An audit of uptake of flu, COVID-19 and pneumococcal vaccines in a cohort of people living with HIV

Background: People living with HIV are at greater risk of complications associated with influenza, SARS-CoV-2 and pneumococcus than the general population and BHIVA guidelines recommend vaccinating all patients against these infections. The purpose of this audit was to determine the uptake of these vaccines, and factors associated with uptake, to inform vaccine delivery models. Method(s): All patients who received HIV care in our service at the end of November 2022 were included. Demographic data were collected from the service database, clinical data and pneumococcal vaccine (Prevenar-13) status were obtained from clinical records and COVID-19 and flu vaccine (2021) uptake was obtained from the Vaccine Management Tool (VMT). At the time of audit all patients were recommended to have received at least 3 doses of a SARS-CoV-2 vaccine. Caldicott approval was received for this work. Result(s): There were 364 patients known to the service of which one was excluded as clinical information was not available. Sixty-seven percent had received flu vaccine, 88% >= one dose of COVID-19 vaccination, 76% at least 3 doses of COVID-19 vaccination and 88% had received Prevenar-13. Three percent had received no vaccines and 60% had completed all vaccines. Uptake of both flu and COVID-19 vaccines were lower in the following groups: <50 years old (51% and 62% respectively), urban residence (65%, 71%), higher deprivation scores (51-65%, 64-75%) less time in HIV care (57%, 70%), those not on ART (13%, 25%), CD4 <200 cells/mm3 (40%, 50%), detectable viral load (33%, 42%), those out of care (23%, 23%) and those known to the harm reduction service (33%, 33%). There was higher uptake of Prevenar-13 in all groups. Uptake of all vaccines was high in those with comorbidities. Conclusion(s): The high uptake of Prevenar-13 in higher risk groups suggests that the model of vaccine delivery, opportunistic and pro-active recall for inhouse vaccination, is more effective for protecting those at highest risk for poor outcomes and for those for whom access is challenging compared to the centralised national recall system at designated Vaccine hubs. Vaccination resourcing, planning and delivery should consider the needs of specific risk groups to ensure best outcomes.

One-minute-sit-to-stand-test elicits less desaturation than 6MWT in advanced respiratory disease

Introduction: During the COVID-19 pandemic pulmonary rehabilitation moved to a telehealth platform and the 1-min sit-to-stand test (1minSTS) was often used instead of the 6-min walk test (6MWT) to evaluate functional exercise capacity. We sought to determine;(i) the extent to which the six-minute walk distance (6MWD) could be estimated from the number of repetitions achieved during the 1minSTS and, (ii) agreement in cardiorespiratory responses elicited collected during the tests. Method(s): Data were extracted from medical records on all people who attended the advanced lung disease service at Fiona Stanley Hospital between September 2021 and January 2022. Pulse rate and oxygen saturation (SpO 2) were measured continuously during both tests using a pulse oximeter. Symptoms were quantified using the Borg scale (0 to 10). Result(s): Data were available on 80 participants (43 males;age 64 +/- 10 years;FEV 1 1.65 +/- 0.77 L). Compared with the 6MWT, the 1minSTS resulted in a higher nadir (mean difference [MD] 4%, 95% CI 3 to 5), higher peak pulse rate (MD 8 bpm, 95% CI 5 to 11), similar intensity of dyspnoea (MD -0.3, 95% CI -0.6 to 0.1) and greater leg fatigue (MD 1.1, 95% CI 0.6 to 1.6). Of those who demonstrated severe desaturation (SpO 2 nadir <85%) on the 6MWT (n = 18), 5 and 10 were classified as moderate (SpO 2 nadir 85% to 89%) or mild desaturators (SpO 2 nadir >= 90%), respectively on the 1minSTS. The equation that represented the relationship between 6MWD and 1minSTS was: 6MWD (m) = 247 + (7 x number of transitions achieved during the 1minSTS;r 2 = 0.44). Conclusion(s): The 6MWT elicited greater desaturation, a lower peak pulse rate and greater leg fatigue than the 1minSTS. A smaller proportion of people will be classified as 'severe desaturators' using the 1minSTS test. The capacity to estimate the 6MWD using results of the 1minSTS is limited.

