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  1. Article ; Online: The Role of Local Public Health Units in Enhancing Outbreak Response in Residential Aged Care Facilities.

    Jalil, Edura / Baptista, Mohana / Crouch, Simon / Stripp, Andrew / Stuart, Rhonda

    Asia-Pacific journal of public health

    2024  Volume 36, Issue 2-3, Page(s) 257–261

    Abstract: Local public health units offer a place-based response to disease threats impacting populations in its catchment. This place-based response can be further strengthened when local public health units (LPHUs) collaborate with local stakeholders, in ... ...

    Abstract Local public health units offer a place-based response to disease threats impacting populations in its catchment. This place-based response can be further strengthened when local public health units (LPHUs) collaborate with local stakeholders, in particular health services, to protect the more vulnerable population. We describe the approaches taken by a newly formed LPHU in southeast metropolitan Victoria, Australia in COVID-19 outbreak management impacting residential aged care facilities (RACFs) in its catchment, throughout the different phases of the pandemic. These collaborative and flexible approaches ensured that public health actions met the demand and needs of stakeholders. Approaches included the development of prioritization and risks matrices, refining known processes such as outbreak management team membership and redefining roles of the LPHU as capacity of stakeholder evolved.
    MeSH term(s) Aged ; Humans ; Public Health ; Homes for the Aged ; Victoria/epidemiology ; Disease Outbreaks/prevention & control
    Language English
    Publishing date 2024-02-26
    Publishing country China
    Document type Journal Article
    ZDB-ID 1025444-4
    ISSN 1941-2479 ; 1010-5395
    ISSN (online) 1941-2479
    ISSN 1010-5395
    DOI 10.1177/10105395241233635
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2802: Show issues Location:
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  2. Article ; Online: Mpox Management: A Holistic Local Response to a Global Threat.

    Crouch, Simon / Jalil, Edura / Pierce, Anna B / Baptista, Mohana / Wong, Evelyn / Stuart, Rhonda

    Journal of public health management and practice : JPHMP

    2023  Volume 30, Issue 2, Page(s) 204–207

    Abstract: Newly formed local public health units in Victoria have been established to support a place-based approach that tailors and delivers public health initiatives and responds to public health incidents and issues. Initially, post-establishment of these ... ...

    Abstract Newly formed local public health units in Victoria have been established to support a place-based approach that tailors and delivers public health initiatives and responds to public health incidents and issues. Initially, post-establishment of these units, public health activities focused on the prevention and control of communicable diseases. In 2022, mpox emerged as a global public health threat. As case numbers rose across Australia, local public health units in Victoria were engaged by the Department of Health to support a localized response to this new threat. The South East Public Health Unit, Monash Health, developed a number of targeted initiatives to control the local spread of mpox, ranging from capacity building of health professionals to increase early diagnosis, contact tracing, facilitating vaccine delivery, and community engagement. This contributed to effective local elimination within 6 months, demonstrating how LPHUs are well placed to engage with local communities and health care providers to respond rapidly to newly emerging public health threats.
    MeSH term(s) Humans ; Mpox (monkeypox) ; Public Health
    Language English
    Publishing date 2023-12-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2027860-3
    ISSN 1550-5022 ; 1078-4659
    ISSN (online) 1550-5022
    ISSN 1078-4659
    DOI 10.1097/PHH.0000000000001870
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    Zs.A 5302: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Achieving COVID-19 vaccination equity in South Eastern Metropolitan Victoria, Australia: a population-based study.

    Wong, Evelyn / Sutton, Brett / McLaughlin, Tom / McGrath, Catherine / Baptista, Mohana / Stripp, Andrew / Stuart, Rhonda L

    The Lancet regional health. Western Pacific

    2023  Volume 39, Page(s) 100900

    Abstract: Background: We describe COVID-19 first and second vaccine uptake across Local Government Areas (LGAs) in Victoria using southeast metropolitan Melbourne catchment as a case study. We explore key policy and implementation strategies that contributed to ... ...

    Abstract Background: We describe COVID-19 first and second vaccine uptake across Local Government Areas (LGAs) in Victoria using southeast metropolitan Melbourne catchment as a case study. We explore key policy and implementation strategies that contributed to equitable uptake.
    Methods: Population level data within the South East Public Health Unit (SEPHU) was used to compare trends in COVID-19 vaccination first and second dose uptake for each of the 11 LGAs in year 2021. Changes in vaccination uptake over the year were reviewed against social and public health measures used during the COVID-19 pandemic in Victoria and strategies in the SEPHU vaccination program.
    Findings: By September 2021, 57% of the eligible population in the least disadvantaged LGA, Bayside, had received their second dose vaccination compared to 32% in the most disadvantaged LGA, Greater Dandenong. By end of 2021, the gap had narrowed with 95% in Bayside and 92% in Greater Dandenong having received their second dose. The increase in vaccination uptake for both LGAs was bimodal. Government policies on vaccine eligibility and the opening of mass vaccination sites preceded the first peak in vaccination uptake. Strong community engagement, addressing misinformation, providing culturally appropriate vaccination services and mass outbreaks preceded the second peak in vaccination uptake.
    Interpretation: Vaccine equity across culturally and economically diverse populations can be achieved through a combination of robust, targeted community engagement, mass deployment of appropriate workforce, vaccination services tailored to cultural needs and sensitivities and accessibility to mass vaccination sites on a backdrop of state-wide policies that incentivise vaccination.
    Funding: None.
    Language English
    Publishing date 2023-09-15
    Publishing country England
    Document type Journal Article
    ISSN 2666-6065
    ISSN (online) 2666-6065
    DOI 10.1016/j.lanwpc.2023.100900
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Opening up safely: public health system requirements for ongoing COVID-19 management based on evaluation of Australia's surveillance system performance.

