The extreme life changes that have been thrust upon the world by the COVID-19 lockdowns have taken a considerable toll on our physical and mental health, without discrimination.

Children, adolescents, adults and the elderly have all been challenged by factors including social isolation, boredom and loneliness, unemployment, financial instability, school and business closures, state and international border closures and extreme and unprecedented social restrictions.

“Common consequences of disease outbreaks include anxiety and panic, depression, anger, confusion, uncertainty and financial stress, with estimates of between 25% to 33% of the community experiencing high levels of worry and anxiety during similar pandemics.” (Black Dog Institute 2020)

As can be expected, the COVID-19 pandemic has led to a significant impact on mental health of the Australian population at large, especially among those who are already vulnerable (Dr. Mandal 2020). Nationally, since 16 March 2020, there has been a 15% increase in the number of Medicare-subsidised mental health services delivered to Australians and 7.4 million services provided (Department of Health 2020).

With around 45% of Australians aged 16-85 said to experience a mental illness in their life (Australian Institute of Health and Welfare 2018), the circumstances of the COVID-19 lockdowns and pandemic have amplified our experience of mental health issues.

It is not surprising that the restrictions imposed on socialising with friends and family, visiting elderly loved ones in care facilities, mourning the death of a loved one at a funeral, celebrating a marriage, attending religious gatherings, working amongst work colleagues, frequenting gyms for exercise or even exercising outdoors (Melbourne, Victoria), have seen the rates of psychological distress, anxiety, and depression symptoms rise among adults in Australia during the peak of the pandemic (Dr Mandal 2020).

Melbourne, Victoria underwent some of the strictest and longest lockdowns in the world (Fernando 2020), triggering an increase in usage of mental health services across the state. The use of Beyond Blue’s Support line was 77% higher in Victoria than in the rest of the country, Victorian use of Lifeline was 16% higher and use of Kids Helpline was 24% higher than in the rest of the country (Department of Health 2020).

Ensuring that essential support was available, the Australian Government prioritised mental health and suicide prevention services with record investment in mental health estimated to be $5.7 billion in 2020–21 including an additional 10 Medicare-subsidised individual psychological therapy sessions available each calendar year, a commitment of $2.4 billion to provide all Australians with access to telehealth, $5 million to fast track electronic prescribing and $25 million to support home delivery of medicines (Department of Health 2020).

This unprecedented investment in mental and physical health funding is assisting Australians to deal with the challenges of lockdowns, isolation, fear for loved ones, and concerns about employment (Aust Government Department of Health 2020). However, despite this, the physical health of many Australians with existing chronic health conditions has been a mounting concern following the sharp fall in healthcare participation as a result of the isolation and social distancing advice, as well as a 40% drop in pathology testing – equivalent to over 60,000 Australians per day not getting tests vital to manage their healthcare (Hepatitis Australia 2020).

This delaying or avoiding necessary routine medical care (despite the availability of telehealth consultations) compounded by the fear of becoming infected with COVID-19 as well as feelings of overburdening the health-care system in a time of crisis could put Australians’ long-term health at risk (Ferguson 2020).

Therefore, while the public health messaging has focused on urging people to stay home as a way of saving lives and preventing the spread of COVID-19, it’s important to highlight that as concern over COVID-19 continues, one of the key exceptions to this is the need to seek medical treatment – even if it is in person.

Anyone worried about their mental health, loneliness, finances, family, or other circumstances should be reassured that help is available and accessible and can contact the Beyond Blue Coronavirus Mental Wellbeing Support Service for free advice and counseling on 1800 512 348 or online. Immediate advice and support is also available through Lifeline (13 11 14) or Kids Helpline (1800 55 1800) (Department of Health 2020).

