Crowne Plaza ready to receive returnees from Thursday

Crowne Plaza managed isolation facility ready to receive returnees from Thursday

The MIQ Technical Advisory Group (TAG) has recommended the Crowne Plaza can receive its next cohort of returnees on 9 September, as planned.

Joint Head of Managed Isolation and Quarantine Brigadier Rose King says this follows a thorough source investigation by public health experts, an additional Infection Prevention and Control assessment and a review of the public walkways next to the facility.

“The Crowne Plaza has been one of our best performing facilities and the TAG’s findings, and the additional assurance review, confirm that the procedures and ventilation at the facility meet the relevant IPC standards, and that the risk to members of the public passing by is so low, it is negligible”, she says.

“From a public health perspective, we believe the Crowne Plaza is safe to recommence accommodating returnees”, says Dr Ashley Bloomfield, Director-General of Health.

“An Auckland Regional Public Health Service investigation into the source of the current community outbreak has concluded that transmission to a member of the public walking through the public atrium at the Crowne Plaza is highly unlikely”, Dr Bloomfield says.

Brigadier King says modelling by engineers at the University of Canterbury suggests that the risk of infection to members of the public if an infectious case were standing in the facility lobby is very low.

“The TAG has also concluded that the risk to members of the public walking through the public atrium is “negligible” and there was no rationale or justification for shutting the public atrium”, Brigadier King says.

“While the source investigation was underway, a number of precautionary measures were taken, including extending the height of the Perspex barrier between the lobby and the adjacent public atrium to the ceiling where it has been sealed.

“The TAG’s review also considered the walkway by the returnee fresh air area, which the public uses to access the Huawei Centre. It found that the risk of exposure to members of the public walking past returnees as they arrived at the facility or while they were getting fresh air was “very low”, and that there was limited public health or IPC rationale in closing this area.

“Although the risk has been deemed very low, out of an abundance of caution we are taking the step of raising the wall of the walkway and placing a roof on top. The roof and wall of the structure will be covered with a plastic coating”, she says.

“The assurance review undertaken last week found that the Crowne Plaza meets the relevant IPC standards, with only minor recommendations for improvement – these included extra signage to remind returnees to sanitise their hands, increased signage for Red or Green staff only zones, and for all of these transition zones to have PPE stations. These will be actioned before the facility welcomes returnees on Thursday.

“MIQ is the frontline of our defence against Covid-19 and more than 170,000 people have been safely through our facilities. We are committed to constantly improving and to continually adding to the layers of defence we have to keep the community safe”, Brigadier King says.

Separately, the vaccination centre in the Atrium is moving to a larger location at 35 Graham Street, with a capacity to vaccinate 1000 people a day - about 400 more than the current site. While the existing centre in the Atrium is perfectly safe, the move will eliminate any concerns people may have had about getting vaccinated there and will also enable us to meet the increasing demand for vaccinations in the central city.

Background

On 9 August a returnee at the Crowne Plaza managed isolation facility tested positive for COVID-19. A returnee in an adjoining room subsequently tested positive also. No further arrivals were placed in the Crowne Plaza while a thorough source investigation was completed. An urgent review of events at the Crowne Plaza and audit of the IPC and ventilation systems was commissioned.

The final source investigation report determined that despite significant investigations into potential epidemiological links, the exact chain of transmission from the MIQ returnee is not able to be determined. This was after reviewing CCTV footage, access card data, and any other available information on the individual’s movements. It also included reviewing specific aspects of the ventilation system in areas where the index case had been.

On 2 September the MIQ Technical Advisory Group (TAG) was reconvened to provide advice on the continued use of the Crowne Plaza as a managed isolation facility. The TAG review did not identify any likely point at which the index case could have transmitted COVID-19 to the general public from the Crowne Plaza MIF.

Dr Ian Town, Chief Science Advisor to the Ministry of Health, was also asked to independently review the TAG’s findings and recommendations regarding the ongoing suitability of the Crowne Plaza as a managed isolation facility. Dr Town endorsed the final advice of the TAG.

The TAG also specifically considered whether transmission could have occurred from the index case to a member of the public walking through the public atrium at the Crowne Plaza. This public walkway, which is separated from the atrium by a Perspex barrier which blocks the two areas, was identified as a potential area where the index case could have transmitted COVID-19 to the community.

The TAG review concluded that the risk of infection to members of the public walking through the public atrium is negligible. This conclusion takes into account advice that:

a) The public health case investigation from Auckland Regional Public Health Service (ARPHS) to determine whether transmission could have occurred from the source case to a member of the public walking through the public atrium at the Crowne Plaza has determined that this is highly unlikely;

b) Modelling by engineers at the University of Canterbury suggest that the risk of infection to members of the public if an infectious case were standing in the MIF lobby is very low (<1%), even under ‘high risk’ ventilation and air flow conditions; and

c) Air flow measurements between the MIF lobby and public atrium also demonstrated that the public atrium was positively pressurised comparative to the MIF lobby, meaning air is more likely to move from the public atrium into the MIF lobby than the reverse.

In this context, TAG also concluded that from a public health and IPC perspective, there is therefore no rationale or justification for shutting the public atrium for any period of time to members of the public. Despite the low risk, the TAG recommended some precautionary measures, primarily - sealing the gap in the Perspex screens separating the public walkway from the MIF lobby. This work has been completed.

Review of IPC at the Crowne Plaza

MIQ operates an ongoing programme of audits of IPC measures, to ensure facilities and practices in managed isolation facilities continue to meet latest IPC standards, including as changes are made in line with evolving scientific understanding of COVID-19 and the risks it poses.

The Crowne Plaza last had a routine IPC audit in June 2021. This audit raised a number of recommendations, related to the exercise area on level 12, smoking areas outside front entrance and inside, social distancing and hand sanitising. All recommendations following that audit were actioned and closed off by 25 June 2021.

An additional IPC audit of the Crowne Plaza was carried out on Wednesday 1 September, following the implementation of a number of measures, both corrective and precautionary. This audit confirmed that the Crowne Plaza meets relevant IPC standards, and was provided to the TAG.

Precautionary measures now in place across all managed isolation facilities

While the source investigation was underway and while the exact nature of transmission from the MIQ returnee couldn’t be confirmed, the MIQ TAG recommended a number of precautionary measures to further reduce the risk of transmission between returnees across all managed isolation facilities, including:

· Updating information provided to returnees on the importance of minimising opening of doors, and of wearing a mask when they are required to open their room door or exit the room;

· Prioritising day 6/7 testing for all returnees on the same floor as a positive case;1 and

· Further reviewing in-MIF processes to reduce the need for returnee movements and reduce the risk of returnees opening doors at similar times.

All recommendations of the TAG review have now been implemented across all managed isolation facilities.

Membership of the MIQ Technical Advisory Group

Pauline Sanders (Northern Managed Facilities),

Emma Hickson, Dr Jeremy Tuohy, Hannah King, Rachael Hopkins, Emma Prestidge, Miranda Walker (Ministry of Health),

Dr Felicity Williamson, Dr Sally Roberts, Dr Jay Harrower (ADHB),

Dr Joshua Freeman (CDHB),

Dr Michelle Balm (CCDHB),

Michael Kerr (Independent Consultant, Mechanical Services),

Ross Major (HVAC Engineer),

Shayne Gray, Daniel Hunt, Tess Ahern, Richard Nicholls, Richard London (MBIE- MIQ)

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