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Bajaj N, Goyal T, Teo K, Yip G. Impact of a general medicine consultant-led ward round in the emergency department. Intern Med J 2024. [PMID: 38465726 DOI: 10.1111/imj.16362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/14/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Patients requiring admission to the general medicine wards in a public hospital are usually assessed by a medical registrar. This study is based at a metropolitan public hospital in Melbourne where the majority of general medicine patients in the emergency department (ED) are not seen by a consultant physician until they are transferred to the ward. AIMS To assess the impact of general medicine consultant-led ward rounds (CWRs) in the ED on patient length of stay (LOS). METHODS One-month audit was conducted of all patients admitted to general medicine and awaiting transfer to ward from ED at a metropolitan public hospital in Melbourne. A general medicine CWR was then implemented in the ED, followed by another 1-month audit, with the primary outcome being LOS and the secondary outcome being 30-day readmission rate. Additionally, admitting medical registrars were invited to complete a survey before and after the implementation of CWRs to assess satisfaction rate. RESULTS Data from electronic medical records were analysed for 162 patients (90 preimplementation group and 72 postimplementation group). The median LOS was 6 days in the preimplementation group and 4 days in the postimplementation group (P = 0.014). There was no significant difference in 30-day readmission rates. Surveys showed admitting medical registrars reported a reduced level of stress and fewer barriers to seeking consultant input following implementation. CONCLUSIONS A CWR in the ED has led to decreased LOS for general medicine patients and improved satisfaction among junior medical staff.
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Affiliation(s)
- Nupur Bajaj
- General Medicine Unit, Eastern Health, Melbourne, Victoria, Australia
| | - Tushar Goyal
- General Medicine Unit, Eastern Health, Melbourne, Victoria, Australia
| | - Ken Teo
- General Medicine Unit, Eastern Health, Melbourne, Victoria, Australia
| | - Gary Yip
- General Medicine Unit, Eastern Health, Melbourne, Victoria, Australia
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Murray JM, Murray DD, Schvoerer E, Akand EH. SARS-CoV-2 Delta and Omicron community transmission networks as added value to contact tracing. J Infect 2024; 88:173-179. [PMID: 38242366 DOI: 10.1016/j.jinf.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/14/2024] [Indexed: 01/21/2024]
Abstract
OBJECTIVES Calculations of SARS-CoV-2 transmission networks at a population level have been limited. Networks that estimate infections between individuals and whether this results in a mutation, can be a way to evaluate fitness of a mutational clone by how much it expands in number as well as determining the likelihood a transmission results in a new variant. METHODS Australian Delta and Omicron SARS-CoV-2 sequences were downloaded from GISAID. Transmission networks of infection between individuals were estimated using a novel mathematical method. RESULTS Many of the sequences were identical, with clone sizes following power law distributions driven by negative binomial probability distributions for both the number of infections per individual and the number of mutations per transmission (median 0.74 nucleotide changes for Delta and 0.71 for Omicron). Using these distributions, an agent-based model was able to replicate the observed clonal network structure, providing a basis for more detailed COVID-19 modelling. Possible recombination events, tracked by insertion/deletion (indel) patterns, were identified for each variant in these outbreaks. CONCLUSIONS This modelling approach reveals key transmission characteristics of SARS-CoV-2 and may complement traditional contact tracing. This methodology can also be applied to other diseases as genetic sequencing of viruses becomes more commonplace.
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Affiliation(s)
- John M Murray
- School of Mathematics and Statistics, UNSW Sydney, NSW 2052, Australia.
| | - Daniel D Murray
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Evelyne Schvoerer
- Laboratory of Virology, University Hospital of Nancy Brabois, F-54500 Vandoeuvre-les-Nancy, France; Lorraine University, Laboratory of Physical Chemistry and Microbiology for Materials and the Environment, LCPME UMR 7564, CNRS, 405 Rue de Vandoeuvre, F-54600 Villers-lès-Nancy, France
| | - Elma H Akand
- School of Mathematics and Statistics, UNSW Sydney, NSW 2052, Australia
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3
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Hickey J, Rancourt DG. Predictions from standard epidemiological models of consequences of segregating and isolating vulnerable people into care facilities. PLoS One 2023; 18:e0293556. [PMID: 37903148 PMCID: PMC10615287 DOI: 10.1371/journal.pone.0293556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/15/2023] [Indexed: 11/01/2023] Open
Abstract
OBJECTIVES Since the declaration of the COVID-19 pandemic, many governments have imposed policies to reduce contacts between people who are presumed to be particularly vulnerable to dying from respiratory illnesses and the rest of the population. These policies typically address vulnerable individuals concentrated in centralized care facilities and entail limiting social contacts with visitors, staff members, and other care home residents. We use a standard epidemiological model to investigate the impact of such circumstances on the predicted infectious disease attack rates, for interacting robust and vulnerable populations. METHODS We implement a general susceptible-infectious-recovered (SIR) compartmental model with two populations: robust and vulnerable. The key model parameters are the per-individual frequencies of within-group (robust-robust and vulnerable-vulnerable) and between-group (robust-vulnerable and vulnerable-robust) infectious-susceptible contacts and the recovery times of individuals in the two groups, which can be significantly longer for vulnerable people. RESULTS Across a large range of possible model parameters including degrees of segregation versus intermingling of vulnerable and robust individuals, we find that concentrating the most vulnerable into centralized care facilities virtually always increases the infectious disease attack rate in the vulnerable group, without significant benefit to the robust group. CONCLUSIONS Isolated care homes of vulnerable residents are predicted to be the worst possible mixing circumstances for reducing harm in epidemic or pandemic conditions.
