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.

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.

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.

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.

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

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.

Ref­er­ences
1. Libraries and archives NT. Span­ish Flu in the Ter­ri­to­ry, 1918 – 1919. (n.d.) Ter­ri­to­ry Sto­ries. https://​lant​.nt​.gov​.au/​e​x​p​l​o​r​e​-​n​t​-​h​i​s​t​o​r​y​/​s​p​a​n​i​s​h​-​f​l​u​-​t​e​r​r​itory

2. Aus­tralian Gov­ern­ment, D. o. H. a. A. C. (2020). Nation­al Review of Hotel Quar­an­tine. Aus­tralia: Depart­ment of Health and Aged Care. https://​www​.health​.gov​.au/​r​e​s​o​u​r​c​e​s​/​p​u​b​l​i​c​a​t​i​o​n​s​/​n​a​t​i​o​n​a​l​-​r​e​v​i​e​w​-​o​f​-​h​o​t​e​l​-​q​u​a​r​a​n​t​i​n​e​?​l​a​n​g​u​a​ge=en

3. INPEX Media Releas­es. (2013, Sept 18). Ichthys LNG Project’s Manig­urr-ma Vil­lage open for busi­ness. https://​www​.inpex​.com. au/news-and-updates/­me­dia-cen­tre/­me­dia-releas­es/ichthys-lng-project-s-manig­urr-ma-vil­lage-open-for-busi­ness/