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Is my RAT actually working? How to tell if your COVID test can detect Omicron

You’ve tested negative for COVID using a rapid antigen test (RAT), but are a close contact of a positive family member and have symptoms. So you might be wondering if you’re really COVID-negative or if the test is working as well as it should. There are many reasons why your RAT may not give you <a href="https://theconversation.com/15-things-not-to-do-when-using-a-rapid-antigen-test-from-storing-in-the-freezer-to-sampling-snot-176364">the results</a> <a href="https://theconversation.com/my-rats-are-negative-but-i-still-think-i-might-have-covid-should-i-get-a-pcr-test-194527">you expect</a>. But one factor is whether RATs can detect the Omicron variant of SARS-CoV-2 (the virus that causes COVID). We know the virus has mutated during the pandemic. So health authorities and researchers are investigating whether RATs can still detect the <a href="https://www.who.int/activities/tracking-SARS-CoV-2-variants">more recent versions</a> of the virus. The good news is, based on the <a href="https://www.tga.gov.au/sites/default/files/2022-10/post-market-review-of-antigen-and-rapid-antigen-tests-table.pdf">limited data released</a>, all RATs meant for use at home in Australia that have been independently tested so far seem to be able to detect Omicron. The bad news is that not all RATs have been independently tested yet. Yours might be one of those. <h2>What do mutations have to do with RATs?</h2> RATs diagnose COVID infection by detecting specific viral proteins. So there are concerns that as the virus evolves and produces altered viral proteins, this may affect the tests’ ability to diagnose COVID as well as they detected previous variants. Whether RATs can adequately detect Omicron has been raised by authorities and researchers in various countries including <a href="https://www.bmj.com/content/378/bmj-2022-071215">The Netherlands</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/35458384/">Belgium</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/36339133/">Chile</a>, as well as Australia. One <a href="https://journals.asm.org/doi/10.1128/jcm.01097-22">Australian study</a> tested six RATs on Delta, and Omicron lineages BA.4, BA.5 and BA.2.75. The researchers found the kits performed equally well across the different samples at higher viral loads (higher concentrations of the virus), although one kit’s overall sensitivity fell below minimum sensitivity requirements. However, <a href="https://pubmed.ncbi.nlm.nih.gov/36339133/">some international studies</a> have found RATs are less able to detect Omicron, particularly when <a href="https://pubmed.ncbi.nlm.nih.gov/36339133/">viral loads are lower</a>. <h2>So what’s the case in Australia?</h2> Australia’s regulator, the Therapeutic Goods Administration (TGA), initially relied on <a href="https://www.tga.gov.au/products/covid-19/covid-19-tests/post-market-review-antigen-and-rapid-antigen-tests">test data</a> provided by RAT manufacturers to determine the test kit met World Health Organization <a href="https://www.who.int/publications/m/item/technical-specifications-for-selection-of-essential-in-vitro-diagnostics-for-sars-cov-2">standards</a> for acceptable sensitivity (ability to detect a positive case). The TGA also requires manufacturers to send updated test data as new variants arise to demonstrate their test still meets those WHO standards. But the TGA has also commissioned <a href="https://www.tga.gov.au/products/covid-19/covid-19-tests/post-market-review-antigen-and-rapid-antigen-tests">independent testing of RATs</a> to verify how well they detect the more recent COVID variants. They are tested for their ability to detect the wild-type virus (the original strain), the Delta variant, and the Omicron variant. The TGA does not state which specific lineages (descendents) of Omicron are included in the testing. As it completes its analysis on individual tests (or groups of tests), the TGA reports them in a <a href="https://www.tga.gov.au/sites/default/files/2022-10/post-market-review-of-antigen-and-rapid-antigen-tests-table.pdf">table that’s publicly available</a>, which will be updated as more data come in. <h2>What does the table tell us?</h2> You can look up the brand name, manufacturer and batch number of the RAT you have at home. Look for those labelled “self-tests” (more on the different types of tests and their results later). The most important columns in the table are those that indicate whether the kit passed its independent validation. Look for four ticks to indicate the kit meets minimum standards for detecting the original virus, Delta and Omicron variants, and has passed the quality test. A cross indicates is has not passed that component of the validation. Haven’t found a result for your RAT? If a product comes in two versions – a self-test and a type of test used in health-care facilities known as a point-of-care test (POCT in the table) – only one may be tested. If that’s the case, the symbol † means testing was only done on one version and you can use those results for your test. Look for a matching registration number to make sure you’re comparing like with like. The final column indicates what type of data the manufacturer has provided. Some manufacturers have tested the sensitivity of their kits for Omicron lineages BA.4 and BA.5. <h2>What does the table not tell us?</h2> Just because your test has no ticks or crosses against it, this doesn’t mean it can’t detect Omicron. It could be that the independent validation has yet to be completed or uploaded to the table. So the jury is out. The table also does not tell us what lineages of Omicron were tested for, although in some cases the manufacturer has supplied clinical test data. The table data were only current as of October. Seeing as the number of cases of sub-variant infections <a href="https://theconversation.com/what-can-we-expect-from-this-latest-covid-wave-and-how-long-is-it-likely-to-last-194444">has risen since then</a>, so we don’t really know if that is impacting on the sensitivity of even those tests that have recently been validated. <h2>I’ve grappled with the table, now what?</h2> If your brand of RAT has the ticks, particularly for Omicron, it has been assessed has having an acceptable sensitivity. If you are buying a RAT, check the table to see if that brand has been tested for sensitivity to the Omicron variant. If your test has been sitting in a cupboard for months, check the expiry date before you use it. Also consider whether it has been stored at the correct temperature during that time (the instruction leaflet will tell you what that is). Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/is-my-rat-actually-working-how-to-tell-if-your-covid-test-can-detect-omicron-196210" target="_blank" rel="noopener">The Conversation</a>.

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Health experts warn workers to stay home amid Covid “variant soup” wave

Health experts are warning people to work from home when they can, as the latest Covid wave is expected to peak before Christmas. Since October, cases have steadily been on the rise in Victoria and New South Wales, following a new “variant soup”. Last week, NSW Health changed its Covid-19 risk rating from green to amber, as cases in NSW and Victoria have doubled in just a fortnight. Hassan Vally, an Associate Professor in Epidemiology at Deakin University, said on Monday that new variants XBB and BQ.1 were driving case numbers as they became more dominant. He also said that the new variants were less severe, but more infectious. “We also know these variants don’t seem to be increasing in virulence … The evidence seems to point to they’re inherently less virulent,” he said during an Australian Science Media Centre briefing. Dr Vally said the current wave was expected to make a sharp increase before a sharp decrease by the end of the year, as he urged people to take “preventative measures” to avoid getting sick. “Each wave seems to be having less impact,” Dr Vally said. He said the threat posed by Covid wasn’t over, but emphasised we had entered a stage of living alongside the virus. Last week, health authorities recommended that residents of NSW wear masks indoors and on public transport if social distancing wasn’t available. NSW residents will also now have to wear masks in all areas of hospitals. In the week ending November 17, there were 27,869 people across NSW infected with Covid-19. Health authorities in NSW, Queensland, Western Australia and the ACT have issued similar warnings, strongly recommending a return to wearing masks in public indoor areas and on public transport, but have shied away from reintroducing mandates. Dr Vally said people who were in a position to work from home should do so when they can. “Maybe this is a point also where people, where they have the flexibility, should work from home a little bit more than what may become normal,” he said. Image credits: Getty Images

News

Aussies warned of “nightmare variant”

NSW’s chief health officer Kerry Chant has warned that Australia is on the brink of another Covid wave. The health official said that sub-variants BQ. 1 and XBB are well on the way of becoming the dominant strain over BA.5 in Australia Dr Chant said the XBB strain, which recently emerged in Singapore, is ripping through the nation at an alarming rate. Some international experts have described the XBB strain as the “nightmare variant” and the “most vaccine-resistant yet”. “We're starting to see an increase in Covid-19 cases and changes in the variants circulating in NSW, which tells us that we're entering the next Covid wave,” Dr Chant said in a video. “By looking at all the local information we have, and what's happening overseas, we believe Covid cases will rise in the coming weeks.” She asked Aussies to keep up to date with their vaccinations to ensure the protection of the vulnerable. “The protection the NSW community has from vaccination and previous infection continues to reduce the risk of severe illness,” she continued. “However the elderly and those with underlying health conditions continue to be at risk.” Image: ABC

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Fears over new Omicron subvariant

There are fears in China that a new subvariant of Omicron has been discovered. The country recorded 13,000 cases of Covid-19 but found a different strain in a patient with mild symptoms. Health officials in Suzhou, west of Shanghai, said the subvariant came from the BA.1.1 branch of Omicron. “This means a new variant of Omicron has been discovered locally,” Zhang Jun, deputy director of the Suzhou Centre for Disease Control and Prevention, told state press agency Xinhua. GISAID, the global database for mutations to be recorded, did not match with the new subvariant. The subvariant has not yet been reported in any other parts of China or globally. However, another variant has been reported in Dalian city, in northern China, which also does not match with any other variant in the database. China is still aiming to eliminate the virus and placed the city of Shanghai, a population of 26 million, into lockdown last week to help lower cases. Image: Getty

News

Could I have had COVID and not realised it?

