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For a century, it’s been illegal to swim in the Seine. Will Paris’s clean-up make the river safe for Olympic swimmers?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/ian-a-wright-5162">Ian A. Wright</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p>Five eagerly anticipated events in the Paris Olympics will be the mens and womens 10 kilometre marathon swimming races, as well as the 1,500 metre swimming section of three triathlon events. Why? Because all will be held in the Seine River in the centre of Paris. The swimmers – including <a href="https://www.swimmingworldmagazine.com/news/trio-complete-an-historic-australian-olympic-marathon-swim-team-for-paris-2024">four Australians</a> – will pass famous landmarks such as the Musee d'Orsay as they swim through the historic heart of the city. This will have enormous scenic appeal for spectators.</p> <p>But will it be safe for swimmers? Rivers running through large cities are <a href="https://www.nature.com/articles/s42949-021-00026-w">often polluted</a>, whether from stormwater, chemical pollution or wastewater spills. As the marathon swimmers pass the <a href="https://musee-egouts.paris.fr/en/">Paris Sewer Museum</a>, they may well wonder if they’re in clean water.</p> <p>For more than 100 years, swimming in the Seine has actually been illegal, due to concerns over what the water could do to human health. Authorities <a href="https://www.theguardian.com/sport/article/2024/may/24/olympic-games-clean-up-aims-to-leave-parisians-swimming-in-the-seine">have been working</a> to clean up the water, spending A$2.2 billion (€1.3 billion) on improving water quality. The goal: cut bacterial contamination by 75% before the first swimmer touches the water. These measures are having an impact – but recent heavy rains have seen bacteria levels spike.</p> <p>While officials have put on brave faces, there’s now a <a href="https://www.reuters.com/sports/olympics/paris-2024-sets-up-reserve-site-marathon-swimming-if-seine-unsuitable-2024-07-05/">contingency plan</a> in case the Seine isn’t safe.</p> <h2>Why swim in the Seine at all?</h2> <p>Urban rivers have a questionable reputation. But this isn’t the first time the Seine River has been used for Olympic swimming.</p> <p>In the 1900 Paris Olympics, <a href="https://olympics.com/en/olympic-games/paris-1900/results/swimming">seven swimming events</a> were all held in the river. These games were the first modern Olympics where <a href="https://olympics.com/ioc/faq/history-and-origin-of-the-games/when-did-women-first-compete-in-the-olympic-games">women could compete</a> in some sports, but swimming was not one of those permitted.</p> <p>The Australian swimmer who competed, Frederick Lane, had to swim under the United Kingdom’s flag as Australia did not have a flag until Federation the following year. He won two gold medals. One was for the 200 metre freestyle race, and the other for a bizarre race never held again: the 200m <a href="https://www.olympedia.org/results/4433">swimming obstacle race</a>, where swimmers had to climb over poles and boats. These Olympics also saw the first and last underwater swimming race, which was also in the Seine.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/606823/original/file-20240715-17-kajph6.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/606823/original/file-20240715-17-kajph6.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/606823/original/file-20240715-17-kajph6.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=378&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/606823/original/file-20240715-17-kajph6.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=378&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/606823/original/file-20240715-17-kajph6.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=378&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/606823/original/file-20240715-17-kajph6.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=475&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/606823/original/file-20240715-17-kajph6.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=475&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/606823/original/file-20240715-17-kajph6.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=475&amp;fit=crop&amp;dpr=3 2262w" alt="historic photo swimming seine river paris" /></a><figcaption><span class="caption">Swimmers took to the Seine’s waters at the 1900 Paris Olympics, when the river ran cleaner.</span> <span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Swimming_1900.jpg">Wikimedia Commons</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure> <p>Back then, the waters of the Seine were cleaner. That’s because there was a great demand for human waste on farms – and cities were the main source. Back then, “night soil” (human waste) had a <a href="https://hess.copernicus.org/articles/11/1757/2007/hess-11-1757-2007.pdf">real market value</a>. No one would think of dumping it in rivers.</p> <p>But as time went on, sewerage systems developed and other fertilisers such as guano and mineral fertilisers arrived. By the early 20th century, most of the city’s wastewater went into the Seine. In 1923, the swimming ban came into effect. A year later, Paris hosted the Olympics for its second time – and swimmers competed in 50 metre pools.</p> <p>In recent years, many cities around the world have worked to clean up their urban waterways. River swimming is <a href="https://www.timeout.com/news/the-european-cities-cleaning-up-rivers-for-wild-swimmers-101821">now common</a> in cities such as Copenhagen, Berlin and Vienna, where river health has improved dramatically.</p> <h2>How can you clean a river like the Seine?</h2> <p>Cleaning the Seine is a challenge. Paris is home to 11 million people, with plenty of industry. Urban rivers are almost inevitably polluted by waste from the <a href="https://www.nature.com/articles/s42949-021-00026-w%5D">surrounding city</a>.</p> <p>Leaking and overflowing sewage systems are a major source of pollution. In places like the UK, <a href="https://www.bbc.com/news/explainers-62631320">sewage spills</a> into waterways have become a major political issue.</p> <p>When wastewater spills into rivers, it carries pollutants and dangerous loads of <a href="https://www.cdc.gov/mmwr/volumes/67/wr/mm6725a1.htm">disease-causing microorganisms</a>, such as <em>Escherichia coli</em> (commonly known as E. coli). Untreated water can have viruses, bacteria and disease-causing protozoa.</p> <p>In the lead-up to the Paris games, authorities have been working to improve water quality enough to bring some Olympic swimming back to the Seine. Stormwater – often contaminated by dog poo or sewage overflows – is <a href="https://www.theguardian.com/environment/2023/oct/08/can-paris-clean-seine-for-next-year-2024-olympics">being cleaned</a> before it is released into the river.</p> <p>Despite the money and effort, there are still real questions over whether it will be enough to guarantee swimmer safety. Bacterial levels hit risky levels <a href="https://edition.cnn.com/2024/07/11/sport/paris-olympics-seine-triathlon-bacteria-spiking-intl/index.html">most days in June</a> due to unseasonally heavy rains, but the water has <a href="https://www.france24.com/en/france/20240712-seine-clean-enough-to-swim-for-most-of-past-12-days-paris-says-ahead-of-olympics">improved in July</a>.</p> <p>This week, French sports minister Amélie Oudéa-Castéra <a href="https://www.nbclosangeles.com/paris-2024-summer-olympics/french-sports-minister-takes-dip-in-seine-river-2024-paris-olympics/3458469/">swam a few metres</a> in the Seine in an effort to douse concerns.</p> <p>By contrast, the other Olympic swimming events will take place in a recently constructed 50 metre pool, which will have very good water quality. The pool water is filtered and treated with a disinfectant such as chlorine or bromine. It will be regularly tested to ensure optimal water quality.</p> <p>At the Tokyo 2020 Olympics, triathletes had to swim in polluted Tokyo Bay. But similar concerns over sickness proved unfounded. The real challenge was the <a href="https://www.theguardian.com/environment/2021/aug/05/olympic-athletes-and-volunteers-in-tokyo-tortured-by-heat">oppressive heat</a>.</p> <h2>What’s at risk?</h2> <p>The most likely outcome if races are held when bacterial levels are unsafe would be getting a gastrointestinal bug.</p> <p>Officials have some control over this. Contamination is worst after heavy rain. Races could be delayed if need be.</p> <p>Many swimmers – especially those who compete in open-water competitions – are familiar with swimming in water with some level of pollution. Some see it as worth the risk. Italian double world champion swimmer Gregorio Paltrinieri <a href="https://www.france24.com/en/live-news/20240226-paris-holds-its-breath-for-olympic-swimming-events-in-murky-seine">said in January</a>:</p> <blockquote> <p>Even if the water is dirty, I would rather swim in an electric atmosphere in the centre of Paris than in an anonymous stretch of water.</p> </blockquote> <p>Paris 2024 organisers previously warned there was no plan B for the 10 km marathon races in the Seine if water quality testing is unsuitable. But this has now changed. If the river isn’t clean enough, open water swimming <a href="https://www.reuters.com/sports/olympics/paris-2024-sets-up-reserve-site-marathon-swimming-if-seine-unsuitable-2024-07-05/">will be moved</a> to the rowing venue.</p> <p>The Olympic triathlon is planned around a swimming leg in the Seine. But triathletes <a href="https://www.espn.com.au/olympics/story/_/id/39912675/triathlon-leg-cancelled-seine-quality-paris-2024-chief">have been told</a> the swim leg could be skipped if the water is unsafe, which would turn the race into a running and cycling duathlon.</p> <p>As the world’s attention turns to Paris, there will be many anxious officials behind the scenes hoping their hard work on making the Seine swimmable pays off.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/231705/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/ian-a-wright-5162">Ian A. Wright</a>, Associate Professor in Environmental Science, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a></em></p> <p><em>Image credits: CARON/ZEPPELIN/SIPA/Shutterstock Editorial </em></p> <p><em>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/for-a-century-its-been-illegal-to-swim-in-the-seine-will-pariss-clean-up-make-the-river-safe-for-olympic-swimmers-231705">original article</a>.</em></p> </div>

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Are you up to date with your COVID, flu and other shots? It might depend on who your GP is

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/anika-stobart-1014358">Anika Stobart</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em></p> <p>Too many older Australians are <a href="https://grattan.edu.au/wp-content/uploads/2023/11/A-fair-shot-How-to-close-the-vaccination-gap-Grattan-Institute-Report.pdf">missing out</a> on recommended vaccinations for COVID, flu, shingles and pneumococcal that can protect them from serious illness, hospitalisation and even death.</p> <p>A new <a href="https://grattan.edu.au/">Grattan Institute report</a> shows vaccination rates vary widely from GP to GP, highlighting an important place to look for opportunities to boost vaccination.</p> <p>Many people get vaccinated at pharmacies, and those vaccinations are counted in our analysis. But we looked at GPs because they have a unique role overseeing someone’s health care, and an important role promoting vaccination.</p> <p>We found that for some GPs, nine in ten of their older patients were vaccinated for flu. For others, the rate was only four in ten. The differences for shingles and COVID were even bigger. For pneumococcal disease, there was a 13-fold difference in GPs’ patient vaccination rates.</p> <p>While some variation is inevitable, these differences are large, and they result in too many people missing out on recommended vaccines.</p> <h2>Some GPs treat more complex patients</h2> <p>A lot of these differences reflect the fact that GPs see different types of patients.</p> <p>Our research shows older people who aren’t proficient in English are up to 15% less likely to be vaccinated, even after other factors are taken into account. And the problem seems to be getting worse.</p> <p>COVID vaccination rates for people 75 years and older fell to just 36% in May 2024. But rates were even lower – a mere 11% – for people who don’t speak English proficiently, and 15% for those who speak a language other than English at home.</p> <p>Given these results, it’s no surprise that GPs with fewer patients who are vaccinated also have more patients who struggle with English. For GPs with the lowest vaccination rates, one-quarter of their patients aren’t proficient in English. For GPs with the highest vaccination rates, it is only 1%.</p> <p>GPs with fewer vaccinated patients also saw more people who live in rural areas, are poorer, didn’t go to university, and don’t have regular access to a GP, all of which reduce the likelihood of getting vaccinated.</p> <p>Many of these barriers to vaccination are difficult for GPs to overcome. They point to structural problems in our health system, and indeed our society, that go well beyond vaccination.</p> <p>But GPs are also a key part of the puzzle. A <a href="https://www.ijidonline.com/article/S1201-9712(14)01379-4/fulltext">strong</a> <a href="https://www.tandfonline.com/doi/full/10.1080/21645515.2020.1780848">recommendation</a> from a GP can make a big difference to whether a patient gets vaccinated. <a href="https://www.aihw.gov.au/reports/primary-health-care/general-practice-allied-health-primary-care">Nearly all</a> older Australians visit a GP every year. And some GPs have room for improvement.</p> <h2>But GPs seeing similar patients can have very different vaccination rates</h2> <p>We compared GPs whose patients had a similar likelihood of being vaccinated, based on a range of factors including their health, wealth and cultural background.</p> <p>Among the GPs whose patients were least likely to get a flu vaccination, some saw less than 40% of their patients vaccinated, while for others in that group, the rate was over 70%.</p> <p>Among GPs with patients who face few barriers to vaccination, the share of their patients who were vaccinated also varied widely.</p> <p>Even within neighbourhoods, GP patient vaccination rates vary a lot. For example, in Bankstown in Sydney, there was a seven-fold difference in COVID vaccination rates and an 18-fold difference for pneumococcal vaccination.</p> <p>Not everything about clinics and patients can be measured in data, and there will be good reasons for some of these differences.</p> <p>But the results do suggest that some GPs are beating the odds to overcome patient barriers to getting vaccinated, while other GPs could be doing more. That should trigger focused efforts to raise vaccination rates where they are low.</p> <h2>So what should governments do?</h2> <p>A comprehensive national reform agenda is <a href="https://grattan.edu.au/wp-content/uploads/2023/11/A-fair-shot-How-to-close-the-vaccination-gap-Grattan-Institute-Report.pdf">needed to increase adult vaccination</a>. That includes clearer guidance, national advertising campaigns, SMS reminders, and tailored local programs that reach out to communities with very low levels of vaccination.</p> <p>But based on the big differences in GPs’ patient vaccination rates, Australia also needs a three-pronged plan to help GPs lift older Australians’ vaccination rates.</p> <p>First, the way general practice is funded needs to be overhauled, providing more money for the GPs whose patients face higher barriers to vaccination. Today, clinics with patients who are poorer, sicker and who struggle with English tend to get less funding. They should get more, so they can spend more time with patients to explain and promote vaccination.</p> <p>Second, GPs need to be given data, so that they can easily see how their vaccination rates compare to GPs with similar patients.</p> <p>And third, Primary Health Networks – which are responsible for improving primary care in their area – should give clinics with low vaccination rates the help they need. That might include running vaccination sessions, sharing information about best practices that work in similar clinics with higher vaccination rates, or offering translation support.</p> <p>And because pharmacies also play an important role in promoting and providing vaccines, governments should give them data too, showing how their rates compare to other pharmacies in their area, and support to boost vaccination uptake.</p> <p>These measures would go a long way to better protect some of the most vulnerable in our society. Governments have better data than ever before on who is missing out on vaccinations – and other types of health care.</p> <p>They shouldn’t miss the opportunity to target support so that no matter where you live, what your background is, or which GP or pharmacy you go to, you will have the best chance of being protected against disease.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/234175/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/peter-breadon-1348098"><em>Peter Breadon</em></a><em>, Program Director, Health and Aged Care, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/anika-stobart-1014358">Anika Stobart</a>, Senior Associate, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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/are-you-up-to-date-with-your-covid-flu-and-other-shots-it-might-depend-on-who-your-gp-is-234175">original article</a>.</em></p> </div>

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We finally know why some people got COVID while others didn’t

