The new infections takes the number of cases linked to the Holiday Inn to eight.
A returned traveller, who tested positive to the virus after finishing her 14-day quarantine period, and a food and beverage worker tested positive on Tuesday and an authorised officer from the hotel tested positive on Sunday.
Three people from the same family who stayed at the Holiday Inn had earlier been moved to a health hotel after testing positive for COVID-19. One of them has since been admitted to intensive care.
Authorities have identified two initial exposure sites linked to the latest former resident infected. The person was at a Commonwealth Bank branch in Glen Waverley between 1.30pm and 2.45pm on Tuesday, and the HSBC Bank in the same south-eastern suburb between 2.15pm and 3.30pm the same day.
There are currently no exposure sites linked to the latest quarantine worker.
South Australians were given eight hours to return home or risk being forced into quarantine after the state’s Chief Health Officer, Nicole Spurrier, and Police Commissioner Grant Stevens announced tougher border restrictions with Victoria about 4pm on Wednesday.
Professor Spurrier said the state was being “extra cautious” in reimposing border restrictions, saying the British variant was of “particular … concern” to health authorities in South Australia.
Victorians cannot travel to SA if they are coming from the greater Melbourne area, and SA travellers wanting to come home will be subject to 14 days in quarantine if they don’t return before midnight.
“Persons who have been in Greater Melbourne on or after 4 February 2021, will be prohibited from entering South Australia unless they are an Essential Traveller or an exempt person,” an SA police statement released late on Wednesday said.
“In addition, this includes a person or a close contact of a person who has been physically present on the site of the Holiday Inn … on or after 12.01 am 27 January 2021 for greater than 15 minutes.”
Victorian authorities earlier on Wednesday said they suspected the use of a nebuliser by a COVID-infected guest caused the spread of the virus at the Holiday Inn.
Returned travellers were evacuated from the hotel at Melbourne Airport and two Catholic schools in Sunbury also closed on Wednesday after Tuesday’s cases were announced.
Authorities are bracing for more community infections after daily testing found COVID-19 fragments in wastewater in areas where close contacts of the recent confirmed cases live.
The nebuliser theory
Victoria’s Chief Health Officer, Brett Sutton, said health authorities were working on the hypothesis that the recent cases were all linked to the use of a nebuliser.
“It vapourises medication or liquid into a fine mist and if that’s breathed in – especially when it is used as medication and someone is infectious or later tests positive – that [pick up] the virus and that mist can then be suspended in the air with very, very fine aerosolised particles,” he said.
Premier Daniel Andrews said the nebuliser was used by a guest with a pre-existing health condition, who was taken to intensive care with the virus on Tuesday and was now fighting for their life.
“We believe that the transmission of the UK strain occurred prior to them entering Victoria,” he said.
Two of the man’s family members had also contracted the virus and remain in quarantine.
Returned travellers have been required to declare any medical devices upon their arrival, but quarantine boss Emma Cassar said the man’s nebuliser seemed to have inadvertently slipped through.
“I think in this instance the individual didn’t recognise his nebuliser … as a medical device,” she said.
Professor Sutton said a nebuliser could create tiny particles of coronavirus that could spread when a hotel room’s door was opened.
“We think the exposures are [linked to] this nebuliser whereby … [the] virus was carried out into the corridor and exposed the authorised officer, the food and beverage service worker and also the other resident. That makes sense in terms of the geography and it makes sense in terms of the exposure time,” he said.
“What we know is that the authorised officer [and] the food and beverage worker had been on the floor for a period of time on those relevant days [when the nebuliser was used].
“We don’t have the exact correlation with the door being open, but … with aerosolised particles they can remain suspended in the air for several minutes so it doesn’t have to happen at the same time.”
Ms Cassar said the earlier identified infected workers were wearing surgical masks and goggles at the time, but all Victorian hotel quarantine workers would now be provided with N95 masks.
Vapourising machines, including sleep apnoea machines, will be banned from standard quarantine hotels and bags thoroughly searched. Anyone needing to use a nebuliser or a similar device will be transferred to a designated “hot” hotel.
In light of the hotel outbreaks, Victoria will not increase its intake of overseas arrivals to 1310 on Monday as planned.
