Factors Impacting Readiness to Perform Secondary Population-Based Triage During the Second Wave of COVID-19 in Victoria, Australia: Pilot Study.

OBJECTIVE: Pandemics generate such a significant demand for care that traditional triage methods can become saturated. Secondary population-based triage (S-PBT) overcomes this limitation. Although the coronavirus disease (COVID-19) pandemic forced S-PBT into operation internationally during the first year of the pandemic, Australian doctors were spared this responsibility. However, the second wave of COVID-19 provides an opportunity to explore the lived experience of preparing for S-PBT within the Australian context.The aim of this study is to explore the lived experience of preparing to operationalize S-PBT to allocate critical care resources during Australia's second wave of COVID-19 in 2020. METHODS: Intensivists and emergency physicians working during the second Victorian COVID-19 surge were recruited by purposive non-random sampling. Semi-structured interviews were hosted remotely, recorded, transcribed, and coded to facilitate a qualitative phenomenological analysis. RESULTS: Six interviews were conducted with an equal mix of intensivists and emergency doctors. Preliminary findings from a thematic analysis revealed 4 themes: (1) threat of resources running; (2) informed decision requiring information; (3) making decisions as we always do; and (4) a great burden to carry. CONCLUSION: This is the first description of this novel phenomenon within Australia and, in doing so, it identified a lack of preparedness to operationalize S-PBT during the second wave of COVID-19 in Australia.

Your Call Is Important to Us: COVID-19 and Trends in Public Health Unit Call Service Utilization.

OBJECTIVE: The aim of this study was to analyze coronavirus disease 2019 (COVID-19) -related call data at Metro North Public Health Unit, Brisbane Australia, over the 2020 calendar year to assist surge preparedness. METHODS: Call data were retrieved by call category or reference to "COVID" in summaries from the call management system at a large metropolitan public health service. Under a mixed-methods approach, qualitative data (caller, call purpose, and call outcome) were categorized with categories arising de novo. Resulting variables were numerically analyzed to identify trends by categories and time. RESULTS: Of the 3468 calls retrieved, 160 duplicates and 26 irrelevant calls were excluded. Of 3282 included calls, general practitioners, followed by the public, contributed the greatest call volumes. Health-care-related callers and the public made 84.2% of calls. Calls most frequently related to patient testing (40.7%) and isolation/quarantine (23.2%). Education provision accounted for 29.4% of all outcomes. A total of 11.8% of all call outcomes involved applying relevant case definitions, and 49.1% of calls were identified as potentially preventable through effective emergency risk communication and targeted call-handling. CONCLUSIONS: This study identified key drivers of public health unit phone service use related to the COVID-19 pandemic throughout 2020. The results highlighted where risk perception influenced call volume and provided important insights for future public health preparedness.

Caregiver resilience and patients with severe musculoskeletal traumatic injuries.

AIMS: This study investigated the association of resilience on caregiver burden and quality of life in informal caregivers of patients with severe traumatic musculoskeletal injuries. METHODS: A prospective cohort study of eligible caregivers and acutely injured trauma patients was conducted during 2018 in South East Queensland, with follow-up 3 months after patient discharge. Resilience was examined using the 10-item Connor Davidson Resilience Scale. The primary outcomes, caregiver burden and quality of life were measured respectively, using the Caregiver Strain Index and the Short Form Version 12 Health Survey. RESULTS: Baseline measures were completed with fifty-three (77%) patient/carer dyads. Thirty-eight (28%) were available for follow up at 3 months. Significant reductions from baseline were found at follow up, for levels of resilience, mental health, physical exercise and community support. In multiple regression models, caregiver resilience at follow-up independently predicted lower caregiver burden (ß = -0.74, p = 0.008) and higher levels of patient physical health and function (ß = -0.69, p = 0.003). CONCLUSIONS: Upon commencing informal care, caregivers' resilience, mental health and support systems are adversely affected. Higher levels of caregiver resilience appear to be protective against caregiver burden and declines in patient physical function. Early evaluation of caregivers' resilience, their physical and mental health and socio-ecological networks could improve carer and patient health outcomes.Implications for rehabilitationAfter 3 months of providing informal care to severely injured musculoskeletal trauma patients, there are apparent declines in their mental health, resilience, community support and physical activity levels. However, those with higher levels of resilience compared to lower levels could be protected against caregiver burden. Higher caregiver resilience could also prevent declines in patients' physical function.The rehabilitation of severe trauma patients should additionally include routine assessment and management of informal caregivers with the aim to prevent caregiver burden.Early clinical assessment of caregiver resilience using a valid resilience measurement tool could identify caregivers at risk of caregiver burden and flag vulnerable caregivers for ongoing support in the community.Early assessment of caregivers' physical and mental health and health related behaviours could flag the need for health promotion interventions aimed at supporting caregivers' physical and mental health.