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Christina Applegate details bout of Covid and Sapovirus amid MS battle

Christina Applegate has detailed her latest health battle amid her multiple sclerosis (MS). Speaking on her MesSy 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. 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. "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. "I had one day when I had a headache and chills and I thought I was making it through this." "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!" She then continued, saying that after contracting the virus she was "p---ing out of her a** for a few days". "I was so dizzy. I was so sick. I couldn't eat... Someone else's poop went into my mouth and I ate it." 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. It is the most common acquired chronic neurological disease affecting young adults, according to MS Australia. Image: Getty

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Michael Slater hit with 19 charges over alleged domestic violence

Michael Slater, a former Australian Test cricketer is being held in police custody after being charged with more than a dozen offences over alleged domestic violence. Slater, 54, had his case briefly heard in Maroochydore Magistrates Court on Monday. It was reported by the ABC that he did not appear and no plea was entered. The charges include domestic violence offences of unlawful stalking or intimidation, breaking into a dwelling with intent at night, common assault, assault occasioning bodily harm and choking or suffocation. The 19 charges relate to offences allegedly committed on Queensland’s Sunshine Coast between December 5, 2023 and April 12 2024. Slater was also charged with breaching bail and and 10 counts of contravening a domestic violence order. He was then remanded in custody, with his case mentioned in the same court on Tuesday afternoon. During that second hearing, Slater collapsed in court after failing in his bid for freedom over an alleged domestic violence incident. Upon learning that his bid for bail had been refused, the former cricket great placed his head in his hands then collapsed while being led back to the cells by Corrective Services staff. Slater made his debut during the 1993 Ashes tour and played 74 tests for Australia. He amassed 5,312 runs and played 42 one-day internationals. Since retiring from cricket in 2004, he has had a successful TV commentary career. Image: Getty

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There are new flu vaccines on offer for 2024. Should I get one? What do I need to know?

<a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Influenza is a common respiratory infection. Although most cases are relatively mild, flu can cause more severe illness in young children and older people. Influenza virtually <a href="https://pubmed.ncbi.nlm.nih.gov/33243355/">disappeared</a> from Australia during the first years of the COVID-19 pandemic when public health restrictions reduced contact between people. Since 2022, it has returned to a seasonal pattern, although the flu season has started and peaked a few months earlier than before 2020. It’s difficult to predict the intensity of the flu season at this point in the year, but we can sometimes get clues from the northern hemisphere. There, the season <a href="https://www.who.int/tools/flunet">started</a> <a href="https://gis.cdc.gov/grasp/fluview/flu_by_age_virus.html">earlier</a> than usual for the third year running (peaking in early January rather than late February/March), with a similar number of reported cases and hospitalisations to the previous year. Influenza vaccines are recommended annually, but there are now an increasing number of different vaccine types. Here’s what to know about this year’s shots, available from <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">this month</a>. <h2>What goes into a flu vaccine?</h2> Like other vaccines, influenza vaccines work by “training” the immune system on a harmless component of the influenza virus (known as an antigen), so it can respond appropriately when the body encounters the real virus. Influenza strains are constantly changing due to genetic mutation, with the pace of genetic change <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10421855">much higher</a> than for SARS-CoV-2 (the virus that causes COVID). The strains that go into the vaccine are <a href="https://www.who.int/teams/global-influenza-programme/vaccines/who-recommendations">reviewed</a> twice each year by the World Health Organization (WHO), which selects vaccine strains to match the next season’s predicted circulating strains. All current influenza vaccines in <a href="https://www.tga.gov.au/resources/publication/meeting-statements/aivc-recommendations-composition-influenza-vaccines-australia-2024">Australia</a> contain four different strains (known as quadrivalent vaccines). One of the strains appeared to <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2314801">disappear</a> during the COVID pandemic, and the WHO has recently <a href="https://cdn.who.int/media/docs/default-source/influenza/who-influenza-recommendations/vcm-southern-hemisphere-recommendation-2024/202309_qanda_recommendation.pdf?sfvrsn=7a6906d1_5">recommended</a> dropping this strain from the vaccine. It’s expected trivalent (three strain) vaccines will become available in the near future. <h2>What’s different about new flu vaccines?</h2> There are eight brands of flu vaccines <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">available</a> in Australia in 2024. These include egg-based vaccines (Vaxigrip Tetra, Fluarix Tetra, Afluria Quad, FluQuadri and Influvac Tetra), cell-based vaccines (Flucelvax Quad), adjuvanted vaccines (Fluad Quad) and high-dose vaccines (Fluzone High-Dose Quad). Until recently, the process of manufacturing flu vaccines has remained similar. Since the development of the influenza vaccine in the <a href="https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-influenza-vaccination">1940s</a>, influenza viruses were grown in chicken eggs, then extracted, inactivated, purified and processed to make up the egg-based vaccines that are still used widely. However, there have been several enhancements to influenza vaccines in recent years. Older people’s immune systems tend not to respond as strongly to vaccines. In some flu vaccines, adjuvants (components that stimulate the immune system) are included with the influenza antigens. For example, an adjuvant is used in the Fluad Quad vaccine, recommended for over 65s. Studies <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">suggest</a> adjuvanted influenza vaccines are slightly better than standard egg-based vaccines without adjuvant in older people. An alternative approach to improving the immune response is to use higher doses of the vaccine strains. An example is Fluzone High-Dose Quad – another option for older adults – which contains the equivalent of four doses of a standard influenza vaccine. Studies <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">suggest</a> the high dose vaccine is better than the standard dose vaccine (without an adjuvant) in preventing hospitalisation and complications in older people. Other manufacturers have updated the manufacturing process. Cell-based vaccines, such as Flucelvax Quad, use cells instead of eggs in the manufacturing process. Other vaccines that are <a href="https://www.cdc.gov/flu/prevent/advances.htm">not yet available</a> also use different technologies. In the past, <a href="https://pubmed.ncbi.nlm.nih.gov/31151913/">manufacturing issues</a> with egg-based vaccines have reduced their effectiveness. Using an alternative method of production provides some degree of insurance against this in the future. <h2>What should I do this year?</h2> Given indications this year’s flu season may be earlier than usual, it’s probably safest to get your vaccine early. This is particularly <a href="https://www.health.gov.au/resources/publications/atagi-statement-on-the-administration-of-seasonal-influenza-vaccines-in-2024?language=en">important</a> for those at highest risk of severe illness, including older adults (65 years and over), those with chronic medical conditions, young children (six months to five years) and Aboriginal and Torres Strait Islander people. Influenza vaccines are also recommended in pregnancy to protect both the mother and the baby for the first months of life. Influenza vaccines are widely available, including at GP clinics and pharmacies, while many workplaces have occupational programs. For high-risk groups, <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">four of the vaccines</a> are subsidised by the Australian government through the <a href="https://www.health.gov.au/our-work/national-immunisation-program">National Immunisation Program</a>. In older people, a number of vaccines are now recommended: <a href="https://www.health.gov.au/sites/default/files/2024-03/atagi-statement-on-the-administration-of-covid-19-vaccines-in-2024.pdf">COVID</a> and influenza, as well as one-off courses of <a href="https://www.health.gov.au/sites/default/files/documents/2020/06/national-immunisation-program-pneumococcal-vaccination-schedule-from-1-july-2020-clinical-advice-for-vaccination-providers.pdf">pneumococcal</a> and <a href="https://www.health.gov.au/topics/immunisation/vaccines/shingles-herpes-zoster-immunisation-service">shingles</a> vaccines. In general, most vaccines can be given in the same visit, but talk to your doctor about which ones you need. <h2>Are there side effects?</h2> All influenza vaccines can <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">cause</a> a sore arm and sometimes more generalised symptoms such as fever and tiredness. These are expected and reflect the immune system reacting appropriately to the vaccine, and are mostly mild and short-term. These side effects are slightly more common in <a href="https://ncirs.org.au/sites/default/files/2021-02/Adjuvanted%20influenza%20vaccine%20vs%20standard%20dose%20influenza%20vaccine%20SoF%20EP%20E2D%20tables_26%20Feb%202021_Final.pdf">adjuvanted</a> and <a href="https://ncirs.org.au/sites/default/files/2022-05/HD%20vs%20sIV%20SoF%20EP%20E2D_March%202022_Final.pdf">high dose</a> vaccines. As with all medications and vaccines, allergic reactions such as anaphylaxis can occur after the flu vaccine. All vaccine providers are trained to recognise and respond to anaphylaxis. People with egg allergies should discuss this with their doctor, but in general, <a href="https://www.allergy.org.au/patients/food-allergy/egg-allergy-flu-vaccine">studies suggest</a> they can safely receive any (including egg-based) influenza vaccines. Serious side effects from the influenza vaccine, such as Guillain-Barré syndrome, a neurological complication, are very rare (one case per million people vaccinated). They are <a href="https://pubmed.ncbi.nlm.nih.gov/23810252/">thought</a> to be less common after influenza vaccination than after infection with influenza.<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/226623/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/allen-cheng-94997">Allen Cheng</a>, Professor of Infectious Diseases, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock 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/there-are-new-flu-vaccines-on-offer-for-2024-should-i-get-one-what-do-i-need-to-know-226623">original article</a>.