It seems not a day goes by without learning someone in our inner circle of family, friends and colleagues has COVID. When we ask how unwell our acquaintance is, the responses vary from “they’re really crook” to “you wouldn’t even know they had it”. This is in line with studies that report moderate to severe illness in a minority of people (usually older with other risk factors) and that <a href="https://www.pnas.org/doi/10.1073/pnas.2109229118" target="_blank" rel="noopener">up to one in three positive people exhibit no symptoms</a>. Given the ubiquitous presence of this <a href="https://theconversation.com/how-does-omicron-compare-with-delta-heres-what-we-know-about-infectiousness-symptoms-severity-and-vaccine-protection-172963" target="_blank" rel="noopener">highly infectious coronavirus</a> in our community and the high rate of asymptomatic illness, those who have not been diagnosed with COVID might wonder, “how would I know if I had been infected?” And, “does it matter if I have?”. How COVID is diagnosed Most people know they’ve had COVID because they had a fever or upper respiratory tract symptoms and/or were exposed to an infected person AND had a swab test (PCR or rapid antigen) that detected the COVID virus (SARS-CoV-2) in the upper airway. At the beginning of 2022, many people with consistent symptoms or high-risk exposures were not able to access PCRs or RATs to confirm their diagnosis, but instead presumed themselves positive and quarantined. It is possible to diagnose past infection in those who never tested positive. A blood test can look for <a href="https://www.bmj.com/content/370/bmj.m3325#:%7E:text=SARS%2DCoV%2D2%20antibody%20tests%20and%20immunity,and%20memory%20against%20future%20infection." target="_blank" rel="noopener">SARS-CoV-2 antibodies</a> (also known as immunoglobulins). When we are infected with SARS-CoV-2, our immune system launches a precision counter strike by producing antibodies against viral targets, specifically the Spike (S) and Nucleocapsid (N) proteins. COVID vaccination <a href="https://theconversation.com/what-happens-when-the-covid-19-vaccines-enter-the-body-a-road-map-for-kids-and-grown-ups-164624" target="_blank" rel="noopener">induces</a> a similar immune response against the S protein only. The S antibody “neutralises” the invader by preventing the virus from attaching to human cells. These antibodies can be detected within one to three weeks after infection and persist for <a href="https://pubmed.ncbi.nlm.nih.gov/33408181/" target="_blank" rel="noopener">at least six months – potentially much longer</a>. A blood test that shows antibodies to S and N proteins indicates someone has been previously infected. Detection of antibodies to the S protein only indicates vaccination (but not infection). The problem with antibody tests Before you rush off to get a COVID antibody test, there are a few notes of caution. There is still <a href="https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests-guidelines.html" target="_blank" rel="noopener">much to learn about the characteristics</a> of the immune response to COVID infection. Not everyone mounts a detectable antibody response following infection and levels can decline to undetectable levels after several months in some people. Because there are other circulating seasonal coronaviruses (such as those that cause the common cold), tests may also pick up antibodies to non-SARS-CoV-2 strains, leading to “false positive” results. Commercial and public hospital pathology labs can perform SARS-CoV-2 antibody testing, but the interpretation of results should be undertaken carefully. So, antibody testing should really only be done when there’s a good reason to: say, when confirming past infection or effectiveness of vaccination is important for the current care of an individual. Diagnosing a post-infectious complication or eligibility for a specific treatment, for example. It could also be useful for contact tracing or for assessing the background population rate of infection. <figure class="align-center "><img src="https://images.theconversation.com/files/452963/original/file-20220318-10592-1aq4y5g.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/452963/original/file-20220318-10592-1aq4y5g.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=438&fit=crop&dpr=1 600w, https://images.theconversation.com/files/452963/original/file-20220318-10592-1aq4y5g.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=438&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/452963/original/file-20220318-10592-1aq4y5g.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=438&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/452963/original/file-20220318-10592-1aq4y5g.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=550&fit=crop&dpr=1 754w, https://images.theconversation.com/files/452963/original/file-20220318-10592-1aq4y5g.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=550&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/452963/original/file-20220318-10592-1aq4y5g.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=550&fit=crop&dpr=3 2262w" alt="" /><figcaption></figcaption></figure> Antibody testing a population “<a href="https://www.ncirs.org.au/our-work/serosurveillance" target="_blank" rel="noopener">Seroprevalence studies</a>” test for the presence of SARS-CoV-2 antibodies in repositories of stored blood that are representative of the general population, such as from a blood bank. This data helps to understand the true extent of COVID infection and vaccination status in the community (and informs our assessment of population susceptibility to future infection and reinfection). It’s more useful than daily reported case numbers, which are skewed towards symptomatic individuals and those with access to swab testing. New <a href="https://www.medrxiv.org/content/10.1101/2021.12.14.21267791v2" target="_blank" rel="noopener">research</a> from the World Health Organization, which is yet to be reviewed by other scientists, reported the results of a meta-analysis of over 800 seroprevalence studies performed around the world since 2020. They estimated that by July 2021, 45.2% of the global population had SARS-CoV-2 antibodies due to past infection or vaccination, eight times the estimate (5.5%) from a year earlier. There are <a href="https://kirby.unsw.edu.au/news/how-many-australians-have-had-covid-19" target="_blank" rel="noopener">plans</a> to conduct <a href="https://www.theguardian.com/australia-news/2022/jan/20/blood-test-surveys-crucial-to-estimate-covid-spread-in-australia-experts-say" target="_blank" rel="noopener">fresh seroprevalence studies</a> in Australia in the coming year, which will <a href="https://academic.oup.com/ofid/article/9/3/ofac002/6517685" target="_blank" rel="noopener">update local data</a> and help us understand to what extent the Omicron wave has washed through the population. Does it matter if I have had COVID and didn’t know? For most people, knowing your COVID infection status is unlikely to be more than a topic of dinnertime conversation. While some studies have pointed to a less robust and durable antibody response following <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7454692/" target="_blank" rel="noopener">mild</a> or <a href="https://pubmed.ncbi.nlm.nih.gov/33208819/" target="_blank" rel="noopener">asymptomatic</a> infection compared with severe illness, it is not known how this influences protection from reinfection. Certainly, the knowledge we have antibodies from past infection should not deter us from being fully up-to-date with COVID vaccination, which remains the best protection against severe illness. There are reports of people with mild or asymptomatic COVID infection developing <a href="https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1" target="_blank" rel="noopener">long COVID</a> – persistent or relapsing symptoms that last several months after initial infection. Symptoms can include shortness of breath, physical and mental fatigue, exercise intolerance, headaches, and muscle and joint pain. However, the <a href="https://www.nature.com/articles/s41591-021-01292-y.pdf" target="_blank" rel="noopener">likelihood</a> of developing this condition appears higher in those who suffer a heavier initial bout of COVID illness. This might be linked with <a href="https://www.cell.com/cell/fulltext/S0092-8674(22)00072-1" target="_blank" rel="noopener">higher viral load</a> at that time. Bottom line As we enter the third year of the COVID pandemic and given that up to one in three infections may be asymptomatic, it is likely many of us have been infected without knowing it. If you are experiencing lingering fatigue, brain fog or other symptoms that could be long COVID, you should talk to your GP. Otherwise, knowing our COVID infection status is unlikely to be of much practical benefit. Antibody testing should be reserved for specific medical or public health indications. Being up-to-date with COVID vaccination is still our best defence against severe illness moving forward.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/178630/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ashwin-swaminathan-1308612" target="_blank" rel="noopener">Ashwin Swaminathan</a>, Senior Lecturer, <a href="https://theconversation.com/institutions/australian-national-university-877" target="_blank" rel="noopener">Australian National University</a> This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-i-have-had-covid-and-not-realised-it-178630" target="_blank" rel="noopener">original article</a>. Image: Getty Images

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A new Covid variant has emerged: Can you get it if you’ve had Covid already?

