Study highlights lack of disease outbreak preparedness

Australia’s health system remains unprepared for a disease outbreak similar to the COVID-19 pandemic, according to newly published research from James Cook University.
 
The case study analysis examines how four different disease groups are managed in Northern Queensland and shows flaws in Australian systems responding to disease outbreaks.
 
The researchers conclude their results ‘highlight limitations and fragility of the public health system more generally, including unclear accountabilities, constraints on local community engagement, and workforce and other resourcing shortfalls’.
 
‘These were framed by state-wide regulatory and organisational incentives that prioritise clinical healthcare rather than disease prevention, health protection, and health promotion,’ their findings read.
 
Chair of RACGP Expert Committee – Quality Care Professor Mark Morgan told newsGP it is ‘absolutely important’ to examine the preparedness of the health system.
 
‘Because there were gaps when we were hit with the COVID-19 pandemic, but also previously with
swine flu and preparation for the possibility of avian influenza,’ he said.
 
‘All of those threats should have led to a robust emergency planning that involved all aspects of the health system.
 
‘That disaster planning is important and should be regular, so I think the researchers are right to have focused on this.’
 
Professor Morgan said Australia is also lacking a large-scale disease surveillance system that actively records and monitors presentations in general practice.
 
‘What’s missing is a massive surveillance system that identifies the reason for visits, identified in general practice records, which could certainly give a very good early warning to an outbreak,’ he said.
 
‘There’s a strong argument for public health use of that sort of data and would be much better than GPs just chatting to each other about whether, for example, there seems to be a lot of gastro around at the moment, or I’m seeing a lot of this infection over another infection.’
 
The Primary Sense system is one example of this and has already been established on the Gold Coast, allowing for heat maps of the area to be generated.
 
‘We’re able to demonstrate emerging outbreaks of reasons for visits and map those to locations, and do that anonymously,’ Professor Morgan said.
 
The study’s researchers analysed the responses from October 2020 to December 2021 for COVID-19, tuberculosis, sexually transmissible infections, and arboviruses.
 
Professor Stephanie Topp, who worked on the project, said they found the Northern Queensland surveillance and response systems for all those groups share at least three common challenges.
 
‘There is weak coordination within and between sectors, leaving the systems prone to error or breakdown, especially in times of stress,’ she said.
 
‘Secondly, a shift in funding has reduced the resources available to maintain and adapt surveillance and response systems in the face of new or shifting threats.
 
‘Thirdly, limited funds and a lack of priority during non-crisis times has left public health units short-staffed for all but the most basic functions.’
 
Professor Topp highlights the political factors that often impede in health planning, with decision makers in the health system often confined by electoral cycles.
 
‘Funding tends to follow such things as hospital bed availability and ramping rates – not the harder-to-quantify but more impactful population health strategies that could prevent or mitigate the next pandemic,’ she said.
 
Professor Morgan also argues that it is key to ‘respectfully engage general practice alongside public health and hospital-based planning’.
 
‘There are lessons to be learned and plans to be made,’ he said.
 
‘There does need to be a decision made that adequately funds the planning process and the maintenance of plans.’
 
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disease surveillance infectious disease pandemic preparedness preventive medicine public health