Policy option	Description	Priority
1. Cap or suspend travel from countries with high infection rates	The Australian and New Zealand governments have the legal powers to reduce the numbers of incoming travellers by restricting the rights of their citizens to return from countries very high incidence rates on public health grounds.	Top priority
2. Pre‐departure testing, with or without quarantine	Expand existing requirements for pre‐departure testing to further source countries. Pre‐departure testing could include both polymerase chain reaction (PCR) testing within 72 hours of departure and rapid testing immediately before departure, to identify infected persons who start shedding virus in the 72 hours preceding departure. Such arrangements are considered legally acceptable. Pre‐departure quarantine (for one week) would provide additional assurance, preferably in an airport hotel in a transport hub where New Zealand and Australian officials are permitted to check quality processes. If this is impractical, incoming travellers could be asked (via the passenger booking system) to self‐quarantine as strictly as possible during the week before travel.	Top priority
3. Pre‐departure vaccination	Make travel contingent on providing evidence of full vaccination. This measure assumes that vaccination at least partially reduces the risk of transmission.	Uncertain
4. Use passenger booking systems to reduce infection risk	Require passengers to declare pre‐departure COVID‐19 precautions when booking quarantine facility accommodation prior to travel. A booking system is operating in New Zealand and could be adopted in Australia.	High priority
5. Increase in‐flight precautions	Explore means for reducing risk of in‐flight infection, as documented on a flight to New Zealand, 30 by more stringent enforcement of mask wearing in airports and during flights, and the use of higher efficacy masks (although fit can be critical to the level of protection) or double masking. The United States Centers for Disease Control found that a medical procedure mask blocked 56.1%, a cloth mask 51.4% of particles ejected by a simulated cough dummy; a cloth mask over a medical procedure mask (double masking) blocked 85.4% of particles. Double masking of the dummy reduced the cumulative exposure of an unmasked receiver dummy by 82.2%; if the source was unmasked and the receiver fitted with a double mask, cumulative exposure was reduced by 83.0%. When both source and receiver were double masked, the cumulative exposure of the receiver was reduced by 96.4%. 31 A laboratory study (in people) that compared the fitted filtration efficiency (FFE) of commonly available masks worn singly, doubled, or in combination found that adding a second medical procedure mask improved mean FFE from 55% to 66%, and wearing a procedure mask under a cloth face covering improved overall FFE from 66% to 81%, probably by reducing leakage between mask and skin. 32 These findings may not fully reflect real world double masking, but suggest that it may reduce both the risk from infected people and the exposure of uninfected persons. Minimising talking during eating and drinking, and improved ventilation and spacing during flights might also be worthwhile.	High priority
6. Reduce infection risk in airports and transit hubs	Minimise the risk of cross‐infection at departure airports and transit hubs by enforcing physical distancing and mask use.	Medium priority
7. Improve local transport	Ensure sufficient physical distancing of travellers on arrival and in transit to quarantine (eg, reduced shuttle capacity); higher efficacy masks or double masking could be required.	Medium priority
8. Shift to discrete quarantine units	Shift some or all quarantine facilities to rural military bases or camps where discrete units (eg, mobile homes or caravans) could be spatially separated, allowing natural ventilation and eliminating shared indoor spaces. The Howard Springs facility, a converted workers’ camp in the Northern Territory, 11 is a successful model. If spaces were limited, these facilities could be used for travellers from the highest risk countries.	High priority
9. Restrict hotel quarantine in large cities to travellers at low risk of being infected	Reserve large city hotel quarantine for lowest risk category travellers, and send those in higher risk categories to hotels in smaller cities. Airport access and the risk associated with additional travelling need to be considered.	High priority
10. Expand PCR testing of saliva of facility workers and travellers	Expand daily PCR testing of saliva from facility workers to all facilities in both countries. This could also be considered for all travellers, possibly in combination with current testing regimens. In light of the greater transmissibility of new SARS‐CoV‐2 variants, testing all workers in border‐associated occupations (including catering and laundry service staff) at least twice per week should be considered. Documentation of negative test results should replace self‐report systems as an occupational requirement for all border workers.	High priority
11. Require vaccination of quarantine staff	Vaccinating all frontline quarantine workers would be particularly valuable should it prove to reduce transmission.	April 2021: nearing completion in some jurisdictions
12. Cohorting of travellers	All arriving travellers on a flight should enter the same quarantine facility, capacity permitting. This approach, introduced in New Zealand in late April 2021, 7 reduces cross‐infection within facilities.	Medium priority
13. Upgrade processes at quarantine facilities	Eliminate shared spaces (no shared exercise areas or smoking areas) to ensure no mixing of residents during the day. Ventilation could be improved, using only rooms with external windows or balconies.	Medium priority
14. Prosecute rule breaking in quarantine facilities	Enforce quarantine facility rules more rigorously. Rule breaking, relatively common in New Zealand facilities, 33 led to no prosecutions during 2020.	Medium priority
15. Improve conditions for quarantine staff	Improve working conditions for quarantine facility staff to minimise overwork (which may increase risk of PPE failures) and prohibit workers take part‐time jobs elsewhere. Staffing inadequacies in New Zealand facilities were a concern as late as February 2021. 34 , 35 Some Australian states have banned frontline quarantine staff from having second jobs. 36	High priority
16. Improve management of travellers who smoke	Introduce measures to reduce need of nicotine‐dependent travellers to smoke in designated areas during travel and in managed quarantine (eg, nicotine replacement treatment as requirement for travel).	Medium priority
17. Add post‐quarantine control measures	Introduce a post‐quarantine period of home quarantine to reduce risk of local transmission by people with undetected infections (ie, those with exceptionally long incubation periods or cross‐infection during quarantine). Post‐quarantine testing could be used to detect such infections.	Medium priority
18. Mandatory digital contact tracing tools	Require quarantine workers to use digital tools (eg, Bluetooth function of COVID‐19 smartphone apps) to facilitate contact tracing in case of border failure. Travellers could be required to use such technologies for two weeks after completing quarantine. Travellers could also use these tools during quarantine, as facilities are sometimes evacuated because of fire alarms and burst water pipes.	Medium priority

COVID‐19 = coronavirus disease 2019; SARS‐CoV‐2 = severe acute respiratory syndrome coronavirus 2.