Between the sea and the sky: A social practice investigation into health behaviours during cruise travel.

ISSUE ADDRESSED: The COVID-19 pandemic has highlighted organised cruise holidays as perfect incubators for microbiological infections due to the constant socialising within closed spaces. Little is known about people's health behaviours and perceptions during cruise holidays. METHODS: Narrative group interviews and respondent photo diary exercises were conducted with families (n = 25) residing in different areas across metropolitan NSW, Australia. Guided by a social practice theoretical approach we undertook a thematic analysis that identifies reasons for choosing a cruise, health considerations and behaviours in relation to cruise travel and awareness of official cruise health information. RESULTS: Cruise travel included a licence to abandon cautious behaviours, reinforced by confidence in the cruise organiser's risk management ability. Health concerns were not a high priority for participants and were mainly understood in terms of eating healthy, modest exercise, managing seasickness and having adequate supplies of medications. Awareness of official cruise health and risk information was largely non-existent. CONCLUSION: Understanding how travel health practices emerge and are likely to be modifiable produces health-promoting awareness and intervention efforts that recognise and link with people's ideas about cruise holidays as times of fun, leisure, relaxation, without interfering with or imposing on them. SO WHAT?: This study highlights the importance of developing health communication and promotion strategies that are responsive to the interconnected meanings, competencies and materials that have a bearing on how cruise travellers understand and enact health-related behaviours in preparation for and during a cruise holiday.

Bondi and beyond. Lessons from three waves of COVID-19 from 2020.

OBJECTIVES: To describe local operational aspects of the coronavirus disease 2019 (COVID-19) response during the first three waves of outbreaks in New South Wales (NSW), Australia, which began in January, July and December 2020. Type of program or service: Public health outbreak response. METHODS: Narrative with epidemiological linking and genomic testing. RESULTS: Epidemiological linking and genomic testing found that during the first wave of COVID-19 in NSW, a large number of community transmissions went undetected because of limited testing for the virus and limited contact tracing of cases. The second wave of COVID-19 in NSW emerged following reintroduction from the second wave in Victoria, Australia in July 2020, and the third wave followed undetected introduction from overseas. By the second and third waves, cases could be more effectively detected and isolated through an increased ability to test and contact trace, and to rapidly genomic sequence severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolates, allowing most cases to be identified and epidemiologically linked. This greater certainty in understanding chains of transmission resulted in control of the outbreaks despite less stringent restrictions on the community, by using a refined strategy of targeted shutdown, restrictions on cases, their close contacts, identified hotspots and venues of concern rather than a whole of community lockdown. Risk assessments of potential transmission sites were constantly updated through our evolving experience with transmission events. However, this refined strategy did leave the potential for large point source outbreaks should any cases go undetected. [Addendum] A fourth wave that began in Sydney in June 2021 challenged this strategy due to the more transmissible nature of the Delta variant of SARS-CoV-2. LESSONS LEARNT: A wave of COVID-19 infections can develop quickly from one infected person. The community needs to remain vigilant, adhering to physical distancing measures, signing in to venues they visit, and getting tested if they have any symptoms. Signing out of venues on exit allows public health resources to be used more efficiently to respond to outbreaks.