Australian Health Protection Principal Committee (AHPPC) statement on coronavirus (COVID-19) 26 February 2020
A statement from the Australian Health Protection Principal Committee about coronavirus (COVID-19).
COVID-19 continues to spread across the world with increasing case numbers in a growing number of countries on several continents. As at 26 February 2020 there had been 80,985 cases and 2,759 deaths, with 96 per cent of cases and 98 per cent of deaths in mainland China. Importantly, over the past two weeks, direct connections between cases in other countries and China has decreased.
AHPPC continues to monitor the effectiveness of the travel restrictions and self-quarantine procedures for people coming from mainland China.
These measures have been successful to date, with a more than 60 per cent reduction in travellers and no cases detected in more than 30,000 Australians returning from mainland China since 1 February 2020. This has been assisted by travel restrictions imposed by China. In addition, a significant number of students from China have spent 14 or more days in third countries and have arrived in Australia to commence or continue their studies, again with no cases detected in this group. The only new COVID-19 detections in Australia in the last two weeks are eight cases in Australian passengers repatriated from the Diamond Princess cruise ship. There remains no evidence of community transmission in Australia, with thousands of negative tests for COVID-19 in the last week alone.
The global epidemiology of COVID-19 continues to evolve. While there are a decreasing number of cases being reported in mainland China (outside of Hubei province), there is a materially increasing risk of sustained transmission being established in several other countries.
In the last few days, rapidly increasing numbers of cases of COVID-19 have been reported in South Korea, Italy, and Iran. The situation in Japan, Hong Kong and Singapore also remains a concern, together with several countries that have reported lower than expected numbers of cases, including Thailand and Indonesia. Whilst case numbers in some of these countries are rising quickly, the prevalence of illness is currently orders of magnitude lower than in Hubei Province.
An assessment of the risk of COVID-19 in those countries is based on many factors, including the identification of transmission chains, the number of reported deaths, recent trends in incidence, the incidence of exported cases and modelled estimates of expected numbers of cases based on travel patterns. The ability of countries to respond effectively to infectious disease outbreaks is also an important consideration, along with the feasibility of stringent mobility restrictions given the current phase of the epidemic globally.
With this change in epidemiology, extending travel bans to restrict travel from multiple countries is not likely to be feasible or effective in the medium term. However, it may be appropriate to consider self-isolation or practise social distancing upon return from higher risk regions.
Hubei province remains contained with travel restrictions in place, the risk to the Australian community from travellers from mainland China appears to have reduced significantly since the inception of travel restrictions on 1 February 2020. This could justify some further easing of travel restrictions.
AHPPC therefore recommends
- the general travel restrictions from mainland China remain in place and be reviewed again in one week;
- as previously indicated, consideration be given to a staged return of specified cohorts of Chinese students from mainland China (excluding Hubei province) being permitted to enter Australia, subject to appropriate screening, quarantine and monitoring to the satisfaction of the relevant state or territory public health authority and commensurate with the jurisdictional capacity to receive and manage students in keeping with risk at the time of travel;
- strict quarantine requirements continue to apply to any travellers (including returning students) who have been in mainland China or been in close contact with someone who is a confirmed case of COVID-19. That is, self-quarantine for 14 days from the date of departure from mainland China or from the date of last contact with a confirmed case;
- surveillance should be maintained to facilitate COVID-19 testing in symptomatic returned travellers from South Korea, Iran, Japan, Italy, Hong Kong, Singapore, Thailand and Indonesia but further travel restrictions are not recommended; and
- clinicians should consider testing for COVID-19 in hospitalised patients with pneumonia who have returned from any country in the last 14 days.