To the Editor: Infectious diseases physicians and microbiologists are pivotal in guiding the response to the coronavirus disease 2019 (COVID‐19) pandemic. Their involvement ranges from managing cases and coordinating local responses to establishing timely and accurate diagnostic testing.1,2 We conducted a survey of infectious diseases physicians and microbiologists in Australia and New Zealand in early March 2020 to assess the impact on workload and the perspectives of infectious diseases physicians in the pre‐pandemic period. Responses were received from 214/600 infectious diseases physicians (35.6%) and 55/310 practising microbiologists (17.7%). During February 2020, infectious diseases physicians spent a median of 27 hours (interquartile range [IQR], 17–50 h) on COVID‐19‐related activities. Microbiologists worked a median of 8 hours (IQR, 2.5–8 h) overtime per week, and nearly one‐third of infectious diseases physicians (70/214) worked late hours at least 3 days a week on COVID‐19‐related activities. While many doctors have been less busy than usual lately,3 infectious diseases physicians and microbiologists have been busier than ever.
At the time of the survey, only 45% (95/212) of infectious diseases physicians agreed that the government's response was well coordinated. Similarly, only 25% (11/42) of microbiologists felt that advice from laboratory regulatory bodies was of assistance. This feedback highlights the confusion and lack of clarity that many clinicians experienced at the beginning of the pandemic. To improve coordination and response, we advocate for the establishment of a national Centre for Disease Prevention and Control.4 This Centre would need to be supported politically and financially by the federal government and all jurisdictions to be effective.
Reflecting the current lack of clear data about therapeutic options for patients with COVID‐19, over three‐quarters (169, 79%) of infectious diseases physicians felt they had equipoise for a clinical trial of specific antiretroviral. We advocate for investigational agents for COVID‐19 to only be used in the context of a clinical trial.5 At this time of great challenge to the Australian and New Zealand health care systems, infectious diseases physicians and microbiologists stand with all health care professionals and members of the community.
The unedited version of this article was published as a preprint on mja.com.au on 20 August 2020.
- 1. Bearman G, Pryor R, Vokes R, et al. Reflections on the COVID‐19 pandemic in the USA: will we be better prepared next time? Int J Infect Dis 2020; 96: 610–613.
- 2. Foley M, O'Neill I, O'Neill B, et al. From bench to bedside — development of an integrated COVID‐19 patient flow management system. J Hosp Infect 2020; 106: 211–213.
- 3. Scott A. How are Australia's doctors faring during COVID‐19? Melbourne: Pursuit, University of Melbourne; 2020. https://pursuit.unimelb.edu.au/articles/how-are-australia-s-doctors-faring-during-covid-19 (viewed Sept 2020).
- 4. Australian Medical Association. Australian National Centre for Disease Control (CDC) — 2017. Canberra: AMA, 2017. https://ama.com.au/position-statement/australian-national-centre-disease-control-cdc-2017 (viewed Sept 2020).
- 5. Denholm JT, Davis J, Paterson D, et al. The Australasian COVID‐19 Trial (ASCOT) to assess clinical outcomes in hospitalised patients with SARS‐CoV-2 infection (COVID‐19) treated with lopinavir/ritonavir and/or hydroxychloroquine compared to standard of care: A structured summary of a study protocol for a randomised controlled trial. Trials 2020; 21: 646.
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