How does Covid quarantine actually work?

As Britain stumbles its way into quarantining incoming travelers from–well, we’ll get to that in a  minute–this might be a good time to talk about the mechanics of quarantine. And its problems. 

Australia’s sets the world standard for Covid quarantine. Or so I’ve read.

Irrelevant photo: Primroses that I haven’t gotten around to planting. When it isn’t too cold to get them into the soil, it’s raining. When it isn’t raining, it’s too cold. What this proves is that I’m not a serious gardener. But they’re beautiful in spite of me.

Not New Zealand? Singapore? South Korea? Sorry, I don’t make the rules here. The BBC tells me Australia’s system is world class, although they put it in quotation marks, introducing a bit of doubt. For all I know, the country gave itself the award. I’d put it in quotes too but they’re expensive, especially when you consider how small they are and that you can’t just use one, you have to use two. Every damn time. 

So let’s just say Australia’s one of a handful of countries that are doing serious quarantine–including Singapore, South Korea, and New Zealand. But the information I have focuses on Australia, so Australia it is.

The country has been able to mostly eliminate the virus, in part by being ruthless in its lockdowns and in part by quarantining incomers, but the quarantine system has had a series of leaks and each one triggers a ruthless response. So far, the combination’s working.

Australia limits the number of people they allow in: It’s returning residents only, and 40,000 of them are stranded abroad, waiting to get home. Those who do get in have to quarantine for fourteen days in a hotel. 

In July, a quarantined traveler gave the virus to a guard and the country realized the system had a few gaps. Up to that point, guards were able to socialize with each other and with quarantined travelers, and at least one had sex with someone in quarantine. And guards’ schedules  moved them from one hotel to another, so any infections they picked up traveled with them. 

At first, the quarantine guards were rent-a-cops–those people employed by private security firms. I don’t know what they were paid or how much training they got, but my best guess is that the numbers on both were low. 

As for the travelers, a few left quarantine, some dramatically, some quietly. Others went shopping (what’s life worth–your own or someone else’s–if you can’t get some deodorant and a bit of alcohol?) and came back. 

That’s now been tightened up. The guards are no longer rent-a-cops. They keep their distance, wear protective gear, are tested regularly, and not only don’t move from one hotel to another but aren’t allowed to hold other jobs, so if they become infected they don’t carry the disease to another workplace.

Even so, there’s been some transmission, probably through hotel corridors, possibly (at least in one New Zealand hotel) through air conditioning systems. South Australia is looking at ways to upgrade ventilation systems. Other places may be as well.

After one breach, where a guard was infected, “They spent hours poring over CCTV footage to find out what [the] guard did wrong,” said Prof Nancy Baxter, head of the Melbourne School of Population and Global Health. “And the thing that guard did wrong was breathe air. All that person did was walk the halls, breathing the air. Right there. That should have been the clarion call that we need to do something different.”

Rooms with windows that open could be a major help, although it may be hard to find hotels that are built that way.

There’s evidence of guest-to-guest transmission by way of the hallways as well. One got infected from a family across the hall. The best guess is that they opened their doors at more or less the same time to pick up their meals. Whoosh: Air from one room flowed into the other one.

What’s kept quarantine breaches from turning into disasters is contact tracing–something Britain’s committed to bungling. 

 

So what are the British plans for quarantine? 

Ergh.

Hotel quarantine’s been in the planning stages for a while. If in fact the current government does plan. Let’s say they do, just to be nice. It’s all due to start on–oh, holy shit, it was due to start today (that’s Monday) and probably has. Somehow. I’m writing this the day before, so I disclaim all responsibility for what happens between 3 p.m. Sunday and Monday morning.

