COVID-19 related outputs from the PCHSS


Selected academic articles and editorials published by PCHSS investigators

24/03/2021 – BMJ Open – Association between telehealth use and general practitioner characteristics during COVID-19: findings from a nationally representative survey of Australian doctors. “ GP characteristics are strongly associated with patterns of telehealth use in clinical work. Infrastructure support and relative pricing of different consultation modes may be useful policy instruments to encourage GPs to deliver care by the most appropriate method.”

16/03/2021 – BMJ Open – Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. “Healthcare utilisation decreased by about a third during the pandemic, with considerable variation, and with greater reductions among people with less severe illness. While addressing unmet need remains a priority, studies of health impacts of reductions may help health systems reduce unnecessary care in the post pandemic recovery.”

01/03/2021 – Australasian Journal on Ageing – The impact of COVID-19 on the quality of life of older adults receiving community-based aged care.“Government messages and support initiatives directed towards technology adoption among older adults receiving home care may assist with maintaining social connection during COVID-19.”

01/03/2021 – Internal Medicine Journal – Utilisation of inpatient rehabilitation following elective total knee or hip replacements in private hospital setting declined during the COVID-19 pandemic. “The observed reductions in inpatient rehabilitation following hip and knee replacement appear to reflect a change in patient and/or clinician preference as a direct result of the pandemic. One possibility is that concern about the risk of contracting the virus in hospital facilities may have assumed greater importance over other concerns.”

26/02/2021 – Frontiers in Public Health – How Australian health care services adapted to telehealth during the COVID-19 pandemic: a survey of telehealth professionals. “Triggered by the pandemic telehealth services have been legitimised to operate on a much larger scale than before and funding in Australia has supported this expansion. As a result of the need to physically distance care, acceptance and confidence in telehealth services as a modality of healthcare delivery has grown significantly. Looking forward to a period beyond the pandemic it is likely that there will be further changes to the regulatory regime for telehealth in Australia.”

22/12/2020 – Journal of Medical Internet Research – COVID-19 as ‘game changer’ for the physical activity and mental well-being of augmented reality game players during the pandemic: mixed methods survey study. “AR games have the potential to promote physical and mental health during the COVID-19 pandemic. Used by populations under isolation and distress, these games can improve physical and mental health by providing virtual socialization, sustained exercise, temporal routine, and mental structure.”

19/12/2020 – International Journal of Pharmacy Practice – The pharmacist informatician: providing an innovative model of care during the COVID-19 crisis. “Improving awareness, training, and the integration about informatics roles as a result of this global pandemic will likely assist with future patient management in the event of future disasters”

09/12/2020 – Public Health Research & Practice – The Australian health system response to COVID-19 from a resilient health care perspective: what have we learned? “Finally, we have learned the value of adapting care processes in response to emerging needs. New models of care have been introduced in elective surgery, in telehealth, through remote monitoring and by bringing the hospital into the home (including remote consultation and assessment). Protocols and new facilities have been implemented to help prioritise and balance the care of people with COVID-19, and those with other, comorbid health conditions, and the private healthcare system has been recruited to provide additional resources (financial and personnel) where necessary.”

11/12/2020 – JMIR medical informatics – Development and validation of a machine learning approach for automated severity assessment of COVID-19 based on clinical and imaging data: retrospective study. “Clinical and imaging features can be used for automated severity assessment of COVID-19 and can potentially help triage patients with COVID-19 and prioritize care delivery to those at a higher risk of severe disease.”

20/11/2020 – International Journal for Quality in Health Care – International survey of COVID-19 management strategies.The world has progressed in its knowledge and sophistication in tackling the pandemic after early and often substantial obstacles were encountered. Most WHO regions have or are in the process of responding well, although some countries have not yet instituted widespread measures known to support mitigation, for example, effective swab testing and social control measures.”

28/10/2020 – Medical Journal of Australia – Can AI help in the fight against COVID-19? In this paper published by Professor Ian Scott and PCHSS’ Professor Enrico Coiera discuss the role of AI in helping to detect outbreaks, trace close contacts, screen for infection and predict patient outcomes. The researchers found that deep learning algorithms were able to accurately identify markers associated with COVID-19, and mobile phone apps could be used effectively to conduct contact tracing.

