In the latest edition of the COVID-19 wrap, public health researcher Alison Barrett reports on a raft of new research and other reports of national and global significance.
COVID-19: An Australian perspective
Shakespeare-Finch, J et al, Journal of Loss and Trauma, 19 June 2020
For Australians, the mental health impacts of the COVID-19 pandemic need to be considered within the context of other traumatic events.
The novel coronavirus was spreading in China as Australia was dealing with devastating bushfires from late 2019 until early 2020 and then floods in February.
The first cases of COVID-19 in Australia were confirmed in late January and border closures and travel restrictions were implemented from mid-March to help prevent the spread of the novel coronavirus.
These closures came not long after bushfire affected regions started the rebuild and recovery process, meaning that rebuilding has been delayed and tourism businesses adversely impacted.
It is unclear at this stage exactly what the financial, social and psychological impact will be from these devastating events, but as Shakespeare-Finch and colleagues write, “it is likely to lead to complex adjustment challenges, reactions and disorders”. They also flag the potential for adversity to lead to “new possibilities.”
A study recently published in The Medical Journal of Australia found that about one-quarter of the Australian population experienced mild to moderate symptoms of depression (26.5%) or anxiety (24.5%) in the first month of COVID-19 restrictions.
In this article, Shakespeare-Finch and colleagues discuss populations at high-risk for developing mental health issues during COVID-19; Australia’s mental health care system and response to COVID-19; and how models of resilience, hope and posttraumatic growth may help Australian’s move forward and recover from the stressful events of 2020.
High-risk population groups during COVID-19 and responses
Populations at high-risk for developing mental health issues during COVID-19 include those affected by bushfires, floods or droughts; Australians with pre-existing mental health issues; Aboriginal and Torres Strait Islanders; and frontline health workers.
Other groups include refugees, asylum seekers, International students and migrant workers, many of whom aren’t eligible to receive government aid and live in crowded conditions conducive to the spreading of SARS-CoV-2.
Mental health care infrastructure and COVID-19 response
The Australian Government allocated $74 million to support the mental health of Australians and expand services during COVID-19.
The authors highlight that one of the positives to come from COVID-19 is the rapid shift to telehealth, enabling more flexibility and capacity to provide services to population groups who may not previously have been able to access mental health services, due to geographical or other barriers.
More funding is required to address longer-term mental health issues that are likely to present themselves in years to come.
Getting on the front foot with mental health and COVID-19
Models of resilience, self-compassion, posttraumatic growth and hope can guide recovery through natural disasters and the pandemic.
Resilience helps protect people during and after challenging times and can be strengthened in many ways. In the context of COVID-19, some of these ways include:
Self-compassion and being considerate to others without judgement, while recognising that everyone is dealing with COVID-19 in some way.
Post-traumatic growth or thriving, indicated after experiencing a stressful event, by following new opportunities, relationships with others, spiritual change, gratefulness, and personal strength.
Increasing hopefulness by setting achievable goals such as cooking a meal, or learning a new skill, to help increase motivation.
Physical activity is particularly important to maintaining mental health, and during the pandemic could be an opportunity to establish social connections.
As frontline health workers are at high risk during pandemics, it’s also important to look after their mental health. Suggestions include providing them with advice on modifiable lifestyle factors including physical activity, diet, smoking and sleep.
In conclusion, the authors write:
We remain optimistic and hope that lessons can be learned from this experience. We know many people are hurting in a variety of ways through isolation, economic, physical, and emotional challenges.
However, if academic and creative literature tells us anything, it is that adversity can also lead to adaptation and new possibilities.”
Australian Bureau of Statistics (ABS): Household impacts of COVID-19 Survey
ABS, 2020
In the fifth ‘Household impacts of COVID-19’ survey conducted by the ABS, key findings indicate that while three-quarters of Australians reported being uncomfortable about going to large public events, about 60 percent of the population would like to return to attending gatherings with family and friends and dining out.
This survey, conducted between 26 and 29 May as COVID-19 restrictions eased around Australia, also found that 86 percent of Australians who worked were comfortable returning to their usual workplace. Survey respondents reported feeling least comfortable about attending large public events (76%) and indoor gatherings of more than 100 people (66%), and travelling by airplane (63%).
When asked what needs to happen to alleviate these concerns, nearly two-thirds reported that the development of a vaccine and lower daily infection rates would help.
The ABS has been conducting surveys with approximately 1,000 people every fortnight since 1 April to gain a brief insight into how Australian households are experiencing the social and economic changes brought on by the COVID-19 pandemic.
Some other key findings from the ‘Household impacts of COVID-19’ surveys during the pandemic include:
- Three-quarters of Australians with children kept them home from school or childcare; 22 percent reduced or changed their working hours.
- Limited internet connection was an issue for 15 percent of school-aged children learning from home.
- Women were more likely than men to work from home (56% compared with 38%); 46 percent of people with paid employment reported working from home.
- In the third survey (conducted between 29 April and 4 May), 94 percent of Australians reported maintaining social distance from others outside their homes and 85 percent reported avoiding public spaces. This is down slightly from the first survey when 98 percent of Australians practised social distancing and 88 percent of Australians avoided public spaces.
- One in six Australians had used a telehealth service.
- One-third of people reported their household finances being worse due to COVID-19.
- One-quarter of Australians received the first one-off $750 Commonwealth support payment.
- Half of Australians aged 18 years and over changed or cancelled travel plans in March as a result of COVID-19.
Some limitations of the data include a small sample size of 1,180 people; however, the ABS advises that it is mostly representative of the Australian population (in geography, age and sex), and based on self-report via Computer Assisted Interview over the phone.
Full issues of the ‘Household impacts of COVID-19’ surveys can be found on the ABS website at the below links:
First issue, 1-6 April
Second issue, 14-17 April
Third issue, 20 April-4 May
Fourth issue, 12-15 May
Fifth issue, 26-29 May
Revealing the most prominent voices of the COVID-19 pandemic
Scimex, 25 June 2020
During times of crisis, such as the COVID-19 pandemic, it is important the media have access to informed scientific and medical experts so they can share accurate and timely information required to keep people safe.
A collaborative project between Australian Science Media Centre (AusSMC) and Streem Media found that Professor Raina Macintyre, a global biosecurity expert at University of New South Wales, was the academic mentioned the most times in Australian news articles involving COVID-19.
She was mentioned in media items 252 times in news published from the initial outbreak of the novel coronavirus in China until the end of May, and followed by Professor Peter Collignon, Laureate Professor Peter Doherty, and Associate Professor Ian Mackay.
The project aimed to find out who made the news, based on mentions in stories about coronavirus, in Australia’s leading newspapers and news websites, and how much media attention those with most relevant expertise in the field had received. The results of the project (not yet peer-reviewed) were shared via media release on Thursday 25 June.
Lyndal Byford, the Director of News and Partnerships at the AusSMC, said “it was reassuring to see that people qualified in immunology, virology and epidemiology had generally been the most prominent academic voices during the pandemic.”
Prime Minister Scott Morrison was the most mentioned public figure and politician overall with 11,294 media items, followed by Chief Medical Officer Brendan Murphy (2,706), NSW Premier Gladys Berejiklian, Federal Treasurer Josh Frydenburg and Queensland Premier, Annastacia Palaszczuk.
The Peter Doherty Institute for Infection and Immunity was the most high-profile institute, followed by CSIRO, Grattan Institute and Kirby Institute at University of New South Wales. University of Sydney, University of Queensland and Australian National University were the most prominent universities, with the highest number of mentions in the media.
Politicians, public servants, lobby group heads and academics were the most prominent voices in the media.
Conal Hanna, Media and Partnerships lead at Streem, said “I think it’s fair to say there has been an unprecedented hunger from the public for scientific information, and at a more detailed level than they would normally seek out.
“Being able to explain complex concepts in accessible ways has been vital to keeping the community safe.”
Professor Gary Mortimer, a retail marketing specialist, was the only non-medical academic in the list of most mentioned academics.
While it is encouraging that the voices of epidemiologists and infectious disease experts are being heard, it would be appropriate to hear more from behavioural or social scientists and risk communicators, given that the ongoing pandemic requires substantial population-level behaviour change and a vital need to communicate messages effectively.
Coming out of COVID-19 lockdown: The next steps for Australian health care
Duckett, S, Grattan Institute, 21 June 2020
A report by Professor Stephen Duckett and colleagues at the Grattan Institute outlines some recommendations for Australia in coming out of the COVID-19 lockdown.
