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    Addressing the oral health needs of Indigenous Australians through water fluoridation

    Andrew McAuliffe, Chris Bourke and Lisa M Jamieson
    Med J Aust 2020; 213 (6): . || doi: 10.5694/mja2.50744
    Published online: 21 September 2020

    To the Editor: Poor oral health profoundly affects a person's ability to eat, speak, socialise, work and learn.1 It has an impact on social and emotional wellbeing, productivity in the workplace, and quality of life. Pain from dental caries is a common experience. In children, dental caries may require treatment under a hospital‐based general anaesthetic — at considerable cost and itself not without risk.2 Poor oral health in childhood is the leading cause of poor adult oral health.1

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      Three‐dimensional printing in a pandemic: panacea or panic?

      Michael Wagels and Dietmar W Hutmacher
      Med J Aust 2020; 213 (6): . || doi: 10.5694/mja2.50753
      Published online: 21 September 2020

      Patience and well designed studies are important for balancing opportunity and risk in uncertain times

      Even before they had to deal with the COVID‐19 pandemic, clinicians were negotiating the infiltration of three‐dimensional printing (3DP) into several aspects of medicine. This development probably began with the invention of stereolithography by Charles Hull in 1983.1 The technology has found broad application in engineering and manufacturing, particularly for computer‐aided design of machine parts. Its principles were also relevant to related aspects of clinical medicine, beginning with the production of reference biomodels from imaging data, and later in virtual surgical planning. It did not take long for the workflow that provided these services in the clinical environment to expand into other areas.

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      • 1 The Australian Centre for Complex Integrated Surgical Solutions, Princess Alexandra Hospital, Brisbane, QLD
      • 2 The University of Queensland, Brisbane, QLD
      • 3 ARC Centre in Additive Biomanufacturing, Queensland University of Technology, Brisbane, QLD


      Competing interests:

      No relevant disclosures.

      • 1. Jain A, Bansal KK, Tiwari A, et al. Role of polymers in 3D printing technology for drug delivery: an overview. Curr Pharm Des 2018; 24: 4979–4990.
      • 2. Ballard DH, Trace AP, Ali S, et al. Clinical applications of 3D printing: primer for radiologists. Acad Radiol 2018; 25: 52–65.
      • 3. Williams E, Bond K, Isles N, et al. Pandemic printing: a novel 3D‐printed swab for detecting SARS‐CoV-2. Med J Aust 2020; 213: 276–279.
      • 4. Vitali J, Cheng M, Wagels M. Utility and cost‐effectiveness of 3D‐printed materials for clinical use. Journal of 3D Printing in Medicine 2019; 3: 209–218.
      • 5. Langridge B, Momin S, Coumbe B, et al. Systematic review of the use of 3‐dimensional printing in surgical teaching and assessment. J Surg Educ 2018; 75: 209–221.
      • 6. Australian Department of Health, Therapeutic Goods Administration. Manufacturing medical devices and IVDs. Sept 2017. https://www.tga.gov.au/node/4425 (viewed July 2020).
      • 7. Bowling M. Catholic colleges printing thousands of face shields for frontline healthcare workers. The Catholic Leader (Brisbane), 8 Apr 2020. https://catholicleader.com.au/news/iona-college-plans-to-print-13000-face-shields-for-frontline-healthcare-workers (viewed July 2020).
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        Beyond the womb: respiratory symptoms in children following acute in utero exposure to fire smoke

        Julie M Marchant and Anne B Chang
        Med J Aust 2020; 213 (6): . || doi: 10.5694/mja2.50757
        Published online: 21 September 2020

        Air pollution poses global health, equity, and environmental problems with short and long term consequences

        The impact of environmental pollutants from diverse sources on health and well‐being is widely recognised.1 However, much remains unknown, including the relative contributions of specific air pollutants, their size effects, the periods of maximum vulnerability, and the longer term effects of acute and prolonged exposure, particularly in children.2,3 The expected increases in the number and intensity of bushfires, as seen in Australia during the summer of 2019–20, require that the effects of such extreme events on public health be explored.