12/10/2020 – JMIR Public Health and Surveillance – Concerns and misconceptions about the Australian Government’s COVIDSafe App: A cross-sectional online survey. “For the COVIDSafe app to be accepted by the public and used correctly, public health messages need to address the concerns of citizens, specifically privacy, data storage, and technical capabilities. Understanding the specific barriers preventing the uptake of contact tracing apps provides the opportunity to design targeted communication strategies aimed at strengthening public health initiatives, such as downloading and correctly using contact tracing apps.”

30/09/2020 – International Journal for Quality in Healthcare – The 40 health systems, COVID-19 (40HS, C-19) study. “Governments around the world are seeking evidence to inform their decisions about the most effective pandemic responses. The 40HS, C-19 study provides a cross-sectional snapshot of 40 health systems and their responses to COVID-19 and underscores the importance of stringency and broad-based testing.”

26/09/2020 – Journal of Telemedicine and Telecare – Building on the momentum: Sustaining telehealth beyond COVID-19. “When the initial disruption of the pandemic eases, and we return to business as usual in the wake of COVID-19, a critical juncture lies ahead: return to previous care models or create the ‘new normal’ with telehealth firmly embedded as an integrated part of care delivery”.

28/08/2020 – Australian Health review – Telehealth uptake in general practice as a result of the coronavirus (COVID-19) pandemic. “Telehealth, the delivery of health care from a distance, enables patients to access routine clinical care (e.g. ongoing management for chronic disease) during infectious disease outbreaks. For decades, telehealth has been widely acknowledged as a valuable method of improving access to healthcare services, which would normally be difficult to access – perhaps due to location (rural and remote) or other barriers (such as frailty, lack of transport or other physical or mental health conditions).”

20/08/2020 – Melbourne Institute – The impact of COVID-19 on GPs and non-GP specialists.“The pandemic has presented many challenges for GPs and non-GP specialists in private practice. There has been significant turbulence and variation in how the sector has been affected. The pandemic has led to new ways of working, organisation, efficiencies and models of care for patients. It will also likely accelerate some preexisting trends in the sector”

14/08/2020 – JMIR Medical Informatics – Automated Severity Assessment of COVID-19 based on Clinical and Imaging Data: Algorithm Development and Validation. “ This study indicates that clinical and imaging features can be used for automated severity assessment of COVID-19 patients and have the potential to assist with triaging COVID-19 patients and prioritizing care for patients at higher risk of severe cases.”

06/08/2020 – MedRxiv – Severity Assessment and Progression Prediction of COVID-19 Patients based on the LesionEncoder Framework and Chest CT“An important future direction of this framework lies in the combination of clinical data and imaging data for better prediction performance, especially for the progression prediction, since clinical data may provide essential indicators of the clinical risks of the patients.”

04/05/2020 – Nature Partner Journals Digital Medicine – Chatbots in the fight against the COVID-19 pandemic. “The WHO Director-General recently called for innovative pandemic responses. To this aim, chatbots are already being deployed in the fight against COVID-19. If designed effectively, chatbots may help prevent misinformation, aid in symptom detection, engender infection-limiting behaviors, and lessen the mental health burden of pandemic response. In a pandemic, no group of people remains unaffected for long.” 

5/06/2020 – Australian Institute of Health Innovation – Any ordinary day. Healthcare must continue in the face of the extraordinary – New opinion piece by Professor Jeffrey Braithwaite on the need for people maintain their normal healthcare regime during the COVID-19 pandemic.

12/05/2020 – The BMJWaste in covid-19 research –An editorial by Professor Paul Glasziou, Assistant Professor Sharon Sanders and Professor Tammy Hoffmann on the “deluge of poor quality research” that is undermining an evidence-based response to COVID-19. The authors highlight the ways in which, amidst the unprecedented levels of focussed research activity brought about by the pandemic, the rush to generate new findings is leading to increased levels of poor study design, inadequate reporting standards, duplication, and waste.

