Despite almost 2 in 3  high-risk patients expressing concern about their personal risk, only 29 per cent have developed a COVID action plan with their GP. This suggests a need for healthcare professionals to proactively address COVID-19 preparedness with their higher risk patients ahead of a historically higher risk season to support them to have an uninterrupted holiday.[1]

The findings were captured in the fifth COVID Community Sentiment Index, a quantitative research survey of 1,000 Australians commissioned by Pfizer Australia in November 2024.
The results showed that less than half of Australians say they would test for COVID-19 if symptomatic, and nearly 1 in 5  would likely go out in public even if they tested positive. [2] With 72 per cent of Australians likely to travel during the holidays, one third do not intend to wash or sanitise their hands regularly while traveling, and two-thirds  say they do not plan to test for COVID-19 before traveling, even if symptomatic. [2]

Among the population at risk of serious illness from COVID-19 – those aged over 50 years, with underlying conditions such as heart disease, diabetes, chronic respiratory conditions, immunocompromised, or from Aboriginal or Torres Strait Islander backgrounds – preparedness remains low.[2]

While two-thirds of Australians at higher risk of serious illness from COVID-19 plan to travel this summer, 2 only  have discussed a COVID-19 action plan with their GP, and just half would test if experiencing symptoms before traveling.[2] Additionally, fewer than 1 in 3  Australians at higher risk of serious illness intend to familiarise themselves with local health services at their travel destinations.[2]

According to Mark Brooke, CEO of Lung Foundation Australia, these figures highlight an opportunity for health professionals to encourage patients at higher risk of serious illness to incorporate health considerations into their travel plans, including having a COVID action plan. “Many Australians are looking forward to a well-deserved break this summer, but for those at higher risk of serious illness, a simple conversation with their GP about a COVID action plan can help avoid unnecessary disruptions and give them the confidence to enjoy their holidays safely.

“Talking to patients at higher risk of serious illness about a COVID action plan before the holiday season ensures they know what steps to take if symptoms appear and can protect themselves and those around them, irrespective of where they are,” Mr Brooke said.

With COVID-19 still present in the community, Australians at higher risk of serious illness are being reminded to take proactive steps to protect their health. For those Australians at higher risk of serious illness who test positive, early action can help reduce the severity of COVID-19.

Dr Krishan Thiru, Medical Director at Pfizer Australia and New Zealand said:
“At this time of year we have previously seen a rise in COVID-19 cases. For patients at higher risk of serious illness, prompt action can mean the difference between mild illness and severe complications. Early discussions with patients about testing, eligibility for oral antivirals and planning for potential exposure are key steps ahead of the summer holiday season.”

This summer provides an important window for healthcare professionals to engage with their patients and ensure they have the tools and knowledge to navigate the continued heightened risks of COVID-19. Early intervention remains a cornerstone in protecting vulnerable populations and mitigating the impact of COVID-19.
Australians can check if they are at higher risk of developing severe illness from COVID-19 and their eligibility for oral antiviral medicines at www.health.gov.au or https://www.knowplango.com.au/

References
1. Australian Government. COVID-19 reporting. Available at: https://www.health.gov.au/topics/covid-19/reporting?language=und (last accessed 19 November 2024)
2. Pfizer Australia and New Zealand. Data on file, November 2024.

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The study, published in Disability and Society, surveyed adults with disabilities who receive government support through the National Disability Insurance Scheme (NDIS), revealing a sharp decline in well-being during pandemic lockdowns.

Researchers found that before the pandemic, around half of the respondents reported being satisfied with their overall well-being. However, this figure dropped to just 38% during lockdowns.

While some improvement was noted after restrictions eased, mental health and happiness levels have yet to return to pre-pandemic norms.

Challenges contributing to decline in well-being

The study identified several challenges contributing to the decline in well-being:

• Disrupted Support Networks: Reduced access to both formal and informal caregivers created significant barriers to completing daily tasks such as shopping, housekeeping, and self-care. This often left family members to fill the gap, adding strain to personal relationships.
• Inaccessible Information: Many participants reported that government health campaigns and COVID-19 guidelines failed to account for their needs, leading to confusion and stress.
• Lack of Personal Protective Equipment (PPE): Securing PPE for themselves and their carers during lockdowns was another major hurdle.

