Public health experts say Australian citizens who test positive to Covid-19 in India should be considered medical evacuations and allowed to return home.

It comes as Qantas says it is investigating suggestions that rapid testing conducted at the departure gate could have resulted in some false positives, barring people who did not have the virus from returning home.

Forty-two of the 150 people booked on the first repatriation flight, which landed in Darwin on Saturday, were barred from flying after they tested positive either in PCR tests in the days prior to departure or rapid antigen tests at the gate, and 30 more were barred as their close contacts. About 80 people made the flight and are quarantining at Howard Springs.

Prof Catherine Bennett, the chair of epidemiology at Deakin University, said that for many Australians in India who might be older or have co-morbidities, repatriation was not a border issue but a health emergency.

“This is more like medevac than a border strategy, and we need to treat it like medevac,” she said.

“We need to shift our thinking from returnees to medical evacuation. These are people who if they do need medical care would do better, much better, in Australia than they would in India.”

That meant configuring a policy not based on the perceived risk to Australia but on the needs of Australians overseas.

The prime minister said on Sunday that allowing people who had tested positive to return to Australia “doesn’t make any sense”.

“I don’t think people are being unfairly blocked,” Scott Morrison told reporters in Gladstone. “In this case, we have got the other side of the coin in a number of cases where people who have tested positive, they may not have been positive.

“But when it comes to protecting Australians health and safety here, then we’re going to be cautious. I know what side of the line we need to be cautious on.”

Morrison said the government was not considering allowing people who had tested positive to board flights.

“I have seen the suggestions from others who seem to think that we can put people who have tested Covid-positive on planes and bring them into Australia,” he said. “I mean that just doesn’t make any sense.

“We all want to support people as much as we can, but by importing Covid into the country, I don’t think it is a very sensible or sound thing to do.”

Bennett said there might be limits in Australia’s capacity to house Covid-positive returnees, who would be housed in medical hotels not the ordinary hotel quarantine system.

But she said where there was capacity, Australia should be running specialist flights staffed by vaccinated flight crews.

Australia in January introduced the mandatory requirement for all international arrivals to return a negative PCR test within 72 hours of travel.

Bennett said testing negative through a PCR test, and especially a pre-flight rapid antigen test, was not a guarantee that a traveller would not rest positive upon landing in Australia.

Associate Prof Hassan Vally, an epidemiologist from La Trobe University, said allowing Australians in India to return home was a “moral and ethical question”, not one of risk.

“The health system in India is either on the brink of collapse or has collapsed,” he said. “They don’t have enough oxygen to support patients who would almost certainly survive if they were in a Western country.”

Vally said the options presented by government – that Australia either kept its borders closed and was safe or allowed people to return and risked massive outbreak – were a false dichotomy. The vaccination of key frontline staff and aged care residents – the latter of which passed 85% last week, according to the federal government – reduced the risk.

“The problem with the current policy on bringing people back from India is bringing people home is seen as an unacceptable risk for the rest of Australia, because our threshold for risk [from Covid-19] is basically zero,” Vally said.

“But if we have zero tolerance for risk we are going to be basically closed off from the rest of the world for the next two to three years while everyone else gets back to normal.”

This content first appear on the guardian

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