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COVID-19 and associated policy responses created unique social, economic and health risks for sex workers. Through semi-structured interviews we explored pre- and early COVID-19 experiences and work practices of ten cisgender female sex workers 50 years of age and older in Queensland, Australia, analysing the findings using a risk environment framework. Throughout early 2020, participants navigated a complex risk environment, managing economic needs, health and safety, occupational stigma and policing. Australia's policy responses altered the risks and opportunities available to participants. Half the participants continued sex work and half stopped sex work with some accessing economic support and withdrawing superannuation savings. Those who continued sex work drew on life and work experience to reassess changing health, stigma, and policing risks, and adapted their work strategies by increasing client screening and modifying services. Participants relied on information from peer networks and organisations to guide work practices but remained wary of contact tracing, police and the media. Decriminalisation of sex work and the strengthening of sex worker organisation and government partnerships are important in embedding equity in responses to ongoing and new public health threats. [ABSTRACT FROM AUTHOR]

In this article, we explore Quick Response (QR) codes (machine-readable optical labels that link to information) and how, after a period of having fallen out of favor, they have been reactivated and have come to underpin COVID-19 automation and contact-tracing efforts. During the pandemic, they were used especially for "safe entry" and other kinds of check-in to locations to facilitate contact tracing. In this context, QR codes facilitate automated decision-making in relation to infectious disease surveillance and disease outbreak control. However, the use of QR codes for contact-tracing purposes has enjoyed mixed success and its implementation has encountered several challenges, as we illustrate through a case study that explores QR codes and COVID contact tracing in Singapore and Australia. [ABSTRACT FROM AUTHOR]

Background Syphilis infections have been increasing in Australia over the past decade. This phenomenon has been associated with a re-emergence of congenital syphilis. Objective The aim of this article is to describe recent epidemiological trends of syphilis infection in Australia, including demographics in which infection rates are rising, such as women of reproductive age. This article also provides an overview of the clinical course and the principles of management for syphilis. Discussion Considered by some as a disease of bygone eras, the resurgence of syphilis in Australia requires clinicians to be alert to this infection once again. Increased testing, prompt management and thorough contact tracing are all required to reverse this trend. Congenital syphilis is a potentially devastating yet preventable consequence of rising infections among women of reproductive age. Universal syphilis screening is recommended for all pregnant women at the initial antenatal visit and is now also recommended in the third trimester in several Australian jurisdictions. [ABSTRACT FROM AUTHOR]

• Lineage 2 is the prevalent lineage among drug-resistant tuberculosis (TB) in Victoria. • Commonest drug-resistant-TB is isoniazid-resistant TB. • Genomics reveal that drug-resistant TB in Victoria, Australia is primarily imported. Whole genome sequencing (WGS) can identify clusters, transmission patterns, and drug resistance mutations. This is important in low-burden settings such as Australia, as it can assist in efficient contact tracing and surveillance. We conducted a retrospective cohort study using WGS from 155 genomically defined drug-resistant Mycobacterium tuberculosis (DR-TB) isolates collected between 2018-2021 in Victoria, Australia. Bioinformatic analysis was performed to identify resistance-conferring mutations, lineages, clusters and understand how local sequences compared with international context. Of the 155 sequences, 42% were identified as lineage 2 and 35% as lineage 1; 65.8% (102/155) were isoniazid mono-resistant, 8.4% were multi-drug resistant TB and 5.8% were pre-extensively drug-resistant / extensively drug-resistant TB. The most common mutations were observed in katG and fabG1 genes, especially at Ser315Thr and fabG1 -15 C>T for first-line drugs. Ser450Leu was the most frequent mutation in rpoB gene. Phylogenetic analysis confirmed that Victorian DR-TB were associated with importation events. There was little evidence of local transmission with only five isolate pairs. Isoniazid-resistant TB is the commonest DR-TB in Victoria, and the mutation profile is similar to global circulating DR-TB. Most cases are diagnosed among migrants with limited transmission. This study highlights the value of WGS in identification of clusters and resistance-conferring mutations. This information is crucial in supporting disease mitigation and treatment strategies. [ABSTRACT FROM AUTHOR]

Syphilis notification rates are rising in Australia, particularly in women of reproductive age. Congenital syphilis has significant morbidity and mortality, which can be easily prevented through antenatal screening, identifying ongoing risks for syphilis at subsequent encounters and early treatment during pregnancy. Asymptomatic presentations are not uncommon, and syphilis can also mimic other conditions. First-line treatment is benzathine benzylpenicillin, and there is emerging evidence for doxycycline for syphilis prevention. Contact tracing remains an important part of management to reduce transmission and the risk of reinfection. [ABSTRACT FROM AUTHOR]

One of the major public health measures to manage and contain the outbreak of the COVID-19 pandemic was to engage in systematic contact tracing, which required gastronomy, community and sporting venues to keep patron registers. Stand-alone and web-based applications, developed by a range of private IT providers, soon replaced pen-and-paper lists. With the introduction of a uniform, state-wide, mandatory data collection system, these private applications became obsolete. Although only active for four months, these applications paved the way for the public acceptance of state-administered collection systems that allowed for an unprecedented, centralized tracking system of the movements of the entire population. This paper discusses the cultural significance of these applications as a game changer in the debate on civil liberties, and addresses the question of how the materiality, or lack thereof, of this digital heritage affects the management of ephemeral smartphone applications, and its preservation for future generations. [ABSTRACT FROM AUTHOR]

During the coronavirus disease 2019 (COVID-19) pandemic, the health care system experienced unprecedented demands with many health care workers being redeployed. Although there are emerging studies investigating redeployment to acute care, the experience of redeployment to roles outside of these settings, such as to contact tracing and monitoring (CTM) teams, has not been reported. This research was designed to explore health care workers' experience of redeployment to a regional COVID-19 CTM team. Staff redeployed to this CTM team completed an anonymous online survey following the second wave of the COVID-19 pandemic in Victoria, Australia. The survey used open-ended questions to explore participants' perceptions of what did and did not work well during their redeployment. Inductive template thematic analysis of the data found that during their redeployment to CTM teams, participants experienced a sense of collaboration, the opportunity for professional growth, and the perception of making a meaningful contribution to the pandemic. Redeployed CTM team members also described a need to adapt to constant change and felt that the redeployment took a personal toll on them. The findings from this research may be useful to support preparedness of health care workers for redeployment in future complex or crisis situations. [ABSTRACT FROM AUTHOR]