Reciprocity and design for an era of compressed temporal and spatial scale

Haraway and others have suggested reciprocity with the non-human world is a pathway to un-derstanding our humanness. Two urgent trends accelerate our need for this reciprocity: the first is the COVID-19 pandemic as a harbinger of future pandemics, and the second is our changing planetary climate. Our present time is increasingly becoming a "present-future,” linked irreversibly by scientific models to specific future states of our planet and local regions. At the same time our bodies are co-evolving with a virus in a global reciprocal process with no end in sight, collapsing our sense of scale and separation among bodies. A long view of time in the past could act as a counterbalance to this experience. Bringing the longue durée model of time into our present requires reestablishing our knowledge of a long-term past in which humans adapted to major changes in climate earlier in the Holocene. Forms of future urban adaptation can embody reciprocity by emphasizing strategies that anticipate change rather than seeking to prevent it, leap-ing forward in time to embrace global changes we are no longer able to prevent. © 2022 Author(s).

Cervical, breast, and colorectal cancer screening by COVID-19 booster and influenza vaccination status in a sample of women in Puerto Rico

Background: Recommendation by a healthcare provider is essential for women to seek preventative cancer screening. Research has shown patients are receptive to information about cancer screening given by health professionals administering influenza vaccines. Promotion of cancer screening during vaccination may be particularly important in Puerto Rico (PR), which, relative to the continental United States, has low cervical and colorectal cancer screening rates. Objective(s): This study aims to determine if receiving the influenza vaccine in the past year or ever receiving the COVID-19 booster is associated with an increased likelihood of women participating in cervical, breast, and colorectal cancer screening in the past year. Method(s): Women older than 18 are recruited weekly in different ongoing community outreach events throughout Puerto Rico as part of the Puerto Rico Community Engagement Alliance (PR-CEAL) against COVID-19 disparities. The PR-CEAL outreach team completes an online community survey as part of their field activities. Initial data was collected from February 17th 2022 through May 28th 2022, with data collection currently ongoing. Pearson chi2 test or Fisher exact test, as appropriate, was used to quantify the association between participation in cancer screening and vaccination status. Result(s): As of May 31st, 253 women with a median age of 59 had been recruited. Of these, 56.1% had received the influenza vaccine in the past year, and 52.6% had received a COVID-19 booster. Nearly 52% of women with the booster and 65% without the booster received cervical cancer screening (p-value =0.29). Women with the booster and those without the booster (75% each) received breast cancer screening (p-value = 0.99). Only 16.1% of women with the booster and 11.8% without the booster had received colorectal cancer screening (p-value = 0.99). Receipt of cancer screening according to influenza vaccine status was as follows: 59.3% vaccinated and 51.5% unvaccinated received cervical cancer screening (p-value = 0.35);31.4% vaccinated and 41.2% unvaccinated received breast cancer screening (p-value = 0.56);and 13.1% vaccinated and 9.3% unvaccinated received colorectal cancer screening (p-value = 0.46). Conclusion(s): No differences in receipt of cancer screening were found by influenza or COVID-19 booster vaccination status among adult women in Puerto Rico. Routine vaccination appointments may therefore represent a missed opportunity to promote cancer screening.

Mortality, incidence and seasonality of canine and feline patients treated with tick antiserum in three far North Queensland veterinary clinics from 2000 to 2020.

Tick paralysis is a paralysis caused by bites from Ixodes holocyclus, affecting an estimated 10,000 companion animals in Australia annually. Despite tick antiserum being the cornerstone of treatment, there are no large-scale general practice studies that examine survival outcomes in tick antiserum-treated animals. In this retrospective study, clinical records from three far north Queensland general practice veterinary clinics were searched for tick antiserum-treated canine and feline patients were seen between 2000 and 2020. Patient records were assessed for survival outcomes, then logistic regression and Bayesian structural time-series model were used to assess trends in incidence and mortality and the relationship between these and time of year, rainfall, and species. The study included 2019 dog and 953 cat records. When patients with unknown outcomes were removed, canine mortality was 11.8% (213/1799) and feline mortality was 5.3% (46/872). Dogs were found to have 2.41 odds of dying following treatment than cats. August and September had the highest mean number of monthly treatments, and rainfall in the previous 5-8 months was positively correlated with the number of patients treated in each month. The odds of mortality did not vary significantly by month or season, and from 2015 onwards, there was a significant decrease in the proportion of dogs treated by the clinics. Overall, this study provides new information on tick antiserum treatment outcomes in general practice as well as new information on tick paralysis incidence in far north Queensland.

