The COVID pandemic began in Australia in March 2020. This project was developed thanks to a NSW Health grant. 32,000 participants from the 45 and Up Study completed five surveys from 2020 to March 2022. The aim of the COVID Insights was to understand the impacts of COVID-19 and COVID-19 prevention strategies on the health, wellbeing and behaviors of a diverse group of older Australians. Understanding this provided evidence to inform policies and practices that support all Australians. The sub-study investigated:

  • the level of understanding of messages about COVID-19 prevention
  • the impact of COVID-19 prevention measures on health and wellbeing, preventive health activities, health services use, behaviours and experiences
  • the influence of demographics, health status and social variables on health outcomes during the COVID-19 pandemic
  • the accessibility of health services during the COVID-19 pandemic.

This study sought to apply an agile methodology to the existing database of participants from the 45 and Up Study – which has tracked the health of more than a quarter of a million elderly NSW residents for the past 15 years. Conducting short online surveys with sub-cohorts of participants and expediting analysis and reporting timelines, enabled the delivery of insights of clinical and policy relevance in relation to the population effects of COVID-19.

A total of 32,115 participants enrolled in the substudy, which involved a series of five online surveys that were conducted throughout 2020-2022. Survey themes were selected to obtain information on the pandemic’s impact on health, loneliness, lifestyle, physical activity, diet, sleep, alcohol use and access to health services, as well as experiences with telehealth, vaccination and more.

From the five surveys, a variation in impacts on the different population groups and stages of the pandemic were reported. Key findings include:

  • Missed healthcare: between Feb-Apr 2021 (survey two), 10% reported missed healthcare in the past month due to the pandemic, increasing to 26% by Sep-Nov 2021 (survey four), and subsequently decreasing to 16% in Mar-Apr 2022 (survey five)
  • Quality of life: overall this remained high, with more than 90% reporting good, very good or excellent quality of life across the different surveys
  • Mental health: as the pandemic progressed, the proportion of participants reporting worsened mental health because of the pandemic, increased from 29% in Jul-Dec 2020 (survey one) to a high of 46% in Sep-Nov 2021 (survey four), before decreasing slightly to 44% in Mar-Apr 2022 (survey five). Disparities were detected in priority groups such as carers and people living with a disability
  • COVID-19 vaccination: in Feb-Apr 2021, 89% intended to get the COVID-19 vaccine with 8% unsure. By the end of 2021, vaccination uptake was high with 92% double vaccinated
  • COVID-19 prevention: behaviours such as mask wearing showed increased uptake across the first four surveys before decreasing in Mar-Apr 2022 (survey five).

Examples of how insights from this study were considered in policy and planning include:

  • decrease in physical activity during the first stayat-home period – informing messaging during subsequent periods that people should stay active in safe ways
  • missed cancer screening – informing future planning for services  increase in the prevalence of mental health concerns – informing mental health service planning
  • negative impact of the pandemic on people with disabilities – informing work on the National Disability Strategy.