Background: The epidemic of novel coronavirus disease (COVID-19) started in Wuhan, China, in December 2019, has been progressed to a pandemic level with high morbidity and mortality affecting many countries globally. Due to varied clinical characteristics of the disease, diagnosis can be missed easily among the affected population. The epidemiological data and early signals of COVID-19 infection are crucial for the disease investigation. Aim: To assess the presence of early signals of COVID-19 in India before official reporting of cases in the country and to compare epidemiological characters using different surveillance sources in the study. Methods: This study uses Epiwatch outbreaks surveillance data from November 2019 to March 2020 was used to determine the trend of pneumonia of unknown causes in India in order to assess if the COVID-19 could have been detected before the first case was reported.The search was carried out using the search terms defined in the study to identify the early signals of COVID-19.The COVID-19 line list extracted from the crowdsourced database (https://www.covid19india.org/) was additionally used to determine the demographic characteristics of cases. A descriptive analysis was conducted. Results: A total of 379 reports was extracted from Epiwatch. In 2019, there were only six reports of pneumonia of unknown causes in India, and the majority of the reports were focused on swine flu or undetected influenza cases. In 2020, there were 312 news reports of unknown pneumonia and COVID-19. The early signals of COVID-19 in India were observed from 24th January 2020 as the trend of pneumonia news had moderately increased. The trend of pneumonia reporting was low before the first confirmed case was reported in India. The study findings also suggested that there was under-reporting of COVID-19 cases in India by the World Health Organization (WHO) and the Ministry of Health, India when compared to data reported by Epiwatch and the line list. Conclusion: The study findings suggested that there were early signals of COVID-19 in India around 24th January when there was a slight increase in the trend of pneumonia reports in the country. The number of COVID-19 cases in India is under-reported by the Ministry of Health and the WHO. The use of online media surveillance reports such as Epiwatch and the line list could provide real-time assessment and timely investigation of emerging diseases globally.

Background: Residential aged-care facilities in Australia emerged as the high-risk setting the COVID-19 outbreaks due to community transmission. The vulnerable aged-care residents of these facilities suffered due to low hospital transfers and high mortality and morbidity rates. This study aimed to monitor and report the burden of COVID-19 in residential aged-care facilities across Australia and the impact of hospital transfer policies on resident hospitalisation during the first year of the pandemic. Methods: We conducted a retrospective cohort study by collecting data from weekly aged-care outbreak reports published by open sources and official government sources between 1st March and 20th November 2020. A comprehensive line list of outbreaks was created using open-source data. The line list included the name of the facility, location, COVID-19 cases among residents, & staff, resident hospitalisations, mode of transmission, number of resident deaths, and state policies involving resident hospitalisation. We also searched the websites of these facilities to collect data on their COVID-19 policies for the residents, staff, and visitors. Statistical analyses were performed on the data obtained. Results: 126 aged-care COVID-19 outbreaks were identified in Australia during the study period. The incidence rate of COVID-19 infections among aged-care residents in Australia was (1118.5 per 100,000 resident population) which is 10 times higher than the general population (107.6 per 100,000 population). The hospitalisation rate for aged-care residents in Australia was 0.93 per 100,000 population. The hospitalisation rate of aged-care residents in Victoria was 3.14 per 100,000 population despite having the highest COVID-19 cases. Excluding South Australia, all states followed ad-hoc case-by-case hospital transfer policies for aged-care residents. Conclusion: This study documented a higher risk of COVID-19 infection for aged-care residents and workers but found low hospitalisation rates among residents across Australia. The hospitalisation rates in Victoria were higher than the national average but low when considering the COVID-19 infection rates in the state. The hospitalisation rates could have been impacted due to the state hospital transfer policies at that time. Immediate transfer of infected residents to hospitals may improve their survival and reduce the risk of infection to the other residents, as healthcare settings have more advanced infection control measures and are well-equipped with trained staff and resources.

Background/Objectives: Poor oral health is a significant global public health concern that adversely affects an individuals’ overall health and general well-being. Occupational therapists are well-suited to promote oral health by supporting activities of daily living (ADLs), thereby improving clients’ oral health outcomes. However, there is limited evidence on the knowledge, attitudes, and practices (KAPs) of occupational therapists regarding oral health, as well as the barriers and facilitators they face in delivering oral healthcare. Methods: This paper outlines a protocol for a mixed-methods systematic review aimed at synthesizing the current evidence on the KAPs of occupational therapists related to oral health, as well as the barriers and facilitators they encounter in promoting it. The upcoming systematic review will follow the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews using a convergent integrated approach to synthesis and integration. The review will include quantitative, qualitative, and mixed-methods studies that report on KAP, barriers, and facilitators associated with occupational therapists’ involvement in oral healthcare. A comprehensive search will be conducted across multiple databases, including MEDLINE (Ovid), CINAHL (EBSCO), SCOPUS, EMBASE (Ovid), and OTseeker to identify relevant studies. Two reviewers will independently screen the studies for eligibility, assess their methodological quality, and extract key data for synthesis. The protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and is registered with PROSPERO (CRD42024522136). Results: The findings from the planned systematic review are expected to provide valuable insights into the role of occupational therapists in promoting oral health, addressing barriers and facilitators, and shaping policies, training programs, and clinical practices. Conclusions: Ultimately, these findings aim to enhance the integration of oral health into occupational therapy and improve client outcomes.

Background Residential aged-care facilities in Australia emerged as the high-risk setting during the COVID-19 outbreaks due to community transmission. The vulnerable aged-care residents of these facilities suffered due to low hospital transfers and high mortality and morbidity rates. This study aimed to assess the burden of COVID-19 in residential aged-care facilities across Australia and the impact of hospital transfer policies on resident hospitalisation during the first year of the pandemic.Methods We conducted a retrospective cohort study by collecting data from weekly aged-care outbreak reports published by open-sources and official government sources between 1st March and 20th November 2020.A comprehensive line list of outbreaks was created using open-source data. Statistical analyses were performed on the data obtained.Results 126 aged-care COVID-19 outbreaks were identified in Australia during the study period. The incidence rate of COVID-19 infections among aged-care residents in Australia was (1118.5 per 100,000 resident population) which is 10 times higher than the general population (107.6 per 100,000 population). The hospitalisation rate for aged-care residents in Australia was 0.93 per 100,000 population. The hospitalisation rate of aged-care residents in Victoria was merely 3.14 per 100,000 population despite having the highest COVID-19 cases in the state. Excluding South Australia, all states followed case-by-case hospital transfer policies for aged-care residents.Conclusion This study documented a higher risk of COVID-19 infection for aged-care residents and workers but found low hospitalisation rates among residents across Australia. The hospitalisation rates in Victoria were higher than the national average but low when considering the COVID-19 infection rates in the state. The hospitalisation rates could have been impacted due to the state hospital transfer policies at that time. We recommend immediate hospital transfer of infected residents to hospitals as healthcare settings follow necessary infection control measures and ensure staff are trained in personal protective equipment use.