        • 1 Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD
        • 2 Queensland Children's Hospital, Brisbane, QLD
        • 3 Menzies School of Health Research, Darwin, NT


        Correspondence: anne.chang@menzies.edu.au
        Acknowledgements: 

        Anne Chang is supported by a National Health and Medical Research Council Practitioner Fellowship (APP1058213) and a top‐up fellowship from the Queensland Children's Hospital Foundation (grant 50286). Julie Marchant is supported by an Early Career Fellowship Grant from the Queensland Children's Hospital Foundation (RPC0772019).

        Competing interests:

        No relevant disclosures.

        • 1. The Lancet Respiratory Medicine. Time to blow away the cobwebs. Lancet Respir Med 2018; 6: 231.
        • 2. The Lancet Respiratory Medicine. Fuelling advances in paediatric lung health. Lancet Respir Med 2020; 8: 125.
        • 3. Black C, Tesfaigzi Y, Bassein JA, Miller SA. Wildfire smoke exposure and human health: significant gaps in research for a growing public health issue. Environ Toxicol Pharmacol 2017; 55: 186–195.
        • 4. Willis GA, Chappell K, Williams S, et al. Respiratory and atopic conditions in children two to four years after the 2014 Hazelwood coalmine fire. Med J Aust 2020; 213: 269–275.
        • 5. Shao J, Zosky GR, Hall GL, et al. Early life exposure to coal mine fire smoke emissions and altered lung function in young children. Respirology 2020; 25: 198–205.
        • 6. Melody SM, Ford J, Wills K, et al. Maternal exposure to fine particulate matter from a coal mine fire and birth outcomes in Victoria, Australia. Environ Int 2019; 127: 233–242.
        • 7. Abdo M, Ward I, O'Dell K, et al. Impact of wildfire smoke on adverse pregnancy outcomes in Colorado, 2007–2015. Int J Environ Res Public Health 2019; 16: 3720.
        • 8. Jayachandran S. Air quality and early‐life mortality: evidence from Indonesia's wildfires. J Human Resources 2009; 44: 916–954.
        • 9. Reid CE, Brauer M, Johnston FH, et al. Critical review of health impacts of wildfire smoke exposure. Environ Health Perspect 2016; 124: 1334–1343.
        • 10. Sun X, Luo X, Zhao C, et al. The associations between birth weight and exposure to fine particulate matter (PM2.5) and its chemical constituents during pregnancy: a meta‐analysis. Environ Pollut 2016; 211: 38–47.
        • 11. Sapkota A, Chelikowsky AP, Nachman KE, et al. Exposure to particulate matter and adverse birth outcomes: a comprehensive review and meta‐analysis. Air Qual Atmos Health 2012; 5: 369–381.
        • 12. Black C, Gerriets JE, Fontaine JH, et al. Early life wildfire smoke exposure is associated with immune dysregulation and lung function decrements in adolescence. Am J Respir Cell Mol Biol 2017; 56: 657–666.
        • 13. Bui DS, Lodge CJ, Burgess JA, et al. Childhood predictors of lung function trajectories and future COPD risk: a prospective cohort study from the first to the sixth decade of life. Lancet Respir Med 2018; 6: 535–544.
        • 14. Duong M, Islam S, Rangarajan S, et al. PURE investigators. Mortality and cardiovascular and respiratory morbidity in individuals with impaired FEV1 (PURE): an international, community‐based cohort study. Lancet Glob Health 2019; 7: e613–e623.
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          Current COVID‐19 guidelines for respiratory protection of health care workers are inadequate

          C Raina MacIntyre, Michelle Ananda‐Rajah, Mark Nicholls and Ashley L Quigley
          Med J Aust 2020; 213 (6): . || doi: 10.5694/mja2.50752
          Published online: 21 September 2020

          Guidelines need to reflect the mounting evidence for airborne transmission of SARS‐CoV‐2

          The guidelines for protection of health care workers in Australia state that a medical mask is indicated for routine care of patients with coronavirus disease 2019 (COVID‐19), and a respirator only for aerosol‐generating procedures.1 These guidelines are not aligned with the growing body of scientific evidence regarding transmission and prevention of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection.

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          • 1 The Kirby Institute, Sydney, NSW
          • 2 Central Clinical School, Monash University, Melbourne, VIC
          • 3 ANZICS, Melbourne, VIC
          • 4 UNSW, Sydney, NSW


          Correspondence: ashley.quigley@unsw.edu.au
          Competing interests:

          No relevant disclosures.

