE for hotel workers, including N95 masks and face shields, to treat hotel quarantine in a similar way to a clinical setting.

Ventilation

A key concern surrounding hotel quarantine is airborne transmission and the possibility that virus can circulate via the hotel’s ventilation and air-conditioning systems. Heating, ventilation and air-conditioning (HVAC) systems can be used as an infection control measure, but have the potential to contribute to the spread of airborne diseases if not used correctly.

Highlighting the role of ventilation in the spread of COVID-19, a collaborative study published in Proceedings of the Royal Society A, involving researchers from the University of Cambridge and Imperial College London, found that in poorly ventilated spaces the SARS-CoV-2 virus spreads further than two metres in seconds.

Dr Pedro de Oliveira from Cambridge’s Department of Engineering said the team’s mathematical modelling could demonstrate the quick spread of small infectious droplets over several metres in a matter of a few seconds and show how these droplets can accumulate in indoor spaces in the long term. Based on their models, the researchers have built Airborne.cam, a free, open-source tool that can be used by those managing public spaces, such as shops, workplaces and classrooms, in order to determine whether ventilation is adequate.

Taghrid Istivan, Associate Professor of Microbiology and Senior Program Leader of Biosciences at RMIT University, explained that the highly infectious and transmissible nature of new SARS-CoV-2 variants — combined with increasing evidence of small droplet and airborne transmission — makes it necessary to consider the shared ventilation and air-conditioning plans in quarantine hotel buildings.

“Hotels were not designed to control the airflow between different rooms and levels, which is necessary in respiratory hospital wards, for example. Therefore, a system similar to the Howard Springs facility in the Northern Territory, with separate ventilation for individual rooms, would be a safer option,” Assoc Prof Istivan said. “Furthermore, the use of the N95-grade masks and face shields in addition to other PPE measures should be considered for all staff working inside hotels where infected travellers are quarantined.”

Air purification technology

The Australian arm of Delos is importing surgical-grade air purification units to Australia that can filter and remove SARS-CoV-2 particles and reduce the viral load within hotel rooms where infected travellers are quarantining. The air purification units utilise electrostatic precipitation combined with mechanical filtration to capture and deactivate particles, bacteria and viruses. The unit also creates a bacteriostatic environment where microorganisms are unable to multiply inside the filter.

Delos Australia President Bill Giannikos said the air purifiers could be used in hotel quarantine to reduce potential viral load within rooms where returned travellers are quarantining or have been diagnosed with COVID-19, thereby limiting the risk of the virus infecting workers and return travellers.

“Air purification systems are considered by many to be a critical supplementary approach to reducing transmission rates by remediating airborne pollutants and contaminants. The ‘Delos powered by Healthway’ air purification units capture ultrafine particles and can reduce particles that carry airborne bacteria and viruses,” he explained.

“In these pandemic times, science-backed air purification units and considered ventilation systems form key components to any safe hotel quarantine setting; however, these should not be pigeon-holed to just quarantine programs. All building owners and managers have a duty of care to the public and need to stay on top of maintenance and servicing ventilation infrastructure to ensure people occupying their indoor spaces are safe from invisible airborne threats.”

Giannikos also discussed the challenges of achieving successful air purification in the hotel setting.

“Many hotels containing original ventilation systems have not been upgraded since they were installed during construction, nor are they designed to adequately filter indoor air. Our new ‘Delos powered by Healthway’ purifiers are capable of trapping and eliminating airborne particles down to 0.007 µm at 99.99% efficiency, smaller than the SARS-Cov-2 virus particles. These filters are an easy-to-move, freestanding unit that can also be wall mounted in a room of choice.”

Delos is liaising with several hoteliers in Australia to roll out the new ‘Delos powered by Healthway’ units. The recent partnership with workplace technology integrator Ci Group will see the unit and other advanced Delos wellness technologies offered to a broad range of hotel, health, and aged-care and commercial hospitality operators around Australia.

Australia’s hotel quarantine system has many challenges ahead, such as the continuing stream of overseas travellers, emerging variants of SARS-CoV-2, and the impact of the various vaccine programs being rolled out globally. Establishing national standards will help to keep the community safe as we navigate living with the coronavirus.

Image credit: ©stock.adobe.com/au/myboys.me