PERSPECTIVES

Professor Ivers discussing trends of the COVID-19 pandemic, we conducted qualitative analysis of the interview data. The analytic steps included reviewing the interview transcripts in detail, deriving initial codes from exact words in the data that appeared to represent key concepts of interest, and sorting related codes into themes that reflected surgeons’ perspectives on re-opening and infection surge.

 

Our analyses uncovered 3 core themes from the interviews. These themes and their supporting insights are highlighted below.

 

1. Second Wave Of COVID-19 Infections In Australia

The trend in COVID-19 infections observed overtime in Australia has been unpredictable. At multiple sites in the most populous states of New South Wales and Victoria, there had been no new cases for weeks. People began to feel the COVID-19 epidemic was under control and close to eradication, as it has been observed in New Zealand. Suddenly, the number of cases began to increase again and now people are on high alert. All the borders across the states in Australia are being shut down. People are watching the rising numbers of new cases every day and feeling quite nervous.

 

In Victoria, private security guards were hired to guard the hotel rooms where the people who had travelled from abroad were taking 14 days for quarantine, while in other states the police from the Australian Defense Force did the job. The security guards in Victoria were not well trained enough and some of them got infected. The disease subsequently spread to their families as well as to more people when big family gatherings took place for Ramadan celebrations. Travelers across the states caused outbreaks at different sites. These events took place before the Australian government was about to open up.

2. Stringent Health Measures To Control The Epidemic

Very stringent health measures have been taken into place at state’s level including, shutting the borders of states, restriction of travelers from abroad and case tracing.

 

In universities, health measures include classrooms to be spaced, rostering to come one week and having the next week at home for smaller teaching rooms, putting in an application to return to work on campus and getting online training modules of risk awareness, physical distancing, placement of hand sanitizers, disinfectant and wipes, separate routes design in a building, and requirement of wearing face masks if people cannot maintain physical distancing.

3. Impact Of COVID-19 On Clinical Research

Many clinical research projects (trials) such as those examining models of care for hip fracture have to stop or be modified due to the COVID-19 outbreak. For international studies, for example, the collaborative projects in Bangladesh, Professor Ivers and the team might want the on-site/local researchers to lead the way because Australian researchers cannot go there at the moment. This might be an opportunity in a way to “truly have capacity development and growth of leading investigators in each of those countries”. Professor Ivers is supporting the Bangladeshi researchers virtually via Zoom and thinks it a great way and views it an opportunity going forward.

 

Some clinical researchers in the hospital are ongoing. However, trials that include very vulnerable populations, for example, “older people, those with lots of comorbidities and living in rural and remote locations in many cases where there's not good care”, may have to stop. Professor Ivers has no idea when they are going to be able to start that up again.

 

Different research directions can be psychological environments for patients, obesity, mental health, healthcare models, access to the health system and social sciences including patient communication.

SENSE-MAKING

Prof. Ivers expressed concerns of the dramatic second wave of the COVID-19 infection in Australia and had an in-depth discussion with Dr. Bhandari on how this would impact clinical research.