COVID-19 Critical Intelligence Unit Updates

Daily Evidence Digests

October

Lifting non-pharmaceutical interventions, vaccines, engines of spread, incubation period

Child and family outcomes post-pandemics, ICU contamination, epidemic suppression and vaccine development

Neurological manifestations, postoperative mortality, congregate living settings, viral shedding

Acknowledging uncertainty, scientific divisions, herd immunity, ultraviolet-B radiation, vaccines

Cytokine elevation, virtual cancer genetic services, comparative evidence on drug treatments, immunity passports

Re-positive patients, sensible medicine, COVID-19 ‘circuit breaks’

All-cause mortality, orthopaedic trauma at RNSH, COVID-19 vaccines

Takotsubo syndrome, arrhythmias in COVID-19, reinfection

Aerosol-generating procedures, vertical transmission during pregnancy, pandemic staffing, excess deaths

Cutaneous COVID-19, regional strategies, complexity science, post-traumatic growth

Psychological impact of isolation, portable negative pressure innovation, sewage surveillance

Aerosols and extubation, severe paediatric ketoacidosis, public health research needs

Acute kidney injury, super-spreaders, communicating risk

Prophylactic anticoagulants, in-hospital cardiac arrest, changes in alcohol consumption, social license and big data

Research letters on aortic valve replacement, in-hospital cardiac arrests, older people in vaccine trials

Hand sanitisers, stroke, flight-associated transmission, off-label use of disinfectants

September

Ventilation, general practice, health system preparedness, social distancing and border restrictions

E-mental health solutions, Favipiravir, poor appetite and overeating during COVID-19, ethics of health worker wellbeing

Easing restrictions, efficacy of masks, patient heterogeneity, herd immunity, telerehabilitation

Pulmonary embolism, politicisation of mask use, animal models for testing, TGA regulation of PPE

ECMO telerounding, point-of-care tests, digital health

Cocooning vulnerable populations, cancer care in Victoria, community testing, decreased ED wait times

Temperature and humidity, methylprednisolone, in-flight transmission, viral loads

COVID-19 transmission, antiviral therapeutics, intimate partner violence, pre-existing immunity, clusters and super-spreading

Diabetes, cultural norms, voice assistants, vaccine update

Universal screening, guideline development, intention to vaccinate

Effect of quarantine and social restrictions, duration of COVID-19 immunity, targeted testing

Drug treatments, adaptive immunity, influenza and COVID-19, speech-generated transmission

Alternative service delivery, risk communication, vaccine confidence, outdoor transmission

Trauma admissions in Westmead Hospital, innate immunity, herd immunity, vaccines

Antibody testing, reduced C.difficile infections, equitable access to vaccines, “variolation”

COVID-19 indirect impact, role of centres of government, non-communicable diseases

Modelling transmission in Victoria, visual summary of drug treatments, corticosteroids, vaccines, healthcare simulation models

Systemic corticosteroids, non-communicable diseases, asymptomatic transmission

Maternal and perinatal outcomes, contact tracing, oxygen targets for mechanical ventilation

Viral transmission, equity, managing uncertainty, mobility data

Medical education, localised lockdowns, long-term care services

Oxygen therapy and infection risk, triage, immune response

August

Post-pandemic clinician mental health, air travel, international data descriptors, mask use, transmission in schools

High flow nasal cannula, diabetes, COVID-19 reinfection, physical distancing, data visualisation

Psychological morbidities, lung transplantation, machine learning, COVID-19 heroes

Haematological and immunological markers, vulnerable populations, aerosol transmission, home care guidelines

Disease management, clinical trials, enhancing value post-COVID-19, fit checking masks

Powered air purifying respirators (PAPR), serological testing, psychiatric syndromes

Testing strategies, mental health, fast‐track care for diabetic foot ulcers

Radiation fractionation, telemedicine in cardiovascular surgery, Auxora randomised controlled trial, advance care planning

Mental health, pulmonary cavitation, long-term care facilities

Endoscopy services, teledentistry, drug repurposing

Risk factors, ECMO, haemodynamic monitoring, diabetes

Convalescent plasma, obesity, precision public health

Tracking the spread, digital public health, post-acute COVID-19, telmisartan

Antiviral agents, telehealth, palliative care, translated COVID-19 resources

Health economics and trade-offs, variation in management of severe COVID-19, WHO indicators

Children and COVID-19, recovery from severe disease, responses to domestic violence, elimination strategies

Immunotherapies, medical waste, healthcare worker wellbeing

ECMO, reopening schools, healthcare workers, WHO timeline

Cancer immunotherapy, oral health services and long-term respiratory complications

Vaccine evaluation, living review of drug treatments, rehabilitation, cellular immune response, modelling hospital resource needs

Thrombolysis for STEMI, Proton Pump Inhibitors, PCR positivity in healthcare workers

July

School closures, reflections from American CEOs, wastewater surveillance

Stroke and preceding infection, behavioural science, travel restrictions

Aboriginal people at risk, pregnancy, planned care

Coagulopathy, aerosols, contact tracing, mental health

Daily Evidence Digest

Health system and quality perspectives, vulnerable populations

Impact of delays in cancer referral and diagnosis, national preparedness, tailoring contact, treatment and support for ethnic groups

Vaccine trials, patient-reported data, emergency preparedness

Risk tool, Victoria lockdown, disease recurrence, defining COVID-19 deaths

Physical distancing, contact tracing, inequalities, screening and risk

Diagnostic tests, impacts on healthcare workers, resuming elective surgery

Viral transmission, vaccine development, probiotics, leadership, triage

Acute kidney injury, convalescent plasma, College updates

Extra‐pulmonary symptoms, gendered attitudes, persistence of antibodies

Surgical workflow, infection prevention precautions and global health law

Reshaping Australia’s health system, RECOVERY trial and rehabilitation post COVID-19

Comparative clinical studies, cancer care, and disparities

Lung abnormalities, immunology, cardiac tele-rehabilitation

Digital pathology, fomites, health literacy, mobile-health

Serological tests, excess deaths, cancer care and surgical recovery

Frailty, intensive care, social distancing, and telehealth

Global perspectives, PPE training, stroke, podcasts

Loneliness, risk communication, screening pre-surgery

June

Infection control, high flow nasal cannulae, Twitter, influenza

Antibody tests, PPE, resuscitation, surveillance

Telehealth, comorbidities, depression and anxiety

Telehealth, comorbidities, depression and anxiety

Healthcare reform, lessons and innovations and research priorities

Artificial intelligence, masks, ethical dilemmas and exit strategies

Home pulse oximetry, transmission dynamics, and virtual hospitals

Genome, telemedicine, ethics, dexamethasone trial

Environmental contamination, vaccinations during COVID-19, research

Urology, diabetes, rheumatic disease, stroke, occupational health

Ethics, viral transmission, equity and ‘lockdown’

Telehealth, maternal complications and extra-pulmonary presentations

Mental health, drug repositioning, phone apps and homelessness

Antivirals, long-term intubation, bacterial co-infection

Testing, diabetes, ethics of drug repurposing, Google search trends, extended use and reuse of facemasks

Non-invasive and extracorporeal oxygenation, mask reuse, adapting care

Aerosol generating procedures, challenges for EDs, myocardial injury

Physical distancing, face masks, heart failure, research quality

Hypertension, mental health, staff wellness, system responses

Cancer, clinical trials, telehealth, and managing teamwork

May

Stroke, ‘outbreak rostering’, viewpoints on policy and clinical research

Cardiac imaging, frailty, 3D printed swabs and rural emergency care toolkit

Ventilation techniques, medical education, neurosurgery, smoking and nicotine

Cardiovascular disease, risk factors, and convalescent plasma

Daily evidence digest

Nutrition, conspiracy theories, supply chain management, cancer care

Clinical course, thrombotic risk, evidence-based virtual care

Non-COVID ED presentations, disability rights, virtual care in NICU and obstetrics, cancer

Safety of corticosteroids, infection control measures, climate and mortality risk

ICU modelling, nutritional risk, spinal cord injury, diabetes

Call for robust trials, convalescent plasma, screening, mortality

Steroids, triage algorithm, ventilator allocation, prognostic tool

Research informed strategy, equity, post infection immunity, symptom tracking

Triple combination treatment, NSW response, non-communicable disease

Screening and diagnosis, paediatrics, post-COVID strategies

Anticoagulation, community-based healthcare, and acute kidney injury

International lessons, emergency departments, acute stoke management

Telemedicine, ethics, equity and NATSIHWA collaboration toolkit

Drug treatments, restarting surgeries, and populations-in-focus

First Nations people, immunosuppressive therapies, stroke, remdesivir

April

Protective immunity, immunosuppressed patients, pathophysiology

Pregnancy, policy comparisons, influenza during COVID-19

Diabetes, kidney transplants, opioid dependence, COVIDSafe

Screening healthcare workers, nutrition and food safety, webinars

Modelling, epidemiology, suicide risk, preventing hospital admissions

Endotheliitis, ventilator demand, testing, infection control, the path forward

Views from oncologists, masks, wellbeing, exit strategies

Cohort study, telehealth, oxygen therapy, protective gowns, WHO guidance

PPE, updates from WHO, health messaging for Aboriginal communities

Emerging from lockdown, testing, treatments, and nosocomial infection

Respiratory and diabetes guidance, infection control and underreporting

Second-wave transmission, managing diabetes, pain

Diagnostic testing, addressing ICU challenges, correctional facilities

Virology, temporary hospitals, reorganisation of care, leadership

ACE-I/ARB continued use, CVD advice, burns, diabetes

NICE Guideline, mental health, telehealth, ethics

New guidance on emergency medicine, re-use of face-piece respirators, NSAIDs, podcasts, tiered staffing