Health authorities have expressed their concern over the spread of a new variant of COVID-19, with NSW Premier Dominic Perrottet saying they would “tailor settings” if needed. A new subvariant of Omicron, called BA.2, has been recorded across the globe and is the dominating strain in at least 18 countries. Currently, the BA.1 Omicron variant remains the top strain in NSW and Victoria, though NSW Health Minister Brad Hazzard said BA.2 could quickly overtake it and cause cases to double within the next four to six weeks. Other states, including Victoria, are expected to follow suit. It comes as both NSW and Victoria recorded a drop in cases on Friday after experiencing 16,288 and 7779 new cases on Thursday. Appearing on Sunrise, Mr Perrottet said that boosters were the best protection against the new variant, and that authorities would “tailor settings” if required. “The best thing we can do is get boosted,” he <a href="https://7news.com.au/news/coronavirus/ba2-omicron-covid-variant-rapidly-sweeping-the-globe-and-could-see-cases-double-in-nsw--c-6013296" target="_blank" rel="noopener">said</a>. “The virus is not going away.” BA.2 explained The Omicron variant of Covid, the dominant version circulating around the world, is made up of several subvariants called BA.1, BA.2, BA.3 and BA.4, with BA.1 and BA.2 being the most common. These two subvariants differ in their genetic sequences, with some studies finding BA.2 has a growth advantage over BA.1. <a href="https://theconversation.com/coronavirus-variants-viral-mutation-and-covid-19-vaccines-the-science-you-need-to-understand-153771" target="_blank" rel="noopener">According to Richard Kuhn</a>, a professor of biological sciences at Purdue University, a variant with a growth advantage is better than the original virus, meaning it can evolve and be “successful” at spreading. In a <a href="https://www.who.int/news/item/22-02-2022-statement-on-omicron-sublineage-ba.2" target="_blank" rel="noopener">statement</a>, the WHO pointed to initial data suggesting BA.2 appears to be more transmissible than BA.1, though the difference between them is less stark than the difference in transmissibility of Omicron BA.1 versus the Delta strain. Can I get BA.2 if I’ve already had Covid? Though studies investigating BA.2 are ongoing, some initial data suggests that people who have been infected with the Omicron variant are protected from reinfection with BA.2 “for the limited period for which data are available”. In a <a href="https://www.medrxiv.org/content/10.1101/2022.02.19.22271112v1" target="_blank" rel="noopener">Danish study</a>, which is yet to be published or peer-reviewed by other scientists, they sequenced samples from 263 people who had been infected with COVID-19 twice between November 11, 2021 and February 11, 2022. Of these, 47 were found to have contracted BA.1 first and BA.2 second, 50 contracted the same variant twice, and 140 contracted BA.2 after they were infected with Delta. Out of those 47 people, the majority were unvaccinated, under the age of 20, and experienced mild symptoms. The WHO’s Technical Advisory Group on SARS-CoV-2 Virus Evolution (TAG-VE) also considered data from South Africa, the UK, and Denmark to assess the severity of disease caused by BA.2, finding that there was no “reported difference” between it and BA.1. Image: Getty Images

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Ben Fordham slams Dr Swan's Covid "alarmism"

Radio broadcaster Ben Fordham has launched a scathing attack on the ABC's Dr Norman Swan, condemning his "Covid scare campaign" in the wake of the Omicron wave. The 2GB radio host jumped to the defence of Dr Angelique Coetzee, who "discovered" the Omicron variant in South Africa, who claims he has been subject to online "attacks" and abuse from scientists, doctors and global politicians for down-playing the severity of the variant. Fordham called out a series of doctors who he called "Covid alarmists", as he urged listeners not to listen to them after citing low deaths rates from the latest Covid variant. "This doctor [Coetzee] should be celebrated for her groundbreaking research on coronavirus but instead she had people trying to convince her to shut her mouth," he said."The death rate from Omicron is 0.1 per cent. Its fatality rate is the same as a bad flu season in Australia.""But the scare campaign has been in overdrive. At the start of the pandemic we were warned about 150,000 deaths in Australia. We've had 4,300.""All tragic but nothing like we warned about," he said. According to the <a href="https://www.health.gov.au/health-alerts/covid-19" target="_blank" rel="noopener">Australian Department of Health</a>, the Australian death toll has been significantly higher since the Omicron variant, as opposed to the 2021 Delta variant. Fordham went on to slam "Covid cheerleader" Dr Swan who recently claimed that Omicron was not as mild as previously believed and gave little to no natural immunity. "Norman Swan was ignoring the science, he was ignoring the scientist who discovered Omicron," Fordham said.The radio host continued his praise of Dr Coetzee, who said she has been "accused of lying" by many global superpowers. "They are accusing me of lying, of downplaying Omicron because of how it has been in Europe … in their minds, it is impossible for a disease with more than 38 mutations to be mild.""I have stated many times before it can be a serious illness if you are unvaccinated and have comorbidities but for the majority of people it is a mild illness.""If a clinical feature proves I am wrong, then I will apologise."Fordham ended the segment by praising Dr Coetzee, who has vowed to "stick to her guns" and not give in to the pressure."Good on you doctor. Don't give in to the scaremongers," he said.Image credits: Instagram @benfordham9 @norman.swan