11/05/2020 – The ConversationShould we re-open pubs next week? The benefits seem to exceed the costs – An article by Professors Jonathan Karnon and Ben W. Mol on the prospect of reopening restaurants and bars in mid-May. The authors make an attempt on the difficult and thankless task of placing a dollar value on the costs and benefits to lives, livelihoods and public finances of such a decision amidst the COVID-19 pandemic.

29/04/2020 – CroakeyAs a Roadmap to Recovery is released, what can health economics offer decision-making? –  An article by Professor Anthony Scott on the role of economists—and particularly health economists—on bringing forward difficult questions related to the trade-offs underlying different policy choices in context of a pandemic like COVID-19. Professor Scott notes that cost-benefit analyses are often seen as “unethical or distasteful” in such a situation, but they in fact reflect unavoidable considerations for maximising life and wellbeing and minimising death and suffering.

21/04/2020 – The ConversationWhat if the vaccine or drugs don’t save us? Plan B for coronavirus means research on alternatives is urgently needed – An article by Professors Paul Glasziou and Tammy Hoffman outlining considerations on dealing with COVID-19 while a vaccine is still in development—or in the case of a vaccine does not emerge by 2021. They highlight how non-drug interventions and prevention measures are the subject of only about 40% of clinical trials and how there is a lack of research—specifically randomised controlled trials—on questions related to how the virus spreads. Moreover, even should a vaccine be developed, it will only address the current pandemic but will not sufficiently prepare us for preventing the spread of future respiratory viruses.

16/04/2020 – Telemedicine and e-Health The role of telehealth in reducing the mental health burden from COVID-19 (Zhou X, Snoswell CL, Harding LE, Bambling M, Edirippulige S, Bai X, Smith AC) – In this journal article, Dr Centaine Snoswell and colleagues explain the risks of social isolation to people’s psychological wellbeing. While the social distancing intervention will likely reduce the spread of the disease, reduced access to friends and family can cause loneliness, degrade those social support networks, and aggravate anxiety and depressive symptoms. Expanding mental health services provided over the telephone or using videoconferencing (collectively known as telehealth) can help in meeting people’s psychological needs in this time of unprecedented healthcare demand.

6/04/2020 – MJA InSight+COVID-19 is opening up fault lines in the health care system – Commentary by Professors Jeffrey Braithwaite and Anthony Scott on how the COVID-19 pandemic will both test the resilience of the Australian healthcare system and expose a pair of long-standing “fault lines” within it. The first of these is the funding for GPs in primary care—specifically the fee-for-service paradigm that the authors argue is “straight from the 19th century”. The second is the division between public and private hospitals, which they suggest is reflective of a funding model that may be ill-equipped to meet the tests of the healthcare system’s resilience that the pandemic has brought about—specifically in relation to the capacity for public-private cooperation and sharing of resources. They conclude that frontline healthcare workers are “finding their hands are tied by a disjointed system that reduces the speed and agility of response.”

05/04/2020 – Applied health economics and health policy – A simple decision analysis of a mandatory lockdown response to the COVID-19 pandemic. “Many countries have now implemented mandatory mass quarantine policies. The use of decision analysis as illustrated in this editorial may have informed the earlier implementation of mandatory lockdown policies in these countries.”

8/04/2020 – The ConversationShould everyone be wearing face masks? It’s complicated – An article by Professors Paul Glasziou and Chris Del Mar on the utility and advisability of wearing face masks as a way of preventing contraction of COVID-19. The authors discuss their analysis of 14 randomised trials on mask wearing and infection for flu-like illnesses. The evidence they reviewed suggested that masks do not significantly protect the wearer but are most useful for infected people—or those suspected to be infected—to wear in order to mitigate the diffusion of infectious aerosols and droplets in the air they breath out. The authors also highlight how the risks of infection change in indoor and outdoor settings, with the latter often posing “little or no risk”.