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Dad awarded compensation after developing heart issue from mandatory vaccine

An Adelaide father is set to receive hefty compensation after a mandatory Covid jab left him with a debilitating health condition. 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. After having two Pfizer vaccines, he suffered some adverse effects, but dismissed his symptoms as nothing serious. 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. 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. 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. "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">9News.</a> The pain kept getting worse until he was rushed to hospital a few weeks later when he thought he was having a heart attack. There he was diagnosed with post-vaccine pericarditis: an inflammation of the membrane around the heart. His illness meant he was unable to work full time, and also meant he was unable to keep up with his young son. "Even today with just mild exertion [I get] chest pains and then it's followed by fatigue, like severe fatigue," Shepard said. "It's heartbreaking to have to say 'sorry buddy, daddy's tired'." Mr Shepherd decided to take legal action after he was unable to work, launching a workers compensation claim against the government. In a landmark ruling in mid-January, the South Australian Employment Tribunal agreed to pay weekly compensation and medical bills to Shepherd. 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. Pericarditis is meant to clear within a few months, but Shepherd's symptoms have plagued him for almost two years. Image credits: 9News

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How long does immunity last after a COVID infection?

<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> 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. 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>. 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? Let’s take a look at what the evidence shows. <h2>B cells and T cells</h2> 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. 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. A <a href="https://www.science.org/doi/full/10.1126/science.abf4063?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&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. 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). <h2>But what about when the virus mutates?</h2> 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. 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. 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. 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. 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>. 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. <h2>What about immunity after vaccination?</h2> 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. But we know COVID vaccine effectiveness wanes over time. A <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2804451?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&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. 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. 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. 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. 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. <h2>What now?</h2> Everyone’s immune system is slightly unique, and SARS-CoV-2 continues to mutate, so knowing exactly how long COVID immunity lasts is complicated. 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. 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>. 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.<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" /> <a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, 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> Image credits: Getty Images 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>.

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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

<a href="https://theconversation.com/profiles/deborah-lupton-9359">Deborah Lupton</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> 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. 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. 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. <h2>Evolving pandemic experiences</h2> 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. 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. 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. The findings show that as the conditions of the pandemic and government management have changed across these years, so have Australians’ experiences. 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. 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&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. <h2>Trust has eroded</h2> 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. 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. 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%). 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. 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>. 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. 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. <h2>Enter complacency</h2> 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. 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. 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. 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. <h2>COVID is still a risk</h2> 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. 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. 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. 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.<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" /> <a href="https://theconversation.com/profiles/deborah-lupton-9359">Deborah Lupton</a>, 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> Image credits: Getty Images 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>.

Caring

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

<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> 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. 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. 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? <h2>Difficulties with data</h2> 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. 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. 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>. 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>. 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. 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. 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. Monthly prescriptions for antivirals on the Pharmaceutical Benefits Scheme were increasing rapidly in November, but we are not given more recent data on this. 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. <h2>What’s happening elsewhere?</h2> 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. 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. <h2>Are vaccines still effective?</h2> 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). 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. 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. 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? 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? <h2>Should we be concerned by this wave?</h2> 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. 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. <h2>What should we expect in 2024?</h2> 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. 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. 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.<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" /> <a href="https://theconversation.com/profiles/adrian-esterman-1022994">Adrian Esterman</a>, Professor of Biostatistics and Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Getty Images 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>.