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Affiliation(s)
- Joseph Hickey
- Correlation Research in the Public Interest, Ottawa, Ontario, Canada
| | - Denis G. Rancourt
- Correlation Research in the Public Interest, Ottawa, Ontario, Canada
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4
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Conway E, Walker CR, Baker C, Lydeamore MJ, Ryan GE, Campbell T, Miller JC, Rebuli N, Yeung M, Kabashima G, Geard N, Wood J, McCaw JM, McVernon J, Golding N, Price DJ, Shearer FM. COVID-19 vaccine coverage targets to inform reopening plans in a low incidence setting. Proc Biol Sci 2023; 290:20231437. [PMID: 37644838 PMCID: PMC10465974 DOI: 10.1098/rspb.2023.1437] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Since the emergence of SARS-CoV-2 in 2019 through to mid-2021, much of the Australian population lived in a COVID-19-free environment. This followed the broadly successful implementation of a strong suppression strategy, including international border closures. With the availability of COVID-19 vaccines in early 2021, the national government sought to transition from a state of minimal incidence and strong suppression activities to one of high vaccine coverage and reduced restrictions but with still-manageable transmission. This transition is articulated in the national 're-opening' plan released in July 2021. Here, we report on the dynamic modelling study that directly informed policies within the national re-opening plan including the identification of priority age groups for vaccination, target vaccine coverage thresholds and the anticipated requirements for continued public health measures-assuming circulation of the Delta SARS-CoV-2 variant. Our findings demonstrated that adult vaccine coverage needed to be at least 60% to minimize public health and clinical impacts following the establishment of community transmission. They also supported the need for continued application of test-trace-isolate-quarantine and social measures during the vaccine roll-out phase and beyond.
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Affiliation(s)
- Eamon Conway
- Population Health and Immunity Division, WEHI, Parkville 3052, Vic, Australia
| | - Camelia R. Walker
- School of Mathematics and Statistics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher Baker
- School of Mathematics and Statistics, The University of Melbourne, Melbourne, Victoria, Australia
- Melbourne Centre for Data Science, The University of Melbourne, Melbourne, Victoria, Australia
- Centre of Excellence for Biosecurity Risk Analysis, The University of Melbourne, Melbourne, Victoria, Australia
| | - Michael J. Lydeamore
- Department of Econometrics and Business Statistics, Monash University, Clayton, Victoria, Australia
| | - Gerard E. Ryan
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Infectious Disease Ecology and Modelling, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Trish Campbell
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Infectious Diseases, The University of Melbourne, Melbourne, Victoria, Australia
| | - Joel C. Miller
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria, Australia
| | - Nic Rebuli
- School of Population Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Max Yeung
- Quantium, Sydney, New South Wales, Australia
| | | | - Nicholas Geard
- School of Computing and Information Systems, The University of Melbourne, Melbourne, Victoria, Australia
| | - James Wood
- School of Population Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - James M. McCaw
- School of Mathematics and Statistics, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jodie McVernon
- Victorian Infectious Diseases Reference Laboratory Epidemiology Unit at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Econometrics and Business Statistics, Monash University, Clayton, Victoria, Australia
| | - Nick Golding
- Infectious Disease Ecology and Modelling, Telethon Kids Institute, Perth, Western Australia, Australia
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - David J. Price
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Infectious Diseases, The University of Melbourne, Melbourne, Victoria, Australia
| | - Freya M. Shearer
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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5
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Moss R, Price DJ, Golding N, Dawson P, McVernon J, Hyndman RJ, Shearer FM, McCaw JM. Forecasting COVID-19 activity in Australia to support pandemic response: May to October 2020. Sci Rep 2023; 13:8763. [PMID: 37253758 DOI: 10.1038/s41598-023-35668-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 05/19/2023] [Indexed: 06/01/2023] Open
Abstract
As of January 2021, Australia had effectively controlled local transmission of COVID-19 despite a steady influx of imported cases and several local, but contained, outbreaks in 2020. Throughout 2020, state and territory public health responses were informed by weekly situational reports that included an ensemble forecast of daily COVID-19 cases for each jurisdiction. We present here an analysis of one forecasting model included in this ensemble across the variety of scenarios experienced by each jurisdiction from May to October 2020. We examine how successfully the forecasts characterised future case incidence, subject to variations in data timeliness and completeness, showcase how we adapted these forecasts to support decisions of public health priority in rapidly-evolving situations, evaluate the impact of key model features on forecast skill, and demonstrate how to assess forecast skill in real-time before the ground truth is known. Conditioning the model on the most recent, but incomplete, data improved the forecast skill, emphasising the importance of developing strong quantitative models of surveillance system characteristics, such as ascertainment delay distributions. Forecast skill was highest when there were at least 10 reported cases per day, the circumstances in which authorities were most in need of forecasts to aid in planning and response.
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Affiliation(s)
- Robert Moss
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
| | - David J Price
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Department of Infectious Diseases, Melbourne Medical School, at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Nick Golding
- Telethon Kids Institute, Perth, WA, Australia
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Peter Dawson
- Defence Science and Technology Group, Melbourne, VIC, Australia
| | - Jodie McVernon
- Department of Infectious Diseases, Melbourne Medical School, at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
- Victorian Infectious Diseases Reference Laboratory Epidemiology Unit, Royal Melbourne Hospital, at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Rob J Hyndman
- Department of Econometrics and Business Statistics, Monash University, Melbourne, VIC, Australia
| | - Freya M Shearer
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - James M McCaw
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- School of Mathematics and Statistics, The University of Melbourne, Melbourne, VIC, Australia
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6
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Eze PU, Geard N, Baker CM, Campbell PT, Chades I. Value of information analysis for pandemic response: intensive care unit preparedness at the onset of COVID-19. BMC Health Serv Res 2023; 23:485. [PMID: 37179300 PMCID: PMC10182758 DOI: 10.1186/s12913-023-09479-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND During the early stages of the COVID-19 pandemic, there was considerable uncertainty surrounding epidemiological and clinical aspects of SARS-CoV-2. Governments around the world, starting from varying levels of pandemic preparedness, needed to make decisions about how to respond to SARS-CoV-2 with only limited information about transmission rates, disease severity and the likely effectiveness of public health interventions. In the face of such uncertainties, formal approaches to quantifying the value of information can help decision makers to prioritise research efforts. METHODS In this study we use Value of Information (VoI) analysis to quantify the likely benefit associated with reducing three key uncertainties present in the early stages of the COVID-19 pandemic: the basic reproduction number ([Formula: see text]), case severity (CS), and the relative infectiousness of children compared to adults (CI). The specific decision problem we consider is the optimal level of investment in intensive care unit (ICU) beds. Our analysis incorporates mathematical models of disease transmission and clinical pathways in order to estimate ICU demand and disease outcomes across a range of scenarios. RESULTS We found that VoI analysis enabled us to estimate the relative benefit of resolving different uncertainties about epidemiological and clinical aspects of SARS-CoV-2. Given the initial beliefs of an expert, obtaining more information about case severity had the highest parameter value of information, followed by the basic reproduction number [Formula: see text]. Resolving uncertainty about the relative infectiousness of children did not affect the decision about the number of ICU beds to be purchased for any COVID-19 outbreak scenarios defined by these three parameters. CONCLUSION For the scenarios where the value of information was high enough to justify monitoring, if CS and [Formula: see text] are known, management actions will not change when we learn about child infectiousness. VoI is an important tool for understanding the importance of each disease factor during outbreak preparedness and can help to prioritise the allocation of resources for relevant information.
