“You go to the local supermarket and it’s in the back of your mind: ‘Am I that person?’ And none of us want to be that person,” Abigail Trewin says.
It’s the keenest fear among staff managing quarantine for thousands of Australians arriving from COVID-stricken countries at the Centre for National Resilience.
Ms Trewin, from the National Critical Care and Trauma Response Centre — the specialist team managing international arrivals at the facility south-east of Darwin — worries one small slip-up could result in infectious staff moving through the general community.
It’s this concern that drives her team of nurses, doctors, support staff, caterers and security guards to deliver an infection control regime considered Australia’s most rigorous.
With hotel quarantine in other states repeatedly proving a weak link in Australia’s plan to protect the community from coronavirus, staff at the Howard Springs facility have taken on a significant role in the effort to bring Australians stranded overseas home.
Catch up on the main COVID-19 news from January 14 with our coronavirus blog.
Last week, the Federal Government confirmed the cap on international arrivals at the facility, a former workers’ village, is lifting from 600 to 850 people a fortnight.
In light of the news, the ABC was given a tour of the international landing pad attempting to withstand a constantly evolving threat.
Arrivals stay in dongas at the centre, which is a former workers’ camp.(ABC News: Jane Bardon)What does infection control look like?
Ms Trewin said many of the specialist medical staff bring experience from overseas disease outbreaks to their day-to-day work at the centre.
“When COVID started, we used a lot of what we had learned when dealing with Ebola to prepare our staff,” she said.
But the staff are continually training, doing practice runs of key exercises and refining their methods to provide the most rigid safety regime they can.
There are controlled entry points and QR code readers on every door, so there is a record of where all staff have been.
Staff practice and refine their infection control regimes constantly.(ABC News: Jane Bardon)
But risks persist and the centre’s manager of nursing, Kath McDermott, said the harsh conditions can lead to even the most experienced medical professionals making mistakes.
Fatigue and heat stress can be testing, especially as staff put on and remove full personal protective equipment — gowns, masks and double sets of gloves.
“All of us clinicians and support staff do daily PPE training, regardless of your seniority and your experience,” Ms McDermott said.
“Before being able to go into the ‘hot zone’, each staff member is individually trained and assessed.”
Kath McDermott manages nursing operations at the centre.(ABC News: Jane Bardon)What’s it like for people staying there?
Of the nearly 2,500 people who have stayed at the centre via the Federal Government’s repatriation flights, 57 have so far have tested positive to coronavirus.
Ms Trewin said her staff have been lucky that most of the cases haven’t been serious and people can be cared for on-site — but the news a resident has the deadly illness can provoke a range of responses.
“Generally, when you are advised of your status determines how people react,” she said.
Abigail Trewin says people in quarantine react differently to being told they have COVID-19.(ABC News: Jane Bardon)
“If you test positive on the first day of arrival, it’s not so terrible — you have 14 more days to go, which you were going to do anyway.
“But if you find out much later in your quarantine stay that you’re positive, that’s really distressing; you were already making plans to leave and now you’re being told you can’t.”
She said many of the new arrivals are surprised by how many people have coronavirus and, while they’re not frightened of their neighbours, people have been very compliant about wearing masks and not leaving their units.
Read more about coronavirus:How do they cater for hundreds of people?
People are given three meals a day at the centre, which means, depending on capacity, staff can be tasked with serving more than 10,000 meals a week.
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Hot dinners are made daily by a local catering company working at the site.
Cold breakfasts and lunches are delivered at the same time under strict conditions, catering director Amanda Swift said.
“Once we’ve packed those up, all 20-plus staff members go on-site and get a swab test done,” she said.
“Then we come back to get the hot food from the kitchen and we pack it all up onto trollies and we streamline it … to try to feed everyone in under 2 hours.”
“We get some beautiful feedback,” she added.
“I think they’re in shock about how fresh and healthy the food is. Everything is homemade.”
Catering staff face the task of preparing hundreds of meals every day.(ABC News: Jane Bardon)What are the biggest challenges?
For many of the staff, working outside, going between the units in temperatures of up to 35 degrees and 95 per cent humidity in full PPE has been one of the biggest challenges.
Registered nurse and midwife Melissa Taylor has just moved to Darwin to work at the facility for six months, particularly to provide care for people arriving while pregnant.
“I was in Melbourne working through the first and second wave, delivering babies in full PPE in hospitals, in the air-conditioning,” she said.
“Coming up here in the heat and the sun — and doing jobs like taking bloods in the heat — has been challenging.”
But she said different cooling strategies staff have developed, like regularly going into air-conditioned spaces, have helped.
Staff at the centre say wearing so much PPE in the stifling heat is one of the biggest challenges.(ABC News: Jane Bardon)What’s changed since the UK strain increased the risk?
Since the more infectious UK variant of coronavirus became a real threat, Ms Trewin has increased testing and segregation among staff.
There has been just one instance of the variant detected at the facility so far — a 26-year-old woman whose case was confirmed last weekend.
“Importantly, staff are now doing daily tests, which is a huge commitment — you ask staff to do a nasal swab, which is not very comfortable, every single morning, just to demonstrate that they continue to be safe.”
Staff at the centre do tests on one another as part of a training exercise.(ABC News: Jane Bardon)
The staff watch and check each other donning their PPE and they are photographed in protective gear each time they go into another area.
“A buddy system is designed to pull each other up, because two sets of eyes are better than one, and so any corrections can be made before we enter an area,” Ms Trewin said.
It is the same system on the way out: the careful removal of PPE is filmed and the videos are audited daily.
Staff at the centre keep thorough photographic records of their PPE.(ABC News: Jane Bardon)Stay up-to-date on the coronavirus outbreak
Staff are also segregated into sections in case any need to isolate and they don’t enter the section for domestic arrivals just over the fence.
At the end of each day, they remove and wash their uniforms, then shower on-site before finally heading home.
They are happy to do it all in the name of providing rigorous infection control.
“All of us have gone through the psychological challenge of working in an environment that is high-risk,” Ms Trewin said.
“The testing every day gives us all a little more confidence that we are good to go home every day to our families.”
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