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

<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> 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. While these strains appear less severe than the original Alpha and Delta variants, the risk of long COVID remains. 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? <h2>When COVID becomes ‘long COVID’</h2> For most people, long COVID means not getting better after a COVID infection. 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. 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. <h2>How common is long COVID?</h2> 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. 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. 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. 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. 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. 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. <h2>What’s different this time?</h2> 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. 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. <h2>Long COVID can affect all aspects of life</h2> 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. 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. 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. <h2>I think I have long COVID, what can I expect from my doctor?</h2> 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. Australia has trailed behind the US, the UK and Europe in rolling out care for long COVID, and in collecting data on the condition. 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. However, there is consensus on what constitutes good care. Clinicians seeing patients with possible long COVID should: <ul> <li> validate the person’s experience of symptoms and the impact their symptoms are having on their functioning, particularly when the cause is not clear </li> <li> diagnose and treat any other health conditions that are part of the picture </li> <li> support people to minimise the impairment their symptoms cause by pacing of physical and cognitive activities. Importantly, this doesn’t involve pushing through fatigue. </li> </ul> 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. <h2>We still need to focus on reducing COVID transmission</h2> The best way to prevent long COVID is to avoid contracting – and spreading – COVID. This means: <ul> <li> getting vaccinated or boosted, if you’re eligible </li> <li> staying home if you feel unwell </li> <li> wearing a mask to protect yourself and vulnerable community members </li> <li> testing for COVID if you have symptoms and if you test positive, taking antivirals (if eligible) and isolating until your symptoms resolve. </li> </ul> Long COVID is not going away, but we all have a role to play in preventing and responding to it. Ruby Biezen from the APPRISE Network and the University of Melbourne and Andrew Lloyd from the Kirby Institute at UNSW contributed to this article.<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" /> <a href="https://theconversation.com/profiles/andrew-baillie-646956">Andrew Baillie</a>, 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> Image credits: Getty Images 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>.

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

<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> 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. 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. 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&CACHEID=ROOTWORKSPACE-abefa4a4-ecaa-4c26-8713-d80c90388545-oIRWpvB">Lagevrio</a> that treat the virus itself. 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>. <h2>What antivirals are available?</h2> <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. 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. 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. 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. <h2>What does the evidence say?</h2> As Lagevrio and Paxlovid are relatively new medicines, we’re still learning how well they work and which patients should use them. 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>. 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. However, few people at highest risk from COVID were included in this trial. So it could offer some benefit for patients in this group. 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. 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. Some people who take COVID antivirals will experience side effects. Mostly these are not serious and will go away with time. 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. 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. <h2>Be prepared</h2> 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. 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. 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>. 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). 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. 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.<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" /> <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, 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> Image credits: Getty Images 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>.

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Millions of high-risk Australians aren’t getting vaccinated. A policy reset could save lives