Background: There are more than 7,800 people living with human immunodeficiency virus (HIV) in Victoria, Australia. Crucial in maximising the individual and population level benefits from antiretroviral therapy (ART) is understanding how to achieve patient retention in care and the factors that drive it. This study was an expansion of a 2015 assessment of HIV-care retention in Victoria, which sought out to determine whether the inclusion of a broader range of HIV-healthcare sites would yield more accurate estimates of retention in HIV-care. We aimed to improve our understanding of HIV-care retention in Victoria, Australia, identify people living with HIV (PLHIV) with unknown outcomes, and attempt to re-engage PLHIV in care. Methods: A network of 15 HIV-care sites was established in Victoria, Australia across diverse care settings which ranged from low-caseload rural sites to high-caseload metropolitan GP clinics and hospitals. Individuals who had an HIV viral load (VL) performed in both calendar years of 2016 and 2017 were classified as retained in care. Individuals with a VL test in 2016 but not in 2017 were considered to potentially have unknown outcomes as they may have been receiving care elsewhere, have disengaged from care or died. For this group, an intervention of cross-referencing partially de-identified data between healthcare sites, and contact tracing individuals who still had unknown outcomes was performed. Results: For 5223 individuals considered to be retained in care across 15 healthcare sites in the study period, 49 had unconfirmed transfers of care to an alternative provider and 79 had unknown outcomes. After the intervention, the number of unconfirmed care transfers was reduced to 17 and unknown outcomes reduced to 51. These changes were largely attributed to people being reclassified as confirmed transfers of care. Retention in care estimates that did not include the patient outcome of confirmed transfer of care ranged from 76.2 to 95.8% and did not alter with the intervention. However, retention in care estimates which considered confirmed transfers and those that re-entered care at a new site as retained in care significantly increased across five of the sites with estimates ranging from 80.9 to 98.3% pre-intervention to 83.3–100% post-intervention. Individuals whose outcomes remained unknown post-intervention were more often men who have sex with men (MSM) when compared to other categories (person who injects drugs (PWID), combined PWID/MSM, men who identify as heterosexual or unknown) (74.5% vs. 53.5%, [p = 0.06]) and receiving ART at their last HIV-care visit (84.3% vs. 67.8% [p = 0.09]). Conclusion: This study confirmed high retention in HIV-care and low numbers of people disengaged from HIV-care in Victoria. This was demonstrated across a larger number of sites with varying models of care than a prior assessment in 2015. These data align with national and state targets aiming for 95% of PLHIV retained in HIV-care. [ABSTRACT FROM AUTHOR]

Purpose: Understanding the privacy concerns of individuals in the adoption of contact tracing apps is critical for the successful control of pandemics like COVID-19. This paper explores the privacy paradox in the adoption of contact tracing apps in Australia. Design/methodology/approach: A comprehensive review of the related literature has been conducted, leading to the development of a conceptual model based on the privacy calculus theory and the antecedent-privacy concern-outcome framework. Such a model is then tested and validated using structural equation modelling on the survey data collected in Australia. Findings: The study shows that perceived benefit, perceived privacy risk and trust have significant influences on the adoption of contact tracing apps. It reveals that personal innovativeness and trust have significant and negative influences on perceived privacy risk. The study further finds out that personal innovativeness is insignificant to perceived benefit. It states that perceived ease of use has an insignificant influence on perceived privacy risk in the adoption of contact tracing apps. Originality/value: This study is the first attempt to use the privacy calculus theory and the antecedent–privacy concern–outcome framework for exploring the privacy paradox in adopting contact tracing apps. This leads to a better understanding of the privacy concerns of individuals in the adoption of contact tracing apps. Such an understanding can help formulate targeted strategies and policies for promoting the adoption of contact tracing apps and inform future epidemic control through effective contact tracing for better emergency management. [ABSTRACT FROM AUTHOR]

Background: The Australian Chlamydia Control Effectiveness Pilot (ACCEPt) was a cluster randomised controlled trial designed to assess the effectiveness of annual chlamydia testing through general practice in Australia. The trial showed that testing rates increased among sexually active men and women aged 16-29 years, but after 3 years the estimated chlamydia prevalence did not differ between intervention and control communities. We developed a mathematical model to estimate the potential longer-term impact of chlamydia testing on prevalence in the general population.Methods: We developed an individual-based model to simulate the transmission of Chlamydia trachomatis in a heterosexual population, calibrated to ACCEPt data. A proportion of the modelled population were tested for chlamydia and treated annually at coverage achieved in the control and intervention arms of ACCEPt. We estimated the reduction in chlamydia prevalence achieved by increasing retesting and by treating the partners of infected individuals up to 9 years after introduction of the intervention.Results: Increasing the testing coverage in the general Australian heterosexual population to the level achieved in the ACCEPt intervention arm resulted in reduction in the population-level prevalence of chlamydia from 4.6% to 2.7% in those aged 16-29 years old after 10 years (a relative reduction of 41%). The prevalence reduces to 2.2% if the proportion retested within 4 months of treatment is doubled from the rate achieved in the ACCEPt intervention arm (a relative reduction of 52%), and to 1.9% if the partner treatment rate is increased from 30%, as assumed in the base case, to 50% (a relative reduction of 59%).Conclusion: A reduction in C. trachomatis prevalence could be achieved if the level of testing as observed in the ACCEPt intervention arm can be maintained at a population level. More substantial reductions can be achieved with intensified case management comprising retesting of those treated and treatment of partners of infected individuals. [ABSTRACT FROM AUTHOR]

Background: Multiple instances of flight-associated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission during long-haul flights have been reported during the COVID-19 pandemic. However, comprehensive investigations of passenger risk behaviours, before, during and after the flight, are scarce.Methods: To investigate suspected SARS-CoV-2 transmission during a flight from United Arab Emirates to Australia in July 2020, systematic, repeated polymerase chain reaction (PCR) testing of passengers in hotel quarantine was linked to whole genome sequencing. Epidemiological analyses of in-depth interviews covering behaviours during the flight and activities pre- and post-boarding were used to identify risk factors for infection.Results: Seventeen of the 95 passengers from four different travel origins had PCR-confirmed infection yielding indistinguishable genomic sequences. Two of the 17 passengers were symptomatic within 2 days of the flight, and classified as co-primary cases. Seven secondary cases were seated within two rows of the co-primary cases, but five economy passengers seated further away and three business class passengers were also infected (attack rate = 16% [15/93]). In multivariable analysis, being seated within two rows of a primary case [odds ratio (OR) 7.16; 95% confidence interval (CI) 1.66-30.85] and spending more than an hour in the arrival airport (OR 4.96; 95% CI 1.04-23.60) were independent predictors of secondary infection, suggesting travel-associated SARS-CoV-2 transmission likely occurred both during and after the flight. Self-reported increased hand hygiene, frequent aisle walking and using the bathroom on the plane did not independently affect the risk of SARS-CoV-2 acquisition.Conclusions: This investigation identified substantial in-flight transmission among passengers seated both within and beyond two rows of the primary cases. Infection of passengers in separate cabin classes also suggests transmission occurred outside the cabin environment, likely at the arrival airport. Recognizing that transmission may occur pre- and post-boarding may inform contact tracing advice and improve efforts to prevent future travel-associated outbreaks. [ABSTRACT FROM AUTHOR]