          • 1. Australian Government Department of Health. Guidance on the use of personal protective equipment (PPE) in hospitals during the COVID‐19 outbreak. Version 6 (19/06/2020). https://www.health.gov.au/resources/publications/guidance-on-the-use-of-personal-protective-equipment-ppe-in-hospitals-during-the-covid-19-outbreak (viewed Aug 2020).
          • 2. Bahl P, Doolan C, de Silva C, et al. Airborne or droplet precautions for health workers treating COVID‐19? J Infect Dis 2020;. https://doi.org/10.1093/infdis/jiaa189 [Epub ahead of print].
          • 3. Wang W, Xu Y, Gao R, et al. Detection of SARS‐CoV‐2 in different types of clinical specimens. JAMA 2020; 323: 1843–1844.
          • 4. Guo Z‐D, Wang Z‐Y, Zhang S‐F, et al. Aerosol and surface distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards, Wuhan, China, 2020. Emerg Infect Dis 2020; 26: 1583–1591.
          • 5. Santarpia JL, Rivera DN, Herrera V, et al. Aerosol and surface contamination of SARS‐CoV‐2 observed in quarantine and isolation care. Sci Rep 2020; 10: 12732.
          • 6. Leung NHL, Chu DKW, Shiu EYC, et al. Respiratory virus shedding in exhaled breath and efficacy of face masks. Nat Med 2020; 26: 676–680.
          • 7. Fears AC, Klimstra WB, Duprex P, et al. Persistence of severe acute respiratory syndrome coronavirus 2 in aerosol suspensions. Emerg Infect Dis 2020; 26: 2168‐2171.
          • 8. Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person‐to-person transmission of SARS‐CoV‐2 and COVID‐19: a systematic review and meta‐analysis. Lancet 2020; 395: P1973–P1987.
          • 9. MacIntyre CR, Chughtai AA. A rapid systematic review of the efficacy of face masks and respirators against coronaviruses and other respiratory transmissible viruses for the community, healthcare workers and sick patients. International. Int J Nurs Stud 2020; 108: 103629.
          • 10. Cook T, Kursumovic E, Lennane S. Exclusive: deaths of NHS staff from covid‐19 analysed. Health Serv J 2020; 22 Apr; https://www.hsj.co.uk/exclusive-deaths-of-nhs-staff-from-covid-19-analysed/7027471.article (viewed Aug 2020).
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          • 13. Keeley AJ, Evans C, Colton H, et al. Roll‐out of SARS‐CoV‐2 testing for healthcare workers at a large NHS Foundation Trust in the United Kingdom, March 2020. Eurosurveillance 2020; 25: 2000433.
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            Burning to reduce fuels: the benefits and risks of a public health protection strategy

            Fay H Johnston
            Med J Aust 2020; 213 (6): . || doi: 10.5694/mja2.50751
            Published online: 21 September 2020

            We need to burn, but it is not a cure‐all and the side effects can be serious

            Fire disasters are one of many serious and escalating environmental health problems that the world, and Australia in particular, is now facing.1 During the black summer of 2019–2020, population exposure to bushfire smoke was almost an order of magnitude greater than that documented for any of the fire seasons for at least the previous two decades, and it was estimated to be responsible for more than 400 premature deaths.2 The fires themselves, including firefighting‐related accidents and injuries, claimed a further 33 lives.3 Furthermore, the trauma experienced by communities affected by the fires, including serious risks to life, homes and livelihoods, will have ongoing psychological, physical health, social and economic impacts.4


            • Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS


            Correspondence: fay.johnston@utas.edu.au
            Competing interests:

            No relevant disclosures.

            • 1. Whitmee S, Haines A, Beyrer C, et al. The Rockefeller Foundation–Lancet Commission on planetary health. Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health. Lancet 2015; 386(10007): 1973–2028.
            • 2. Johnston FH, Borchers Arriagada N, Morgan GG, et al. Unprecedented health costs of smoke‐related PM2.5 from the 2019–20 Australian megafires. Nat Sustain 2020. In press.
            • 3. Jalaludin B, Johnston F, Vardoulakis S, Morgan G. Reflections on the catastrophic 2019–2020 Australian bushfires. The Innovation 2020; 1: 100010.
            • 4. Newnham EA, Titov N, McEvoy P. Preparing mental health systems for climate crisis. Lancet Planet Health 2020; 4: e89–e90.
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            • 8. Penman TD, Collins L, Duff TD, et al. Scientific evidence regarding the effectiveness of prescribed burning. In: Leavesley A, Wouters M, Thornton R; editors. Prescribed burning in Australasia: the science, practice and politics of burning the bush. Melbourne: Australasian Fire and Emergency Services Council, 2020; pp 99–110.
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            • 10. Meier EA, Thorburn PJ. Long term sugarcane crop residue retention offers limited potential to reduce nitrogen fertilizer rates in Australian wet tropical environments. Front Plant Sci 2016; 7: 1017.
            • 11. Costello O. Fire has spirit. In: Leavesley A, Wouters M, Thornton R; editors. Prescribed burning in Australasia: the science, practice and politics of burning the bush. Melbourne: Australasian Fire and Emergency Services Council, 2020; pp 66–67.
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            • 13. Trauernicht C, Brook BW, Murphy BP, et al. Local and global pyrogeographic evidence that indigenous fire management creates pyrodiversity. Ecol Evol 2015; 5: 1908–1918.
            • 14. McCaw WL. Managing forest fuels using prescribed fire–a perspective from southern Australia. For Ecol Manag 2013; 294: 217–224.
            • 15. Schwilk DW, Keeley JE, Knapp EE, et al. The national Fire and Fire Surrogate study: effects of fuel reduction methods on forest vegetation structure and fuels. Ecol Appl 2009; 19: 285–304.
            • 16. Johnson CN, Prior LD, Archibald S, et al. Can trophic rewilding reduce the impact of fire in a more flammable world? Philos T R Soc B 2018; 373: 20170443.
            • 17. Curran TJ, Perry GL, Wyse SV, et al. Managing fire and biodiversity in the wildland‐urban interface: A role for green firebreaks. Fire 2018; 1: 3.
            • 18. Bowman DM, Daniels LD, Johnston FH, et al. Can air quality management drive sustainable fuels management at the temperate wildland–urban interface? Fire 2018; 1: 27.
            • 19. Australasian Fire and Emergency Services Authorities Council. National position on prescribed burning. Melbourne: AFAC, 2016. https://knowledge.aidr.org.au/media/4869/national-position-on-prescribed-burning.pdf (viewed Aug 2020).
            • 20. Brownson RC, Fielding JE, Green LW. Building capacity for evidence‐based public health: reconciling the pulls of practice and the push of research. Annu Rev Public Health 2018; 39: 27–53.
            • 21. Dovers S. Prescribed burning as a public policy problem. In: Leavesley A, Wouters M, Thornton R; editors. Prescribed burning in Australasia: the science, practice and politics of burning the bush. Melbourne: Australasian Fire and Emergency Services Council, 2020; pp 15–17.
            • 22. Australasian Fire and Emergency Service Authorities Council. Overview of prescribed burning in Australasia. Report for the National Burning Project, subproject 1. Melbourne: AFAC, 2015. https://knowledge.aidr.org.au/media/4893/overview-of-prescribed-burning-in-australasia.pdf (viewed Aug 2020).
            • 23. Penman TD, Bradstock R, Price O. Reducing wildfire risk to urban developments: Simulation of cost‐effective fuel treatment solutions in south eastern Australia. Environ Modell Softw 2014; 52: 166–175.
            • 24. Cirulis B, Clarke H, Boer M, et al. Quantification of inter‐regional differences in risk mitigation from prescribed burning across multiple management values. Int J Wildland Fire 2020; 29: 414–426.
            • 25. Bowman DM, Williamson GJ, Abatzoglou JT, et al. Human exposure and sensitivity to globally extreme wildfire events. Nat Ecol Evol 2017; 1: 0058.
            • 26. Furlaud JM, Williamson GJ, Bowman DM. Simulating the effectiveness of prescribed burning at altering wildfire behaviour in Tasmania, Australia. Int J Wildland Fire 2018; 27: 15–28.
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            • 29. Cascio WE. Wildland fire smoke and human health. Sci Total Environ 2018; 624: 586–595.
            • 30. Horsley JA, Broome RA, Johnston FH, et al. Health burden associated with fire smoke in Sydney, 2001–2013. Med J Aust 2018; 208: 309–310. https://www.mja.com.au/journal/2018/208/7/health-burden-associated-fire-smoke-sydney-2001-2013
            • 31. Borchers Arriagada N, Palmer AJ, Bowman DM, et al. Exceedances of national air quality standards for particulate matter in Western Australia: sources and health‐related impacts. Med J Aust 2020; 213: 280–281.
            • 32. Broome RA, Johnston FH, Horsley J, Morgan GG. A rapid assessment of the impact of hazard reduction burning around Sydney, May 2016. Med J Aust 2016; 205: 407–408. https://www.mja.com.au/journal/2016/205/9/rapid-assessment-impact-hazard-reduction-burning-around-sydney-may-2016
            • 33. Williamson G, Bowman DMJS, Price O, et al. A transdisciplinary approach to understanding the health effects of wildfire and prescribed fire smoke regimes. Environ Res Lett 2016; 11: https://doi.org/10.1088/1748-9326/11/12/125009
            • 34. Driscoll DA, Bode M, Bradstock RA, et al. Resolving future fire management conflicts using multicriteria decision making. Conserv Biol 2016; 30: 196–205.
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              Motherhood and medicine: systematic review of the experiences of mothers who are doctors