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/marko-nikolic-1543289">Marko Nikolic</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> and <a href="https://theconversation.com/profiles/kaylee-worlock-1543639">Kaylee Worlock</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a></em></p> <p>Throughout the pandemic, one of the key questions on everyone’s mind was why some people avoided getting COVID, while others caught the virus multiple times.</p> <p>Through a collaboration between University College London, the Wellcome Sanger Institute and Imperial College London in the UK, we set out to answer this question using the world’s first controlled <a href="https://www.nature.com/articles/s41591-022-01780-9">“challenge trial” for COVID</a> – where volunteers were deliberately exposed to SARS-CoV-2, the virus that causes COVID, so that it could be studied in great detail.</p> <p>Unvaccinated healthy volunteers with no prior history of COVID were exposed – via a nasal spray – to an extremely low dose of the original strain of SARS-CoV-2. The volunteers were then closely monitored in a quarantine unit, with regular tests and samples taken to study their response to the virus in a highly controlled and safe environment.</p> <p>For our <a href="https://www.nature.com/articles/s41586-024-07575-x">recent study</a>, published in Nature, we collected samples from tissue located midway between the nose and the throat as well as blood samples from 16 volunteers. These samples were taken before the participants were exposed to the virus, to give us a baseline measurement, and afterwards at regular intervals.</p> <p>The samples were then processed and analysed using single-cell sequencing technology, which allowed us to extract and sequence the genetic material of individual cells. Using this cutting-edge technology, we could track the evolution of the disease in unprecedented detail, from pre-infection to recovery.</p> <p>To our surprise, we found that, despite all the volunteers being carefully exposed to the exact same dose of the virus in the same manner, not everyone ended up testing positive for COVID.</p> <p>In fact, we were able to divide the volunteers into three distinct infection groups (see illustration). Six out of the 16 volunteers developed typical mild COVID, testing positive for several days with cold-like symptoms. We referred to this group as the “sustained infection group”.</p> <p>Out of the ten volunteers who did not develop a sustained infection, suggesting that they were able to fight off the virus early on, three went on to develop an “intermediate” infection with intermittent single positive viral tests and limited symptoms. We called them the “transient infection group”.</p> <p>The final seven volunteers remained negative on testing and did not develop any symptoms. This was the “abortive infection group”. This is the first confirmation of abortive infections, which were previously <a href="https://www.nature.com/articles/s41586-021-04186-8">unproven</a>. Despite differences in infection outcomes, participants in all groups shared some specific novel immune responses, including in those whose immune systems prevented the infection.</p> <p>When we compared the timings of the cellular response between the three infection groups, we saw distinct patterns. For example, in the transiently infected volunteers where the virus was only briefly detected, we saw a strong and immediate accumulation of immune cells in the nose one day after infection.</p> <p>This contrasted with the sustained infection group, where a more delayed response was seen, starting five days after infection and potentially enabling the virus to take hold in these volunteers.</p> <p>In these people, we were able to identify cells stimulated by a key antiviral defence response in both the nose and the blood. This response, called the “interferon” response, is one of the ways our bodies signal to our immune system to help fight off viruses and other infections. We were surprised to find that this response was detected in the blood before it was detected in the nose, suggesting that the immune response spreads from the nose very quickly.</p> <h2>Protective gene</h2> <p>Lastly, we identified a specific gene called HLA-DQA2, which was expressed (activated to produce a protein) at a much higher level in the volunteers who did not go on to develop a sustained infection and could hence be used as a marker of protection. Therefore, we might be able to use this information and identify those who are probably going to be protected from severe COVID.</p> <p>These findings help us fill in some gaps in our knowledge, painting a much more detailed picture regarding how our bodies react to a new virus, particularly in the first couple of days of an infection, which is crucial.</p> <p>We can use this information to compare our data to other data we are currently generating, specifically where we are “challenging” volunteers to other viruses and more recent strains of COVID. In contrast to our current study, these will mostly include volunteers who have been vaccinated or naturally infected – that is, people who already have immunity.</p> <p>Our study has significant implications for future treatments and vaccine development. By comparing our data to volunteers who have never been exposed to the virus with those who already have immunity, we may be able to identify new ways of inducing protection, while also helping the development of more effective vaccines for future pandemics. In essence, our research is a step towards better preparedness for the next pandemic.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/233063/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/marko-nikolic-1543289">Marko Nikolic</a>, Principal Research Fellow/Honorary consultant Respiratory Medicine, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> and <a href="https://theconversation.com/profiles/kaylee-worlock-1543639">Kaylee Worlock</a>, Postdoc Research Fellow, Molecular and Cellular Biology, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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-finally-know-why-some-people-got-covid-while-others-didnt-233063">original article</a>.</em></p> </div>

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COVID vaccines saved millions of lives – linking them to excess deaths is a mistake

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/paul-hunter-991309">Paul Hunter</a>, <em><a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a></em></p> <p>A recent <a href="https://bmjpublichealth.bmj.com/content/2/1/e000282">study</a> has sparked another <a href="https://nypost.com/2024/06/06/us-news/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths-since-pandemic-study/">round of</a> <a href="https://www.telegraph.co.uk/news/2024/06/04/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths/">headlines</a> <a href="https://www.gbnews.com/health/covid-vaccine-side-effects-deaths">claiming</a> that COVID vaccines caused excess deaths. This was accompanied by a predictable outpouring of <a href="https://x.com/DrAseemMalhotra/status/1797922073798717524">I-told-you-sos</a> on social media.</p> <p>Excess deaths are a measure of how many more deaths are being recorded in a country over what would have been expected based on historical trends. In the UK, and in many other countries, death rates have been higher during the years 2020 to 2023 than would have been expected based on historic trends from before the pandemic. But that has been known for some time. A couple of years ago I wrote an article for <a href="https://theconversation.com/summer-2022-saw-thousands-of-excess-deaths-in-england-and-wales-heres-why-that-might-be-189351">The Conversation</a> pointing this out and suggesting some reasons. But has anything changed?</p> <p>The authors of the new study, published in BMJ Public Health, used publicly available data from <a href="https://ourworldindata.org/COVID-vaccinations">Our World in Data</a> to determine which countries had “statistically significant” excess deaths – in other words, excess deaths that couldn’t be explained by mere random variation.</p> <p>They studied the years 2020 to 2022 and found that many, but not all, countries did indeed report excess deaths. The authors did not try to explain why these excess deaths occurred, but the suggestion that COVID vaccines could have played a role is clear from their text – and indeed widely interpreted as such by certain newspapers.</p> <p>There is no doubt that a few deaths were associated with <a href="https://journals.sagepub.com/doi/full/10.1177/25166026211053485">the COVID vaccines</a>, but could the vaccination programme explain the large number of excess deaths – 3 million in 47 countries – that have been reported?</p> <p>Based on <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessdeathsinenglandandwales/march2020todecember2021">death certificates</a>, during 2020 and 2021 there were more deaths from COVID than estimated excess deaths in the UK. So during the year 2021 when most vaccine doses were administered, there were actually fewer non-COVID deaths than would have been expected. It was only in 2022 that excess deaths <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathregistrationsummarystatisticsenglandandwales/2022">exceeded COVID deaths</a>.</p> <p>If the vaccination campaign was contributing to the excess deaths that we have seen in recent years, then we should expect to see more deaths in people who have been vaccinated than in those who have not. The most reliable analysis in this regard was done by the UK’s <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessdeathsinenglandandwales/march2020todecember2021">Office for National Statistics (ONS)</a>. In this analysis, the ONS matched death registrations with the vaccine histories of each death recorded. They then calculated “age-standardised death rates” to account for age differences between those vaccinated and those not.</p> <p>What the ONS found was that in all months from April 2021 to May 2023, the death rate <a href="https://www.ons.gov.uk/redir/eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJpbmRleCI6MSwicGFnZVNpemUiOjEwLCJwYWdlIjoxLCJ1cmkiOiIvcGVvcGxlcG9wdWxhdGlvbmFuZGNvbW11bml0eS9iaXJ0aHNkZWF0aHNhbmRtYXJyaWFnZXMvZGVhdGhzL2RhdGFzZXRzL2V4Y2Vzc2RlYXRoc2luZW5nbGFuZGFuZHdhbGVzIiwibGlzdFR5cGUiOiJyZWxhdGVkZGF0YSJ9.Cot-XDe8Rr07paGllBNnVVz1nTqnXfVafn2woA3tk0c">from all causes was higher</a> in the unvaccinated than in people who had been vaccinated at least once.</p> <p>That deaths from all causes were lower in the vaccinated than the unvaccinated should come as no surprise given that COVID was a major cause of death in 2021 and 2022. And there is ample evidence of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492612/">protective effect of vaccines</a> against severe COVID and death. But what is even more convincing is that, even when known COVID deaths were excluded in the ONS report, the death rate in the unvaccinated was still higher, albeit not by very much in more recent months.</p> <p>Some COVID deaths would certainly not have been recognised as such. But, on the other hand, people with chronic conditions, such as diabetes, were a high priority for vaccination. And these people would have been at increased risk of death even before the pandemic.</p> <h2>Possible causes</h2> <p>If the vaccine is not the cause of the excess deaths, what was?</p> <p>The major cause of the excess deaths reported in the first two years of the BMJ Public Health study was deaths from COVID. But by 2022, excess deaths exceeded COVID deaths in many countries.</p> <p>Possible <a href="https://theconversation.com/summer-2022-saw-thousands-of-excess-deaths-in-england-and-wales-heres-why-that-might-be-189351">explanations</a> for these excess deaths include longer-term effects of earlier COVID infections, the return of infections such as influenza that had been suppressed during the COVID control measures, adverse effects of lockdowns on physical and mental health, and delays in the diagnosis of life-threatening infections as health services struggled to cope with the pandemic and its aftermath.</p> <p>We do need to look very carefully at how the pandemic was managed. There is still considerable debate about the effectiveness of different behavioural control measures, such as self-isolation and lockdowns. Even when such interventions were effective at reducing transmission of COVID, what were the harms and were the gains worth the harms? Nevertheless, we can be confident that the excess deaths seen in recent years were not a consequence of the vaccination campaign.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/231776/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/paul-hunter-991309">Paul Hunter</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/covid-vaccines-saved-millions-of-lives-linking-them-to-excess-deaths-is-a-mistake-231776">original article</a>.</em></p> </div>

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With all this bird flu around, how safe are eggs, chicken or milk?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p>Recent outbreaks of bird flu – in <a href="https://www.cdc.gov/flu/avianflu/avian-flu-summary.htm">US dairy herds</a>, <a href="https://www.abc.net.au/news/rural/2024-06-04/third-victorian-poultry-farm-declares-outbreak-avian-influenza/103932694">poultry farms in Australia</a> and elsewhere, and <a href="https://theconversation.com/bird-flu-is-hitting-australian-poultry-farms-and-the-first-human-case-has-been-reported-in-victoria-heres-what-we-know-230691">isolated cases</a> <a href="https://www.statnews.com/2024/05/30/bird-flu-third-case-human-infection-caused-respiratory-symptoms/">in humans</a> – have raised the issue of food safety.</p> <p>So can the virus transfer from infected farm animals to contaminate milk, meat or eggs? How likely is this?</p> <p>And what do we need to think about to minimise our risk when shopping for or preparing food?</p> <h2>How safe is milk?</h2> <p>Bird flu (or avian influenza) is a bird disease caused by specific types of influenza virus. But the virus can also infect cows. <a href="https://www.cdc.gov/flu/avianflu/avian-flu-summary.htm">In the US</a>, for instance, to date more than 80 dairy herds in at least nine states have been infected with the H5N1 version of the virus.</p> <p>Investigations are <a href="https://www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/livestock">under way</a> to confirm how this happened. But we do know infected birds can shed the virus in their saliva, nasal secretions and faeces. So bird flu can potentially contaminate animal-derived food products during processing and manufacturing.</p> <p>Indeed, fragments of bird flu genetic material (RNA) were found in <a href="https://theconversation.com/how-bird-flu-virus-fragments-get-into-milk-sold-in-stores-and-what-the-spread-of-h5n1-in-cows-means-for-the-dairy-industry-and-milk-drinkers-228689">cow’s milk</a> from the dairy herds associated with <a href="https://www.statnews.com/2024/05/30/bird-flu-third-case-human-infection-caused-respiratory-symptoms/">infected US farmers</a>.</p> <p>However, the spread of bird flu among cattle, and possibly to humans, is likely to have been caused through contact with <a href="https://www.agriculturedive.com/news/contaminated-milk-equipment-potential-source-of-bird-flu-spread-to-cattle/712555/">contaminated milking equipment</a>, not the milk itself.</p> <p>The test used to detect the virus in milk – which uses similar PCR technology to lab-based COVID tests – is also highly sensitive. This means it can detect very low levels of the bird flu RNA. But the test does not distinguish between live or inactivated virus, just that the RNA is present. So from this test alone, we cannot tell if the virus found in milk is infectious (and capable of infecting humans).</p> <p>Does that mean milk is safe to drink and won’t transmit bird flu? Yes and no.</p> <p>In Australia, where bird flu has not been reported in dairy cattle, the answer is yes. It is safe to drink milk and milk products made from Australian milk.</p> <p>In the US, the answer depends on whether the milk is <a href="https://www.sciencedirect.com/science/article/abs/pii/B978184569216250013X?via%3Dihub">pasteurised</a>. We know pasteurisation is a common and reliable method of destroying concerning microbes, including influenza virus. Like most viruses, influenza virus (including bird flu virus) is inactivated by heat.</p> <p>Although there is little direct research on whether pasteurisation inactivates H5N1 in milk, we can extrapolate from what we know about heat inactivation of H5N1 in <a href="https://www.sciencedirect.com/science/article/pii/S0362028X22060732?via%3Dihub">chicken</a> and <a href="https://www.mdpi.com/2036-7481/13/4/60">eggs</a>.</p> <p>So we can be confident there is no risk of bird flu transmission via pasteurised milk or milk products.</p> <p>However, it’s another matter for unpasteurised or “raw” US milk or milk products. A recent <a href="https://www.nejm.org/doi/full/10.1056/NEJMc2405495">study</a> showed mice fed raw milk contaminated with bird flu developed signs of illness. So to be on the safe side, it would be advisable to avoid raw milk products.</p> <h2>How about chicken?</h2> <p>Bird flu has caused sporadic outbreaks in wild birds and domestic poultry worldwide, including <a href="https://theconversation.com/bird-flu-is-hitting-australian-poultry-farms-and-the-first-human-case-has-been-reported-in-victoria-heres-what-we-know-230691">in Australia</a>. In recent weeks, there have been <a href="https://www.abc.net.au/news/rural/2024-06-04/third-victorian-poultry-farm-declares-outbreak-avian-influenza/103932694">three reported outbreaks</a> in <a href="https://agriculture.vic.gov.au/biosecurity/animal-diseases/poultry-diseases/avian-influenza-bird-flu#h2-0">Victorian poultry farms</a> (two with H7N3 bird flu, one with H7N9). There has been <a href="https://www.abc.net.au/news/rural/2024-05-23/bird-flu-detected-western-australia-chicken-farm/103880002">one</a> reported outbreak in <a href="https://www.agric.wa.gov.au/livestock-biosecurity/avian-influenza">Western Australia</a> (H9N2).</p> <p>The strains of bird flu identified in the Victorian and Western Australia outbreaks can cause human infection, although these <a href="https://agriculture.vic.gov.au/biosecurity/animal-diseases/poultry-diseases/avian-influenza-bird-flu#h2-8">are rare</a> and typically result from close contact with infected live birds or <a href="https://www.who.int/emergencies/situations/avian-influenza-a-(h7n9)-virus-outbreak">contaminated environments</a>.</p> <p>Therefore, the chance of bird flu transmission in chicken meat is remote.</p> <p>Nonetheless, it is timely to remind people to handle chicken meat with caution as many dangerous pathogens, such as <em>Salmonella</em> and <em>Campylobacter</em>, can be found on chicken carcasses.</p> <p>Always handle chicken meat carefully when shopping, transporting it home and storing it in the kitchen. For instance, make sure no meat juices cross-contaminate other items, consider using a cool bag when transporting meat, and refrigerate or freeze the meat within two hours.</p> <p><a href="https://theconversation.com/no-you-shouldnt-wash-raw-chicken-before-cooking-it-so-why-do-people-still-do-it-192723">Avoid washing your chicken</a> before cooking to prevent the spread of disease-causing microbes around the kitchen.</p> <p>Finally, cook chicken thoroughly as viruses (including bird flu) <a href="https://www.sciencedirect.com/science/article/pii/S0362028X22060732?via%3Dihub">cannot survive</a> cooking temperatures.</p> <h2>Are eggs safe?</h2> <p>The recent Australian outbreaks have occurred in egg-laying or mixed poultry flocks, so concerns have been raised about bird flu transmission via contaminated chicken eggs.</p> <p>Can flu viruses contaminate chicken eggs and potentially spread bird flu? It appears so. A <a href="https://www.sciencedirect.com/science/article/pii/S0196655306011862?via%3Dihub">report</a> from 2007 said it was feasible for influenza viruses to enter through the eggshell. This is because influenza virus particles are smaller (100 nanometres) than the pores in eggshells (at least 200 nm).</p> <p>So viruses could enter eggs and be protected from cleaning procedures designed to remove microbes from the egg surface.</p> <p>Therefore, like the advice about milk and meat, cooking eggs is best.</p> <p>The <a href="https://www.fda.gov/food/egg-guidance-regulation-and-other-information/questions-and-answers-regarding-safety-eggs-during-highly-pathogenic-avian-influenza-outbreaks">US Food and Drug Administration</a> recommends cooking poultry, eggs and other animal products to the proper temperature and preventing cross-contamination between raw and cooked food.</p> <h2>In a nutshell</h2> <p>If you consume pasteurised milk products and thoroughly cook your chicken and eggs, there is nothing to worry about as bird flu is inactivated by heat.</p> <p>The real fear is that the virus will evolve into highly pathogenic versions that can be transmitted from <a href="https://theconversation.com/bird-flu-is-hitting-australian-poultry-farms-and-the-first-human-case-has-been-reported-in-victoria-heres-what-we-know-230691">human to human</a>.</p> <p>That scenario is much more frightening than any potential spread though food.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/231280/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/enzo-palombo-249510">Enzo Palombo</a>, Professor of Microbiology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>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/with-all-this-bird-flu-around-how-safe-are-eggs-chicken-or-milk-231280">original article</a>.</em></p> </div>

