PCHSS’ COVID-19 related research, editorials and resources

Selected academic articles and editorials published by PCHSS investigators

22/06/2020 – The ConversationTelehealth in lockdown meant 7 million fewer chances to transmit the coronavirus – Analysis by Dr Centaine Snoswell and Associate Professor Liam Caffery on the massive increase in telehealth consultations resulting from the COVID-19 pandemic. Over seven million MBS-funded consults were conducted between March and June, with the vast majority carried out by telephone.

22/06/2020 – ISQua – Health inequalities, COVID-19, Black Lives Matter – A commentary by Professor Jeffrey Braithwaite and Wendy Nicklin on behalf of the International Society for Quality in Health Care (ISQua) on the challenges of racial injustice and health inequities against the backdrop of the global pandemic.

5/06/2020 – AIHI – 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.

01/06/2020 – The Melbourne Institute – Who is avoiding necessary health care during the COVID-19 pandemic? – A report by Professor Anthony Scott and colleagues that finds rates of necessary healthcare avoidance during COVID19 are higher for those in financial stress and mental distress. The study looks into policies that could help encourage greater use of healthcare to improve wellbeing and avoid more expensive care later on.

13/05/2020 – Croakey‘Iso’ – a spur to think about social prescribing – A piece by Leanne Wells of the Consumers Health Forum of Australia that argues that the isolation brought about by COVID-19 may serve as a catalyst for Australia to more fully consider the “emerging practice of social prescribing”.

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 focused 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.

4/05/2020 – npj Digital MedicineChatbots in the fight against the COVID-19 pandemic – Commentary by Dr Adam Miner, Dr Liliana Laranjo and Dr Baki Kocaballi on the promise (and the potential pitfalls) of institutions employing chatbots, software programs that talk with people through voice or text in natural language, to share information, give advice and offer emotional support during the 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.

16/04/2020 – Applied Health Economics and Health PolicyThe Case for a Temporary COVID-19 Income Tax Levy Now, During the Crisis – An editorial by Professor Jonathan Karnon on putting in place a temporary income tax levy as a way to reduce longer-term consequences of increased government spending during COVID-19. The article notes that such a measure would be a positive policy option for two main reasons: (1) the pandemic has already constrained opportunities for consumption, so it is less likely to reduce overall economic activity, and (2) the economic impact of the pandemic has been uneven, so placing the tax burden those who continue to be employed and receive an income could help prevent an increase in economic inequality.

15/04/2020 – The ConversationA temporary income tax hike is the bitter but equitable pill Australia should swallow – An article by Professor Jonathan Karnon noting that “the COVID-19 economic crisis is unique” and that Australia is “leaving it to a small proportion of the community to shoulder most of the economic pain.” The piece argues that special measures may be warranted to tackle the financial burden brought on by the pandemic, such as a temporary income tax levy to help Australians ‘share the pain’.

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.”

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”.

5/04/2020 – Applied Health Economics and Health Policy – A Simple Decision Analysis of a Mandatory Lockdown Response to the COVID‑19 Pandemic – An editorial by Professor Jonathan Karnon outlining a decision analysis scheme for policymakers seeking to decide between pursuing an maximalist approach (e.g., mass quarantine) or a gradualist approach (e.g., based on providing advice and raising awareness) in order to contain the spread of COVID-19. The article provides a decision tree pointing to potential health and economic consequences of different courses of action.

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 websiteCOVID-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

17/08/2020 – ZD NetReal time GP data to be used for Australian COVID-19 management – An article on a project led by Professor Andrew Georgiou to collect near real-time data across 500 Australian practices to map the effect of COVID-19 on different areas of care.

24/07/2020 – NewsGPCoronavirus endgame: What will it take to bring COVID-19 under firm control? – An article providing a round-up of six Australian medical experts’ views on how COVID-19 might eventually be brought under control. Professor Paul Glasziou pointed to a “Swiss cheese model”, embracing a variety of approaches – including vaccines, contact-tracing, and social distancing – to compensate for the holes of any single approach.

10/07/2020 – The Independent Australia bragged it was leading the world in its coronavirus response. What went wrong? – An article analysing the unexpected, wintertime COVID-19 spike in Australia, featuring the commentary of Professor Paul Glasziou.

3/07/2020 – NewsGPTop experts call for major new coalition on non-medical pandemic research – An article on a call by a number of prominent health experts, including Professor Paul Glasziou, for the formation of an international group focused on non-medical responses to COVID-19. The piece notes how, to date, the most effective responses to the pandemic have been behavioural and social practices, not drugs or vaccines.

29/06/2020 – UQmedicine – COVID-19 – A PANDEMIC Revolution – An interview with Dr Centaine Snoswell on how the COVID-19 pandemic has dramatically expanded and accelerated her work in telehealth. Dr Snoswell points to some of the key considerations for the smooth integration of virtual care into regular health practice in the years ahead.

12/06/2020 – Chemical & Engineering NewsHydroxychloroquine trials in turmoil – An article on the closely-followed developments surrounding the antimalarial drug hydroxychloroquine as a treatment for COVID-19. With two large clinical trials suggesting that the drug is not effective to prevent or treat the COVID-19, Professor Paul Glasziou suggested that attentions be redirected to other potential treatments.

4/06/2020 – ABC News Asymptomatic coronavirus cases account for 15pc of COVID-19 infections: study – An article highlighting recent research by Professor Paul Glasziou and colleagues concluding that about 15% of people who contract COVID-19 never show any symptoms. Some earlier studies suggested that nearly half of people with COVID-19 were asymptomatic, but Glasziou et al.’s research indicates that that figure is closer to one in six people.

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)

13/04/2020 – The LighthouseHow chatbots support us in COVID-19 – An article on the work by Dr Liliana Laranjo and colleagues on chatbots, computer programs that simulates human conversation, and their potential to help organisations provide vital information and advice amidst the pandemic.

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 – NEWS.com.auCall 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”.