Public Health

2022 HIGHLIGHTS

Study of household spread of COVID-19 delivers results for current and future pandemics 

A study of how pathogens spread in Australian households has contributed essential knowledge to effectively respond to outbreaks such as COVID-19. Adapted from WHO protocols, the Australian ‘First Few X’ (FFX) COVID-19 study examined the first few hundred cases of the pandemic to better understand the virus and guide public health recommendations.

During 2022, the research team, led by University of Melbourne Professor Jodie McVernon, Director of Doherty Epidemiology and co-Lead for the Public Health cross-cutting discipline at the Doherty Institute, published an analysis highlighting the value of FFX studies for COVID-19 in the Western Pacific Region. The team modelled the spread of SARS-CoV-2 within households in the early stages of the pandemic in Australia. This epidemiological study, the first of its kind in Australia, showed that while children were less infectious than adults in this setting, they were more susceptible to infection. Finally, researchers conducted an evaluation of the Australian FFX Household Transmission Project through consultation with participants. The result is a set of recommendations outlining how future FFX studies should be implemented and integrated into pandemic preparedness plans to contribute to future emergency public health response, which we are supporting through ongoing partnership with WHO. 

Lab-in-a-van mobile testing in COVID hotspots supports Victoria’s pandemic response

High testing rates and rapid contact tracing were important COVID-19 control measures in Victoria. To support these responses, the Doherty Institute’s Lab Van became Australia’s first accredited mobile testing unit. In 2022, the Lab Van team published the process of design, implementation and performance of the unit benchmarked against a central reference laboratory. During the pandemic, the mobile unit was deployed to COVID-19 hotspots and was able to produce rapid results within an hour and a half of testing. The Lab Van was especially useful in regional Victoria to decrease the logistical issues of communities having to travel for COVID-19 testing. 

Study shows self-collected nasal swabs reliable and effective for COVID-19 testing 

Before rapid antigen tests (RATs) were widely accessible in Victoria, polymerase chain reaction (PCR) testing was still the primary means for diagnosis of COVID-19. To support Victoria’s public health response, VIDRL, in collaboration with VCS Pathology, established a validation study, where individuals who attended a drive-through testing clinic in Victoria’s west were given the opportunity to collect their own sample for PCR testing. The aim was to investigate whether an individual who collected their own nasal sample would produce a similar result to a healthcare professional collected sample.  

The 427 paired samples collected and tested, between February and June 2022, produced comparable results, supporting the fact that self-collection is a reliable and viable method to test for COVID-19. Furthermore, the scientists found that self-collected samples provided enough material for clinical genomics to identify the virus variant an individual was infected with, thus also supporting their potential use in surveillance programs. The study, led by The Royal Melbourne Hospital’s Professor Deborah Williamson, then-Director of VIDRL at the Doherty Institute, and funded by the Victorian Department of Health, showed that self-collection for COVID-19 detection can help reduce the burden on healthcare teams and provide broader access to sensitive and accurate diagnostics. 

Blood test survey paints clearer picture of COVID-19 infection in community  

Between July and October 2022, the Victorian Department of Health engaged VIDRL to conduct a blood testing program to better estimate SARS-CoV-2 infection in the community through antibody detection, as widespread PCR testing programs ceased. VIDRL surveyed approximately 2,000 samples, linking them to the Australian Immunisation Register (AIR) and Departmental case notification data, to investigate sample infection and immunisation history. This program estimated that approximately 40 per cent of COVID-19 cases in the community had been detected and reported via existing mechanisms, demonstrating a significant underestimate of infections in the Victorian population. Linkage with available data showed that younger age groups and unvaccinated individuals were less likely to have been tested. Case detection also appeared to be closely related to the number of vaccine doses an individual had received, suggesting people that had better health self-awareness were more likely to report infections. These findings present further opportunities for community engagement and information sharing around the importance of vaccination in reducing the likelihood of infection.  

Can specially developed RATs accurately detect multiple respiratory viruses at once? 

COVID-19 RATs have become the cornerstone of community SARS-Cov-2 diagnostics in Australia. The majority of these tests only detect SARS-CoV-2. As internal and international borders fully reopened in 2022, transmission of influenza and other respiratory pathogens, which had largely been absent throughout the COVID-19 pandemic, increased. VIDRL performed an internal laboratory assessment of two RATs developed to simultaneously test for SARS-CoV-2, influenza A and influenza B from one sample. This thorough analysis showed that these RATs, known as "multiplexed" because they can check for multiple viruses at once, were able to accurately detect infections with SARS-CoV-2, influenza A and influenza B, while not getting confused with other common respiratory viruses. This study highlighted, from a laboratory perspective, that multiplexed antigen tests may be useful in high-risk settings, such as hospitals and aged care facilities, where regular testing is required. These tests could also help with proper isolation and clinical management by providing accurate and timely diagnosis right at the testing location. 

VIDRL’s response to mpox public health emergency  

As a national reference laboratory for smallpox, VIDRL played a central role in detecting and reporting Australia’s first cases of mpox (formerly known as monkeypox) in late June with the help of rapid diagnosis and whole genome sequencing. Collaborating closely with health clinics and the Australian Department of Health, VIDRL generated crucial scientific data that informed the public health response nationally and in Victoria. Throughout the mpox outbreak, the team tested over 2,500 samples and provided after-hours triaging and lab testing. This work was critical in supporting authorities with prompt and efficient management of community cases. Beyond the Doherty Institute, VIDRL distributed control materials to other public health laboratories and assisted with quality assurance programs. The team also conducted an independent evaluation of a range of commercially available diagnostic tests to assess accuracy and reliability and help healthcare professionals and patients make informed decisions about their use in clinical practice. Given their expertise, VIDRL also provided scientific and advisory input into the World Health Organization's testing policy for mpox. 

VIDRL’s efforts during the outbreak highlighted the pivotal role and impact that public health laboratories have both locally, nationally and globally. 

Doherty diagnostic unit celebrates 50 years as an accredited public health laboratory 

MDU PHL is the longest continuously serving public health laboratory in Australia. To operate as an official public health laboratory requires accreditation from the National Association of Testing Authorities. Over the 50 years of accredited service, the public health laboratory has extended its accreditation to cover multiple fields of public health testing in Victoria to support health outcomes for people, animals and the environment. MDU PHL performs microbiological testing for notifiable pathogens and organisms of public health significance, including surveillance of food, and environmental and waterborne diseases. 

Launching Australia’s first hepatitis B community-led organisation 

Together with a group of scientists and advocates, Nafisa Yussf and Lien Tran, researchers from the WHO Collaborating Centre for Viral Hepatitis at the Doherty Institute, co-founded Hepatitis B Voices Australia (Hep B Voices) – Australia’s first hepatitis B community-led organisation. Led by people with lived experience of hepatitis B in Australia, Hep B Voices aims to support, represent and advocate for the health and wellbeing of people impacted by chronic hepatitis B.