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AstraZeneca admits to Covid vaccine's deadly side effect

<p>AstraZeneca has admitted that their Covid vaccine carries a very rare but deadly side effect, as "dozens" of class-action lawsuits pile up. </p> <p>The UK pharmaceutical giant could be facing damages of up to $38 million, as lawyers representing complainants whose loved ones who were injured or killed from the jab called the vaccine "defective". </p> <p>Those who received the AstraZeneca Covid-19 vaccine could be susceptible to a rare and potentially blood clotting disorder called thrombosis with thrombocytopenia syndrome, or TTS, in which patients suffer from blood clots as well as a low blood platelet count. </p> <p>While the side effect is rare, recent research from RMIT University and Monash University found Australia’s Covid-19 vaccination rollout likely prevented the death of 17,760 people aged over 50 in New South Wales between August 2021 and July 2022, with some researchers suggesting that AstraZeneca alone helped saved as many as six million lives worldwide, according to the <a title="nypost.com" href="https://nypost.com/2024/04/29/world-news/astrazeneca-cops-to-rare-deadly-side-effect-of-covid-jab-as-lawsuits-mount/"><em>New York Post</em>.</a></p> <p>AstraZeneca, which is contesting the claims, acknowledged in a February legal document that its vaccine can “in very rare cases,” cause the clotting condition, while also acknowledging that the potential complication was listed as a side effect of the vaccine since its release.</p> <p>So far, 51 cases have been filed in London’s High Court, estimated to be worth around $190 million (GBP100 million) total, according to the UK newspaper<a title="www.telegraph.co.uk" href="https://www.telegraph.co.uk/news/2024/04/28/astrazeneca-admits-covid-vaccine-causes-rare-side-effect/"> <em>The Telegraph</em></a>.</p> <p>However, thanks to a deal struck between AstraZeneca and the UK government during the worst of the pandemic, the drugmaker has been pre-emptively indemnified against future lawsuits – which means any successful claims for payouts will be born by taxpayers.</p> <p>One of the claimants is father-of-two Jamie Scott, who was left with a permanent brain injury after suffering a clot following receiving the vaccine in April 2021. </p> <p>His wife, Kate, told <a title="www.telegraph.co.uk" href="https://www.telegraph.co.uk/news/2024/04/28/astrazeneca-admits-covid-vaccine-causes-rare-side-effect/"><em>The Telegraph</em> </a>she’s hopeful the company’s admission will accelerate the outcome of their case.</p> <p>“We need an apology, fair compensation for our family and other families who have been affected. We have the truth on our side, and we are not going to give up.”</p> <p><em>Image credits: Getty Images </em></p>

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Christina Applegate details bout of Covid and Sapovirus amid MS battle

<p>Christina Applegate has detailed her latest health battle amid her multiple sclerosis (MS).</p> <p>Speaking on her <em>MesSy</em> podcast with co-host Jamie-Lynn Sigler, the actress revealed her rough experience after contracting Covid for the first time, which then turned into long Covid, and to make matters worse, she then contracted Sapovirus from contaminated food. </p> <p>Sapoviruses can cause acute gastroenteritis, and the actress candidly shared that she had been wearing diapers in recent weeks because of how often she has had to go to the bathroom. </p> <p>"I finally got the Covies.. someone real close to me dropped the ball and came home with the stuff and it spread all over the house," she began.</p> <p>"I had one day when I had a headache and chills and I thought I was making it through this."</p> <p>"It turned into long covid and it turned into a chest infection and then my heart was doing weird stuff, where it just speeds up... so I was like mother f--ker!"</p> <p>She then continued, saying that after contracting the virus she was "p---ing out of her a** for a few days".</p> <p>"I was so dizzy. I was so sick. I couldn't eat... Someone else's poop went into my mouth and I ate it."</p> <p>The actress recently revealed that she has 30 lesions on her brain from her MS,  a condition where the body's own immune system mistakenly attacks and damages the fatty material around the nerves, which can cause a range of symptoms. </p> <p>It is the most common acquired chronic neurological disease affecting young adults, according to MS Australia. </p> <p><em>Image: Getty</em></p>

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Dog care below freezing − how to keep your pet warm and safe from cold weather, road salt and more this winter

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/erik-christian-olstad-1505284">Erik Christian Olstad</a>, <a href="https://theconversation.com/institutions/university-of-california-davis-1312">University of California, Davis</a></em></p> <p>Time outside with your dog in the spring, summer and fall can be lovely. Visiting your favorite downtown café on a cool spring morning, going to a favorite dog park on a clear summer evening or going on walks along a river when the leaves are changing color are all wonderful when the weather is favorable. But in much of the country, when winter rolls around, previously hospitable conditions can <a href="https://theconversation.com/is-winter-miserable-for-wildlife-108734">quickly turn chilly and dangerous</a> for people and pups alike.</p> <p>Winter brings some unique challenges for dog owners, since dogs still need activity and socialization during colder seasons. Studies have shown that dog owners are almost 50% less likely to walk their dogs <a href="https://doi.org/10.3390/ani11113302">when the weather gets cold</a>. Knowing the basics of winter safety is critical to maintaining a healthy lifestyle for your dog.</p> <p>I am an <a href="https://www.vetmed.ucdavis.edu/faculty/erik-olstad">assistant professor</a> at the University of California Davis School of Veterinary Medicine who weathered polar vortexes with my dog while living in Michigan early in my career. While I’ve since moved to sunny California, I’ve seen how quickly frigid temperatures can turn dangerous for pets.</p> <h2>Breed and age differences</h2> <p>Not all dogs have the same abilities to deal with cold weather. A short-coated dog like a Chihuahua is much more susceptible to the dangers of cold weather than a thick-coated husky. When the weather dips below 40 degrees Fahrenheit (4 degrees Celsius), the well-acclimated husky may be comfortable, whereas the Chihuahua would shiver and be at risk of hypothermia.</p> <p>Additionally, if your dog is used to warm weather, but you decide to move to a colder region, the dog will need time to acclimate to that colder weather, even if they have a thick coat.</p> <p>Age also affects cold-weather resilience. Puppies and elderly dogs can’t withstand the chill as well as other dogs, but every dog is unique – each may have individual health conditions or physical attributes that make them more or less resilient to cold weather.</p> <h2>When is my dog too cold?</h2> <p>Pet owners should be able to recognize the symptoms of a dog that is getting too cold. Dogs will shiver, and some may vocalize or whine. Dogs may resist putting their feet down on the cold ground, or burrow, or try to find warmth in their environment when they are uncomfortable.</p> <p>Just like people, <a href="https://vcahospitals.com/know-your-pet/frostbite-in-dogs">dogs can get frostbite</a>. And just like people, the signs can take days to appear, making it hard to assess them in the moment. The most common sites for frostbite in dogs are their ears and the tips of their tails. Some of the initial signs of frostbite are skin discoloring, turning paler than normal, or purple, gray or even black; red, blistered skin; swelling; pain at the site; <a href="https://www.britannica.com/science/ulcer">or ulceration</a>.</p> <p>Other <a href="https://vcahospitals.com/know-your-pet/frostbite-in-dogs">serious signs of hypothermia</a> include sluggishness or lethargy, and if you observe them, please visit your veterinarian immediately. A good rule to live by is if it is too cold for you, it is too cold for your dog.</p> <p>Getting your dog a <a href="https://www.cnn.com/cnn-underscored/pets/best-winter-dog-coats-jackets">sweater or jacket</a> and <a href="https://www.akc.org/expert-advice/vets-corner/protect-dogs-paws-snow-ice-salt/">paw covers</a> can provide them with protection from the elements and keep them comfortable. Veterinarians also recommend closely monitoring your dog and limiting their time outside when the temperature nears the freezing point or drops below it.</p> <h2>Road salt dangers</h2> <p>Road salt that treats ice on streets and sidewalks <a href="https://www.cbc.ca/news/canada/kitchener-waterloo/ice-salt-toxic-for-pets-1.5020088">can also harm dogs</a>. When dogs walk on the salt, the sharp, rough edges of the salt crystals can irritate the sensitive skin on their paws.</p> <p>Dogs will often lick their feet when they’re dirty, wet or irritated, and if they ingest any salt doing that, they may face GI upset, dehydration, kidney failure, seizures or even death. Even small amounts of pure salt can <a href="https://www.petpoisonhelpline.com/pet-tips/my-dog-ate-road-salt-will-they-be-okay/">disrupt critical body functions</a> in dogs.</p> <p>Some companies make pet-safe salt, but in public it can be hard to tell what type of salt is on the ground. After walking your dog, wash off their feet or boots. You can also keep their paw fur trimmed to prevent snow from balling up or salt collecting in the fur. Applying a thin layer of petroleum jelly or <a href="https://www.akc.org/expert-advice/lifestyle/how-to-make-your-own-paw-balm-for-winter/">paw pad balm</a> to the skin of the paw pads can also help protect your pet’s paws from irritation.</p> <h2>Antifreeze risks</h2> <p><a href="https://www.britannica.com/science/antifreeze-chemical-substance">Antifreeze, or ethylene glycol</a>, is in most vehicles to prevent the fluids from freezing when it gets cold out. Some people pour antifreeze into their toilets when away from their home to prevent the water in the toilet from freezing.</p> <p>Antifreeze is an exceptionally dangerous chemical to dogs and cats, as it tastes sweet but can be deadly when ingested. If a pet ingests even a small amount of antifreeze, the substance causes a chemical cascade in their body that results in severe kidney damage. If left untreated, the pet may have <a href="https://www.petpoisonhelpline.com/pet-owner-blog/antifreeze-poisoning/">permanent kidney damage or die</a>.</p> <p>There are safer antifreeze options on the market that use ingredients other than ethylene glycol. If your dog ingests antifreeze, please see your veterinarian immediately for treatment.</p> <p>When temperatures dip below freezing, the best thing pet owners can do is keep the time spent outside as minimal as possible. Try some <a href="https://www.akc.org/expert-advice/lifestyle/great-indoor-games-to-play-with-your-dog/">indoor activities</a>, like hide-and-seek with low-calorie treats, fetch or even an interactive obstacle course. Food puzzles can also keep your dog mentally engaged during indoor time.</p> <p>Although winter presents some unique challenges, it can still be an enjoyable and healthy time for you and your canine companion.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/221709/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/erik-christian-olstad-1505284">Erik Christian Olstad</a>, Health Sciences Assistant Professor of Clinical Veterinary Medicine, <a href="https://theconversation.com/institutions/university-of-california-davis-1312">University of California, Davis</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/dog-care-below-freezing-how-to-keep-your-pet-warm-and-safe-from-cold-weather-road-salt-and-more-this-winter-221709">original article</a>.</em></p> </div>

Family & Pets

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Altitude sickness is typically mild but can sometimes turn very serious − a high-altitude medicine physician explains how to safely prepare

