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The World Health Organization (WHO) announced overnight that the coronavirus (2019-nCoV) Public Health Emergencies of International ConcernEmphasize the need for countries around the world to take decisive action in the face of this epidemic.
The Australian government is currently negotiating with the Chinese government to arrange for some of the 600 Australian citizens stranded in Wuhan to return home.
The controversial plan would have kept the evacuees in quarantine. Christmas Island2,600 kilometres off the coast of Western Australia, where they will remain for 14 days.
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Many people condemn this measure In harsh response; healthy Australians were quarantined on a remote island, most notorious as a refugee detention centre, to protect the rest of the Australian population.
This practice of isolating large numbers of people is undoubtedly unprecedented in recent history. But how does it work? And does it work?
First, a little history
For thousands of years, isolating the sick has been the main means of preventing public health epidemics. First introduced As a strategy to stop the Black Death. Even as early as the Bible, there are records of isolating lepers.
Quarantining travellers was also common in Australia in the early days of colonisation. In the 19th and early 20th centuries, most Australian states set up quarantine stations to prevent people arriving by ship from spreading diseases such as measles, cholera and typhoid. If an outbreak occurred on board a ship, passengers would be quarantined upon arrival.
Glenn Hunt/AAP
The stations now sit silent and unused; reminders of a period in Australia’s history when deaths from infectious diseases were widespread.
Mass quarantines are considered a public health response from a distant era before antibiotics and vaccines. The quarantine of Wuhan evacuees on Christmas Island has no modern parallel in Australia.
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Why should healthy people be quarantined?
Some 7,818 Cases of the coronavirus have now been recorded worldwide, with 82 reported in 18 countries outside China.
We don’t have a vaccine or antiviral yet Preventing or treating virusesSo we need alternative strategies to slow its spread, including isolation and quarantine.
Isolating patients is a Effective ways to reduce transmission Virus.
For many viruses, an infected person can infect others only if they show symptoms of the disease.
But some viruses can be spread without symptoms — either during the incubation period (the days before people are obviously sick, thought to be Up to 14 days for coronavirus) or people who have never been sick.
Asymptomatic cases, where people infected with the virus do not show any symptoms, can quickly spread the disease to others without realizing it if they are in public.
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Unfortunately, preliminary evidence suggests that coronavirus Can spread When someone has the virus but appears well.
A woman from China was reportedly infected Four German colleagues During a training session in Germany. The woman did not feel ill until she flew back to China, so she may have infected her colleagues When she had no symptoms Or very mild symptoms.
Likewise, when an outbreak occurs within a household, Ten years old Although he had no symptoms, he was found to have the virus.
What are other countries doing?
Other countries include Japan and the United States are implementing voluntary quarantines for evacuees from Wuhan. In the United States, March Air Reserve BaseMilitary base in California is providing shelter for Wuhan evacuees 72 hoursThey are then monitored at home during the remaining 14-day incubation period.
But where do you quarantine large groups of people who may have a contagious disease if you don’t want to risk people not voluntarily self-isolating, especially when the number could be in the hundreds?
Home Affairs/AAP
If you choose to place them in a hotel, such as the current Chinese women’s ice hockey team debuts in Brisbaneyou need a hotel that is willing to take in potentially infectious people.
This can cause concern. What if other guests learn that there may be someone with a contagious disease in the hotel they are staying at? Do hotel staff also need to be quarantined? How can we ensure that people in quarantine do not leave the hotel?
A hospital might seem like a sensible choice, but you’ll need to use a lot of beds and resources to house and care for healthy people.
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Will it work?
Isolating Australians in remote detention centres in case they have a communicable disease is more like the script for a disaster movie than a modern public health response.
But from an outbreak response perspective, assuming Christmas Island has good medical facilities, the move should ensure early detection of illness in any evacuees and prevent further spread of the coronavirus.
That being said, we are still in uncharted territory. No one knows for sure whether quarantining the Wuhan evacuees on Christmas Island will be effective.
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