THE Northern Territory’s strict public health measures in response to COVID-19 have so far proved successful in containing community transmission and preventing any deaths, despite the NT hospital system often operating “beyond capacity”, according to the authors of a research letter published online today by the Medical Journal of Australia.
“Hospitals in the Northern Territory often operate beyond capacity and serve a sparsely distributed population with rates of chronic disease and household overcrowding that are higher than in many other parts of Australia,” wrote the authors, led by Dr Nicholas Douglas, an infectious diseases physician at Royal Darwin Hospital and researcher at the Menzies School of Health Research at Charles Darwin University.
“The NT consequently adopted particularly strict public health measures to avert the potentially catastrophic consequences of community transmission … including supervised isolation until viral clearance of all people with confirmed infections.”
Between 4 March and 4 April 2020, 28 cases of COVID-19 were diagnosed in the NT, all linked to overseas or interstate travel. Two patients required supplemental oxygen, one of whom also required intubation. There were no deaths. Symptoms had been present for a median 3 days before oro-nasopharyngeal swab collection and lasted a median 9.5 days. Viral RNA could be detected for a median 25 days after symptom onset, and in most patients for more than 2 weeks after symptom resolution.
“Prolonged compulsory isolation was distressing for several patients,” the authors acknowledged, though measures were taken to counter this.
“The priority of the strict NT isolation requirements for patients with COVID-19 was viral containment at a time when data on the duration of viral transmissibility were sparse.
“More recent evidence suggests that viable SARS-CoV-2 is rarely isolated more than 10 days from symptom onset, and requirements have consequently been eased, while maintaining supervised isolation with health management during the period of greatest infectivity.”
The strict isolation response has so far proven successful in the NT, the authors wrote.
“Epidemiologic and genomic analyses suggest that this response has successfully prevented local community transmission of the virus.”
All MJA COVID-19 articles are open access and can be found at: https://www.mja.com.au/journal/covid-19
All MJA media releases are open access and can be found at: https://www.mja.com.au/journal/media
- Cate Swannell