MIQ failings: City on verge of outbreak

Only the quick action of a Christchurch health worker prevented a wider Covid-19 outbreak in the city late last year, according to information in a new report.

The Canterbury District Health Board (CDHB) report by doctors working in managed isolation and quarantine (MIQ) facilities said poor ventilation and doublebunking among newly-arrived fishing crews helped spread Covid and led to two health workers becoming infected.

The outbreak affected 31 out of 235 Russian and Ukrainian mariners plus the health workers at the Sudima Christchurch Airport Hotel during October and November.

The report has prompted changes to the way large groups are managed in MIQ – including a second group of Russian and Ukrainian mariners who arrived this month.

It said the health worker took a Covid test the same day they developed a temperature and runny nose, and a day after feeling fatigued and receiving a negative Covid result. They then self-quarantined at home.

Before the positive test, the worker visited a local supermarket.

‘‘We are very grateful that this staff member sought testing for mild symptoms, even though [they] just had a negative test,’’ a letter from public health physician Dr Daniel Williams, which was included in the report, says. ‘‘It [they] didn’t, we’d be in a much bigger mess.’’

Emails from CDHB staff, released under the Official Information Act, show just three of the 235 fishermen spoke English.

An email written by CDHB medical officer of health Anna Stevenson said about two-thirds of the fishermen were chain smokers and made up to four visits an hour to the outside smoking area.

‘‘Compliance with requests to physically distance from other crew was patchy and in the first couple of days there [were] frequent exchanges of cigarettes, lighters, cellphones etc,’’ Stevenson wrote to Ministry of Health officials.

Dr Josh Freeman, a microbiologist and clinical director of infection prevention and control, also observed mariners moving back and forth through the hotel’s corridors to go to the smoking area. ‘‘In a hotel environment with poor ventilation in corridors, these factors all added up to being conducive to the inhalation of Covid-19 aerosols.’’

It was these risks that led to the eventual spread of Covid-19 to two health staff, he said. Both became infected despite ‘‘exemplary adherence’’ to personal protective equipment (PPE) recommendations and infection prevention protocols.

The report states each worker separately caught the virus from different fishermen who were highly infectious at the time. Both fishermen wore masks and the health workers were in full PPE, including a visor or goggles.

The report recommends catering better for smokers, as MIQ was not set up to manage large numbers of chain-smoking guests, and says having more translators was

‘‘critical’’ for non-English speaking groups.

It also said double-bunking (two beds per room) should not be allowed to happen again, an engineering review of ventilation in Canterbury’s MIQ facilities should be done, and CCTV cameras should be mandatory.

The Sudima does not have CCTV, the report notes.

The report found the outbreak among the fishermen ‘‘severely stress-tested’’ MIQ protocols. It is thought 12 of the men had Covid-19 on arrival in Christchurch.

Double-bunking was labelled as ‘‘problematic’’ and ‘‘patently absurd’’ by University of Otago epidemiologist and public health expert Dr Nick Wilson. ‘‘New Zealand just seems to . . . take shortcuts on the cheap.’’

Wilson said people would have been lifting their masks while sharing smoking areas.

‘‘This is just not how you do quarantine,’’ he said upon hearing that cigarettes were shared between returnees during their first few days.

Deputy director of public health Dr Niki Stefanogiannis said changes introduced included providing more translators, information and welcome packs in Russian and Ukrainian, and detailing expectations before people arrived. Double-bunking was banned, and smokers were allocated rooms with balconies to prevent groups gathering.

The Ministry of Business, Innovation and Employment had also formed a special team to handle large groups and make sure plans were in place for their arrival.

Officials were ‘‘working closely with the fishing companies’’, she said.