16/03/2020 – MJA InSight+COVID-19: we need health services researchers in hospitals now – An article by Professor Jeffrey Braithwaite and Dr Robyn Clay-Williams on the contemporary status of the COVID-19 pandemic and the prospect of its rapid spread overwhelming Australian health systems. The authors outline the research activities of the Australian Institute of Health Innovation, with its focus on understanding “resilient” healthcare—that is, “the ability for a system to maintain its function when challenged by unexpected events”. They propose that, in the face of such events, health system researcher can assist healthcare providers to strike the right balance between excessively protocolised care and over-flexible approaches to cope with new tests.

20/03/2020 – Journal of Telemedicine and Telecare Telehealth for global emergencies: implications for coronavirus disease 2019 (COVID-19) (Smith AC, Thomas E, Snoswell CL, Haydon H, Mehrotra A, Clemensen A, Caffery LJ) – In this journal article, Dr Centaine Snoswell and Associate Professor Liam Caffrey, along with colleagues, highlight how the COVID-19 health crisis could be used as an inflection point for moving telehealth from the fringes of healthcare to part of “business as usual”. They outline how telehealth has been used in other emergency situations in the past few decades, the barriers to greater telehealth uptake, and the potential for the practice in the current moment.

12/03/2020 – The ConversationWant to Skype your GP to avoid exposure to the coronavirus? Here’s what you need to know about the new telehealth option – An article by Dr Centaine Snoswell and Professor Anthony Smith advising Australians on how to make use of telehealth services on the heels of a new federal government telehealth program to respond to COVID-19. The authors explain who is eligible for the program, some of the history of telehealth in emergency situations, and how the pandemic may result long-term expansion of telehealth services.

5/03/2020 – CroakeyMaking the most of telehealth in COVID-19 responses, and beyond – An article by Dr Centaine Snoswell and colleagues encouraging wider adoption of telehealth during the COVID-19 public health crisis, while acknowledging that it is not a panacea and noting a number of significant barriers to ensuring its widespread and equitable use.

Online resources developed by PCHSS investigators

01/04/2020 – University of Queensland – Quick Guides for telehealth – A resource page providing a variety of useful infographics on telehealth for healthcare professionals and consumers on the following topics: “Quick start to videoconferencing”, “Communicating effectively online”, “Video conference software”, “Purchasing video conferencing devices”, “Zoom security”, “What is telehealth and is it right for you?”, and “Attending a video consultation”.

18/03/2020 – YouTube channel of Paul Glasziou – Corona Virus: How can we stop the spread? Testing & barrier prevention – A two-minute video explaining how COVID-19 expands within a population and how to “flatten the curve” with testing and prevention strategies.

20/03/2020 – Australasian Association for Academic Primary Care website – COVID-19 Resources for Primary Care – A list of COVID-19 resources developed by Professor Paul Glasziou for the primary care community.

Selected articles in the popular press featuring commentary by PCHSS investigators and partners

5/06/2020 – PCHSS Telehealth stream investigators examined telehealth usage in Australia since the start of the coronavirus pandemic.

16/5/2020 – Daily TelegraphCoronavirus: Which nations are beating COVID-19 — and which are not? An article about how different countries are coping with COVID-19 with comments from Professor Paul Glasziou about what Australia can learn from overseas experiences. (Note: Pay wall)

26/04/2020 – NewsMailPLAN C: Our last hope if virus vaccine comes to nothing – An article on the prospect of dealing with the COVID-19 pandemic in the medium- and long-term should a vaccine either not emerge soon or at all. It outlines the question of treatments to mitigate the effects of infection as well as personal, social, and lifestyle changes to limit the spread of the virus. Quoting a piece in The Conversation from Professors Paul Glasziou and Tammy Hoffman, the article notes that we are “being saved by non-drug interventions such as quarantine, social distancing, handwashing, and – for healthcare workers – masks and other protective equipment.”

24/04/2020 – ABC Radio Melbourne – [Interview of Jeffrey Braithwaite on Evenings] – A radio interview with Professor Jeffrey Braithwaite on the prospect of easing COVID-19 restrictions in Australia. Professor Braithwaite comments that finding a “sensible centre” in situation of countless trade-offs may be the best course for the country. ProfessorBraithwaite outlines considerations such as the importance of adequate testing, the possibility of achieving “herd immunity”, and the necessity of communities and institutions being able to remain agile and build a “new normal” in the wake of the outbreak.

