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: Objectives: To describe patterns of SARS‐CoV‐2 transmission in non‐healthcare workplace settings during the first six months of COVID‐19 spread, in New South Wales (NSW), Australia. Methods: Locally acquired COVID‐19 cases between February 2020 and August 2020 were reviewed to determine the: total number of workplace‐associated cases and clusters; workplace type; and modes of transmission. Results: There were 72 COVID‐19 workplace clusters with 231 cases and an additional 11 workplace‐acquired cases who were not part of a cluster. Workplaces most associated with clusters included construction, manufacture and trade (31%, 22 clusters), office and clerical (25%, 18 clusters) and retail (14%, 10 clusters). Most transmission events were best explained by direct transmission, with two workplace clusters demonstrating evidence of partial indirect spread. Conclusions: Findings demonstrate workplace settings, particularly construction, office and retail settings have heightened risk of transmission. Implications for public health: The risk of infectious disease transmission is well understood for healthcare workers, despite other workplace types representing higher volumes of workers with less risk controls. This study should assist policy makers and the public to understand COVID‐19 transmission in workplaces and the heightened risks associated with certain workplace settings., The policy response to preventing and controlling COVID‐19 transmission in most countries moved rapidly from targeted to broad travel restrictions and included limits to physical movement and working from home [...]

: Objective: Western Sydney Local Health District (WSLHD) measured the utility and validity of rapid molecular point‐of‐care testing (POCT) in aged care facilities (ACFs) experiencing influenza‐like illness (ILI) outbreaks against routine laboratory testing. Methods: A descriptive epidemiological study into 82 respiratory outbreaks reported across 63 ACFs within WSLHD supporting approximately 6,500 residents aged ≥65 years and staffed by ∼6,500 employees, from 1 August 2018 to 31 December 2019. Results: WSLHD Public Health Unit performed on‐site testing at 27 ACF outbreaks (34%), while 53(66%) ACFs conducted only routine laboratory testing. The Xpert®Xpress Flu/RSV molecular PCR provided a sensitivity and specificity of 100%. Those with on‐site testing, antiviral prophylaxis was prescribed at 75% of facilities within 24 hours of testing, as opposed to 32% of those using laboratory testing (p Conclusions: On‐site ACF testing is reliable and practical for early identification of influenza, enabling timely use of antiviral treatment and prophylaxis, and was associated with decreased hospitalisation. Public health implications: Enhanced respiratory surveillance and on‐site testing should be strongly considered as part of routine management of respiratory outbreaks in ACFs and may reduce outbreak severity., Respiratory viruses are highly infectious agents that adversely affect the health of adults aged ≥65 years.[sup.1] In closed population settings such as aged care facilities (ACFs) in particular, respiratory viruses [...]

: Objectives: To study COVID?19 (Delta Variant) cases and close contacts co?located within households. Focusing on epidemiology of transmission of COVID?19, quarantine duration and utilisation of infection control behaviours under a telehealth model of care in an elimination setting. Methods: A retrospective cohort analysis examined household spread of infection, duration of quarantine and change in PCR CT value during illness. A survey explored infection control behaviours used by household members during isolation and quarantine. Results: The cohort was 141 individuals in 35 households. Thirty?seven were index cases, and 48 became positive during quarantine, most within 10 days. Whole?household infection occurred in 12 households with multiple members. Behaviours focused on fomite transmission reduction rather than preventing aerosol transmission. The median duration of close contact household quarantine was 25 days. The majority of COVID?19 cases were de?isolated after 14 days with no evidence of further community transmission. Conclusion: Intrahousehold transmission was not universal and, if it occurred, usually occurred quickly. Behaviours utilised focused on fomites, suggesting a need for improved education regarding the potential utilisation of strategies to prevention the transmission of aerosols. Households experienced long durations of home?based quarantine. Implications for public health: The impact of long quarantine durations must be considered, particularly where most community benefit from quarantine is achieved within 10 days from exposure in the setting of the Delta Variant. Education of households regarding aerosol risk reduction is a potential strategy in the household setting of individuals at risk of disease progression., The incursion of SARS?CoV?2 into the Australian community from returning travellers and subsequent community transmission has required a significant public health response since the commencement of the pandemic. In the [...]

: Objective: Since 2014, five Australian states have enacted ‘No Jab, No Play’ policies requiring children to be fully vaccinated to attend childcare and early education services. We review the five policies and their implications for implementers – including healthcare and childcare service providers – and analyse factors that shaped the design of state policies. Methods: We employed documentary analysis and analysed key informant interviews in NVivo 12. Results: Our findings reveal similarities and differences between state provisions regarding exemptions, grace periods, responsibilities of service providers and sanctions for non‐compliance. We elaborate on five factors of influence that have shaped No Jab, No Play policies: i) impetus for change; ii) policy normalisation, growing concurrence and stringency; iii) increased co‐optation of childcare providers into vaccination governance; iv) policy influence and lessons; and v) partisan politics and the development of party ideologies over time. Conclusion: A range of factors contribute to how and why Australia's NJNPlay policies have taken their current forms. Implications for public health: NJNPlay policies impact families and healthcare providers as part of the broader policy ecosystem concerned with maintaining high immunisation rates in Australia. Increased coercion of parents over time has been tempered by partisan positions on exemptions for disadvantage., Governments globally are introducing or tightening childhood vaccine mandates to address parental vaccine refusal.[sup.1] Australia's state‐level ‘No Jab, No Play’ (‘NJNPlay’) policies limit enrolment in childcare and early learning facilities. [...]