“Our findings highlight the gaps in support services created by the pandemic and the immense toll it took on daily life for those relying on NDIS home supports, underscoring how essential continuous, reliable support is for Australians with disabilities,” says Professor Joanne Arciuli from Flinders’ Caring Futures Institute.

“The reduction in available support services limited access to basic daily activities, contributing to feelings of isolation, insecurity and loss of independence, and sometimes adding stress to familial relationships and friendships, further impacting participants’ mental and emotional well-being.”

Voices from the Community

The survey was designed by Dr Darryl Sellwood, a researcher with lived experience of disability, ensuring that the study captured nuanced perspectives.

Some participants shared positive experiences, such as tighter bonds with family members or discovering new coping mechanisms.

However, these moments were overshadowed by the widespread sense of isolation, insecurity, and reduced independence.

“In future, there is a need for streamlined communication strategies that consider the needs of all individuals, particularly those with disabilities who may require additional support or resources that are adapted to their specific needs,” says Dr Sellwood.

‘An Urgent Call to Action

The researchers are urging policymakers and healthcare providers to prioritise inclusivity in future public health responses.

“Our study serves as an urgent call for action, urging policymakers and healthcare providers to recognise the heightened vulnerability of Australians with disabilities during times of crisis,” says Dr Sellwood.

“Future policies and public health responses must prioritise inclusivity by ensuring that individuals with disabilities are not only considered, but actively involved in the planning process.”

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Dr Daniel Nour, founder of not-for-profit Street Side Medics and 2022 Young Australian of the Year, urges Australian doctors to continue to engage with their patients at higher risk of serious illness from COVID-19 on proactive steps they can take ahead of winter: “For most people, COVID-19 is no longer front of mind but all of us on the frontline are still seeing the significant impact of the virus on the more vulnerable members of our communities. If a patient you treat is at higher risk of serious illness, encourage them to put together a COVID plan now, test if they suspect COVID-19, and be ready to act fast and implement their plan if they test positive”, Dr Nour said.

The research found that more than a third (35 per cent) of Australians were not aware that oral antiviral medicines can help reduce the risk of serious illness from COVID-19 and more than half (54 per cent) were not aware they need to be started within five days of symptoms starting or testing positive.

Additionally, the research showed 41 per cent of doctors do not always prescribe oral antiviral medicines to patients at higher risk of serious illness from COVID-19, with less severe symptoms reported as one of the leading barriers.

Dr Nour responded to these findings, adding: “If your patient is in the one in four Australians at risk of serious illness from COVID-19, they may be eligible for oral antiviral medicines. Don’t wait for worsening symptoms; treatment with oral antivirals needs to be commenced as soon as possible after testing positive for COVID-19 and within five days of symptoms starting.”

Dr Krishan Thiru, Medical Director at Pfizer Australia and New Zealand, said understanding the sentiment of GPs around COVID-19 was important because they are often the first point of contact for someone with a health concern.

“While we have been living with COVID-19 for four years, these results show GPs are still concerned about the impact of the virus in their communities – nearly 9 in 10 (86 per cent) GPs say they are concerned about misinformation around COVID-19 and oral antivirals. Now is the time for GPs to speak with their patients who are at higher risk of serious illness from COVID-19, provide them with accurate information, and jointly develop a plan in case they test positive for the virus,” Dr Thiru said

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New research conducted by Pfizer indicates that one-third of Australians do not believe that practising COVID-safe behaviours and keeping up to date with immunisation to protect against COVID-19 is important.

The COVID Community Sentiment Index, a quantitative research survey regularly commissioned by Pfizer Australia, canvassed Australians’ views on COVID-19 in November 2023. Results showed that one in three (33 per cent ) Australians do not think COVID safe measures, such as wearing masks, hand sanitisation and social distancing are important for protection against the disease.

One-third (34 per cent) also do not believe that staying up to date with vaccinations is important.1 Additionally, just under two-thirds of Australians (64%) do not think that new COVID-19 variants will have a significant impact on them in one year’s time.

