The challenge of managing quarantine requirements for overseas travellers or returning Australian citizens has created an urgent demand for purpose built COVID-19 quarantine facilities over the course of the pandemic. Leading \ academics have joined the call for such facilities to be prioritised in every Australian state after the Federal Government announced its support for such a facility in Victoria, as the Victorian Government wrestled with its latest lockdown following a breach in its hotel quarantine system.
Professor Mary Louise McLaws, a world-renowned epidemiologist, has stated that requirements for infection control such as 10 full air changes per room per person are simply not possible in the current hotel type quarantine facilities. The efficacy of the hotel quarantine system has been further called into question through research out of the University of Melbourne that shows that there has been one breach for every 204 COVID-19 infected travellers that have been quarantined in hotels.
It may come as a surprise to some that the idea of a dedicated quarantine facility is not at all new. In Australia, there were dedicated quarantine facilities built in almost every state as early as the mid-eighteenth century. For example, the North Head Quarantine Station was built in 1832 to contain a Cholera outbreak, and was only decommissioned in 1984, making it Australia's longest functioning quarantine facility. The Howard Springs facility near Darwin that is being lauded as the gold standard for dedicated quarantine facilities was actually commissioned by Japanese mining firm Ipex to house its 3,500 workers. Abandoned by Ipex in 2018, this facility was repurposed as a dedicated quarantine facility in February 2020.
Tone Wheeler, Principal Architect at Environa Studio, argues that the design of dedicated quarantine facilities can draw on Australia's rich legacy in this area. He also believes that the imperative for dedicated quarantine facilities near all of Australia's international airports can be made a reality by leveraging off Australia's mining industry experience in building instant towns, and by developing the prefabrication industry in Australia as a mainstay in construction.
Aerial view of Quarantine Station - c.1930 / Image courtesy of The Office of Environment and Heritage (QS2007.3)
Dedicated quarantine facilities are designed around two major requirements: 1) Infection prevention and control, and 2) Resident care and well-being. Infection prevention and control is achieved by minimising interaction between people, provision of independent ventilation systems, and the use of logistical, maintenance and operational systems based on infection control and well-being.
Artist illustration of a single bed quarantine room
Minimising interaction between people includes resident-to-staff interaction, but also resident-to-resident interaction and group-to-group interaction. Ensuring that individuals, groups, and populations within these facilities are adequately air-gapped from each-other is vital to halting the spread of infection. This necessitates the provision of facilities for cooking, laundry and exercise within each accommodation unit. Moreover, there is a requirement for such self-contained accommodation to be available for individuals as well as family groups with small children. Each unit should also have an independent ventilation system, openable windows for natural ventilation and a covered outdoor veranda that can provide residents with an outdoor area as well as serving as a controllable area for staff-resident interaction.
In addition to accommodation, dedicated quarantine facilities also require administrative facilities, catering facilities, commercial laundry facilities, medical clinics, waste management facilities, and police or security stations.
Minimising interaction between people can be achieved through a security principle called access control. Access control is achieved through physical means of creating separation and enforced through Electronic Access Control Systems (EACS) that authorise or deny access. EACS can also be enabled using Smartphone based credentials so as to also allow contact tracing if required. EACS would also be a critical system in managing external access to the dedicated quarantine facility and preventing/allowing access to the quarantined areas. Clear signage and wayfinding work in tandem with access control to ensure that residents and staff do not unintentionally enter certain areas.
Soft and hard landscaping can be employed to reinforce access control while maintaining aesthetic requirements that contribute towards well-being. For dedicated quarantine facilities that are being designed from scratch, design employing CPTED methodologies can be the primary mechanisms to achieve security whilst simultaneously ensuring resident wellbeing. This necessitates the engagement of Licensed Security Consultants in the planning stage of the design, rather than relegating this to the construction stage, as is often the case. Security can be further bolstered through provision of video surveillance and appropriate lighting, while allowing for privacy of the residents. Introduction of help-points within accommodation as well as on pathways can enable the provision of a higher level of care.
Security is about implementing a risk management approach, prescribed in Standards such as ISO 31000, HB167 and ISO 22341. A key to managing risks, including the risk of infection, is to engage with the stakeholders and those who are involved in managing and delivering the operational aspects of dedicated quarantine facilities. Engagement with stakeholders through risk or security workshops increases awareness and creates an organisational culture of proactive risk management as opposed to a system predicated on the adherence to rules. Other mechanisms for achieving engagement include employee and resident inductions that incorporate relevant infection and security risk mitigation strategies.
Fire Safety within buildings is provisioned within the National Construction Code (NCC) which encompasses the Building Code of Australia (BCA). The objectives of the NCC are to ensure safe evacuation of a building and the minimise damage to other property. Fire safety is achieved through combinations of active and passive measures. Active measures include sprinklers, smoke alarms, break glass alarms, and fire extinguishers. Passive measures include building separation, fire rated walls, fire doors and fire stairs. As most dedicated quarantine facilities have been designed as single storey accommodation units, active measures such as smoke alarms, break glass alarms and fire extinguishers and passive measures such as building separation and fire rated walls will play a dominant role in the fire safety strategy.
Early engagement of Registered Fire Safety Engineers allows for input into the design, where simple measures such as building separation, placement of egress exits and use of fire rated walls can help achieve fire safety objectives. This advice is delivered through the conduct of a Fire Engineering Concept Design Study (FECDS).
Current plans to build a number of these facilities nationally presents an opportunity to learn from Australia's historical legacy and employ innovative design to deliver the objectives of infection control and resident well-being. Security and Fire Safety are vital considerations that can inform the design of dedicated quarantine facilities. Early engagement of these respective disciplines will ensure that architects and planners are able to achieve many of the security and fire safety requirements through design rather than requiring expensive after-measures in the scenario where these disciplines are only considered at the time of construction.