First documented gymnasium cluster of COVID-19 with whole genome sequencing in Australia.

Background: Transmission of coronavirus disease 2019 (COVID-19) has been demonstrated in fitness settings internationally. We report the first documented case of transmission of COVID-19 in a gymnasium in Australia in 2020. Methods: Case finding and case interviews were conducted among attendees in a Western Sydney gymnasium, Australia. Whole genome sequencing using an amplicon-based approach was performed on all SARS CoV-2 polymerase chain reaction positive samples detected through surveillance. Results: We show that five cases of COVID-19 were linked to the gymnasium, with transmission occurring on 7 July 2020, when the index case transmitted the infection to four other gymnasium attendees through the sharing of an enclosed space. Conclusions: There is an ongoing risk of transmission of COVID-19 within gymnasium environments and they are justifiably classified as a 'high-risk' venue. There may be a need to expand ventilation and space requirements to prevent transmission of COVID-19 in such settings in the context of severe COVID-19 variants or to prevent respiratory disease transmission in general.

Culturally and linguistically diverse voices and views in COVID-19 pandemic plans and policies.

Objective: This paper presents a rapid assessment of coronavirus disease 2019 (COVID-19) pandemic plans and explores the representation of culturally and linguistically diverse (CALD) communities in such plans. Four levels of pandemic plans were reviewed: regional, state, national and international. Methods: Discussions with representatives from four CALD communities informed the development of search and selection criteria for the COVID-19 plans, which were gathered and assessed using a CALD lens. Six COVID-19 pandemic plans that met the inclusion criteria were critically assessed. Results: The reviewed plans did not report any CALD community voices, views or consultations with community groups in the development phase, nor did they acknowledge the diversity of CALD populations. A few plans noted the vulnerability of CALD communities, but none discussed the challenges CALD communities face in accessing health information or health services during the pandemic, or other structural barriers (social determinants of health). Discussion: Our analysis revealed major gaps in all pandemic plans in terms of engaging with immigrant or CALD communities. Policies and plans that address and consider the complex needs and challenges of CALD communities are essential. Collaboration between public health services, multicultural services and policy-makers is vital for the inclusion of this higher-risk population.

High COVID-19 attack rate among attendees of wedding events in Bali, Indonesia, March 2020.

BACKGROUND: Large gatherings are associated with the spread of coronavirus 2019 disease (COVID-19); however, transmission dynamics are not well understood. We investigated a cluster of COVID-19 cases in returning Australian residents who attended wedding events in Bali, Indonesia, during 15- 21 March 2020. Attendees participated in various social events and were in close proximity, providing multiple opportunities for transmission. METHODS: We conducted a retrospective cohort study of the 41 attendees, of whom 17 participated in a structured interview that included history of illness, risk exposures and event attendance. We obtained data for the remaining 24 participants through corroborative histories and public health unit case investigations. RESULTS: COVID-19 was identified in 56% of attendees (23/41), with illness onset between 21 March and 2 April 2020. One secondary case was identified in a household contact of an attendee. The median age of cases was 31 years (range 3-64). One case was hospitalised and did not require critical care. There were no deaths. No cases occurred among six attendees who left prior to the actual wedding day. Guests attended multiple events and participated in high-risk transmission behaviours such as shaking hands, kissing, dancing, sharing drinks and sharing shisha (water pipes). Attack rates ranged from 64% to 87% for different exposures. We could not identify a single risk exposure that accounted for all cases; it is therefore likely there were multiple episodes of transmission. CONCLUSION: Our investigation identified a high attack rate of COVID-19 among a cohort of wedding event attendees. Attendees engaged in close physical contact, shared drinks and shisha, and were in close proximity during the wedding events, which may have contributed to the high attack rate. This outbreak highlights the significant role social events can play in transmission of COVID-19 and underscores why it is important to limit gatherings and close physical contact to control the spread of the virus.