Study makes recommendations for future pandemic planning

Evaluation of an Australian study into household transmission of COVID-19 has led to four key recommendations for future preparedness.

The original study was based on national protocol and conducted early in the pandemic in 2020 to provide essential data to inform Australia’s public health response.

Adrian Marcato, co-author and PhD candidate at the University of Melbourne located in the Doherty Institute, said the Australian First Few X Household Transmission Project for COVID-19 (FFX Project) was rapidly adapted from the World Health Organization (WHO) protocols.

“The original FFX Project in 2020 was designed to meet information needs early in the COVID-19 pandemic. Learnings from the project, including baseline data about the transmission of early SARS-CoV-2 strains from children and adults in Australia, were published in Lancet Regional Health Western Pacific in 2022,” Marcato said.

The 2020 FFX Project faced many challenges, and the current follow-up evaluation was designed to document the strengths and challenges of the original approach. The evaluation study was published in January 2023 in BMC Public Health.

Four recommendations for future preparedness planning emerged from the evaluation process, which covered issues such as logistics and study design, ethics, governance and data management:

1. Partnerships

“Partnerships between researchers and public health officials are key to implementing an FFX study, so the first recommendation is to strengthen and mature partnerships and collaborations to enable a more rapid and effective activation of the study,” Marcato said.

2. Integrated data

Better integration of FFX studies into the public heath response is needed.

“Ideally a national FFX data system would enable rapid collection of the required data and would be integrated into existing data infrastructure at all government levels, to help provide the best possible pandemic outcomes for Australia.”

3. Pre-approved protocols

The development of pre-approved FFX protocols in advance of an infectious emergency would be more efficient and effective.

Marcato added, “Well-designed protocols can be rapidly adapted to fit the emergency at hand. Having protocols and approvals in place would enable culturally appropriate data collection for First Nations peoples and people at greater risk of disease.”

4. National data infrastructure

“The final recommendation calls for investment in national data infrastructure. In Australia, health care is run by local, state and territory, and federal governments. This means there are many differences around how data are collected and shared” he said.

The original 2020 project involved NSW, WA, SA and QLD jurisdictional health departments and the Royal Children’s Hospital in Victoria — at least one partner from each FFX site was invited to participate in the evaluation.

The FFX Project was a partnership between the Australian Department of Health (currently the Department of Health and Aged Care), state and territory health departments and the Australian Partnership for Preparedness Research on Infectious Disease Emergencies (APPRISE) team based at the University of Melbourne and the University of Adelaide.

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