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Affiliation(s)
- Peter U Eze
- School of Computing and Information Systems, University of Melbourne, Victoria, Australia.
| | - Nicholas Geard
- School of Computing and Information Systems, University of Melbourne, Victoria, Australia
| | - Christopher M Baker
- School of Mathematics and Statistics, University of Melbourne, Victoria, Australia
- Melbourne Centre for Data Science, University of Melbourne, Victoria, Australia
- Centre of Excellence for Biosecurity Risk Analysis, University of Melbourne, Victoria, Australia
| | - Patricia T Campbell
- Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Iadine Chades
- CSIRO Land and Water Dutton Park, CSIRO, Brisbane, Australia
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7
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Betti MI, Abouleish AH, Spofford V, Peddigrew C, Diener A, Heffernan JM. COVID-19 Vaccination and Healthcare Demand. Bull Math Biol 2023; 85:32. [PMID: 36930340 PMCID: PMC10021065 DOI: 10.1007/s11538-023-01130-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/09/2023] [Indexed: 03/18/2023]
Abstract
One of the driving concerns during any epidemic is the strain on the healthcare system. As we have seen many times over the globe with the COVID-19 pandemic, hospitals and ICUs can quickly become overwhelmed by cases. While strict periods of public health mitigation have certainly helped decrease incidence and thus healthcare demand, vaccination is the only clear long-term solution. In this paper, we develop a two-module model to forecast the effects of relaxation of non-pharmaceutical intervention and vaccine uptake on daily incidence, and the cascade effects on healthcare demand. The first module is a simple epidemiological model which incorporates non-pharmaceutical intervention, the relaxation of such measures and vaccination campaigns to predict caseloads into the Fall of 2021. This module is then fed into a healthcare module which can forecast the number of doctor visits, the number of occupied hospital beds, number of occupied ICU beds and any excess demand of these. From this module, we can also estimate the length of stay of individuals in ICU. For model verification and forecasting, we use the four most populous Canadian provinces as a case study.
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Affiliation(s)
- Matthew I Betti
- Mathematics and Computer Science, Mount Allison University, Sackville, NB, Canada
| | | | | | | | | | - Jane M Heffernan
- Modelling Infection and Immunity Lab, Centre for Disease Modelling, Mathematics and Statistics, York University, Toronto, ON, Canada.
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8
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Zomerdijk N, Jongenelis MI, Collins B, Turner J, Short CE, Smith A, Huntley K. Factors associated with changes in healthy lifestyle behaviors among hematological cancer patients during the COVID-19 pandemic. Front Psychol 2023; 14:1081397. [PMID: 36968693 PMCID: PMC10033534 DOI: 10.3389/fpsyg.2023.1081397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/20/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundThere is a paucity of research examining the effects of the COVID-19 pandemic on the healthy lifestyle behaviors of hematological cancer patients. We examined changes in healthy lifestyle behaviors since the pandemic and identified factors associated with these changes among members of this high-risk population.MethodsHematological cancer patients (n = 394) completed a self-report online survey from July to August 2020. The survey assessed pandemic-related changes in exercise, alcohol consumption, and consumption of fruit, vegetables, and wholegrains. Information relating to several demographic, clinical, and psychological factors was also collected. Factors associated with changes in healthy lifestyle behaviors were analyzed using logistic regression.ResultsJust 14% of patients surveyed reported exercising more during the pandemic (39% exercised less). Only a quarter (24%) improved their diet, while nearly half (45%) reported eating less fruit, vegetables, and wholegrains. Just over a quarter (28%) consumed less alcohol (17% consumed more alcohol). Fear of contracting COVID-19 and psychological distress were significantly associated with reduced exercise. Younger age was significantly associated with both increased alcohol consumption and increased exercise. Being a woman was significantly associated with unfavorable changes in diet and being married was significantly associated with decreased alcohol consumption.ConclusionA substantial proportion of hematological cancer patients reported unfavorable changes in healthy lifestyle behaviors during the pandemic. Results highlight the importance of supporting healthy lifestyle practices among this particularly vulnerable group to ensure health is optimized while undergoing treatment and when in remission, particularly during crisis times like the COVID-19 pandemic.
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Affiliation(s)
- Nienke Zomerdijk
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Victorian Comprehensive Cancer Centre Alliance, Parkville, VIC, Australia
- *Correspondence: Nienke Zomerdijk,
| | - Michelle I. Jongenelis
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Melbourne Centre for Behaviour Change, University of Melbourne, Parkville, VIC, Australia
| | - Ben Collins
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Jane Turner
- Faculty of Medicine, University of Queensland, Herston, QLD, Australia
- Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
| | - Camille E. Short
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Melbourne Centre for Behaviour Change, University of Melbourne, Parkville, VIC, Australia
- School of Health Sciences, University of Melbourne, Parkville, VIC, Australia
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Milch V, Nelson AE, Austen M, Hector D, Turnbull S, Sathiaraj R, Der Vartanian C, Wang R, Anderiesz C, Keefe D. Conceptual Framework for Cancer Care During a Pandemic Incorporating Evidence From the COVID-19 Pandemic. JCO Glob Oncol 2022; 8:e2200043. [PMID: 35917484 PMCID: PMC9470141 DOI: 10.1200/go.22.00043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE With successive infection waves and the spread of more infectious variants, the COVID-19 pandemic continues to have major impacts on health care. To achieve best outcomes for patients with cancer during a pandemic, efforts to minimize the increased risk of severe pandemic infection must be carefully balanced against unintended adverse impacts of the pandemic on cancer care, with consideration to available health system capacity. Cancer Australia's conceptual framework for cancer care during a pandemic provides a planning resource for health services and policy-makers that can be broadly applied globally and to similar pandemics. METHODS Evidence on the impact of the COVID-19 pandemic on cancer care and health system capacity to June 2021 was reviewed, and the conceptual framework was developed and updated. RESULTS Components of health system capacity vary during a pandemic, and capacity relative to pandemic numbers and severity affects resources available for cancer care delivery. The challenges of successive pandemic waves and high numbers of pandemic cases necessitate consideration of changing health system capacity in decision making about cancer care. Cancer Australia’s conceptual framework provides guidance on continuation of care across the cancer pathway, in the face of challenges to health systems, while minimizing infection risk for patients with cancer and unintended consequences of delays in screening, diagnosis, and cancer treatment and backlogs because of service interruption. CONCLUSION Evidence from the COVID-19 pandemic supports continuation of cancer care wherever possible during similar pandemics. Cancer Australia's conceptual framework, underpinned by principles for optimal cancer care, informs decision making across the cancer care continuum. It incorporates consideration of changes in health system capacity and capacity for cancer care, in relation to pandemic progression, enabling broad applicability to different global settings.
