“I don’t trust the state level of government any more. They’ve really killed my trust in this system,” said the father of one, who asked for his name not to be published to protect his family’s identity.
“I was getting misinformation left, right and centre ever since we arrived at the first hotel.”
The 38-year-old, who has been discharged from hospital and is now back in hotel quarantine with his family, revealed on Wednesday he had contacted the Australian Commission on Safety and Quality in Health Care and requested an independent review.
He said his request for an independent investigation was in response to a state government audit of the Holiday Inn incident, which found there was no record of him declaring the device.
The man said he was never asked for his account of events prior to the audit being conducted. He said he was told on Tuesday, after being contacted by the Health Department, that there were three different files for his case.
The man said he had also contacted the office of federal Health Minister Greg Hunt, who on Tuesday also called for an independent investigation of the matter.
Emma Cassar, the head of Victoria’s hotel quarantine program, said an incident review led by the state’s health department and Safer Care Victoria was being undertaken of how the returned traveller was able to use a nebuliser in his hotel room and whether any staff were at fault.
When asked by a reporter on Tuesday if she had spoken to the returned traveller, Ms Cassar said she had spoken to the man directly and apologised “for his treatment”.
The Victorian man said he declared the nebuliser to staff at the hotel shortly after arriving at the Holiday Inn on January 23.
He said he also declared the nebuliser to staff at a medi-hotel at Flinders Lane after being transported there when he tested positive to the virus.
Staff at that hotel initially gave him permission to use the device in his hotel room, before supplying him with an asthmatic spacer a few hours later, he said.
Australian guidelines strongly recommend against using nebulisers on patients with COVID-19 because of fears the device could spray virus-contaminated air through a room and encourage sick patients to cough.
Royal Australasian College of Physicians president John Wilson said the devices pose a clear risk.
“There is ample evidence that coughing and nebuliser generation create aerosols that have the potential to spread virus,” Professor Wilson said.
However, the International Society of Aerosols in Medicine, the British National Institute for Health and Care Excellence and Public Health England all advise there is no risk.
Professor David Morton, associate head of Deakin University’s school of engineering, has spent much of his career working with nebulisers. He said the devices did not directly increase the amount of virus-carrying particles in the air.
Putting the nebuliser aside, Lidia Morawska, a world-leading aerosol spread expert and director of the International Laboratory for Air Quality and Health, said the bigger problem was that virus-carrying aerosols escaped the hotel room and infected others.
Professor Morawska said if airborne spread had been taken seriously, that would not have happened, even if there was a nebuliser.
Professor Morawska said “authorities made a big deal of the use of the nebulisers – since people generally don’t know what it is and what it does, to divert the attention from the very issue of ventilation and air flow in the hotel”.
A spokeswoman for COVID-19 Quarantine Victoria said investigations into the source of the outbreak were continuing.
“As more becomes known about this virus – including the emergence of new, hyper-infectious variants of the virus – we are looking at how we can continue to strengthen our hotel quarantine program practices based on the advice of health experts.”
The Holiday Inn cluster, which has so far infected 19 people, triggered a five-day lockdown across Victoria aimed at preventing the highly infectious British variant of the coronavirus spreading further throughout the community.
Among those infected in the outbreak was the man’s partner and his three-month-old daughter.
It is suspected the use of the nebuliser caused fine aerosolised particles carrying coronavirus to be suspended in the air and spread throughout the hotel.
The returned traveller, who public health officials described as the index patient of the cluster, said he was unsure when he became infected with the virus.
He tested negative before boarding a flight from Europe at the end of January and returned a negative test again on the third day of his quarantine in Melbourne.
He suspects he may have been exposed to the virus at an airport on the way home, or on the bus from Melbourne Airport to the Holiday Inn, where he says he and his family were unable to socially distance from other returned travellers on the 500-metre trip.
On the sixth day of his quarantine, the man spoke to a doctor about getting another test as his symptoms were worsening, but was told it would not be necessary because he had been tested three days earlier so it was unlikely to be coronavirus.
Victorian Chief Health Officer Brett Sutton said public officials still suspected the use of the nebuliser helped seed the Holiday Inn cluster, but conceded it was difficult to determine with absolute certainty how the outbreak unfolded.
Epidemiological links strongly pointed to those who were on the same floor of the quarantine hotel being infected when the nebuliser was in use on day five and six of the man’s quarantine.
In the wake of the outbreak, all returned travellers will have their bags searched upon arrival in Melbourne.
Australian Commission on Safety and Quality in Health Care chief executive Adjunct Professor Debora Picone confirmed late Wednesday she had received the man’s request and would be investigating the incident.The state government was contacted, but declined to comment further.
Melissa Cunningham is The Age’s health reporter.
Liam is The Age and The Sydney Morning Herald’s science reporter