Managed quarantine (including hotel quarantine) for international arrivals to Australia continues to be important in Australia’s response to COVID-19. It helps to prevent transmission of COVID-19 and protect the Australian community. The Australian Health Protection Principal Committee (AHPPC) continues to monitor current quarantine arrangements and look for ways to continuously improve our system, in line with the National Hotel Quarantine principles.
The Communicable Diseases Network Australia (CDNA), the Public Health Laboratory Network (PHLN) and the Infection Control Expert Group (ICEG) inform this work.
The AHPPC recommends that:
- checks, audits and reviews should focus on compliance and identifying existing controls that need to be modified or where additional controls are needed
- states and territories regularly review their quarantine program to identify and address ways to improve
- jurisdictions should have assurance processes to support continuous improvement
- managed quarantine programs support vigilance, best practice, and quarantine workers to raise issues
- audits, evaluations and reviews should be shared with other jurisdictions.
To best support continuous improvement in quarantine processes, the AHPPC will discuss emerging evidence and managed quarantine issues every week.
Managed quarantine for international arrivals to Australia - including hotel quarantine and other highly controlled settings - is Australia’s first line of defence against COVID-19 and continues to play a vital role in Australia’s public health response. Our rigorous quarantine system has allowed Australia to succeed in implementing a suppression strategy, with a goal of no community transmission.
The Australian Health Protection Principal Committee (AHPPC) continues to consider current managed quarantine arrangements. The goal of managed quarantine is to prevent transmission of COVID-19 and protect the Australian community. In line with AHPPC’s National Hotel Quarantine Principles, AHPPC has considered options for continuous quality improvement processes to strengthen and optimise Australia’s managed quarantine program. AHPPC has been guided by the expert advice of the Communicable Diseases Network Australia (CDNA), the Public Health Laboratory Network (PHLN) and the Infection Control Expert Group (ICEG).
Framework supporting continuous improvement in managed quarantine
AHPPC considered processes for quality assurance, review and continuous improvement in managed quarantine. AHPPC recommended that:
- Checks, audits and reviews are to focus on assuring compliance and on identifying aspects of the system that could be managed by the modification of existing controls or by the application of additional controls.
- Risk mitigation strategies and resourcing decisions should be informed by the Hierarchy of Controls to prevent and reduce transmission of COVID-19.
- The hierarchy of controls ranks mitigation measures by the level of protection and reliability, so that higher level controls are implemented, where possible.
- For example, pre-flight testing of individuals aims to prevent importation of COVID-19 into Australia – a higher level control. Whereas the use of Personal Protective Equipment (PPE) is a lower level control aimed at protecting workers from transmission.
- States and territories will regularly review their managed quarantine programs to identify and address areas for improvement as they arise.
- Jurisdictions should develop assurance processes for managed quarantine programs to inform and refine processes and support continuous improvement.
- Programs should consider the inclusion of routine regular monitoring and compliance.
- Formal reviews should be conducted following transmission events to inform best practice arrangements.
- Assurance processes should take into account differences between jurisdictional guidance and operations.
- Jurisdictions may also consider peer reviewing managed quarantine programs, from time to time.
- Managed quarantine programs encourage an environment of constant vigilance, reinforcement of best practice, and high levels of support for quarantine workers to raise concerns and issues within their employment setting through a culture of speaking up for safety.
- The results of audits, evaluations and reviews be shared with all states and territories to facilitate learning and the continuing development and implementation of best practice.
- This will include establishing a national register of formal audits and reviews into managed quarantine.
AHPPC will continue to consider lessons learned in managed quarantine settings and will discuss on a weekly basis. This will include considering the results of audits and any future reviews into managed quarantine. Regular routine consideration is designed to support a process of continuous improvement. Future guidance regarding managed quarantine will consider the outcomes of reviews, audits and evaluations to optimise national arrangements.
Priorities for continuous improvement
Given the emergence of COVID-19 variants of concern and acknowledging recent incursions linked to managed quarantine, AHPPC has highlighted the importance of continuing to evaluate new research and evidence to optimise managed quarantine arrangements. AHPPC has identified a range of priority matters requiring further consideration and research. AHPPC has requested the assistance of expert committees including ICEG, CDNA, PHLN and the National COVID-19 Health and Research Advisory Committee (NCHRAC) to consider current and future priorities.
AHPPC will continuously evaluate emerging evidence and apply findings and lessons learned to managed quarantine policies. AHPPC will consider the expert advice of ICEG, CDNA, PHLN and NCHRAC during the AHPPC’s weekly discussion on managed quarantine. AHPPC’s priority issues will continuously evolve in line with the findings of audits and reviews, in order to best support continuous quarantine improvement processes.