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Affiliation(s)
- Vivienne Milch
- Cancer Australia, Sydney, New South Wales, Australia
- The University of Notre Dame, Sydney, New South Wales, Australia
| | - Anne E. Nelson
- Evidence Review Contractor, Sydney, New South Wales, Australia
| | | | - Debra Hector
- Cancer Australia, Sydney, New South Wales, Australia
| | | | | | | | - Rhona Wang
- Cancer Australia, Sydney, New South Wales, Australia
| | - Cleola Anderiesz
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- National Breast Cancer Foundation, Sydney, New South Wales, Australia
| | - Dorothy Keefe
- Cancer Australia, Sydney, New South Wales, Australia
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10
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Associations between the COVID-19 Pandemic and Hospital Infrastructure Adaptation and Planning—A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138195. [PMID: 35805855 PMCID: PMC9266736 DOI: 10.3390/ijerph19138195] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 12/17/2022]
Abstract
The SARS-CoV-2 pandemic has put unprecedented pressure on the hospital sector around the world. It has shown the importance of preparing and planning in the future for an outbreak that overwhelms every aspect of a hospital on a rapidly expanding scale. We conducted a scoping review to identify, map, and systemize existing knowledge about the relationships between COVID-19 and hospital infrastructure adaptation and capacity planning worldwide. We searched the Web of Science, Scopus, and PubMed and hand-searched gray papers published in English between December 2019 and December 2021. A total of 106 papers were included: 102 empirical studies and four technical reports. Empirical studies entailed five reviews, 40 studies focusing on hospital infrastructure adaptation and planning during the pandemics, and 57 studies on modeling the hospital capacity needed, measured mostly by the number of beds. The majority of studies were conducted in high-income countries and published within the first year of the pandemic. The strategies adopted by hospitals can be classified into short-term (repurposing medical and non-medical buildings, remote adjustments, and establishment of de novo structures) and long-term (architectural and engineering modifications, hospital networks, and digital approaches). More research is needed, focusing on specific strategies and the quality assessment of the evidence.
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11
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Booton RD, Powell AL, Turner KME, Wood RM. Modelling the Effect of COVID-19 Mass Vaccination on Acute Hospital Admissions. Int J Qual Health Care 2022; 34:6572765. [PMID: 35459950 DOI: 10.1093/intqhc/mzac031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 03/14/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Managing high levels of acute COVID-19 bed occupancy can affect the quality of care provided to both affected patients and those requiring other hospital services. Mass vaccination has offered a route to reduce societal restrictions while protecting hospitals from being overwhelmed. Yet, early in the mass vaccination effort, the possible impact on future bed pressures remained subject to considerable uncertainty. The aim of this study was to model the effect of vaccination on projections of acute and intensive care bed demand within a one million resident healthcare system located in South West England. METHODS An age-structured epidemiological model of the Susceptible-Exposed-Infectious-Recovered (SEIR) type was fitted to local data up to the time of the study, in early March 2021. Model parameters and vaccination scenarios were calibrated through a system-wide multi-disciplinary working group, comprising public health intelligence specialists, healthcare planners, epidemiologists, and academics. Scenarios assumed incremental relaxations to societal restrictions according to the envisaged UK Government timeline, with all restrictions to be removed by 21 June 2021. RESULTS Achieving 95% vaccine uptake in adults by 31 July 2021 would not avert a third wave in autumn 2021 but would produce a median peak bed requirement approximately 6% (IQR: 1% to 24%) of that experienced during the second wave (January 2021). A two-month delay in vaccine rollout would lead to significantly higher peak bed occupancy, at 66% (11% to 146%) of that of the second wave. If only 75% uptake was achieved (the amount typically associated with vaccination campaigns) then the second wave peak for acute and intensive care beds would be exceeded by 4% and 19% respectively, an amount which would seriously pressure hospital capacity. CONCLUSION Modelling influenced decision making among senior managers in setting COVID-19 bed capacity levels, as well as highlighting the importance of public health in promoting high vaccine uptake among the population. Forecast accuracy has since been supported by actual data collected following the analysis, with observed peak bed occupancy falling comfortably within the inter-quartile range of modelled projections.
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Affiliation(s)
| | - Anna L Powell
- Modelling and Analytics, UK National Health Service (BNSSG CCG), UK
| | - Katy M E Turner
- Bristol Medical School, University of Bristol, UK.,Health Data Research UK South West Better Care Partnership, UK
| | - Richard M Wood
- Modelling and Analytics, UK National Health Service (BNSSG CCG), UK.,Health Data Research UK South West Better Care Partnership, UK.,School of Management, University of Bath, UK
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12
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Hamiduzzaman M, Siddiquee N, McLaren H. COVID-19 risk perceptions and precautions among the elderly: A study of CALD adults in South Australia. F1000Res 2022; 11:43. [PMID: 35356314 PMCID: PMC8933644 DOI: 10.12688/f1000research.74631.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Coping with COVID-19 is a challenge for culturally and linguistically diverse (CALD) older adults. In Australia, little attention has been given to understanding associations between cultural contexts, health promotion, and socio-emotional and mental health challenges of older CALD adults during the COVID-19 pandemic. Therefore, we have collected data from older CALD adults to examine their COVID-19 risk perceptions and its association with their health precautions, behavioural dimensions and emergency preparation. Methods: A cross-sectional survey was conducted in South Australia. The CALD population aged 60 years and above were approached through 11 South Australian multicultural NGOs. Results: We provide the details of 155 older CALD South Australians’ demographics, risk perceptions, health precautions (problem-and-emotion-focused), behavioural dimensions and emergency preparation. The explanatory variables included demographic characteristics (age, gender, education and ethnicity); and risk perception (cognitive [likelihood of being affected] and affective dimension [fear and general concerns], and psychometric paradigm [severity, controllability, and personal impact]. The outcome measure variables were health precautions (problem-focused and emotion-focused), behavioral adaptions and emergency preparation. Conclusions: This dataset may help the researchers who investigate multicultural health or aged care in the pandemic and or who may have interest to link with other datasets and secondary use of this primary dataset in order to develop culturally tailored pandemic-related response plan. The data set is available from
Harvard Dataverse.