: Objective: To describe the operationalisation of a novel outdoor quarantine facility managed by the Australian Medical Assistance Team, the Howard Springs International Quarantine Facility (HSIQF) at the Centre for National Resilience in the Northern Territory, Australia. Methods: We collated documentation and data from HSIQF to describe policies and procedures implemented and performed a descriptive analysis of key procedures and outcomes. Results: From 23 October 2020 to 31 March 2021, 2.2% (129/5,987) of residents were confirmed COVD‐19 cases. On average per day, 82 [Interquartile Range (IQR): 29‐95] staff completed personal protective equipment (PPE) training, 94 [IQR: 90‐104] staff completed antigen testing and 51 [IQR: 32‐136] staff completed polymerase chain reaction testing. The operation focused on building a safe environment with infection prevention and control adherence and workforce sustainability. There was no leakage of SARS‐CoV‐2 to staff or the community and no PPE compromises requiring staff to quarantine for 14 days. Conclusion: HSIQF demonstrates the operationalisation of an effective, safe and replicable quarantine system. Implications for public health: Quarantine is a critical public health tool for pandemic control. The HSIQF operations may be useful to inform the establishment and management of quarantine facilities for future and current disease outbreaks., International travel has driven global transmission of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Travel‐related control measures, including mandatory quarantine for returned travellers, were implemented early in the pandemic in [...]

: Objective: This research sought to gauge the extent to which doctors, nurses and paramedics in Australia were concerned about contracting SARS?CoV?2 during the country's first wave of the virus in April 2020. Methods: Australian registered doctors, nurses and paramedics (n=580) completed an online questionnaire during April 16?30, 2020 (period immediately following the highest four?week period (first wave) of SARS?CoV?2 confirmed cases in Australia). Results: During April 2020, two?thirds of participants felt it was likely they would contract SARS?CoV?2 at work. Half the participants suggested Personal Protective Equipment (PPE) supplies were inadequate for them to safely perform their job, with two?thirds suggesting management advised them to alter normal PPE use. One?third of participants suggested they were dissatisfied with their employer's communication of COVID?19 related information. Conclusions and implications for public health: After reports of PPE shortages during Australia's first SARS?CoV?2 wave, and suggestions access to PPE was still limited during Australia's second wave five months later, we must forecast for this and future pandemics ensuring adequate access to PPE for frontline healthcare workers. Further, ensuring consistent and standardised pathways for communication to staff (acknowledging the reality that information may rapidly change) will help alleviate frustration and anxiety., Australia adopted an early public health response limiting community transmission of the SARS?CoV?2 virus that worked to comparatively limit the levels of acute hospitalisation and mortalities seen in many other [...]

: Objective: In Australia, people residing remotely typically experience increased travel time to health services, and remote health services often have unfavourable population‐to‐provider ratios. The state of Victoria was treated as a case study and a spatial analysis investigated the impact of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) point‐of‐care‐test (POCT) site location (Major City, Inner Regional or Outer Regional) on the mean travel time for closest residents and the number of closest residents. Methods: A network analysis established the travel time from every mesh block in Victoria to the closest POCT site. Inferential analyses investigated the impact of POCT site location on travel time and the number of closest residents. Results: Compared to urban locations, the mean travel time for closest residents to rural POCT sites was significantly higher, while rural POCT sites had significantly fewer residents to service. Conclusions: Findings confirm Australian health service literature suggesting that rural regions have poorer proximate availability of health services, while also contrasting to literature indicating that Australian rural regions have fewer health services per capita. Implications for public health: Localities within outer regional Victoria are candidates for a localised response to reduce unnecessary travel. Employing innovative service models may improve health service access and use and reduce population‐to‐provider ratios in rural locations., The World Health Organization declared the novel coronavirus (COVID‐19) a global pandemic on 11 March 2020.[sup.1] As of 2 February 2021, more than 100 million people have contracted the virus [...]

Fund and use 'living' reviews of the latest data to steer research practice and policy. Fund and use 'living' reviews of the latest data to steer research practice and policy., Author(s): Julian Elliott, Rebecca Lawrence, Jan C. Minx, Olufemi T. Oladapo, Philippe Ravaud, Britta Tendal Jeppesen, James Thomas, Tari Turner, Per Olav Vandvik, Jeremy M. Grimshaw Author Affiliations: Illustration by [...]

: Objective: Investigate the response of the Therapeutic Goods Administration's (TGA) new advertising complaint system to resubmitted complaints about complementary medicine weight loss products previously upheld by the Complaint Resolution Panel. Methods: Between July 2018 and July 2019, complaints about a convenience sample of 22 complementary medicines by eight sponsors, advertised on 140 different internet sites (cases), were resubmitted to the TGA. FatBlaster products featured. Follow‐up occurred in February 2021. Results: A search of the TGA advertising complaints database found ‘no result’ for 84% of the 140 cases submitted. Despite the TGA delisting three products and sponsors delisting ten others, all products complained about were still being advertised. Some products had minor changes in imagery but not claims. The sponsor (Cat Media, Naturopathica) had listed three new FatBlaster weight loss products. Conclusions: The TGA failed to protect consumers from ineffective weight loss medicines. Implications for public health: Weight loss medicines with misleading and deceptive claims are likely to divert users from evidence‐based weight loss activities. The TGA should ask for the evidence supporting promotional claims for these products and, if this is lacking, delist the entire class of products. For recalcitrant sponsors who repeatedly make egregious claims, civil and criminal penalties should be applied., Of 23 OECD countries, Australia has the fifth‐highest rate of obesity and overweight. Obesity is second only to smoking as a risk factor for disease.[sup.1] Reducing the increasing number of [...]