<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/ingrid-burfurd-1295906">Ingrid Burfurd</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> Each year, vaccines prevent thousands of deaths and hospitalisations in Australia. But millions of high-risk older Australians <a href="https://grattan.edu.au/report/a-fair-shot-ensuring-all-australians-can-get-the-vaccines-they-need/">aren’t getting</a> recommended vaccinations against COVID, the flu, pneumococcal disease and shingles. Some people are more likely to miss out, such as migrant communities and those in rural areas and poorer suburbs. As our new <a href="https://grattan.edu.au/report/a-fair-shot-ensuring-all-australians-can-get-the-vaccines-they-need/">Grattan report shows</a>, a policy reset to encourage more Australians to get vaccinated could save lives and help ease the pressure on our struggling hospitals. <h2>Adult vaccines reduce the risk of serious illness</h2> Vaccines slash the risk of <a href="https://www.ncirs.org.au/sites/default/files/2021-03/Influenza-fact-sheet_31%20March%202021_Final.pdf">hospitalisation</a> and serious illness, <a href="https://ncirs.org.au/recent-covid-19-vaccination-highly-effective-against-death-caused-sars-cov-2-infection-older">often by more than half</a>. COVID has already caused more than <a href="https://www.abs.gov.au/statistics/health/causes-death/provisional-mortality-statistics/latest-release">3,000 deaths in Australia this year</a>. On average, the flu kills about <a href="https://www.doherty.edu.au/news-events/news/statement-on-the-doherty-institute-modelling">600 people a year</a>, although a bad flu season, like 2017, can mean <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0%7E2017%7EMain%20Features%7EAustralia's%20leading%20causes%20of%20death,%202017%7E2">several thousand deaths</a>. And pneumococcal disease may also kill <a href="https://www.aihw.gov.au/getmedia/49809836-8ead-4da5-81c4-352fa64df75b/aihw-phe-263.pdf?inline=true">hundreds</a> of people a year. Shingles is rarely fatal, but can be extremely painful and cause <a href="https://www.healthdirect.gov.au/shingles#complications">long-term nerve damage</a>. Even before COVID, vaccine-preventable diseases caused tens of thousands of potentially preventable hospitalisations each year – more than <a href="https://www.aihw.gov.au/reports/primary-health-care/disparities-in-potentially-preventable-hospitalisa/data">80,000 in 2018</a>. Vaccines offered in Australia have been tested for safety and efficacy and have been found to be <a href="https://www.health.gov.au/topics/immunisation/about-immunisation/vaccine-safety#:%7E:text=serious%20side%20effects.-,Vaccine%20safety%20monitoring,approved%20for%20use%20in%20Australia.">very safe</a> for people who are <a href="https://www.health.gov.au/topics/immunisation/when-to-get-vaccinated/national-immunisation-program-schedule">recommended to get them</a>. <h2>Too many high-risk people are missing out</h2> Our <a href="https://grattan.edu.au/report/roundabouts-overpasses-carparks-hauling-the-federal-government-back-to-its-proper-role-in-transport-projects">report</a> shows that before winter this year, only 60% of high-risk Australians were vaccinated against the flu. Only 38% had a COVID vaccination in the last six months. Compared to a year earlier, two million more high-risk people went into winter without a recent COVID vaccination. Vaccination rates have fallen further since. Just over one-quarter (<a href="https://www.health.gov.au/sites/default/files/2023-11/covid-19-vaccine-rollout-update-10-november-2023.pdf">27%</a>) of people over 75 have been vaccinated in the last six months. That leaves more than 1.3 million without a recent COVID vaccination. Uptake is also low for other vaccines. Among Australians in their 70s, <a href="https://ncirs.org.au/sites/default/files/2022-12/Coverage%20report%202021%20SUMMARY%20FINAL.pdf">less than half</a> are vaccinated against shingles and only one in five are vaccinated against pneumococcal disease. These vaccination rates aren’t just low – they’re also unfair. The likelihood that someone is vaccinated changes depending on where they live, where they were born, what language they speak at home, and how much they earn. For example, at the start of winter this year, the COVID vaccination rate for high-risk Aboriginal and Torres Strait Islander adults was only 25%. This makes them about one-third less likely to have been vaccinated against COVID in the previous six months, compared to the average high-risk Australian. For more than 750,000 high-risk adults who do not speak English at home, the COVID vaccination rate is below 20% – about half the level of the average high-risk adult. Within this group, 250,000 adults aren’t proficient in English. They were 58% less likely to be vaccinated