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Affiliation(s)
- Mohammad Hamiduzzaman
- College of Health, Medicine & Wellbeing, The University of Newcastle, Department of Rural Health, Taree, New South Wales, 2430, Australia
| | - Noore Siddiquee
- College of Business, Government & Law, Flinders University, Adelaide, South Australia, Australia
| | - Helen McLaren
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
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13
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Moss R. Commentary on "Transparent modeling of influenza incidence": Because the model said so. INTERNATIONAL JOURNAL OF FORECASTING 2022; 38:620-621. [PMID: 35185231 PMCID: PMC8846926 DOI: 10.1016/j.ijforecast.2021.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- Robert Moss
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3052, Australia
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14
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Tiruvoipati R, Gupta S, Haji K. COVID-19 Is Not Comparable to H1N1 Influenza. Ann Am Thorac Soc 2022; 19:509-510. [PMID: 34818143 PMCID: PMC8937222 DOI: 10.1513/annalsats.202110-1097le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Ravindranath Tiruvoipati
- Penninsula HealthMelbourne, Victoria, Australia
- Peninsula Clinical School, Monash UniversityMelbourne, Victoria, Australia
- Corresponding author (e-mail: )
| | - Sachin Gupta
- Penninsula HealthMelbourne, Victoria, Australia
- Peninsula Clinical School, Monash UniversityMelbourne, Victoria, Australia
| | - Kavi Haji
- Penninsula HealthMelbourne, Victoria, Australia
- Monash UniversityMelbourne, Victoria, Australia
- University of MelbourneMelbourne, Victoria, Australia
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15
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Occhipinti JA, Rose D, Skinner A, Rock D, Song YJC, Prodan A, Rosenberg S, Freebairn L, Vacher C, Hickie IB. Sound Decision Making in Uncertain Times: Can Systems Modelling Be Useful for Informing Policy and Planning for Suicide Prevention? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031468. [PMID: 35162491 PMCID: PMC8835017 DOI: 10.3390/ijerph19031468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 02/01/2023]
Abstract
The COVID-19 pandemic demonstrated the significant value of systems modelling in supporting proactive and effective public health decision making despite the complexities and uncertainties that characterise an evolving crisis. The same approach is possible in the field of mental health. However, a commonly levelled (but misguided) criticism prevents systems modelling from being more routinely adopted, namely, that the presence of uncertainty around key model input parameters renders a model useless. This study explored whether radically different simulated trajectories of suicide would result in different advice to decision makers regarding the optimal strategy to mitigate the impacts of the pandemic on mental health. Using an existing system dynamics model developed in August 2020 for a regional catchment of Western Australia, four scenarios were simulated to model the possible effect of the COVID-19 pandemic on levels of psychological distress. The scenarios produced a range of projected impacts on suicide deaths, ranging from a relatively small to a dramatic increase. Discordance in the sets of best-performing intervention scenarios across the divergent COVID-mental health trajectories was assessed by comparing differences in projected numbers of suicides between the baseline scenario and each of 286 possible intervention scenarios calculated for two time horizons; 2026 and 2041. The best performing intervention combinations over the period 2021–2041 (i.e., post-suicide attempt assertive aftercare, community support programs to increase community connectedness, and technology enabled care coordination) were highly consistent across all four COVID-19 mental health trajectories, reducing suicide deaths by between 23.9–24.6% against the baseline. However, the ranking of best performing intervention combinations does alter depending on the time horizon under consideration due to non-linear intervention impacts. These findings suggest that systems models can retain value in informing robust decision making despite uncertainty in the trajectories of population mental health outcomes. It is recommended that the time horizon under consideration be sufficiently long to capture the full effects of interventions, and efforts should be made to achieve more timely tracking and access to key population mental health indicators to inform model refinements over time and reduce uncertainty in mental health policy and planning decisions.
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Affiliation(s)
- Jo-An Occhipinti
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; (D.R.); (A.S.); (Y.J.C.S.); (A.P.); (S.R.); (L.F.); (C.V.); (I.B.H.)
- Computer Simulation & Advanced Research Technologies (CSART), Sydney, NSW 2021, Australia
- Correspondence: ; Tel.: +61-467-522-766
| | - Danya Rose
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; (D.R.); (A.S.); (Y.J.C.S.); (A.P.); (S.R.); (L.F.); (C.V.); (I.B.H.)
| | - Adam Skinner
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; (D.R.); (A.S.); (Y.J.C.S.); (A.P.); (S.R.); (L.F.); (C.V.); (I.B.H.)
| | - Daniel Rock
- Medical School, University of Western Australia, Perth, WA 6009, Australia;
- WA Primary Health Alliance, Perth, WA 6008, Australia
| | - Yun Ju C. Song
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; (D.R.); (A.S.); (Y.J.C.S.); (A.P.); (S.R.); (L.F.); (C.V.); (I.B.H.)
| | - Ante Prodan
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; (D.R.); (A.S.); (Y.J.C.S.); (A.P.); (S.R.); (L.F.); (C.V.); (I.B.H.)
- Computer Simulation & Advanced Research Technologies (CSART), Sydney, NSW 2021, Australia
- School of Computer, Data and Mathematical Sciences, Western Sydney University, Penrith, NSW 2751, Australia
| | - Sebastian Rosenberg
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; (D.R.); (A.S.); (Y.J.C.S.); (A.P.); (S.R.); (L.F.); (C.V.); (I.B.H.)
| | - Louise Freebairn
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; (D.R.); (A.S.); (Y.J.C.S.); (A.P.); (S.R.); (L.F.); (C.V.); (I.B.H.)
