Evidence check
A rapid review outlining the available evidence on a discrete topic or question. Evidence includes grey and peer review literature. View all Evidence Checks by date of publication.
Archive Renal dialysis and COVID-19 vaccination
Added: 13 Dec 2021
What is the evidence for the use of SARS-CoV-2 vaccinations in renal dialysis patients?
- Generally, studies have shown SARS-CoV-2 vaccinations are safe and effective in renal dialysis patients, with a substantial humoral response for most patients after two vaccine doses.
- However, the humoral response rate may be lower in renal dialysis patients compared to the general population. This may justify changes to the vaccination schedule for these patients.
- SARS-CoV-2 vaccines are not contraindicated in kidney disease patients and Kidney Health Australia recommends vaccination for people with kidney disease, including patients on dialysis.
Archive Risk mitigation strategies and levers - retired living evidence
Added: 13 Dec 2021
What are risk mitigation strategies and levers to slow the spread of the SARS-CoV-2 virus in the community?
- Factors to consider for determining mitigation strategies include the level of community transmission, number and type of outbreaks in specific settings or with vulnerable populations, the severity of the disease, the impact of community transmission on healthcare capacity, public health capacity, community characteristics such as the size of a community and level of engagement and support, and the epidemiology in surround jurisdictions.
- While some strategies are distinct others are unified. While as a strategy, test, trace, isolate and quarantine are generally integrated, we have included these separately in the risk mitigation strategies below to provide clear evidence and examples of each component.
Archive Paediatric respiratory infections
Added: 6 Dec 2021
What is the evidence for paediatric respiratory infections after lockdown and school reopening during COVID-19?
- Countries in both southern and northern hemispheres reported no immediate impact on the incidence of respiratory pathogens following reopening of schools and day care centres. However, some countries such as the U and China reported eran increase in intseasonal RSV activity.
- There is a concern that due to the reduced circulation of RSV during the winter months of 2020/21, older infants and toddlers might now be at increased risk of severe RSV-associated illness since they may not have had typical levels of exposure to RSV during the past 15 months.
- In several jurisdictions, the routine use of influenza vaccines and antiviral medications in the prevention and treatment of respiratory infections in children are recommended.
Archive Deep cleans
Added: 19 Apr 2021
Updated: 6 Dec 2021
What is the evidence for fomite transmission and deep cleaning of COVID-19?
- In February 2020, the World Health Organisation (WHO) noted fomites as a potential route ofCOVID-19 transmission.1 However, in July 2020, an update noted that despite consistent evidence of SARS-CoV-2 RNA on certain surfaces, there is no direct evidence of fomitetransmission.
- Despite the low risk of fomite transmission, there continues to be significant investment in deep-cleaning and disinfection to reduce potential surface contamination . A Nature perspective in January 2021 questioned the value of this.
Archive Test, trace, isolate and quarantine
Added: 14 Oct 2021
Updated: 16 Nov 2021
What is the evidence for and jurisdictional policies on test, trace, isolate and quarantine strategies for COVID-19?
- Modelling studies have found that test, trace, isolate and quarantine can prevent transmission, reduce the reproductive number, decease years of life lost and hospital bed use and reduce mortality.
- The elements of these programs found to be effective include a strong test component. To be strong requires high testing rates, timely contact tracing, high quarantine compliance, timely self-isolation of symptomatic individuals and quarantine of their household contacts. It also means comprehensive case finding, repeated testing to minimise false diagnoses and pooled testing in resource-limited circumstances. Effective elements also include an extended quarantine period and the use of digital tools for contact tracing and self-isolation.
- Internationally, many jurisdictions have implemented test, trace, isolate and quarantine (TTIQ)strategies. These can have differing lengths of time in isolation, testing requirements andexceptions for vaccinated people.
Archive Respiratory therapies and COVID-19
Added: 4 Nov 2021
What is the evidence for the use of respiratory therapies for the management of COVID-19?
- Respiratory therapies may be used to provide oxygen for adults with COVID-19. Alternatives to invasive mechanical ventilation include standard oxygen delivery devices, non-invasive ventilation, including continuous positive airway pressure (CPAP), and high flow nasal oxygen therapy.
- Aerosol-generating procedures increase transmission risk and may result in airborne transmission of COVID-19. Many respiratory therapies are considered to be aerosol-generating procedures.
- Prone positioning is a technique used to help patients with acute respiratory distress syndrome (ARDS) breathe better and may be beneficial in awake patients with COVID-19.
Archive Hospitalisation and ICU admission relative risk
Added: 4 Nov 2021
What is the evidence for the relative risk of hospitalisation and ICU admission for vaccinated versus unvaccinated people?
- The effectiveness of vaccines can be assessed by comparing the risk of hospitalisation or ICU admission among vaccinated versus unvaccinated people.
- Data from NSW has shown that the majority of COVID-19 patients in intensive care units are unvaccinated or only partially vaccinated.
- In patients 16 years and older, there was a 24-fold higher risk of hospitalisation and a 46-fold higher risk of ICU admission in unvaccinated people compared to vaccinated people. The difference increases in the 40-59 years age group, with a 47-fold higher risk of hospitalisation and a 70-fold higher risk of ICU admission.
Archive Foetal and neonatal outcomes of COVID-19 in pregnancy
Added: 29 Oct 2021
What evidence is available for adverse foetal and neonatal outcomes, for example miscarriage, stillbirth and neonatal death, associated with COVID-19 infection during pregnancy?
- Pregnant people with COVID-19 may be at increased risk of adverse birth outcomes, including preterm delivery, low birth weight and neonatal intensive care unit admission. However, there was no increased risk of foetal or neonatal mortality compared to the general population.
- Severe COVID-19 infections in pregnant people were associated with foetal death, stillbirth, preterm birth, and low birth weight.
- The risk of neonatal intensive care unit admission is higher in pregnant people with COVID-19 compared to those without COVID-19.
Rapid evidence checks are based on a simplified review method and may not be entirely exhaustive, but aim to provide a balanced assessment of what is already known about a specific problem or issue. This brief has not been peer-reviewed and should not be a substitute for individual clinical judgement, nor is it an endorsed position of NSW Health. Evidence checks are archived a year after the date of publication.