Dr. Cillian De Gascun:

I can speak from a virology perspective. I am not necessarily up to speed with the measures in all of the individual nursing homes. However, at this point in time we know that the majority of virus transmission occurs through either direct contact or droplet spread or, in certain circumstances, and perhaps more so in hospitalised setting, where aerosols are generated in the course of an aerosol generating procedure.

In the context of trying to prevent transmission, it comes down to good infection prevention and control measures, which obviously includes the use of appropriate PPE and ensuring that we have sufficient supplies of PPE for all settings in the healthcare system, whether that be nursing homes, residential care facilities or acute hospitals. One of the challenges that we have seen in recent months in residential care facilities is that these are not straightforward healthcare settings. They are peoples' homes and that makes it more challenging than an acute hospital setting from the point of view of deep cleaning, disinfection, sterilising, physical distancing and all of those things. These are social settings and that is one of the benefits of them from the point of view of managing individuals after they go into residential care.

From a virus perspective, ultimately it can be controlled with physical distancing, good hand hygiene, good respiratory etiquette, and it will need, as I said, adequate supplies of PPE, increased cleaning and maybe a review of some of the soft furnishings and that type of thing where the virus is difficult to eradicate. We have to learn from the experience that we have had during this first iteration of the virus so that we are in a better position and more prepared should we see a resurgence.

What is interesting, as an aside to highlight, is that Australia is in its influenza season at the moment and, from memory, they have had their mildest May in terms of an influenza season for over a decade. It is significantly down on last year, and presumably because of the indirect benefits of physical distancing, good respiratory etiquette and good hand hygiene. All of these things that we are recommending for SARS-CoV-2 should actually benefit us for influenza as well when the time comes.