Caring

How to look after your mental health if you’re at home with COVID

For many of us, catching COVID and isolating at home can be a lonely, scary and distressing experience. For those with a pre-existing mental illness, it can be even more difficult. The following strategies are designed to help you look after your mental health if you get COVID and are isolating at home. Remember the basics When living in a time of great uncertainty and threat, it can be difficult to remember and practice <a rel="noopener" href="https://www.headtohealth.gov.au/covid-19-support/covid-19-support" target="_blank">simple strategies</a> to maximise wellness. If you’re isolating at home with COVID, it’s important to: <ul> <li> manage fever and other symptoms like aches, pains and sore throat with paracetamol or ibuprofen </li> <li> maintain a healthy diet </li> <li> keep your fluid intake up, particularly if you have a fever </li> <li> <a rel="noopener" href="https://health.clevelandclinic.org/returning-to-sports-or-exercise-after-recovering-from-covid-19/" target="_blank">stop exercise</a> for at least 10 days, and depending on the severity of your symptoms, return to exercise slowly (if you have any questions about returning to exercise, ask your GP) </li> <li> <a rel="noopener" href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-recovery-breathing-exercises" target="_blank">deep breathing</a>, which can help lung function and help you stay calm during isolation and recovery, but this should be done in consultation with your doctor </li> <li> practise <a rel="noopener" href="https://coronavirus.beyondblue.org.au/Managing-my-daily-life/Coping-with-isolation-and-being-at-home/how-mindfulness-can-help-during-the-coronavirus-pandemic" target="_blank">mindfulness</a> to help cope with the inevitable anxiety around illness and isolation </li> <li> find distractions like reading, watching movies or doing a <a rel="noopener" href="https://www.abc.net.au/news/2021-09-15/new-research-supports-arts-for-mental-health/100452968" target="_blank">creative activity</a>, which can help keep your brain from fixating on worry (this is particularly important for children) </li> <li> and stay connected with friends and family, online or over the phone. </li> </ul> It’s important to monitor your COVID symptoms. The Royal Australian College of General Practitioners has a useful <a rel="noopener" href="https://www.racgp.org.au/FSDEDEV/media/documents/Clinical%20Resources/Guidelines/Managing-mild-COVID-19-at-home-with-assistance-from-your-GP.pdf" target="_blank">symptom diary</a> to assist with this. Or use the <a rel="noopener" href="https://www.healthdirect.gov.au/symptom-checker/tool/basic-details" target="_blank">Healthdirect symptom checker</a> to decide whether you need medical help. If you live alone, you should arrange for someone to contact you regularly to make sure you are managing. Some coping strategies to avoid During times of anxiety and uncertainty, such as isolating at home with COVID, it’s understandable people may turn to <a rel="noopener" href="https://adf.org.au/covid-19/" target="_blank">drugs and alcohol</a>, <a rel="noopener" href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00435-1/fulltext" target="_blank">unhealthy eating</a>, <a rel="noopener" href="https://aifs.gov.au/agrc/publications/gambling-australia-during-covid-19" target="_blank">gambling</a>, or other addictions to manage psychological discomfort. These strategies may temporarily alleviate stress. But they can cause more mental health issues in the longer term. It’s also important to avoid “<a rel="noopener" href="https://www.merriam-webster.com/words-at-play/doomsurfing-doomscrolling-words-were-watching" target="_blank">doom scrolling</a>”, which is the tendency to continue to scroll through bad news on your mobile phone, even though the news is saddening, disheartening or depressing. You might want to disengage from mainstream or social media if it has become harmful to your mental health. It’s been extra hard for those with mental illnesses The COVID pandemic has made living with mental illness even more difficult. The last few years have been challenging and exhausting for many. People with mental illnesses, and other chronic conditions, have had to adapt their normal management strategies to cope, shifting care and <a rel="noopener" href="https://www.health.gov.au/initiatives-and-programs/digital-mental-health-services" target="_blank">some forms of therapy online</a>. Recovery from, and management of, mental illness often involves activities like exercise, positive social engagement and therapy – all of which may be limited due to COVID restrictions, financial constraints and staff shortages. Acute services, including hospitals and general practice, are struggling to meet demand. Isolation can be particularly difficult for people who don’t have a <a rel="noopener" href="https://www.nejm.org/doi/full/10.1056/NEJMp2024046" target="_blank">safe and secure home</a>. People experiencing domestic violence have more difficulty accessing care as they may <a rel="noopener" href="https://www.anrows.org.au/publication/covid-19-fast-facts-prevalence-of-domestic-violence-among-women-during-the-covid-19-pandemic/" target="_blank">not be safe interacting with health professionals</a> in their homes. <a rel="noopener" href="https://www.aihw.gov.au/reports/child-protection/child-protection-in-the-time-of-covid-19/summary" target="_blank">Children are at increased risk</a> of harm if they live with domestic violence. They may have no safe places to go when schools or childcare facilities are closed, so family, friends and services like <a rel="noopener" href="https://kidshelpline.com.au/" target="_blank">Kids Helpline</a> play an important role in supporting children. Seeking help There are many resources available to assist you if you’re isolating due to COVID. Your GP can provide advice, help you navigate the health system and treat physical and mental health symptoms, via <a rel="noopener" href="https://www.health.gov.au/sites/default/files/documents/2021/12/medicare-telehealth-services-consumer-information.pdf" target="_blank">telehealth over the phone or online</a>. Medicare rebates for telehealth are available if you have seen the GP face to face in the previous 12 months. The <a rel="noopener" href="https://www.health.gov.au/contacts/national-coronavirus-helpline" target="_blank">National Coronavirus Helpline</a> is a 24-hour service that provides free advice on how to seek medical help. Beyond Blue offers a <a rel="noopener" href="https://coronavirus.beyondblue.org.au/COVID-normal" target="_blank">series of resources</a> for adapting to the pandemic, including for Australians living overseas and people who speak languages other than English. The organisation also offers free counselling during the pandemic. Call 1800 512 348 to speak with a trained mental health professional, or chat online. The federal government provides a free mental health service for people in <a rel="noopener" href="https://headtohelp.org.au" target="_blank">Victoria</a>, <a rel="noopener" href="https://www.headtohealth.gov.au/popup" target="_blank">NSW and the ACT</a> who’ve been affected by the pandemic. Call 1800 595 212 from Monday to Friday, 8:30am-5pm. The <a rel="noopener" href="https://raisingchildren.net.au/guides/raising-healthy-minds" target="_blank">Raising Healthy Minds app</a> has information, ideas and guidance for parents to help them support their child’s mental health and well-being. People who are experiencing domestic violence can access support through calling 1800RESPECT on 1800 737 732 or visiting the organisation’s <a rel="noopener" href="https://1800respect.org.au/" target="_blank">website</a>. Each state and territory also offers <a rel="noopener" href="https://www.healthdirect.gov.au/covid-19-and-mental-health" target="_blank">a mental health service</a> to help you access local support: <ul> <li> ACT — Canberra Health Services Access Mental Health on 1800 629 354 or 02 6205 1065 (available 24/7) </li> <li> NSW — Mental Health Line on 1800 011 511 (available 24/7) </li> <li> NT — Northern Territory Mental Health Line on 1800 682 288 (available 24/7) </li> <li> Queensland — Mental health access line on 1300 642 255 (available 24/7) </li> <li> SA — SA COVID-19 Mental Health Support Line on 1800 632 753 (available 8am-8pm) </li> <li> Tasmania — Mental Health Service Helpline on 1800 332 388 </li> <li> Victoria — Head to Help on 1800 595 212 (available 8:30am-5pm, Monday to Friday) </li> <li> WA — Mental Health Emergency Response Line on 1300 555 788 (metro) or 1800 676 822 (Peel) (available 24/7). </li> </ul> <hr /> If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/174536/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a rel="noopener" href="https://theconversation.com/profiles/louise-stone-454952" target="_blank">Louise Stone</a>, General practitioner; Associate Professor, ANU Medical School, <a rel="noopener" href="https://theconversation.com/institutions/australian-national-university-877" target="_blank">Australian National University</a> This article is republished from <a rel="noopener" href="https://theconversation.com" target="_blank">The Conversation</a> under a Creative Commons license. Read the <a rel="noopener" href="https://theconversation.com/how-to-look-after-your-mental-health-if-youre-at-home-with-covid-174536" target="_blank">original article</a>.

Mind

I just recovered from Omicron – how long does my immunity last?

<div class="copy"> If you recently recovered from an <a rel="noreferrer noopener" href="https://cosmosmagazine.com/health/covid/omicron-update-170122/" target="_blank">Omicron infection</a>, do you now have free rein to do whatever you want without risk of reinfection? And if so, for how long? Two main factors affect how well your acquired immunity after Omicron infection will protect you. First, your antibody levels. “If high levels of neutralising antibodies are elicited to Omicron following infection, then we would expect to see some level of protection against reinfection with Omicron, but this is likely to be short-lived,” says Professor Gilda Tachedjian, a virologist at the Burnet Institute and past president of the Australian Virology Society. Generally, a more severe infection generates a higher level of antibodies than an asymptomatic infection, explains Professor Anthony Cunningham, an infectious diseases physician and clinical virologist at the University of Sydney. But when the level of neutralising antibodies begins to drop, your likelihood of reinfection rises. It’s simply too early to know how long Omicron immunity will last, he says. From vaccine studies, we know that antibody levels begin to drop after three to six months. A <a rel="noreferrer noopener" href="https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(21)00219-6/fulltext" target="_blank">recent study</a> published in The Lancet estimated that reinfection by SARS-CoV-2 under endemic conditions would likely occur between three months and five years after peak antibody response. Almost certainly, Cunningham says, there will be a lot of individual variation, similar to what has been observed with previous strains. This variation depends on the severity of the disease you experienced, and whether you have had a vaccine. The second factor: emerging variants. Our waning antibodies may not be able to target any new variants that come along. The Omicron variant, for example, largely evades immunity from past infection and vaccines. A recent <a rel="noreferrer noopener" href="https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/report-49-Omicron/" target="_blank">report</a> from Imperial College London estimates that the risk of reinfection with Omicron is 5.4 times greater than that of the Delta variant. “The most likely outcome is that you won’t get re-infected with Omicron because the expectation is that the Omicron wave will decline, but then the greatest risk is that another strain comes along,” says Cunningham. “It all depends on what type of strain comes next.” Even if you have had a recent Omicron infection, don’t throw your mask away, warns Cunningham: “The more virus circulates in the world, the more likely it is that we’ll see new strains.” Although protection from reinfection might not last for long, experts think T-cells might come to the rescue. While antibodies directly bind and neutralise virions, preventing an infection, T-cells activate once the infection is established. They target and kill virus-infected cells, helping to clear the infection and reduce its severity. This arm of the immune response tends to be broader than antibodies – and thus more likely to recognise variants, and to last longer, Tachedjian explains. “Hopefully, you will be asymptomatic or have a less severe disease [the second time around].” Image credits: Getty Images </div> <div id="contributors"> This article was originally published on <a href="https://cosmosmagazine.com/health/covid/immunity-after-omicron-infection/">cosmosmagazine.com</a> and was written by Dr Manuela Callari. </div>