Hotel quarantine only applies to people coming from countries that scare us. Or, to be more accurate, whose germs scare us. They call it the red list, because red’s a scary color. Just ask a bull. Or J. Edgar Hoover. (Sorry–antiquated American joke and not worth explaining. If you didn’t get it, count yourself lucky.) If you came from (or through) one of the countries that scare us, you’ll be escorted to your hotel, which you had to book in advance. And pay for. And it’s not going to be cheap: £1,750 for one person. More if you add family members.

Don’t kid yourself that Australia picks up the costs of quarantine either. 

When I talk about scary countries, though, I’m not talking about xenophobia. I’m talking about countries that harbor Covid variants which aren’t already running wild in Britain. They may be here, mind you, and one definitely is, but they’re still shy. They’re leaning against the wall and waiting to see if someone will ask them to dance. 

On the other hand, if the country you’re coming from doesn’t scare us, you can go home and quarantine by your own glorious self. Because if you’re infected, you’re infected with garden-variety Covid: the kind we already have plenty of. And since you’re allegedly quarantining at home, if you wander out to buy dish soap, an onion, and a liter of vodka, no one will know. 

And no one will ask how you’re going to get home and who you’ll breathe on in the process. 

The theory behind the scary-country list is that it will let Britain keep out the most problematic of the Covid variants. And it just remotely might if we actually knew where they were, but they’re not in the habit of sending us notes: Headed to Switzerland now. Go ahead and eat without me. They just pop up around the globe, and we’re always behind the game, wondering how they got there and how long ago.

What the scary-country list will do, at its best, is keep the problematic variants down to a manageable level, at least initially. But that’s how Covid got away from us to begin with. We didn’t want all the disruption of closed borders and a long lockdown, so we went for the easy option.

You may have noticed that we haven’t kept it to a manageable level. Ah, but a country can dream, can’t it?

To keep the dream alive, countries can be added to the scary-country list with just a few hours’ notice, promoting the illusion that we can respond quickly as the situation changes. What a traveler’s supposed to do about quarantine arrangements when that happens is anyone’s guess.

Scotland is quarantining every incoming traveler in a hotel, but Scotland is still part of Britain and can’t quarantine people coming in from England, tempting as it might be.

If you have come into Britain from (or through) a scary country, while you’re in quarantine you can go outside for a few reasons, including exercise, but not unescorted. You’ll have someone following you with a huge feathery fan to brush the germs away so they can’t hurt anyone. 

An Australian epidemiologist considers it risky to let anyone leave their room for any reason. An American blogger sitting in Cornwall considers it even riskier to elect an incompetent government.

I don’t know why, but no one listens to the blogger. I don’t know how many people listen to the epidemiologist.

The British government set up a website for people to book their quarantine hotels. The site promptly crashed. And the advice page on hotel quarantine? It didn’t bother linking to the booking page. Plus last I heard, just a day or three ahead of quarantine being put into action, the Border Force didn’t have a clue what it was supposed to do once the system started. Because why would anyone bother to tell them?  

The government had published guidance for the hotels, though. Staff will wear surgical masks. In Australia, they use a mask with a higher level of protection. 

Nothing had been said about staggering meal delivery times. And whatever the plan was for testing staff (let’s be rash and assume there is one), it’s not in print yet either.

Travelers do need to have proof that they tested negative for Covid, but since no one can tell a real certificate from a fake one yet, and since people can become infected after they tested, that’s not a hell of a lot of help.

If an occupied room needs emergency maintenance, repair people are supposed to wear gear that protects against droplets. Not aerosols, which are smaller, lighter, and hang around longer. They’re known to be an important way that the virus spreads.

On the other hand, you know how it is. That kind of protection costs money. Wouldn’t it be cheaper to lose a maintenance person or two, and maybe a family member, and invite the virus variant to travel into the surrounding community with them?

Back in Australia, Professor Nancy Baxter says, “I truly believe that if you’re putting workers in harm’s way, which essentially you are, by putting them in a quarantine hotel, and exposing them to people potentially with Covid-19, that there’s a duty of care that those people have the highest possible protection from infection.”

