"I will say the picture of the background is not related to the words”: using corpus linguistics and focus groups to reveal how speakers of English as an additional language perceive the effectiveness of the phraseology and imagery in UK public health tweets during COVID-19

This paper reports on an application of a multimodal corpus-based study into the effectiveness of public health information about COVID-19 for speakers of English as an additional language (EAL) in the UK. A corpus of information tweets from 13 UK public health agencies totalling 560,000 words, with concomitant images and videos, was collected between March 2020 and February 2021. The most frequent n-grams occurring across all 13 public health agencies, and sample images occurring alongside these, were identified. In this study, we examine how images and videos combine with the phraseology to shape these COVID-19 public health information messages. Following this, six illustrative tweets were used as prompts for three focus groups of EAL participants based in the UK representing a range of first languages and occupations. Data from the focus groups was analysed in order to identify how common public health phraseology and images were received, understood and responded to by participants and how they felt they could be amended to increase their effectiveness for EAL speakers. We conclude with suggestions for making the language of public health messages simpler and more direct, aligning images more clearly with the language used and removing linguistic ambiguity. These recommendations for how such messaging could be improved in future public health campaigns could ensure a more effective and inclusive public health response.

Rapid on-site molecular Point of Care Testing during influenza outbreaks in aged care facilities improves antiviral use and reduces hospitalisation.

OBJECTIVE: Western Sydney Local Health District (WSLHD) measured the utility and validity of rapid molecular point-of-care testing (POCT) in aged care facilities (ACFs) experiencing influenza-like illness (ILI) outbreaks against routine laboratory testing. METHODS: A descriptive epidemiological study into 82 respiratory outbreaks reported across 63 ACFs within WSLHD supporting approximately 6,500 residents aged ≥65 years and staffed by ∼6,500 employees, from 1 August 2018 to 31 December 2019. RESULTS: WSLHD Public Health Unit performed on-site testing at 27 ACF outbreaks (34%), while 53(66%) ACFs conducted only routine laboratory testing. The Xpert®Xpress Flu/RSV molecular PCR provided a sensitivity and specificity of 100%. Those with on-site testing, antiviral prophylaxis was prescribed at 75% of facilities within 24 hours of testing, as opposed to 32% of those using laboratory testing (p<0.01). There were 24 of 181 ACF residents hospitalised in the POCT group compared to 76 of 357 in the laboratory-only group (OR=0.57; p=0.02). CONCLUSIONS: On-site ACF testing is reliable and practical for early identification of influenza, enabling timely use of antiviral treatment and prophylaxis, and was associated with decreased hospitalisation. PUBLIC HEALTH IMPLICATIONS: Enhanced respiratory surveillance and on-site testing should be strongly considered as part of routine management of respiratory outbreaks in ACFs and may reduce outbreak severity.