Authorities expecting more cases after virus detected in wastewater
Meanwhile, daily testing has found COVID-19 fragments in wastewater from Melbourne’s northern suburbs, Health Minister Martin Foley said.
Anyone who was in Coburg or Reservoir in the 72 hours before February 6 and who is showing any sign of illness should get tested immediately.
Residents of Glenroy, Broadmeadows, Westmeadows and Roxburgh Park are also being asked to get tested if they have any symptoms after unexpected viral fragments were found in wastewater from those areas.
“There are no known cases residing in those particular catchments, but there are a number of contacts [who live there],” Mr Foley said.
Five of Holiday Inn worker’s close contacts test negative
The food and beverage worker at the Holiday Inn who tested positive on Tuesday had tested negative at the end of her last shift on February 4, but developed symptoms two days later.
On February 8 she was advised she was a primary close contact of her COVID-infected colleague – the authorised officer – and was required to get tested and isolate.
“She got tested on the morning of the ninth and returned a positive result,” Mr Andrews said.
Seven of the woman’s 13 household and social contacts have so far tested negative.
The returned traveller who tested positive on Tuesday largely stayed at home after leaving the hotel, potentially exposing only her family members and close household contacts to the virus.
Authorities are awaiting the test results from two close contacts of the authorised officer, but so far six have tested negative.
Eight cases have emerged at the Holiday Inn in less than a week, while 10 have been detected in less than a fortnight across three Victorian quarantine hotels. Three of them are confirmed to have the more infectious British variant of COVID-19.
Guests at the Holiday Inn started being transferred to the Pullman Hotel on Swanston Street on Wednesday morning.
COVID-19 Quarantine Victoria, the government agency overseeing the quarantine program, said 48 guests were considered primary close contacts of the cases revealed on Tuesday.
Any guests who were due to leave quarantine in the next three days will be required to stay at least another three days.
Health authorities said anyone who spent more than 15 minutes at the Holiday Inn Melbourne Airport between January 27 and February 9 must immediately isolate, get a test and stay isolated for 14 days.
Brisbane’s Hotel Grand Chancellor, which operated as a quarantine facility, was evacuated in mid-January after a casual cleaner tested positive for the highly infectious British strain of the virus. Six cases were linked to a cluster traced to the seventh floor of the hotel.
All guests at the Grand Chancellor were evacuated individually in ambulances to another quarantine hotel where they were required to restart their 14-day quarantine period.
But Mr Andrews batted away questions about why people from the Holiday Inn were transferred together on a bus, saying the transport method was “based on advice”.
“The safest method will have been used, they will have done a full rating of what risk those people posed based on their individual circumstances and their shared circumstances,” he said.
Two schools closed, new exposure sites in Sunbury
Salesian College in Sunbury and nearby St Anne’s Primary School will reopen on Thursday, after closing as a precaution on Wednesday. Some members of the school communities who were linked to the infected Holiday Inn food and beverage worker have been cleared as secondary close contacts.
Berejiklian says Andrews “pretty good at spin”
The latest outbreak has fuelled interstate tensions over standards in hotel quarantine.
NSW Premier Gladys Berejiklian took a swipe at her Victorian counterpart after he claimed Victoria had “higher standards” in quarantine hotels than NSW on Tuesday.
“I can foreshadow for you that we’re not going to anywhere near the capacity NSW has, we will have less capacity because we have a different model and, I believe, higher standards,” Mr Andrews said.
Speaking to Sydney radio station 2GB on Wednesday morning, Ms Berejiklian said the Victorian Premier was “pretty good at spin”.
“I think the people of NSW don’t want me to lower myself to those sorts of statements,” she said.
The NSW Premier said she believed the success of a state’s hotel quarantine system should be measured by how many Australians have been returned home while keeping the community safe.
“Is the system in NSW perfect? No. And I would never boast about it.”
Mr Andrews responded to Ms Berejiklian’s comments at his own press conference soon after.
“I’m not interested in having an argument with Gladys, and I’ll somehow find a way to recover from that barb,” he said.
With Mary Ward
Rachael Dexter is a breaking news reporter at The Age.
Melissa Cunningham is The Age’s health reporter.
Paul is a Victorian political reporter for The Age.
David Estcourt is a court and general news reporter at The Age.