Against a picturesque backdrop of K'gari and a golden sunrise, Greg Messer's freestyle stroke powers through Hervey Bay's glassy, autumnal waters.
A few strokes away, partner Nicola Wellings makes "sure that he's never actually alone", regularly checking on the 75-year-old with the bright orange buoy in tow.
Their prudent precautions have been the couple's new normal since Greg collapsed and clinically died — for more than 15 minutes — after a cardiac arrest in October 2020 following a triathlon swim.
"I had no idea that anything was going to happen … I was in the waves right at the beach, stood up — that's the last I remember," he said.
"Absolutely critical" to his survival was the swift action of bystanders, including lifesavers and off-duty medical staff who administered CPR and shocks from an automated external defibrillator (AED), Greg said.
"I was so lucky there was a doctor and emergency nurse on the beach and two very fit lifesavers," he said.
"If I hadn't had them … I wouldn't be here for sure."
Researchers identify 60 high-risk LGAs
Nearly 70 Australians have a cardiac arrest out of hospital every day , but only 10 per cent survive due to delays in receiving CPR, defibrillation and treatment by emergency services, according to the National Heart Foundation of Australia.
In an effort to improve the survival rate, Monash University's Professor Janet Bray set about making change.
After finding that the impact of expensive, cardiac arrest education campaigns waned over time, Professor Bray and her colleagues mined an Australian and New Zealand cardiac arrest registry in search of a more cost-effective solution for the community.
Their research, published in the journal PLOS One, analysed the data of more than 62,000 cardiac arrests that had occurred outside of a hospital between 2017-2019 in Australia and New Zealand.
Sixty local government areas — mostly in regional and remote New South Wales, Queensland and Western Australia — were identified with a high risk of out of hospital cardiac arrest and a low rate of bystanders providing CPR assistance.
On Queensland's Fraser Coast, where Greg and Nicola live, bystanders gave CPR assistance in less than 59 per cent of the cardiac arrest incidents, among the lowest in the country.
The couple acknowledge how close Greg came to being a statistic, if it wasn't for the quick-thinking actions of those nearby who knew CPR.
"I owe them everything," Nicola said.
"Without them, I wouldn't have my partner."
She said it took her "a lot of months to move beyond that trauma", but she learnt it haunted others too who were also nearby at the time.
"Because that was such a public space, the impacts were more far reaching than even we had realised," she said.
"Several weeks later I was in a triathlon down here and a young man walked up and said, 'My son wants to make sure you're okay because he saw you on the beach' … and it was a young eight or nine-year old boy."
Confidence, frailty among reasons regional areas at highest risk
Professor Bray said the research group was looking into how to get "the biggest bang for our buck" through a targeted trial campaign to improve awareness and knowledge of CPR.
She said their research identified that in the high-risk regions with an older population, for those aged over 65, a fear of causing harm was a barrier to performing CPR.
"As people get older they get frailer as well, so it might be that they feel like they can't perform CPR or they're worried about hurting the person through doing CPR," she said.
CJ Beazley, a trainer with St John Ambulance, teaches first aid from Townsville to Hervey Bay and regularly has students in their 50s and 60s learning CPR for the first time.
He says the best way to overcome any barriers and fears is to be educated.
"We often get stories of repeat students who say that I did my course last year and then a few months later I had to put it into practice, and I knew what to do," Mr Beazley said.
"Just having that knowledge in general, it plays a huge role in how people are going to react when they're put in those situations."
'You don't waste the second life'
Greg, who was later diagnosed with the genetic condition hypertrophic cardiomyopathy and fitted with a defibrillator, now stays active with a daily regimen of a gym session, ocean swim and 35-kilometre bike ride.
The couple is preparing for their next challenge — an 8km swim from Magnetic Island to Townsville with Nicola paddling alongside in a kayak.
"He's not someone that's going to sit at home and watch TV for the rest of his life, he enjoys his exercise, that's his hobby … so I had to get used to that very quickly," she said.
Greg said his goal is to "finish alive" which relies on him listening to his body, and the defibrillator.
So far it has gone off twice, on both occasions when Greg's competitive nature pushed him too hard while ocean swimming.
"I've sort of learned to read the device and know when I'm doing it too hard," he said.
"If people swim up next to me now … I just ignore them and I swim at my pace — a pretty slow pace, I might admit, but I'll get there."
Greg says his gratitude for that life-saving care nearly four years ago motivates him to the next challenge.
"The stars aligned for me and believe me I know it — I'm lucky to be here.
"That's one of the reasons that I go out and do these challenges, because you don't waste the second life.
"You get out there and make the most of it well."