    Lokuge, Kamalini / D'Onise, Katina / Banks, Emily / Street, Tatum / Jantos, Sydney / Baptista, Mohana / Glass, Kathryn

    BMC medicine

    2022  Volume 20, Issue 1, Page(s) 157

    Abstract: Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) community transmission was eliminated in Australia from 1/11/2020 to 30/6/2021, allowing evaluation of surveillance system performance in detecting novel outbreaks, including ... ...

    Abstract Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) community transmission was eliminated in Australia from 1/11/2020 to 30/6/2021, allowing evaluation of surveillance system performance in detecting novel outbreaks, including against variants of concern (VoCs). This paper aims to define system requirements for coronavirus disease 2019 (COVID-19) surveillance under future transmission and response scenarios, based on surveillance system performance to date.
    Methods: This study described and evaluated surveillance systems and epidemiological characteristics of novel outbreaks based on publicly available data, and assessed surveillance system sensitivity and timeliness in outbreak detection. These findings were integrated with analysis of other critical COVID-19 public health measures to establish future COVID-19 management requirements.
    Results: Twenty-five epidemiologically distinct outbreaks and five distinct clusters were identified in the study period, all linked through genomic sequencing to novel introductions from international travellers. Seventy percent (21/30) were detected through community testing of people with acute respiratory illness, and 30% (9/30) through quarantine screening. On average, 2.07% of the State population was tested in the week preceding detection for those identified through community surveillance. From 17/30 with publicly available data, the average time from seeding to detection was 4.9 days. One outbreak was preceded by unexpected positive wastewater results. Twenty of the 24 outbreaks in 2021 had publicly available sequencing data, all of which identified VoCs. A surveillance strategy for future VoCs similar to that used for detecting SARS-CoV-2 would require a 100-1000-fold increase in genomic sequencing capacity compared to the study period. Other essential requirements are maintaining outbreak response capacity and developing capacity to rapidly engineer, manufacture, and distribute variant vaccines at scale.
    Conclusions: Australia's surveillance systems performed well in detecting novel introduction of SARS-CoV-2 while community transmission was eliminated; introductions were infrequent and case numbers were low. Detection relied on quarantine screening and community surveillance in symptomatic members of the general population, supported by comprehensive genomic sequencing. Once vaccine coverage is maximised, future COVID-19 control should shift to detection of SARS-CoV-2 VoCs, requiring maintenance of surveillance systems and testing all international arrivals, alongside greatly increased genomic sequencing capacity. Effective government support of localised public health response mechanisms and engagement of all sectors of the community is crucial to current and future COVID-19 management.
    MeSH term(s) Australia/epidemiology ; COVID-19/diagnosis ; COVID-19/epidemiology ; Humans ; Public Health ; Quarantine ; SARS-CoV-2/genetics
    Language English
    Publishing date 2022-04-15
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2131669-7
    ISSN 1741-7015 ; 1741-7015
    ISSN (online) 1741-7015
    ISSN 1741-7015
    DOI 10.1186/s12916-022-02344-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Severity of COVID-19 among Residents in Aged Care Facilities in Victoria, Australia: A Retrospective Cohort Study Comparing the Delta and Omicron Epidemic Periods.

    Muleme, Michael / McNamara, Bridgette J / Ampt, Frances H / Baptista, Mohana / Dittmer, Jennifer / Osborne, Aaron / Ahmed, Hibaq / Hales, Gabrielle / Kabwe, Mwila / Main, Stephanie / Moreira, Clarissa / Silverstein, Solomon / Sotheran, Emily / Athan, Eugene / Johnson, Paul D R / O'Brien, Daniel P / Sullivan, Sheena G

    Journal of the American Medical Directors Association

    2023  Volume 24, Issue 4, Page(s) 434–440.e5

    Abstract: Objectives: During the COVID-19 pandemic, no country with widespread community transmission has avoided outbreaks or deaths in residential aged care facilities (RACFs). As RACF residents are at high risk of morbidity and mortality from COVID-19, ... ...

