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Ready for the next pandemic?

12 Dec 2023

Is Australia ready for future pandemics? Whether we can curb the spread will depend on the nation’s ability to run effective quarantine facilities, writes Senior Research Officer, Angela Sheedy. Along with a project team at Charles Darwin University Menzies School of Medicine, she has recently made her contribution to the cause, distilling the lessons from the successful Howard Springs Quarantine Facility into a set of open-access online guidelines.

Did you know, the first case of the Span­ish flu pan­dem­ic of 1918 arrived in Aus­tralia in Dar­win? Due to quar­an­tine poli­cies, the case was iso­lat­ed at Chan­nel Island and the flu nev­er spread to the com­mu­ni­ty. It was not until 1919 when a ship from inter­state brought the virus to NT soils that Span­ish flu spread across the Ter­ri­to­ry (inter­state ves­sels not required to quarantine).¹

Sound famil­iar?

In mod­ern his­to­ry, we no longer saw a need for quar­an­tine. This was thanks to pub­lic health actions such as vac­ci­na­tions, and estab­lished and enforced cus­toms and bor­der poli­cies and process­es. COVID-19 re-intro­duced quar­an­tine prac­tices to Aus­tralia and the world, but it was prob­lem­at­ic to see where this ser­vice belonged.

In some parts of Aus­tralia, it was man­aged by police; in oth­ers, by the health depart­ment. Quar­an­tine appeared in hotels, spe­cial care hos­tels and stand-alone facil­i­ties, each offer­ing vary­ing lev­els of health sup­port for res­i­dents. It was con­fus­ing for staff, caused anx­i­ety and fear for res­i­dents and in some cas­es led to large out­breaks of COVID-19 into the wider community.²

As we are aware it is not a mat­ter of if, but a mat­ter of when the next pan­dem­ic occurs and we owe it to health staff and com­mu­ni­ties to be bet­ter pre­pared next time. This means pre­plan­ning for a coher­ent quar­an­tine ser­vice response.

CNR domes­tic res­i­dent arrival, August 2021

CNR staff in Orange Zone

Howard Springs Quar­an­tine Facility

Locat­ed approx­i­mate­ly 30km out of Dar­win, The Cen­tre for Nation­al Resilience (CNR), Howard Springs Quar­an­tine Facil­i­ty was orig­i­nal­ly Ichthys LNG Project’s Manig­urr-ma Vil­lage (work­ers camp) able to hold around 3,500 workers.³

On com­ple­tion of the Ichthys LNG project the site was hand­ed over to the NT Gov­ern­ment in ear­ly 2019 and was vacant at the time the COVID-19 pan­dem­ic arrived.

Reflect­ing the diverse and inno­v­a­tive pan­dem­ic respons­es of health staff, the site con­sist­ed of a large health and nurs­ing lead­er­ship team and pro­vid­ed res­i­dents access to basic pri­ma­ry health services.

Senior nurs­ing staff received CRANAplus ALS, REC and MEC train­ing to assist with onsite res­i­dent emer­gen­cies and a pri­ma­ry health-based tran­si­tion to prac­tice nurs­ing course was estab­lished with the Aus­tralian Pri­ma­ry Health Care Nurs­es Association.

CNR work­ing site map with res­i­dent zones marked

New health team mod­els were intro­duced, with hybrid approach­es of non-health/ad­min­is­tra­tion staff trained to work along­side nurs­ing staff and the site saw the intro­duc­tion of the Assis­tant in Nurs­ing role, bring­ing stu­dent nurs­es offi­cial­ly into the NT Health work­force for the first time.

The site quar­an­tined over 33,000 res­i­dents from human­i­tar­i­an flights such as Afghan refugees, repa­tri­at­ed Aus­tralians from across the world, inter­na­tion­al trav­ellers inclu­sive of CDU stu­dents and fruit pick­ers, and domes­tic residents. 

At its peak, the site host­ed 2,600 res­i­dents onsite with over 500 staff.

CNR Green Zone signage

Despite hav­ing staff work­ing in a hot trop­i­cal region with risk of heat stroke, res­i­dent snakes, and many oth­er chal­lenges in this unique health work­force envi­ron­ment, the site upon its clo­sure in June 2022 had no record of COVID-19 trans­mis­sion from res­i­dents to staff.

Apply­ing the lessons learned

At Charles Dar­win Uni­ver­si­ty, Men­zies School of Med­i­cine, a project team set out to deter­mine what was required for a coher­ent and sup­port­ive quar­an­tine ser­vice with a focus on the Cen­tre For Nation­al Resilience (CNR), Howard Springs Quar­an­tine Facility.

CNR nurs­ing staff skills refresh­er and training

This project sought to learn from CNR’s quar­an­tine ser­vice deliv­ery and res­i­dent care that con­tributed to its suc­cess and present these as an open-access resource for use in future pan­demics; a quar­an­tine 101 guide. Ulti­mate­ly, it’s the resource we nev­er want to use but know we need to have.

The out­comes of the project have now been col­lat­ed to inform a set of six guide­lines pre­sent­ed for use as an open-access web resource across:

1. Process­es, infra­struc­ture and communication

2. Infec­tion pre­ven­tion and control

3. Health Workforce

4. Res­i­dent care

5. Health, well­be­ing and clin­i­cal care

6. NT COVID-19 response

Aer­i­al pho­to of CNR site

The guide­lines are tes­ta­ment to the dili­gence of the site’s work­force to estab­lish coher­ent pol­i­cy and processes. 

They present a resource that can be used local­ly and glob­al­ly, not just for future pan­demics but for any health dis­as­ter or emer­gency where iso­la­tion or quar­an­tine is required.

To access the web­page, vis­it quar​an​tine​-guide​.cdu​.edu​.au
To enquire about the project, email QuarantineGuideContact@​cdu.​edu.​au