              Rebekah Hoffman, Judy Mullan, Marisa Nguyen and Andrew D Bonney
              Med J Aust 2020; 213 (7): . || doi: 10.5694/mja2.50747
              Published online: 14 September 2020

              Abstract

              Objective: To synthesise what is known about women combining motherhood and a career in medicine by examining the published research into their experiences and perspectives.

              Study design: We reviewed peer‐reviewed articles published or available in English reporting original research into motherhood and medicine and published during 2008–2019. Two researchers screened each abstract and independently reviewed full text articles. Study quality was assessed.

              Data sources: CINAHL, MEDLINE, PsycINFO, Web of Science, and Scopus abstract databases.

              Data synthesis: The database search identified 4200 articles; after screening and full text assessment, we undertook an integrative review synthesis of the 35 articles that met our inclusion criteria.

              Conclusions: Three core themes were identified: Motherhood: the impact of being a doctor on raising children; Medicine: the impact of being a mother on a medical career; and Combining motherhood and medicine: strategies and policies. Several structural and attitudinal barriers to women pursuing both medical careers and motherhood were identified. It was often reported that women prioritise career advancement by delaying starting a family, and that female doctors believed that career progression would be slowed by motherhood. Few evaluations of policies for supporting pregnant doctors, providing maternity leave, and assisting their return to work after giving birth have been published. We did not find any relevant studies undertaken in Australia or New Zealand, nor any studies with a focus on community‐based medicine or intervention studies. Prospective investigations and rigorous evaluations of policies and support mechanisms in different medical specialties would be appropriate.

              Protocol registration: PROSPERO CRD42019116228.

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              • Graduate School of Medicine, University of Wollongong, Wollongong, NSW


              Correspondence: rhoffman@uow.edu.au
              Acknowledgements: 

              We thank University of Wollongong librarian Brian Kenady for his guidance and the time taken to developing our search strategy.

              Competing interests:

              No relevant disclosures.

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              • 48. Miller AR. The effects of motherhood timing on career path. J Popul Econ 2011; 24: 1071–1100.
              • 49. Pringle JK, Harris C, Ravenswood K, et al. Women's career progression in law firms: views from the top, views from below. Gend Work Organ 2017; 24: 435–499.
              • 50. Cebeza‐García L, Del Brio EB, Rueda C. Legal and cultural factors as catalysts for promoting women in the boardroom. BRQ Bus Res Q 2019; 22: 56–67.
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                Sexual misconduct by doctors: a problem that has not gone away

                Cherrie Ann Galletly
                Med J Aust 2020; 213 (5): . || doi: 10.5694/mja2.50734
                Published online: 7 September 2020

                The medical profession has the opportunity to prevent further harm to patients and damage to public trust

                Bismark and colleagues1 report the disappointing finding that health practitioners, particularly doctors, continue to be found guilty of sexual misconduct with patients. During 2011–2016, Australian regulators received more than 100 notifications of sexual misconduct by Australian doctors each year. As with other sexual crimes, it is likely that many victims do not make formal complaints; in this study, only 34% of notifications were made by affected patients.


