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  • Isolation: A key pillar of COVID control
    by Burnet Institute on 9月 29, 2022 at 2:00 下午

    If you think scrapping COVID isolation periods will get us back to work and past the pandemic, think again: Burnet Institute Director and CEO Professor Brendan Crabb AC; Head, Biosecurity Program, Kirby Institute, UNSW Sydney, Professor C Raina MacIntyre and ; Head, University of Melbourne School of Population & Global Health, Professor Nancy Baxter write for The Conversation. COVID is an exceptional disease and was at its deadliest this year, causing more deaths in Australia between June and August 2022 than at any other time. There have been 288 deaths from influenza so far this year compared to more than 12,000 deaths from COVID. The number of deaths from COVID in Australia in the first nine months of 2022 is more than ten times the annual national road toll of just over 1,000 – but we are not rushing to remove seat belts or drink-driving laws so people can have more freedom. Isolation flattens the COVID curve by stopping infectious people from infecting others, and is a key pillar of COVID control. Removing isolation will not help the workforce Workforce shortages have been felt in every sector during the pandemic. Shortages of health workers have resulted in the need to import workers from overseas, and deadly outcomes for patients in some cases. During epidemic peaks this year, the workforce was so badly affected that supermarket shelves could not be stocked. Removing the isolation period is hoped to ease workforce shortages - but any relief will be short-lived. At times when COVID numbers are increasing, allowing infectious people to mingle freely at work and socially will create epidemic growth and make the crisis even worse. At the current time, when cases are relatively low, removing isolation mandates will not materially benefit the workforce, but will make the workplace and schools less safe. Eliminating isolation rules provides the opportunity for governments to save costs. Without mandatory isolation support, payments for workers needing to isolate will end. While politicians spin this as trusting Australians to take “personal responsibility”, sadly many Australians will simply not have the means to take time off work. With elimination of mandatory isolation periods, essential workers in low paying jobs will find themselves at even more risk of contracting COVID in the workplace. The pandemic is not over Newer variants of SARS-CoV-2, the virus that causes COVID-19, are more immune-evasive than ever. Immunity from vaccines wanes within two to three months, and so too does immunity from infection. Hybrid immunity is cited as a reason for abandoning isolation, but is unlikely to eventuate. Indeed, we saw this with the recent BA5 wave leading to more hospitalisations and deaths than the January/February BA1 wave, despite the presence of much higher vaccine and infection-based immunity in the community. While no doubt this immunity prevented an even worse outcome, it clearly did not keep pace with virus evolution. While it was hoped hybrid immunity from vaccines and prior infection would reduce subsequent infections, this has not been the reality. Reinfection is becoming more common with variants that are increasingly distant from the original virus. And evidence is accruing that reinfection can cause severe disease. The most vulnerable may be forced to withdraw from society and from unsafe workplaces to protect themselves. But it is a misconception that COVID is trivial for everyone else. People who are happy and healthy today could become disabled or chronically ill from COVID. How #longCOVID impairs patients’ lung function: 🫁 Obstruction – decreased airflow🫁 Restriction – reduced lung volume🫁 Impaired perfusion – decreased blood flow(via @UVa) https://t.co/OcLTODZuid— The Conversation U.S. (@ConversationUS) September 25, 2022 The long-term complications of COVID-19 are substantial, and can include effects on the lungs, heart, brain and immune system. At 12 months after infection, the risk of heart attacks, strokes, blood clots and other complications including sudden death are about double compared to people who were never infected. Chronic complications can occur even after mild infection – including heart failure, strokes and dementia. Dropping isolation will increase COVID transmission and result in an increase in serious chronic illness. It could be a mass disabling event and so drive major economic and societal losses. The availability of treatments has been cited as a reason to cease isolation – but these are restricted to limited subgroups, and not available to everyone. COVID is an epidemic disease and has behaved in a predictable way since 2020, causing recurrent epidemic waves. Reality check: #SARSCoV2 will never be endemic. It is an epidemic disease, and always will be. This means it will find unvaccinated or under-vaccinated people and spread rapidly in those groups. It will display the typical waxing and waning pattern of epidemic diseases 1/5. pic.twitter.com/eMSytche7P— Raina MacIntyre 😷💉📈 (@Globalbiosec) November 15, 2021 Ceasing isolation will hasten the onset of the next wave. Allowing mass infection also creates favourable conditions for emergence of new variants which have been more contagious or more vaccine or treatment resistant. What we need to do instead To maximise productivity, health and social success, instead of ignoring COVID, we should tackle it with a layered approach to mitigation of transmission. This includes raising rates of boosters, widening access to antivirals and other treatments, masks, safe indoor air, and widely accessible testing. Making isolation a rule, and supporting people financially to do so, has been a key pillar of our defences. This is still needed as viral evolution continues to outpace immunity. We just had our worst wave and there is nothing to suggest the next won’t be similarly bad. Workplace absenteeism is a function of transmission, so better control of SARS-CoV-2 will result in greater productivity, less disruption to families and businesses, and a more successful way forward to living with COVID.

