Key lessons from the COVID-19 public health response in Australia.

Australia avoided the worst effects of the COVID-19 pandemic, but still experienced many negative impacts. Reflecting on lessons from Australia's public health response, an Australian expert panel composed of relevant discipline experts identified the following key lessons: 1) movement restrictions were effective, but their implementation requires careful consideration of adverse impacts, 2) disease modelling was valuable, but its limitations should be acknowledged, 3) the absence of timely national data requires re-assessment of national surveillance structures, 4) the utility of advanced pathogen genomics and novel vaccine technology was clearly demonstrated, 5) decision-making that is evidence informed and consultative is essential to maintain trust, 6) major system weaknesses in the residential aged-care sector require fixing, 7) adequate infection prevention and control frameworks are critically important, 8) the interests and needs of young people should not be compromised, 9) epidemics should be recognised as a 'standing threat', 10) regional and global solidarity is important. It should be acknowledged that we were unable to capture all relevant nuances and context specific differences. However, the intent of this review of Australia's public health response is to critically reflect on key lessons learnt and to encourage constructive national discussion in countries across the Western Pacific Region.

Duration of Behavioral Policy Interventions and Incidence of COVID-19 by Social Vulnerability of US Counties, April-December 2020.

OBJECTIVE: State-issued behavioral policy interventions (BPIs) can limit community spread of COVID-19, but their effects on COVID-19 transmission may vary by level of social vulnerability in the community. We examined the association between the duration of BPIs and the incidence of COVID-19 across levels of social vulnerability in US counties. METHODS: We used COVID-19 case counts from USAFacts and policy data on BPIs (face mask mandates, stay-at-home orders, gathering bans) in place from April through December 2020 and the 2018 Social Vulnerability Index (SVI) from the Centers for Disease Control and Prevention. We conducted multilevel linear regression to estimate the associations between duration of each BPI and monthly incidence of COVID-19 (cases per 100 000 population) by SVI quartiles (grouped as low, moderate low, moderate high, and high social vulnerability) for 3141 US counties. RESULTS: Having a BPI in place for longer durations (ie, ≥2 months) was associated with lower incidence of COVID-19 compared with having a BPI in place for <1 month. Compared with having no BPI in place or a BPI in place for <1 month, differences in marginal mean monthly incidence of COVID-19 per 100 000 population for a BPI in place for ≥2 months ranged from -4 cases in counties with low SVI to -401 cases in counties with high SVI for face mask mandates, from -31 cases in counties with low SVI to -208 cases in counties with high SVI for stay-at-home orders, and from -227 cases in counties with low SVI to -628 cases in counties with high SVI for gathering bans. CONCLUSIONS: Establishing COVID-19 prevention measures for longer durations may help reduce COVID-19 transmission, especially in communities with high levels of social vulnerability.

Trends in Percentages of the US Population Covered by State-Issued COVID-19 Nonpharmaceutical Interventions, March 1, 2020-August 15, 2021.

Trends in the percentages of the US population covered by state-issued nonpharmaceutical interventions (NPIs), including restaurant and bar restrictions, stay-at-home orders, gathering limits, and mask mandates, were examined by using county-specific data sets on state-issued orders for NPIs from March 1, 2020, to August 15, 2021. Most of the population was covered by multiple NPIs early in the pandemic. Most state-issued orders were lifted or relaxed as COVID-19 cases decreased during summer 2020. Few states reimplemented strict NPIs during later surges in US COVID-19 cases over the winter of 2020-2021. The exceptions were mask mandates, which covered about 80% of the population between August 2020 and February 2021, and the most restrictive gathering limits, which covered a maximum of 66% of the population in early 2020 and 68% of the population in winter 2020-2021. Most NPIs were lifted by the end of the analysis period.

Concession-bargaining in Australian higher education: the case of the National Jobs Protection Framework

Australian universities suffered significant financial losses due to the COVID-19 pandemic. The National Tertiary Education Union (NTEU) responded with a concession-bargaining strategy, offering university managements a National Jobs Protection Framework (NJPF), which traded pay reductions for job security measures. This article provides an account of the development, promotion, and eventual collapse of the NJPF. We analyse the arguments for and against the NJPF, drawing on contemporary material from its supporters and opponents, and insights from the literature on concession-bargaining. We conclude that concession-bargaining was an unsuccessful strategy for the union, and put forward an alternative industrial strategy.

