OrthoPod Perspectives
Mohit Bhandari, MD, PhD, FRCSC
Editor-in-Chief, OrthoEvidence
Professor, Division of Orthopaedic Surgery,
McMaster University
President, Canadian Orthopaedic Association
July 29, 2020 | Episode 61
Rebecca Ivers
Head, School of Public Health and Community
Medicine, University of New South Wales

“Information is rampant, misinformation is doubly rampant. So, finding voices of reason, and voices of thought, and voices of data, makes it so much easier to weed through all the noise. I can’t thank you enough, Dr. Ivers, for taking time to give us some signal amongst all of this noise today.”  — Dr. Bhandari


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.

“[…] we were feeling like we were well under control of the epidemic in Australia, but of course, now, things have changed quite dramatically right in the middle of us. There’s pretty, pretty intense second wave […] privatized security firms and lack of training and that’s really where it started from […] we actually now have outbreaks in New South Wales because of travelers from Victoria.” — Prof. Ivers

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.

“We’re certainly starting to open up with the university. We’ve got very stringent health measures for our universities that are in place. Procedures that people can start to safely come back to work. […] This is something that we actually feel is really important – to give people comfort as they’re coming back in.  And it also allows us to know who’s on campus […] so that if we do have an outbreak, we know who’s been there and we can quickly identify them […]” — Prof. Ivers

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.

“I need to sit down and start thinking about my next programs of work. Does every single thing that we think about have to have a lens of COVID over it?” — Prof. Ivers

“It’s going to change the way we do research […] right now everything has been so “COVID-related”, find a vaccine, do trials, find a treatment, do trials. […] It’s a different psychological environment for patients undergoing surgery. The Non-COVID care is deeply impacted—and a major target for research.” — Dr. Bhandari

Questions and Answers:
Dr. Bhandari: When do we come back to “normal”?
Prof. Ivers: It won’t end. The current mode of life will last for a couple of years (2022).
Dr. Bhandari: Is vaccine development our only hope?
Prof. Ivers: I’m not optimistic about vaccines, because usually it is not possible to vaccinate everyone.
Dr. Bhandari: What are students’ attitudes toward getting back to face to face classes?
Prof. Ivers: Students aren’t interested in coming back to face to face experiences. International students who are in Sydney want to come to real class to ensure the value of their paid-for education.

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.

How to Cite:
Rebecca Ivers. (2020, July). Australia’s New Rise of COVID cases. Available from: