Australian researchers have created a COVID-19 risk calculator to encourage discourse about getting vaccinated. Health Europa spoke to Dr Kirsty Short, virologist and co-lead researcher for the calculator, to find out more.
Australian researchers have developed a tool to help people understand their risk of hospitalisation or death from COVID-19 infection. The so-called Immunisation Coalition COVID-19 Risk Calculator (CoRiCal), will facilitate discussions about the probability of developing an atypical blood clot from the AstraZeneca vaccine, compared to the risk of dying from COVID-19. It takes into account age, sex, if the person has been vaccinated, and the community transmission scenario – whether there are high, medium or low levels of COVID-19 community transmission.
Health Europa spoke to virologist and co-lead researcher of CoRiCal, Dr Kirsty Short, to find out more about how the COVID-19 risk calculator can be used, and how it will help benefit both GPs and members of the public.
Why was the COVID-19 risk calculator created? How will it help support both GPs and the wider care community?
We wanted to create the COVID-19 risk calculator to help people understand the risk-benefit analysis that has to be done in the context of vaccination. Looking at potential risk factors for becoming seriously ill from COVID-19 was particularly important in the Australian context, because there are large parts of the country where there are no cases. Where I live, in Queensland, there have been seven COVID-19 deaths, all of which occurred in 2020. While a low mortality rate is a good thing, it also means people may not be fully aware, or appreciate, how life threatening this virus can be.
The COVID-19 risk calculator is a tool that helps people understand why they must get vaccinated. It allows them to input information about levels of COVID-19 in their area and better understand the importance of getting vaccinated, particularly if the number of COVID cases and transmission rates are high. Furthermore, the COVID-19 risk calculator can encourage a dialogue so that if, for instance, there are no cases of COVID now, people understand that this situation could dramatically change once borders open up again. The tool gives an individual risk assessment in tandem with levels of COVID-19 within the community.
Has misinformation been a concern in addressing the spread of COVID-19? Are there any specific demographics in which levels of mistrust and/or vaccine hesitancy are particularly high?
One of the key challenges we saw in Australia was the emergence of blood clots associated with the AstraZeneca vaccine.
In a scenario where you have a large number of COVID-19 cases, the risk of a blood clot from the vaccine falls in comparison. However, in Australia where we had a low incidence of COVID, the risks associated with getting the vaccine become more heavily weighted. That is, in part, why we wanted to create the risk calculator and why we looked at scenarios where the person had one or two doses of the AstraZeneca vaccine.
We are aiming to share statistics for the Pfizer vaccine soon. One important addition to the Pfizer calculator is the inclusion of the number of months since your second dose. Therefore, we can look at the importance of having a booster injection, and the significance of waning immunity. That is something that we are going to incorporate into the next model. There has been vaccine hesitancy here and a lot of concern. It is fine to have questions and concerns, but there needs to be a dialogue about it.
How has the digitisation of healthcare affected the delivery of monitoring tools? What are the advantages and disadvantages of monitoring people’s health this way?
We will see the digitisation of healthcare more and more. For example, I do a lot of work looking at viral infections in patients with type 1 diabetes (T1D), and in T1D what has been revolutionary is how blood glucose monitors can be used in tandem with patients’ devices to constantly assess their blood glucose levels, without the need for finger pricking.
All these digital technologies are amazing and are changing healthcare. We are also seeing digitisation in the COVID-19 pandemic. There are cases of people using machine learning to help predict patient outcomes and help triage patients. It is definitely an area that is emerging.
There are always going to be concerns with data protection, however. This will not be a concern with the risk calculator because it is all anonymised. But once you get into more fine data, there are concerns about data sharing and availability. This is something we must catch up with as digital technologies can really support the delivery of care.
How do you want to see CoRiCal rolled out on a larger scale?
This question relates to the updates we are doing now, so as I mentioned before, we are creating a model for the Pfizer vaccine and including the number of months since your second dose. This will help people understand the importance of a booster vaccine, which is a key piece of data that is emerging. It must be known that a booster vaccination is important for everyone, not just for those who are clinically vulnerable.
We are also adding extra features into the model such as your risk of long COVID. This is a really important factor to consider, because for young people, they probably do not have a high risk of dying from COVID-19 as they are not in the at-risk group, but they could, however, develop long COVID. That is something that I would be very concerned about, being so fatigued six months after the infection that I could not return to work. There are important things that we need to build into the model and the risk calculator.
This is just the beginning; we want to use the risk calculator as a way to start a dialogue. We are hoping that this is a technology that we can use to adapt other things as well, like when we talk about flu vaccination, because that is obviously very important. We could also adapt the calculator in the context of paediatric vaccinations. There are lots of ways in which we want to take this forward to create informed decision making, for both the patient and the clinician.
Kirsty Short
Senior Lecturer
School of Chemistry and Molecular Biosciences
www.uq.edu.au
This article is from issue 20 of Health Europa Quarterly. Click here to get your free subscription today.
