Objective: To quantify the prevalence of known health‐related risk factors for severe COVID‐19 illness among Aboriginal and Torres Strait Islander adults, and their relationship with social determinants. Methods: Weighted cross‐sectional analysis of the 2018‐19 National Aboriginal and Torres Strait Islander Health Survey; Odds Ratios for cumulative risk count category (0, 1, or ≥2 health‐related risk factors) by social factors calculated using ordered logistic regression. Results: Of the adult population, 42.9%(95%CI:40.6,45.2) had none of the examined health‐related risk factors; 38.9%(36.6,41.1) had 1, and 18.2%(16.7,19.7) had ≥2. Adults experiencing relative advantage across social indicators had significantly lower cumulative risk counts, with 30‐70% lower odds of being in a higher risk category. Conclusions: Aboriginal and Torres Strait Islander peoples must continue to be recognised as a priority population in all stages of pandemic preparedness and response as they have disproportionate exposure to social factors associated with risk of severe COVID‐19 illness. Indigeneity itself is not a ‘risk’ factor and must be viewed in the wider context of inequities that impact health Implications for public health: Multi‐sectoral responses are required to improve health during and after the COVID‐19 pandemic that: enable self‐determination; improve incomes, safety, food security and culturally‐safe healthcare; and address discrimination and trauma.

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Accurate and current information has been highlighted across the globe as a critical requirement for the COVID-19 pandemic response. To address this need, many interactive dashboards providing a range of different information about COVID-19 have been developed. A similar tool in Australia containing current information about COVID-19 could assist general practitioners and public health responders in their pandemic response efforts. The COVID-19 Real-time Information System for Preparedness and Epidemic Response (CRISPER) has been developed to provide accurate and spatially explicit real-time information for COVID-19 cases, deaths, testing and contact tracing locations in Australia. Developed based on feedback from key users and stakeholders, the system comprises three main components: (1) a data engine; (2) data visualization and interactive mapping tools; and (3) an automated alert system. This system provides integrated data from multiple sources in one platform which optimizes information sharing with public health responders, primary health care practitioners and the general public.

Aims: Enhanced data collection during infectious disease emergencies, such as the COVID-19 pandemic, must inform the clinical and public health responses appropriate for Australian First Nations populations. To inform the design of such data collection protocols, we systematically reviewed the reported outcomes for the First Nations population related to A(H1N1) 2009 pandemic influenza infection. Methods: We searched PubMed and Google using the search terms: pandemic AND Australia AND 2009 AND (Indigenous OR Aboriginal OR "Torres Strait"). Data extracted included: location; study design; data source(s), number of study participants and the number and percentage that were First Nations; completeness of First Nations status; and reported outcomes (stratified by First Nations status). Each study was also reviewed for documentation of engagement or consultation with First Nation individuals, communities or health services regarding the study design, data collection, analysis, interpretation and reporting. Results: Our search identified 53 citations, with 13 deemed eligible for inclusion. Most studies were case-series (n=6) and used primary data (n=8) and/or secondary data (n=10). The number of First Nations participants ranged from 13 to 3,966. The proportion of First Nations participants per study varied from 1.8% to 100%. Completeness of reporting First Nations status ranged from 62% to 100%. Reported outcomes stratified by First Nations status included notification rate (n=3), comorbidities/risk factors (n=4), severity of disease (hospital admission (n=8), intensive care unit admission (n=8), death (n=5)) and interventions (anti-viral use (n=2) and vaccination (n=4)). There were no studies that described engagement/consultation with First Nations individuals, communities or health services regarding any aspect of the study process. Conclusion: Studies identified in this review mostly used secondary data and reported on outcomes relating to severity, and comorbidities and other risk factors. Studies specifically designed for First Nations populations are required to fully understand the contributing factors for the frequency and severity of disease in an infectious disease emergency and inform appropriate responses. First Nations communities and health services need to be adequately engaged and participate in the design, implementation, analysis and reporting of such enhanced data collection studies.

IntroductionFirst Nations Peoples of Australia have not been included in the development nor prioritised in pre-2009 pandemic plans despite being a priority population in Australian health policy. Marginalised groups experience amplified barriers and systemic disadvantage in emergencies, however, their voices have not been heard in past pandemic responses. Through effective engagement with disadvantaged and oppressed groups, health authorities can gain a deeper understanding of how to design and implement pandemic control strategies. There have been limited studies with First Nations Peoples that has focused on pandemic planning and response strategies. Deliberative inclusive approaches such as citizens juries have been a way to uncover public perceptions.MethodsQualitative thematic research methods were used to conduct the study. We convened five First Nations Community Panels in three locations in Australia between 2019 and 2020. We used an Indigenist research approach, community-based Participatory Action Research framework and ‘yarning’ to understand whether Community Panels were an acceptable and appropriate way of engaging First Nations Peoples. Forty First Nations participants were purposively recruited through local and cultural networks. Panels heard evidence supporting various pandemic response strategies, and cross-questioned public health experts.ResultsAll 40 participants from the 5 panels verbally indicated strong support of the Community Panels approach as an effective way of engaging First Nations Peoples in making decisions about pandemic planning and response strategies. The main theme of ‘respect’ centred on the overarching principle that First Nations Peoples are important in the context of continuation of culture and ongoing political resistance.ConclusionFirst Nations Community Panels are a way of enabling active participation of First Nations peoples, increasing knowledge and understanding, and a way for government and policymakers to respectfully listen to First Nations opinions and values.