Uncertainty and agency in COVID-19 hotel quarantine in Australia

Jane Williams; Gwendolyn Gilbert; Angus Dawson; John Kaldor; David Hendrickx; Bridget Haire

doi:10.1016/j.ssmqr.2021.100034

Uncertainty and agency in COVID-19 hotel quarantine in Australia

SSM Qual Res Health. 2022 Dec:2:100034. doi: 10.1016/j.ssmqr.2021.100034. Epub 2021 Dec 16.

Authors

Jane Williams¹, Gwendolyn Gilbert^{1

2}, Angus Dawson^{1

2}, John Kaldor³, David Hendrickx⁴, Bridget Haire⁵

Affiliations

¹ Sydney Health Ethics, The University of Sydney, Australia.
² Sydney Institute for Infectious Diseases, The University of Sydney, Australia.
³ Kirby Institute, University of New South Wales, Australia.
⁴ Wesfarmer's Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia.
⁵ Kirby Institute, University of New South Wales; Australian Human Rights Institute, University of New South Wales, Australia.

Abstract

Mandatory 14-day hotel COVID-19 quarantine was introduced for international arrivals into Australia in late March 2020, with no precedent and little time to prepare. This public health initiative was a key factor in Australia's relatively low COVID-19 burden in the first 18 months of the pandemic. We conducted an empirical bioethics study exploring the experience of people who had quarantined in hotels in Australia. We used in depth interviews to develop an understanding of context and normative analysis to consider whether the way the program is conducted is ethically justifiable. 58 people participated; they had been in hotel quarantine in different parts of Australia in the period March 2020-January 2021. Participants faced considerable uncertainty while in quarantine and many experienced this as burdensome. Some uncertainty resulted from not being given information about key aspects of quarantine, some from rules that changed frequently or were otherwise inconsistent, some from being physically isolated. Lack of information and uncertainty contributed to diminished agency. Communication efforts made by individual hotels was well received. Earlier ethics literature about quarantine does not take into account the context our participants described, where the hotel and supervision arrangements were central to the experience. We argue that more suitable arrangements must be made if quarantine is to be an ongoing proposition.

Keywords: COVID-19; Empirical bioethics; Qualitative research; Quarantine.