                • 1 Adelaide Medical School, University of Adelaide, Adelaide, SA
                • 2 Ramsay Health Care (SA), The Adelaide Clinic, Adelaide, SA
                • 3 Northern Adelaide Local Health Network, Adelaide, SA


                Competing interests:

                No relevant disclosures.

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                  New Zealand's COVID‐19 elimination strategy

                  Michael G Baker, Amanda Kvalsvig and Ayesha J Verrall
                  Med J Aust 2020; 213 (5): . || doi: 10.5694/mja2.50735
                  Published online: 7 September 2020

                  Compared with the mitigation and suppression approaches of most Western countries, elimination can minimise direct health effects and offer an early return to social and economic activity

                  On 23 March 2020, New Zealand committed to an elimination strategy in response to the coronavirus disease 2019 (COVID‐19) pandemic. Prime Minister Jacinda Ardern announced that on 26 March, NZ would commence an intense lockdown of the country (the highest level of a four‐level response framework1). At the time, NZ had just over 100 COVID‐19 cases and no deaths, so this “go early, go hard” approach surprised many. However, there were compelling reasons for NZ to pursue elimination.2

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                  • University of Otago, Wellington, NZ


                  Correspondence: michael.baker@otago.ac.nz
                  Acknowledgements: 

                  We thank our many colleagues who have contributed to development of the NZ elimination strategy, notably Professor Nick Wilson at the University of Otago, Wellington. We also acknowledge funding support from the Health Research Council of NZ (20/1066), which did not have any role in the planning, writing or publication of the work or the decision to publish.

                  Competing interests:

                  No relevant disclosures.

                  • 1. New Zealand Government. New Zealand COVID‐19 alert levels summary. https://covid19.govt.nz/assets/COVID_Alert-levels_v2.pdf (viewed June 2020).
                  • 2. Baker M, Kvalsvig A, Verrall A, et al. New Zealand's elimination strategy for the COVID‐19 pandemic and what is required to make it work. N Z Med J 2020; 133: 10–14.
                  • 3. Ministry of Health. New Zealand Influenza Pandemic Plan: a framework for action. 2nd ed. Wellington: Ministry of Health, 2017. https://www.health.govt.nz/system/files/documents/publications/influenza-pandemic-plan-framework-action-2nd-edn-aug17.pdf (viewed June 2020).
                  • 4. Ferguson NM, Laydon D, Nedjati‐Gilani G, et al. Impact of non‐pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand. London: Imperial College London, 2020. https://spiral.imperial.ac.uk:8443/handle/10044/1/77482 (viewed June 2020).
                  • 5. Anderson RM, Heesterbeek H, Klinkenberg D, et al. How will country‐based mitigation measures influence the course of the COVID‐19 epidemic? Lancet 2020; 395: 931–934.
                  • 6. World Health Organization. Report of the WHO‐China Joint Mission on Coronavirus Disease 2019 (COVID‐19). 16‐24 February 2020. Geneva: WHO, 2020. https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf (viewed July 2020).
                  • 7. Wang CJ, Ng CY, Brook RH. Response to COVID‐19 in Taiwan: Big Data analytics, new technology, and proactive testing. JAMA 2020; 323: 1341–1342.
                  • 8. Cowling BJ, Ali ST, Ng TWY, et al. Impact assessment of non‐pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. Lancet Public Health 2020; 5: e279–e288.
                  • 9. Kang J, Jang YY, Kim J, et al. South Korea's responses to stop the COVID‐19 pandemic. Am J Infect Control 2020;. https://doi.org/10.1016/j.ajic.2020.06.003 [Epub ahead of print].
                  • 10. Dowdle WR. The principles of disease elimination and eradication. Bull World Health Organ 1998; 76 (Suppl 2): 22–25.
                  • 11. Papania MJ, Orenstein WA. Defining and assessing measles elimination goals. J Infect Dis 2004; 189 (Suppl 1): S23–S26.
                  • 12. Baker M, Wilson N, Hendy S, et al. The need for a robust scientific definition for the elimination of COVID‐19 from New Zealand. Public Health Expert 2020; 5 May. https://blogs.otago.ac.nz/pubhealthexpert/2020/05/05/the-need-for-a-robust-scientific-definition-for-the-elimination-of-covid-19-from-new-zealand/ (viewed July 2020).
                  • 13. Wilson N, Telfar Barnard L, Kvalsvig A, et al. Potential health impacts from the COVID‐19 pandemic for New Zealand if eradication fails: report to the NZ Ministry of Health. Wellington: University of Otago Wellington, 2020.
                  • 14. Wilson N, Barnard LT, Summers JA, et al. Differential mortality rates by ethnicity in 3 influenza pandemics over a century, New Zealand. Emerg Infect Dis 2012; 18: 71–77.
                  • 15. Kissler SM, Tedijanto C, Goldstein E, et al. Projecting the transmission dynamics of SARS‐CoV‐2 through the postpandemic period. Science 2020; 368: 860–868.
                  • 16. Ferretti L, Wymant C, Kendall M, et al. Quantifying SARS‐CoV‐2 transmission suggests epidemic control with digital contact tracing. Science 2020; 368: eabb6936.
                  • 17. Howell BE, Potgieter PH. A tale of two contact‐tracing apps – comparing Australia's COVIDSafe and New Zealand's NZ COVID Tracer. SSRN 2020; 15 June. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3612596 (viewed July 2020).
                  • 18. He X, Lau EHY, Wu P, et al. Temporal dynamics in viral shedding and transmissibility of COVID‐19. Nat Med 2020; 26: 672–675.
                  • 19. Kvalsvig A, Wilson N, Chan L, et al. Mass masking: an alternative to a second lockdown in Aotearoa. N Z Med J 2020; 133: 8–13.
                  • 20. Horton R. Coronavirus is the greatest global science policy failure in a generation. The Guardian 2020; 9 Apr https://www.theguardian.com/commentisfree/2020/apr/09/deadly-virus-britain-failed-prepare-mers-sars-ebola-coronavirus (viewed June 2020).
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                    Navigating the complexities of voluntary assisted dying in palliative care