ON A JOURNEY INTO THE UNKNOWN: Critical Care Pedagogy, COVID, and Teacher Education

In this chapter, the authorial team reflects on caring classroom practices during and after the COVID-19 pandemic. Through their reflection, they consider the question: Why should we-and how can we-enact a critical care pedagogy within teacher education programs now and into the future? This chapter addresses how the redesign of coursework should institutionalize caring classroom practices and what specific classroom practices can be used to center critical care pedagogy. The chapter concludes by questioning how teacher educators might institutionalize these practices in colleges of education. © 2023 selection and editorial matter, Melanie Shoffner and Angela W. Webb;individual chapters, the contributors.

Evidence-based implementation of our “Structured urinary Continence Assessment and Management Plan” practice change package to improve continence assessment, diagnosis and management on wards admitting patients post-stroke

Background: Urinary continence assessment and management plans are recommended in stroke clinical guidelines, however this care is often not provided. Aim: To determine the proportion of hospitalised patients with continence symptoms who have an assessment, diagnosis and management plan, before, and following the implementation of a practice change intervention. Methods: Fifteen wards (acute=3, rehabilitation=7, acute and rehabilitation= 5), that admit adult patients with stroke at 12 hospitals (metropolitan= 4, regional=8) participated. We implemented our evidence-based Structured urinary Continence Assessment and Management Plan (SCAMP) intervention (clinical decision tool, practice guidelines, webbased clinician education modules) using implementation strategies to overcome identified barriers. Screening and auditing of consecutive medical record for three 3-month periods were undertaken: before implementation (T0);after the 6-month implementation period (T1), and after a 6-month maintenance period (T2). The records of symptomatic inpatients were audited in detail. Descriptive statistics for The proportions of eligible symptomatic inpatients receiving continence assessment, diagnosis and management plans are presented. Results: All wards contributed data at T0, and 11/15 wards at T1 and T2. The onset of COVID19 prevented implementation at two rural wards, and two metropolitan wards closed immediately after implementation was completed. The proportion of symptomatic inpatients relative to all screened was: T0= 33% (283/849), T1= 33% (239/723), T2= 36% (247/695). The characteristics of symptomatic inpatients included: age(years) mean(SD) T0= 79(13), T1= 76(15), T2= 76(14);females T0= 57%(161/283);T1= 55%(132/239);T2= 58%(143/247). The proportions of symptomatic patients receiving components of care were: assessment within 72 hours T0= 38%, T1= 64%, T2= 64%;diagnosis T0= 30%, T1= 70%, T2= 72%;management plan T0= 7%, T1= 25%, T2= 23%. Discussion: From this large, multi-site study we identified implementation of our SCAMP intervention resulted in immediate improvements in continence care, that were sustained six months later. This intervention appears promising to increase access to best-practice continence care.

Sustaining the renal nursing workforce

Background The prevalence of kidney disease continues to increase, as does the acuity of kidney care. Patients with kidney failure are older, sicker and less mobile. Health systems are under more pressure to manage growing care needs and capacity constraints. This is likely to have an impact on nursing workforce experiences. Aims The aim of this research was to examine nephrology nursing in South Australia to understand the impact of increasing acuity and organisational factors that may support and sustain the workforce. Methods An exploratory semi-structured qualitative approach, facilitating eight focus groups with 36 nephrology nurses across six public metropolitan renal units was applied. Data were thematically analysed. Findings Three central themes relating to nursing culture, patient acuity and organisational factors that impact the nursing workforce were identified. Sub-themes identified were pride and passion, teamwork and collegiality, increasing patient acuity and the lack of clinical rationalisation in kidney care, the value of a 'flat' hierarchy, and vulnerability during the COVID-19 pandemic. Consequently, we identified a disconnect between institutional expectations and what the participants considered pragmatic reality. Participants reported sustained workplace pressure, a 'triage' approach to care, and a sense of work left undone. Conclusion Nephrology nurses experience a gap between 'supply and demand' on their time, resources and workload. These findings highlight the need for further exploration of the root causes and the development of new systems to provide quality, safe and rewarding care for patients and to reduce the risk of workforce moral distress and burnout.

Integrating Oral Health into Pediatric Telemedicine Visits

Background: Connecting the mouth to the rest of the body is critical for providing whole-person, patient-centered, comprehensive healthcare. The COVID-19 crisis has provided an opportunity for elevation and expansion of oral health prevention education into telemedicine, particularly using video connections. Access to dental care substantially decreased during this time. Public acceptance and demand have increased simultaneously. Most oral health conditions are preventable (-30-85%) with improvement of personal habits and quality dental care. Integration of prevention-centric approaches to oral health care into telemedicine can overcome barriers and have a favorable impact on oral and overall health of all populations. Using a DEI lens, we propose to create a compendium of effective best practices/innovations for oral health integration in telemedicine (OHFT) that can be adopted widely at minimal cost to support the value of oral health to overall health throughout pediatric healthcare. Methods: To create comprehensive guidance around best practices/innovations incorporating oral health into telemedicine visits, we will conduct expansive focus groups (30+) to research and pilot an assortment of modalities and messages for OHFT in the next 12 months. HTHC at PAAAP will continue working towards collective impact with Primary Care Collaborative, the Oral Health Section of the American Academy of Pediatrics (AAP) and OPEN in subsequent years to 1) monitor pilots/innovations, 2) initiate establishing a CPT procedure code with RVUs, 3) seek USPSTF recommendation of “A” or “B”, and 4) work with AAP Bright Futures Guideline for inclusion of the procedure. We will seek and spread via publication and conference presentations best practices/innovations providing an assortment of modalities and messages for inclusion across the spectrum of telemedicine visits, beginning with pediatric telemedicine visits. Results: Implementation of OHFT will insure reaching all in need. Sustainability would be provided by assuring reimbursement for clinician time spent on implementing OHFT. We postulate a dramatic increase in population oral health and OH literacy from implementation of OHFT. Conclusion: In summary: • OHFT serves families without transportation, CSHCN who are difficult to transport, etc. Many occupy homes impacted by discriminatory practices and poverty. • Smartphone pictures of teeth, mouth, toothbrush, and toothpaste, emailed in advance of the visit ,can be used to aid in addressing the specific needs of the child via video telemedicine - all in about 2 minutes. • Best patient/family centered OHFT practices will be updated frequently for needs of specific communities - CSHCN, limited resources, persons of color, etc. • A CPT Code with RVUs for payment for the services as a procedure, will build profit center capacity increasing oral health literacy of the community along with adoption of good prevention practices. • Medical telehealth visits are demanded by the public. Best practices/innovations must be evaluated through lenses of quality as well as DEI.

STROKE CARE QUALITY BETWEEN 2017- 2020: OBSERVATIONAL DATA FROM THE AUSTRALIAN STROKE CLINICAL REGISTRY

Background and aims: National clinical quality registries facilitate reliable monitoring of stroke care by providing local hospital teams with data on their performance compared to national benchmarks. We aimed to assess changes in stroke care over time from public hospitals participating in the Australian Stroke Clinical Registry (AuSCR). Methods: AuSCR stroke quality care indicators were compared between 2017 and 2020, using a matched-hospital design. Analyses were limited to adults with stroke or transient ischaemic attack admitted to hospitals contributing ≥30 episodes each year during the study period. Descriptive statistics and linear tests for trend were used to assess changes in quality indicators across years. Results: Among 47 eligible hospitals, admissions increased from 13,508 (2017) to 18,139 (2020). Overall, half were aged ≥75 years, 45% were female, and 59% had a severe stroke (no differences by year). Between 2017 and 2020, improvements were observed for: endovascular retrieval (+8%;P<0.001), hyperacute antithrombotics (+6%;P<0.001), mobilisation during admission (+3%;P<0.001), swallow screen/assessment within 4 hours (+12%;P<0.001), discharge care planning (+11%;P<0.001), and discharge secondary prevention medications (+10%;P<0.001). However, delivery of thrombolysis remained unchanged (-1%;P=0.07), door-toneedle within 60 minutes decreased (-6%;P=0.008), and access to stroke unit care declined in 2020 (76% 2019 vs 72% 2020;P<0.001). Conclusion: Improvements in many indicators of quality stroke care have been observed within Australian hospitals participating in a national registry. Declines in timeliness to thrombolysis and access to stroke units in 2020 represent a likely consequence of the COVID-19 pandemic that requires national action.