Where Britain does provide guidance, though, is on fines. Because when you can’t set things up so that people can easily do things right, you can surely punish the hell out of them for doing it wrong. Avoiding quarantine can earn you a fine of anywhere between £5,000 and £10,000 pounds. And lying about your travel history on the new form that asks where you’ve been? That could get you 10 years in jail. 

Or a stern talking-to from the judge. It’s too early to know how seriously this stuff will be treated.

As I-don’t-remember-who has already pointed out, there’s a certain irony to Boris Johnson’s government wanting to lock people up for lying. He made his career by lying and when he was a journalist he lost jobs for it. 

The day before the system went live, unions representing airport and hotel workers were busily pointing out the flaws in the plan, including letting soon-to-be-quarantined travelers mix in the airport with staff and with no-quarantine travelers as they get off planes and wait in one enclosed space after another. It’ll be a duty-free germ exchange. 

Even a spokesperson for Heathrow Airport was complaining about “significant gaps” in the protocols. 

In the meantime, Britain’s cabinet members are pulling in two directions about summer vacations–which aren’t called vacations in Britain, they’re called holidays. The health secretary dangled the prospect of people being able to go on summer holidays within Britain. The prime minister dangled the prospect of staying the hell home. Travel companies are dangling everything they can think of and promising full refunds, eternal love, and the fountain of youth if you’re not allowed to go. 

Your Covid update for the day

Can I take time off from being snarky and welcome a moment of sanity? Any minute now, the British government’s expected to announce a hotel quarantine on returning travelers. 

Travel in the age of Covid

Up to now, we’ve had a do-it-yourself quarantine: You go home, you add water and shake vigorously, you take a Covid test or two, then you wait ten days or until the world’s ready for you to emerge blinking into the sunlight. 

Or you do none of that. Who’ll know?

And that’s the problem with the do-it-yourself system. Some unknown percent of arriving travelers go home, have a nice shower, and since they’ve added water consider the thing done, so they go out and buy groceries. And, of course, even the people who take the quarantine seriously have to get home, leaving a viral trail from the airport to wherever they live.

The noise accompanying the expected change is all about the newer, scarier Covid variants from Brazil and South Africa, so it’s not clear yet whether the quarantine will apply to everyone coming into the country or just to people coming from countries known to have the variant. 

If it’s limited to a few countries, it’ll be the policy equivalent of wearing your mask underneath your nose and pretending you’ve done your bit to battle Covid. Most countries don’t do enough virus sequencing to know which variants they’re dealing with. In other words, the variants are circulating in more countries than we know about.

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Irrelevant photo: I wouldn’t swear to it, but I think this is a viola. At any rate, it was a volunteer last summer.

In another moment of startling good sense, vaccines minister Nadhim Zahawi said it was “far too early” to talk about people booking summer holidays. 

The travel industry is not happy about any of this.

 

Vaccine news

Moderna reports that its vaccine is effective against both the British and South African Covid variants, although it’s not as effective against the South African variant as they’d like. The company will test a second booster shot, making a total of three shots, with the third one designed specifically for the South African variant.

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If you’ve been reading stand-your-hair-on-end stories about people in Europe dying after getting a Covid vaccine, go find your comb and get your hairdo in place: There’s no evidence that their deaths had anything to do with the vaccine. 

In most countries, early vaccinations have focused on the elderly, and–well, the thing about old people is that we develop the habit of dying. In larger numbers than other age groups. So the vaccinated group included a lot of people who weren’t well to start with. And they died, but their deaths haven’t been linked to the vaccines. 

I subscribe to, among other things, a conspiracy-inflected newsletter, and it’s been counting the dead gleefully, without hinting that there might be extenuating circumstances. 

It helps me remember how crazy the world’s gotten lately.