<p><em><a href="https://theconversation.com/profiles/brian-strickland-1506270">Brian Strickland</a>, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</a></em></p> <p>Equipped with the latest gear and a thirst for adventure, mountaineers embrace the perils that come with conquering the world’s highest peaks. Yet, even those who tread more cautiously at high altitude are not immune from the health hazards waiting in the thin air above.</p> <p>Altitude sickness, which most commonly refers to <a href="https://medlineplus.gov/ency/article/000133.htm">acute mountain sickness</a>, <a href="https://doi.org/10.1016/j.pcad.2010.02.003">presents a significant challenge</a> to those traveling to and adventuring in high-altitude destinations. Its symptoms can range from <a href="https://doi.org/10.1089/ham.2017.0164">mildly annoying to incapacitating</a> and, in some cases, may progress to more <a href="https://doi.org/10.1183/16000617.0096-2016">life-threatening illnesses</a>.</p> <p>While <a href="https://doi.org/10.18111/9789284424023">interest in high-altitude tourism is rapidly growing</a>, general awareness and understanding about the hazards of visiting these locations <a href="https://doi.org/10.1089/ham.2022.0083">remains low</a>. The more travelers know, the better they can prepare for and enjoy their journey.</p> <p>As an <a href="https://som.cuanschutz.edu/Profiles/Faculty/Profile/36740">emergency physician specializing in high-altitude illnesses</a>, I work to improve health care in remote and mountainous locations around the world. I’m invested in finding ways to allow people from all backgrounds to experience the magic of the mountains in an enjoyable and meaningful way.</p> <h2>The science behind altitude sickness</h2> <p>Altitude sickness is rare in locations lower than 8,200 feet (2,500 meters); however, <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">it becomes very common</a> when ascending above this elevation. In fact, it affects about <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">25% of visitors to the mountains of Colorado</a>, where I conduct most of my research.</p> <p>The risk rapidly increases with higher ascents. Above 9,800 feet (3,000 meters), up to <a href="https://www.ncbi.nlm.nih.gov/books/NBK430716/">75% of travelers</a> may develop symptoms. Symptoms of altitude sickness are usually mild and consist of <a href="https://doi.org/10.1089/ham.2017.0164">headache, dizziness, nausea, fatigue and insomnia</a>. They usually <a href="https://doi.org/10.1016/j.rceng.2019.12.009">resolve after one to two days</a>, as long as travelers stop their ascent, and the symptoms quickly resolve with descent.</p> <p>When travelers do not properly acclimatize, they can be susceptible to life-threatening altitude illnesses, such as <a href="https://doi.org/10.1016/j.resp.2007.05.002">high-altitude pulmonary edema</a> or <a href="https://doi.org/10.1089/1527029041352054">high-altitude cerebral edema</a>. These conditions are characterized by fluid accumulation within the tissues of the lungs and brain, respectively, and are the <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">most severe forms of altitude sickness</a>.</p> <p>Altitude sickness symptoms are thought to be caused by <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">increased pressure surrounding the brain</a>, which results from the failure of the body to acclimatize to higher elevations.</p> <p>As people enter into an environment with lower air pressure and, therefore, <a href="https://doi.org/10.1001/jamanetworkopen.2023.18036">lower oxygen content</a>, their <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">breathing rate increases</a> in order to compensate. This causes an increase in the amount of <a href="https://doi.org/10.1016/s1357-2725(03)00050-5">oxygen in the blood as well as decreased CO₂ levels</a>, which then increases blood pH. As a result, the <a href="https://doi.org/10.1093%2Fbjaceaccp%2Fmks047">kidneys compensate</a> by removing a chemical called bicarbonate from the blood into the urine. This process makes people urinate more and helps correct the acid and alkaline content of the blood to a more normal level.</p> <figure><iframe src="https://www.youtube.com/embed/iv1vQPIdX_k?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Tips for preventing or reducing the risk of altitude sickness.</span></figcaption></figure> <h2>The importance of gradual ascent</h2> <p>High-altitude medicine experts and other physicians <a href="https://doi.org/10.1016/s0140-6736(76)91677-9">have known for decades</a> that <a href="https://doi.org/10.1089/ham.2010.1006">taking time to slowly ascend is the best way</a> to prevent the development of altitude sickness.</p> <p>This strategy gives the body time to complete its natural physiologic responses to the changes in air pressure and oxygen content. In fact, spending just <a href="https://doi.org/10.1089/ham.2010.1006">one night at a moderate elevation</a>, such as Denver, Colorado, which is at 5,280 feet (1,600 meters), has been shown to <a href="https://doi.org/10.7326/0003-4819-118-8-199304150-00003">significantly reduce the likelihood of developing symptoms</a>.</p> <p>People who skip this step and travel directly to high elevations are <a href="https://doi.org/10.1093/jtm/taad011">up to four times more likely</a> to develop altitude sickness symptoms. When going to elevations greater than 11,000 feet, multiple days of acclimatization are necessary. Experts generally recommend ascending <a href="https://doi.org/10.1089/ham.2010.1006">no more than 1,500 feet per day</a> once the threshold of 8,200 feet of elevation has been crossed.</p> <p>Workers at high altitude, such as <a href="https://doi.org/10.1089/ham.2020.0004">porters in the Nepali Himalaya</a>, are at <a href="https://doi.org/10.1016/j.wem.2018.06.002">particular risk of altitude-related illness</a>. These workers often do not adhere to acclimatization recommendations in order to maximize earnings during tourist seasons; as a result, they are more likely to experience <a href="https://www.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness">severe forms of altitude sickness</a>.</p> <h2>Effective medications</h2> <p>For more than 40 years, <a href="https://doi.org/10.1056/nejm196810172791601">a medicine called acetazolamide</a> has been used to <a href="https://medlineplus.gov/druginfo/meds/a682756.html">prevent the development of altitude sickness</a> and to treat its symptoms. Acetazolamide is <a href="https://www.ncbi.nlm.nih.gov/books/NBK557838/">commonly used as a diuretic</a> and for the <a href="https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma">treatment of glaucoma</a>, a condition that causes increased pressure within the eye.</p> <p>If started <a href="https://doi.org/10.1378/chest.09-2445">two days prior</a> to going up to a high elevation, acetazolamide can <a href="https://doi.org/10.1378/chest.09-2445">prevent symptoms of acute illness</a> by speeding up the acclimatization process. Nonetheless, it does not negate the recommendations to ascend slowly, and it is <a href="https://doi.org/10.1016/j.wem.2019.04.006">routinely recommended only</a> when people cannot slowly ascend or for people who have a history of severe altitude sickness symptoms even with slow ascent.</p> <p>Other medications, including ibuprofen, have <a href="https://doi.org/10.1016/j.wem.2012.08.001">shown some effectiveness</a> in treating acute mountain sickness, although <a href="https://doi.org/10.1016/j.amjmed.2018.10.021">not as well as acetazolamide</a>.</p> <p>A <a href="https://pubmed.ncbi.nlm.nih.gov/2028586/">steroid medication called dexamethasone</a> is effective in both treating and preventing symptoms, but it does not improve acclimatization. It is <a href="https://doi.org/10.1016/j.wem.2019.04.006">recommended only when acetazolamide is not effective</a> or cannot be taken.</p> <p>Additionally, it is important to <a href="https://wwwnc.cdc.gov/travel/page/travel-to-high-altitudes">avoid alcohol during the first few days at higher altitudes</a>, as it impairs the body’s ability to acclimatize.</p> <h2>Unproven therapies and remedies are common</h2> <p>As high-altitude tourism becomes increasingly popular, multiple commercial products and remedies have emerged. Most of them are not effective or provide no evidence to suggest they work as advertised. Other options have mixed evidence, making them difficult to recommend.</p> <p>Medications such as <a href="https://doi.org/10.1089/ham.2007.1037">aspirin</a>, <a href="https://doi.org/10.1183/13993003.01355-2017">inhaled steroids</a> and <a href="https://doi.org/10.1089/ham.2011.0007">sildenafil</a> have been proposed as possible preventive agents for altitude sickness, but on the whole they have not been found to be effective.</p> <p><a href="https://doi.org/10.1093/qjmed/hcp026">Supplements and antioxidants have no proven benefit</a> in preventing or treating altitude sickness symptoms. Both normal and high-altitude exercise are popular ways to prepare for high elevations, especially among athletes. However, beyond <a href="https://doi.org/10.1097/jes.0b013e31825eaa33">certain pre-acclimatization strategies</a>, such as brief sojourns to high altitude, <a href="https://doi.org/10.1016/j.tmaid.2013.12.002">physical fitness and training is of little benefit</a>.</p> <p><a href="https://missouripoisoncenter.org/canned-oxygen-is-it-good-for-you">Canned oxygen</a> has also exploded in popularity with travelers. While <a href="https://doi.org/10.1016/0140-6736(90)93240-p">continuously administered medical oxygen</a> in a health care setting can alleviate altitude sickness symptoms, portable oxygen cans <a href="https://doi.org/10.1016/j.wem.2019.04.006">contain very little oxygen gas</a>, casting doubt on their effectiveness.</p> <p>Some high-altitude adventure travelers sleep in <a href="https://doi.org/10.2165/00007256-200131040-00002">specialized tents</a> that simulate increased elevation by lowering the quantity of available oxygen in ambient air. The lower oxygen levels within the tent are thought to accelerate the acclimatization process, but the tents aren’t able to decrease barometric pressure. This is an important part of the high-altitude environment that induces acclimatization. Without modifying ambient air pressure, these <a href="https://doi.org/10.1016/j.wem.2014.04.004">tents may take multiple weeks</a> to be effective.</p> <p>Natural medicines, such as <a href="https://doi.org/10.1580/08-weme-br-247.1">gingko</a> and <a href="https://doi.org/10.1186/s40794-019-0095-7">coca leaves</a>, are touted as natural altitude sickness treatments, but few studies have been done on them. The modest benefits and significant side effects of these options makes their use <a href="https://doi.org/10.1016/j.wem.2019.04.006">difficult to recommend</a>.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/8469948/">Staying hydrated</a> is very important at high altitudes due to fluid losses from increased urination, dry air and increased physical exertion. <a href="https://doi.org/10.1186%2Fs12889-018-6252-5">Dehydration symptoms</a> can also mimic those of altitude sickness. But there is <a href="https://doi.org/10.1580/1080-6032(2006)17%5B215:AMSIOF%5D2.0.CO;2">little evidence that consuming excessive amounts of water</a> can prevent or treat altitude sickness.</p> <p>The mountains have something for visitors of all interests and expertise and can offer truly life-changing experiences. While there are health risks associated with travel at higher elevations, these can be lessened by making basic preparations and taking time to slowly ascend.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/222057/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/brian-strickland-1506270"><em>Brian Strickland</em></a><em>, Senior Instructor in Emergency Medicine, <a href="https://theconversation.com/institutions/university-of-colorado-anschutz-medical-campus-4838">University of Colorado Anschutz Medical Campus</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/altitude-sickness-is-typically-mild-but-can-sometimes-turn-very-serious-a-high-altitude-medicine-physician-explains-how-to-safely-prepare-222057">original article</a>.</em></p>

Travel Trouble

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Dad awarded compensation after developing heart issue from mandatory vaccine

<p>An Adelaide father is set to receive hefty compensation after a mandatory Covid jab left him with a debilitating health condition. </p> <p>In 2021 at the height of the Covid pandemic in Australia, 44-year-old Daniel Shepherd was required to receive tow Covid vaccinations, due to his hands on role at an aged care facility. </p> <p>After having two Pfizer vaccines, he suffered some adverse effects, but dismissed his symptoms as nothing serious. </p> <p>In the months after, Shepherd was required to have a booster shot when he began a new job with the Department of Child Protection in October of the same year. </p> <p>In January 2022, the father was told if we wanted to keep his job as a health and childcare worker, he needed to have the jab. </p> <p>After eventually agreeing to the booster, Shepherd has his third dose of Pfizer in late February 2022, but began suffering from chest pains just hours later. </p> <p>"It felt like someone had their knee right on my chest," he told <a href="https://www.9news.com.au/national/adelaide-news-covid-vaccine-man-to-get-government-compensation-after-developing-heart-condition/55cc0fbf-4631-4cf0-b395-8c8b6c71a43f" target="_blank" rel="noreferrer noopener"><em>9News</em>.</a></p> <p>The pain kept getting worse until he was rushed to hospital a few weeks later when he thought he was having a heart attack.</p> <p>There he was diagnosed with post-vaccine pericarditis: an inflammation of the membrane around the heart.</p> <p>His illness meant he was unable to work full time, and also meant he was unable to keep up with his young son.</p> <p>"Even today with just mild exertion [I get] chest pains and then it's followed by fatigue, like severe fatigue," Shepard said.</p> <p>"It's heartbreaking to have to say 'sorry buddy, daddy's tired'." </p> <p>Mr Shepherd decided to take legal action after he was unable to work, launching a workers compensation claim against the government.</p> <p>In a landmark ruling in mid-January, the South Australian Employment Tribunal agreed to pay weekly compensation and medical bills to Shepherd.</p> <p>Doctors were unanimous in his case that the vaccine was the cause of his inability to work, but the government argued emergency directions that were in place at the time trumped the laws around workplace injury.</p> <p>Pericarditis is meant to clear within a few months, but Shepherd's symptoms have plagued him for almost two years.</p> <p><em>Image credits: 9News</em></p>

Legal

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How long does immunity last after a COVID infection?

<p><em><a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/dr-wesley-freppel-1408971">Dr Wesley Freppel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p>Nearly four years into the pandemic, Australia, like many other countries, is still seeing large numbers of <a href="https://nindss.health.gov.au/pbi-dashboard/">COVID cases</a>. Some 860,221 infections were recorded around the country in 2023, while 30,283 cases have already been reported in 2024.</p> <p>This is likely to be a significant underestimate, with fewer people testing and reporting than earlier in the pandemic. But the signs suggest parts of Australia are experiencing yet <a href="https://www.abc.net.au/news/2024-01-23/covid-19-case-numbers-from-australia-states-and-territories/103374656">another COVID surge</a>.</p> <p>While some lucky people claim to have never had COVID, many are facing our second, third or even fourth infection, often despite having been vaccinated. You might be wondering, how long does immunity last after a previous infection or vaccination?</p> <p>Let’s take a look at what the evidence shows.</p> <h2>B cells and T cells</h2> <p>To answer this question, we need to understand a bit about how <a href="https://theconversation.com/what-happens-in-our-body-when-we-encounter-and-fight-off-a-virus-like-the-flu-sars-cov-2-or-rsv-207023">immunity</a> to SARS-CoV-2 (the virus that causes COVID) works.</p> <p>After being infected or vaccinated, the immune system develops specific antibodies that can neutralise SARS-CoV-2. B cells remember the virus for a period of time. In addition, the immune system produces memory T cells that can kill the virus, and remain in the blood for some months after the clearance of the infection or a vaccination.</p> <p>A <a href="https://www.science.org/doi/full/10.1126/science.abf4063?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org">2021 study</a> found 98% of people had antibodies against SARS-CoV-2’s spike protein (a protein on the surface of the virus that allows it to attach to our cells) one month after symptom onset. Six to eight months afterwards, 90% of participants still had these neutralising antibodies in their blood.</p> <p>This means the immune system should have recognised and neutralised the same SARS-CoV-2 variant if challenged within six to eight months (if an infection occurred, it should have resulted in mild to no symptoms).</p> <h2>But what about when the virus mutates?</h2> <p>As we know, SARS-CoV-2 has mutated over time, leading to the emergence of new variants such as alpha, beta, delta and omicron. Each of these variants carries mutations that are new to the immune system, even if the person has been previously infected with an earlier variant.</p> <p>A new variant likely won’t be <a href="https://www.science.org/doi/10.1126/science.adj0070">perfectly recognised</a> – or even <a href="https://www.cell.com/cell/pdf/S0092-8674(21)01578-6.pdf">recognised at all</a> – by the already activated memory T or B cells from a previous SARS-CoV-2 infection. This could explain why people can be so readily reinfected with COVID.</p> <p>A recent <a href="https://www.thelancet.com/article/S0140-6736(22)02465-5/fulltext#seccestitle10">review of studies</a> published up to the end of September 2022 looked at the protection conferred by previous SARS-CoV-2 infections.</p> <p>The authors found a previous infection provided protective immunity against reinfection with the ancestral, alpha, beta and delta variants of 85.2% at four weeks. Protection against reinfection with these variants remained high (78.6%) at 40 weeks, or just over nine months, after the previous infection. This protection decreased to 55.5% at 80 weeks (18 months), but the authors noted there was a lack of data at this time point.</p> <p>Notably, an earlier infection provided only 36.1% protection against a reinfection with omicron BA.1 at 40 weeks. Omicron has been described as an <a href="https://www.nature.com/articles/s41564-022-01143-7">immune escape variant</a>.</p> <p>A prior infection showed a high level of protection against severe disease (above 88%) up to 40 weeks regardless of the variant a person was reinfected with.</p> <h2>What about immunity after vaccination?</h2> <p>So far almost 70 million COVID vaccines <a href="https://www.health.gov.au/topics/covid-19/reporting">have been administered</a> to more than <a href="https://www.health.gov.au/resources/publications/covid-19-vaccine-rollout-update-12-january-2023?language=en">22 million people</a> in Australia. Scientists estimated COVID vaccines prevented around <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00320-6/fulltext">14.4 million deaths</a> in 185 countries in the first year after they became available.</p> <p>But we know COVID vaccine effectiveness wanes over time. A <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2804451?utm_source=For_The_Media&amp;utm_medium=referral&amp;utm_campaign=ftm_links&amp;utm_term=050323">2023 review</a> found the original vaccines were 79.6% and 49.7% effective at protecting against symptomatic delta infection at one and nine months after vaccination respectively. They were 60.4% and 13.3% effective against symptomatic omicron at the same time points.</p> <p>This is where booster doses come into the picture. They’re important to keep the immune system ready to fight off the virus, particularly for those who are more vulnerable to the effects of a COVID infection.</p> <p>Plus, regular booster doses can provide immunity against different variants. COVID vaccines are constantly being <a href="https://mvec.mcri.edu.au/references/covid-19/">reviewed and updated</a> to ensure optimal protection against <a href="https://www.who.int/activities/tracking-SARS-CoV-2-variants">current circulating strains</a>, with the latest shot available designed to target <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants">the omicron variant XBB 1.5</a>. This is similar to how we approach seasonal flu vaccines.</p> <p>A <a href="https://www.nature.com/articles/s41598-023-50335-6">recent study</a> showed a COVID vaccination provides longer protection against reinfection than natural protection alone. The median time from infection to reinfection in non-vaccinated people was only six months, compared with 14 months in people who had received one, two or three doses of vaccine after their first infection. This is called <a href="https://www.science.org/doi/10.1126/science.abj2258">hybrid immunity</a>, and other research has similarly found it provides better protection than natural infection alone.</p> <p>It also seems timing is important, as receiving a vaccine too soon after an infection (less than six months) appears to be <a href="https://www.nature.com/articles/s41598-023-50335-6">less effective</a> than getting vaccinated later.</p> <h2>What now?</h2> <p>Everyone’s immune system is slightly unique, and SARS-CoV-2 continues to mutate, so knowing exactly how long COVID immunity lasts is complicated.</p> <p>Evidence suggests immunity following infection should generally last six months in healthy adults, and can be prolonged with vaccination. But there are exceptions, and all of this assumes the virus has not mutated so much that it “escapes” our immune response.</p> <p>While many people feel the COVID pandemic is over, it’s important we don’t forget the lessons we have learned. Practices such as wearing a mask and staying home when unwell can reduce the spread of many viruses, not only <a href="https://www.bmj.com/content/375/bmj-2021-068302">COVID</a>.</p> <p>Vaccination is not mandatory, but for older adults eligible for a booster under the <a href="https://www.health.gov.au/news/atagi-update-on-the-covid-19-vaccination-program">current guidelines</a>, it’s a very good idea.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/221398/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/lara-herrero-1166059"><em>Lara Herrero</em></a><em>, Research Leader in Virology and Infectious Disease, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/dr-wesley-freppel-1408971">Dr Wesley Freppel</a>, Research Fellow, Institute for Glycomics, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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/how-long-does-immunity-last-after-a-covid-infection-221398">original article</a>.</em></p>

