Responding to public health risks, pandemics and emergencies - University of Wollongong

We research public health

The ACHEEV team talks about their research into public health and infectious disease

Chris Degeling [00:00:02] Part of our work attitude is focused on how best to manage the risks and harms infectious diseases like influenza, tuberculosis and rabies. These types of risks raise different issues and can require different modes of thinking and acting by policymakers, practitioners and by citizens. Infectious diseases do not just affect individuals, but spread within populations and even between species.

Julie Hall [00:00:26] This means that sometimes the needs and interests of infected individuals and the broader community can be in conflict. But this requires the public to accept some loss of privacy to improve public health surveillance.

Chris Degeling [00:00:38] At the same time, climate change and economic development are increasing the risk of infectious diseases carried by other species. We want to know what policy measures and interventions citizens are willing to accept in order to protect themselves and others from infectious diseases. In the laboratory, on a farm, on a train across our shared environment, we need to understand what people hold to be important and the values they believe should guide and inform infectious disease policy ACHEEV is part of that conversation.

Chris Degeling [00:00:02] Part of our work attitude is focused on how best to manage the risks and harms infectious diseases like influenza, tuberculosis and rabies. These types of risks raise different issues and can require different modes of thinking and acting by policymakers, practitioners and by citizens. Infectious diseases do not just affect individuals, but spread within populations and even between species.

Julie Hall [00:00:26] This means that sometimes the needs and interests of infected individuals and the broader community can be in conflict. But this requires the public to accept some loss of privacy to improve public health surveillance.

Chris Degeling [00:00:38] At the same time, climate change and economic development are increasing the risk of infectious diseases carried by other species. We want to know what policy measures and interventions citizens are willing to accept in order to protect themselves and others from infectious diseases. In the laboratory, on a farm, on a train across our shared environment, we need to understand what people hold to be important and the values they believe should guide and inform infectious disease policy ACHEEV is part of that conversation.

Since 2019 our experience of life on earth has changed dramatically. There have been more public health emergencies—pandemics, floods, fires and other disasters—and these emergencies are increasingly severe. This is forcing governments, health authorities and individuals to consider how best to respond. There is often no clear solution, and different courses of action can benefit some and burden others. In this theme, we ask questions about how people are adapting to our changing circumstances and what values are important to the public acceptability and legitimacy of proposed solutions.

ACHEEV explores how emerging public health risks are changing the way people live—with each other, and with other animals—and how these risks should be managed. By conducting high quality social and deliberative research, as well as policy and ethics analyses, we can develop recommendations about what should be done.

We are especially focused on how public health policies and programs can reflect and respond to the values of diverse communities, and can ensure they are fair and legitimate.

Projects

Ethics, politics and technologically enhanced communicable disease surveillance
Meeting the Challenge of Antimicrobial Resistance
Pandemic vaccine distribution
Narratives of Recovery - Practices supporting community mental health and wellbeing post bush fires and COVID 19
A Qualitative Study of the Experiences of Frontline Healthcare Workers regarding Infection Prevention and Control (IPC) during the COVID-19 pandemic
One Health and public values
Social and ethical Issues in TB Elimination and targeting LTBI screening
Understanding Parents who are Cautious About Vaccination (UPCAV)
Emergency responders and pet owners: Assigning and taking responsibility for pets in natural disasters

Researchers

Dr Chris Degeling
Professor Lyn Gilbert (University of Sydney)
Dr Jane Johnson (Macquarie University)
Julie Hall

Project Description

Successful implementation of public health policies must account for social, ethical and political concerns. This program of research is part of a larger grant to develop new approaches to communicable disease surveillance and outbreak response. Our part of this project aims to identify factors likely to promote or impede the introduction of new technology into communicable disease surveillance programs and effective responses to emerging infectious disease threats. Based on the results we will to develop a robust ethical framework to support policy development and informed decision-making, taking into account intergovernmental, political and border control issues with implications for human rights, distributive justice and international policy.

Project partners

University of Sydney, University of Western Australia, Monash University

Project website

CREID

Funding

2016-2022 - National Health and Medical Research Council (NHMRC) Centre for Research Excellence “Protecting the Public from Emerging Infectious Diseases" $2.5 million

Outcomes

Other Outcomes

Interviewed for “The Wire” 2SER on the COVIDSafe App – (August 3, 2020)
- Is COVIDSafe working or is it too early to call?
Interviewed by Lindsay McDougall on Drive on ABC Illawarra
- Have Australians become more accepting of surveillance after COVID-19?

