Introduction There is no publicly available national data on healthcare worker infections in Australia. It has been documented in many countries that healthcare workers are at increased occupational risk of COVID-19. We aimed to estimate the burden of COVID-19 on Australia healthcare workers and the health system by obtaining and organizing data on HCW infections, analyzing national HCW cases in regards to occupational risk and analyzing healthcare outbreak. Methods We searched government reports and websites and media reports to create a comprehensive line listing of Australian healthcare worker infections and nosocomial outbreaks between January 25 th and July 8 th , 2020. A line list of healthcare worker related COVID-19 reported cases was created and enhanced by matching data extracted from media reports of healthcare related COVID-19 relevant outbreaks and reports, using matching criteria. Rates of infections and odds ratios (ORs) for healthcare workers were calculated per state, by comparing overall cases to healthcare worker cases. To investigate the sources of infection amongst healthcare workers, transmission data were collated and graphed to show distribution of sources. Results We identified 36 hospital outbreaks or outbreaks between January 25 th and July 8 th , 2020. According to our estimates, at least 536 healthcare workers in Australia have been infected with COVID-19, comprising 6.03% of all reported infections. The rate of healthcare worker infection was 72/100,000 and of community infection 34/100,000. healthcare workers were 2.76 times more likely to contract COVID-19 (95% CI 2.53 to 3.01; P <0.001). The timing of hospital outbreaks did not always correspond to community peaks. Where data were available, a total of 131 healthcare workers across 21 outbreaks, led to 1656 healthcare workers being furloughed for quarantine. One hospital was closed and had 1200 workers quarantined in one outbreak. Conclusion The study shows that HCWs were at nearly 3 times the risk of infection. Of concern, this nearly tripling of risk occurred during a period of low community prevalence suggesting failures at multiple hazard levels including PPE policies within the work environment. Even in a country with relatively good control of COVID-19, healthcare workers are at greater risk of infection than the general community and nosocomial outbreaks can have substantial effects on workforce capacity by the quarantine of numerous workers during an outbreak. The occurrence of hospital outbreaks even when community incidence was low, highlights the high risk setting that hospitals present. Australia faces a resurgence of COVID-19 since late June 2020, with multiple hospital outbreaks. We recommend formal reporting of healthcare worker infections, testing protocols for nosocomial outbrea...

The present questionnaire based study examined the beliefs about and confidence in supporting bereaved individuals with a learning disability in health ( n =35) and social care staff ( n = 71). The study found that the knowledge of both health and social care staff about the grieving process in individuals with a learning disability was good, with staff recognizing the emotional and behavioural impact this could have on clients. No significant results were found in relation to knowledge about the grieving process in respect of occupational group, gender, experience of working in learning disability services or experience of supporting a client with a learning disability who had been bereaved. Significant results were found in relation to the confidence of staff in both providing support to people with a learning disability who were bereaved and in teaching people with a learning disability about death. Males, social care staff, those who had had experience of supporting a bereaved client and those who had had more experience of working in learning disability services rated themselves as significantly more confident in supporting bereaved people with a learning disability. In addition the two latter groups also rated themselves as significantly more confident in teaching individuals with a learning disability about death. The implications of the study are discussed.

Zhang and colleagues call for continued use of non-pharmaceutical interventions to control covid-19 during and after vaccine roll outs This article is part of a collection proposed by the Peking University Centre for Public Health and Epidemic Preparedness and Response. Open access fees were funded by individual institutions.The BMJ commissioned, peer reviewed, edited, and made the decision to publish. Li-Ming Li advised on commissioning for this collection. Jin-Ling Tang, Di Wang, and Kamran Abbasi were the lead editors for The BMJ.

Primary and secondary care services are charged with failing to adequately detect and treat mental disorder in older adults due to the ‘understandability phenomenon’; the belief that mental disorder in old age is inevitable and therefore not worthy of intervention. Quantitative data appear to support this hypothesis but lack the explanatory power of detailed accounts. Nine general practitioners (GPs) participated in group interviews about their assessment and treatment of older patients, and their expectations and experience of referral to secondary care. Resulting transcripts were subject to Thematic Analysis. Respondents recognised the unique features of these clients, and their impact on the detailed, recursive processes of assessment, clinical decision-making and intervention. GPs described confidence in managing most cases of mental disorder, describing the role of secondary care as one of consultancy in extreme or unusual cases. GPs did view mental disorder as commonly originating in adverse circumstances, and queried the validity of pharmacological or psychological interventions in these cases. They did not, however, equate understandability with acceptability, and called for social interventions to be integrated with health-care interventions to tackle the cause of mental disorder in older adults. At a wider level, findings highlight the discrepancy between assumptions about GP attitudes and actions, and their own accounts. At a local level, findings will assist in focusing secondary care service development where need is perceived, into consultancy and training.

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