This article draws on the paradigm of media operationalism to understand the somatechnical construction of bodies during the COVID-19 pandemic. According to the concept of somatechnics, one's experience with the social world is articulated through the available technologies and techniques required to and developed from using these technologies (Sullivan and Murray 2016). By drawing on the case of the Service Victoria app, the digital COVID-19 contact tracing system launched by the Victoria State government in Australia, I focus on the transformative meaning of technologies and somatechnics and how subjectivity is being redefined through the lens of technological utilisation. I suggest that all human-related forms of relations (human-to-human and human-to-machine) have become secondary and give way to the synchronic data-to-data relation of the app. In the regime of operational media, the body is not just a historical and cultural construction but a techno-transactional object that supports the optimisation of automated-decision making. The recent operational-turn in media studies provides a useful pathway to rethink the changing meaning of body and the human/technologies entanglement. [ABSTRACT FROM AUTHOR]

Mobile phone-based applications (apps) can promote faster targeted actions to control COVID-19. However, digital contact tracing systems raise concerns about data security, system effectiveness, and their potential to normalise privacy-invasive surveillance technologies. In the absence of mandates, public uptake depends on the acceptability and perceived legitimacy of using technologies that log interactions between individuals to build public health capacity. We report on six online deliberative workshops convened in New South Wales to consider the appropriateness of using the COVIDSafe app to enhance Australian contact tracing systems. All groups took the position (by majority) that the protections enacted in the app design and supporting legislation were appropriate. This support is contingent on several system attributes including: the voluntariness of the COVIDSafe app; that the system relies on proximity rather than location tracking; and, that data access is restricted to local public health practitioners undertaking contact tracing. Despite sustained scepticism in media coverage, there was an underlying willingness to trust Australian governing institutions such that in principle acceptance of the new contact tracing technology was easy to obtain. However, tensions between the need to prove system effectiveness through operational transparency and requirements for privacy protections could be limiting public uptake. Our study shows that informed citizens are willing to trade their privacy for common goods such as COVID-19 suppression. But low case numbers and cautionary public discourses can make trustworthiness difficult to establish because some will only do so when it can be demonstrated that the benefits justify the costs to individuals. [ABSTRACT FROM AUTHOR]

Background: The high contagiousness of the SARS-CoV-2, the large proportion of the population at risk of serious illness which will require hospital care and, certainly, the necessary need to protect public health has led countries worldwide to quickly resolve measures. Aims: Public health policies regarding the COVID-19 pandemic management of Australia, New Zealand, Singapore, Finland and Iceland. Methods: A narrative literature review was conducted. The evaluation of the effectiveness of the countries' health policies was carried out using three indicators: the Case Fatality Rate (CFR), the number of cases and the number of deaths per 100,000 people. Results: The very fast response of the governments, the strict lockdown, the quarantine measures, the travel restrictions, the systematic testing, tracing and epidemiological surveillance, the effective communication between officials and citizens, the government's response to COVID-19 focused on allowing the relevant experts to convey important information directly to the public, the testing of older people and health professionals and the mobile tracing applications compose the most important public health interventions. All these measures combined with the adoption and implementation by the citizens and with the organization of health systems, resulted in better management of the pandemic in the countries under study. Discussion: These measures have undoubtedly been important public health policies, which are a testament to future responses to such pandemics. [ABSTRACT FROM AUTHOR]

This article seeks to identify traces of language contact between speakers of Australian languages and speakers of Austronesian languages other than Macassans. I put forward evidence for lexical borrowing into northern Australian languages from Austronesian languages in South and East Sulawesi, Maluku and Timor-Rote, as well as from Austronesian languages of the Sama-Bajau and Oceanic subgroups. Although the evidence is fragmentary, the presence of these borrowings could be taken to indicate a more varied history of contact with Australia than the Macassan-dominated linguistic data suggest. [ABSTRACT FROM AUTHOR]

The ability to treat gonorrhoea with current first-line drugs is threatened by the global spread of extensively drug resistant (XDR) Neisseria gonorrhoeae (NG) strains. In Australia, urban transmission is high among men who have sex with men (MSM) and importation of an XDR NG strain in this population could result in an epidemic that would be difficult and costly to control. An individual-based, anatomical site-specific mathematical model of NG transmission among Australian MSM was developed and used to evaluate the potential for elimination of an imported NG strain under a range of case-based and population-based test-and-treat strategies. When initiated upon detection of the imported strain, these strategies enhance the probability of elimination and reduce the outbreak size compared with current practice (current testing levels and no contact tracing). The most effective strategies combine testing targeted at regular and casual partners with increased rates of population testing. However, even with the most effective strategies, outbreaks can persist for up to 2 years post-detection. Our simulations suggest that local elimination of imported NG strains can be achieved with high probability using combined case-based and population-based test-and-treat strategies. These strategies may be an effective means of preserving current treatments in the event of wider XDR NG emergence. Author summary: In most high-income settings, gonorrhoea is endemic among men who have sex with men (MSM). While gonorrhoea remains readily treatable with antibiotics, there are major concerns about the threat of antimicrobial resistance arising from recent reports of treatment failure with first-line therapy and limited remaining treatment options. Here we investigated the potential for test-and-treat response strategies to eliminate such strains before their prevalence reaches a level requiring a shift to new first line therapies. Rather than directly consider resistance, we explore the mitigating effect of various test-and-treat measures on outbreaks of a generic imported strain which remains treatable. This is done within the framework of a realistic mathematical model of gonorrhoea spread in an MSM community that captures cases, anatomical sites of infection and sexual contacts at an individual level, calibrated to relevant Australian epidemiological data. The results indicate that strategies such as partner testing and treatment in combination with elevated asymptomatic community testing are highly effective in mitigating outbreaks but can take up to 2 years to achieve elimination. As there are currently no clear alternative drugs of proven efficacy and safety to replace ceftriaxone in first-line therapy, these promising results suggest potential for use of these outbreak response strategies to preserve current treatment recommendations. [ABSTRACT FROM AUTHOR]