REFERENCES

1. Australian Government Department of Health. The mental health impact of COVID-19, 2020. https://www.health.gov.au/news/the-mental-health-impact-of-covid-19 (accessed Nov 2020).
2. Australian Institute of Health and Welfare. Australia’s Health 2018: in brief – how do we compare with similar counties, 2018. https://www.aihw.gov.au/reports/australias-health/australias-health-2018-in-brief/contents/how-do-we-compare-with-similar-countries (accessed Nov 2020).
3. Black Dog Institute. Mental Health Ramifications of COVID-19: The Australian context, 2020. https://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/20200319_covid19-evidence-and-reccomendations.pdf (accessed Nov 2020).
4. Department of Health – Ministers. Caring for Mental and Physical Health during the pandemic, 2020. https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/caring-for-mental-and-physical-health-during-the-pandemic (accessed Nov 2020).
5. Dr Mandal, A. Mental health problems peak alongside COVID-19 in Australia, 2020 https://www.news-medical.net/news/20200729/Mental-health-problems-peak-alongside-COVID-19-in-Australia.aspx (accessed Nov 2020).
6. Ferguson, C. SBS Insight. Managing chronic conditions in the time of coronavirus, 2020. https://www.sbs.com.au/news/insight/managing-chronic-conditions-in-the-time-of-coronavirus (accessed Nov 2020).
7. Fernando, G. SBS News. Is Melbourne’s coronavirus lockdown really the longest in the world? Here’s how other countries stack up, 2020. https://www.sbs.com.au/news/is-melbourne-s-coronavirus-lockdown-really-the-longest-in-the-world-here-s-how-other-countries-stack-up (accessed Oct 2020).
8. Hepatitis Australia. Not seeking help may place your health, or your life, at risk, 2020. https://www.hepatitisaustralia.com/news/not-seeking-help-may-place-your-health-or-your-life-at-risk (accessed Nov 2020).

How will the COVIDSafe app work?

A user voluntarily downloads the app from the app store. The user registers to use the app by entering a name, phone number and postcode, and selecting their age range. They will receive a confirmation SMS text message to complete the installation of the app. On the basis of this information, an encrypted reference code is generated for the app on that phone. That code is changed every 2 hours to make it even more secure.

The app uses Bluetooth to look for other devices that have the app installed. It takes a note when that occurs, securely logging the other users’ encrypted reference code. The date and time, distance and duration of the contact are generated on the user’s phone and also recorded. The location is not recorded.

This information is securely encrypted and stored on the phone.

The app uses a rolling 21 day window to allow for the maximum 14 day incubation period, and the time taken to confirm a positive test result. The rolling 21 day window allows the app to continuously note only those user contacts that occur during the coronavirus incubation window. Contacts that occurred outside of the 21 day window are automatically deleted from the user’s phone.

The contact information on the phone is not accessible by anyone (including the user of the phone), until the user is diagnosed with coronavirus and they upload the contact information to a highly secure information storage system.

The uploaded information enables state or territory health officials to contact the user and close contacts to provide advice on actions they should take to manage their health.

This cycle continues if a user of the app who was a close contact subsequently tests positive.

What will the app do?

The COVIDSafe app will allow state and territory health officials to contact you if you have been in contact with someone with COVID-19 (coronavirus). They tell you:

• what to look out for
• whether you need to quarantine
• how, when and where to get tested, and
• how you can protect yourself and your family and friends

 

If you become infected with coronavirus, the app will assist state and territory health officials to notify people with whom you have had close contact and advise them about self-quarantine and getting tested.

This will speed up current manual processes and make it quicker to stop the spread of the virus, particularly if restrictions are eased.

The app operates on a person’s phone as they go about their day.

It securely logs the encrypted reference codes of devices of other people who are using the app who have been in close proximity to you.

The close contact information can only be accessed by relevant health officials if there has been a positive case to help alert those who may need to be tested.

The app will never track your location.

Is there a risk that people may report false positives?

Information collected by the app that is uploaded to the highly secure information storage system will only be accessed by state and territory health officials once a user has a positive diagnosis. This positive diagnosis must be verified by health officials.

Who is a ‘close contact’ for notification purposes?

