The weakest link

The perils of trying to maintain Covid-Zero

Welcome to Plugging the Gap (my email newsletter about Covid-19 and its economics). In case you don’t know me, I’m an economist and professor at the University of Toronto. I have written lots of books including, most recently, on Covid-19. You can follow me on Twitter (@joshgans) or subscribe to this email newsletter here.


The other day, I listed Australia as a place where things are working. They are … almost. Australia has a Covid-Zero policy that maintains tight border controls to keep Covid-19 cases to zero and allow pretty normal lives. The policy requires international travellers to spend 14 days in a Quarantine Hotel where they receive two PCR tests during their stay. This is an onerous requirement as tennis players travelling to the Australian Open recently found out. This policy should do the trick. But it hasn’t. Last week, Perth went into lockdown for a few days when a quarantine worker tested positive. This week, Melbourne faced restrictions. Both of these quick reactions have come from past experience that locking down early is better than waiting. However, one has to think of the cost here. Covid-19 is going to get to those hotels. That is the whole point. But those hotels are not bubbles. They have workers. That is the weak link.

To be sure, much is done to protect those workers. Hotels don’t operate normally. There are procedures to keep workers away from residents. So what happened?

Western Australia

Let’s start with Perth. What happened? Officials do not actually know.

Health Minister Roger Cook said it was suspected the transmission of the virus to case 903 happened on January 24.

The security guard was deployed at the hotel on that day as a “static” guard who sat in a chair at the end of the hallway on the same floor as quarantined guests.

Mr Cook said he was not required to wear a mask while he remained in that spot which was 3 metres away from the infected hotel guest.

“He was based, as I said, at a static location near the stairwell. At least two doors away from the room we think was responsible for the transmission of COVID-19,” he said.

“His role there was to monitor the floor to make sure no one left the room and, as I said, was sitting in a chair ... a safe distance from the room in question.”

Mr Cook said there were seven visits to the room of the COVID-19 infected guest but contrary to previous reports, the security guard had not been the one to deliver them medication.

“The security guard did not approach the door during the day,” he said.

The current blame is being placed on the lack of a mask requirement. But that is just a hypothesis. If you sit in a place all day, unless you have medical grade masks, a mask isn’t going to cut it against the new Covid-19 strain (which is what this was). It looks like reasonable precautions were being taken.

However, let’s look at the testing. First of all, quarantined travellers are tested just twice (usually a few days after they arrive and a few days before they leave). Why aren’t they screened daily using rapid antigen screens? It costs very little and can ensure that cases are picked up quickly and extra precautions are put in place so the workers aren’t exposed.

Second, what about the employees? The workers are tested but not often. This one had symptoms before he got a test. From here the plot thickens. From WA Today:

Daily testing of hotel quarantine workers, which could have identified WA’s first community transmission case of COVID-19 in nearly 10 months several days earlier, was only rolled out on Friday, Premier Mark McGowan has revealed.

Following a National Cabinet meeting on January 8 all states and territories agreed to roll out daily tests of hotel quarantine workers after a Brisbane hotel worker was infected with the highly transmissible UK COVID-19 variant.

Victoria had already been doing daily saliva testing and Queensland enacted their testing regime three days later but Mr McGowan said on Sunday that WA had only just finished testing its new regime at the Novotel hotel last week.

“We put in place the saliva testing as quickly as we could using the health department and appropriate protocols, unfortunately, it didn’t start until late this week,” he said.

“It’s not easy, it is a big exercise to roll out.”

Well, that really cheeses me off. Yes, it is hard to get screening in place (I know it more than anyone). But it is not hard to do it in a rough and ready way while you work out best practices. So in WA’s case, they missed it by that much. But if this is your weakest link why did the Australian government wait until this year to decide to roll out daily testing? It boggles the mind. It is mismanagement of the highest order.

Victoria

Let’s move on to Melbourne where another quarantine worked tested positive this week. In that case, there was daily screening. The details are still emerging on this one but it looks like all protocols were followed. The chances are that this is a case of the new variants being really powerful and even in a hotel spreading can potentially occur. But, interestingly, it seems that workers were tested (which is why this was caught) but again residents are not tested daily. That could have picked up those with high viral loads. In the end, because tennis players crossed over with all of this, some 600 of them are isolating again.

Nonetheless, this time around, you might be tempted to say, “it is what it is.” But it is February. A vaccine has been available since December. The Australian government has not rushed to procure vaccines. Nor should they necessarily do so as Australia is at Covid-Zero and doesn’t need mass vaccination as urgently as other places. However, Covid-Zero is a tough policy to maintain. You cannot tell me that it wouldn’t be possible to pay top dollar and procure vaccines for quarantine workers who, despite doing all you can, can still get infected and pass it through to the community. To be sure, if you have regular screening of everyone, there is a good chance leakages can be caught. But, there is a vaccine. The Australian government has sensibly placed these workers at the very front of the queue to get vaccines when they eventually arrive. But these workers and the country need them to have the best vaccines right now! The Australian government needs to be held to account for lockdowns and restrictions that occur that could have been mitigated by obvious, economically sensible actions.

Summary

My point here is not that there is a perfect way to keep hotel workers from becoming infected in all instances. There isn’t. Instead, because it is the weakest link to very sizeable costs, there is simply no excuse for skimping on any expenditures that could improve safety. Preventing just one ‘leakage’ can justify them all. Why that isn’t being done is beyond me.


What did I miss?