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Purpose To examine changing patterns of ophthalmic presentations to emergency departments (EDs) during the lockdowns associated with the first wave of the COVID-19 pandemic in Australia and the two months immediately following lockdown relaxation. Patients and Methods This was a retrospective audit of triage coding and ICD-10-AM coding for all patient presentations to four Australian EDs from March 29 to May 31 in 2019 and 2020 (the COVID-19 lockdown period and the corresponding period in 2019), and from June 1 to July 31 in 2019 and 2020 (the post-lockdown period and the corresponding period in 2019). Number of ophthalmic presentations triaged per day and number of seven common and/or time-sensitive, vision threatening ophthalmic diagnoses were examined. Differences in mean daily presentation numbers were assessed with non-paired Student’s t -test with Bonferroni correction. Results Total ophthalmic presentations per day during COVID-19 lockdowns fell by 16% compared to the corresponding period in 2019 (13.0 ± 4.0 in 2019 vs 10.8 ± 3.3 in 2020, mean ± standard deviation; p =0.01). There was also a significant decrease in presentations of atraumatic retinal detachment, conjunctivitis, and eye pain. In the two months following easing of lockdown restrictions, total ophthalmic presentations per day returned to the same level as that of the corresponding period in 2019 (12.2 ± 4.3 in 2019 vs 12.3 ± 4.1 in 2020, p =0.97). Conclusion Total ophthalmic presentations and presentations of atraumatic retinal detachment, conjunctivitis and, eye pain to EDs fell during the lockdowns associated with the first wave of COVID-19 in Australia. These may represent delays in patients seeking appropriate medical attention and may have implications on patient morbidity long after the COVID-19 pandemic.

BACKGROUND Majority of smokers are aware of health consequences due to smoking but reported inability to quit smoking in multiple studies. Reasons attributed to continued smoking include multiple causes like addiction, habit and stress, as well as face-valid causes such as disease, personality problems, weakness of character, etc. Tobacco cessation services promoted by World Health Organization (WHO) are typically to be initiated by the service provider and include brief opportunistic assessment for smoking cessation widely known as 5A’ and 5R’s for brief assessment. Health interventions are identified by WHO as an effective way to enhance the promotion of tobacco cessation as only three percent of smokers manage to quit without help of intervention. This study explored the awareness of smart phone apps for smoking cessation among private healthcare providers in Chennai. METHODS A qualitative, explorative study through one-on-one, personal interviews among 36 randomly approached and consenting healthcare providers primarily providing tobacco related health care services including dentists, psychiatrists, ear – nose - throat surgeons, general medicine, respiratory medicine, surgeons and obstetricians at six private teaching medical institutes was conducted from July 2020 to October 2020 in Chennai. RESULTS The results showed that majority of the healthcare providers lack awareness of smart phone-based apps for smoking cessation. However, a very small minority3 who were aware were limited by social determinants of health of the clients such as perceived poor digital literacy, unaffordability of internet packages to recommend them. CONCLUSIONS The healthcare providers from various fields lacked the awareness of smart phone apps aiding with smoking cessation with the exception of a minor few3 who acknowledged their existence but were engaged very minimally with these modalities. KEYWORDS Healthcare Providers’ Awareness, Smart Phone Based-Apps, Smoking Cessation Apps, Tobacco Clients, Personal Interviews

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