Protocol for a winter sentinel surveillance program of notifiable respiratory viruses in Queensland.

BACKGROUND: With the reduction in access to polymerase chain reaction (PCR) testing and changes in testing guidelines in Australia, a reduced number of people are seeking testing for coronavirus disease (COVID-19), limiting the opportunity to monitor disease transmission. Knowledge of community transmission of COVID-19 and other respiratory viruses is essential to better predict subsequent surges in cases during the pandemic to alert health services, protect vulnerable populations and enhance public health measures. We describe a methodology for a testing-based sentinel surveillance program to monitor disease in the community for early signal detection of SARS-CoV-2 and other respiratory viruses. METHODS/DESIGN: A longitudinal active testing-based sentinel surveillance program for respiratory viruses (including SARS-CoV-2, influenza A, influenza B and Respiratory Syncytial Virus) will be implemented in some regions of Queensland. Adults will be eligible for enrolment if they are part of specific community groups at increased risk of exposure and have not had a COVID-19 infection in the last 13 weeks. Recruitment via workplaces will occur in-person, via email and through online advertisement. Asymptomatic participants will be tested via PCR for SARS-CoV-2 infection by weekly self-collected nasal swabs. In addition, symptomatic participants will be asked to seek SARS-CoV-2 and additional respiratory virus PCR testing at nominated COVID-19 testing sites. SARS-CoV-2 and respiratory virus prevalence data will be analysed weekly and at the end of the study period. DISCUSSION: Once implemented, this surveillance program will determine the weekly prevalence of COVID-19 and other respiratory viruses in the broader community by testing a representative sample of adults, with an aim to detect early changes in the baseline positivity rate. This information is essential to define the epidemiology of SARS-CoV-2 in the community in near-real time to inform public health control measures and prepare health services and other stakeholders for a rise in service demand.

Outbreak of SARS-CoV-2 Delta variant on a single liquified natural gas (LNG) vessel, with estimates of vaccine effectiveness.

In August 2021, there was an outbreak of severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) Delta variant on an international liquified natural gas (LNG) vessel offshore to Gladstone, Queensland. Fourteen of the 26 crew members aboard the vessel tested positive for SARS-COV-2 on PCR during the outbreak. Vaccine effectiveness (VE) was 52% for all lab-confirmed SARS-CoV-2 infections, 65% for symptomatic SARS-CoV-2 infection and 100% for severe SARS-CoV-2. The attack rate (AR) of SARS-CoV-2 Delta variant was 54% (14/26). With heightened public health measures and infection control practices, we were able to declare the outbreak over in 26 days.

Protocol on establishing a prospective enhanced surveillance of vaccine preventable diseases in residential aged care facilities in Central Queensland, Australia: an observational study.

INTRODUCTION: Infectious diseases are a major cause of mortality and morbidity among the highly vulnerable occupants of residential aged care facilities (RACFs). The burden of vaccine preventable diseases (VPDs) among RACFs residents is mostly unknown and there is a lack of quality data from population-based prospective VPD surveillance in RACFs. The increasing burden of emerging and existing VPDs (eg, COVID-19, influenza, pneumococcal, pertussis and varicella-zoster) necessitates the establishment of an active enhanced surveillance system to provide real-time evidence to devise strategies to reduce the burden of VPDs in RACFs. METHOD AND ANALYSIS: This study proposes a prospective active enhanced surveillance that will be implemented in RACFs across the Central Queensland (CQ) region. The study aims to measure the burden, identify aetiologies, risk factors, predictors of severe outcomes (eg, hospitalisations, mortality) and impact of the existing National Immunization Program (NIP) funded vaccines in preventing VPDs in this vulnerable population. CQ Public Health Unit (CQPHU) will implement the active surveillance by collecting demographic, clinical, pathological, diagnostic, therapeutic and clinical outcome data from the RACFs based on predefined selection criteria and case report forms as per routine public health practices. Descriptive statistics, univariate and multivariate regression analysis will be conducted to identify the predictors of morbidity and clinical outcomes following infection. ETHICS AND DISSEMINATION: The study has been approved by the CQHHS Human Research Ethics Committee (HREC) (reference number HREC/2021/QCQ/74305). This study involves data that is routinely collected as part of the surveillance of notifiable conditions under the Public Health Act 2005. The CQHHS HREC approved a request to waive consent requirements of study participants as researchers will be provided non-identifiable data. The findings from the study will be actively disseminated through publication in peer-reviewed journals, conference presentations, social and print media, federal, state, and local authorities to reflect on the results that may facilitate revision of policy and highlight the stakeholders, funding bodies both locally and internationally.

The barriers and enablers to downloading the COVIDSafe app - a topic modelling analysis.

OBJECTIVE: We report a survey in regional Queensland to understand the reasons for suboptimal uptake of the COVIDSafe app. METHODS: A short five-minute electronic survey disseminated to healthcare professionals, mining groups and school communities in the Central Queensland region. Free text responses and their topics were modelled using natural language processing and a latent Dirichlet model. RESULTS: We received a total of 723 responses; of these, 69% had downloaded the app and 31% had not. The respondents' reasons for not downloading the app were grouped under four topics: lack of perceived risk of COVID-19/lack of perceived need and privacy issues; phone-related issues; tracking and misuse of data; and trust, security and credibility. Among the 472 people who downloaded the app and provided text amenable to text mining, the two topics most commonly listed were: to assist with contact tracing; and to return to normal. CONCLUSIONS: This survey of a regional population found that lack of perceived need, concerns around privacy and technical difficulties were the major barriers to users downloading the application. Implications for public health: Health promotion campaigns aimed at increasing the uptake of the COVIDSafe app should focus on promoting how the app will assist with contact tracing to help return to 'normal'. Additionally, health promotors should address the app's impacts on privacy, people's lack of perceived need for the app and technical barriers.

