Covid-19

Managed isolation ‘a system under extreme stress’

A review of the Government's managed isolation and quarantine facilities at the border has found "a system under extreme stress," Marc Daalder reports

The Government has responded to a review that found its managed isolation and quarantine operations were "under extreme stress" by pumping more staff and money into the system.

The review, carried out by NZDF, police and corrections personnel, found that the managed isolation and quarantine project was "not readily able to respond to the increasing demands being placed upon it" under Level 1. Increased flows of arrivals, combined with the difficulty of balancing Level 4 conditions inside facilities with lax restrictions in the surrounding communities, have left staff demoralised and the broader system faltering.

"The staff servicing the MIQ [managed isolation and quarantine] system have almost all been involved in the response for a significant period with little or no real respite. Fatigue increases the risks of error," the review stated.

"Current staff resourcing to coordinate the MIQ system is sufficient only to manage the immediate issue of trying to balance limited bed space against increasing passenger numbers."

The Government is taking action "swiftly to address all the issues that this review has identified to ensure we have the capacity and procedures to keep the system robust and working efficiently" Housing Minister Megan Woods, who was put in charge of the operation after two people left managed isolation without a test and tested positive on two weeks ago, said in a statement.

This will include sending in more Ministry of Health staff to ensure health checks are delivered consistently and to provide support for other health issues, like mental health problems and addiction.

The Government will also increase security for transferring returnees to facilities, standardise procedures across facilities and communicate better with both returnees and the communities where they will be located.

The review's main conclusions found the system under-resourced and struggling to respond to policy changes that were issued on short notice.

"There were occasions when policy decisions were made with little understanding of the operational consequences. These occasions have increased the stress on staff on the ground," the review found.

"The policy to implement testing at days 3 and 12 was enacted without notice causing a significant bottleneck in the system and frustration. Attempts to prioritise the day-12 samples were unsuccessful due to laboratory constraints."

In response to the review, the Ministry of Health will be amending its testing regime to ensure results of day 12 testing are available the next day, so further delays are not experienced.

From a system and operational perspective, the different agencies working in the facilities were too siloed, the review found. 

"It appears that the system response is not sufficiently integrated. There are occasions when independent actions are appropriate, such as the provision of specialist medical advice, but too much separation hampers decision-making and co-ordination," the review stated.

The review said a national strategic planning capability should be developed and lines of accountability need to be cleared up, in part through dissolving many of the organisational silos.

Flight manifests are also provided on short notice, meaning those involved in high-level planning are unable to look too far ahead.

"Flight manifests are not received by the system until the inbound aircraft departs its overseas origin. This impacts significantly on the ability to commence planning prior to physical entry into NZ, particularly for flights from Australia," the review stated.

"An investment in strategic planning will result in better resource allocation, a cost- effective operation and enhanced trust and confidence in the MIQ process both from staff and returnees," it recommended.

The system for transferring people to managed isolation in particular is also lacking, the review found. People are shepherded through the arrivals hall to buses, which "increases the risk of absconding, as well as contact with the families and members of the public, while transferring to coaches".

PPE is also not required to be worn by returnees during this process. The review recommended a more efficient process and a review of the PPE policy.

The review also wanted to see facilities located away from CBDs, as they provide limited space for physical exercise without coming in contact with the public and make safe and isolated transfers of people more difficult. The Jet Park Hotel, which the reviewers visited, was considered an excellent example of managed isolation and quarantine, but the review recommended splitting the quarantine function into a separate facility.

A permanent police presence at managed isolation facilities should be considered, the review stated.

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