December 6, 2020

From hotel to pizza shop to lockdown: has South Australia learned Victoria’s Covid tracing lessons?

https://www.theguardian.com/australia-news/2020/nov/19/from-hotel-to-pizza-shop-to-lockdown-has-south-australia-learned-victorias-covid-tracing-lessons

As tense South Australians swirled around Unley Shopping Centre on Wednesday afternoon trying to figure out what to buy for their first full lockdown – “screw essentials, I need ice-cream!” – council worker Anne Ross was standing in the long queue for the supermarket, calmly preparing for her third time around.

Ross had secured an exemption to enter SA from her home state of Victoria several weeks earlier, escorted by police to Adelaide, so she could grieve with relatives after her mother died.

Little did she anticipate how the tables would turn. “Now I’m stuck here,” she tells Guardian Australia with a laugh.

Ross hopes the six-day lockdown announced for SA on Wednesday doesn’t develop into the marathon she experienced at home.

“I think South Australia is in a fortunate position, in that they can learn from what happened in Victoria,” she says.

The daily press conferences are a similar experience, but the Victorian premier, Daniel Andrews, has been swapped out for his South Australian counterpart, Steven Marshall, and in place of Victoria’s chief health officer, Prof Brett Sutton, is SA’s calm voice of scientific authority, Prof Nicola Spurrier.

The biggest difference Ross has noticed in the response so far has been in the detail of the contact-tracing announcements “right down to the number of minutes someone was in a particular location”.

Adelaide residents queue for supermarket shopping after South Australia was thrown into a snap six-day lockdown.



Adelaide residents queue for supermarket shopping after South Australia was thrown into a snap six-day lockdown. Photograph: Peter Mundy/Speed Media/REX/Shutterstock

Spurrier has been able to provide the public with a detailed breakdown of possible transmission sites across Adelaide.

Dr Stephen Duckett, the health program director for the Grattan Institute, agrees South Australia has had an opportunity to learn from other states.

“NSW was the first to do tracing of contacts at the second level, they shared this with Victoria, and now we see it in South Australia,” he says. “There’s a good network of sharing experiences between the states.”

SA approaches it like this. Once SA Pathology has processed a positive case, it immediately alerts the SA Health contact-tracing team, which attempts to call the patient within a few hours.

In detailed phone interviews, the contact tracer records who the patient came into contact with and where they went.

Contacts of positive cases receive daily messages or phone calls to find out if symptoms have developed, to determine if they need to get tested.

The investigation into the cluster that has since shut down the state began after a woman in her 80s presented to the Lyell McEwin hospital with symptoms on Friday evening.

She tested positive, and contact tracers identified that her daughter worked as a cleaner at the Peppers quarantine hotel, where she is believed to have contracted the virus from a contaminated surface.

The cleaner also infected two security guards. None of the hotel quarantine workers exhibited any symptoms, but passed the virus on to their family members.

One day after the positive case was identified, Spurrier was able to provide the public with a list of potential transmission sites and times, which has continued to grow over the subsequent days.

More than 4,000 people have been ordered into quarantine.

Of particular concern is potential transmission through the Woodville Pizza Bar, which employed a worker who also had a part-time role as a security guard in hotel quarantine.

All customers who visited between 6 and 16 November have been ordered to self-quarantine, along with those they live with, and get tested.

Similar advice was issued to visitors to the Aquadome aquatic centre between 11am and 1.30pm on 14 November and the Lyell McEwin hospital emergency department, coinciding with the visit of the first identified case between 5.30pm on 13 November and 8am on 14 November.

On Wednesday, Marshall and Spurrier together announced a six-day lockdown, to serve as a “circuit breaker” to give contact tracers more time to catch up with the virus’s progress. As of Wednesday, 22 cases had been directly linked to the cluster, with a further seven suspected cases.

“All of the cases … have been linked and that is a phenomenal effort,” Spurrier said. “It means that we are very early at the beginning of this, and we have a very short window of opportunity to close it down and stamp it out in our communities.”

But Duckett notes there are lessons the state has failed to learn from the Victorian experience.

Hotel quarantine workers were tested only if they exhibited symptoms, meaning they had already spread the virus in the community by the time it was detected.

SA hotel quarantine workers are now subject to mandatory weekly tests, a standard which is set to be rolled out nationally.

“Another thing that surprised me is that at least one of the security guards had a second job,” Duckett says. “They should have had full-time security guards: this is something we learned from the aged care experience, when workers with multiple jobs proved to be risks.”

Back in the queue at Unley Shopping Centre, Ross is reluctant to be too harsh. “It’s great to look back and talk about what they could have done, like testing staff weekly, but I don’t know, I think it’s unlucky.”