Epidemiology and clinical features of COVID-19 outbreaks in aged care facilities: A systematic review and meta-analysis.

BACKGROUND: COVID-19 outbreaks in aged care facilities (ACFs) often have devastating consequences. However, epidemiologically these outbreaks are not well defined. We aimed to define such outbreaks in ACFs by systematically reviewing literature published during the current COVID-19 pandemic. METHODS: We searched 11 bibliographic databases for literature published on COVID-19 in ACFs between December 2019 and September 2020. Original studies reporting extractable epidemiological data as part of outbreak investigations or non-outbreak surveillance of ACFs were included in this systematic review and meta-analysis. PROSPERO registration: CRD42020211424. FINDINGS: We identified 5,148 publications and selected 49 studies from four continents reporting data on 214,380 residents in 8,502 ACFs with 25,567 confirmed cases of COVID-19. Aged care residents form a distinct vulnerable population with single-facility attack rates of 45% [95% CI 32-58%] and case fatality rates of 23% [95% CI 18-28%]. Of the cases, 31% [95% CI 28-34%] were asymptomatic. The rate of hospitalization amongst residents was 37% [95% CI 35-39%]. Data from 21 outbreaks identified a resident as the index case in 58% of outbreaks and a staff member in 42%. Findings from the included studies were heterogeneous and of low to moderate quality in risk of bias assessment. INTERPRETATION: The clinical presentation of COVID-19 varies widely in ACFs residents, from asymptomatic to highly serious cases. Preventing the introduction of COVID-19 into ACFs is key, and both residents and staff are a priority group for COVID-19 vaccination. Rapid diagnosis, identification of primary and secondary cases and close contacts plus their isolation and quarantine are of paramount importance. FUNDING: Queensland Advancing Clinical Research Fellowship awarded to Prof. Gulam Khandaker by Queensland Health's Health Innovation, Investment and Research Office (HIRO), Office of the Director-General.

Notifiable diseases after implementation of COVID-19 public health prevention measures in Central Queensland, Australia.

ABSTRACT: The implementation of public health measures to control the current COVID-19 pandemic (such as wider lockdowns, overseas travel restrictions and physical distancing) is likely to have affected the spread of other notifiable diseases. This is a descriptive report of communicable disease surveillance in Central Queensland (CQ) for six months (1 April to 30 September 2020) after the introduction of physical distancing and wider lockdown measures in Queensland. The counts of notifiable communicable diseases in CQ in the six months were observed and compared with the average for the same months during the years 2015 to 2019. During the study's six months, there were notable decreases in notifications of most vaccine-preventable diseases such as influenza, pertussis and rotavirus. Conversely, notifications increased for disease groups such as blood-borne viruses, sexually transmitted infections and vector-borne diseases. There were no reported notifications for dengue fever and malaria which are mostly overseas acquired. The notifications of some communicable diseases in CQ were variably affected and the changes correlated with the implementation of the COVID-19 public health measures. BACKGROUND: The current COVID-19 pandemic has led to some significant changes to local, regional and national public health practices including social distancing and wider lockdown. These measures have been previously reported to be associated with reductions in the incidence of gastrointestinal and respiratory diseases as well as of other airborne transmitted agents.1,2 A preliminary analysis was conducted assessing the impact of these measures on nationally notifiable diseases across Australia;3 however, the impact of these measures on communicable diseases within regional Australia is not well established. Like most regional areas, Central Queensland (CQ) has a lower population density and considerable distance from major cities; it will be informative to understand how these measures impact on notifiable conditions in this regional setting. We aimed to identify the patterns of change in reported notifiable conditions to the Central Queensland Public Health Unit (CQPHU), during a six-month period (1 April to 30 September 2020) following the implementation of COVID-19 measures. Here, we compare these notifications to the surveillance data for the same six-month period for the previous five years (2015 to 2019). METHODS: The study encompasses all notifiable conditions reported from CQ, which covers approximately 226,000 population and is spread over 117,588 square kilometres. Communicable diseases data were retrieved from the Queensland Notifiable Conditions System (NoCS), an online epidemiological database, from 1 January 2015 to 30 September 2020. The data were collected under the Public Health Act 2005, a legislative authority that provides permission to access health information. Permission to publish was given by the Communicable Diseases Branch of Queensland. Data were extracted on selected notifiable diseases in Queensland: blood-borne viruses (BBV), gastrointestinal diseases, sexually transmissible infections (STIs), vaccine-preventable diseases (VPDs), vector-borne diseases, zoonotic diseases and other diseases. For each disease, the count for six months following the implementation of COVID-19 public health measures (1 April to 30 September 2020) was compared with the average for the same six-month period during the years 2015 to 2019. RESULTS: From 1 April to 30 September 2020, after the implementation of Queensland's COVID-19 preventive measures, there was a decrease seen in several diseases notifications reported to the CQPHU, mostly VPDs, when compared with the same months for each of 2015 to 2019 and for the 5-year average (2015-2019) for those months (Table 1). However, increases in notifications for April-September 2020 were observed in a greater number of other notifiable disease groups.