First, the authors highlight some key successes and failures in Australia’s response to date:
Failures include the mismanagement of the Ruby Princess cruise ship; borders closing too slowly; aspects of the health system responding slowly; and mixed messages for population expectations.
Key successes highlighted are the government being informed by experts and the establishment of the National Cabinet; mandatory quarantine for travellers and closure of international borders; public adoption and acceptance of physical distancing; and expansion of telehealth.
Coming out of lockdown should be managed carefully in order to prevent, or minimise the effects of, a second wave of coronavirus and further outbreaks, such as those being seen in in Victoria over the past two weeks.
“It’s dangerous for people to think this fight is over. The nature of the virus hasn’t changed – our behaviour has,” Duckett said.
Their recommendations are to:
- Maintain social distancing where there are local active cases of COVID-19.
- Reimpose local lockdowns when major outbreaks occur.
- When there aren’t active local COVID-19 cases, capacity restraints in workplaces, shops and hospitality can relax; testing must continue; as must quarantining for people from overseas.
- The Commonwealth Government should expand telehealth and contemplate new models of funding for general practice, to pay for telehealth items.
- State and Commonwealth governments should make the health system more efficient by connecting public and private health sectors. For example, by negotiating for private hospitals to undertake some of the elective surgeries, this will help clear the current backlog; expand out-of-hospital care.
- Improve health system readiness by reviewing approaches to COVID-19 pandemic and integrating lessons learned into Australia’s pandemic response plans.
In conclusion, Duckett said:
If Australia gets this transition to a ‘new normal’ wrong, we won’t benefit from the overdue health system changes that the crisis forced on us.
That would be another tragedy on top of the trauma caused by the pandemic itself.”
The full report can be viewed here.
COVID-19 Global trends and analyses: June, Update 4
Toole, M et al, Burnet Institute, 26 June 2020
On 29 June 2020, global COVID-19 cases passed 10 million and deaths passed 500,000.
While 43 countries have seen a decline in cases over the past two weeks, 77 countries have experienced a growth in new cases.
Cases of COVID-19 are rising rapidly in India, Pakistan, Bangladesh, Brazil, US, Russia, Peru, Chile, Saudi Arabia and Mexico. The US accounts for 28 percent of the world’s total cases.
It took 98 days for 100,000 cases to be reported in Africa; that figure doubled in 18 days.
Case study
The world’s largest refugee camp in Bangladesh has officially reported 38 cases/2 deaths but with low testing rates it’s hard to know for certain. A modelling study estimated that 70-98 percent of refugees could be infected and 2,000-3,000 deaths would occur during first 12 months.
The report describes additional case studies in India, Indonesia, Papua New Guinea and Africa; it can be viewed here.
Outcomes of easing restrictions
Cluster outbreaks have been experienced in countries that had responded well to their original outbreaks of COVID-19 (for example, Greece, Denmark, Czech Republic, Portugal, Germany and South Korea) and since eased restrictions.
Since the end of May, South Korea has reported between 30 and 50 new cases each day, in a “persistent series of clusters, mainly in metropolitan Seoul”. The authors say “this is not dissimilar to the current trend in Melbourne”.
Measures implemented in South Korea since restrictions eased include a mobile phone QR code scanning for entry and exit to high-risk places including gyms and nightclubs; and monitoring of international visitors via daily recording of health status on a mobile phone app for 14 days.
At present, South Korea does not intend to lockdown if there is a second wave; however, the Government acknowledges that lockdowns may be required.
The report also describes the outcomes of easing restrictions in Israel, Beijing, China, Germany, and US; and can be viewed here.
More COVID-19 reports, news and research by the Burnet Institute can be found at their Knowledge Hub for COVID-19.
Alison Barrett is a Masters by Research candidate and research assistant at University of South Australia, with interests in public health, rural health and health inequities. Follow on Twitter: @AlisonSBarrett. Croakey thanks her for providing this column as a probono service to our readers.
See previous editions of the COVID wrap.
COVID-19 Twitter lists
- Follow this Twitter list for informed news sources, global and Australian.
- Follow this Twitter list for news from Aboriginal and Torres Strait Islander health organisations and experts.