- Computer Simulation & Advanced Research Technologies (CSART), Sydney, NSW 2021, Australia
| | - Catherine Vacher
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; (D.R.); (A.S.); (Y.J.C.S.); (A.P.); (S.R.); (L.F.); (C.V.); (I.B.H.)
- St Vincent’s Clinical School, University of New South Wales, Sydney, NSW 2052, Australia
| | - Ian B. Hickie
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; (D.R.); (A.S.); (Y.J.C.S.); (A.P.); (S.R.); (L.F.); (C.V.); (I.B.H.)
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16
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Rahman A, Kuddus MA, Ip RHL, Bewong M. A Review of COVID-19 Modelling Strategies in Three Countries to Develop a Research Framework for Regional Areas. Viruses 2021; 13:2185. [PMID: 34834990 PMCID: PMC8623457 DOI: 10.3390/v13112185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/18/2021] [Accepted: 10/26/2021] [Indexed: 12/17/2022] Open
Abstract
At the end of December 2019, an outbreak of COVID-19 occurred in Wuhan city, China. Modelling plays a crucial role in developing a strategy to prevent a disease outbreak from spreading around the globe. Models have contributed to the perspicacity of epidemiological variations between and within nations and the planning of desired control strategies. In this paper, a literature review was conducted to summarise knowledge about COVID-19 disease modelling in three countries-China, the UK and Australia-to develop a robust research framework for the regional areas that are urban and rural health districts of New South Wales, Australia. In different aspects of modelling, summarising disease and intervention strategies can help policymakers control the outbreak of COVID-19 and may motivate modelling disease-related research at a finer level of regional geospatial scales in the future.
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Affiliation(s)
- Azizur Rahman
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW 2678, Australia; (M.A.K.); (R.H.L.I.); (M.B.)
- Institute for Land, Water and Society (ILWS), Charles Sturt University, Albury, NSW 2640, Australia
| | - Md Abdul Kuddus
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW 2678, Australia; (M.A.K.); (R.H.L.I.); (M.B.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4814, Australia
- Department of Mathematics, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Ryan H. L. Ip
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW 2678, Australia; (M.A.K.); (R.H.L.I.); (M.B.)
| | - Michael Bewong
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW 2678, Australia; (M.A.K.); (R.H.L.I.); (M.B.)
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17
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Abstract
INTRODUCTION The novel COVID-19 pandemic struck the world unprepared. This keynote outlines challenges and successes using data to inform providers, government officials, hospitals, and patients in a pandemic. METHODS The authors outline the data required to manage a novel pandemic including their potential uses by governments, public health organizations, and individuals. RESULTS An extensive discussion on data quality and on obstacles to collecting data is followed by examples of successes in clinical care, contact tracing, and forecasting. Generic local forecast model development is reviewed followed by ethical consideration around pandemic data. We leave the reader with thoughts on the next inevitable outbreak and lessons learned from the COVID-19 pandemic. CONCLUSION COVID-19 must be a lesson for the future to direct us to better planning and preparing to manage the next pandemic with health informatics.
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Affiliation(s)
- Mujeeb A. Basit
- Clinical Informatics Center, UT Southwestern, Medical Center, Dallas, TX, USA
- Department of Internal Medicine, UT Southwestern, Medical Center, Dallas, TX, USA
| | - Christoph U. Lehmann
- Clinical Informatics Center, UT Southwestern, Medical Center, Dallas, TX, USA
- Departments of Pediatrics, Population & Data Sciences, and Bioinformatics, UT Southwestern, Medical Center, Dallas, TX, USA
| | - Richard J. Medford
- Clinical Informatics Center, UT Southwestern, Medical Center, Dallas, TX, USA
- Department of Internal Medicine, UT Southwestern, Medical Center, Dallas, TX, USA
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18
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Marschner IC. Estimating age-specific COVID-19 fatality risk and time to death by comparing population diagnosis and death patterns: Australian data. BMC Med Res Methodol 2021; 21:126. [PMID: 34154563 PMCID: PMC8215490 DOI: 10.1186/s12874-021-01314-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022] Open
Abstract
Background Mortality is a key component of the natural history of COVID-19 infection. Surveillance data on COVID-19 deaths and case diagnoses are widely available in the public domain, but they are not used to model time to death because they typically do not link diagnosis and death at an individual level. This paper demonstrates that by comparing the unlinked patterns of new diagnoses and deaths over age and time, age-specific mortality and time to death may be estimated using a statistical method called deconvolution. Methods Age-specific data were analysed on 816 deaths among 6235 cases over age 50 years in Victoria, Australia, from the period January through December 2020. Deconvolution was applied assuming logistic dependence of case fatality risk (CFR) on age and a gamma time to death distribution. Non-parametric deconvolution analyses stratified into separate age groups were used to assess the model assumptions. Results It was found that age-specific CFR rose from 2.9% at age 65 years (95% CI:2.2 – 3.5) to 40.0% at age 95 years (CI: 36.6 – 43.6). The estimated mean time between diagnosis and death was 18.1 days (CI: 16.9 – 19.3) and showed no evidence of varying by age (heterogeneity P = 0.97). The estimated 90% percentile of time to death was 33.3 days (CI: 30.4 – 36.3; heterogeneity P = 0.85). The final age-specific model provided a good fit to the observed age-stratified mortality patterns. Conclusions Deconvolution was demonstrated to be a powerful analysis method that could be applied to extensive data sources worldwide. Such analyses can inform transmission dynamics models and CFR assessment in emerging outbreaks. Based on these Australian data it is concluded that death from COVID-19 occurs within three weeks of diagnosis on average but takes five weeks in 10% of fatal cases. Fatality risk is negligible in the young but rises above 40% in the elderly, while time to death does not seem to vary by age. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01314-w.
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Affiliation(s)
- Ian C Marschner
- Trials Centre, National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, NSW, 2006, Australia.