Reducing plastic waste in paeds ED

Aims/Objectives/Background Venepuncture and PVC insertion are common procedures in Children's ED and often include blood cultures. Opening a universal dressing pack (udp) including a plastic tray, sterile swabs, gloves and 2 plastic sterile field drapes (sfd) is common practice. Our department was making a huge spend on udp's. We aimed to determine if this was necessary and if we could reduce our plastic waste. Methods/Design A sample of 8 doctors across all grades demonstrated their set up for both procedures. We replaced udp in the IV trollies with x2 sfd pack (sfdp). Information was disseminated via weekly staff brief. Trollies are restocked each night using attached flashcards which were updated appropriately. The use and costs of dressing packs in ED was determined for April-June 2019. We planned to compare this for April-June 2020. Results/Conclusions All clinicians were opening a dressing pack for procedures but 87.5% only used the sfd and swabs. 100% discarded gloves due to inappropriate size and 100% discarded the tray. All staff adopted the new equipment with no problems identified. 3500 udps were being used in dept in 3 months. Udp v sfdp per item costs 32p v 8p, weight 65 g v 30 g. Due to CoVID-19 pandemic the number of ED attendances significantly reduced therefore costs were based on 2019 usage. In 3 months switching from udp to sfd would save £840 and 122.5 kg of refuse weight. Volumes of stocks were reduced from 0.05 m2 to 0.01 m2 for 50 udp v 50 sfdp which aids storage and restocking of IV trollies releasing staff time. We demonstrated a significant reduction in unnecessary plastic waste while also reducing costs and need for storage and restocking whilst maintaining safe practice. This has been rolled out in the neighbouring Clinical Decision Unit with anticipation of being a permanent change in both areas.

Cardioembolic Stroke in a Patient with Coronavirus Disease of 2019 (COVID-19) Myocarditis: A Case Report.

INTRODUCTION: There is a growing body of literature detailing coronavirus 2019 (COVID-19) cardiovascular complications and hypercoagulability, although little has been published on venous or arterial thrombosis risk. CASE REPORT: In this report, we present a single case of cardioembolic stroke in the setting of COVID-19 related myocarditis, diagnosed via cardiac magnetic resonance imaging and echocardiography. COVID-19 infection was confirmed via a ribonucleic acid polymerase chain reaction assay. CONCLUSION: Further research is needed to evaluate the hypercoagulable state of patients with COVID-19 to determine whether prophylactic anticoagulation may be warranted to prevent intracardiac thrombi and cardioembolic disease in patients with COVID-19 related myocarditis.

Timing of State and Territorial COVID-19 Stay-at-Home Orders and Changes in Population Movement - United States, March 1-May 31, 2020.

SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is thought to spread from person to person primarily by the respiratory route and mainly through close contact (1). Community mitigation strategies can lower the risk for disease transmission by limiting or preventing person-to-person interactions (2). U.S. states and territories began implementing various community mitigation policies in March 2020. One widely implemented strategy was the issuance of orders requiring persons to stay home, resulting in decreased population movement in some jurisdictions (3). Each state or territory has authority to enact its own laws and policies to protect the public's health, and jurisdictions varied widely in the type and timing of orders issued related to stay-at-home requirements. To identify the broader impact of these stay-at-home orders, using publicly accessible, anonymized location data from mobile devices, CDC and the Georgia Tech Research Institute analyzed changes in population movement relative to stay-at-home orders issued during March 1-May 31, 2020, by all 50 states, the District of Columbia, and five U.S. territories.* During this period, 42 states and territories issued mandatory stay-at-home orders. When counties subject to mandatory state- and territory-issued stay-at-home orders were stratified along rural-urban categories, movement decreased significantly relative to the preorder baseline in all strata. Mandatory stay-at-home orders can help reduce activities associated with the spread of COVID-19, including population movement and close person-to-person contact outside the household.