@qldhealthnews report into the recent hotel quarantine outbreak is very interesting.

The first thing to do with any scientific report is to seperate any findings or measurements from supposition or conclusions.

They do not KNOW how it happened as yet.

They did not have CCTV everywhere, and so they used interviews, some CCTV footage, and took environmental swabs.

Two pairs of travellers, a cleaner and their partner were covid positive within a short space of time.

Both the travelling pairs (case 1/2 and case 5/6) transited through Doha, and had very similar but not identical strains of covid.

The cleaner and partner strain matched case 1/2. The cleaner cleaned the room next door to case 1/2. Therefore 1/2 transmitted to cleaner without face 2 face contact.

Somehow... ->

Case 5/6 is harder to link directly to case 1/2, or the cleaner. The timing of infection positivity on day 10 means that infection in quarantine with slight variation in RNA code is possible, but a late presentation of overseas acquired infection can’t be ruled out.

Let’s stay with the cleaner and case 1/2 for now.

There was no face to face contact. The cleaner never went into the travellers room. Only worked in two adjacent rooms.

We know room 702 was on the central air conditioning system... was room 703 and 704A? I could not find this detail on the report.

Room 711 was on a split system and not linked by AC directly.

The review team notes room 702 and 712 did not have virus RNA on swabbing of AC units... room 703 and 704A swab results were not included.

Air flow studies of other air pathways are still pending.

Until these are done, an investigation into potential airborne transmission in this scenario is incomplete.

There are some really good things about this review.

Recommending airborne transmission precautions (even though they are hanging on to fomites for dear life).

Recommending PPE is worn by staff with training, and a buddy system to check.

Encouraging a safety culture! After being told to stop being anxious for a year, this is a breath of fresh air!

The case of how room 711 might have been infected while in quarantine is not known yet, if it did occur.

With airflow studies pending, this is a space to watch.

The conclusions of shared fomites is premature, but in the spirit of safety, I would never exclude it.

Important to note that opening doors is an airborne transmission risk & they have clearly stated they are concerned about it.

All of the following are airborne precautions.

Another interesting thing is laundry day. It should be taken into consideration that when beds are changed, a lot of particles are thrown into the air. It may be wise to ventilate/HEPA filter the room and let it settle before placing linen in a paper bag outside the door.

There are other minor interesting points in the study, like the RNA left behind after furious scrubbing... here is the link if you want to enjoy.

https://www.health.qld.gov.au/__data/assets/pdf_file/0020/1022681/hotel-grand-chancellor-review-report-queensland-health.pdf

In conclusion, airborne transmission is still being investigated. The heavy reliance on shared fomites in the reports conclusion is premature.

Very good recommendations for the future though, on all aspects of infection control, including mitigation for airborne transmission.