Shepparton coronavirus outbreak highlights Victoria’s COVID-19 contact tracing system
The spotlight has been thrown back onto Victoria’s contact tracing process this week, with the revelation a man who unwittingly sparked a coronavirus outbreak in Kilmore also visited Shepparton but did not initially tell authorities.
It prompted an acknowledgement from Chief Health Officer Brett Sutton that Victorian authorities might need to do more to interrogate the facts behind evidence given by people in contact tracing interviews.
A quick recap on how the outbreak spread
Authorities still don’t know how it began, but a household cluster broke out in Frankston, in Melbourne’s south-east.
That household included a cleaner, who worked at the Butcher Club in Chadstone between September 21-23, before calling and telling the employer they had been visited by police and told to stay home.
Two days later they tested positive to coronavirus, but the Department of Health and Human Services’ Jeroen Weimar said the cleaner did not disclose to contact tracers during interviews that they had worked at the Butcher Club earlier in the week.
“What would have made a difference in the Butcher Club is having a better understanding of the cleaner’s working experience there from the Frankston cluster,” he said.
The link was only discovered when a Butcher Club worker tested positive on September 28, and the shop was closed and staff told to quarantine.
But on September 30, as one quarantined staff member awaited their test results, one of their household contacts left home and went to regional Victoria for permitted work, stopping at Kilmore for breakfast and infecting a cafe worker.
That Melbourne traveller, who would later test positive, told authorities they also went to Benalla, but didn’t tell contact tracers they stopped in the regional city of Shepparton too.
The link was only discovered when a tyre shop worker at Shepparton tested positive to the virus on Tuesday night, and told contact tracers about their contact with the traveller.
A swift and aggressive outbreak plan was put into place, with everyone who had attended a list of exposure sites asked to get tested and to quarantine along with their close contacts.
Why was the visit to Shepparton not discovered earlier?
Mr Weimar said contact tracers asked the man for details of all of his activities in the days before his infection.
Mr Weimar said he did not believe further evidence was sought about the veracity of his answers.
On Wednesday, authorities again interviewed the man about his movements to ensure they had the full and complete picture.
Could phone data help contact tracers get the full picture?
Under Victoria’s state of emergency, the Chief Health Officer has extraordinary powers which can be invoked in the name of protecting public health.
Professor Sutton was asked on Wednesday whether this could include checking licence plate records with police or accessing mobile phone GPS data.
“I can share information with relevant agencies for the purpose of determining public health risk,” he said.
“I can request almost anything for the purpose of determining public health risk.”
When asked if contact tracers should consider requesting phone location data if they have a suspicion a person is not being forthright, Professor Sutton replied: “Yeah, I think so.”
Federal Health Minister Greg Hunt said the situation was “not acceptable”, but said he could not say whether authorities could have done more.
But he said he believed it was critical Victoria adopted “an entirely granular approach to each case, where they are using all of the available tools, in order to track them down”.
Should contact tracers adopt a higher degree of suspicion?
Professor Sutton was asked whether contact tracers should automatically assume every detail offered by a person needed to be independently verified.
He said authorities would “have to consider” working on the basis that they needed to go back to people to validate information.
“If we’ve got that suspicion that information is being hidden and there’s another mechanism to validate that, I’ll absolutely use those powers,” he said.
But he also noted that while using “every tool at our disposal”, he did not want to create a situation where people withheld information due to fear authorities would look at other personal data.
“There is a balancing act there as well, but if we have to interrogate phones for GPS information, those powers are available and we’ll consider them,” he said.
Professor Sutton also stressed it was important people felt supported to tell the full truth without fear of consequences for them, their income or their family.
“I recognise that there are issues that sometimes relate to a person wilfully hiding stuff and others who are genuinely fearful of consequences with respect of visa status — a lot of people have fears about what it might mean for their work,” he said.
“They should all be reassured that no employer has a right to sack you, to stop giving you hours because you become infected with coronavirus and subsequently recover.
“You have all of the normal entitlements of work that you have now.”
Mr Weimar told ABC Radio Melbourne the Melbourne traveller and Frankston cleaner were “particularly extreme” examples and outliers against the vast majority of Victorians working together as one community.
“The concern we have is we need to continue to explain to people, to appeal to all of our better instincts, because we still have months [to go in the pandemic],” he said.
Are people reminded they won’t be fined for rule breaches they disclose?
Professor Sutton said he would have to check how that critical information was being conveyed during interviews, but said contact tracers were trained to ensure that message got through.
Premier Daniel Andrews said “the treasure here is the truth”, and people would be supported for being honest.
“There is nothing to be afraid of,” he said.
“And no matter what you tell us about your movements you’re not going to get into trouble, we just need to know because that’s the most important thing.
“I don’t want to get to a situation where we’ve got to reverse the onus and we just assume everybody’s lying to us, I think that’s got a whole range of issues with it.”
Mr Andrews said DHHS was working towards a situation where a case or close contact will have ongoing communication with one contact tracer or team to facilitate a better relationship.
The ABC has asked DHHS for more information on the latest guidance and protocols behind contact tracing interviews to better understand these issues.
You could be fined for withholding information from contact tracers
Mr Andrews said the Melbourne traveller had been referred to the DHHS compliance team, who were in contact with Victoria Police, and could face a fine.
He did not outline what the specific offence or fine could be.
When asked whether people should be fined for lying during contact tracing interviews, Mr Andrews said: “Well I think that’s certainly more likely but I’m not the one issuing the fines.”
Support for extended quarantine contacts likely to be on offer
Around the time of the Kilmore outbreak, Victorian health authorities began asking not just close contacts of a case, but their immediate close contacts to enter quarantine as well for 14 days.
“It is an attempt to try and have perhaps some tighter settings in those that are most proximate to an outbreak that then allows the broader community to open up faster,” Mr Andrews said.
He said it was likely the same $450 isolation payment available to close contacts could be made to extended contacts being asked to quarantine.
How is Victoria’s contact tracing infrastructure shaping up?
Victoria’s public health infrastructure came into the pandemic in March less prepared than other states due to years of inadequate funding, Public Health Association of Australia chief executive Terry Slevin said.
“It wasn’t sufficiently resourced as we came into this pandemic,” he said, adding the crisis has shown the costs of underspending on public health.
At the start of the month, the Government entered into a contract with tech giant Salesforce in a bid to overhaul its contact tracing system.
Salesforce says its system, which is used in South Australia, Western Australia and New Zealand, will help contact tracers enter information into a single program and then map known contacts to piece together potential chains of transmission.
Mr Andrews said on Wednesday that system had been running in parallel with the state’s previous system, and a full switchover had either happened or would happen soon.
“What it allows us to do is have that connectivity of data, everyone’s looking at the same screen, the same picture in real time whether they’re in Shepparton, the outer suburbs of Melbourne or at Lonsdale Street,” he said.
He also noted National Cabinet had tasked Chief Scientist Alan Finkel with developing a national system that could be integrated with each state’s system to allow cross-border information sharing.
Mr Hunt said his number one public health focus at the moment was ensuring improvement in Victoria’s contact tracing continued.
“So there has been significant improvement, but honestly there is more to go,” he said.
Mr Slevin said there had been big steps taken since March, but an ongoing commitment to funding public health was needed to ensure those improvements were followed beyond the pandemic.
“In terms of gearing up that machinery in a short space of time, that’s an enormous challenge,” he said.
“To build the expertise you need takes years, if not decades and to build those systems to be solid and reliable, that’s an ongoing challenge.”