  • COVID isolation rule change 'disappointing'
    by Burnet Institute on 9月 29, 2022 at 2:00 下午

    In an interview with ABC TV News Channel’s Ros Childs, Burnet Institute Director and CEO Professor Brendan Crabb AC describes the decision by National Cabinet to scrap mandatory COVID isolation as disappointing, illogical and distressing.Ros Childs: Professor Brendan Crabb, Director of the Burnet Institute, Brendan, thanks for being with us. What’s your reaction to the news that mandatory COVID isolation has been scrapped? Prof Brendan Crabb: Well, it’s a disappointing, pretty dark day, actually. You know, it’s just illogical, and ill-informed. But for me, I find it quite distressing. You know, the Chief Health Officer or Chief Medical Officer, you heard there saying we’re much more immune now and so we can look forward to sort of less COVID as a result. Well, it’s true, we’re much more immune, but we just had our worst wave in July and August, we had far more deaths than we had earlier in the year. We had more hospitalisations than we had earlier in the year. And this notion that somehow COVID is like the flu is just wildly wrong. It’s 40, or 50 times worse than the flu for severe outcomes. And it’s also a different infection. It’s an infection of the organs in your body, of your heart and of your brain and of your blood vessels. And it’s leaving this long COVID burden that is possibly worse than the acute burden. So yeah, quite a quite a disturbing day. Directly, isolation is a very important adjunct to vaccination and to, you know, treating the air, cleaning the air and wearing a mask - it’s all we’ve really got. It’s also of little cost if there’s low COVID. So one of the reasons given for scrapping it is there’s less COVID around at the moment, so why not keep it? Because there’s less cost with it. And of course, it helps knock the top off the next wave, so it’s a bizarre decision. Ros Childs: The isolation period has been gradually reduced over time, it went from 14 days to seven days, to five now zero. How long ideally, would you like to see the isolation time? How many days would you like people to stay home for? We are going to have more virus as a result of the decision to scrap mandatory isolation @CrabbBrendan tells @abcnews "We seem to have surrendered to the virus for now and for its devastating effects. I just don't understand because we can hold the line." https://t.co/mneeKbnhId pic.twitter.com/Um5E13HzHS— Burnet Institute (@BurnetInstitute) September 30, 2022 Prof Brendan Crabb: Well, I think firstly, having some (time) sends a very good signal. You know, it’s not the flu, it’s much worse than the flu. And this sends that signal to have any mandatory isolation period at all and, and of course, assistance for those to stay home in the form of payments. Realistically, seven days was an absolute minimum. You know, you need a bit longer to be confident that you’re not transmitting the virus. So we very much are going to have more virus as a result. You mentioned that whittling down not just the isolation period, but of other COVID measures, the mandatory masks and so on, the flattening of the vaccination curves, you know, all of those will have contributed to why we had worse COVID in July and August. But what’s also really happening is very rapid evolution of this virus itself. And the next wave has started in Europe and of course, will follow here soon after. We really very much want to be ready for that. You need to understand that we’ve got 20 to 25,000 Australians who will die this year because of COVID, a good 15 percent increase on our normal death rate. These are people who would otherwise have lived. I didn’t hear that really stressed today. And that’s one of the really distressing things. This is a forgotten group of people. It’s a terrible epidemic that’s going on at the moment. It’s nothing like any other respiratory disease and I find that just quite a disingenuous line of discussion. Ros Childs: In light of the announcement should aged care homes and other vulnerable locations step up their defences to keep people they are looking after safe? Prof Brendan Crabb: Well, they have to, because the community is not going to do it for them. That’s really what the announcement today said. It’s unfair. And it’s also only very limited in how successful they can be. Of course, aged care facilities and all vulnerable people, of course, many of us don’t know who’s vulnerable and who’s not who’s immunocompromised, and, and so on - who’s on cancer therapies, and all of those groups are at higher risk. They have to be more careful because the community is not going to do it for them. Australia’s new Covid rules: isolation recommended but not required https://t.co/dOOQUxNylI— Guardian Australia (@GuardianAus) September 30, 2022 You know, that’s the big failing, it’s all of our duty to protect the most vulnerable in our community. On top of that, of course, we’re all vulnerable. Long COVID and the effects of long COVID are not so age dependent. They’re not so obviously vulnerability dependent. They can affect us all. But yes, aged care facilities are going to have to step up because they’re on their own. Ros Childs: And, Brendan, are we getting anywhere near a herd immunity situation? Or does the emergence of different variants really mean that that is unachievable? Prof Brendan Crabb: It does mean it’s unachievable. Herd immunity does look like it’s unachievable with the tools we’ve got at the moment. There’s a lot being made of infection on top of vaccination boosting your immunity, which is true, it does boost your immunity. But the waves are still getting worse for Australia. Even though that immunity is a really good thing, they will be vastly worse without it. So the virus is still beating us. That’s why the BA five wave was worse than the BA one wave we had in February for hospitalisations and deaths despite our immunity being fantastically better. So the next wave or two we can expect a similar effect - maybe less cases but likely to be still worse, severe outcomes or bad severe outcomes. That’s a very realistic option, at least, that we have to plan for. No, herd immunity with the tools we have is impossible. We need these public health interventions to augment what we have. There are good days ahead because we’re getting better vaccines. There will be tools that end this pandemic. We don’t have them now. We seem to have surrendered to the virus for now and for its devastating effects. Just something I just don’t understand because we can hold the line. We can hold the line and there’ll be better solutions with vaccines that knock this on its head, with drugs that knock this on its head. We don’t have them just yet. Ros Childs: Brendan Crabb, very good to talk to you, thank you.

  • Elimination of hepatitis C the focus of new funding grant
    by Burnet Institute on 9月 15, 2022 at 2:00 下午

    $14 million for health research partnerships The elimination of hepatitis C in Australia is closer following a AUD$1.4 million boost to research. This is part of a $14 million investment in 12 research projects announced today at Burnet Institute by Federal Minister for Health and Aged Care, the Hon Mark Butler MP to help deliver better health care for Australians.   Hepatitis C is one of the major causes of liver cirrhosis, liver cancer and liver failure. It can be eliminated by sustaining high rates of treatment, but Australia’s rates have stalled over recent years. Research led by Professor Mark Stoové, head of public health at Burnet Institute, will identify how to best follow up notifications to improve hepatitis C treatment rates. The Burnet-led project ‘Optimising public health notification systems to achieve hepatitis C elimination in Australia’ involves a collaboration with Hepatitis Australia, the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine and the Paul Ramsay Foundation. Minister Butler said the Burnet-led grant was an example of the importance of finding innovative ways to link the 50 per cent of Australians with chronic hepatitis C who have yet to take up the game-changing direct-acting antiviral (DAA) treatment option to clear the virus. *(https://youtu.be/l9U9h4MOq94) “Around 50 per cent of Australians with chronic hepatitis have availed themselves of this treatment (DAAs) and had wonderful results, both individually and for our country and the sustainability of our health system. The challenge now is connect that other 50 per cent of Australians with these amazing treatment,” Minister Butler said. “We need to think of innovative ways to do that. This van that reaches out to communities across Victoria and the extraordinary work of Burnet’s team, is one example of that. One of the partnership grants that we are announcing today, led by the Burnet Institute and Professor Mark Stoové and Professor Margaret Hellard, partners with the Ramsay Foundation, who has contributed a great amount of funding to this, also along with patient groups through Hepatitis Australia and clinicians through ASHM as well.” Image: Burnet Institute Director and CEO, Professor Brendan Crabb AC welcomed Minister Butler’s announcement of funding support to help eliminate hepatitis C. Image: Minister Butler meets Burnet’s hepatitis C field nurse, Kate Allardice and LiverWELL’s Frank Carlus, who has cleared the hepatitis virus after using DAA treatment. Credit: Blue Tree Studios A Chief Investigator on the grant, Professor Margaret Hellard said, “Hepatitis C is now curable and you no longer have to die from it, thanks to the breakthrough treatments (DAAs). Australia has made great inroads and we are more than 50 per cent there. But there are more people with hepatitis C who are not being treated, and they are at risk of dying of liver cancer or liver failure. That can be changed." *(https://youtu.be/hAj2TmPCkWI) “This grant is about finding that other 50 per cent and how can we engage with them in an innovative way and systems. How do we work with affected communities? How do we work with community-based organisations and State governments? We are grateful to philanthropy partners like the Ramsay Foundation who have provided funding for this to engage with that final 50 per cent - the final phase of hepatitis C elimination. “It is possible to achieve this task with innovative surveillance systems, innovative approaches to care like the van, like point-of-care tests, we can change this and achieve elimination of hepatitis C by 2030. Australia is leading on this and the world is looking to us to achieve this.” Image: Minister Butler meets (L-R) Associate Professor Joseph Doyle, Professor Brendan Crabb AC, Professor Margaret Hellard AM, Frank Carlus and Kate Allardice. Associate Professor Joseph Doyle, a Chief Investigator from Alfred Health and Monash University said: “Australia can eliminate hepatitis C as a public health threat by sustaining high rates of hepatitis C treatment. But Australia’s rates of hepatitis C treatment have stalled over recent years.” “All hepatitis C diagnoses are notified to health departments and this partnership project will implement and evaluate a series of strategies across all states and territories and identify the most effective ways of following up notifications to enhance rates of hepatitis C treatment and cure in Australia.” Image: Professor Caroline Homer AO, NHMRC Council Chair made a short speech. Image: Hepatitis nurse Kate Allardice and Frank Carlus demonstrating some of the health care undertaken in the Burnet Hepatitis C outreach van. NHMRC PARTNERSHIP PROJECTS The Partnership Project scheme provides funding for researchers and partner organisations to work together to define research questions, undertake the research, and interpret and translate the findings into health policy and practice.  Minister Butler added:  “The Partnership Projects announced today have the potential to improve the health and wellbeing of Australians across a range of areas. The projects will help us eliminate hepatitis C, better connect youth mental health services, help kids with cerebral palsy and improve road safety.” “These partnerships help connect our best scientists with government and industry support, allowing them to do their vital work.”  NHMRC CEO Professor Anne Kelso AO said:  “NHMRC’s Partnership Projects demonstrate the power of collaboration between researchers, policy makers and health service providers to ensure the right research questions are asked and the research outcomes will be implemented into better health policy and care.” Click HERE to read the Minister’s media statement.

  • The staggering costs of COVID-19 outlined in a Lancet Commission report.
    by Burnet Institute on 9月 15, 2022 at 3:00 上午

    A global panel looked at the staggering costs of COVID-19 – 17.7m deaths and counting. Professors and panellists on The Lancet COVID-19 Commission Professor Margaret Hellard AM and Monash Professors John Thwaites and Liam Smith share key insights from the Commission’s latest report regarding the global COVID-19 response. The article below was first published in The Conversation. A global report released today highlights massive global failures in the response to COVID-19. The report, which was convened by The Lancet journal and to which we contributed, highlights widespread global failures of prevention and basic public health. This resulted in an estimated 17.7 million excess deaths due to COVID-19 (including those not reported) to September 15, 2022. The report also highlights that the pandemic has reversed progress made towards the United Nations Sustainable Development Goals in many countries further impacting on health and wellbeing. The report, from The Lancet COVID-19 Commission, found most governments were ill-prepared, too slow to act, paid too little attention to the most vulnerable in their societies, and were hampered by low public trust and an epidemic of misinformation. However, countries of the Western Pacific – including East Asia, Australia and New Zealand – adopted more successful control strategies than most. This had resulted in an estimated 300 deaths per million in the region (around 558 per million in Australia and 382 per million in New Zealand to September 12). This is compared with more than 3,000 per million in the United States and the United Kingdom. The report advised 11 key recommendations for ending the pandemic and preparing for the next one. Co-operation lacking The report is the result of two years’ work from global experts in public policy, health, economics, social sciences and finance. We contributed to the public health component. One of the report’s major criticisms is the failure of global cooperation for the financing and distribution of vaccines, medicines and personal protective equipment for low-income countries. This is not only inequitable but has raised the risk of more dangerous variants. The report highlighted the critical role of strong and equitable public health systems. These need to have: strong relationships with local communities; investment in behavioural and social science research to develop more effective interventions and health communication strategies; and continuously updated evidence. Report: 11 Recommendations The report’s recommendations to end the pandemic and prepare for future ones. 1. Vaccines plus other measures – establishing global and national ‘vaccination plus’ strategies. This would combine mass immunisation in all countries, ensure availability of testing and treatment for new infections and long COVID, coupled with public health measures such as face masks, promotion of safe workplaces, and social and financial support for self-isolation. 2. Viral origins – an unbiased, independent and rigorous investigation is needed to investigate the origins of SARS-CoV-2, the virus that causes COVID-19, including from a natural spillover from animals or a possible laboratory-related spillover. This is needed to prevent future pandemics and strengthen public trust in science and public authorities. 3. Bolster the World Health Organization and maintain it as the lead organisation for responding to emerging infectious diseases. Give WHO new regulatory authority, more backing by national political leaders, more contact with the global scientific community and a larger core budget. 4. Establish a global pandemic agreement and strengthen international health regulations. New pandemic arrangements should include bolstering WHO’s authority, creating a global surveillance and monitoring system for infectious disease outbreaks. It would also include regulations for processing international travellers and freight under global pandemic conditions, and the publication of an annual WHO report on global pandemic preparedness and response. 5. Create a new WHO Global Health Board to support WHO decision-making especially on controversial matters. This would be composed of heads of government representing each of the six WHO regions and elected by the member states of those regions. 6. New regulations to prevent pandemics from natural spillovers and research-related activities and for investigating their origins. Prevention of natural spillovers would require better regulation of domestic and wild-animal trade and enhancement of surveillance systems for pathogens (disease-causing micro-organisms) in domestic animals and humans. The World Health Assembly should also adopt new global regulations on biosafety to regulate international research programs dealing with dangerous pathogens. 7. A 10-year global strategy by G20 (Group of Twenty) nations, with accompanying finance, to ensure all WHO regions, including the world’s poorer regions, can produce, distribute, research and develop vaccines, treatments and other critical pandemic control tools. 8. Strengthen national health systems based on the foundations of public health and universal health coverage and grounded in human rights and gender equality. 9. Adopt national pandemic preparedness plans, which include scaling up community-based public health systems, investment in a skilled workforce, investment in public health and scientific literacy to “immunise” the public against dis-information, investment in behavioural and social sciences research to develop more effective interventions, protection of vulnerable groups, establishment of safe schools and workplaces, and actions to improve coordinated surveillance and monitoring for new variants. 10. Establishment of a new Global Health Fund where – with the support of WHO – there is increased and effective investment for both pandemic preparedness and health systems in developing countries, with a focus on primary care. 11. Sustainable development and green recovery plans. The pandemic has been a setback for sustainable development so bolstering funding to meet sustainability goals is needed. Unlock a new approach To improve the world’s ability to respond to pandemics we need to unlock a new approach. The key component to any meaningful transformation is to collaborate and work towards a new era of multilateral cooperation. Governments in Australia, Aotearoa New Zealand and elsewhere have talked about ‘building back better’. We need to take the lessons learnt from the failures of the past few years and build a stronger framework. This will not only help reduce the dangers of COVID-19 but also forestall the next pandemic and any future global crisis. By reassessing and strengthening global institutions and co-operation, we can build and define a more resilient future. Chris Bullen, Professor of Public Health, University of Auckland, co-authored this article and The Lancet COVID-19 Commission report on which it was based. FIND OUT MORE ABOUT KNOW-C19 Professor Margaret Hellard AM is a leading infectious diseases clinician, researcher and a Deputy Director (Programs) at Burnet Institute. She has also played a key role in Burnet’s COVID-19 response through the Know-C19 Flagship Program.

  • Imagining COVID is ‘like the flu’ is cutting thousands of lives short. It’s time to wake up.
    by Burnet Institute on 9月 15, 2022 at 1:00 上午

    Burnet Institute Director and CEO Professor Brendan Crabb AC and Associate Principal Research Fellow Michael Toole AM examine the common narrative comparing COVID to influenza in this commentary for The Conversation. It is difficult to understand the ease with which we have accepted a major proportion of the Australian population getting infected with COVID in just a matter of months. Many have been infected multiple times, potentially exposing them to long COVID and other problems we are only beginning to understand. In the past 75 years, only the second world war has had a greater demographic impact on Australia than COVID in 2022. As of September 12, Australia had reported more than 10 million cases of COVID. Of those, 96 per cent were reported in 2022, coinciding with a succession of various Omicron sub-variants and the removal of most protective measures. What’s more, the number of reported cases is probably an underestimate. While the midsummer wave of Omicron led to the highest number of reported cases since the pandemic began, the subsequent winter waves have killed thousands more people. Between January 5 and March 16 this year, 3,341 Australians died with COVID, compared with 8,034 between April 4 and September 16, with August being the most deadly month of the pandemic for Australia. One often forgotten impact of these deaths is that an estimated 2,000 Australian children have lost at least one parent as a result of the COVID pandemic. Rather than national cabinet looking at pandemic leave and under pressure to cut isolation periods, what’s needed is a shared vision and a strategic COVID plan that acknowledges it is not “just like the flu”. A disease evolving quicker than our defences The deadly July-August wave happened despite greatly increased immunity from third- and fourth-dose vaccination, natural infection, and lifesaving therapies introduced in April this year. In other words, Omicron has evolved faster than the tools we are using to combat it. So far in 2022, more than 12,000 Australians have died with COVID, six times the number of deaths in the previous two years. This is a disease so significant it has reduced global life expectancy, one of the best measures of human development. No other war or disease has done that in more than 65 years, not even the HIV pandemic. The global estimates have been reinforced in several countries, including the United States, where life expectancy has fallen by almost three years since 2019. Changes in life expectancy only happen when very large numbers of people die “before their time”. In Australia there were 17% more deaths reported this year to the end of May by the Australian Bureau of Statistics than the five-year average. This does not count our most recent and lethal BA.5 wave. The ABS report shows two things. First, COVID is killing large numbers of people both directly and indirectly. At this rate, we can expect to lose many more lives by year’s end. Second, people are dying earlier than they otherwise would have, meaning our life expectancy trajectory will take a hit. Then there is all we know about long COVID and its effects on the lungs, heart, brain, kidneys and immune system. It affects at least 4% of those infected with Omicron, including those vaccinated and those with mild initial illness. We are being warned to prepare for what is effectively a mass disabling event with no known cure or end point. Not ‘like the flu’ How did we come to this point? A key reason we have become so complacent is the common narrative comparing COVID to influenza – in the sense that we should live with COVID in the same way we do with the flu. The statistics demonstrate a different picture. From the start of this year to August 28, there had been just under 218,000 reported cases of flu and 288 deaths this year. There have been 44 times as many COVID cases and 42 times as many related deaths. (It is worth noting here authorities are urging caution when comparing this flu season to previous years, given COVID measures and changes in health behaviour.) Around 1,700 people have been hospitalised with the flu this year. Yet on just one day in July, 5,429 COVID patients were in hospital. In Australia, we have just had our worst COVID wave in terms of the number of deaths and people admitted to hospital, a wave that is ongoing with thousands still in hospital and around 360 people dying each week. Government health advisers are warning of another COVID wave in the coming months. Independent MP Monique Ryan is calling for a national COVID summit and more transparency regarding planning. In contrast, this year’s influenza wave looks to be over. Expendable lives This has been a devastating year for older Australians. More than 3,000 residents of aged care facilities have died of COVID, triple the combined number who died in 2020 and 2021. As things stand, these lives appear invisible and expendable. The most important discussion now is not about changes to any one intervention. It is one of overall strategy, one that focuses on reducing the spread of the virus. Immunity from infection is, of course, real. It’s why people usually recover from infection, why waves disappear, and indeed what drives viral evolution to “escape immunity”. But the more important questions are how much protection it offers, for how long, and at what cost? We now know immunity from Omicron infection is relatively poor and short-lived and is outpaced by rapid viral evolution, even in the face of vaccination. Although vaccination vastly reduces the risk of serious illness, waves of infection continue to sweep through large populations, with many susceptible to reinfection within months. This continues to damage our short and long-term health, our health system, and our society. COVID is nothing at all like the flu. It is causing a vastly worse scale of damage. We must change our tactics to dramatically cut transmission. In addition to a more vigorous campaign to increase vaccine booster coverage, we need to invest in indoor ventilation and actively promote the benefits of wearing high-quality masks in crowded indoor settings. And we need a powerful messaging campaign to wake us from our ‘just like the flu’ slumber. Find out more about Know-C19 Burnet’s flagship initiative.

  • Symposium brings students together again
    by Burnet Institute on 9月 14, 2022 at 11:00 下午

    Burnet Institute honours, masters and PhD students came together to showcase their work at the recent 2022 Student Symposium. From malaria to postnatal care, COVID-19, to safe injecting facilities, the day showcased the breadth and depth of Burnet research. And being able to run the Symposium as a hybrid event this year offered the best of both worlds, said Burnet Institute 2022 Student Representative (Life Sciences) Brianna Jesaveluk. “It was a great opportunity to get the student group all together in one place, we’ve been missing that aspect for a couple of years,” she said. “And it’s great to be able to offer it on Zoom as well, so we can have that flexibility for people who can’t here in person.” Masters and PhD students presented a Three Minute Thesis (3MT), which requires candidates to explain their research engagingly in the space of three minutes, and understood by an informed, non-specialist audience. Honours students presented a 10-minute overview of their work in preparation for their final assessment. For Mary Malek, presenting for the first time about her honours project on health care providers’ experiences of providing abortion care at 20 weeks, was an initially nerve-racking but ultimately beneficial experience. “I thought it was a really valuable way to practice communicating my work,” she said. “I had all these other wonderful presentations to take in and see all the wonderful work other students were doing too. “Also meeting other people in the Institute as well and doing a bit of networking. I thought it was a really great day.” The Symposium also featured presentations by two guest speakers, the University of Melbourne’s Associate Professor Jen Martin on ‘How to give a better science talk’, and doctor, lawyer, disability advocate and researcher Dr Dinesh Palipana on ‘The choice to do the hard things’. Image: Award winners announced at the 2022 Student Symposium (left to right) Chiara Drago, Timothy Ho, Katelyn Stanhope, Lachlan Faktor, Mary Malek and Shan Huang. Student Symposium award winners were: Best Honours Presentation: Lachlan Faktor (Defining quality of maternal and newborn care from the perspectives of stakeholders in PNG) Best Three Minute Thesis Presentation: Shan Huang (Digital Height Devices to measure stunting in children for low resource settings) People’s Choice Honours Presentation: Chiara Drago (The PvAMA1 protein as a potential vaccine target for malaria) People’s Choice Three Minute Thesis Presentation: Timothy Ho (Identifying Strategies to Generate Potent and Long-Lasting Immunity in Malaria Vaccines) Special support for Honours students A new prize category was also presented at the Symposium – the inaugural Honours Professional Development Awards. “This prize was established after student committees noticed over the years that there was a gap in the opportunities available to honours students in terms of professional development activities,” Ms Jesaveluk said. “There isn’t really an avenue for them to gain funding towards presenting their research at conferences, and often honours students do stay on in the following years as research assistants or as early PhDs,” she said. “Having that gap funded allows them to get the opportunity to attend conferences, to present their actual honours work.” The prize awards funding for the winners to use towards conference attendance or professional development activities. Honours Professional Development award winners were: Honours Professional Development Award (Life Sciences): Katelyn Stanhope Honours Professional Development Award (Public Health): Mary Malek Reflecting on the day, Brendan Harney, 2022 Student Representative (Public Health), said the symposium achieved its goals of giving students the opportunity to learn about and gain confidence in presenting their research, as well as reflect on why they are doing their research. “The symposium certainly reinvigorated the student body, being able to spend a full day together, hear from our Director and CEO Professor Brendan Crabb, and witness the encouragement and support from the rest of the Institute,” he said. Image: Symposium co-hosts and 2022 Student Representatives Brendan Harney and Brianna Jesaveluk. “Thinking about what our speaker Dinesh Palipana shared, sometimes there are easy options in life, but the hard options are good because they’re the ones that are likely to create more impact. And that’s exactly what we’re all doing at Burnet – creating and translating knowledge from our research, so all people have the opportunity to have better health.” The Symposium was sponsored by the Monash Graduate Association, Capstone Editing, New England Biolabs and MP Biomedicals.

  • Reflecting on the importance of the 56th PNG Medical Symposium
    by Burnet Institute on 9月 13, 2022 at 8:00 上午

    Burnet Institute Senior Research Fellow Dr Stefanie Vaccher based in PNG, reflects on the importance of the 56th Papua New Guinean Medical Symposium held in Port Moresby, PNG from 5 to 7 September 2022. I had the privilege to both attend the 56th Papua New Guinean Medical Symposium held last week, and present findings of some recent work undertaken here, a literature review of the most effective ways COVID-19 antigen rapid diagnostic tests could be used in PNG. The group organising the meeting – the Medical Society of PNG – pre-dates PNG’s independence by over a decade. This in itself highlights the depth and breadth of medical research that is being conducted in PNG, by Papua New Guineans. This symposium allowed locally led research to be the focus of the meeting and ensured that future research in PNG would benefit from the sharing of new ideas, successes, and strategies for overcoming challenges. With a recently elected government and a new 10-year National Health Plan, the conference was well-timed to address priority health areas and issues of local and national significance. Despite the conference theme being around COVID-19, and the undeniable impact of COVID-19 on the health system more broadly, the presentations covered a wide range of topics including Japanese encephalitis, childhood nutrition and stunting, tuberculosis, cervical cancer screening, and oral hygiene. Presentations gave a good overview of the wide range of health issues that affect PNG, and the conference was a valuable opportunity for clinicians and researchers from across the country to come together and discuss their work in a way they haven’t been able to for the past two years. Image: One of the symposium presentations was about a homemade device to measure the length of a newborn baby’s foot as a proxy for low birth weight. Credit: Stefanie Vaccher The ingenuity that was on display, from a homemade device to measure the length of a newborn baby’s foot as a proxy for low birth weight, to new malaria surveillance strategies, provided valuable lessons to all attendees. There were also critical insights into local issues that are not always evident at other international conferences. For instance, the pervasiveness of betel nut (buai) chewing in PNG and the myriad health problems it can cause was a common theme across several presentations. This created links between previously siloed fields, such as dentistry and harm reduction, and helped develop new ways of thinking about endemic issues. Furthermore, the opportunity to learn from other researchers in PNG about local cultural beliefs and kastom in the areas where they were working was invaluable. For instance, the gifts one researcher brought for village elders as a mark of respect, or the importance of visiting the community before the study began to not only meet with key leaders, but also to conduct general community education and awareness, and give people time to get to know the research team and consider what questions they may have. Image: The conference also included stunning displays of some of PNG’s many cultures. Credit: Stefanie Vaccher The discussion time at the end of presentation sessions gave more people the chance to have their voices heard. While attendees did not always agree with one another, even on fundamental issues such as the importance of COVID-19 vaccination in PNG, the format of the conference allowed people to share their views and find like-minded individuals and potential new collaborators. The shared social connections over many lunches, dinners, and cups of tea strengthened old friendships and built new ones, a fundamental part of any conference. Image: The symposium provided an opportunity to strengthen old friendships and build new ones. Credit: Burnet Institute Alongside stunning displays of some of PNG’s many cultures both during presentations and at the final dinner, the whole conference was a fascinating learning experience.

  • Burnet research being presented at PNG Medical Symposium
    by Burnet Institute on 9月 8, 2022 at 4:30 上午

    The impact of COVID-19 on leading diseases and medical treatment in Papua New Guinea is a major focus of this week’s Medical Society of PNG’s Symposium in Port Moresby. Read on for updates from the conference. DAY 3: WEDNESDAY 7 SEPTEMBER Image: Dr Stefanie Vaccher presenting at the 56th Medical Symposium. Dr Stefanie Vaccher presented a literature review looking at the most effective ways COVID-19 antigen rapid diagnostic tests could be used in PNG. The review found further discussions with both health and non-health partners is critical to understand gaps, priorities for future work, and impact on future testing strategies in PNG. Rapid antigen tests are best for identifying people with high viral load, those who are highly infectious. Testing and interpretation of results is situation dependent - good surveillance information is needed to understand background prevalence of COVID-19 in a particular location, as well as contextual knowledge of the implications for someone of testing positive. DAY 2: TUESDAY 6 SEPTEMBER Burnet’s flagship initiative and the highly collaborative Healthy Mothers, Healthy Babies (HMHB) project, based in Kokopo, East New Britain, was just one of many research updates on Day 2 of the conference. HMHB Principal Investigator Dr Michelle Scoullar said in previously published research they found high rates of Mycoplasma genitalium and other reproductive tract infections in pregnant women. Principal Investigator Dr Michelle Scoullar said in previously published research by @HMHB_Burnet in 🇵🇬they found high rates of Mycoplasma genitalium and other reproductive tract infections in pregnant women which had an adverse impact on birth outcomes. 👉🏽https://t.co/oVaHmAIPCx pic.twitter.com/rsABtKzzVl— Burnet Institute (@BurnetInstitute) September 6, 2022 Today, Dr Scoullar spoke about what impact these infections have on adverse birth outcomes in her presentation, High burden of reproductive reproductive tract infections in pregnancy increases risk of adverse birth outcomes in East New Britain Province, PNG. Mental health and child wellbeing an important priority for #PNG - important to have a multi sectoral approach to an enabling environment, prevention and clinical care. #MsPeleMelepia 🙌🏾🙌🏾 @BurnetInstitute @WHO @UNICEF pic.twitter.com/uNNI9B9C2f— Dr Michelle Scoullar (@MJLScoullar) September 6, 2022 East New Britain Research Team leader Pele Melepia presented on strengthening mental health psychosocial support systems and services for children and adolescents in PNG, a study being conducted for UNICEF. Mental health and child wellbeing is an important priority for PNG, and as Ms Melepia outlined, it’s important to have a multi-sectoral approach - across the health, education, justice, and social welfare sectors - to identify any gaps in services and how best they can be improved from clinical, prevention and promotion perspectives. Fantastic 1st conference talk #MsPriscahHezeri 🙌🏾🙌🏾🎉 outlining the importance of #qualitycare for pregnancy, labour & newborn care 🤰🏾👶🏾 in #PNG 🇵🇬@BurnetInstitute @pngimr pic.twitter.com/ZRCgViL3pO— Dr Michelle Scoullar (@MJLScoullar) September 6, 2022 Research Officer Priscah Hezeri gave her first conference talk outlining the importance of quality maternal and newborn care. The work she presented was from the ‘Gutpela Helt Sevis Stadi - Helti mama bel, helti beibi stadi’ (‘Quality of pregnancy, childbirth, and newborn health services study - Healthy Mothers, Healthy Babies Research Program’) - a study based in East New Britain, PNG. The Gutpela Sevis study uses a unique ‘Partnership Defined Quality’ approach to empower both communities and health facilities to work together in identifying and defining quality, and subsequently problem-solving strategies to improve quality. Medical Laboratory Scientist Nomin-Dora Tenakanai presented interim results from the EZARET Study: Exploring Zoonotic Association and Risks for Extrapulmonary Tuberculosis in PNG. This study explores bacteriological testing of extrapulmonary TB (EPTB) - TB occurring in the body somewhere other than the lungs - including whether any TB found is drug resistant or of zoonotic origin. In the past there has been limited data on the causes of the comparatively high incidence of EPTB in PNG, which this work is seeking to change. A key change we are starting to see thanks to the study is that more clinical staff are taking samples for testing from people who present with symptoms of TB lymphadenitis (enlarged lymph nodes). This wasn’t done routinely in all facilities before the study, with diagnosis often based on symptoms that sometimes have other causes. Image: Members of Burnet’s Daru team (left to right) Naomi Pank, Alexa Murray, Oretha Mehngonzeh, Clodia Manorh and Ruth Bala. Burnet Institute staff based in Daru gave a series of presentations on the Daru TB program. Clodia Manorh presented on the clinical aspects of the Daru TB program, focusing on the fluoroquinolone-resistant TB cases in Daru between 2013 and 2020. Naomi Pank spoke about the public health aspect, focusing on a community outbreak investigation of fluoroquinolone-resistant TB in Daru. While identification of the outbreak of fluoroquinolone-resistant TB was delayed due to the COVID-19 pandemic, the prompt response by the Daru TB team was critical in this outbreak investigation. Interestingly, mixed TB cases were identified in the same households, suggesting there was greater transmission outside of households in Western Province. And Ruth Bala presented on the peer education and counselling aspect of the program, focusing on the challenges identified by TB patients during counselling sessions. Scientific Officer Benishar Kombut from the PNG Institute of Medical Research spoke about their field evaluation of a Burnet-developed malaria test called LAMP for detecting Plasmodium vivax infections during pregnancy. Senior molecular scientist Rebecca Narokobi spoke about the STRIVE PNG project which aims to strengthen vector borne disease surveillance and response by strengthening molecular surveillance capacity and generating molecular diagnostic data to monitor vector borne pathogens. She presented preliminary dengue and arbovirus data generated from eight surveillance sentinel sites across the country. Preliminary findings indicated that one per cent of febrile cases presenting during 2019 to 2020 at health facilities were dengue infections. Cases were detected intermittently during this period and DENV1, DENV3 & DENV4 were found to be in circulation, with DENV3 more common and found primarily in Morobe Province. Molecular data also showcased a possible Chikungunya outbreak in Sandaun Province between September and November 2020. These results are integrated onto the STRIVE-Tupaia platform which allows decision makers to review, interpret and respond to outbreaks in their province. OPENING DAY: MONDAY 5 SEPTEMBER The 56th Medical Symposium was opened with an inspiring speech from PNG’s Prime Minister, the Honourable James Marape on 5 September. Burnet Institute acknowledges the ongoing commitment and support from the Prime Minister for medical research and public health programs. After a 2-year gap due to COVID-19, leading medical researchers are meeting in 🇵🇬 to share vital insights. Our PNG Country Director, Dr Kudakwashe Chani, said: “The pandemic has brought a renewed sense of the need to bridge the gap between research, policy and implementation.” pic.twitter.com/MnghO6kWEc— Burnet Institute (@BurnetInstitute) September 6, 2022 Burnet’s PNG Country Director, Dr Kudakwashe Chani, said the symposium brings together the medical research community in PNG. “This is the first symposium since the emergence of the COVID-19 pandemic, bringing a renewed sense of the need to bridge the gap between research, policy and implementation,” he said. “Burnet Institute in PNG is pleased to be part of the symposium to share work that we collaborated on with other key stakeholders in PNG and in the region, and to contribute to local evidence.” Thirty-four Burnet staff and researchers are attending the symposium from PNG and Australia, some of whom will be presenting this collaborative work. The topics they are presenting on include maternal and child health, tuberculosis, dengue, and the most effective way to use COVID-19 antigen rapid diagnostic tests in PNG.

  • Burnet awarded grant to develop next generation liver test
    by Burnet Institute on 9月 7, 2022 at 4:30 上午

    The Burnet Diagnostics Initiative (BDI) will develop a rapid point-of-care (POC) test to better monitor liver health, thanks to funding from the Victorian Government. Over 10 million Australians are believed to suffer from some form of liver disease, yet almost 50 per cent of these people are undiagnosed. There are usually no symptoms of liver dysfunction until very late stages of disease. The two-year $500,000 Victorian Medical Research Acceleration Fund grant will help support BDI’s development of a next generation POC test focused on community-based screening of liver function, and ensure timely clinical interventions for people with liver damage. The BDI has already successfully developed a first-generation POC test, which takes only 30 minutes to read the result from a finger prick of blood. This new funding will enable a second-generation test to be developed, which through using the latest technology will bring that test time down to 15 minutes or shorter. Professor Heidi Drummer, Scientific Director of the BDI, said a rapid POC test for alanine aminotransferase (ALT), a biomarker in the blood that can indicate liver damage, would be a game-changer for acute and chronic liver disease and liver cancer prevention globally. “The ability to diagnose liver disease earlier using a simple screening tool could transform how we manage liver health in Australia and globally,” Professor Drummer said. “A simple screening test that could be performed by healthcare workers in community settings to detect liver inflammation of any cause, would then prompt further investigations for underlying liver disease before any major liver damage occurs,” she said. Metabolic associated fatty liver disease (MAFLD), due to obesity, is the most common chronic liver disease in Australia. Alcohol-related liver disease (ALD) is also on the rise. Access to a POC test that could be used in a variety of settings - from busy Emergency Departments to self-testing at home - could help identify the need for earlier health interventions to reverse liver damage and prevent the diseases progressing to cirrhosis and liver cancer. Currently, the global market for liver disease tests is valued at USD$30 billion and expected to reach $50 billion by 2028. The BDI-led test is being developed in collaboration with other members of the Alfred Research Alliance, St Vincent’s and The Austin hospitals, AnteoTech Ltd and Atomo Diagnostics Limited. The Burnet Diagnostics Initiative (BDI), established in 2021, aims to enhance the translation of existing and new technologies into practical health solutions. Currently the portfolio of activities of the BDI includes tests for the measurement of liver function, syphilis, and a series of diagnostic assays for COVID-19.

  • Prestigious grant to profile responses to COVID-19 vaccines in vulnerable people
    by Burnet Institute on 9月 6, 2022 at 4:12 上午

    Burnet Institute is part of a consortium led by Monash University, that’s been awarded a $6.3 million Medical Research Future Fund (MRFF) grant to profile COVID-19 vaccine responses in our most vulnerable populations. The consortium, entitled PROPHECY (Profiling immune RespOnse in Paediatric and High-risk populations to SARS-CoV-2), is led by a diverse team of Melbourne-based scientists and clinician researchers. Funded over four years, the consortium will characterise the immune response to SARS-CoV-2 variants and COVID-19 vaccines in children, adolescents, adults and vulnerable populations who are at risk of severe disease. Burnet’s Co-Program Director of Disease Elimination, Professor Heidi Drummer, is part of the PROPHECY Executive team. “I am really delighted to be a part of this multi-institutional consortium to examine how some of our most vulnerable members of the community, those with underlying immune deficiencies and paediatric populations, develop immune responses to COVID-19 vaccines and infection with SARS-CoV-2,” she said. “The results of our study will help us understand who is at risk of severe disease and optimise vaccination strategies.” PROPHECY will evaluate antibodies and cellular immune responses after infection or vaccination in children and adults with underlying health conditions including chronic kidney disease, lung disease, immune deficiencies, immunosuppressive treatments, and stem and solid organ transplant recipients. “This study will comprehensively profile the immune responses to infection and COVID-19 vaccines in these patient groups,” Dr Gabriela Khoury, from the Monash Biomedicine Discovery Institute, said. A unique component of the MRFF-funded project is the breadth of clinical specialties coming together to support the research, according to Executive team member, Associate Professor Benjamin Rogers from Monash University and Monash Health. “Previous research has often focused on a single speciality or condition,” Associate Professor Rogers said. “With PROPHECY we will learn how to better protect and treat COVID-19 in patients with weakened immune systems from a range of different conditions.” And the researchers hope the findings will inform future clinical care for the disease. “Through this study, we hope to guide the future development of improved vaccination and treatment strategies for those most at risk of severe COVID-19,” Professor Drummer said. The study includes 15 Chief Investigators spanning the Alfred Research Alliance precinct, including the Monash Central Clinical School, Burnet Institute, and Alfred Health, as well as the Monash Biomedical Discovery Institute in Clayton, Monash Health, and the Murdoch Children’s Research Institute and Royal Children’s Hospital in Parkville. The PROPHECY Executive team will also work alongside consumer patient organisations such as AusPIPS, NAPWHA, MSK and Crohn’s and Colitis Australia, and Victorian Government’s Safer Care Victoria, to ensure patients’ voices are considered in the project. The MRFF grant was one of 14 announced by Federal Health Minster, the Hon Mark Butler.

 

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