New guidance for Aboriginal people, GP telehealth, surge capacity, model-based analysis of severity, vulnerable workforce

CPAP, neurosurgery, occupational medicine, surgery, gastroenterology, maintaining essential services, spirometry

March

New guidance, cardiac patients, rapid EBM reviews, ED, telehealth

Community health workers, elective surgery, hospital capacity, telehealth, de-isolation, modelling, clinical trials

Ethics, remote assessment, use of mechanical ventilation in UK, management strategies in China

Evidence Checks

Epidemiology, Transmission, Virology

Community transmission and hospital infection, stages of pandemic, immunity, and vaccination.

Cardiopulmonary resuscitation (CPR)

COVID-19 infection and transmission in domestic animals

Surgical masks and oxygen therapy

Face masks and COVID-19 transmission in the community

Cardiac stress testing

COVID-19 transmission risk on aircraft

Hydrotherapy and COVID-19

Nosocomial COVID-19 infections

COVID-19 infectivity and transmission in children

Sanitising and covering large medical imaging equipment

Modes of transmission for COVID-19

Winter and COVID-19 transmission Rapid

The effect of COVID-19 on healthcare workforce - infections

Symptomatology and Treatment

Pathogenesis, asymptomatic, pre-symptomatic, severity, seroconversion, drugs, and recovery.

Medium- and long-term health sequelae of COVID-19

Vascular dysfunction and COVID-19

Risks associated with surgery in people with COVID-19

Computed tomography use during the COVID-19 pandemic

Large vessel occlusion strokes in COVID-19 patients

Immunosuppression and COVID-19

Renal replacement therapies for COVID-19 positive patients in ICU

NIPPV and requirements

Fibrinolysis and PCI for STEMI

Inpatient management of COVID-19

Neonates and COVID-19

Non-invasive ventilation and inspiratory muscle training for spinal cord injury patients

COVID-19 testing before surgery

Continuous Positive Airway Pressure (CPAP) machines

Spirometry and transmission risk

Prone position for COVID-19 patients

Laparoscopy during COVID-19

Drug therapies and COVID-19

Medical college advice on COVID-19

Select international medical college advice on COVID-19

Surgical specialties advice on COVID-19

ECMO and COVID-19

Clinical Models of Care

Triage, virtual care, hospitalisation, palliative care, temporary hospitals, infection control, and ethics.

Models of emergency department mental health care

Conducting virtual respiratory assessments and monitoring via telehealth

Preserving consumer and patient partnership during COVID-19

Virtual care and telehealth for specific conditions

Reducing adverse impacts of people with a lived experience of severe mental health issues during COVID-19

Assessment and management of COVID-19 patients in the emergency department (ED)

Homelessness and COVID-19

Telehealth and COVID-19

Pulmonary rehabilitation and COVID-19

Diabetes care during COVID-19

Rehabilitation needs of post-acute COVID-19 patients

Intubation in the emergency department during COVID-19

Management of acute behavioural disturbance and COVID-19

Validated tools to diagnose respiratory illness via telehealth

Triage tools for ICU admission during COVID-19

Palliative care and COVID-19

Telemedicine in intensive care units – An evidence check

System Capacity and Planning

Infrastructure, hospital capacity, human resources, supplies, measurement and monitoring, surveillance, prediction, evaluation, and post-pandemic.

Elective surgical procedures, non-surgical alternatives and shared decision-making

Waste from personal protective equipment

Resuming elective surgery – Volume-outcome relationships in surgery

Extended use or reuse of personal protective equipment

Resuming elective surgery – the evidence for prehabilitation

Resuming elective surgery - Post-surgery innovations

Resuming elective surgery – productivity and efficiency approaches

Resuming elective surgery - Post-surgery innovations: enhanced recovery after surgery, early mobilisation and discharge

Resuming elective surgery – low-value care

Resuming elective surgery

Extended use or reuse of personal protective equipment

The impact of COVID-19 on clinical education and training

Workforce reconfiguration

Guidance and underlying evidence about personal protective equipment (PPE) use during COVID-19

Domestic and family violence and COVID-19

Temporary shared accommodation (boarding houses, backpacker accommodation and hostels)

Mental health of healthcare workers

Tools to support communication between patients and families

Dedicated or temporary COVID-19 healthcare facilities

Thermal imaging for detection of fever

Personal protective equipment and intrapartum care for low risk women

Ventilation use for COVID-19 patients

Models for redeploying staff