CQ Health’s Public Health and Clinical Research Director Professor Gulam Khandaker.
CQ Health’s Public Health and Clinical Research Director Professor Gulam Khandaker.

Rocky researchers publish largest COVID-19 aged care study

A team of Rockhampton researchers has completed an international research project on COVID-19 outbreaks in residential aged care facilities.

The research was published in the Lancet Group Open access journal EClinicalMedicine, among the world's oldest and best-known general medical journals.

CQ Health's Public Health and Clinical Research director Professor Gulam Khandaker led the research team that went through more than 5000 documents.

It identified 49 studies from 14 countries across four continents, sorting through data on 214,380 residents in 8502 care homes, with 25,567 confirmed cases of COVID-19.

One of the researchers, a joint CQ Public Health Unit and CQUniversity PhD student Rashidul Hashan, was writing the paper from his hospital bed in Bangladesh while being treated for COVID-19.

"This is testament to the dedication of the team members to this project," Mr Khandaker said.

"We have a very modest team working in Rockhampton and we've led the largest study in the world of COVID-19 outbreaks in aged care.

"It shows that regional public health units can do good quality and valuable research with the right support, and we thank the Director-General and Queensland Health for their support to allow us to do this study."

CQ Health chief executive Steve Williamson said the team's work was of global significance.

"It is fantastic that our CQ Health team is at the leading edge of important COVID research to protect some of the most vulnerable in society," he said.

In 2019 Prof Khandaker was awarded a research fellowship by Queensland Health to investigate the burden and preventive strategies for vaccine-preventable infectious diseases in aged-care facilities.

"Then COVID came, and as a group we were best prepared to answer some of the questions that were arising about the behaviour of the virus in aged-care facilities," Mr Khandaker said.

"While we had an outbreak at North Rockhampton Nursing Centre with one case identified, we knew we had to look at the bigger picture to get meaningful data.

"This led to this systematic review and meta-analysis, where we took data from all outbreaks across the world and combined them to this report.

"This gives greater confidence and power and the highest level of evidence to get to the truth."

The study showed that aged care residents formed a distinct vulnerable population with COVID-19 attack rates of 45 per cent and case fatality rates of 23 per cent during outbreaks.

Moreover, nearly one third of COVID-19 cases during aged-care outbreaks were asymptomatic and more than one third of the confirmed cases required hospitalisation.

Outbreaks were introduced into aged-care facilities by both residents (58 per cent) and staff (42 per cent).

Mr Khandaker said the study could be used in developing prevention strategies, royal commissions and inquiries and vaccine prioritisation.

"We found both high attack and fatality rates, but many asymptomatic cases too," he said.

"Preventing the introduction of COVID-19 infection into aged-care facilities should be an urgent priority.

"During outbreaks, early case identification through facility-wide serial testing of all residents and staff, plus reducing staff movements within and between aged-care facilities are proven strategies to decrease the impact of COVID-19 in aged-care facilities."

The researchers involved in the study were:

- Mohammad Rashidul Hashan (CQ Public Health Unit and CQUniversity)

- Dr Nicolas Smoll (CQ Public Health Unit)

- Dr Catherine King (National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead)

- Dr Hannah Ockenden-Muldoon (CQ Public Health Unit)

- Jacina Walker (CQ Public Health Unit)

- Dr Andrew Wattiaux (Gold Coast Public Health Unit)

- Dr Julieanne Graham (CQ Health Executive Director Medical Services)

- Professor Robert Booy (National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead)

- Professor Gulam Khandaker

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