Greater risk of aerosol transmission with the Delta variant has triggered changes to operation of MIQ – highlighting limitations to housing our MIQ facilities in hotels
The advent of a new strain of Covid – along with examples of transmission through the air overseas – have spurred the Government to take a look at the air flow and ventilation of New Zealand’s MIQ facilities.
But despite those in charge of MIQ admitting new variants of the virus require adaptation of how the facilities operate, many of the necessary adjustments will only be made towards the end of this year.
Joint head of MIQ Brigadier Rose King, who took over the role from Brigadier Jim Bliss earlier this month, said as the virus changes and adapts, so does MIQ.
“A lot of work has been going into scientific investigations into the role ventilation may play in airborne transmissions,” she said. “As well as the role positive and negative pressure plays in corridors.”
After the virus was transmitted across a hotel hallway in Adelaide in early May, it became apparent that the new Delta variant of Covid-19 would require new procedures to maintain the impenetrability of the MIQ system.
Delta’s increased ability to transmit by air means the changes announced and enacted in MIQ have focused on air pressure and ventilation.
“From the scientific literature, it is now clear that good ventilation in indoor settings is very important for preventing Covid-19 transmission,” said University of Otago epidemiologist Professor Nick Wilson.
But with 31 different facilities to deal with – all with their own inbuilt ventilation systems – some of these changes are only expected at the end of the year. And as the world learned in 2020, a lot can change in a span of six months.
Meetings have started with the owner-operators of MIQ facilities around the country to find out if hotel ventilation systems need renovation to decrease risk of transmission through the vents.
“It’s important to remember that hotels were never designed to be isolation or quarantine facilities,” King said. “The ventilation systems were designed to operate to meet hotel standards, they were never designed for viral containment.”
Work has been completed at the Pullman and Grand Mercure hotels in Auckland, and is underway at the Grand Millennium.
However, King estimated it may be months before the ventilation fixes are finished, potentially even the end of the year.
The delay may be down to the juggling act of renovating a working MIQ facility – there is a chance the facilities will need to be emptied before the work on the ventilation can be done.
“In order to do the work across the remaining sites, some of the facilities may need to be empty,” said King. “Obviously we can’t empty all our facilities at once, so we’re having to coordinate the work across the whole portfolio.”
The nature of this undertaking is complicated by the fact that each facility may need very different work done.
“Each facility is physically different in terms of its structure and how its ventilation systems operate,” said King. “The work undertaken at one site may be very different to the work required at another site.”
Needing to adjust an entire ventilation system may suggest hotels are an imperfect place to house those in managed isolation – a sentiment echoed in MBIE’s recent assessment of the MIQ system, which claimed issues with some aspects of operation came from not having purpose-built isolation facilities.
“It is very hard to ‘fix’ hotel quarantine facilities in terms of ventilation,” said Wilson. “This is why in Australia, they are expanding the Howard Springs facility outside Darwin with separate single-storied units, and why the Victoria government in Australia is starting to build new dedicated quarantine facilities.”
At the beginning of June, the Australian government announced a NZ$215 million, 500-bed dedicated facility to be built towards the end of this year outside of Melbourne.
MBIE’s assessment of the MIQ system said the experience with facilities that were previously hotels has raised questions as to whether purpose-built facilities are the way forward in New Zealand.
The report said it was not feasible to have dedicated facilities up and running by the time they were needed at the beginning of the pandemic, but suggested they could be a potential option in future: “Whether it is realistic to commission dedicated isolation facilities to be available for future pandemics would need to be subjected to a business case, taking into account a full evaluation of the effectiveness and cost of the experience with the Covid-19 approach to managed isolation.”
But even before the Government takes a look at the ventilation systems of the hotels in the MIQ system – and certainly before they look into building their own facilities – they are looking into other ways to clear the air.
Among these are air filtration units, which are being installed as an added layer of protection in hallways and lifts.
Operational changes have been made across all of the facilities to try and control air flow and reduce the chances of another Adelaide hotel hallway incident.
What this means is guests of the facility are required to close the windows in their rooms before opening the door – should they be lucky enough to have windows that open.
King said the preferred situation is that the MIQ rooms have negative air pressure, so “when room doors are opened, then air moves from the corridors and shared spaces into the rooms – not from the rooms to the shared spaces”.
MIQ staff no longer visit sequential doors – “rather, we ‘bunny hop’ and open alternate doors to limit the chance of air flows moving between rooms”, King said.
All of these measures hope to reduce the chance of travellers picking up the virus while in managed isolation. And with more than 140,000 people having been through the MIQ system so far, there are a lot of immune systems at stake.