Researchers

Project Description

Antimicrobial resistance (AMR) is a significant global problem. A major driver of the development of AMR is indiscriminate or inappropriate use of antibiotics across various sectors of the community. Building on collaborations with researchers and clinicians across a range of international and local institutions, the aim of this program of research is to better understand the drivers of antibiotic misuse, and the barriers to responsible prescribing in three sectors: consumers in the broader community; aged care providers; and agriculture.

Project partners

Warrigal Care

Funding

2020-2022 - University of Wollongong Global Challenges Keystone Award, $350,000

2015-2018 - National Health and Medical Research Council (NHMRC). Can One Health strategies be more effectively implemented through prior identification of public values? $565,106 AUD. Degeling C, Gilbert L, Wilson A, Kerridge I, Ward M, Stewart C.

Outcomes

Other Outcomes

UOW researchers on the hunt for farmers to participate in new study

Researchers

COVID-19 has highlighted the importance of fair and effective strategies to distribute vaccinations during a pandemic. Irrespective of how long it takes for a pandemic vaccine to be available, however, initial supply will be limited and will likely be exceeded by demand. Working with large a multidisciplinary teams from universities and health departments across Australia, we are conducting ethical analysis and bringing the public into deliberation on key issues and dilemmas on how best to distribute limited vaccine resources during times of public health emergency.

Project partners

Australian Partnership for Preparedness Research on Infectious Disease Emergencies Centre of Research Excellence (APPRISE)

Project website

Community perspectives on distributing an initially limited supply of vaccines in the event of an influenza pandemic

Funding

Department of Health Commonwealth Government of Australia, Citizens’ juries as an extension of the initial pandemic influenza vaccination target groups (TP707690), $123,000

Outcomes

Other Outcomes

Interviewed by Liam Mannix for The Age / Sydney Morning Herald - Prisoners and the obese priority groups for COVID-19 vaccine (December 9, 2020)

Researchers

Assoc Professor Lynne Keevers, Julaine Allan, Dr Chris Degeling, Dr Katarzyna Olcoń, Dr Mim Fox, Summer Finlay

Project Description

Local responses to immediate community need are grounded in contextual knowledge and use existing resources rather than relying on mainstream system-wide interventions. Combining practice based participatory inquiry, action research and policy analysis, this research addresses a knowledge gap of how a local health district (LHD) and an Aboriginal Community Controlled Health Organisation (ACCHO) design and deliver interventions to address complex health and social issues in a region in the context of a combined environmental and public health crisis.

Project partners

Waminda: South Coast Women's health and Welfare Aboriginal Corporation.

Illawarra Shoalhaven Local Health District, NSW

Funding

2020-2023 – Medical Research Future Fund (MRFF) COVID 19 Mental Health Research – $425,803

Outcomes

This research project will inform future health system responses to COVID-19 and other disasters by investigating two different community wellbeing interventions delivered in bushfire-ravaged communities on the South Coast of NSW.

Other Outcomes

Researchers examine community mental health responses to bushfires, COVID-19

Illawarra Mercury - UOW-led study will guide future health responses to disasters

Researchers

Dr Chris Degeling
Professor Lyn Gilbert (University of Sydney)
Professor Alex Broom (University of Sydney)
Dr Suyin Hor (University of Technology, Sydney)
Dr Leah Veazey Williams (University of Sydney)
Dr Mary Wyer (APPRISE)
Associate Professor Jennifer Broom (University of Queensland)
Associate Professor Penelope Burns (Australian National University)
Julie Hall

Project Description

The COVID-19 pandemic has elevated the significance and impact of infection prevention and control (IPC) to levels not seen for decades. This project focuses on health care worker experiences of the politics and practices of IPC during the pandemic with a particular focus on how health care providers balance perceived (and relative) risks and manage ethical and moral conflicts and dilemmas.

Project partners

University of Sydney
University of Technology Sydney
Sunshine Coast Hospital and Health Service
Westmead Hospital
Illawarra Shoalhaven Local Health District

Project website

Australian Partnership for Preparedness Research on Infectious Disease Emergencies (APPRISE)

Funding

APPRISE - Special COVID-19 call for research projects 2020-21 $163,000

Outcomes

This project will generate a comprehensive understandings of clinical perspectives on providing and receiving frontline care in a pandemic including the informed preferences of care providers, thereby enhancing quality of life for those giving and receiving it.