A Participatory Design Approach for Re-engaging HBCU Students in Gaming Curricula

Attracting and retaining underrepresented minorities to computing is difficult, particularly African-Americans. Interest in interactive computing techniques like gaming, mixed reality, and user experience design has helped to spark interest in undergraduate computing majors by more African American students. Undergraduate computing students rarely participate in designing their own learning experiences in game-oriented computing courses. This paper discusses the use of participatory design techniques to improve the learning experience of students studying how to design and develop interactive games at a Historically Black College (HBCU). Activities included design thinking lessons, start-up activities and student reflection journals, and to understand how the gaming sequence could be improved at the university. Results of the participatory design approach showed that students were enthusiastic about creating games surrounding social issues;however a small cohort size and interruption due to COVID-19 contributed to various challenges experienced by the study. However, approaches used in the paper could be replicated across other HBCUs or other universities experiencing a decline in gaming participation by underrepresented students. © 2021 IEEE.

The Effect of the ENJOY Seniors Exercise Park Physical Activity Program on Falls in Older People in the Community: A Prospective Pre-Post Study Design.

BACKGROUND: The ENJOY project (Exercise interveNtion outdoor proJect in the cOmmunitY for older people) is a community-based research project actively promoting physical activity engagement through the delivery of an exercise program using outdoor multimodal exercise equipment. This study investigated the impact of the physical activity program on falls in older people. METHOD: This study was a multi-site prospective study with a pre-post intervention design and 12-month follow up. Eighty older people with increased falls risk underwent a 12-week supervised outdoors exercise program followed by a 6-month maintenance phase. The proportion of fallers and falls incidence were compared between the preceding and the prospective years. RESULTS: A sample of 54 (age 72.4±7.3, 79.6% women) was available for the 12 months analysis (due to COVID19 lockdowns, data of 19 participants were excluded and 4 dropped out). Number of fallers (from 51.8% to 31.4%, p=0.03) and falls incidence (from 42 to 29 falls, p<0.01) were significantly reduced at the 12-months follow up. CONCLUSION: The ENJOY Seniors Exercise Park program integrates outdoor multimodal exercise stations including specific exercises designed to challenge dynamic balance during functional daily movements. The outcomes provide preliminary evidence for the potential positive impact of the ENJOY Seniors Exercise Park in reducing falls for older people.

PERCEPTIONS OF TELEMEDICINE OFFICE VISITS DURING THE COVID-19 PANDEMIC

The COVID-19 pandemic has dramatically changed the way physicians interact with patients. During the pandemic numerous constraints were implemented to reduce the risk of transmitting the virus. Telemedicine, defined as either phone or video calls, emerged as a replacement to in-person office visits. Prior to the pandemic 8% of physician offices used telemedicinetools as compared to 84% today. Previous studies have reported favorable patient impressions of telemedicine visits. This study defined which aspects of the interactions were favorable, determined factors influencing opinion, compared telemedicine quality directly to in-person visits and determined preferences for future visits. METHODS Surveys were delivered by mail or in person to 1000 randomly selected patients (pts) of Sierra Endoscopy Center and Sierra Nevada Gastroenterology Medical Assoc, a community based gastroenterology practice in Grass Valley, CA. Each pt had a telemedicine visit (TMV) from April 1-Aug 30, 2020. 330 surveys were returned. Surveys contained a 5 point Likert scale set of questions rating the quality, communication effectiveness, physician compassion/empathy, thoroughness and convenience of the visit. TMV was directly compared to in person visits (IPV) for the same qualities, as well as future preference. Demographics, distance from office, insurance, employment status, previous experience with office and reason for office visit were recorded. RESULTS Overall satisfaction with quality of TMV=4.5 on Likert scale, 5 being strongly agree. Satisfaction with communication=4.7, physician compassion/empathy=4.6,thoroughness= 4.3, convenience=3.8. Acceptance of future TMV=4.0. Direct comparison of TMV to IPV significantly favored in person in overall quality (78 vs 12 vs 10% either), communication (66 vs 20%), physician compassion (73 vs 11%), thoroughness (69 vs 14%). TMV rated higher in convenience (67 vs 29%). Preference for future visits was 48% in person and 46% TMV. Distance >20miles preferred TMV. Retirees and age >70yo strongly favored IPV. DISCUSSION Previous studies have reported high pt satisfaction with TMV. This study supports those findings but also shows a strong preference for in-person visits when comparing quality, communication, compassion and thoroughness. Distance >20 miles favored TMV, whereas retirees and age >70yo favored IPV. Choice for future visits were fairly equally divided between telemedicine and in-person, with telemedicine preferred in 46% of pts. This may be due to a desire for convenience and a concern about the increased risk of exposure to COVID-19 inherent to an in-person office visit. We speculate that when the pandemic resolves, a majority of pts will prefer to resume in-person visits while some will prefer to continue telemedicine.. Further studies are needed to determine the future role of telemedicine in patient care.(Table Presented) (Table Presented) (Figure Presented)