Background: Australian states and territories used test-trace-isolate-quarantine (TTIQ) systems extensively in their response to the COVID-19 pandemic in 2020-2021. We report on an analysis of Australian case data to estimate the impact of test-trace-isolate-quarantine systems on SARS-CoV-2 transmission., Methods: Our analysis uses a novel mathematical modelling framework and detailed surveillance data on COVID-19 cases including dates of infection and dates of isolation. First, we directly translate an empirical distribution of times from infection to isolation into reductions in potential for onward transmission during periods of relatively low caseloads (tens to hundreds of reported cases per day). We then apply a simulation approach, validated against case data, to assess the impact of case-initiated contact tracing on transmission during a period of relatively higher caseloads and system stress (up to thousands of cases per day)., Results: We estimate that under relatively low caseloads in the state of New South Wales (tens of cases per day), TTIQ contributed to a 54% reduction in transmission. Under higher caseloads in the state of Victoria (hundreds of cases per day), TTIQ contributed to a 42% reduction in transmission. Our results also suggest that case-initiated contact tracing can support timely quarantine in times of system stress (thousands of cases per day)., Conclusion: Contact tracing systems for COVID-19 in Australia were highly effective and adaptable in supporting the national suppression strategy from 2020-21, prior to the emergence of the Omicron variant in November 2021. TTIQ systems were critical to the maintenance of the strong suppression strategy and were more effective when caseloads were (relatively) low., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Jodie McVernon reports financial support was provided by Australian Government Department of Health and Aged Care., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Crusted scabies is endemic in some remote Aboriginal communities in the Northern Territory (NT) of Australia and carries a high mortality risk. Improvement in active case detection (ACD) for crusted scabies is hampered by a lack of evidence about best practice. We therefore conducted a systematic review of ACD methods for leprosy, a condition with similar ACD requirements, to consider how findings could be informative to crusted scabies detection. Methods and principle findings: We conducted systematic searches in MEDLINE, CINAHL, Scopus and the Cochrane Database for Systematic Reviews for studies published since 1999 that reported at least one comparison rate (detection or prevalence rate) against which the yield of the ACD method could be assessed. The search yielded 15 eligible studies from 511. Study heterogeneity precluded meta-analysis. Contact tracing and community screening of marginalised ethnic groups yielded the highest new case detection rates. Rapid community screening campaigns, and those using less experienced screening personnel, were associated with lower suspect confirmation rates. There is insufficient data to assess whether ACD campaigns improve treatment outcomes or disease control. Conclusion: This review demonstrates the importance of ACD campaigns in communities facing the highest barriers to healthcare access and within neighbourhoods of index cases. The potential benefit of ACD for crusted scabies is not quantified, however, lessons from leprosy suggest value in follow-up with previously identified cases and their close contacts to support for scabies control and to reduce the likelihood of reinfection in the crusted scabies case. Skilled screening personnel and appropriate community engagement strategies are needed to maximise screening uptake. More research is needed to assess ACD cost effectiveness, impact on disease control, and to explore ACD methods capable of capturing the homeless and highly mobile who may be missed in household centric models. Author summary: Crusted scabies is a severely debilitating skin disease with potentially fatal consequences that is endemic in some remote Aboriginal communities in the Northern Territory (NT) of Australia. Early detection is essential to maximise the chance of recovery and help prevent transmission of scabies to others. There is little knowledge about how to actively detect crusted scabies, so we sought relevant knowledge about a disease with many similarities: leprosy. The review demonstrates the importance of ACD campaigns in communities facing the highest barriers to healthcare access and within neighbourhoods of index cases. Lessons for crusted scabies in the NT include the importance of skilled screening personnel and appropriate community engagement strategies to maximise screening uptake. More research is needed to assess ACD cost effectiveness, impact on disease control, and to explore ACD methods capable of capturing the homeless and highly mobile who may be missed in household centric models. [ABSTRACT FROM AUTHOR]

In this article we explore preliminary findings from the study COVIDSafe and Beyond: Perceptions and Practices conducted in Australia in 2020. The study involved a survey followed by interviews, and aimed to capture the dynamic ways in which members of the Australian public perceive the impact of Covid practices – especially public health measures like the introduction of physical and social distancing, compulsory mask wearing, and contact tracing. In the rescripting of public space, different notions of formal and informal surveillance, along with different textures of mediated and social care, appeared. In this article, we explore perceptions around divergent forms of surveillance across social, technological, governmental modes, and the relationship of surveillance to care in our media and cultural practices. What does it mean to care for self and others during a pandemic? How does care get enacted in, and through, media interfaces and public interaction? [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the adoption of contact tracing apps through a hybrid analysis of the collected data using structural equation modelling (SEM) and artificial neural networks (ANN), leading to the identification of the critical determinants for the adoption of contact tracing apps in Australia. Design/methodology/approach: A research model is developed within the background of the unified theory of acceptance and use of technology (UTAUT) and the privacy calculus theory (PCT) for investigating the adoption of contact tracing apps. This model is then tested and validated using a hybrid SEM-ANN analysis of the survey data. Findings: The study shows that effort expectancy, perceived value of information disclosure and social influence are critical for adopting contact tracing apps. It reveals that performance expectancy and perceived privacy risks are indirectly significant on the adoption through the influence of perceived value of information disclosure. Furthermore, the study finds out that facilitating condition is insignificant to the adoption of contact tracing apps. Practical implications: The findings of the study can lead to the formulation of targeted strategies and policies for promoting the adoption of contact tracing apps and inform future epidemic control for better emergency management. Originality/value: This study is the first attempt in integrating UTAUT and PCT for exploring the adoption of contact tracing apps in Australia. It combines SEM and ANN for analysing the survey data, leading to better understanding of the critical determinants for the adoption of contact tracing apps. [ABSTRACT FROM AUTHOR]

In response to the COVID-19 pandemic, many Governments are instituting mobile tracking technologies to perform rapid contact tracing. However, these technologies are only effective if the public is willing to use them, implying that their perceived public health benefits must outweigh personal concerns over privacy and security. The Australian federal government recently launched the 'COVIDSafe' app, designed to anonymously register nearby contacts. If a contact later identifies as infected with COVID-19, health department officials can rapidly followup with their registered contacts to stop the virus' spread. The current study assessed attitudes towards three tracking technologies (telecommunication network tracking, a government app, and Apple and Google's Bluetooth exposure notification system) in two representative samples of the Australian public prior to the launch of COVIDSafe. We compared these attitudes to usage of the COVIDSafe app after its launch in a further two representative samples of the Australian public. Using Bayesian methods, we find widespread acceptance for all tracking technologies, however, observe a large intention-behaviour gap between people's stated attitudes and actual uptake of the COVIDSafe app. We consider the policy implications of these results for Australia and the world at large. [ABSTRACT FROM AUTHOR]

In absence of a COVID-19 vaccine, testing, contact tracing and social restrictions are among the most powerful strategies adopted around the world to slow down the spread of the pandemic. Citizens of most countries are suffering major physical, psychological and economic distress. At this stage, a safe and effective COVID-19 vaccine is the most sustainable option to manage the current pandemic. However, vaccine hesitancy by even a small subset of the population can undermine the success of this strategy. The objective of this research is to investigate the vaccine characteristics that matter the most to Australian citizens and to explore the potential uptake of a COVID-19 vaccine in Australia. Through a stated preference experiment, preferences towards a COVID-19 vaccine of 2136 residents of the Australian states and territories were collected and analysed via a latent class model. Results show that preferences for mild adverse cases, mode of administration, location of administration, price and effectiveness are heterogeneous. Conversely, preferences for immediacy and severe reactions are homogeneous, with respondents preferring a shorter period until vaccine is available and lower instances of severe side effects. The expected uptake of the vaccine is estimated under three different scenarios, with the value of 86% obtained for an average scenario. By calculating individual preferences, the willingness to pay is estimated for immediacy, effectiveness, mild and severe side effects. [ABSTRACT FROM AUTHOR]