    Abstract Objectives: During the COVID-19 pandemic, no country with widespread community transmission has avoided outbreaks or deaths in residential aged care facilities (RACFs). As RACF residents are at high risk of morbidity and mortality from COVID-19, understanding disease severity risk factors is imperative.
    Design: This retrospective cohort study aimed to compare COVID-19 disease severity (hospitalization and deaths) and associated risk factors among RACF residents in Victoria, Australia, across Delta and Omicron epidemic periods.
    Settings and participants: Resident case hospitalization risk (HR) and case fatality risk (CFR) were assessed using Victorian RACFs COVID-19 outbreaks data across 2 epidemic periods; Delta, 994 resident cases linked to 86 outbreaks; and Omicron, 1882 resident cases linked to 209 outbreaks.
    Methods: Adjusting for outbreak-level clustering, age, sex, up-to-date vaccination status, and time since last vaccination, the odds of hospitalization and death were compared using mixed effects logistic regression.
    Results: The HR and CFR was lower during the Omicron period compared with the Delta period [HR 8.2% vs 24.6%, odds ratio (OR) 0.17, 95% CI 0.11-0.26, and CFR: 11.4% vs 18.7%, OR 0.40, 95% CI 0.28-0.56]. During both periods, males had higher odds of hospitalization and odds of death; being up to date with vaccination reduced odds of hospitalization by 40% (excluding nonemergency patient transfers) and odds of death by 43%; and for each month since last vaccination, odds of hospitalization increased by 9% and odds of death by 16%.
    Conclusions and implications: This study provides empirical evidence of lower COVID-19 severity among RACF residents in the Omicron period and highlights the importance of up-to-date and timely vaccination to reduce disease severity in this cohort.
    MeSH term(s) Male ; Humans ; Aged ; Victoria/epidemiology ; Pandemics ; Retrospective Studies ; COVID-19/epidemiology ; Disease Outbreaks
    Language English
    Publishing date 2023-01-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2171030-2
    ISSN 1538-9375 ; 1525-8610
    ISSN (online) 1538-9375
    ISSN 1525-8610
    DOI 10.1016/j.jamda.2023.01.006
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    Zs.A 5971: Show issues Location:
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  6. Article ; Online: Opening up safely: public health system requirements for ongoing COVID-19 management based on evaluation of Australia's surveillance system performance

    Lokuge, Kamalini / D'Onise, Katina / Banks, Emily / Street, Tatum / Jantos, Sydney / Baptista, Mohana / Glass, Kathryn

    medRxiv

    Abstract: Background Ongoing management of COVID-19 requires an evidence-based understanding of the performance of public health measures to date, and application of this evidence to evolving response objectives. This paper aims to define system requirements for ... ...

    Abstract Background Ongoing management of COVID-19 requires an evidence-based understanding of the performance of public health measures to date, and application of this evidence to evolving response objectives. This paper aims to define system requirements for COVID-19 management under future transmission and response scenarios, based on surveillance system performance to date. Methods From 1st November 2020 to 30th June 2021 community transmission was eliminated in Australia, allowing investigation of system performance in detecting novel outbreaks, including against variants of concern (VoCs). We characterised surveillance systems in place from peer-reviewed and publicly available data, analysed the epidemiological characteristics of novel outbreaks over this period, and assessed surveillance system sensitivity and timeliness in outbreak detection. These findings were integrated with analysis of other critical COVID-19 public health measures to establish requirements for future COVID-19 management. Findings Australia reported 25 epidemiologically distinct outbreaks and 5 distinct clusters of cases in the study period, all linked through genomic sequencing to breaches in quarantine facilities housing international travellers. Most (21/30, 70%) were detected through testing of those with acute respiratory illness in the community, and 9 through quarantine screening. For the 21 detected in the community, the testing rate (percent of the total State population tested in the week preceding detection) was 2.07% on average, was higher for those detected while prior outbreaks were ongoing. For 17/30 with data, the delay from the primary case to detection of the index case was, on average 4.9 days, with 10 of the 17 outbreaks detected within 5 days and 3 detected after > 7days. One outbreak was preceded by an unexpected positive wastewater detection. Of the 24 outbreaks in 2021, 20 had publicly available sequencing data, all of which were VoCs. Surveillance for future VoCs using a similar strategy to that used for detecting SARS-CoV-2 to date would necessitate a 100-1,000-fold increase in capacity for genomic sequencing. Interpretation Australia9s surveillance systems performed well in detecting novel introduction of SARS- CoV-2 in a period when community transmission was eliminated, introductions were infrequent and case numbers were low. Detection relied on community surveillance in symptomatic members of the general population and quarantine screening, supported by comprehensive genomic sequencing. Once vaccine coverage is maximised, the priority for future COVID-19 control will shift to detection of SARS-CoV-2 VoCs associated with increased severity of disease in the vaccinated and vaccine ineligible. This will require ongoing investment in maintaining surveillance systems and testing of all international arrivals, alongside greatly increased genomic sequencing capacity. Other essential requirements for managing VoCs are maintaining outbreak response capacity and developing capacity to rapidly engineer, manufacture, and distribute variant vaccines at scale. The most important factor in management of COVID-19 now and into the future will continue to be how effectively governments support all sectors of the community to engage in control measures.
    Keywords covid19
    Language English
    Publishing date 2021-12-09
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2021.12.06.21266926
    Database COVID19

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