for COVID in the previous six months, compared to the average high-risk person. High-risk adults who speak English at home have a flu vaccination rate of 62%. But for people from 29 other language groups, who aren’t proficient in English, the rate is less than 31%. These 39,000 people have half the vaccination rate of people who speak English at home. These vaccination gaps contribute to the differences in people’s health. Australians born overseas don’t just have much lower rates of COVID vaccination, they also have much higher rates of death from COVID. Where people live also affects vaccination rates. High-risk people living in remote and very remote areas are less likely to be vaccinated, and even within capital cities there are big differences between different areas. <h2>We need to set ambitious targets</h2> Australia needs a vaccination reset. A new National Vaccination Agreement between the federal and state governments should include ambitious but achievable targets for adult vaccines. This can build on the success of targets for childhood and adolescent vaccination, setting targets for overall uptake and for communities that are falling behind. The federal government should ask the Australian Technical Advisory Group on Immunisation (ATAGI) to advise on vaccination targets for COVID, flu, pneumococcal and shingles for all high-risk older adults. <h2>Different solutions for different barriers</h2> Barriers to vaccination range from the trivial to the profound. A new national vaccination strategy needs to dismantle high and low barriers alike. First, to increase overall uptake, vaccination should be easier, and easier to understand. The federal government should introduce vaccination “surges”, especially in the lead-up to winter, as <a href="https://www.who.int/europe/news/item/09-10-2023-vulnerable--vaccinate.-protecting-the-unprotected-from-covid-19-and-influenza">countries in Europe</a> do. During surges, high-risk people should be able to get vaccinated even if they have had a recent infection or injection. This will make the rules simpler and make vaccination in aged care easier. Surges should be reinforced with advertising explaining who should get vaccinated and why. High-risk people should get SMS reminders. Second, targeted policies are needed for the many people who are happy to use mainstream primary care services, but who don’t get vaccinated – for example, due to <a href="https://theconversation.com/how-can-governments-communicate-with-multicultural-australians-about-covid-vaccines-its-not-as-simple-as-having-a-poster-in-their-language-156097">language barriers</a>, or living in <a href="https://theconversation.com/over-half-of-eligible-aged-care-residents-are-yet-to-receive-their-covid-booster-and-winter-is-coming-205403">aged care</a>. <a href="https://www.health.gov.au/our-work/phn/what-PHNs-are">Primary Health Networks</a> should get funding to coordinate initiatives such as vaccination events in aged care and disability care homes, workforce training to support culturally appropriate care, and provision of interpreters. Third, tailored programs are needed to reach <a href="https://www.aihw.gov.au/reports/australias-health/health-promotion">people who are not comfortable or able to access mainstream health care</a>, who have the most complex barriers to vaccination – for example, distrust of the health system or poverty. These communities are all very different, so one-size-fits-all programs don’t work. The pandemic showed that vaccination programs can succeed when they are designed and delivered with the communities they are trying to reach. Examples are “<a href="https://pubmed.ncbi.nlm.nih.gov/36366401/">community champions</a>” who challenge misinformation, or health services organising vaccination events where communities work, gather or <a href="https://www.theguardian.com/australia-news/2021/aug/11/hundreds-queue-for-hours-and-some-camp-overnight-at-pop-up-vaccine-clinic-in-sydneys-lakemba">worship</a>. These programs should get ongoing funding, but also be accountable for achieving results. Adult vaccines are the missing piece in Australia’s whole-of-life vaccination strategy. For the health and safety of the most vulnerable members of our community, we need to close the vaccination gap. <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/217915/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, 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/ingrid-burfurd-1295906">Ingrid Burfurd</a>, Senior Associate, Health Program, Grattan Institute, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> Image credits: Shutterstock 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/millions-of-high-risk-australians-arent-getting-vaccinated-a-policy-reset-could-save-lives-217915">original article</a>.