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It’s 4 years since the first COVID case in Australia. Here’s how our pandemic experiences have changed over time

<p><em><a href="https://theconversation.com/profiles/deborah-lupton-9359">Deborah Lupton</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>It might be hard to believe, but four years have now passed since the <a href="https://www.health.gov.au/topics/covid-19/about">first COVID case</a> was confirmed in Australia on January 25 2020. Five days later, the <a href="https://www.who.int/publications/m/item/covid-19-public-health-emergency-of-international-concern-(pheic)-global-research-and-innovation-forum">World Health Organization</a> (WHO) declared a “public health emergency of international concern”, as the novel coronavirus (later named SARS-CoV-2) began to spread worldwide.</p> <p>On March 11 the WHO would declare COVID a pandemic, while around the same time Australian federal and state governments hastily <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/pubs/rp/rp2021/Chronologies/COVID-19StateTerritoryGovernmentAnnouncements">introduced measures</a> to “stop the spread” of the virus. These included shutting Australia’s international borders, closing non-essential businesses, schools and universities, and limiting people’s movements outside their homes.</p> <p>I began my project, <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2023.1092322/full">Australians’ Experiences of COVID-19</a>, in May 2020. This research has continued each year to date, allowing me to track how Australians’ attitudes around COVID have changed over the course of the pandemic.</p> <h2>Evolving pandemic experiences</h2> <p>We recruited participants from across Australia, including people living in regional cities and towns. Participants range in age from early adulthood to people in their 80s.</p> <p>The first three stages of the project each involved 40 interviews with separate groups of participants (so 120 people in total). These interviews were done in May to July 2020 (stage 1), September to October 2021 (stage 2), and September 2022 (stage 3). Stage 4 was an online survey with 1,000 respondents, conducted in September 2023.</p> <p>Limitations of this project include the small sample sizes for the first three stages (as is common with qualitative interview-based research). This means the findings from those phases are not generalisable, but they do provide rich insights into the experiences of the interviewees. The quantitative stage 4 survey, however, is representative of the Australian population.</p> <p>The findings show that as the conditions of the pandemic and government management have changed across these years, so have Australians’ experiences.</p> <p>In the <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10743-7">early months of the pandemic</a>, some people reported becoming confused, distressed and overwhelmed by the plethora of information sources and the fast-changing news environment. On the other hand, seeking out information provided reassurance and comfort in response to their anxiety and uncertainty about this new disease.</p> <p>Australians <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781003280644-28/covid-19-crisis-communication-deborah-lupton">continued to rely heavily</a> on news reports and government announcements in the first two years of the pandemic. Regular briefings from premiers and <a href="https://theconversation.com/chief-health-officers-are-in-the-spotlight-like-never-before-heres-what-goes-on-behind-the-scenes-166828?utm_source=twitter&amp;utm_medium=bylinetwitterbutton">chief health officers in particular</a> were highly important for how they learned what was happening, as were updates in the media on case numbers, hospitalisations, deaths and progress towards vaccination targets.</p> <h2>Trust has eroded</h2> <p>Australians appear to have lost a lot of trust in COVID information sources such as news media reports, health agencies and government leaders. Early strong support of federal, state and territory governments’ pandemic management in <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10743-7">2020</a> and <a href="https://www.tandfonline.com/doi/full/10.1080/14649365.2023.2240290">2021</a> has given way to much lower support more recently.</p> <p>My <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023 survey</a> (this is published as a report, not peer-reviewed) found doctors were considered the most trustworthy sources of COVID information, but even they were trusted by only 60% of respondents.</p> <p>After doctors, participants trusted other experts in the field (53%), Australian government health agencies (52%), global health agencies (49%), scientists (45%) and community health organisations (35%). Australian government leaders were towards the lower end of the spectrum (31%).</p> <p>In <a href="https://academic.oup.com/heapro/article/38/1/daac192/7026242?login=false">2021</a>, Australians responded positively to the vaccine targets and “<a href="https://www.premier.vic.gov.au/victorias-roadmap-delivering-national-plan">road maps</a>” set by governments. These clear guidelines, and especially the promise that the initial doses would remove the need for lockdowns and border closures, were strong incentives to get vaccinated in 2021.</p> <p>Unfortunately, the prospect that vaccines would control COVID was shown to be largely unfounded. While COVID vaccines were and continue to be very effective at protecting against severe disease and death, they’re less effective at <a href="https://coronavirus.jhu.edu/vaccines/vaccines-faq">stopping people becoming infected</a>.</p> <p>Once very high numbers of eligible Australians became vaccinated against the delta variant, <a href="https://pubmed.ncbi.nlm.nih.gov/37068078/">omicron reached Australia</a>, resulting in Australia’s first big wave of infection. This led to disillusionment about vaccines’ value for many participants.</p> <p>In the <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023 survey</a>, respondents reported a high uptake of the first three COVID shots. But when asked whether they planned to get another vaccine in the next 12 months, almost two-thirds said they did not, or they were unsure.</p> <h2>Enter complacency</h2> <p>Complacency now seems to have set in for many Australians. This can be linked to the progressive withdrawal of strong public health measures such as quarantine, mandatory isolation when infected, and testing and tracing regimens.</p> <p>Meanwhile, the media, government leaders and health agencies have played less of an active public role in conveying COVID information. This has led to uncertainty about the extent to which COVID is still a risk and lack of incentive to take protective actions such as mask wearing.</p> <p>In <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023</a>, after mandates had ended, only 9% of respondents said they always wore a mask in indoor public places. Only a narrow majority of respondents even supported compulsory masking for workers in health-care facilities.</p> <p>The <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023 survey</a> confirmed many Australians no longer feel at risk from COVID. Some 17% of respondents said COVID was definitely still posing a risk to Australians, while a further 42% saw COVID as somewhat of a risk. This left 28% who did not view COVID as much of a continuing risk, and 13% who thought it was not a risk at all.</p> <h2>COVID is still a risk</h2> <p>Whether or not people feel at continuing risk from COVID, the pandemic is still significantly affecting Australians. The <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023 survey</a> found more than two-thirds of respondents (68%) reported having had at least one COVID infection to their knowledge, including 13% who had experienced three or more. Of those who’d had COVID, 40% said they experienced ongoing symptoms, or long COVID.</p> <p>If the pandemic loses visibility in public forums, people have no way of knowing the risk of infection continues, and are therefore unlikely to take steps to protect themselves and others.</p> <p>Updated case, hospitalisation, death and vaccination numbers should be communicated regularly, as <a href="https://theconversation.com/covid-is-surging-in-australia-and-only-1-in-5-older-adults-are-up-to-date-with-their-boosters-220839">used to be the case</a>. To combat confusion, complacency and misinformation, all health advice should be based on the latest robust science.</p> <p>Australians are operating in a vacuum of information from trusted sources. They need much better and more frequent public health campaigns and risk communication from their leaders.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/220336/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/deborah-lupton-9359"><em>Deborah Lupton</em></a><em>, SHARP Professor, Vitalities Lab, Centre for Social Research in Health and Social Policy Centre, and the ARC Centre of Excellence for Automated Decision-Making and Society, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Getty </em><em>Images </em></p> <p><em>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/its-4-years-since-the-first-covid-case-in-australia-heres-how-our-pandemic-experiences-have-changed-over-time-220336">original article</a>.</em></p>

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COVID is surging in Australia – and only 1 in 5 older adults are up to date with their boosters

<p><em><a href="https://theconversation.com/profiles/adrian-esterman-1022994">Adrian Esterman</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Do you have family members or friends sick with a respiratory infection? If so, there’s a good chance it’s COVID, caused by the JN.1 variant currently circulating in Australia.</p> <p>In particular, New South Wales is reportedly experiencing its <a href="https://www.abc.net.au/news/2024-01-09/nsw-sydney-covid-variant-virus-pandemic-hospitalisations/103298610">highest levels</a> of COVID infections in a year, while Victoria is said to be facing a “<a href="https://www.9news.com.au/national/victoria-in-midst-of-double-wave-of-covid19--as-jn1-triggers-infections-surge/4dada2cb-7d56-436a-9490-cad1d908a29a">double wave</a>” after a surge late last year.</p> <p>But nearly four years into the pandemic, data collection is less comprehensive than it was, and of course, fewer people are testing. So what do we know about the extent of this wave? And importantly, are we adequately protected?</p> <h2>Difficulties with data</h2> <p>Tracking COVID numbers was easier in the first half of last year, when each state and territory provided a weekly update, giving us data on case notifications, hospitalisations, ICU numbers and deaths.</p> <p>In the second half of the year some states and territories switched to less frequent reporting while others stopped their regular updates. As a result, different jurisdictions now report at different intervals and provide varying statistics.</p> <p>For example, <a href="https://www.health.vic.gov.au/infectious-diseases/victorian-covid-19-surveillance-report">Victoria</a> still provides weekly reports, while NSW publishes <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Documents/respiratory-surveillance-20240106.pdf">fortnightly updates</a>.</p> <p>While each offer different metrics, we can gather – particularly from data on hospitalisations – that both states are experiencing a wave. We’re also seeing high levels of COVID <a href="https://www.health.vic.gov.au/infectious-diseases/victorian-covid-19-surveillance-report">in wastewater</a>.</p> <p>Meanwhile, <a href="https://health.nt.gov.au/covid-19/data">Northern Territory Health</a> simply tell you to go to the Australian government’s Department of Health website for COVID data. This houses the only national COVID <a href="https://www.health.gov.au/topics/covid-19/reporting?language=und">data collection</a>. Unfortunately, it’s not up to date, difficult to use, and, depending on the statistic, often provides no state and territory breakdowns.</p> <p>Actual case notifications are provided on a separate <a href="https://nindss.health.gov.au/pbi-dashboard/">website</a>, although given the lack of testing, these are likely to be highly inaccurate.</p> <p>The <a href="https://www.health.gov.au/topics/covid-19/reporting?language=und">Department of Health website</a> does provide some other data that gives us clues as to what’s happening. For example, as of one month ago, there were 317 active outbreaks of COVID in aged care homes. This figure has been generally rising since September.</p> <p>Monthly prescriptions for antivirals on the Pharmaceutical Benefits Scheme were increasing rapidly in November, but we are not given more recent data on this.</p> <p>It’s also difficult to obtain information about currently circulating strains. Data expert Mike Honey provides a regularly updated <a href="https://github.com/Mike-Honey/covid-19-genomes?tab=readme-ov-file#readme">snapshot</a> for Australia based on data from GISAID (the Global Initiative on Sharing All Influenza Data) that shows JN.1 rising in prevalence and accounting for about 40% of samples two weeks ago. The proportion is presumably higher now.</p> <h2>What’s happening elsewhere?</h2> <p>Many other countries are currently going through a COVID wave, probably driven to a large extent by JN.1. These include <a href="https://www.rnz.co.nz/news/national/506301/covid-19-complacency-waning-immunity-contribute-to-fifth-wave-epidemiologist">New Zealand</a>, <a href="https://www.independent.co.uk/news/world/europe/facemasks-mandatory-spain-hospitals-b2475563.html">Spain, Greece</a> and the United States.</p> <p>According to cardiologist and scientist Eric Topol, the US is currently experiencing its <a href="https://www.latimes.com/opinion/story/2024-01-04/covid-2024-flu-virus-vaccine">second biggest wave</a> since the start of the pandemic, linked to JN.1.</p> <h2>Are vaccines still effective?</h2> <p>It’s expected the current COVID vaccines, which target the omicron variant XBB.1.5, are still <a href="https://www.gavi.org/vaccineswork/seven-things-you-need-know-about-jn1-covid-19-variant">effective</a> at reducing hospitalisations and deaths from JN.1 (also an omicron offshoot).</p> <p>The Australian Technical Advisory Group on Immunisation (ATAGI) updated their <a href="https://www.health.gov.au/news/atagi-update-on-the-covid-19-vaccination-program">advice</a> on booster shots in September last year. They recommended adults aged over 75 should receive an additional COVID vaccine dose in 2023 if six months had passed since their last dose.</p> <p>They also suggest all adults aged 65 to 74 (plus adults of any age who are severely immunocompromised) should consider getting an updated booster. They say younger people or older adults who are not severely immunocompromised and have already had a dose in 2023 don’t need further doses.</p> <p>This advice is very confusing. For example, although ATAGI does not recommend additional booster shots for younger age groups, does this mean they’re not allowed to have one?</p> <p>In any case, as of <a href="https://www.health.gov.au/resources/publications/covid-19-vaccine-rollout-update-8-december-2023?language=en">December 6</a>, only 19% of people aged 65 and over had received a booster shot in the last six months. For those aged 75 and over, this figure is 23%. Where is the messaging to these at-risk groups explaining why updating their boosters is so important?</p> <h2>Should we be concerned by this wave?</h2> <p>That depends on who we mean by “we”. For those who are vulnerable, absolutely. Mainly because so few have received an updated booster shot and very few people, including the elderly, are wearing masks.</p> <p>For the majority of people, a COVID infection is unlikely to be serious. The biggest concern for younger people is the risk of long COVID, which research suggests <a href="https://www.nature.com/articles/s41591-022-02051-3">increases</a> with each reinfection.</p> <h2>What should we expect in 2024?</h2> <p>It’s highly likely we will see repeated waves of infections over the next 12 months and beyond, mainly caused by waning immunity from previous infection, vaccination or both, and new subvariants.</p> <p>Unless a new subvariant causes more severe disease (and at this stage, there’s no evidence JN.1 does), we should be able to manage quite well, without our hospitals becoming overwhelmed. However, we should be doing more to protect our vulnerable population. Having only one in five older people up to date with a booster and more than 300 outbreaks in aged care homes is not acceptable.</p> <p>For those who are vulnerable, the usual advice applies. Make sure you’re up to date with your booster shots, wear a P2/N95 mask when out and about, and if you do get infected, take antivirals as soon as possible.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/220839/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/adrian-esterman-1022994"><em>Adrian Esterman</em></a><em>, Professor of Biostatistics and Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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/covid-is-surging-in-australia-and-only-1-in-5-older-adults-are-up-to-date-with-their-boosters-220839">original article</a>.</em></p>

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I have COVID. How likely am I to get long COVID?