Body

Travelling couple share their cruise experience amid Omicron

A couple from Queensland have decided to not let the current wave of Omicron get the best of them and their plans to travel the world. Ed and Patrea Stuttard left their home on the Gold Coast after Christmas to fly to the US and board their first cruise in nearly two years. The retirees are now sailing around the waters of Mexico, and are currently on cruise number three of the six they have planned. The pair are avid cruise-goers, having racked up an impressive 49 voyages before they departed on their current journey. "We just love being on the ocean and just love everything it offers and having had it taken away for nearly two years is really tough, you know, when you're retired. It's just taken away something that we really love," Mrs Stuttard told <a rel="noopener" href="https://9now.nine.com.au/a-current-affair/coronavirus-aussie-couple-sail-on-cruise-ship-amid-omicron-covid19-wave/baef58e9-09fd-47f0-8993-0819bacffed9" target="_blank">A Current Affair</a>. The couple decided to document their recent trip to show other travellers how life on board has changed since the Covid pandemic. They are both hoping the cruising industry back home in Australia soon lifts the two-year ban on international voyages. "That's why we decided to fly out and have New Year's on board a cruise ship, leaving for America. There were no options at home and we can't understand why," Mr Stuttard said. "They are opening up hospitality, they are opening up music venues but they are ignoring the cruise industry and that's just criminal." Both Mr and Mrs Stuttard had to show proof of their double vaccination status before being let on board, as well as returning negative Covid tests. "We had our third shot so we actually feel safer here than we do in our local mall and they are continually reminding people to put on their mask," Mrs Stuttard said. Cleaning protocols on board are endless, with cleaning staff everywhere to make the ship as safe as possible. "We were joking with people earlier today that if you stand still long enough, they'll come and sanitise you. Anything that doesn't move is being wiped down daily," Mr Stuttard said. With life on the waters of Mexico a world away from Australia's current Omicron wave, there is no current plan for the Federal Government to kickstart the cruising industry. Joel Katz from Cruise Lines International Association said Australia desperately needs a plan to get back on the water. "We're saying, 'let's start off with local cruising, carrying locals only', while we still have questions about international tourism," Mr Katz said. He said, "From the early days of the pandemic, the industry has been working with medical experts and epidemiologists to develop the most comprehensive COVID safe protocols out of any sector of travel and tourism." While the waters of Australia remain closed for cruising operations, the Stuttards will remain overseas to continue their care-free life at sea. Image credits: A Current Affair

Cruising

Anthony Callea slams government after testing positive for Covid-19

Anthony Callea has detailed his "scary" experience after testing positive for Covid-19 in a lengthy post on Instagram. The 39-year-old singer said he has been in "the most excruciating pain" since his diagnosis, and has been relying on "a ridiculous amount of pain killers" to help the symptoms. “This sh*t is real and from what I can understand and what my Dr has observed from what I have and am going through, it seems I have the Delta variant,” Callea posted to his 140,000 Instagram followers. “My head felt like it was about to combust, my throat, well I have never felt pain in my throat like that before, it was like someone stabbing me right in the throat!" “My chest was tight, I felt as though I was about to burst my ear drums and my body overall just felt like it was shutting down.” Callea, who is double vaccinated, said he took a rapid test as soon as his symptoms first began, which returned a positive result. “The past 3 days have been really scary. I’ve never felt like this before in my life,” Callea added. “Today is the first day I’m actually feeling somewhat human, I can’t speak from all the coughing, I’m really tired and throat is still sore, but at least I feel alive." “Thankfully I’m double vaxxed, would hate to think what I’d be like if I weren’t.” <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/CYV3XEDPCOP/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/CYV3XEDPCOP/?utm_source=ig_embed&utm_campaign=loading" target="_blank">A post shared by A N T H O N Y C A L L E A (@anthonycallea)</a> </div> </blockquote> Anthony praised his husband, actor Tim Campell - who tested negative - for taking care of him during his isolation period, before lashing out at the federal government for the "shambolic mess" of the pandemic response. “If only our Government would do the right thing by others and it’s people and manage this shambolic mess!” he wrote. “I could go on and on but I don’t have the energy.” Continuing on his rant, Anthony took aim at the government's decision to let tennis champion Novak Djokovic into Australia: a decision that has since been overturned. He said, “Seeing that the Australian Open is allowing Djokovic to play is a slap in the face to every single Australian and business that has done the right thing in the past 2 years,” he said. He finished his lengthy post by telling everyone to stay safe, and his predictions for the future. He wrote, "Stay safe everyone, I feel as though the next few months are going to be a s*** show! Yay to 2022 hey?" Image credits: Instagram @anthonycallea

Caring

Top Covid expert sees an end to pandemic within two months

A top health official in Denmark has predicted that the Covid pandemic could end within two months in some countries, thanks to the Omicron variant. Tyra Grove Krause, the chief epidemiologist at Denmark’s State Serum Institute, told <a rel="noopener" href="https://nyheder.tv2.dk/2022-01-03-ssi-vi-kan-have-vores-normale-liv-tilbage-om-to-maaneder" target="_blank">Danish TV 2</a> that a recent study conducted by the institute has found that Covid hospitalisations have halved with Omicron, as opposed to the previous Delta variant. When questioned about how long the virus will affect daily life in Denmark, she said, “I think it will have that in the next two months, and then I hope the infection will start to subside and we get our normal lives back”. Dr Grove Krause’s research also stated that “Omicron is here to stay”. “It will provide some massive spread of infection in the coming month. When it’s over, we’re in a better place than we were before,” the paper said. Dr Grove Krause claims that daily life may return to normal within a few months as more people are likely to become infected, raising the level of natural immunity for the majority of the population. “Omicron will peak at the end of January, and in February we will see declining infection pressure and a decreasing pressure on the health care system,” she said. “But we have to make an effort in January, because it will be hard to get through”. “In the long run, we are in a place where coronavirus is here, but where we have restrained it, and only the particularly vulnerable need to be vaccinated up to the next winter season,” she said. The optimistic news out of Denmark comes just days after the <a rel="noopener" href="https://www.who.int" target="_blank">World Health Organisation</a> made a similarly positive statement about Omicron. “If we put an end to inequality, we will put an end to the pandemic and the global nightmare that we have all gone through,” WHO chief Tedros Adhanom Ghebreyesus said in a speech on New Year’s Eve. Top US pandemic Adviser Anthony Fauci also said that the experience in South Africa, where the new variant quickly peaked before subsiding, offered some hope to other countries. “When one looked at the relationship and the ratio between hospitalisations and cases (in South Africa), it was lower, the duration of hospital stay was lower, the requirements for oxygen was lower,” he said. “We’re seeing a bit of that, not as pronounced, in the UK, but certainly that trend. And if you look here at the United States, we don’t want to get complacent at all, and you don’t want to jump to a positive conclusion, because it’s still early," he said. Image credits: Getty Images