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19
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Dandekar R, Henderson SG, Jansen HM, McDonald J, Moka S, Nazarathy Y, Rackauckas C, Taylor PG, Vuorinen A. Safe Blues: The case for virtual safe virus spread in the long-term fight against epidemics. PATTERNS (NEW YORK, N.Y.) 2021; 2:100220. [PMID: 33748797 PMCID: PMC7961183 DOI: 10.1016/j.patter.2021.100220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Viral spread is a complicated function of biological properties, the environment, preventative measures such as sanitation and masks, and the rate at which individuals come within physical proximity. It is these last two elements that governments can control through social-distancing directives. However, infection measurements are almost always delayed, making real-time estimation nearly impossible. Safe Blues is one way of addressing the problem caused by this time lag via online measurements combined with machine learning methods that exploit the relationship between counts of multiple forms of the Safe Blues strands and the progress of the actual epidemic. The Safe Blues protocols and techniques have been developed together with an experimental minimal viable product, presented as an app on Android devices with a server backend. Following initial exploration via simulation experiments, we are now preparing for a university-wide experiment of Safe Blues.
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Affiliation(s)
- Raj Dandekar
- Department of Computational Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139-4307, USA
| | - Shane G. Henderson
- School of Operations Research and Information Engineering, Cornell University, Rhodes Hall, Ithaca, NY 14853, USA
| | - Hermanus M. Jansen
- Department of Applied Mathematics, Delft University of Technology, Mekelweg 4, 2628CD Delft, The Netherlands
| | - Joshua McDonald
- School of Mathematics and Physics, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Sarat Moka
- School of Mathematics and Physics, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Yoni Nazarathy
- School of Mathematics and Physics, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Christopher Rackauckas
- Department of Mathematics, Massachusetts Institute of Technology, Cambridge, MA 02139-4307, USA
| | - Peter G. Taylor
- School of Mathematics and Statistics, the University of Melbourne, Melbourne, VIC 3010, Australia
| | - Aapeli Vuorinen
- Department of Industrial Engineering and Operations Research, Columbia University, New York, NY 10027, USA
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20
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Platt DE, Parida L, Zalloua P. Lies, Gosh Darn Lies, and not enough good statistics: why epidemic model parameter estimation fails. Sci Rep 2021; 11:408. [PMID: 33432032 PMCID: PMC7801491 DOI: 10.1038/s41598-020-79745-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/02/2020] [Indexed: 12/03/2022] Open
Abstract
We sought to investigate whether epidemiological parameters that define epidemic models could be determined from the epidemic trajectory of infections, recovery, and hospitalizations prior to peak, and also to evaluate the comparability of data between jurisdictions reporting their statistics. We found that, analytically, the pre-peak growth of an epidemic underdetermines the model variates, and that the rate limiting variables are dominated by the exponentially expanding eigenmode of their equations. The variates quickly converge to the ratio of eigenvector components of the positive growth mode, which determines the doubling time. Without a sound epidemiological study framework, measurements of infection rates and other parameters are highly corrupted by uneven testing rates, uneven counting, and under reporting of relevant values. We argue that structured experiments must be performed to estimate these parameters in order to perform genetic association studies, or to construct viable models accurately predicting critical quantities such as hospitalization loads.
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Affiliation(s)
- Daniel E Platt
- Computational Genomics, IBM T. J. Watson Research Center, New York, USA.
| | - Laxmi Parida
- Computational Genomics, IBM T. J. Watson Research Center, New York, USA
| | - Pierre Zalloua
- TH Chan Harvard School of Public Health, Harvard University, Cambridge, USA.
- School of Medicine, University of Balamand, P.O. Box 33, Amioun, Lebanon.
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21
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Cheng AC. The role of mathematical models in developing policies for controlling COVID-19 transmission. Med J Aust 2021; 214:74-75. [PMID: 33410179 DOI: 10.5694/mja2.50914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Allen C Cheng
- Monash University, Melbourne, VIC.,Alfred Health, Melbourne, VIC
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22
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Rafiq M, Macías-Díaz JE, Raza A, Ahmed N. Design of a nonlinear model for the propagation of COVID-19 and its efficient nonstandard computational implementation. APPLIED MATHEMATICAL MODELLING 2021; 89:1835-1846. [PMID: 32982020 PMCID: PMC7506502 DOI: 10.1016/j.apm.2020.08.082] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/14/2020] [Accepted: 08/26/2020] [Indexed: 05/03/2023]
Abstract
In this manuscript, we develop a mathematical model to describe the spreading of an epidemic disease in a human population. The emphasis in this work will be on the study of the propagation of the coronavirus disease (COVID-19). Various epidemiologically relevant assumptions will be imposed upon the problem, and a coupled system of first-order ordinary differential equations will be obtained. The model adopts the form of a nonlinear susceptible-exposed-infected-quarantined-recovered system, and we investigate it both analytically and numerically. Analytically, we obtain the equilibrium points in the presence and absence of the coronavirus. We also calculate the reproduction number and provide conditions that guarantee the local and global asymptotic stability of the equilibria. To that end, various tools from analysis will be employed, including Volterra-type Lyapunov functions, LaSalle's invariance principle and the Routh-Hurwitz criterion. To simulate computationally the dynamics of propagation of the disease, we propose a nonstandard finite-difference scheme to approximate the solutions of the mathematical model. A thorough analysis of the discrete model is provided in this work, including the consistency and the stability analyses, along with the capability of the discrete model to preserve the equilibria of the continuous system. Among other interesting results, our numerical simulations confirm the stability properties of the equilibrium points.
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Affiliation(s)
- Muhammad Rafiq
- Faculty of Engineering, University of Central Punjab, Lahore, Pakistan
| | - J E Macías-Díaz
- Departamento de Matemáticas y Física, Universidad Autónoma de Aguascalientes, Avenida Universidad 940, Ciudad Universitaria, Aguascalientes 20131, Mexico
| | - Ali Raza
- Department of Mathematics, National College of Business Administration and Economics Lahore, Pakistan
| | - Nauman Ahmed
- Department of Mathematics and Statistics, The University of Lahore, Lahore, Pakistan
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23
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Cook MJ, Dri GG, Logan P, Tan JB, Flahault A. COVID-19 Down Under: Australia's Initial Pandemic Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8939. [PMID: 33271867 PMCID: PMC7730791 DOI: 10.3390/ijerph17238939] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/22/2020] [Accepted: 11/26/2020] [Indexed: 12/15/2022]
Abstract
The following case study aims to provide a broad overview of the initial Australian epidemiological situation of the novel coronavirus disease (COVID-19) pandemic. We provide a case presentation of Australia's current demographic characteristics and an overview of their health care system. The data we present on Australia's COVID-19 situation pertain to the initial wave of the pandemic from January through to 20 April 2020. The results of our study indicate the number of reported COVID-19 cases in Australia reduced, and Australia initially managed to successfully flatten the curve-from an initial doubling time of 3.4 days at the end of March 2020 to a doubling time of 112 days as of 20 April 2020. Using SEIR mathematical modelling, we investigate a scenario assuming infections increase once mitigation measures are lifted. In this case, Australia could experience over 15,000 confirmed cases by the end of April 2020. How Australia's government, health authorities and citizens adjust to preventative measures to reduce the risk of transmission as well as the risk of overburdening Australia's health care system is crucial. Our study presents the initial non-pharmaceutical intervention measures undertaken by the Australian health authorities in efforts to mitigate the rate of infection, and their observed and predicted outcomes. Finally, we conclude our study by presenting the observed and expected economic, social, and political disruptions Australians may endure as a result of the initial phase of the pandemic.
