Control of COVID-19 in Australia through quarantine: the role of Special Health Accommodation (SHA) in New South Wales, Australia

Abstract Background The first COVID-19 cases were diagnosed in Australia on 25 January 2020. Initial epidiemiology showed that the majority of cases were in returned travellers from overseas. One aspect of Public Health response was to introduce compulsory 14 day quarantine for all travellers returning to NSW by air or sea in Special Health Accommodation (SHA).MethodsThe SHA was established with a comprehensive governance structure, clinical management through rpavirtual hospital remote management and site management with health care workers, NSW Police and accommodation staff.Findings From 29 March to 29 April 2020, 373 returned travellers were admitted to the SHA from Sydney Airport. 88 (26.1%) of those swabbed were positive for SARS-CoV 2, 0.91% of all returning air travellers. The day of diagnosis of COVID-19 varied from Day 1 to Day 13, with 63.6% (n=56) of these in the first week of quarantine. 50% of the people in the SHA were referred to rpavirtual for ongoing clinical management. 7 patients required admission to hospital for ongoing clinical care.InterpretationThe Public Health response to COVID-19 in Australia included early and increased case detection through testing, tracing of contacts of confirmed cases, social distancing and prohibition of gatherings. In addition to these measures, the introduction of mandated self-quarantine for travellers to Australia was integral to the successful containment of COVID-19 in NSW and in Australia through the prevention of transmission locally and interstate from returning travellers.