Planning for the next pandemic? Recommendations emerge from evaluation of an Australian COVID-19 household transmission study

January 31, 2023

A follow-up evaluation of an Australian study of household transmission of COVID-19 has led to four key recommendations for future pandemic plans.

The original national study of household transmission, based on a global protocol, was conducted early in the pandemic to provide essential data to improve Australia’s public health response.

Mr Adrian Marcato, co-author and PhD student at University of Melbourne, said the Australian First Few X Household Transmission Project for COVID-19 (FFX Project) was rapidly adapted from the World Health Organization (WHO) Unity Studies FFX and household transmission protocols for COVID-19.

“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 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 Australian FFX Project approach. The evaluation study was published in January 2023 in BMC Public Health.

“Given our experiences in the original FFX project between April and October 2020, this evaluation was designed to explore and consolidate the strengths and challenges of FFX-style studies in Australia so we could make recommendations to improve future pandemic preparedness plans.”

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.

Marcato said 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.

“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.”

He said the next two recommendations were better integration of FFX studies into the public heath response and the development of pre-approved FFX protocols in advance of an infectious emergency.

“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.”

“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.

“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.”

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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