                    Eswaran Waran and Leeroy William
                    Med J Aust 2020; 213 (5): . || doi: 10.5694/mja2.50729
                    Published online: 24 August 2020

                    Voluntary assisted dying is not part of palliative care

                    The Voluntary Assisted Dying Act 2017 (Vic)1 came into effect in Victoria on 19 June 2019. We present the case of an inpatient death under the voluntary assisted dying Act in our health service and describe a short case history followed by a discussion examining two relevant topics related to voluntary assisted dying and palliative care: conscientious objection and the complexity of palliative care involvement.


                    • 1 Eastern Health, Melbourne, VIC
                    • 2 Monash University, Melbourne, VIC
                    • 3 La Trobe University, Melbourne, VIC


                    Competing interests:

                    No relevant disclosures.

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                      “Now we say Black Lives Matter but … the fact of the matter is, we just Black matter to them”1

                      Chelsea J Bond, Lisa J Whop, David Singh and Helena Kajlich
                      Med J Aust 2020; 213 (6): . || doi: 10.5694/mja2.50727
                      Published online: 17 August 2020

                      If Black lives matter we need to be prepared to examine and address racial violence within the Australian health system

                      My name is Kevin Yow Yeh and today I march for every Black death in custody but I especially march for my grandfather Kevin Yow Yeh Sr. At the age of 34 this man apparently had a heart attack at a Mackay watch house … This last month we've seen plenty of stats, 430 plus Black deaths in custody … and that's only since the Royal Commission, but what about all those deaths that led to that. My grandfather was one of them. Let's humanise these stories. When this man had a heart attack, he left his wife and he left five young children. My grandmother was still having his children when she had to put this man in the ground. That's why we march! Of course we stand in solidarity with our brothers in America. And, of course we stand in solidarity with our sisters in West Papua … but today we stand for our lives here, on stolen land.2

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                      • 1 University of Queensland, Brisbane, QLD
                      • 2 National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT


                      Correspondence: c.bond3@uq.edu.au
                      Acknowledgements: 

                      We would like to acknowledge the work of the National Justice Project, which provides a targeted health law service for First Nations peoples and communities who have experienced discrimination in health care or medical negligence.

                      Competing interests:

                      Chelsea Bond is a recipient of an Australian Research Council Discovery Early Career Award (180100090). Lisa Whop is a recipient of a National Health and Medical Research Council Early Career Fellowship (1142035), and a member of the Aboriginal and Torres Strait Islander Health Strategy Group of the Australian Health Practitioner Regulation Agency.

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