Marketing mortality? Healthy vs. unhealthy food in television advertising

Background: Cardiovascular disease has been the leading killer of Americans since the Spanish flu pandemic of 1918, despite recent COVID-19 mortality. During this global pandemic, the social distancing and stay-athome requests, there was increased television (TV) engagement, and media marketing has become more impactful in modifying consumer behaviors. Purpose: We evaluated the healthfulness of food marketing in the United States (US), based on TV commercials most frequently aired on American primetime networks during the COVID-19 pandemic. Methods:We reviewed a total of 104 TV commercials between 2020-2021 on network and cable programs dividing them into 4 categories: 1) fastfood chains, 2) brand-recognized individual items, 3) grocery chains, and 4) home-delivery meals. The food items displayed in each commercial were recorded and scored based on the previously validated healthful versus unhealthful nutrition scoring system (Sajita, et al., JACC 2017), assigning either positive or negative values for each food item in the commercial. Results: We found that 58% of the commercials advertised food from fastfood chains (mean score = -2.82, indicating an average of nearly 3 more unhealthy items than healthy items per commercial), 27% were brandrecognized individual items (-0.86), 9% were grocery chains (-0.90), and 6% were for home-delivery meals (-0.33), with significant differences noted between fast-food and individual items, home deliveries and grocery chains (each p<0.0001). Conclusions: This study demonstrated that commercial TV in the US routinely promotes the consumption of foods that are known in published medical literature to be unhealthy, particularly those underpinning cardiovascular disease and its risk factors. In order to prevent an increase in cardiovascular mortality during and after this global pandemic, we suggest regulation and or legislation to curtail the frequency and/or content of these commercials, and consider a ban on such advertising to children, similar to that previously employed in Canada and the European Union.

SARS-CoV-2 known and unknowns, implications for the water sector and wastewater-based epidemiology to support national responses worldwide: early review of global experiences with the COVID-19 pandemic

Wastewater surveillance of pathogens may be a useful tool to help determine whether clinical surveillance of disease is effective or inadequate due to under-reporting and under-detection. In addition, tracking of pathogen concentrations over time could potentially provide a measure of the effectiveness of public health control measures and the impact of the gradual relaxation of these controls. Analysis of wastewater using quantitative molecular methods offers a real-time measure of infections in the community, and thus is expected to provide a more sensitive and rapid indication of changes in infection rates before such effects become detectable by clinical health surveillance. Models may help to back-calculate wastewater prevalence to population prevalence or to correct pathogen counts for wastewater catchment-specific and temporal effects. They may also help to design the wastewater sampling strategy. This article provides a brief summary of the history of pathogen wastewater surveillance to help set the context for the SARS-CoV-2 wastewater-based epidemiology (WBE) programmes currently being undertaken globally.

Wastewater monitoring for SARS-CoV-2. (Special Issue: COVID-19.)

Wastewater monitoring (WM) of SARS-CoV-2 from sewers was applied throughout the world early in the COVID-19 pandemic. Sharing of protocols and experiences in WM of SARS-CoV-2 by national and international researchers and practitioners has been vital to ensuring the sensitivity and specificity of the methods. WM has been a valuable adjunct to human clinical testing, and when positive results occur in sewage, community testing has been increased. WM findings allow public health officials to track and respond to the impacts of loosening lockdown restrictions, demonstrating when return to normal social activities might occur without a resurgence of rapid community transmission, and they are particularly useful in areas with low human case numbers and/or low clinical testing rates. New research is required to address several practical knowledge gaps, for example, sampling protocols, prediction of case prevalence from viral numbers by modelling, and determination of detection limits. Communication to the Australian public of WM of SARS-CoV-2 has been via interactive, visual dashboards. Once SARS-CoV-2 vaccinations are introduced, WM could help track the underlying circulation of the virus in the population, the spread of known variants and its future evolution.