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Affiliation(s)
- Matthew James Cook
- Global Studies Institute, University of Geneva, 1205 Geneva, Switzerland; (G.G.D.); (P.L.); (J.B.T.)
- Melbourne School of Population and Global Health, University of Melbourne, Bouverie Street, Carlton, VIC 3053, Australia
| | - Gabriela Guizzo Dri
- Global Studies Institute, University of Geneva, 1205 Geneva, Switzerland; (G.G.D.); (P.L.); (J.B.T.)
| | - Prishanee Logan
- Global Studies Institute, University of Geneva, 1205 Geneva, Switzerland; (G.G.D.); (P.L.); (J.B.T.)
| | - Jia Bin Tan
- Global Studies Institute, University of Geneva, 1205 Geneva, Switzerland; (G.G.D.); (P.L.); (J.B.T.)
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland;
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24
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Curtis SJ, Cutcher Z, Brett JA, Burrell S, Richards MJ, Hennessy D, Gang RF, Lau CL, Rowe S. An evaluation of enhanced surveillance of hospitalised COVID-19 patients to inform the public health response in Victoria. Commun Dis Intell (2018) 2020; 44. [PMID: 33357173 DOI: 10.33321/cdi.2020.44.98] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Public health surveillance is crucial for supporting a rapid and effective response to public health emergencies. In response to the coronavirus disease (COVID-19) pandemic, an enhanced surveillance system of hospitalised COVID-19 patients was established by the Victorian Department of Health and Human Services (DHHS) and the Victorian Healthcare Associated Infection Surveillance System Coordinating Centre. The system aimed to reduce workforce capacity constraints and increase situational awareness on the status of hospitalised patients. Methods The system was evaluated, using guidelines from the United States Centers for Disease Control and Prevention, against eight attributes: acceptability; data quality; flexibility; representativeness; simplicity; stability; timeliness; and usefulness. Evidence was generated from stakeholder consultation, participant observation, document review, systems review, issues log review and audits. Data were collected and analysed over a period of up to three months, covering pre- and post-implementation from March to June 2020. Results This system was rapidly established by leveraging established relationships and infrastructure. Stakeholders agreed that the system was important but was limited by a reliance on daily manual labour (including weekends), which impeded scalability. The ability of the system to perform well in each attribute was expected to shift with the severity of the pandemic; however, at the time of this evaluation, when there were an average 23 new cases per day (0.3 cases per 100,000 population per day), the system performed well. Conclusion This enhanced surveillance system was useful and achieved its key DHHS objectives during the COVID-19 public health emergency in Victoria. Recommendations for improvement were made to the current and future systems, including the need to plan alternatives to improve the system's scalability and to maintain stakeholder acceptability.
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Affiliation(s)
- Stephanie J Curtis
- National Centre for Epidemiology and Population Health, the Australian National University, Australia Capital Territory, Australia.,Department of Health and Human Services, Victoria, Australia
| | - Zoe Cutcher
- Department of Health and Human Services, Victoria, Australia
| | - Judith A Brett
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre, the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Simon Burrell
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre, the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Michael J Richards
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre, the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | | | - Rebecca F Gang
- Department of Health and Human Services, Victoria, Australia
| | - Colleen L Lau
- Department of Global Health, the Australian National University, Australia Capital Territory, Australia
| | - Stacey Rowe
- Department of Health and Human Services, Victoria, Australia
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25
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Liu B, Spokes P, Alfaro-Ramirez M, Ward K, Kaldor J. Hospital outcomes after a COVID-19 diagnosis from January to May 2020 in New South Wales Australia. ACTA ACUST UNITED AC 2020; 44. [PMID: 33357174 DOI: 10.33321/cdi.2020.44.97] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective To describe hospitalisation rates following COVID-19 infection in NSW. Design, setting and participants Analysis of all confirmed COVID-19 cases diagnosed in NSW from 1 January to 31 May 2020 extracted from the NSW Notifiable Conditions Information Management System and linked to routinely collected hospitalisation data. Outcome measures In-patient hospitalisations and hospital service utilisation details. Results There were 3,101 COVID-19 cases diagnosed between 1 January and 31 May 2020 in NSW: mean age 46.7 years, 50.5% were females. Overall, 12.5% (n = 389) had a record of inpatient hospitalisation, 4.2% (n = 130) were admitted to ICU and 1.9% (n = 58) received ventilation. Among adult cases, hospital and ICU admission rates increased with increasing age: 2.9% of those aged 20-29 years were hospitalised, increasing to 46.6% of those aged 80-89 years; 0.6% of those aged 20-29 years were admitted to ICU, increasing to 11.2% of those aged 70-79 years. The median time from symptoms to hospitalisation was seven days (IQR 4-11). The median time in hospital was nine days (IQR 4-20), and in ICU six days (IQR 2-15); the median time in hospital increased with older age. Almost half (49.4%) of those hospitalised with a diagnostic code had pneumonia/lower respiratory tract infection and another 36.6% had an upper respiratory tract infection or other known COVID-19 symptoms. Conclusion COVID-19 is a serious infection particularly in older adults. During January to May of 2020, 1 in 8 of those diagnosed in NSW were hospitalised. While this partly reflects the cautious approach to case management in the initial phase of the pandemic, it also demonstrates the large potential impact of COVID-19 on Australian health services and need for continuing mitigation strategies.
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Affiliation(s)
- Bette Liu
- School of Population Health, University of New South Wales.,New South Wales Ministry of Health
| | | | | | | | - John Kaldor
- Kirby Institute, University of New South Wales
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