Professor Robert Booy, Infectious Diseases Specialist, University of Sydney, is urging Australians to resist complacency ahead of the holiday season.

“As much as we would all like to forget about COVID-19, COVID-19 is not done with us. Evidence shows that the disease continues to evolve and have significant impact in our communities, especially those at higher risk of severe illness. With COVID-19 part of our new reality, we need to continue to embed some habits and measures to protect ourselves and our communities,” Professor Booy said.

The research also found that more than half (57 per cent) of older Australians, who are often at higher risk of severe disease, believe new variants of COVID-19 will not have a significant impact on them a year from now. In addition, one-third (31 per cent) of older Australians think that vaccinations will not be important for protection against COVID-19 one year for now.

“With many people travelling and gathering to celebrate the holiday season, it’s important to remember that COVID loves a crowd. Even though most healthy Australians are protected against severe COVID, there remain a few million vulnerable people who have not had an updated COVID-19 vaccination in the last six months. Taking precautions this Christmas is only sensible,” Professor Booy said.

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Providers can refer to the Australian Immunisation Handbook to check which vaccines are recommended by age group.²

ATAGI’s statement reflects the need to protect Australians, particularly vulnerable groups including those over 75 years and younger people with medical comorbidities, who are at greater risk of serious illness and hospitalisation from COVID-19.²

The Therapeutic Goods Administration (TGA) has approved monovalent COVID-19 vaccines that address Omicron XBB-related sublineages,^3,4 which currently account for the majority of COVID-19 cases globally.⁵

Although Omicron BA.4/BA.5-adapted bivalent COVID-19 vaccines provide some protection against a range of outcomes from XBB-related COVID-19,^6,7 evidence suggests that vaccines better matched to currently circulating strains can further help improve protection against symptomatic and severe COVID-19.⁸

“COVID-19 is constantly evolving and XBB is antigenically distant to the original Omicron variants we have seen before. This is why we need new tools to fight the virus,” said Dr Krishan Thiru, Pfizer Australia & New Zealand Country Medical Director.

“COVID-19 was the third leading cause of death in 2022, after ischaemic heart disease and dementia.⁹ The virus continues to pose a health risk to communities and individuals of all ages and backgrounds, in particular certain population groups such as older individuals and those with underlying comorbidities.^10,11,12 Whilst many are feeling COVID fatigue, we urge Australians to continue being vigilant and heed the health advice of the World Health Organization and Australia’s health authorities,” he said.

“Australia is experiencing an eighth COVID-19 wave and we are seeing an uptick in the number of cases and hospitalisations across the country. Being vigilant about staying up to date with vaccination and lowering our risk of infection is critical as we head into the holiday period and families and friends gather in large groups, or travel interstate and abroad. We are reminding Australians that COVID loves a crowd.

“The first line of defence is to get vaccinated, and also wear masks when needed, maintain physical distance wherever possible, avoid high-risk settings, and practice good hygiene,” Dr Thiru said.

Pfizer is working closely with the Australian Government to commence supply as quickly as possible. The use of vaccines should be in accordance with official Government recommendations.

References:

1. New Covid-19 vaccines available to target current variants. Health Portfolio Ministers. Australian Government Department of Health and Aged Care. Available at: https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variantsAccessed November 2023.
2. ATAGI recommendations on use of the Moderna and Pfizer monovalent Omicron XBB.1.5 COVID-19 vaccines. Australian Government Department of Health and Aged Care Available at: https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccinesAccessed November 2023.
3. Australian Government Department of Health and Aged Care. ARTG Public Summary documents COMIRNATY Omicron XBB.1.5 (raxtozinameran) COVID-19 Vaccine. Available at: http://www.tga.gov.au/resources/artg?keywords=XBB+1.5. Accessed November 2023.
4. Australian Government Department of Health and Aged Care. ARTG Public Summary documents SPIKEVAX XBB.1.5 (andusomeran) COVID-19 Vaccine. Available at: tga.gov.au/resources/artg?keywords=XBB+1.5. Accessed November 2023.
5. World Health Organization. COVID-19 Weekly Epidemiological Update: Edition 158 published 1 September 2023. Available at: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19—1-september-2023
6. Link-Gelles R, Ciesla AA, Roper LE, et al. Early estimates of bivalent mRNA booster dose vaccine effectiveness in preventing symptomatic SARS-CoV-2 infection attributable to Omicron BA.5– and XBB/XBB.1.5–related sublineages among immunocompetent adults — Increasing community access to testing program, United States, December 2022–January 2023. MMWR Morb Mortal Wkly Rep 2023;72:119–124. doi: http://dx.doi.org/10.15585/mmwr.mm7205e1
7. Link-Gelles R, Weber ZA, Reese SE, et al. Estimates of bivalent mRNA vaccine durability in preventing COVID-19–associated hospitalization and critical illness among adults with and without immunocompromising conditions — VISION Network, September 2022–April 2023. MMWR Morb Mortal Wkly Rep 2023;72:579–588. DOI: http://dx.doi.org/10.15585/mmwr.mm7221a3
8. Khoury DS, Docken SS, Subbarao K, Kent SJ, Davenport MP, Cromer D. Predicting the efficacy of variant-modified COVID-19 vaccine boosters. Nature Medicine. 2023 Mar;29(3):574-8. Available at: https://pubmed.ncbi.nlm.nih.gov/36864253/
9. Australian Bureau of Statistics. (2022). Causes of Death, Australia. ABS. https://www.abs.gov.au/statistics/health/causes-death/causes-death-australia/latest-release
10. World Health Organization. COVID-19 Weekly Epidemiological Update, Edition 152; July 20, 2023.
11. World Health Organization. Coronavirus disease (COVID-19). Accessed November 2023. who.int/health-topics/coronavirus#tab=tab_1
12. European Centre for Disease Prevention and Control. Interim public health considerations for COVID- 19 vaccination roll-out during 2023. Updated April 5, 2023. Accessed November 14, 2023.

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COVID and pandemic preparedness
Associate Professor James Trauer, Head of the Epidemiological Modelling Unit for the School of Public Health and Preventive Medicine says,
 “Vaccination remains our most important defence against Covid, even though the virus shouldn’t ruin Christmas this year. We are currently experiencing a significant wave of transmission in Australia. Testing has declined markedly and the daily number of cases doesn’t provide a clear picture of the extent of transmission any more. However, other data sources still give us a good sense. For example, wastewater surveillance and hospital admissions show a marked increase in infections over the last few months.

“Overall, the severity of Covid cases has decreased, with fewer people admitted to ICU than in previous years. This is attributable to high levels of population immunity, which is contributed to by both natural immunity (from past infection) and vaccination-derived immunity.

“Covid is now an ‘endemic’ infection, meaning that the infection cannot be eliminated and transmission occurs continuously. When immunity after infection is short-lived, endemic transmission occurs in peaks and troughs as immunity from previous waves fades. This is an expected feature of endemic Covid.

“The emergence of new variants is also contributing to these ebbs and flows. Although a few current variants are being closely watched, none of the currently circulating strains seem to cause more severe disease than the preceding strains. Because new variants are contributing significantly to each wave of infection, it is more difficult than ever before to predict when they will peak.

“Because immunity after infection is so short-lived, reducing transmission in the short-term will have little effect on the number of times people get infected with Covid over the course of several years. Therefore, our most important protection against the effects of Covid is  immunity, which can be enhanced through vaccination.“As per ATAGI’s recommendations, this is appropriately focused on the most vulnerable to severe outcomes, particularly those aged over 65 or those with risk factors (and especially those aged over 75). Anyone who meets ATAGI’s current recommendations for receiving a booster vaccine should strongly consider this. This is particularly relevant as the recently ATAGI-approved monovalent vaccines become available, which induce stronger immunity against the current circulating variants.

“In addition to vaccination, taking precautions when visiting persons at high risk of severe outcomes (e.g. visiting aged care facilities) remains important. This includes testing in advance and wearing face masks during such interactions. However, these interventions will have a minimal effect on the trajectory of the current wave. Persons at risk of severe disease should also consider testing to ensure that antiviral medications can be provided as soon as possible after symptoms of Covid occur.”

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While sports injuries declined during COVID-19 due to lockdown measures and event cancellations, the number of Australians admitted to hospital for injuries sustained while playing sports has returned to pre-COVID trends.

This is according to a new report from the Australian Institute of Health and Welfare (AIHW) titled, ‘Sports injuries in Australia’.

“In response to COVID-19 lockdowns and the cancellation of many sporting activities, there was a decline in the number of sports injury hospitalisations in 2019–20, but in 2020–21, the numbers rebounded to pre-pandemic trends, increasing by 27%,” says AIHW spokesperson Dr Heather Swanston.

The AIHW shows that cycling accounted for the highest number of sports injury hospitalisations in 2020–21, with 9800 injury hospitalisations – up from 8000 in 2019–20 – an increase of 35 injury hospitalisations per week.

“Unlike many other sports, there was a rise in the number of cycling injuries in 2019–20 and 2020–21, which may reflect increased participation rates in solo sports with the onset of COVID-19 that has continued with the lifting of restrictions,” says Dr Swanston.

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In some, these symptoms last months or years, causing mild lethargy, chronic fatigue, depression and other conditions, as well as, for many, the inability to live as they previously did.

Research suggests that between one month and one year after first experiencing the symptoms of COVID-19, one in five people aged between 18 and 64 years has at least one medical condition that might be due to the COVID virus. Among those aged 65 and older, the proportion is one in four.

Associate Professor Anthony Byrne is a thoracic physician at St Vincent’s public and private hospitals in Sydney. Along with Professor Steven Faux, he leads the Long COVID Rehabilitation Clinic at St Vincent’s.

“We have a six- to 12-month waitlist at present,” Professor Byrne said of the clinic. “With increased staffing, we’re hopeful that this will reduce to three months later in the year.

“A specialist clinic like ours sees the most severely affected patients. Many are unable to work, months after the virus, and have already seen their GP, and often other specialists. Some have had visits to the emergency department with chest pain and breathlessness.

“Most patients will benefit from GP and allied health support, but some are still debilitated and are looking for answers. We don’t have all the answers but can investigate less common causes of their symptoms, which can lead to specific treatments for asthma, bacterial and fungal infections, blood clots, insomnia, sleep apnoea and chronic pain, etc.”

Risk factors 

• A severe illness that coincides with the onset of COVID-19, especially if this has required hospitalisation.
• Experiencing certain medical conditions before contracting the COVID-19 virus.
• Experiencing a condition that affects the organs and tissues (multisystem inflammatory syndrome) while sick with COVID-19 or later.

Long COVID is more common in adults than in children and teens.

Symptoms 

• Fatigue.
• Inability to sustain physical activity due to respiratory difficulties or lethargy.
• Fever.
• Lung (respiratory) symptoms, including difficulty breathing or shortness of breath and coughing.

Less common symptoms may include:

• Neurological or mental health conditions such as difficulty concentrating, headaches, sleep problems, pins-and-needles feeling, a loss of smell or taste.
• Joint or muscle aches.
• Heart symptoms or conditions, including chest pain and fast or pounding heartbeat.
• Digestive symptoms, including stomach ache or indigestion.
• Blood clots and vascular issues, including deep vein thrombosis.

Treatment/management 

If someone is experiencing one or more of the symptoms listed above, consulting with their primary healthcare provider is advised. A pharmacist can explain what a doctor or specialist practitioner will be likely to ask and what tests or investigations may be part of the consultation process, including:

• What exacerbates or causes symptoms to appear.
• How often these symptoms occur and for how long.
• How symptoms affect lifestyle and activities.

“We see patients from 16 to 90 years of age,” Professor Byrne said. “Most are 20 to 50 with a two-to-one female predominance. Most were not admitted to hospital for their initial infection. Many have missed weeks or months of work. Some have other comorbid diseases, but many were previously fit and well in high-paying, professional jobs. Stress at the time of acute infection is a strong predictor of long COVID and is also a factor in preventing recovery.

“Recovery from long COVID is variable, but for the five to 10 per cent that have long COVID at three months, most are still affected by 12 months. However, with comprehensive management, they’re much more functional and less disabled.”