Researchers

Dr Chris Degeling
Professor Lyn Gilbert (University of Sydney)
Professor Michael Ward (University of Sydney)
Professor Andrew Wilson (University of Sydney)
Dr Jane Johnson (Macquarie University)
Dr Victoria Brookes (University of Sydney)

Project Description

More than half of all human pathogens are known to have originated from nonhuman animals and the vast majority of emerging human diseases are zoonoses. Therefore our response to Emerging infectious diseases (EIDs) must consider connections and interdependencies between human, nonhuman animal and ecological health. How we understand and seek to manage our relationship with the natural world effects social and economic inequities and the distribution of benefits and burdens between humans and other species. In this project we examine the ethical and political issues raised by EIDs in Australia to support the articulation of EID risk management policies and practices.

Project website

One Health Ethics

Funding

2015-2018 - National Health and Medical Research Council (NHMRC). Can One Health strategies be more effectively implemented through prior identification of public values? $565,106 AUD. Degeling C, Gilbert L, Wilson A, Kerridge I, Ward M, Stewart C

2016-2022 - National Health and Medical Research Council (NHMRC) Centre for Research Excellence “Protecting the Public from Emerging Infectious Diseases" $2.5 million CIs Sorrell T, Smith D, Holmes E, Gilbert L, Iredell J, Sintchenko V, Jones C, Dwyer D, Cheng A; AIs: Coriea E, Degeling C, Norris J, Effler P, Kirk M, Imrie A, Webb C.

Outcomes

Researchers

Project Description

The incidence and impacts of tuberculosis infections track with social and economic disadvantage – even in high income countries. Consequently, in low burden settings such as Australia the pursuit of TB elimination through targeted latent tuberculosis infection (LTBI) screening and health service provision for TB raises a number of ethical issues. These projects examine programmatic constraints and the ethical and socio-cultural dimensions of TB control and prevention in Australia.

Project partners

Funding

2019 - Victorian Tuberculosis Program, Melbourne Heath, Citizens’ Juries on Latent Tuberculosis Infection; $60,000
2018-2019 – UOW Faculty of Social Sciences NHMRC Near Miss Award $10,000
2018-2019 – Australian Respiratory Council Harry Windsor Research Award. “TB elimination: a qualitative investigation of the perspectives of South Asian migrant communities in the Illawarra” $20,000
2016-2018 – TB CRE Research Project Seed Funding $20,000

Outcomes

Researchers

Professor Stacy Carter
Dr Chris Degeling
Professor Julie Leask (University of Sydney)
Dr Kerrie Wiley (University of Sydney)
Penelope Robinson (University of Sydney)
Professor Paul Ward (Flinders University)
Professor Lesley Barclay (University of Sydney)

Project Description

Childhood vaccination is one of the great public health success stories of the 20^th Century, responsible for large reductions in child mortality and in the incidence of once-common diseases. About 95% of five year-old Australian children are fully vaccinated. However a very small proportion of parents refuse vaccination altogether, and others are hesitant. As non-vaccinating families often cluster in certain suburbs or regions, this can increase the risk of disease transmission. This project seeks to engage vaccine hesitant or refusing parents respectfully, to understand their practices from their perspective. We are also engaging with non-vaccinating parents and the general public about how public health authorities and others should act and why, recognising that there will always be members of the Australian community who are cautious about vaccination.

Funding

NHMRC Project Grant #1126543. 2017-2021. $743,963

Outcomes

Researchers

Cheryl Travers
Dr Chris Degeling (Primary Supervisor)
Professor Stacy Carter (Co-supervisor)
Non-UOW Co-supervisor Dr Melanie Rock (University of Calgary)

Project Description

The goal of this PhD study is to learn more about the relationship between emergency frontline responders and pet owners in natural disasters like fires, floods and storms. The increasing frequency, scale and intensity of natural disasters can affect whole populations and is an emerging and important public health issue. Emergency managers from all levels of government have identified a lack of understanding of people’s behaviour toward animals in disasters and people not taking responsibility for their animals, as barriers to the integration of animals into emergency management. People can make evacuation decisions based on their pet’s welfare and create risk for themselves, emergency responders and others. Research into the human-animal bond and the implications for public health and disaster management is in its infancy in Australia. My study will add to a growing knowledge base, which we consider essential to effective disaster preparedness and responses, and to the promotion of health and wellbeing post-disaster.