Caring

Peter “Captain Covid” Helliar asks burning Covid question

Comedian and Project co-host Peter Heliar used an interview with Covid expert Dr Norman Swan to ask for some health advice for himself, a month after battling COVID-19. The 46-year-old suddenly disappeared from the show in early November, revealing shortly after via social media that he had been diagnosed with Covid. Having received both Covid jabs, the comic described his symptoms as no worse than a “mild cold”. On Thursday night’s episode, he took the opportunity to ask Dr Swan what people who had been infected, like himself, should do about getting dose three of the vaccine as the Omicron variant makes its way through the community. <blockquote class="twitter-tweet"> As some states continue to drop restrictions for the unvaccinated, other states are bringing rules back as Omicron continues to spread. Dr <a href="https://twitter.com/normanswan?ref_src=twsrc%5Etfw">@normanswan</a> tells us more.<a href="https://twitter.com/hashtag/TheProjectTV?src=hash&ref_src=twsrc%5Etfw">#TheProjectTV</a> <a href="https://t.co/vU0HGIAaiA">pic.twitter.com/vU0HGIAaiA</a> — The Project (@theprojecttv) <a href="https://twitter.com/theprojecttv/status/1471396116935675907?ref_src=twsrc%5Etfw">December 16, 2021</a></blockquote> “There’s been a lot of different advice for people who’ve had Covid - including myself, Captain Covid - when is the right time?” he <a rel="noopener" href="https://www.news.com.au/entertainment/tv/current-affairs/peter-helliars-one-big-question-after-battling-covid/news-story/481e1a7b3fb9328e95f3aabc21bc2024" target="_blank">asked</a>. “The good news for people who’ve had the infection is it’s the equivalent of having a third dose of the vaccine,” said Dr Swan. “So, Pete, you might be OK, at least for the time being.” “I was double-vaxxed when I got Covid,” Heliar told him. “So you’ve effectively had a third dose, and there’s probably not a breakneck rush. But you’re not going to come to any harm if you have a fourth one, just to be sure,” he advised. Dr Swan also shared some worrying advice for anyone who received doses of AstraZeneca. “Astra, after about 14 or 15 weeks, has zero protection against symptomatic disease,” he said, referring to data which had been released from Britain. “It’s probably got some protection against hospitalisation, but zero protection against symptomatic disease. That’s why the British went for three months (for boosters), and it’s why we should too.” Panellist Jan Fran, who was one of many young Australians to get the AstraZeneca jab, was particularly concerned, and asked how she and others like her could protect themselves against the Omicron variant. “Hearing you say that does not fill me with a lot of confidence,” she said. “What advice do you have for people like me who might be worried they have no protection at all?” Dr Swan reiterated that the AstraZeneca vaccine did protect people against hospitalisation - “but what you’ve got to do, as soon as you’re eligible, is get a booster. Whatever’s available, Pfizer or Moderna. And in the meantime, I’d be wearing a mask and taking a bit of care.” His appearance on the show comes as the country records exponentially growing Covid case numbers, with NSW recording 2213 new cases on Friday. Image: The Project (Twitter)

Caring

We calculated the impact of ‘long COVID’ as Australia opens up. Even without Omicron, we’re worried

Over the past two years, we’ve learned COVID-19 survivors can develop a range of longer-term symptoms we now call “<a href="https://theconversation.com/long-covid-a-public-health-experts-campaign-to-understand-the-disease-152212">long COVID</a>”. This includes people who did not have severe illness initially. Such <a href="https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1">longer-term symptoms</a> can affect multiple systems in the body. This can result in ongoing, severe fatigue plus a wide range of other symptoms, including pain, as well as breathing, neurological, sleep and mental health problems. So far, Australia has had far fewer COVID-19 cases than many other nations. But as we <a href="https://www.australia.gov.au/framework-national-reopening">re-open</a>, this situation may change. So we will likely see more long COVID in the months and years ahead. Our research, which we posted <a href="https://www.researchsquare.com/article/rs-1066181/v1">online as a pre-print</a> and so has yet to be independently verified, examined the shifting burden of disease of COVID-19 as Australia re-opens and as high vaccination rates reduce mortality and severe illness. We show how long COVID will increasingly drive the burden of COVID illness, even as death rates decline. We <a href="https://iht.deakin.edu.au/wp-content/uploads/sites/153/2021/12/Briefing-Paper_Long-Covid_Final.pdf">also estimate</a> the likely numbers of long COVID cases we can expect in Australia over the two years following reopening. We wrote this <a href="https://iht.deakin.edu.au/wp-content/uploads/sites/153/2021/12/Briefing-Paper_Long-Covid_Final.pdf">briefing paper</a> before the rise of Omicron, the impact of which we’re yet to fully understand. <h2>Here’s what we did and what we found</h2> We examined the 2021 Delta outbreaks in <a href="https://www.coronavirus.vic.gov.au/victorian-coronavirus-covid-19-data">Victoria</a> and <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Documents/covid-19-surveillance-report-20211111.pdf">New South Wales</a> in which nearly 140,000 people had been infected by the end of October. We estimated long COVID prevalence using two sources. A large dataset <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/1april2021">from the UK</a> found more than 13% of people had symptoms after 12 weeks. A much smaller study <a href="https://www.sciencedirect.com/science/article/pii/S2666606521001024?via%3Dihub">conducted in NSW</a> found about 5% had symptoms over roughly the same period. Our modelling suggests, by the end of October, the combined Victoria and NSW outbreaks may <a href="https://iht.deakin.edu.au/wp-content/uploads/sites/153/2021/12/Briefing-Paper_Long-Covid_Final.pdf">have already led to</a> 9,450–19,800 people having developed long COVID that could last 12 weeks after their COVID infection. Even more will have experienced long COVID symptoms for a shorter time: 34,000-44,500 people will likely have symptoms for at least three weeks after first becoming ill, but our model indicates more than half will then recover over the following nine weeks. We also estimated the likely consequences for long COVID if we follow Australia’s national re-opening plan, based on interim modelling from the <a href="https://www.doherty.edu.au/uploads/content_doc/DOHERTY_MODELLING_INTERIM_REPORT_TO_NATIONAL_CABINET_17TH_SEPTEMBER_2021.pdf">Doherty Institute</a>, which has since been updated. The Doherty Institute modelled various scenarios with different vaccination rates and public health measures in place. These gave different estimates of COVID-19 cases. We combined these with our upper and lower estimates for long COVID prevalence. We calculated that more limited relaxation of public health measures could generate 10,000-34,000 long COVID cases (people with symptoms lasting at least 12 weeks). More complete relaxation of public health measures could lead to 60,000-133,000 long COVID cases. Based on the longer-term UK data for long COVID prevalence, we calculated 2,000-11,000 people might still be sick a year after their initial infection. What we cannot be absolutely certain about is the impact of vaccination on the expected number of long COVID cases. Some studies suggest that if vaccinated people become infected, this reduces their chance of developing long COVID, but <a href="https://www.nature.com/articles/d41586-021-03495-2">the evidence remains uncertain</a>. <h2>Many impacts, beyond health</h2> Long COVID can be a debilitating and distressing health condition. It also has a number of economic impacts, for the health system and people’s ability to work. For instance, people with long COVID require <a href="https://ahha.asn.au/publication/health-policy-issue-briefs/deeble-issues-brief-no-40-managing-long-term-health">coordinated care</a> across a range of different health services and specialties. Recent data from the UK’s <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/2december2021">Office for National Statistics</a> indicate that around 1.2 million people reported long COVID symptoms in the four weeks to the end of October. The UK health secretary <a href="https://www.independent.co.uk/news/health/sajid-javid-long-covid-nhs-b1934861.html">said he was alarmed</a> at the growing scale of this problem for the National Health Service. Indeed, attempts to provide long COVID care through specialised hospital-based clinics in the UK and elsewhere have led to <a href="https://www.thetimes.co.uk/article/long-queues-for-long-covid-clinics-jk8jr7tt6">long waiting times and uneven access</a>. <a href="https://images.theconversation.com/files/436524/original/file-20211209-23-1lleiea.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/436524/original/file-20211209-23-1lleiea.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" alt="Exhausted health worker leaning on hospital wall holding cup of coffee" /></a> Health systems will be under strain, particularly if health workers are struggling with long COVID. <a href="https://www.shutterstock.com/image-photo/portrait-tired-exhausted-nurse-doctor-having-1698233623" class="source">Shutterstock</a> By contrast, Australia needs to <a href="https://ahha.asn.au/publication/health-policy-issue-briefs/deeble-issues-brief-no-40-managing-long-term-health">focus urgently on</a> identifying and counting long COVID. It also needs to establish mechanisms to coordinate care for long COVID by mobilising resources across the community and private sectors, not just public hospitals. Meeting the emerging needs of people with long COVID represents an additional burden on health-care systems <a href="https://www.mja.com.au/journal/2021/215/11/entering-australias-third-year-covid-19">already battered</a> by COVID and rapidly rising backlogs of care for other conditions. If health-care workers are <a href="https://pubmed.ncbi.nlm.nih.gov/33830208/">particularly at risk</a> of long COVID as some people claim, this will further stretch health systems as they take time out to recover or leave the workforce. Beyond health care, long COVID again highlights weaknesses which were made clear early in the COVID-19 pandemic, but which have not yet been remedied. COVID-19 has <a href="https://www.theguardian.com/australia-news/datablog/2021/oct/12/delta-deaths-expose-australias-great-disadvantage-divide">more severely affected</a> those who are socially and economically disadvantaged, and who rely on insecure employment. We expect long COVID to continue to be over-represented in this already disadvantaged population. <h2>Avoiding COVID-19 in the first place</h2> While societies around the world grapple with addressing the types of disadvantage the pandemic has exposed, there are several steps individual people can take to minimise their risk of long COVID. Obviously, this means minimising your risk of COVID-19 in the first place. This means vaccination, mask wearing where appropriate, and complying with other public health measures. Meanwhile, if you test positive for COVID-19, isolate early, rest and do not return to work until you have fully recovered.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/168662/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/martin-hensher-856597">Martin Hensher</a>, Associate Professor of Health Systems Financing & Organisation, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/mary-rose-angeles-1274581">Mary Rose Angeles</a>, Associate Research Fellow, Health System Financing and Sustainability, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-calculated-the-impact-of-long-covid-as-australia-opens-up-even-without-omicron-were-worried-168662">original article</a>. Image: Shutterstock