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The fear that Covid will mutate until it’s beyond the reach of vaccines has kept the news–and I assume sensible scientists as well–focused on Covid’s new variants. So let’s talk about variants:

They happen by accident. Mutations are random–they have no plan and no goal. If you’re not a fan of evolution, this is the time to change the channel, because what I’m talking about is evolution at work, but speeded up enough that we can see it happening. Some of the variations are disasters for the virus and they fall off social media. Some don’t matter–they don’t have good publicity agents, they post on Twitter but no one likes or retweets them, and we never hear about them. 

Some, though, work well. I’m taking that from the virus’s point of view, remember, so that means they’re more infectious or they change clothes so the vaccine-primed immune system stops recognizing them. They’re the Kim Kardashians of the virus world. 

The reason I’m dragging you through all this is that the more times the virus mutates, the more chances it has to hit on a winning formula. So the more people become infected, the greater the chance the virus has of becoming even scarier. 

In people with suppressed immune systems, it may get to mutate even more freely.

Could it mutate enough times to become less scary? Of course. The process can go in any direction. But we can’t know which one it’ll take. It’s not a bet I’d like to make. If you hear someone saying that no one is safe until we’re all safe, this is what they’re talking about. 

Bjorn Meyer of the Pasteur Institute said that with vaccination and the distancing and cleaning measures that are in place around the world, the virus’s successful mutations are more likely to affect how easily it’s transmitted rather than how lethal it becomes. I have no idea why that should be true, so I’ll just have to take his word for it and skip merrily on to the next item.

 

Antibody therapy

A joint Swiss, Czech, and Italian effort has developed a second-generation double antibody that protects against Covid.

A what?

I know. Me too. Think of it as an arranged marriage. The researchers introduced two natural Covid antibodies that target separate sites on the virus and fused them into a single artificial molecule. As long as they both may live or until one of them has an affair with some other antibody, whichever comes first.

In pre-clinical trials, the artificial antibody neutralized Covid and its variants and kept the virus from changing its structure. If it changes its structure, remember, the antibody has to close its eyes and count to seven while the virus hides.

The antibody stands a good chance of both preventing and treating Covid but it still needs to go through human trials before. If it does go into use, it looks like a single injection will reduce the viral load in the lungs and minimize inflammation. 

Politics, economics, and interviews

I don’t know about you, but I was impressed that England had instituted a £500 grant for low-income people who test positive for Covid and have to self-isolate. It didn’t sound like enough, but it was better than nothing. Until I found out that three-quarters of the people who apply for it are turned down.

Local governments say they’re having to turn people down because the criteria are too narrow.

Thanks, guys, you’ve renewed my faith in the incompetence of the current government.

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Speaking of which: Britain’s work and pensions secretary walked out on a TV interview when she didn’t like the interviewer’s paraphrase of what she said.

Okay, it was a Zoom interview. It’s hard to walk out them with any flair, but she did turn off her camera. 

It started when Therese Coffey said Britain’s death rate was so high because it had an obesity problem and an older population. To translate that, it means, None of this is the government’s fault. 

The interviewer, Piers Morgan, turned it so the seams showed. So the public was too old and too fat, then?

“I think that’s a very insulting thing that you’ve just said,” Coffey answered. “I also have to point out that you started this interview late. Unfortunately I have to go to other broadcasters as well, and I wish we had more time.”

“It was you that boycotted the programme,” Morgan said. “Please don’t play the ‘we haven’t given you enough time’ card, because we gave you eight months and you didn’t turn up.”

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A recent report tells us that the wealth of the world’s ten richest people has increased enough during the pandemic to pay for the planet’s entire population to be vaccinated. And enough pocket money will be left over to make up for the income the poorest of them have lost. 

So how much is that in numbers? It’s £400 billion. Of course, if you have to split that with nine other people, all you get to take home is £40 billion.

 

The almost obligatory snippet of good news

I’m not doing well on the good news front, but research from the University of Illinois reports that the psychological problems of lockdown tend to fade with time as people adjust to the new normal. 

Sorry–best I could do today.