.Introduction: Cruise ship linked COVID-19 outbreaks have been identified as a potential source of community transmission of COVID-19 in Australia and worldwide. The risk factors and potential mitigation around COVID-19 infections on cruise ships and communities is a research gap. Methods: A correlation and regression analyses for risk factors for COVID-19 attack rates oncruise ships worldwide with reported COVID-19 from January 1, 2020 to May 11, 2020 were performed, with a more detailed analysis done for Australia. Geospatial emerging hot spot analysis during key time periods was used to assess temporal trends in spatial clustering of COVID-19 cases related to two cruise ship events in NSW, Australia. Results: For 36 cruise ships with global COVID-19 cases, available cabins had a moderate inverse correlation with the attack rate (-0.4154; 95% CI [-0.0002, -0.00003], P < 0.0118). The number of cabins, the number of decks with cabins, and passenger-to-space ratio were significantly associated with attack rate, however, the duration at sea was not. By May 2020, cruise ship passengers made up 14.9% of COVID-19 cases in Australia and 27% of the COVID-19 related deaths. Emerging hot spots of community transmission in Sydney occurred during 1-2 incubation periods of two cruise ship events. Conclusion: Mitigation of risk on cruise ships should focus on spatial design and reducing crowding, including rapid surveillance and on-board testing. To mitigate this risk during the era of COVID-19, all passengers disembarking an infected ship should be quarantined for at least the 14-day window period and tested for COVID-19, regardless of symptoms. Vaccination should be a pre-requisite for travel of any kind once available. [ABSTRACT FROM AUTHOR]

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., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: John Murray reports financial support, article publishing charges, and travel were provided by Australian Research Council., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

In Australia, the first known case of Spanish flu - also referred to as "pneumonic influenza" in this country - was reported on 10 January 1919.[1] Fifty days later, on 1 March 1919, the very first issue of I Clinical and Experimental Optometry i - then called I The Commonwealth Optometrist i - was published.[2] Notwithstanding the significant morbidity, mortality, social upheaval and economic disruption associated with such a pandemic, this timing was fortuitous from the perspective of ophthalmic history, as it helps us understand the impact of the Spanish flu upon optometry at that time. We also searched the Trove database of the National Library of Australia for published material linking the terms "optician", "optometrist" or "optometry" with "Spanish flu", "pneumonic influenza" or "influenza", published during 1919. The capacity for a clear acrylic (plexiglass) slitlamp shield to reduce droplet exposure is explored by Murnain et al.[32] Conclusions In Australia, the mortality and morbidity of the Spanish flu pandemic (two million cases and 15,000 deaths)[1] was far worse than that of the COVID-19 pandemic so far (7,220 cases and 102 deaths).[6] Paradoxically, the impact on society has been the reverse. At present with COVID-19, optometry practices have closed; many optometrists are unemployed; optometry educational establishments have been shut down; optometry students are unable to receive face-to-face clinical training; and optometrists, like everyone else, are largely confined to their homes. [Extracted from the article]

Background Patient-delivered partner therapy (PDPT) is a method for an index patient to give treatment for genital chlamydia to their sexual partner(s) directly. In Australia, PDPT is considered suitable for heterosexual partners of men and women, but is not uniformly endorsed. We explored the policy environment for PDPT in Australia and considered how PDPT might become a routine option.Methods: Structured interviews were conducted with 10 key informants (KIs) representing six of eight Australian jurisdictions and documents relevant to PDPT were appraised. Interview transcripts and documents were analysed together, drawing on KIs' understanding of their jurisdiction to explore our research topics, namely the current context for PDPT, challenges, and actions needed for PDPT to become routine.Results: PDPT was allowable in three jurisdictions (Victoria, New South Wales, Northern Territory) where State governments have formally supported PDPT. In three jurisdictions (Western Australia, Australian Capital Territory, Tasmania), KIs viewed PDPT as potentially allowable under relevant prescribing regulations; however, no guidance was available. Concern about antimicrobial stewardship precluded PDPT inclusion in the South Australian strategy. For Queensland, KIs viewed PDPT as not allowable under current prescribing regulations and, although a Medicine and Poisons Act was passed in 2019, it is unclear if PDPT will be possible under new regulations. Clarifying the doctor-partner treating relationship and clinical guidance within a care standard were viewed as crucial for PDPT uptake, irrespective of regulatory contexts.Conclusion: Endorsement and guidance are essential so doctors can confidently and routinely offer PDPT in respect to professional standards and regulatory requirements. [ABSTRACT FROM AUTHOR]

Planning for a re-emergent epidemic of smallpox requires surge capacity of space, resources and personnel within health systems. There are many uncertainties in such a scenario, including likelihood and size of an attack, speed of response and health system capacity. We used a model for smallpox transmission to determine requirements for hospital beds, contact tracing and health workers (HCWs) in Sydney, Australia, during a modelled epidemic of smallpox. Sensitivity analysis was done on attack size, speed of response and proportion of case isolation and contact tracing. We estimated 100638 clinical HCWs and 14595 public hospital beds in Sydney. Rapid response, case isolation and contact tracing are influential on epidemic size, with case isolation more influential than contact tracing. With 95% of cases isolated, outbreak control can be achieved within 100 days even with only 50% of contacts traced. However, if case isolation and contact tracing both fall to 50%, epidemic control is lost. With a smaller initial attack and a response commencing 20 days after the attack, health system impacts are modest. The requirement for hospital beds will vary from up to 4% to 100% of all available beds in best and worst case scenarios. If the response is delayed, or if the attack infects 10000 people, all available beds will be exceeded within 40 days, with corresponding surge requirements for clinical health care workers (HCWs). We estimated there are 330 public health workers in Sydney with up to 940,350 contacts to be traced. At least 3 million respirators will be needed for the first 100 days. To ensure adequate health system capacity, rapid response, high rates of case isolation, excellent contact tracing and vaccination, and protection of HCWs should be a priority. Surge capacity must be planned. Failures in any of these could cause health system failure, with inadequate beds, quarantine spaces, personnel, PPE and inability to manage other acute health conditions. [ABSTRACT FROM AUTHOR]

In 2012, over 239 000 people were living in Australia with chronic hepatitis B (CHB). Australia's Second National Hepatitis B Strategy (2014) recommends testing contacts to increase identification of people with CHB, but it is generally poorly performed. CHB prevalence in Australia is increasing and contact tracing (CT) remains an untapped strategy for identifying infected individuals. A systematic CT system has been established in a government-funded primary health centre in Melbourne, which services 2000 refugees. This mixed-methods study aimed to describe the structure of the CT system, determine its effectiveness and identify enablers of success. The CT system's structure was elicited from field notes. CT effectiveness (proportion of contacts traced and serologically confirmed as infected or immune to HBV) was determined by auditing clinical records. Semi-structured interviews with seven health professionals were thematically analysed to identify enablers of CT success. Overall, 122 CHB index cases had 420 contacts. And 90.0% (n = 380) of 420 contacts were successfully traced, 68.0% (n = 83) of index cases had 100% of their contacts successfully traced and 80.7% (n = 339) of all contacts were immune; 28.8% (n = 121) had evidence of previous exposure and 55.0% (n = 231) had evidence of vaccination. Also, 8.1% (n = 34) were chronically infected. Interviews elicited seven themes important to the success of the CT system: Teamwork; Organisation; Health professional expertise; Patient education; Centralisation of the system; Influence of patient culture; and Use of nurses in CT. Teamwork and Organisation were previously unidentified in the literature. This CT system is successful and could be implemented elsewhere, provided an organised, cohesive, nurse-led team is established. [ABSTRACT FROM AUTHOR]

