Another two individuals linked to Melbourne’s Airport Holiday Inn have tested positive to coronavirus, bringing the total number of cases in the cluster to 13.
- There are now 13 positive cases linked to the Holiday Inn Melbourne Airport outbreak
- One of the positive cases had been in a wastewater catchment where coronavirus fragments were earlier detected
- A list of coronavirus exposure sites was updated to include the Brunetti cafe at Melbourne Airport
The two infections were announced by the Victorian Department of Health late on Thursday and are both household primary close contacts of previously confirmed cases.
The Victorian Department of Health revealed that two household close contacts of workers, and another worker, tested positive.
It later announced that another location at the airport — the Brunetti cafe in terminal four — had been “added to our list of tier 1 exposure sites” after further investigations.
“Anyone who visited this location must isolate, test and remain isolated for 14 days,” the Victorian Department of Health said on Twitter.
It added that it applied to those who were at Brunetti between 4:45am and 1:15pm on Tuesday, February 9.
During an earlier press conference on Thursday afternoon, the state’s COVID-19 testing commander Jeroen Weimar confirmed that the two household close contacts were spouses of workers who had earlier tested positive.
He also said that a test of an assistant manager at the hotel had come back positive.
“The third case of today … is a staff member at the Holiday Inn, so this is somebody who worked directly in the Holiday Inn hotel. She was already a primary close contact, she tested yesterday and turned positive this afternoon.”
They were still in the process of identifying the movements of the latest cases prior to their isolation and the onset of their presumed infectious period, he said.
“That work is being done at this point in time,” Mr Weimar said.
There are now 13 positive cases linked to the Holiday Inn outbreak, which authorities believe was sparked by a COVID-positive resident who used a personal nebuliser while staying at the hotel.
Health officials believe mist from the nebuliser — a medical device that vaporises medicine — may have led to an “exposure event” that infected other people in the hotel.
Since authorities discovered the nebuliser last Friday, three workers and two returned travellers have tested positive to the virus, including two on Wednesday.
Mr Weimar said that genomics testing had confirmed that the first six cases were all the same UK variant.
“It is our working assumption therefore that all 11 cases associated with the Holiday Inn cluster are all of the UK variant,” he said.
CMO says household contacts ‘no added risk to the community’
At a press conference on Thursday afternoon, Federal Chief Medical Officer Paul Kelly said he had spoken to his Victorian counterparts several times in recent days and was “very confident” they were doing what they needed to.
Professor Kelly said that because both of the new cases were already in quarantine, there was “no added risk to the community”.
He added that he was “absolutely confident” the nebuliser infection was a single event.
There had been “many, many negative tests so far” aside from the two household contacts, he said.
“We are at day seven since that incident with the use of a nebuliser in a particular room on a particular floor of the Holiday Inn Hotel,” he said.
“All of the cases so far have been related to that floor … so I’m absolutely confident it was a single event and that hazard has been removed and so far now it is about making sure that anyone who might be in the community who is positive is found and isolated.
“So that is the issue in relation to the epidemic at the moment.”
Minister says case detected in area where wastewater ‘fragments’ were found
The cases confirmed on Wednesday were a worker at the Holiday Inn Melbourne airport, and an international traveller who completed hotel quarantine there. No new overseas-acquired cases were reported.
Authorities received 22,570 test results on Wednesday, a slight decrease from the 22,849 processed on Tuesday.
A new drive-through testing site has been set up in Sunbury, north-west of Melbourne, in the former Masters carpark across the road from Woolworths.
The health department has asked anyone who visited a “Tier 1” exposure site during the listed exposure period to immediately get tested and quarantine for 14 days.
The list of sites includes shops in Sunbury, Glen Waverley, Springvale and other Melbourne suburbs.
Anyone who visited the “Tier 2” Sunbury Square Shopping Centre between 3:40pm and 4:30pm on February 5 has been asked to get tested and isolate until they get a negative result.
Transport Infrastructure Minister Jacinta Allan said one of the people who tested positive on Wednesday had been in a wastewater surveillance catchment area that detected fragments of the virus.
“And that does put into context that unexpected wastewater detection that the Minister for Health spoke of yesterday, in that it’s now been revealed that it’s been linked to one of those new cases that has emerged,” she said.
Quarantine workers shouldn’t need N95 masks, says epidemiologist
The Victorian Government says protocols are being tightened to prevent similar exposure events.
However, experts say the incident points to broader problems with airflow, and have raised questions about whether hotels are suitable places to house COVID-positive patients.
Epidemiologist Mary-Louise McLaws, an advisor to the World Health Organization, said the rooms and corridors in quarantine hotels should get at least 10 air changes per hour, and wants to see a report confirming that is happening.
“Until we can prove that, then COVID-positive patients are in the wrong place, because those rooms are not air-ducted properly to clean out the particles,” she told RN Breakfast.
She also said while N95 masks were important for hospital workers doing procedures that generate aerosols, like intubating a patient, a face shield and surgical mask should be good enough for places with adequate airflow and ventilation.
“Going into the corridors should not pose such a problem that they [hotel quarantine workers] need to wear a fitted mask, because they also have to be fitted to ensure they’re the right size and the seal,” she said.
COVID-19 Quarantine Victoria (CQV) commissioner Emma Cassar confirmed a worker who was wearing an N95 mask was among the recent cases.
Nebuliser not ‘the question’, aerosols expert says
Lidia Morawska, an aerosols expert from the Queensland University of Technology, said people infected with the coronavirus would be breathing out virus “all the time”.
Professor Morawska said while using a nebuliser may have meant there was more virus in the room, she was still “scratching her head” about how it could been the main driver of the latest outbreak.
“It’s really not a question of what was happening in the room or was it the nebuliser or not, but how did the virus escape from the room? In my view this is the question, and this has not been explained,” she told ABC News Breakfast.
She said ventilation was “a significant means for controlling the virus”.
“In Melbourne, what happened in that hotel, in any hotel in Australia, where there were infections in Brisbane, Perth, Sydney, all these cases should be investigated, and with the specific focus of what is the airflow in this hotel, and how that airflow could have transmitted the virus from one place to another,” she said.
The Victorian Government has ordered a full ventilation assessment of all hotels in the quarantine system, to be carried out by an independent assessor with expertise in in-building safety and airflow. The assessment is expected to take about six weeks.
On Wednesday, Deputy Chief Health Officer Melanie Van Twest told ABC Radio Melbourne a ventilation assessment of the hotels was done when they were brought into use, and the engineering assessment said there was no air circulation between rooms.
She also said she understood that each hotel room should be negatively pressured.
However, she said the last engineering assessment was done about three months ago now, and the new variants that have emerged has made tackling the virus more challenging.
“We are doing everything we can to make it safe,” she said.