References

• Mayo Clinic. COVID-19: Long-term effects.
• St Vincent’s Hospital. svhlunghealth.com.au/about-us/whats-new/new-post-acute-long-covid-clinic.
• Theconversation.com The mystery of ‘long COVID’: up to 1 in 3 people who catch the virus suffer for months. Here’s what we know so far.

This Health Series feature was originally published in the May issue of Retail Pharmacy magazine. 

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Professor Murphy has been Secretary since 2020, after joining the Department as Chief Medical Officer in 2016.

Australians will long remember Professor Murphy as the health expert who helped steer the nation through the worst of the COVID-19 pandemic; however, his time as Secretary was broader than that.

Professor Murphy has overseen the start of the aged care, mental health, primary care and health workforce reform. His leadership also helped the Department to renew its focus on Commonwealth-State health relations, including advising the National Cabinet.

Reflecting on the COVID-19 pandemic, National President of the Pharmacy Guild of Australia, Professor Trent Twomey says Professor Murphy faced unprecedented challenges during his time as head of the Department and leading the COVID response.

“This was a time when the country, and indeed the world, was trying to grapple with this virus which kept evolving, leaving them with few, if any, precedents to follow,” Professor Twomey said.

“It was a time when hard decisions had to be made, and Professor Murphy did not flinch in doing what he felt was right and appropriate.

”Professor Murphy also faced the dynamic of the tyranny of distance, which presented supply chain issues in sourcing much-needed COVID-19 vaccinations, rapid antigen tests and other medicines and supplies needed to help combat the pandemic.

“He was unwavering in his commitment to protect the communities throughout Australia as best he could.”

Professor Twomey says the Pharmacy Guild worked closely with Professor Murphy and the department in negotiating for pharmacists to administer the COVID-19 vaccines.

“We knew that being the most accessible healthcare professionals meant we could make a very significant contribution to protecting Australians against the virus,” he said.

“After some hesitancy, community pharmacies were brought into the vaccination rollout and today have administered nearly 10 million doses of COVID-19 vaccines.

“Professor Murphy also leaves a legacy of having pivoted the Department of Health and Ageing to deal with the pandemic while also ensuring business-as-usual programs were maintained.

“I wish Professor Murphy a happy retirement and congratulate him on his achievements.”

Adding to this, National President of the Pharmaceutical Society of Australia (PSA), Dr Fei Sim says she is saddened by “Professor Murphy’s decision to step down as Secretary of the Department”.

“Professor Murphy has led our health care system through the most turbulent time in recent history,” Dr Sim said.

“During his tenure as Secretary of the Department of Health, he not only navigated a global pandemic but also led reforms in aged care, primary care and the healthcare workforce.

“Under Professor Murphy’s leadership, the Federal Government made the largest investment in pharmacy outside of the Community Pharmacy Agreement, announcing $345.7 million to embed pharmacists in Residential Aged Care Facilities to improve medicine safety for our oldest Australians.

“On behalf of pharmacists across Australia, I thank Professor Murphy for his leadership and his support of our profession.

“I wish him well in his retirement and look forward to working closely with the incoming Secretary to continue healthcare reforms and create a world-class health system that works for all Australians,” she said.

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The analysis shows that hybrid immunity provides higher protection, demonstrating the advantages of vaccination even after people have had COVID-19.

The researchers say immunity from previous infection alone appears to last longer and be more effective than vaccination alone, but the combined immunity from both is the best. They say that when considering more rounds of vaccination, countries will need to consider how much immunity their populations already have.

Based on data from 26 studies, the analysis shows that protection against severe disease and hospitalisation remains high 12 months after developing hybrid immunity or infection, compared to unvaccinated and uninfected individuals.

For example, one year after developing hybrid immunity, a person had at least a 95% lower chance of getting severe COVID-19 or needing hospitalisation. In comparison, those who were infected a year ago but not vaccinated had a 75% lower chance of the same.

Protection against reinfection was lower than that against severe disease, though still substantial. Those with hybrid immunity had a 42% lower chance of being reinfected one year later. Those who had been infected before had a 25% lower chance of the same.

These findings are the product of a joint collaboration between the World Health Organization, the Unity Studies and SeroTracker.

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