The aim of this study is to characterize close contacts of cases diagnosed with Invasive Meningococcal Disease (IMD) in further understanding their role in how IMD is spread and their experience throughout the contact tracing process. An epidemiological review (2015-2020) of close contacts was undertaken to identify, characterize and assess their management and the public health response. Close contacts participated in semi-structured interviews (October 2019 to 2020) to identify type of contact with the case, understand their level of satisfaction concerning close contact management, and challenges associated with recommending prophylactic measures. Thematic analysis was used to identify themes. We interviewed 28 close contacts across ten IMD cases, and identified four major themes – knowledge about IMD/perception of risk; adherence to recommendations provided by the health department; quality of management and public heath response by the health department, and experience in receiving antibiotic prophylaxis. Majority of close contacts had prior knowledge about IMD but experienced anxiety about their risk of contracting it; many believed that the function of clearance antibiotic was to prevent them from contracting the disease; contacts were satisfied with the information they received during the initial contact from the health department and presented to the emergency department of a hospital to receive clearance antibiotics within 24 hours of notification. Most close contacts did not receive any information at the hospital on the side effects or function of the antibiotics that they received. This study provided an in-depth insight on the experience of contact tracing for IMD close contacts as well as a better understanding of disease transmission, and identified gaps in the public health follow-up of close contacts. Findings from this study has implications for the public health response and management of close contacts recommended in jurisdictional IMD guidelines, for Australia and more broadly internationally. [ABSTRACT FROM AUTHOR]

Improved partner notification (PN) after HIV diagnosis could help control HIV among men who have sex with men (MSM). However, there is little evidence exploring what this experience is like for Australian MSM and how achievable it is in the era of the Internet and smartphones. Fifteen of 39 invited MSM recently diagnosed with HIV undertook a semistructured interview about PN. Interviews were thematically analyzed using a combined deductive/inductive approach. Three main themes arose: fear of PN and HIV disclosure, partners' unexpected reactions, and the need for more patient support. MSM found PN difficult and uncomfortable and described fear about potential repercussions of PN; however, they felt it was the right thing to do. Regular partners were more likely to be notified, and in person, because of the availability of contact information but more notably because of a sense of moral responsibility. Men commonly had few contact details for casual partners and preferred PN strategies that allowed them to remain anonymous, largely reflecting the reasons for and ways in which they met casual partners: online or through apps and predominantly for once-off, anonymous sex. Most described unexpected positive responses from partners who were contacted personally by the men. Our study also showed that participants required professional support to carry out PN, especially with casual partners, as well as support around understanding the implications of and treatments relating to being HIV positive. PN could be improved by offering more options that allow the index patient to remain anonymous, particularly when notifying casual partners. [ABSTRACT FROM AUTHOR]

The 'Australian Sexually Transmitted Infection (STI) Management Guidelines For Use In Primary Care' (www.sti.guidelines.org.au ) provide evidence-based, up-to-date guidance targeted at use in primary care settings. A major review of the guidelines was undertaken in 2020-22. All content was reviewed and updated by a multi-disciplinary group of clinical and non-clinical experts, and assessed for appropriateness of recommendations for key affected populations and organisational and jurisdictional suitability. The guidelines are divided into six main sections: (1) standard asymptomatic check-up; (2) sexual history; (3) contact tracing; (4) STIs and infections associated with sex; (5) STI syndromes; and (6) populations and situations. This paper highlights important aspects of the guidelines and provides the rationale for significant changes made during this major review process.

Abstract: Timor-Leste, a small, mountainous half-island nation which shares a land border with Indonesia and which is 550 km from Australia, has a population of 1.3 million and achieved independence for the second time in 2002. It is one of the poorest nations in Asia. In response to the global coronavirus disease 2019 (COVID-19) pandemic, the Timor-Leste Ministry of Health undertook surveillance and contact tracing activities on all notified COVID-19 cases. Between 1 January 2020 and 30 June 2022, there were 22,957 cases of COVID-19 notified which occurred in three waves, the first which was delayed until April 2021 (community transmission of B.1.466.2 variant following major flooding), followed by waves in August 2021 (B.1.617.2 Delta variant transmission) and February 2022 (B.1.1.529 Omicron variant transmission). There were 753 people hospitalised due to COVID-19 and 133 deaths. Of the 133 deaths, 122 (92%) were considered not fully vaccinated (< 2 COVID-19 vaccines) and none had received boosters. Timor-Leste implemented measures to control COVID-19, including: rapid closure of international borders; isolation of cases; quarantining of international arrivals and close contacts; restrictions on internal travel; social and physical distancing; and, finally, a country-wide vaccination program. The health system's capacity was never exceeded., (© Commonwealth of Australia CC BY-NC-ND.)

Background: Chlamydia, caused by Chlamydia trachomatis, is the most common reportable infection in many developed countries. Testing, treatment, and partner notification (PN) are key strategies for chlamydia control. In 2008 the Let Them Know (LTK) PN website was established, which provided means for people to send anonymous PN messages by text messaging (short message service, SMS), email, or letter.Objective: We evaluated PN practices among Australian family planning clinicians following chlamydia diagnosis and assessed how often clinicians refer their patients to the LTK website.Methods: A mixed methods approach included a Web-based cross-sectional survey of Australian family planning clinicians to examine PN attitudes and practices and focus groups to explore the context of LTK website use.Results: Between May 2012 and June 2012, all clinicians from 29 different family planning services (n=212) were invited to complete the survey, and 164 participated (response rate=77.4%); of the clinicians, 96.3% (158/164) were females, 56.1% (92/164) nurses, and 43.9% (72/164) doctors. More than half (62.2%, 92/148) agreed that PN was primarily the client's responsibility; however, 93.2% (138/148) agreed it was the clinician's responsibility to support the client in informing their partners by providing information or access to resources. Almost half (49.4%, 76/154) of the clinicians said that they always or usually referred clients to the LTK website, with variation across clinics in Australian states and territories (0%-77%). Eleven focus groups among 70 clinicians at 11 family planning services found that the LTK website had been integrated into routine practice; that it was particularly useful for clients who found it difficult to contact partners; and that the LTK letters and fact sheets were useful. However, many clinicians were not aware of the website and noted a lack of internal clinic training about LTK.Conclusions: The LTK website has become an important PN tool for family planning clinicians. The variation in referral of patients to the LTK website and lack of awareness among some clinicians suggest further promotion of the website, PN training, and clinic protocols are warranted. [ABSTRACT FROM AUTHOR]