<p><em><a href="https://theconversation.com/profiles/andrew-baillie-646956">Andrew Baillie</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/amelia-gulliver-17440">Amelia Gulliver</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>; <a href="https://theconversation.com/profiles/lena-sanci-523666">Lena Sanci</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/lucette-cysique-1495512">Lucette Cysique</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/philip-britton-1127089">Philip Britton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>EG.5 or the Eris COVID variant is dominant in parts of <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Documents/respiratory-surveillance-20231202.pdf">Australia</a>. Eris, along with other circulating strains, are descendants of Omicron.</p> <p>While these strains appear less severe than the original Alpha and Delta variants, the risk of long COVID remains.</p> <p>So what does the latest data say about the chance of long COVID? What symptoms should you look out for? And what can be done to support people with long COVID?</p> <h2>When COVID becomes ‘long COVID’</h2> <p>For most people, long COVID means not getting better after a COVID infection.</p> <p>The World Health Organization <a href="https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1">defines long COVID</a> as continuing or new symptoms at least three months from the start of a COVID infection that last at least two months and cannot be explained by an alternative diagnosis.</p> <p>The most <a href="https://link.springer.com/article/10.1007/s10654-022-00962-6">common symptoms</a> include fatigue, brain fog, breathlessness, headaches and abdominal pain. But people with long COVID can experience <a href="https://www.sciencedirect.com/science/article/pii/S1684118222001864?via%3Dihub">a wide range</a> of problems including cardiovascular issues, mental health problems such as depression and anxiety, insomnia, muscle and joint pain, and gastrointestinal problems.</p> <h2>How common is long COVID?</h2> <p>Australian data on long COVID <a href="https://www.mja.com.au/journal/2023/218/10/long-covid-australia-achieving-equitable-access-supportive-health-care">remains limited</a> compared to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm">international data</a>, and estimates of its prevalence have varied. A report from Australia’s parliamentary inquiry into long COVID, <a href="https://parlinfo.aph.gov.au/parlInfo/download/committees/reportrep/RB000006/toc_pdf/SickandtiredCastingalongshadow.pdf">published in April</a>, suggested 2%-20% of people may develop long COVID following an infection.</p> <p>A recent Australian study conducted when vaccines were widely available indicates earlier Omicron variants <a href="https://doi.org/10.3390/ijerph20186756">saw 10% of people</a> who caught COVID develop long COVID.</p> <p>Another recent study, yet to be peer-reviewed, found <a href="https://www.medrxiv.org/content/10.1101/2023.08.06.23293706v1">18.2%</a> of those infected went on to have long COVID. The wide-ranging estimates are likely to be because of different COVID variants, differences in vaccination, and different long COVID definitions and assessment methods.</p> <p>The risk is lower in children. One Australian study indicated persistent symptoms in <a href="https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00124-3/fulltext">8% of children</a> who had COVID in 2020, while <a href="https://www.medrxiv.org/content/10.1101/2023.03.14.23287239v1">preliminary research</a> points to a slightly lower risk among children infected in 2021.</p> <p>But more research is needed, especially as the virus continues to evolve. This can be complicated because typical long COVID symptoms are common to many other health problems. As in other countries, more research is now underway <a href="https://www.apprise.org.au/broad-research-area/insights-into-long-covid/">in Australia</a> to determine the accurate prevalence of the condition using a definition and methods that carefully exclude other causes.</p> <p>Although research on long COVID risk factors with new variants is ongoing, we expect being female, having more severe initial disease and having other health conditions will <a href="https://doi.org/10.1001/jamainternmed.2023.0750">increase a person’s chance</a> of getting long COVID.</p> <h2>What’s different this time?</h2> <p>Research shows COVID vaccines offer <a href="https://www.mdpi.com/1660-4601/19/19/12422">protection</a> against long COVID. As well as vaccinations, immunity from previous COVID infections and antiviral treatments are contributing to less severe COVID and potentially <a href="https://theconversation.com/could-antivirals-reduce-your-risk-of-long-covid-where-the-research-is-up-to-on-prevention-and-treatment-216529">less long COVID</a> than we saw earlier in the pandemic.</p> <p>But while the Omicron waves may lead to <a href="https://www.smh.com.au/national/newer-virus-strains-less-likely-to-cause-long-covid-20231123-p5emag.html">fewer cases of long COVID</a> than the earlier Alpha and Delta variants, because so many Australians are contracting COVID, this will still result in a large number of people with long COVID. And each <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm">repeat infection</a> presents a new risk of prolonged symptoms.</p> <h2>Long COVID can affect all aspects of life</h2> <p>Long COVID can <a href="https://doi.org/10.1093/ije/dyad033">impact</a> a person’s life in many ways. Fatigue following exertion, brain fog and other symptoms can reduce capacity to perform tasks such as concentrating at a computer, manual labour, and even normal household tasks.</p> <p>Many people with long COVID submitted evidence to the recent <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/LongandrepeatedCOVID/Report/Chapter_4_-_Lived_experiences_of_long_COVID">parliamentary inquiry</a> that they were unsupported, stigmatised, isolated, and not taken seriously by health professionals.</p> <p>Evidence suggests many symptoms <a href="https://www.thelancet.com/journals/lanepe/article/PIIS2666-77622200250-2/fulltext">will improve</a> in most people over <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00138-4/fulltext">12 to 18 months</a>, although recovery time can differ between symptoms. Some, including gastrointestinal and respiratory symptoms, tend to <a href="https://www.nature.com/articles/s41579-022-00846-2">resolve sooner than others</a>, such as cognitive symptoms.</p> <h2>I think I have long COVID, what can I expect from my doctor?</h2> <p>Long COVID is the kind of challenge Australia’s <a href="https://dx.doi.org/10.5694/mja2.51950">health system finds most difficult</a>. GPs are stretched and the small number of specialist <a href="https://www.abc.net.au/news/2023-12-12/long-covid-clinics-are-closing-as-us-clinic-expands/103186272">long COVID clinics</a> are struggling to maintain funding.</p> <p>Australia has trailed behind the US, the UK and Europe in rolling out care for long COVID, and in collecting data on the condition.</p> <p>As a result, support for long COVID in Australia is <a href="https://doi.org/10.3389/phrs.2023.1606084">hard to access</a>, expensive and patchy.</p> <p>However, there is consensus on what constitutes good care. Clinicians seeing patients with possible long COVID should:</p> <ul> <li> <p>validate the person’s experience of symptoms and the impact their symptoms are having on their functioning, particularly when the cause is not clear</p> </li> <li> <p>diagnose and treat any other health conditions that are part of the picture</p> </li> <li> <p>support people to minimise the impairment their symptoms cause by pacing of physical and cognitive activities. Importantly, this doesn’t involve pushing through fatigue.</p> </li> </ul> <p>These steps are not a cure but they may improve a person’s ability to function in their day-to-day life, at work and to fulfil their caring responsibilities.</p> <h2>We still need to focus on reducing COVID transmission</h2> <p>The best way to prevent long COVID is to avoid contracting – and spreading – COVID. This means:</p> <ul> <li> <p>getting vaccinated or boosted, if you’re eligible</p> </li> <li> <p>staying home if you feel unwell</p> </li> <li> <p>wearing a mask to protect yourself and vulnerable community members</p> </li> <li> <p>testing for COVID if you have symptoms and if you test positive, taking antivirals (if eligible) and isolating until your symptoms resolve.</p> </li> </ul> <p>Long COVID is not going away, but we all have a role to play in preventing and responding to it.</p> <p><em>Ruby Biezen from the APPRISE Network and the University of Melbourne and Andrew Lloyd from the Kirby Institute at UNSW contributed to this article.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/218808/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/andrew-baillie-646956"><em>Andrew Baillie</em></a><em>, Professor of Allied Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/amelia-gulliver-17440">Amelia Gulliver</a>, Senior Research Fellow, ANU College of Health and Medicine, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>; <a href="https://theconversation.com/profiles/lena-sanci-523666">Lena Sanci</a>, Professor, Department of General Practice and Primary Care, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/lucette-cysique-1495512">Lucette Cysique</a>, Senior Research Fellow, Viral Immunology Systems Program, The Kirby Institute, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/philip-britton-1127089">Philip Britton</a>, Associate Professor, Child and Adolescent Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/i-have-covid-how-likely-am-i-to-get-long-covid-218808">original article</a>.</em></p>

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Are catnip and treats like it safe for cats? Here’s how they affect their minds and moods

<p><em><a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/anne-quain-12802">Anne Quain</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Cats kept indoors can <a href="https://safeandhappycats.com.au/">live a good life</a> when they get access to a variety of positive experiences. Examples include performing natural behaviours, feeling safe at home and using their full sensory capabilities, including their sense of smell.</p> <p>Plants such as catnip, cat thyme and silver vine are potent smelly stimulants that can affect cat minds and moods.</p> <p>Ever wondered if these mind-altering substances are safe gifts for our feline friends? And importantly, is it OK to provide these, or is offering catnip to a cat like offering alcohol to a child?</p> <h2>Catnip, cat thyme and silver vine, oh my!</h2> <p>Owners who are concerned about their cats feeling bored and frustrated might offer them fresh or dried catnip (<em>Nepeta cataria</em>), silver vine (<em>Actinidia polygama</em>), cat thyme (<em>Teucrium marum</em>) or other plant materials such as valerian (<em>Valeriana officinalis</em>) and Tatarian honeysuckle (<em>Lonicera tatarica</em>). These last couple <a href="https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-017-0987-6">could offer an alternative</a> if your cat doesn’t respond to catnip.</p> <p>Toys filled with the leaves or extracts of these plants can cause apparently euphoric behaviour in domestic cats (as well as big cats like leopards and jaguars). Not all cats respond this way to these smells, which is <a href="https://bmcbiol.biomedcentral.com/articles/10.1186/s12915-022-01369-1">believed to have a genetic basis</a>.</p> <h2>Are these treats safe for cats?</h2> <p>Cats have a highly developed sense of smell. Some plants release chemical compounds to deter insects or to attract predators of insects that might otherwise destroy them. This includes <a href="https://www.science.org/doi/10.1126/sciadv.aba0721">nepetalactone</a>, an ingredient isolated from catnip and silver vine.</p> <p>Indeed, <a href="https://www.science.org/content/article/why-cats-are-crazy-catnip">it has been argued </a> that exposure to nepetalactone leads to an increase in feel-good hormones in cats. It may also act as a <a href="https://www.science.org/doi/10.1126/sciadv.abd9135">natural mosquito repellent</a> (note that it does not repel all mosquitoes and is not effective for flea or tick control).</p> <p>This may be why sniffing catnip, silver vine and some other plants causes cats to roll on their backs and rub their chins, cheeks and bodies on the plants. Other <a href="https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-017-0987-6">observed behaviours</a> include: licking, shaking their head while carrying plant material in their mouth, drooling, kicking the plant material with their hind feet, and a “wavelike” motion of the skin over their backs as muscles contract and relax.</p> <p>These responses <a href="https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-017-0987-6">generally don’t last long</a>, usually seconds to minutes, before cats relax or resume their normal behaviour.</p> <p>Rather than becoming addicted to these substances, cats are more likely to become habituated and desensitised, with the plants having less effect over time. When sniffed, these plants <a href="https://www.cell.com/iscience/fulltext/S2589-0042(23)01925-9">appear</a> to have <a href="https://bmcbiol.biomedcentral.com/articles/10.1186/s12915-022-01369-1">no adverse effects</a> on cats.</p> <figure><iframe src="https://www.youtube.com/embed/yNUz4zQTA1E?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Cats (and a dog!) react to the active compound in catnip and silver vine, nepetalactone.</span></figcaption></figure> <h2>Is it ethical to alter the minds of our cats?</h2> <p>When considering how to improve the lives of animals we care for, we tend to focus on whether the benefits outweigh the potential harms.</p> <p>Despite some marketing claims that these plants activates the brain’s opioid system, delivering a “natural high” for cats, there is no evidence these substances actually alter the minds of cats in the same way as alcohol or other drugs alter the minds of humans.</p> <p>The marketing of these cat treats as “kitty crack” or “<a href="https://www.meowijuana.com/">meowijuana</a>” and silver vine sticks as “<a href="https://www.nekopiapets.com.au/product-page/joycat-cat-cigarettes-silvervine-stick">kitty cigarettes</a>” is likely to deter some people from offering their cats <a href="https://bmcbiol.biomedcentral.com/articles/10.1186/s12915-022-01369-1">this kind of olfactory stimulation</a>.</p> <p>Unlike offering alcohol to a child, though, the evidence suggests our cats are OK when given access to these treats. These items won’t induce psychosis and won’t lead to addiction or withdrawal symptoms. And we don’t need to worry about our cats operating heavy machinery or making important decisions under the influence of mind-altering substances!</p> <p>Provided they can walk away at any time, it seems reasonable to let them opt in to a fun time.</p> <p>In fact, we harness the power of cats’ sense of smell in other ways by using <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435919/">synthetic feline facial pheromones</a>. This can help reduce fear, anxiety and distress in cats. These substances can come in useful in settings such as multi-cat households or when moving house.</p> <h2>How to make sure your cat has the purr-fect time</h2> <p>Offering a range of smells (olfactory stimulation) is just one way to ensure your cat has a varied and interesting life. Here are some tips:</p> <ul> <li> <p>offer cats choices to interact with treats and toys – don’t force them</p> </li> <li> <p>rotate the toys and experiences on offer, so every day offers something fresh</p> </li> <li> <p>offer items that cats can scratch – scratching posts and corrugated cardboard are popular items</p> </li> <li> <p>if you are concerned your cat has swallowed part of a toy or seems unwell, check in with your vet.</p> </li> </ul> <p>Given the short-lived effects of these plant-based olfactory stimulants on cats, it is important that we <a href="https://www.sciencedirect.com/science/article/abs/pii/S0168159119301054">optimise their environment, lifestyle and interactions</a> with humans to improve their welfare. We can’t just rely on catnip or silver vine to give our cats a good life indoors – it’s really up to us!<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/214947/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/mia-cobb-15211"><em>Mia Cobb</em></a><em>, Research Fellow, Animal Welfare Science Centre, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/anne-quain-12802">Anne Quain</a>, Senior Lecturer, Sydney School of Veterinary Science, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/are-catnip-and-treats-like-it-safe-for-cats-heres-how-they-affect-their-minds-and-moods-214947">original article</a>.</em></p>

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COVID wave: what’s the latest on antiviral drugs, and who is eligible in Australia?