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Pfizer booster may offer important protection against Omicron variant

Pfizer has announced that a booster of its COVID-19 vaccine may improve protection against the new Omicron variant of the virus. Pfizer and its partner BioNTech said on Wednesday that while two doses of the vaccine may not be sufficient protection against the Omicron variant, lab tests showed that a booster shot increased people’s levels of antibodies capable of fighting Omicron by 25-fold. For those who have not yet received a booster, two doses should still prevent severe disease or death. Health authorities in Australia, the US and around the world have been urging those eligible to get a third dose as soon as they are able. Dr Mikael Dolsten, Pfizer’s chief scientific officer, told the Associated Press, "Go and get your third boost as soon as possible. This is comforting and a very positive message that we now have a plan that will induce immunity that is likely to protect from infection, symptomatic illness and severe disease from now across the entire winter season." US President Joe Biden said the Pfizer booster news was “very encouraging” although he cautioned, “that’s the lab report. There’s more studies going on.” The findings were announced in a press release and have not yet been subject to scientific review. Pfizer tested blood samples taken a month after a booster had been administered and found that people had levels of Omicron-neutralising antibodies that were similar to amounts proven protective against earlier variants after two doses. It’s important to note that scientists don’t yet know how big a threat the Omicron variant is. Delta remains responsible for most of the current COVID-19 cases around the world, but the Omicron variant carries an unusually large number of mutations, and scientists are working quickly to learn how easily it spreads, whether it causes more serious illness than other variants, and how resistant it might be to vaccines. Image: Jasmin Merdan

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WHO finally releases positive Omicron news

Top scientists at the World Health Organisation (WHO) have provided a positive update about the severity of the Omicron COVID-19 variant, but caution that more research is needed. The organisation's second-in-command said the new variant seems to be no worse than any other strain according to “preliminary data”. “In fact, if anything, the direction is towards less severity,” WHO emergencies director Michael Ryan <a rel="noopener" href="https://www.news.com.au/technology/science/who-provides-positive-omicron-news-but-says-more-research-is-needed/news-story/2792b33c69d75dcdc651e69e499cea81" target="_blank">said</a> in an interview, though he stressed that more research was needed to confirm the findings. Mr Ryan also said it was “highly unlikely” that existing Covid vaccines would be completely ineffective against Omicron. “We have highly effective vaccines that have proved effective against all variants so far, in terms of severe disease and hospitalisation … There’s no reason to expect that it wouldn’t be so [for Omicron]," he added. However, he acknowledged that it was possible that current vaccines could be less effective against Omicron. The update comes as lab tests of the new variant in South Africa suggest it could partially evade the Pfizer vaccine. The <a rel="noopener" href="https://www.ahri.org/wp-content/uploads/2021/12/MEDRXIV-2021-267417v1-Sigal.pdf" target="_blank">South African study</a> - which is yet to be published or peer-reviewed - suggests that the Pfizer vaccine isn’t fully effective against the Omicron variant, finding that the vaccine may have fewer antibodies that can neutralise the new strain. Professor Alex Sigal, a virologist at the Africa Health Research Institute and the study’s leader, said Omicron’s ability to evade the vaccine antibodies is “incomplete”, the <a rel="noopener" href="https://www.bbc.com/news/world-59573037" target="_blank">BBC</a> reported. Professor Penny Ward, a visiting Professor at King’s College London, <a rel="noopener" href="https://www.sciencemediacentre.org/expert-reaction-to-preprint-of-lab-study-from-south-africa-looking-at-omicron-and-extent-of-pfizer-vaccine-immune-escape/" target="_blank">said</a> that the findings are unsurprising, given the large number of mutations found in the Omicron strain. Despite the decreased effectiveness, Professor Sigal said that vaccination, combined with previous infection, could still protect individuals from severe symptoms. This also suggests that boosters could be of significant benefit. However, more work will be needed to confirm these findings, due to the study’s small sample size of only 12 patients. More data on the effectiveness of the vaccine against Omicron is expected to be released in the coming days. No significant data has been released confirming the effectiveness of the Moderna, AstraZeneca, or other vaccines against the variant. Image: Getty Images

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Superspreader fears for over 100 people on party boat

At least 140 people could have potentially been exposed to the Omicron variant of COVID-19 during a Sydney Harbour boat party. NSW Health has confirmed that five people who attended the party on Friday December 3 have tested positive for COVID-19, and genome sequencing is underway to determine if any of them have the new strain of the virus. According to NSW Health, “Preliminary results indicate two are likely to have it.” The party took place on a boat operated by Cadman Cruises, and was jointly billed as “Flow Fridays — 90s Themed Boat Party” and “Freaky Sunday Afrovibe: The Last Dance”. It left King Street Wharf at 7.30 pm and returned four hours later. Contact tracers are working to get in touch with the roughly 140 attendees who checked in using a QR code, and all are being told that they must immediately get tested, isolate, and await further public advice. All known positive cases are currently isolating at home. So far, 31 cases of the Omicron variant have been detected in NSW, after six new cases were confirmed on Tuesday, and 10 on Monday. Of those 31 cases, 20 are linked to two Sydney schools – Regents Park Christian School and St Peter Chanel Catholic Primary School, both in Regents Park – and the Sydney Indoor Climbing Gym in Villawood. Eleven of the known Omicron cases were acquired overseas or on an international flight. So far, no Omicron cases have been admitted to hospital for treatment in NSW. Five Omicron cases have been detected in the ACT and one in the Northern Territory, while one possible case remains under investigation in Victoria. Image: wundervisuals

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"The scariest answer I've heard this year": Waleed Aly's Omicron shock