State and Territory public health officials will have the contact information for other users who have been within approximately 1.5 metres of the infected user for 15 minutes or more.

How does the app know a ‘close contact’ has occurred?

When 2 (or more) app users come into close proximity their phones exchange Bluetooth signals and make a series of ‘digital handshakes’.

The app records the encrypted reference code, time and proximity of 2 users, through the strength of the Bluetooth signals. This allows the approximate distance between the users and the duration the contact occurred to be determined once the data is uploaded to the highly secure information storage system.

The proximity for a close contact is approximately 1.5 metres, for a period of 15 minutes or more.

To be effective, users should have the app running in the background of their phone whenever they are coming into contact with people. Users of the app will receive daily notifications to ensure the app is running.

Why does the app only notify close contacts in the last 21 days?

The average incubation period for someone who contracts COVID-19 is typically 5 to 6 days, however the World Health Organization currently estimate that the incubation period can be up to 14 days.

The app uses a rolling 21-day window to allow for the maximum 14-day incubation period, and the time taken to confirm a positive test result.

The rolling 21-day window allows the app to continuously monitor only those user contacts that occur during the coronavirus incubation window.

Contacts that occurred outside of the 21-day window are automatically deleted from the user’s phone.

What information is captured by the COVIDSafe app?

The app only uses the information that’s needed to alert close contacts and allow health officials to make contact with them.

This information is only the encrypted reference code, date, time, duration and proximity of contacts.

At registration, the user provides their name, phone number and postcode, and selects their age range, which generates an encrypted code

All further information about contacts collected by the app is encrypted and stored within the app on the phone. Users cannot access contact information stored on their phone.

If the user deletes the app, all contact information is deleted.

The contact information on the phone is not accessible by anyone, unless the user is diagnosed with coronavirus and they upload the contact information to a highly secure information storage system.

Can a user or health official view the information stored on the phone including the contact log?

No. All information that is stored on the phone is digitally encrypted and cannot be accessed or viewed by any users or health officials.

Contact information older than 21 days on your phone is automatically deleted.

Can the app be used to track a user or contact?

No. It does not record an individual’s location or movements. The app only records that a contact occurred to allow health officials to contact those users to enable them to quickly self-quarantine and/or seek medical attention.

The app cannot be used to enforce quarantine or isolation restrictions or any other laws.

Commonwealth and state/territory law enforcement agencies will not be allowed to access any information from the app, unless investigating misuse of that information itself.

Do I have to use the COVIDSafe app?

No. Its use is entirely voluntary but using it will help save lives.

For the app to work, it must be running in the background on your phone. Other apps can be used at the same time.

You can delete the app from your phone at any time. This will delete all the app information from your phone.

At the end of the Australian pandemic, users will be prompted to delete the app from their phone. This will delete all app information on a person’s phone. The information contained on the highly secure information storage system will also be destroyed at the end of the pandemic.

If a user receives a close contact notification, will they be advised who the contact was?

No. This will operate in the same way as existing contact processes run by State and Territory health officials.

A phone call will be made to users who have had close contact with another user once that user is independently confirmed as having COVID-19. This phone call will be made by State or Territory health officials.

Close contact information is only available to State and Territory health officials once a user is confirmed as coronavirus positive, and the user securely uploads the information stored on their phone.

These calls will only be made to close contacts that have occurred in the 21 days before the information has been uploaded. This early notification allows users to quickly self-quarantine and seek medical attention.

Why should I use the COVIDSafe app?

Receiving early notification that you may have been exposed to coronavirus means you can be tested or go into quarantine, so your health and others’ is protected.

Without the assistance of technology, finding people who may have been exposed to the virus relies on people being able to recall who they have been around and knowing the details of every individual they have been in close contact with. In many cases, we don’t know the names and contact details of those we’ve been in close contact with (for example, at the supermarket or on the train).

The COVIDSafe app uses technology to make this process faster and more accurate.

The COVIDSafe app has been developed to ensure your information and privacy is strictly protected.