<p><em><a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Australia is experiencing a <a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">fresh wave of COVID</a>, seeing increasing cases, more hospitalisations and a greater number of prescriptions for COVID antivirals dispensed over recent months.</p> <p>In the early days of the pandemic, the only medicines available were those that treated the symptoms of the virus. These included steroids and analgesics such as paracetamol and ibuprofen to treat pain and fever.</p> <p>We now have two drugs called <a href="https://www.health.wa.gov.au/%7E/media/Corp/Documents/Health-for/Infectious-disease/COVID19/Treatment/COVID19-PAXLOVID-Patient-information.pdf">Paxlovid</a> and <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/abefa4a4-ecaa-4c26-8713-d80c90388545/COVID-19+Treatment+Fact+Sheet+-+Molnupiravir+-+Prescribers+20220428.pdf?MOD=AJPERES&amp;CACHEID=ROOTWORKSPACE-abefa4a4-ecaa-4c26-8713-d80c90388545-oIRWpvB">Lagevrio</a> that treat the virus itself.</p> <p>But are these drugs effective against current variants? And who is eligible to receive them? Here’s what to know about COVID antivirals as we navigate this <a href="https://www.smh.com.au/national/a-slightly-more-dangerous-place-australia-is-in-its-eighth-covid-wave-20231030-p5eg5k.html">eighth COVID wave</a>.</p> <h2>What antivirals are available?</h2> <p><a href="https://www.tga.gov.au/resources/artg/389801">Paxlovid</a> is a combination of two different drug molecules, nirmatrelvir and ritonavir. The nirmatrelvir works by blocking an enzyme called a protease that the virus needs to replicate. The ritonavir is included in the medicine to protect the nirmatrelvir, stopping the body from breaking it down.</p> <p>Molnupiravir, marketed as <a href="https://www.tga.gov.au/resources/artg/372650">Lagevrio</a>, works by forcing errors into the RNA of SARS-CoV-2 (the virus that causes COVID) as it replicates. As these errors build up, the virus becomes less effective.</p> <p>This year in Australia, the <a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">XBB COVID strains</a> have dominated, and acquired a couple of key mutations. When COVID mutates into new variants, it doesn’t affect the ability of either Paxlovid or Lagevrio to work because the parts of the virus that change from the mutations aren’t those targeted by these two drugs.</p> <p>This is different to the <a href="https://app.magicapp.org/#/guideline/L4Q5An/section/E8kMVn">monoclonal antibody-based medicines</a> that were developed against specific strains of the virus. These drugs are not thought to be effective for any variant of the virus <a href="https://www.who.int/activities/tracking-SARS-CoV-2-variants">from omicron XBB.1.5 onwards</a>, which includes the current wave. This is because these drugs recognise certain proteins expressed on the surface of SARS-CoV-2, which have changed over time.</p> <h2>What does the evidence say?</h2> <p>As Lagevrio and Paxlovid are relatively new medicines, we’re still learning how well they work and which patients should use them.</p> <p>The latest <a href="https://app.magicapp.org/#/guideline/L4Q5An/section/L0OPkj">evidence</a> suggests Paxlovid decreases the risk of hospitalisation if taken early by those at <a href="https://www.nsw.gov.au/covid-19/testing-managing/antivirals">highest risk of severe disease</a>.</p> <p>Results from <a href="https://www.nejm.org/doi/10.1056/NEJMoa2116044">a previous trial</a> suggested Lagevrio might reduce COVID deaths. But a more recent, <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4237902">larger trial</a> indicated Lagevrio doesn’t significantly reduce hospitalisations or deaths from the virus.</p> <p>However, few people at highest risk from COVID were included in this trial. So it could offer some benefit for patients in this group.</p> <p>In Australia, Lagevrio is not routinely <a href="https://app.magicapp.org/#/guideline/L4Q5An/section/L0OPkj">recommended</a> and Paxlovid is preferred. However, not all patients can take Paxlovid. For example, people with medical conditions such as <a href="https://www.paxlovidhcp.com/moderate-renal-impairment">severe kidney or liver impairment</a> shouldn’t take it because these issues can affect how well the body metabolises the medication, which increases the risk of side effects.</p> <p>Paxlovid also can’t be taken alongside some <a href="https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0020/702821/Information-for-patients-family-and-carers-nirmatrelvir-and-ritonavir.PDF">other medications</a> such as those for certain heart conditions, mental health conditions and cancers. For high-risk patients in these cases, Lagevrio can be considered.</p> <p>Some people who take COVID antivirals will experience side effects. Mostly these are not serious and will go away with time.</p> <p>Both <a href="https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0020/702821/Information-for-patients-family-and-carers-nirmatrelvir-and-ritonavir.PDF">Paxlovid</a> and <a href="https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0008/702818/Information-for-patients-family-and-carers-molnupiravir.PDF">Lagevrio</a> can cause diarrhoea, nausea and dizziness. Paxlovid can also cause side effects including muscle aches and weakness, changes in taste, loss of appetite and abdominal pain. If you experience any of these, you should contact your doctor.</p> <p>More serious side effects of both medicines are allergic reactions, such as shortness of breath, swelling of the face, lips or tongue and a severe rash, itching or hives. If you experience any of these, call 000 immediately or go straight to the nearest emergency department.</p> <h2>Be prepared</h2> <p>Most people will be able to manage COVID safely at home without needing antivirals. However, those at higher risk of severe COVID and therefore <a href="https://www.nsw.gov.au/covid-19/testing-managing/antivirals#:%7E:text=Both%20are%20available%20in%20NSW,Lagevrio%C2%AE%20(molnupiravir)launch.">eligible for antivirals</a> should seek them. This includes people aged 70 or older, people aged 50 or older or Aboriginal people aged 30 or older with one additional risk factor for severe illness, and people 18 or older who are immunocompromised.</p> <p>If you are in any of these groups, it’s important you <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Documents/translated/plan-ahead-covid-flu-english.pdf">plan ahead</a>. Speak to your health-care team now so you know what to do if you get COVID symptoms.</p> <p>If needed, this will ensure you can start treatment as soon as possible. It’s important antivirals are started within <a href="https://www.nsw.gov.au/covid-19/testing-managing/antivirals#:%7E:text=Both%20are%20available%20in%20NSW,Lagevrio%C2%AE%20(molnupiravir)launch.">five days of symptom onset</a>.</p> <p>If you’re a high-risk patient and you test positive, contact your doctor straight away. If you are eligible for antivirals, your doctor will organise a prescription (either an electronic or paper script).</p> <p>These medicines are available under the Pharmaceutical Benefits Scheme (PBS) and subsidised for people with a Medicare card. The cost for each course is the standard <a href="https://www.pbs.gov.au/info/about-the-pbs#:%7E:text=Patient%20co%2Dpayments,you%20have%20a%20concession%20card.">PBS co-payment</a> amount: A$30 for general patients and A$7.30 for people with a concession card.</p> <p>So you can rest and reduce the risk of spreading the virus to others, ask your pharmacy to deliver the medication to your home, or ask someone to collect it for you.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/218423/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/jessica-pace-1401278"><em>Jessica Pace</em></a><em>, Associate Lecturer, Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, Associate Professor of the School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/covid-wave-whats-the-latest-on-antiviral-drugs-and-who-is-eligible-in-australia-218423">original article</a>.</em></p>

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Should we still be using RATs to test for COVID? 4 key questions answered

<p><em><a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>We’re currently navigating <a href="https://www.thenewdaily.com.au/life/health/2023/11/15/covid-australia-eighth-wave">an eighth wave</a> of <a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">COVID infections</a> in Australia. However the threat COVID poses to us is significantly less than it has ever been, thanks to immunity we’ve acquired through <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00801-5/fulltext">a combination</a> of prior infection and vaccination.</p> <p>That said, COVID is by no means behind us. The threat of severe illness remains higher for many people, and we’re all potentially at risk of developing <a href="https://www.health.gov.au/topics/covid-19/long-covid">long COVID</a>.</p> <p>While many people appear to be doing fewer rapid antigen tests (RATs) than they used to – if any at all – with rising cases, and as we head towards the festive season, testing continues to be important.</p> <p>So what do you need to know about testing in this wave? Here are four key questions answered.</p> <h2>1. When should I do a RAT?</h2> <p>There are a few situations where determining your COVID status is important to inform your actions, particularly during an uptick in infections. With more circulating virus, your index of suspicion that you have COVID if you’re experiencing cold-like symptoms should be higher.</p> <p>RATs work best when they’re used to confirm whether you have COVID when you <a href="https://www.tga.gov.au/products/covid-19/covid-19-tests/how-testing-works-covid-19">have respiratory symptoms</a> and are infectious. So the primary use of RATs should be to determine your COVID status when you’re sick. A positive test should prompt you to isolate, and if you’re eligible, to seek antivirals.</p> <p>Testing might also be worthwhile if you’ve come into contact with someone with COVID but you haven’t developed symptoms. If you find you have in fact contracted the virus, you can take steps to avoid spreading it to other people (you can infect others even <a href="https://www.healthline.com/health/what-is-asymptomatic-covid#prevalence">when you’re asymptomatic</a>). This is especially important if you’re going to be socialising in large groups or in contact with people who are vulnerable.</p> <p>Another situation in which to consider testing, particularly at this time of year, is before attending large social gatherings. While the reliability of a RAT is never perfect, do the test as close to the event as possible, because your disease status <a href="https://www.businessinsider.com/omicron-rapid-test-hour-before-party-not-day-before-expert-2021-12">can change quickly</a>.</p> <h2>2. Should I test multiple times?</h2> <p>Yes. RATs are not as sensitive as PCR tests, which is the trade-off we make for being able to do this test at home and <a href="https://www.wsj.com/articles/public-health-officials-pursue-covid-19-tests-that-trade-precision-for-speed-11599562800">getting a rapid result</a>.</p> <p>This means that while if you test positive with a RAT you can be very confident you have COVID, if you test negative, you cannot be as confident that you don’t have COVID. That is, the test may give you a false negative result.</p> <p>Although RATs from different manufacturers have different accuracies, all RATs approved by Australia’s Therapeutic Goods Administration must have a sensitivity of <a href="https://www.tga.gov.au/products/covid-19/covid-19-tests/covid-19-rapid-antigen-self-tests-home-use/covid-19-rapid-antigen-self-tests-are-approved-australia#:%7E:text=For%20rapid%20antigen%20tests%2C%20this,specificity%20of%20at%20least%2098%25.">at least 80%</a>.</p> <p>The way to increase your confidence in a negative result is to do multiple RATs serially – each negative test increases the confidence you can have that you don’t have COVID. If you have symptoms and have tested negative after your first RAT, <a href="https://www.fda.gov/medical-devices/safety-communications/home-covid-19-antigen-tests-take-steps-reduce-your-risk-false-negative-results-fda-safety">the advice</a> is to repeat the test after 48 hours, and potentially a third time after another 48 hours if the second test is also negative.</p> <h2>3. Do RATs detect the latest variants?</h2> <p>Since RATs <a href="https://www.healthdirect.gov.au/covid-19/testing#:%7E:text=Rapid%20antigen%20tests%2C%20or%20RATs,of%20proteins%20of%20the%20virus.">detect particular surface proteins</a> on SARS-CoV-2 (the virus that causes COVID), it’s theoretically possible that as the virus evolves, the reliability of these tests may be affected.</p> <p>However, RATs were designed to detect a part of the virus that is not as likely to mutate, so the hope is these tests <a href="https://www.health.com/do-covid-tests-work-new-variants-7967102">will continue to hold up</a> as SARS-CoV-2 evolves.</p> <p>The performance of RATs is continually being assessed by manufacturers. So far, there’s been no change reported in the ability of these tests to <a href="https://www.ama.com.au/articles/tga-updated-advice-rats-nearing-expiry-and-rats-efficacy-current-strains#:%7E:text=The%20TGA%20has%20received%20evidence,19%20RAT%20post%2Dmarket%20review.">detect the latest variants</a>.</p> <h2>4. Can I rely on expired RATs?</h2> <p>At this point in the pandemic, you might have a few expired tests at the back of your cupboard.</p> <p>Technically the most appropriate advice is to say you should never use a diagnostic test <a href="https://www.tga.gov.au/products/covid-19/covid-19-tests/covid-19-rapid-antigen-self-tests-home-use/covid-19-rapid-antigen-self-tests-are-approved-australia">past its expiry date</a>. As a general principle the performance of a test cannot be guaranteed beyond this date. The risk is that over time the components of the RAT degrade and if you use a test that’s not working optimally, it’s more likely to indicate <a href="https://www.health.com/can-you-use-expired-covid-test-6827970">you don’t have COVID</a> when you actually do, which may have consequences.</p> <p>However, as for all things COVID, the answer is not so black and white. Since these tests were new when they were introduced earlier in the pandemic, manufacturers didn’t have specific data on their performance over time, and so the expiry dates given were necessarily conservative.</p> <p>It’s likely these tests will work beyond the expiry dates on the packet, but just how long and how well they work is a bit of an unknown, so we need to be cautious.</p> <p>The other thing to consider is ensuring you store RATs correctly. Storage instructions should be found on the packet, but the key issue is making sure they’re not exposed to extreme temperatures. In particular, <a href="https://7news.com.au/lifestyle/health-wellbeing/how-to-properly-store-your-at-home-covid-19-rapid-antigen-tests-c-5465412">high temperatures</a> may damage the chemicals in the test which may reduce its sensitivity.</p> <h2>The path from here</h2> <p>Regular upticks in COVID cases are something we’re going to have to get used to. At these times, we should all be a bit more cautious about looking after ourselves and others as we go about our lives. What this looks like will vary for different people depending on their personal circumstances.</p> <p>However, being up to date with <a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">booster vaccinations</a>, having a plan for <a href="https://www.health.gov.au/topics/covid-19/oral-treatments">accessing antivirals</a> if you’re eligible, <a href="https://theconversation.com/with-covid-surging-should-i-wear-a-mask-217902">wearing masks</a> in high-risk settings and testing all continue to play an important role in responding to COVID.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/218016/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/hassan-vally-202904"><em>Hassan Vally</em></a><em>, Associate Professor, Epidemiology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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/should-we-still-be-using-rats-to-test-for-covid-4-key-questions-answered-218016">original article</a>.</em></p>

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With COVID surging, should I wear a mask?

<p><em><a href="https://theconversation.com/profiles/c-raina-macintyre-101935">C Raina MacIntyre</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>COVID is <a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">on the rise again</a>, with a peak likely over the holiday season.</p> <p>Given this, health authorities in a number of Australian states have recommended people start <a href="https://www.thenewdaily.com.au/life/health/2023/11/15/covid-australia-eighth-wave">wearing masks again</a>. In <a href="https://www.abc.net.au/news/2023-11-17/wa-public-hospitals-mask-requirements-roger-cook-covid-19/103120580">Western Australia</a>, masks have been made mandatory in high-risk areas of public hospitals, while they’ve similarly been reintroduced in health-care settings in <a href="https://www.adelaidenow.com.au/coronavirus/mandatory-face-masks-introduced-in-lyell-mcewin-and-modbury-hospitals-as-covid-wave-hits-sa/news-story/b4bad98deb02a66dde4cf866f60b607a">other parts of the country</a>.</p> <p>Hospitals and aged care facilities are definitely the first places where masks need to be reinstated during an epidemic. But authorities are <a href="https://www.thenewdaily.com.au/life/health/2023/11/15/covid-australia-eighth-wave">differing in their recommendations</a> currently. Calls to mask up, particularly in the wider community, <a href="https://www.9news.com.au/national/queensland-covid-chief-health-officer-confirms-covid-wave/a3a92381-bd6f-4175-a366-3b8e0f627990">have not been unanimous</a>.</p> <p>So amid rising COVID cases, should you be wearing a mask?</p> <h2>COVID is still a threat</h2> <p>Unfortunately, SARS-CoV-2 (the virus that causes COVID) has not mutated into just a trivial cold.</p> <p>As well as causing symptoms in the initial phase – which can be especially serious for people who are vulnerable – the virus can lead to <a href="https://www.nature.com/articles/s41579-022-00846-2">chronic illness</a> in people of any age and health status due to its ability to affect blood vessels, <a href="https://academic.oup.com/eurheartjsupp/article/25/Supplement_A/A42/7036729">the heart</a>, lungs, brain and immune system.</p> <p>COVID and its ongoing effects are contributing to <a href="https://www.nature.com/articles/s41591-023-02521-2">substantial disability</a> in society. Loss of productivity due to long COVID is affecting <a href="https://www.mckinsey.com/industries/healthcare/our-insights/one-billion-days-lost-how-covid-19-is-hurting-the-us-workforce">workforce and economies</a>.</p> <p>While public messaging to “live with COVID” has seemingly encouraged us to move on from the pandemic, SARS-CoV-2 has other ideas. It has <a href="https://erictopol.substack.com/p/the-virus-is-learning-new-tricks">continued to mutate</a>, become <a href="https://www.ebgtz.org/resource/omicron-faqs/">more contagious</a>, and to evade the protection offered by vaccines.</p> <p>COVID is not endemic, but is <a href="https://www.cnbc.com/2022/02/02/covid-will-never-become-an-endemic-virus-scientist-warns.html">an epidemic virus</a> like influenza or measles, so we can expect waves to keep coming. With this in mind, it’s definitely worth protecting yourself – particularly when cases are rising.</p> <h2>What can we do to protect ourselves?</h2> <p>We know SARS-CoV-2 transmits <a href="https://www.thelancet.com/article/S0140-6736(21)00869-2/fulltext">through the air</a> we breathe. We also know a lot of the transmission risk is <a href="https://abcnews.go.com/Health/covid-transmission-asymptomatic/story?id=84599810">from people without symptoms</a>, so you can’t tell who around you is infectious. This provides a strong rationale for universal masking during periods of high transmission.</p> <p>The need is highest in hospitals where thousands of unsuspecting patients have caught COVID during the course of the pandemic and <a href="https://www.theage.com.au/national/victoria/a-death-sentence-more-than-600-people-die-after-catching-covid-in-hospital-20230621-p5di7x.html">hundreds have died</a> as a result in Victoria alone. Aged care facilities are similarly vulnerable.</p> <p>Masks <a href="https://theconversation.com/yes-masks-reduce-the-risk-of-spreading-covid-despite-a-review-saying-they-dont-198992">do work</a>. A Cochrane review suggesting they don’t was flawed and subject to <a href="https://www.thestar.com/news/canada/how-the-cochrane-review-went-wrong-report-questioning-covid-masks-blows-up-prompts-apology/article_80b67196-5872-5b1a-a208-b0a525f8de5b.html">an apology</a>.</p> <p>Masks work equally by protecting others and protecting you. By visualising human exhalations too tiny to see with the naked eye, my colleagues and I showed how masks <a href="https://theconversation.com/which-mask-works-best-we-filmed-people-coughing-and-sneezing-to-find-out-143173">prevent outward emissions</a> and how each layer of a mask improves this.</p> <p>The most protective kind of mask is <a href="https://theconversation.com/time-to-upgrade-from-cloth-and-surgical-masks-to-respirators-your-questions-answered-174877">a respirator or N95</a>, but any mask protects <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm">more than no mask</a>.</p> <p>Wearing a mask when visiting health-care or aged-care facilities is important. Wearing a mask at the shops, on public transport and in other crowded indoor settings will improve your chances of having a COVID-free Christmas.</p> <h2>What about vaccines?</h2> <p>Although the virus’ evolution has challenged vaccines, they remain very important. Boosters will improve protection because vaccine immunity wanes and new mutations make older vaccines less effective.</p> <p>In May 2023 the <a href="https://www.who.int/news/item/18-05-2023-statement-on-the-antigen-composition-of-covid-19-vaccines">World Health Organization</a> outlined why <a href="https://erictopol.substack.com/p/the-ba286-variant-and-the-new-booster">monovalent boosters</a> matched to a single current circulating strain gives better protection than the old bivalent boosters (which target two strains). The XBB boosters are available <a href="https://www.sbs.com.au/news/article/the-covid-19-vaccines-australians-cant-get-yet/ueac5puue">in the United States</a>, and will be available in Australia <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">from December 11</a>.</p> <p>Testing and treatment will also help. There are effective antivirals for COVID, but you cannot get them without a COVID test, and <a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">testing rates</a> are very low. Having some RAT tests on hand means you can quickly isolate and get antivirals if indicated.</p> <p>Finally, safe indoor air is key. Remember that SARS-CoV-2 spreads silently, mainly by inhaling contaminated air. Opening a window or using an air purifier can significantly reduce your risk, especially in crowded indoor settings <a href="https://iopscience.iop.org/article/10.1088/2752-5309/ace5c9">like schools</a>. A <a href="https://ozsage.org/media_releases/">multi-layered strategy</a> of vaccines, masks, safe indoor air, testing and treatment will help us navigate this COVID wave.</p> <hr /> <p><em>Editor’s note: This article has been updated to reflect the announcement that monovalent XBB 1.5 vaccines will be deployed as part of Australia’s COVID vaccination program.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/217902/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/c-raina-macintyre-101935">C Raina MacIntyre</a>, Professor of Global Biosecurity, NHMRC Principal Research Fellow, Head, Biosecurity Program, Kirby Institute, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>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/with-covid-surging-should-i-wear-a-mask-217902">original article</a>.</em></p>