Image: The Project Leading US epidemiologist Eric Feigl-Ding has issued a dire warning to those unconcerned about the new Omicron variant, saying that the notion that this strain is a milder version of the disease is a “sweet little lie”. Appearing on Monday’s episode of The Project, Feigl-Ding’s worrying predictions clearly rattled host Waleed Aly, who dubbed one of the public health scientist’s responses “the scariest answer I’ve heard this year.” Feigl-Ding told The Project hosts that with a new variant circulating, Australians should be vaccinating children “as soon as possible”. “There’s been a lot of misinformation last year that kids can’t be infected, kids are immune – that’s not true. If anything, the Delta variant is much more severe in children, hospitalisation rates are much higher, and that’s before Omicron,” he said. “Kids do get sick, kids do get hospitalised and they do die. Please protect them against Omicron – vaccinating them is of the highest urgency.” The Project panellist Peter Helliar then asked where we might be in the life of this pandemic, prompting a dispiriting answer from Feigl-Ding, who says it is “far from over,” pointing to what he called a “vaccine apartheid” in regions like southern Africa, where new variants are able to emerge in populations with low vaccination rates. Feigl-Ding noted that the WHO had already announced they may switch to using stars and constellations if they run out of Greek letters to name Covid variants – a fact that left host Aly stunned. “I am petrified that the thing they went to after the Greek alphabet was the universe," he said, referring to the new variant's name. "As though we needed something that infinite to capture what might happen in the pandemic. That is the scariest answer I think I’ve heard this year.” Not all medical experts share Feigl-Ding’s views on Omicron – one leading voice even believes Omicron could, counterintuitively, spell “the end of Covid”. “I actually think there is a silver lining here, and this may signal the end of Covid-19, with it attenuating itself to such an extent that it is highly contagious but does not cause severe disease. That’s what happened with Spanish flu,” says Dr Richard Friedland, CEO of the Netcare Group, which operates more than 50 hospitals in South Africa.

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Hospitalisation of children sparks concern over Omicron Covid variant

A South African doctor has expressed concern over the effects of the new Omicron COVID-19 variant on children, saying that more have been hospitalised with moderate to severe symptoms as a result. Dr Rudo Mathivha, head of Intensive Care at Chris Hani Baragwanath hospital, said the number of patients reporting to hospitals has increased exponentially since the new variant took hold. She said the hospital has reportedly admitted around 5-10 children at a time. The doctor also spoke of a 15-year-old with the virus who had died after his condition rapidly deteriorated, as well as of a 17-year-old who had been placed on a ventilator in ICU with coronavirus-related pneumonia. However, it is unclear whether they both had the Omicron variant. “The situation is pretty concerning,” Dr Mathivha told the South African Broadcasting Corporation (SABC). <blockquote class="twitter-tweet"> The omicron variant is sending more children to hospital in South Africa. Infants, who largely only had a mild course of illness with previous variants are now experiencing moderate to severe symptoms. H/T: <a href="https://twitter.com/KatePri35772611?ref_src=twsrc%5Etfw">@KatePri35772611</a> & <a href="https://twitter.com/NjbBari3?ref_src=twsrc%5Etfw">@NjbBari3</a>.<a href="https://t.co/DmdM47dGts">pic.twitter.com/DmdM47dGts</a> — Dr Zoë Hyde (@DrZoeHyde) <a href="https://twitter.com/DrZoeHyde/status/1467377852274266112?ref_src=twsrc%5Etfw">December 5, 2021</a></blockquote> “Because this is not something that we had observed with the first, second and third wave. “... In the past, the children used to get a Covid infection … and it wouldn’t really put them down, it wouldn’t really send them to hospital in big numbers to be admitted. “We are now seeing them coming in with moderate to severe symptoms needing supplemental oxygen, needing supportive therapy, needing to stay in hospital for quite a number of days. “But what really broke my heart yesterday was a 15-year-old previously well child, no illness. Two day history of fever, comes into the hospital, tests positive for Covid and literally deteriorates in front of our eyes and nothing, no supportive therapy that we could do could help him. Dr Mathivha <a rel="noopener" href="https://www.nzherald.co.nz/world/covid-19-omicron-outbreak-children-hospitalised-with-moderate-to-severe-symptoms/QCNS4VJU3H2WEN3UOJU5PEZXYM/" target="_blank">said</a> the boy was the first “child who had no comorbidities, and nothing existing before” who had died of Covid that she was aware of. <blockquote class="twitter-tweet"> Stark warning from experienced clinician at the front line. Hospitals are not made to handle mass paediatric casualties of the toddler age group. Not only in South Africa… anywhere… <a href="https://t.co/RkrF0jbaJs">pic.twitter.com/RkrF0jbaJs</a> — #MasksInSchools Dr Noor Bari (@NjbBari3) <a href="https://twitter.com/NjbBari3/status/1467300490790592519?ref_src=twsrc%5Etfw">December 5, 2021</a></blockquote> She also warned that the hospital may not be able to accommodate any more children soon, describing it as a “major problem” for the hospital to face. “Our hospitals were not built to house a lot of children. Because naturally children do not get that sick in multitude,” she explained. “We will not be able to accommodate them, and I’m not saying this to make people panic. “I am saying this to say, all these preventive measures we take to interrupt the transmission of Covid let them be applied to the children as well.” As South Africa faces its fourth wave of the virus, children remain ineligible for vaccination. The South African Government said the new variant of COVID-19 has been disproportionately affecting children under five, while experts rubbish the idea that the variant is “mild”. “The incidence in those under five is now second highest, second only to those over 60,” government advisor Waasila Jassat told reporters in Johannesburg. She said there has been “quite a sharp increase” in hospital admissions “across all groups but particularly in the under five” demographic. Though the Omicron variant was first detected in Botswana, the neighbouring country of South Africa has become the epicentre of the strain, with the city of Tshwane, in the Gauteng province, becoming one of the worst affected regions. An analysis by South Africa’s National Institute for Communicable Diseases (NICD) has found a recent surge in toddlers being admitted to hospital due to Covid. Dr Waasila Jassat, from the NICD, said young children seemed to be “more at risk”, but it was unclear whether the surge in admissions was linked to Omicron. “When you look at the numbers of admission by age, what we normally see is a large number of admissions in older people,” Dr Jassat said during a media briefing held by the Department of Health. “But in this early resurgence in Tshwane, we are seeing most admissions in the 0-2 age group. And we are seeing a large number of admissions in the middle ages, sort of around 28 to 38.” Dr Jassat noted that the trend could be due to children under 12 still being unvaccinated, and because parents were more concerned about the new variant, making them more likely to take their children to hospital at the first signs of illness. “The very young children have an immature immune system and they are also not vaccinated, so they are more at risk.” Image: Getty Images

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Why Omicron could be our "get out of pandemic" card

A leading epidemiologist has discussed how the new Covid-19 Omicron variant could be the "blessing" experts have been waiting for. Appearing on <a rel="noopener" href="https://7news.com.au/sunrise/on-the-show/leading-epidemiologist-claims-omicron-could-be-our-way-out-of-pandemic-c-4782308" target="_blank">Sunrise</a>, Professor Tony Blakely said Omicron could be the pathway out of the pandemic if it proves to be more infectious but less severe, as experts have predicted. “A year ago we were hoping that a more infectious, but less virulent variant comes along, which is what Omicron might be,” he said on Thursday. The variant was first reported after cases emerged in South Africa, and initial reports indicate that the new strain of the virus is more transmissible but causes less severe illness than Delta. The <a rel="noopener" href="https://7news.com.au/sunrise/on-the-show/leading-epidemiologist-claims-omicron-could-be-our-way-out-of-pandemic-c-4782308" target="_blank">World Health Organisation</a> expected to be able to provide clearer information on the Omicron variant "within days". The University of Melbourne virus expert has said there are early signs that Omicron could "displace" the dominant Delta strain, while also stressing that it is too early to make an official statement. “This one should be more mild, but we don’t know exactly how much more mild it is, so that means that the hospitalisation rate should be less severe,” he explained.” “It might become our get out of the pandemic card.” Despite this seemingly good news, Professor Blakely also warned that although Omicron appears to be less dangerous than Delta, the next strain may not be. “There will be more variants, and it is not guaranteed that the variant after Omicron and the next one will each be milder, it could become more severe.” “So it’s a really interesting time to be an epidemiologist.” Image credits: Getty Images / Sunrise

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Is my RAT actually working? How to tell if your COVID test can detect Omicron