22/04/2020 – Kaiser Family Foundation ­– Editorials, Opinion Pieces Discuss Various Aspects of Coronavirus Pandemic, Including Vaccine R&D, Lessons, Key Issues For Future ­– An article providing a roundup from around the internet of resources from experts on the COVID-19, featuring a short description of an article by Professors Paul Glasziou and Tammy Hoffman outlining considerations on dealing with COVID-19 while a vaccine is still in development.

22/04/2020 – for more research on virus spread – An article detailing the concerns of Professor Paul Glasziou about the medical research community failing to give due attention to understanding how COVID-19 spreads. As energies are centred on the development of a vaccine, Professor Glasziou notes that there continue to be “many unknowns” about how long the virus survives on surfaces, whether washing hands with soap or using hand sanitizer is more effective, how the virus is transmitted through coughs and sneezes, and other subjects. Professor Glasziou points to the need for more research on these fronts.

15/04/2020 – ABC NewsQueensland’s coronavirus infection rate is slowing, so where to next? – An article on the apparent effectiveness of Queensland’s social distancing efforts and its slowing COVID-19 infection rate, which points just over a thousand confirmed cases and six deaths. Professor Paul Glasziou comments that, despite the state adopting less-stringent lockdowns than states such as New South Wales and Victoria, the state of Queensland has experienced “the same sort of rise and fall”. The article also points to the interesting statistic that, across Australia, women in their 20s have accounted for the highest number of total confirmed infections.

1/04/2020 – The Morning BulletinWhen we’ll know restrictions are working – An article on the apparent effectiveness of steps Australia has taken to mitigate the spread of COVID-19. Professor Paul Glasziou comments that “things are actually looking very good”, that social distancing interventions would begin to demonstrate their impact within the coming week or two.

31/03/2020 – ABC NewsExperts hopeful Australia is turning corner on coronavirus as Health Minister declares curve is flattening – An article on the hopeful signs that Australia has been successful in flattening the curve of COVID-19 growth. Professor Paul Glasziou comments that “things are actually looking very good” and that social distancing interventions have borne fruit in bringing the virus’s spread under control.

27/03/2020 – The ChronicleCOVID-19’s impact on health cover – An article on scheduled premium increases of certain health funds on 1 April, set to move ahead despite restrictions on surgery and other treatments. Consumers Health Forum CEO Leanne Wells urges such funds to reconsider moving forward with the planned price hikes.

27/03/2020 – Herald SunCoronavirus: The private health funds not dumping April 1 – An article listing three large health funds that will not postpone scheduled premium increases on 1 April in light of COVID-19, despite restrictions on surgery and other treatments. Consumers Health Forum CEO Leanne Wells urges such funds to reconsider moving forward with the planned price hikes.

22/03/2020 – CroakeyEpisode1: COVID19: Meeting the Challenges – The first episode in a COVID-19 podcast series from Croakey, featuring an interview with Dr Centaine Snoswell on telehealth services.

17/03/2020 – The GuardianPrivate health sector’s claim of closure after coronavirus elective surgery shutdown is ‘disingenuous’ – An article on a claim by private hospitals that, without government financial assistance, they may be forced to close as a result of the cancellation of non-essential elective surgeries amidst the COVID-19 outbreak. Consumers Health Forum CEO Leanne wells comments that the government and the private hospital sector should work together in this time of crisis.

17/03/2020 – The ConversationCoronavirus weekly: expert analysis from The Conversation global network – An article providing a roundup of insights from experts on the COVID-19, featuring a short description of an article by Dr Centaine Snoswell and Professor Anthony Smith on telehealth services.

30/01/2020 – NewsGP ­– Is quarantining children a sensible precaution amid coronavirus? – An article from late January featuring the perspective of Professor Paul Glasziou on the prospect of quarantining children because of the COVID-19 outbreak. Professor Glasziou comments that closing schools could be a reasonable option by pointing to a finding in a 2019 article he co-authored that suggested, as others had found before, that such a measure “clearly reduces transmission”.

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