Background One of the cornerstones of Australia's public health programmes to eliminate tuberculosis (TB) is the identification and treatment of latent tuberculosis infection (LTBI). Aims The main aim of this study is to determine the demographics, compliance, completion rates and adverse events of patients on preventive therapy ( PT) for LTBI at our institution. The secondary aim is to determine the rates of isoniazid ( INH) hepatotoxicity and identify any contributory factors. Methods The method used was an audit using medical records of 100 consecutive patients (2010-2014) treated with PT for LTBI. Results Seventy-two patients with confirmed LTBI started 9 months of INH and 22 started 4 months of rifampicin ( RIF). The median age was 30 years. Half the patients were born in high TB-prevalence countries. Fifty-six per cent were contacts of index cases with confirmed TB, and 26% were pre-immunosuppression. Seventy-seven per cent completed PT with adequate compliance. Thirty-three per cent on INH and 23% on RIF experienced some liver function test ( LFT) abnormality while on treatment. INH was ceased in 3% due to asymptomatic hepatic dysfunction (transaminases >5x upper limit of normal). No patients had permanent liver damage. Significant risk factors for liver dysfunction during PT were risk factors for liver disease ( [ABSTRACT FROM AUTHOR]

Background: The Australian Chlamydia Control Effectiveness Pilot (ACCEPt) was a cluster randomised controlled trial designed to assess the effectiveness of annual chlamydia testing through general practice in Australia. The trial showed that testing rates increased among sexually active men and women aged 16-29 years, but after 3 years the estimated chlamydia prevalence did not differ between intervention and control communities. We developed a mathematical model to estimate the potential longer-term impact of chlamydia testing on prevalence in the general population., Methods: We developed an individual-based model to simulate the transmission of Chlamydia trachomatis in a heterosexual population, calibrated to ACCEPt data. A proportion of the modelled population were tested for chlamydia and treated annually at coverage achieved in the control and intervention arms of ACCEPt. We estimated the reduction in chlamydia prevalence achieved by increasing retesting and by treating the partners of infected individuals up to 9 years after introduction of the intervention., Results: Increasing the testing coverage in the general Australian heterosexual population to the level achieved in the ACCEPt intervention arm resulted in reduction in the population-level prevalence of chlamydia from 4.6% to 2.7% in those aged 16-29 years old after 10 years (a relative reduction of 41%). The prevalence reduces to 2.2% if the proportion retested within 4 months of treatment is doubled from the rate achieved in the ACCEPt intervention arm (a relative reduction of 52%), and to 1.9% if the partner treatment rate is increased from 30%, as assumed in the base case, to 50% (a relative reduction of 59%)., Conclusion: A reduction in C. trachomatis prevalence could be achieved if the level of testing as observed in the ACCEPt intervention arm can be maintained at a population level. More substantial reductions can be achieved with intensified case management comprising retesting of those treated and treatment of partners of infected individuals., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Little is known about the transmission dynamics of the B.1.617.2 (Delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children and young adolescents. We investigated an outbreak in an Australian high school, with limited public health mitigation measures in place, to understand the school activities associated with transmission, and the role of young adolescents in spreading SARS-CoV-2., Methods: All 1,164 school attendees were monitored for SARS-CoV-2 infection through their mandated 14-day quarantine period. A cohort study design was used to investigate the effect of contact with the index case in different classes on the transmission of SARS-CoV-2, and the effect of vaccination among household contacts on becoming infected by SARS-CoV-2., Results: There were 48 outbreak cases, including 14 students and one teacher who likely acquired their infection at the school. Attack rates among students in the index case's classes ranged from 0% to 45%. The greatest risk of infection for students in the same grade attending a class with the index case were from the drama class (risk ratio, RR: 111.6; 95% confidence interval (95% CI): 14.88-837.19) and the personal development, health, and physical education class (RR: 7.45: 95% CI: 2.27-24.44). The overall household attack rate was 57%, and household contacts who were not fully vaccinated were 2.9 times more likely (95% CI: 1.07-7.87) to become cases than were effectively-vaccinated household contacts., Conclusion: Children can play an important role in the transmission of the Delta variant of SARS-CoV-2 within schools and at home. Transmission in this outbreak was largely associated with active, practical lessons that had close contact between students. This study demonstrates that the absence of public health and social measures in a low-incidence context resulted in the rapid spread of coronavirus disease 2019 (COVID-19) within an educational setting. These findings reinforce the role of public health and social measures and vaccinations to reduce airborne transmission and to enable a safe face-to-face learning environment., (© Commonwealth of Australia CC BY-NC-ND.)

(1) Background: Contact tracing and notification apps for coronavirus disease 2019 (COVID-19) are installed on smartphones and are intended to detect contact with another person's device. A high installation rate is important for these apps to enable them to be effective countermeasures against the silent transmission of diseases. However, the installation rate varies among apps and regions and the penetration dynamics of these applications are unclear. (2) Methods: The download behavior of contact tracing applications was investigated using publicly available datasets. The increase in downloads was modeled using a system dynamics model derived from the product growth model. (3) Results: The imitation effects present in the traditional product growth model were not observed in COVID-19 contact tracing apps. The system dynamics model, without the imitation effect, identified the downloads of the Australian COVIDSafe app. The system dynamics model, with a layered adopter, identified the downloads of the Japanese tracing app COCOA. The spread of COVID-19 and overall anti-COVID-19 government intervention measures in response to the spread of infection seemed to result in an increase in downloads. (4) Discussion: The suggested layered structure of users implied that individualized promotion for each layer was important. Addressing the issues among users who are skeptical about adoption is pertinent for optimal penetration of the apps.

Cryptosporidium is an important protozoan parasite and due to its resistance to chlorine is a major cause of swimming pool-associated gastroenteritis outbreaks. The present study combined contact tracing and molecular techniques to analyse cryptosporidiosis cases and outbreaks in Western Australia in 2019 and 2020. In the 2019 outbreak, subtyping at the 60 kDa glycoprotein (gp60) gene identified 89.0% (16/18) of samples were caused by the C. hominis IdA15G1 subtype. Amplicon next generation sequencing (NGS) at the gp60 locus identified five C. hominis IdA15G1 subtype samples that also had C. hominis IdA14 subtype DNA, while multi locus sequence typing (MLST) analysis on a subset (n = 14) of C. hominis samples identified three IdA15G1 samples with a 6 bp insertion at the end of the trinucleotide repeat region of the cp47 gene. In 2020, 88.0% (73/83) of samples typed were caused by the relatively rare C. hominis subtype IbA12G3. Four mixed infections were observed by NGS with three IdA15G1/ IdA14 mixtures and one C. parvum IIaA18G3R1 sample mixed with IIaA16G3R1. No genetic diversity using MLST was detected. Epidemiological and molecular data indicates that the outbreaks in 2019 and 2020 were each potentially from swimming pool point sources and a new C. hominis subtype IbA12G3 is emerging in Australia. The findings of the present study are important for understanding the introduction and transmission of rare Cryptosporidium subtypes to vulnerable populations. • Analysis of swimming pool-associated cryptosporidiosis outbreaks in Western Australia. • Next Generation, Sanger sequencing and multi locus typing of outbreak cases. • Two separate outbreaks linked to aquatic centres via typing and tracing. • Emergence of a relatively rare C. hominis subtype IbA12G3 in Australia. [ABSTRACT FROM AUTHOR]

