Millions of people across the world are going into temporary exile to stem the spread of the new viral pandemic.
A 14-day isolation for those infected or at risk of exposure is considered one of the best ways to slow down the virus – in the absence of a vaccine – and so stave off a sudden crush of cases in emergency departments.
So what are you expected to do and who has to stay home? Should you prepare ahead of time? And do governments have powers to enforce quarantines?
Who has to self-isolate?
You must isolate yourself at home for at least 14 days (which is considered the total incubation period before symptoms of the virus emerge) if:
- You have arrived in Australia from overseas after midnight Sunday, March 15
- You have been in close contact with a confirmed case of COVID-19
For a virus that can jump from person to person via water droplets expelled from the nose and mouth, close contact means at least 15 minutes of face-to-face conversation or about two hours in an enclosed space together.
Because so many new cases are still linked to people returning from overseas, all arrivals will now be escorted from the airport and put up in hotels, at government expense, for the 14-day isolation window. The army has even been called in to help police enforce the quarantines.
What’s the difference between social distancing and self-isolation?
Everyone is being asked to engage in “social distancing” – staying home for all but essential errands, avoiding gatherings and keeping about 1.5 metres away from other people. But if authorities tell you to go into self-isolation, there are stricter rules. You shouldn’t leave your property – not even for exercise in a remote place or to go to the chemist – and you should wear a surgical mask any time you are near others, whether in the kitchen or taking an Uber straight home to start your exile.
Once you’re on your lonesome, official guides say you can ditch the mask and even venture outside into your garden or balcony. They suggest keeping up your spirits with a routine: working from home or getting homework sent to you, exercising, staying in touch with loved ones, even tackling boredom with “crafts and board games”. There’s also a reminder not to “rely too heavily on television and technology”.
Should your family and roommates stay home too?
In China, there are stories of whole families dragged off to quarantine or even welded into their houses but here authorities have stopped short of asking your household to join you in self-isolation (unless you are a confirmed case or awaiting test results).
Mostly, the person at risk should keep their distance as much as possible in the home – using a separate bathroom and avoiding communal areas. Don’t have visitors over (not even that technician to fix the NBN) and, if you’re in a hotel, try to stay in your room. If you’re living with someone under isolation, wash your hands religiously and wear a surgical mask if caring for them.
While the virus can survive longer on surfaces than initial estimates – up to a few days – it can be killed by simple disinfectant. A government spokeswoman said other known coronaviruses don’t tend to spread via breastfeeding, which is still considered beneficial to a baby’s health, and there is no evidence so far to suggest this virus is any different. But parents are urged to take precautions around their babies, such as washing their hands, following proper cough etiquette and, if diagnosed or at risk, wearing a mask.
New Zealand’s self-isolation guidelines offer more helpful detail on living with others while you are self-isolating. Don’t share beds, linen or food –take meals back to your room rather than eating with family. “You should not share dishes, drinking glasses, cups, eating utensils, towels, pillows or other items with other people in your home” and wash everything you use thoroughly.
What about pets?
As for your other roomates, despite hysteria in Hong Kong about pets spreading the virus, the World Health Organisation says you can’t catch the virus from domestic animals and they should not be abandoned. The risk instead would come in if a pet itself became a contaminated “surface” (from all those sloppy kisses). So cuddle the family fur-ball all you like – just be wary of sending them straight into the next room to kiss the rest of the household goodnight too.
Can you go out for supplies in isolation?
No. Health authorities have already rebuked people who tested positive for COVID-19 and stopped off at chemists or supermarkets for supplies on the way home from the hospital. Instead, ask others to buy what you need or have it delivered. Companies from Coles to UberEats are already preparing for increased drop-offs as the coronavirus spreads, rolling out hand sanitisers and, in the case of Deliveroo, free protective masks to drivers. The app EASI has even reduced delivery fees to encourage customers to choose delivery and “help restaurants (especially Asian restaurants) … survive in this difficult period”. But these services are out of the range of many regional communities and the federal government has called on those around people in isolation to help them out (safely). “Make them a curry,” the Prime Minister Scott Morrison has suggested.
How much should you be stocking up?
Experts have recommended making modest preparations in case you are required to self-isolate but panic buyers are being urged to stand down as serious shortages of medications, face masks and, most terrifyingly, toilet paper, now loom. There’s no need to hoard, Victorian Premier Daniel Andrews said on March 16, as he declared a state of emergency.
“If everybody goes out and buys not two weeks’ worth of staples but two months’ worth, the shelves will be empty and the only people who suffer then are vulnerable people who might not have got to the shops, or can’t go to four different supermarkets and get the basics that they need.”
Care packages will be available for vulnerable self-isolators in Victoria.
What if you need medical treatment?
Once you’re in isolation, your state health authority will keep a close eye on you, calling to check how you’re feeling. You should talk to your doctor as well as loved ones about what to do if your condition worsens – symptoms to watch out for include shortness of breath, severe fatigue or a high fever. If you need help, call ahead to let paramedics or a doctor know why you’re in isolation.
About 80 per cent of COVID-19 patients so far have recovered on their own, even from pneumonia, without serious complications. The death rate is hovering at about 1 per cent (much higher than the flu but less dangerous than the other two coronavirus strains to jump from animals into humans in recent years – SARS and MERS).
Can you walk your dog?
If you’ve been told to self-isolate, you must stay home, Australia’s Deputy Medical Officer Paul Kelly has said. No surfing, no dog-walking, no bushwalking, no solo strolls on remote beaches. Stay home.
For everyone else, practise social distancing, avoiding gatherings and having visitors over. You should stay home unless you are:
- Shopping for what you need (such as food or supplies to help keep you at home such as sports mats)
- Getting medical care
- Exercising outside (but you must stick with just those in your household or a maximum of one other person)
- Attending work or school if you cannot attend either remotely
What powers does government have to force quarantines?
The federal government can call on its rarely used powers under the Biosecurity Act to compel someone to go into quarantine, submit to testing or treatment or provide contact details and condition updates to health officials. An order can last up to three months and states have their own powers to detain you too – as of March 6, Queensland had already issued 2700 people with “voluntary notices” to self-isolate. Hefty fines and even prison time have been flagged for those at risk who break the rules.
Federal Attorney-General Christian Porter says entire areas of the country could also be locked down as “human health response zones” requiring screening to move in and out.
Australia’s Chief Medical Officer, Brendan Murphy, concedes enforcing self-isolation is very hard as health officials turn to detective work to track down people deemed at risk. But “most people are doing the right thing”, he says. Still, to slow the spread of the virus, more extreme social distancing measures could be on the horizon.
South Australia, the ACT and Victoria have already declared states of emergency, to help them enforce home quarantines and bans on non-essential gatherings.
Does isolation work to slow the number of cases?
Fresh outbreaks in Iran, Italy, South Korea, and the US have seen the WHO step up calls for more “aggressive” containment measures. In China, new infections have slowed dramatically – a sign its extraordinary containment efforts have worked.
WHO Director-General Tedros Adhanom Ghebreyesus says now is the time for “pulling out all stops” – not for giving up. Past examples of containment, such as during the infamous 1918 Spanish flu pandemic, also show its power. The US city of Philadelphia, for example, took 14 days to mount a public health response to its first cases and recorded twice as many deaths from the influenza strain than St Louis, which took action within just two days.
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With Michael Fowler, Lydia Lynch and Ben Preiss
Sherryn Groch is the explainer reporter for The Age and The Sydney Morning Herald.