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What are the new COVID booster vaccines? Can I get one? Do they work? Are they safe?

<p><em><a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>As the COVID virus continues to <a href="https://pubmed.ncbi.nlm.nih.gov/36680207/">evolve</a>, so does our vaccine response. From <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">December 11</a>, Australians will have access to <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">new vaccines</a> that offer better protection.</p> <p>These “monovalent” booster vaccines are expected to be a <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">better match</a> for currently circulating strains of SARS-CoV-2, the virus that causes COVID.</p> <p>Pfizer’s monovalent vaccine will be <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">available</a> to eligible people aged five years and older. The Moderna monovalent vaccine can be used for those aged 12 years and older.</p> <p>Who is eligible for these new boosters? How do they differ from earlier ones? Do they work? Are they safe?</p> <h2>Who’s eligible for the new boosters?</h2> <p>The federal government has accepted the Australian Technical Advisory Group (ATAGI) recommendation to use the new vaccines, after Australia’s regulator <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">approved their use last month</a>. However, vaccine eligibility has remained the same since September.</p> <p>ATAGI <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">recommends</a> Australians aged over 75 get vaccinated if it has been six months or more since their last dose.</p> <p>People aged 65 to 74 are recommended to have a 2023 booster if they haven’t already had one.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=315&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=315&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=315&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=396&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=396&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=396&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">For people without risk factors.</span> <span class="attribution"><a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></span></figcaption></figure> <p>Adults aged 18 to 64 <em>with</em> underlying risk factors that increase their risk of severe COVID are also recommended to have a 2023 booster if they haven’t had one yet. And if they’ve already had a 2023 booster, they can consider an additional dose.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=311&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=311&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=311&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=391&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=391&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=391&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">Advice for people with risk factors.</span> <span class="attribution"><a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></span></figcaption></figure> <p>For adults aged 18 to 64 <em>without</em> underlying risk factors who have already received a 2023 booster, an additional dose isn’t recommended. But if you’re aged 18 to 64 and haven’t had a booster in 2023, you can consider an additional dose.</p> <p>Additional doses aren’t recommended for children <em>without</em> underlying conditions that increase their risk of severe COVID. A primary course is not recommended for children aged six months to five years <em>without</em> additional risk factors.</p> <h2>Monovalent, bivalent? What’s the difference?</h2> <p><strong>From monovalent</strong></p> <p>The initial COVID vaccines were “monovalent”. They had one target – the original viral strain.</p> <p>But as the virus mutated, we assigned new letters of the Greek alphabet to each variant. This brings us to Omicron. With this significant change, we saw “immune evasion”. The virus had changed so much the original vaccines didn’t provide sufficient immunity.</p> <p><strong>To bivalent</strong></p> <p>So vaccines were updated to target an early Omicron subvariant, BA.1, plus the original ancestral strain. With two targets, these were the first of the “bivalent” vaccines, which were approved in Australia <a href="https://theconversation.com/omicron-specific-vaccines-may-give-slightly-better-covid-protection-but-getting-boosted-promptly-is-the-best-bet-190736">in 2022</a>.</p> <p>Omicron continued to evolve, leading to more “immune escape”, contributing to repeated waves of transmission.</p> <p>The vaccines were updated again in <a href="https://theconversation.com/havent-had-covid-or-a-vaccine-dose-in-the-past-six-months-consider-getting-a-booster-199096">early 2023</a>. These newer bivalent vaccines target two strains – the ancestral strain plus the subvariants BA.4 and BA.5.</p> <p><strong>Back to monovalent</strong></p> <p>Further changes in the virus have meant our boosters needed to be updated again. This takes us to the recent announcement.</p> <p>This time the booster targets another subvariant of Omicron known as XBB.1.5 (sometimes known as <a href="https://theconversation.com/the-kraken-subvariant-xbb-1-5-sounds-scary-but-behind-the-headlines-are-clues-to-where-covids-heading-198158">Kraken</a>).</p> <p>This vaccine is monovalent once more, meaning it has only one target. The target against the original viral strain has been removed.</p> <p>According to advice given to the World Health Organization <a href="https://www.who.int/news/item/18-05-2023-statement-on-the-antigen-composition-of-covid-19-vaccines">in May</a>, this is largely because immunity to this original strain is no longer required (it’s no longer infecting humans). Raising immunity to the original strain may also hamper the immune response to the newer component, but we’re not sure if this is occurring or how important this is.</p> <p>The United States <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">approved</a> XBB.1.5-specific vaccines from Pfizer and Moderna in <a href="https://www.fda.gov/news-events/press-announcements/fda-takes-action-updated-mrna-covid-19-vaccines-better-protect-against-currently-circulating">mid-September</a>. These updated vaccines have also been <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">approved in</a> places including Europe, Canada, Japan and Singapore.</p> <p>In Australia, the Therapeutic Goods Administration (TGA) approved them <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">in October</a>.</p> <h2>Do these newer vaccines work?</h2> <p>Evidence for the efficacy of these new monovalent vaccines comes from the results of research <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2023-PI-02409-1&amp;d=20231117172310101">Pfizer</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">Moderna</a> submitted to the TGA.</p> <p>Evidence also comes from a <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">preprint</a> (preliminary research available online that has yet to be independently reviewed) and an update Pfizer <a href="https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-09-12/10-COVID-Modjarrad-508.pdf">presented</a> to the US Centers for Disease Control.</p> <p>Taken together, the available evidence shows the updated vaccines produce good levels of antibodies in <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">laboratory studies</a>, <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">in humans</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">mice</a> when compared to previous vaccines and when looking at multiple emerging variants, including EG.5 (sometimes known as <a href="https://theconversation.com/the-who-has-declared-eris-a-variant-of-interest-how-is-it-different-from-other-omicron-variants-211276">Eris</a>). This variant is the one causing high numbers of cases around the world currently, including in Australia. It is very similar to the XBB version contained in the updated booster.</p> <p>The updated vaccines should also cover <a href="https://theconversation.com/how-evasive-and-transmissible-is-the-newest-omicron-offshoot-ba-2-86-that-causes-covid-19-4-questions-answered-212453">BA.2.86 or Pirola</a>, according to <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">early results</a> from clinical trials and the US <a href="https://www.cdc.gov/respiratory-viruses/whats-new/covid-19-variant.html">Centers for Disease Control</a>. This variant is responsible for a rapidly increasing proportion of cases, with case numbers growing <a href="https://twitter.com/BigBadDenis/status/1725310295596560662?s=19">in Australia</a>.</p> <p>It’s clear the virus is going to continue to evolve. So performance of these vaccines against new variants will continue to be closely monitored.</p> <h2>Are they safe?</h2> <p>The <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2023-PI-02409-1&amp;d=20231117172310101">safety</a> of the updated vaccines has also been shown to be similar to previous versions. Studies <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">comparing them</a> found no significant difference in terms of the adverse events reported.</p> <p>Given the availability of the updated vaccines, some countries have removed their approval for earlier versions. This is because newer versions are a closer match to currently circulating strains, rather than any safety issue with the older vaccines.</p> <h2>What happens next?</h2> <p>The availability of updated vaccines is a welcome development, however this is not the end of the story. We need to make sure eligible people get vaccinated.</p> <p>We also need to acknowledge that vaccination should form part of a comprehensive strategy to limit the impact of COVID from now on. That includes measures such as mask wearing, social distancing, focusing on ventilation and air quality, and to a lesser degree hand hygiene. Rapidly accessing antivirals if eligible is also still important, as is keeping away from others if you are infected.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/217804/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/paul-griffin-1129798"><em>Paul Griffin</em></a><em>, Professor, Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">original article</a>.</em></p>

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Not all beer and pokies: what Australians did with their super when COVID struck

<p><em><a href="https://theconversation.com/profiles/nathan-wang-ly-1380895">Nathan Wang-Ly</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/ben-newell-46">Ben Newell</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>What happens when people withdraw their retirement savings early?</p> <p>We’ve just found out.</p> <p>During the first year of COVID Australians who faced a 20% decline in their working hours (or turnover for sole traders) or were made unemployed or were on benefits were permitted to take out up to <a href="https://www.ato.gov.au/Individuals/Super/In-detail/Withdrawing-and-using-your-super/COVID-19-early-release-of-super-(closed-31-December-2020)/">A$10,000</a> of their super between April and June 2020, and a further $10,000 between July and December.</p> <p>Five million took up the offer. They withdrew <a href="https://www.apra.gov.au/covid-19-early-release-scheme-issue-36">$36 billion</a>.</p> <p>Most of those surveyed by the Institute of Family Studies said they used the money to cover <a href="https://aifs.gov.au/sites/default/files/publication-documents/2108_6_fias_superannuation_0.pdf">immediate expenses</a>. But definitions of “immediate” can vary.</p> <p>Real time transaction card data appeared to show early withdrawers boosted their spending by an average of <a href="https://www.illion.com.au/buy-now-pay-later-winner-of-stimulus/">$3,000</a> in the fortnight after they got the money.</p> <p><a href="https://www.stptax.com/emergency-super-withdrawal-spent-on-pokies-beer-and-uber-eats/">One interpretation</a> said they spent the money on “beer, wine, pokies, and takeaway food, rather than mortgages, bills, car debts, and clothes”.</p> <p>In order to get a more complete picture, we obtained access to millions of anonymised transaction records of customers of Australia’s largest bank, the <a href="https://www.sciencedirect.com/science/article/pii/S0313592622001060?via%3Dihub#bfn3">Commonwealth Bank</a>.</p> <p>The data included 1.54 million deposits likely to have been money withdrawn through the scheme including 1.04 million we are fairly confident did.</p> <h2>Who dipped into super?</h2> <p>The data provided by the bank allows us to compare circumstances of withdrawers and non-withdrawers including their age, time with the bank, and banking behaviour before COVID.</p> <p>We find withdrawers tended to be younger and in poorer financial circumstances than non-withdrawers before the pandemic. Six in ten of the withdrawers were under the age of 35, a finding consistent with data reported by the <a href="https://www.abc.net.au/news/2020-05-25/coronavirus-early-access-superannuation-young-people/12282546">Australian Taxation Office</a>.</p> <p>Withdrawers tended to earn less than non-withdrawers, even non-withdrawers of the same age. Only 17% of withdrawers for whom we could identify an income earned more than $60,000 compared with 26% of non-withdrawers. And withdrawers had lower median bank balances ($618 versus $986).</p> <p>For those with credit cards and home loans, withdrawers were about twice as likely to be behind on repayments as non-withdrawers (9.7% versus 5.8% for credit cards, and 8.2% versus 3.4% for home loans).</p> <p>These characteristics suggest that, despite concerns of the scheme being exploited due to the application process <a href="https://www.abc.net.au/news/2020-09-03/-are-people-being-allowed-to-access-their-super-without-scrutiny/12618002">not requiring any documentation</a>, most of those using the scheme genuinely needed the money.</p> <h2>Where did the money go?</h2> <p>Compared to non-withdrawers, those who withdrew increased their spending (on both essential and discretionary items), paid back high-interest debts, boosted their savings, and became less likely to miss debt payments.</p> <p>Withdrawers spent an average of $331 more per month on debit cards in the three months after withdrawal, and $126 per month in the following three months.</p> <p>They spent an extra $117 per month on credit cards during the first three months, which shrank to an extra $13 per month in the following three months.</p> <p>The average withdrawer spent 7% more per month on groceries than the average age and income matched non-withdrawer, 12% more on utilities such as gas and electricity, 16% more on discretionary shopping, and 20% more on “entertainment,” a Commonwealth Bank category that includes gambling.</p> <h2>Less debt, less falling behind</h2> <p>In the three months that followed withdrawing, withdrawers also averaged $437 less credit card debt and $431 less personal loan debt than age and income matched non-withdrawers, differences that shrank to $301 and $351 in the following three months.</p> <p>They also became less likely to fall behind on credit card and personal loan payments, a difference that vanished after three months.</p> <p>Our interpretation is that the scheme achieved its intended purpose: it provided many Australians in need with a financial lifeline and helped buoy them during uncertain and turbulent times.</p> <h2>Lessons learned</h2> <p>At the same time, our <a href="https://www.sciencedirect.com/science/article/pii/S0313592622001060?via%3Dihub#bfn3">findings</a> identify areas of concern. The fact that most withdrawals were for the permitted maximum of $10,000 highlights the need to carefully consider the withdrawal limit.</p> <p>While these sums might simply reflect the true amount of money individuals needed to sustain themselves, it might be that many withdrawers were unsure of how much to <a href="https://cepar.edu.au/sites/default/files/Determinants%20of%20Early%20Access%20to%20Retirement%20Savings_Lessons%20from%20the%20COVID19%20Pandemic_BatemanDobrescuLiuNewellThorp_July21.pdf">withdraw</a> – not knowing how long the pandemic would continue.</p> <p>Another consideration is how to best support withdrawers after they have taken out the money. More than half were under the age of 35, and might find themselves with a good deal less super than they would have in retirement.</p> <p>The government has already introduced <a href="https://www.ato.gov.au/super/apra-regulated-funds/in-detail/apra-resources/re-contribution-of-covid-19-early-release-super-amounts/">tax concessions</a> for withdrawers who contribute funds back into their retirement savings accounts. Super funds might also be able to help, by sending targeted messages to those who have withdrawn.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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;" src="https://counter.theconversation.com/content/190911/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/nathan-wang-ly-1380895"><em>Nathan Wang-Ly</em></a><em>, PhD Student, School of Psychology, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/ben-newell-46">Ben Newell</a>, Professor of Cognitive Psychology, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>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/not-all-beer-and-pokies-what-australians-did-with-their-super-when-covid-struck-190911">original article</a>.</em></p>

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