This paper offers insight into and analysis of the disparate and diverse experiences of Australians with disability, at the intersections of technology and geography during the COVID-19 pandemic. Drawing on interviews with the blind and low vision community we identify a significant cross-generational uptake of smartphones. Participants demonstrate a reflexive and creative use of these devices when faced with reduced accessibility, and the significance of geography – not simply the distinctions between countries, but between urban and regional residents. These interviews are contextualised within a broader discussion of how Australians with disability responded to the pandemic via analysis of blogs, articles and social media. We focus on the voices and perspectives of disabled people, and that community's emphasis on individuality and intradisability diversity. Lastly, we present an overview of the discussions being held around the role of contact tracing and apps, privacy, validity and vulnerability. This discourse is important for ensuring support for the disability community pre and post global health emergencies, but also a valuable exemplar for understanding the relationship between digital inclusion and social equality more broadly. [ABSTRACT FROM AUTHOR]

Objective: To conduct a real-time audit to assess a Continuous Quality Improvement (CQI) activity to improve the quality of public health data in the Sydney Local Health District (SLHD) Public Health Unit during the first wave of COVID-19., Methods: A real-time audit of the Notifiable Conditions Information Management System was conducted for positive cases of COVID-19 and their close contacts from SLHD. After recording missing and inaccurate data, the audit team then corrected the data. Multivariable regression models were used to look for associations with workload and time., Results: A total of 293 cases were audited. Variables measuring completeness were associated with improvement over time (p<0.0001), whereas those measuring accuracy reduced with increased workload (p=0.0003). In addition, the audit team achieved 100% data quality by correcting data., Conclusion: Utilising a team, separate from operational staff, to conduct a real-time audit of data quality is an efficient and effective way of improving epidemiological data. Implications for public health: Implementation of CQI in a public health unit can improve data quality during times of stress. Auditing teams can also act as an intervention in their own right to achieve high-quality data at minimal cost. Together, this can result in timely and high-quality public health data., (© 2021 The Authors.)

Governments around the world have increasingly relied on technology to promote public health, such as using electronic health records and portable fitness devices. During the COVID-19 pandemic, "contact tracing apps" for smartphones have also been promoted in many countries as a way to allow public officials to facilitate contact tracing. But uptake in virtually all countries where such apps have been promoted is slow, one reason being privacy concerns. Conducting three experiments across France (n = 471), Australia (n = 202), and the United States (n = 1005), we explore if salient COVID-19 concerns, which intuitively should increase concerns about personal and public health, might in fact increase privacy concerns and thereby reduce uptake of contact tracing apps. Using an experimental design where we randomly assign participants to either a disease concerns or control condition, we find that salient COVID-19 concerns decrease intentions to download contact tracing apps. Mediation results reveal that greater valuations of privacy explain the lower willingness. We therefore explain why COVID-19 contact tracing apps that are promoted when the pandemic is at its peak see low levels of uptake. Our results provide policy makers with implications concerning how to promote uptake to help "flatten the curve" of not just the current pandemic but potentially also future ones. • Contact tracings app can "flatten the curve" but there are privacy concerns. • Disease concerns may heighten privacy concerns. • Thus, disease concerns may explain why tracing app uptake is slow. • Three experiments in France, Australia, and the United States tested our hypotheses. • Explanatory mediators included social conservatism and greater privacy concerns. [ABSTRACT FROM AUTHOR]

The article informs about improving the COVID-19 pandemic response for priority communities using first nations health principles in Australia. It also mentions establishing a unique model of Case, Contact and Outbreak Management (CCOM) dedicated to priority communities, based on Aboriginal community-controlled health principles and self-determination.

Summary: Data on 259 notified cases of genital chlamydia infection diagnosed in Victoria Australia in January and February 1995 were augmented by call-back. Risk factor data was available for 221. Patients were primarily adolescents or young adults (median age 23 years); 66% were women. Men were more commonly symptomatic. Persons without symptoms were tested as a result of partner notification, sexual risk, termination of pregnancy, or because of abnormalities on genital examination. Limitations of antigen-based screening tests in low prevalence populations were rarely considered. Although antimicrobial treatment usually accorded with available guidelines, case management was not well geared to reducing the broader issue of risk of this infection in the community. Data management systems for handling name-coded data, and systems for recall and follow-up of diagnosed patients and their partners were often inadequate. Sexual history taking had not generally identified details of sexual partners. Partner notification was generally regarded as the patient's responsibility and professional help with contact tracing was rarely sought. Control of chlamydia will require much greater attention to management issues, particularly contact tracing. [ABSTRACT FROM AUTHOR]

Objective: Many governments are using contact tracing mobile applications (CTMAs) yet public adoption of such systems has been relatively low. The main objective of this paper is to profile adopters (and non-adopters) of Australia's COVIDSafe CTMA., Materials and Methods: We use latent profile analysis to examine predictors of CTMA download behaviour. Specifically, we draw on a representative Australian sample (N = 2575) to examine the interplay between age, education, income, dispositional desire for privacy and political ideology on download behaviour. We examine trust in government as a mediating mechanism between profiles and download behaviour., Results: Our analysis produces seven profiles. Trust in government mediates the relationship between most profiles and download behaviour. A combination of wealth and education appear to be key explanatory factors of CTMA download behaviour. Two profiles -- comprising individuals with high income and education -- had the highest rates of download behaviour. Profiles with low download percentages comprised politically left-leaning participants with average to low income and education., Conclusion: Our findings clearly indicate the profiles of people who are (not) likely to download a CTMA. Practical ways to improve widespread adoption include providing structural support to the more vulnerable members of society, making clear the societal benefits of downloading CTMAs, and engaging in bipartisan promotion of such apps., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objectives: The early stages of the COVID-19 pandemic illustrated that SARS-CoV-2, the virus that causes the disease, has the potential to spread exponentially. Therefore, as long as a substantial proportion of the population remains susceptible to infection, the potential for new epidemic waves persists even in settings with low numbers of active COVID-19 infections, unless sufficient countermeasures are in place. We aim to quantify vulnerability to resurgences in COVID-19 transmission under variations in the levels of testing, tracing and mask usage., Setting: The Australian state of New South Wales (NSW), a setting with prolonged low transmission, high mobility, non-universal mask usage and a well-functioning test-and-trace system., Participants: None (simulation study)., Results: We find that the relative impact of masks is greatest when testing and tracing rates are lower and vice versa. Scenarios with very high testing rates (90% of people with symptoms, plus 90% of people with a known history of contact with a confirmed case) were estimated to lead to a robustly controlled epidemic. However, across comparable levels of mask uptake and contact tracing, the number of infections over this period was projected to be 2-3 times higher if the testing rate was 80% instead of 90%, 8-12 times higher if the testing rate was 65% or 30-50 times higher with a 50% testing rate. In reality, NSW diagnosed 254 locally acquired cases over this period, an outcome that had a moderate probability in the model (10%-18%) assuming low mask uptake (0%-25%), even in the presence of extremely high testing (90%) and near-perfect community contact tracing (75%-100%), and a considerably higher probability if testing or tracing were at lower levels., Conclusions: Our work suggests that testing, tracing and masks can all be effective means of controlling transmission. A multifaceted strategy that combines all three, alongside continued hygiene and distancing protocols, is likely to be the most robust means of controlling transmission of SARS-CoV-2., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)