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

<a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> 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. 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>. 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. So what do you need to know about testing in this wave? Here are four key questions answered. <h2>1. When should I do a RAT?</h2> 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. 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. 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. 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>. <h2>2. Should I test multiple times?</h2> 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>. 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. 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>. 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. <h2>3. Do RATs detect the latest variants?</h2> 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. 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. 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>. <h2>4. Can I rely on expired RATs?</h2> At this point in the pandemic, you might have a few expired tests at the back of your cupboard. 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. 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. 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. 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. <h2>The path from here</h2> 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. 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.<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" /> <a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, Associate Professor, Epidemiology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Getty Images 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>.

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With COVID surging, should I wear a mask?

<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> 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. 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>. 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>. So amid rising COVID cases, should you be wearing a mask? <h2>COVID is still a threat</h2> Unfortunately, SARS-CoV-2 (the virus that causes COVID) has not mutated into just a trivial cold. 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. 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>. 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. 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. <h2>What can we do to protect ourselves?</h2> 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. 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. 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>. 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. 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>. 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. <h2>What about vaccines?</h2> 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. 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>. 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. 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. <hr /> 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.<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" /> <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> Image credits: Getty Images 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>.

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

<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> 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. 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. 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. Who is eligible for these new boosters? How do they differ from earlier ones? Do they work? Are they safe? <h2>Who’s eligible for the new boosters?</h2> 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. 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. People aged 65 to 74 are recommended to have a 2023 booster if they haven’t already had one. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=315&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=315&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=315&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=396&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=396&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=396&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>For people without risk factors. <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></figcaption></figure> Adults aged 18 to 64 with 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. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=311&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=311&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=311&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=391&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=391&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=391&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Advice for people with risk factors. <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></figcaption></figure> For adults aged 18 to 64 without 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. Additional doses aren’t recommended for children without underlying conditions that increase their risk of severe COVID. A primary course is not recommended for children aged six months to five years without additional risk factors. <h2>Monovalent, bivalent? What’s the difference?</h2> From monovalent The initial COVID vaccines were “monovalent”. They had one target – the original viral strain. 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. To bivalent 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>. Omicron continued to evolve, leading to more “immune escape”, contributing to repeated waves of transmission. 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. Back to monovalent Further changes in the virus have meant our boosters needed to be updated again. This takes us to the recent announcement. 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>). This vaccine is monovalent once more, meaning it has only one target. The target against the original viral strain has been removed. 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. 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. 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>. <h2>Do these newer vaccines work?</h2> 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=&id=CP-2023-PI-02409-1&d=20231117172310101">Pfizer</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">Moderna</a> submitted to the TGA. 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. 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. 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>. 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. <h2>Are they safe?</h2> The <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2023-PI-02409-1&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. 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. <h2>What happens next?</h2> 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. 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.<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" /> <a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, Professor, Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Getty Images 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>.

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

<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> What happens when people withdraw their retirement savings early? We’ve just found out. 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. 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>. 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. 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. <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”. 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>. 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. <h2>Who dipped into super?</h2> 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. 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>. 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). 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). 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. <h2>Where did the money go?</h2> 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. 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. 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. 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. <h2>Less debt, less falling behind</h2> 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. They also became less likely to fall behind on credit card and personal loan payments, a difference that vanished after three months. 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. <h2>Lessons learned</h2> 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. 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. 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. 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.<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" /> <a href="https://theconversation.com/profiles/nathan-wang-ly-1380895">Nathan Wang-Ly</a>, 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> Image credits: Getty Images 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>.

Money & Banking

Qantas found guilty of firing health worker during pandemic

Qantas has been found guilty of firing a health and safety officer during the early days of the pandemic, a NSW district court judge has found. The airline dismissed Theo Seremetidis in early 2020 after he expressed concerns about safety protocol for flights arriving from China in the first months of the Covid-19 pandemic. According to SafeWork NSW, Qantas breached part 6 of the Work Health and Safety Act and discriminated against Mr Seremetidis when he was stood down. On Thursday, the court heard elements of the matter brought by SafeWork NSW were established beyond reasonable doubt and Qantas Ground Services is “guilty of the offence charged”. They specifically related to standing down Mr Seremetidis “to his detriment” and the main reason for his dismissal was a prohibited reason, because he had exercised a power as a health and safety representative by directing workers to cease unsafe work. The prosecution was brought about after Mr Seremetidis launched a complaint about his former workplace with the Transport Workers Union (TWU), who took the complaint to SafeWork NSW. Judge David Russell said he accepted SafeWork NSW’s submissions that Qantas Ground Services “actively sidelined” Mr Seremetidis and ignored his concerns. <div>“Firstly … by cutting him off from other staff who were seeking his help,” he said. “And secondly, by standing him down and requiring him to leave the airport forthwith. “I formed the view that he attempted to carry out his duties as a health and safety representative conscientiously and carefully,” he said. TWU President and NSW/Qld Secretary Richard Olsen welcomed the verdict on SafeWork NSW’s primary charge. “This is a fantastic result. Theo is a workplace hero and today he has been vindicated. When the TWU urged SafeWork NSW to prosecute this case, Theo courageously took on one of Australia’s biggest corporate bullies and won,” he said. Image credits: TWU </div>

Legal

From COVID to gastro, why are cruise ships such hotbeds of infection?

<a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Dual outbreaks of <a href="https://www.abc.net.au/news/2023-11-12/grand-princess-ship-adelaide-covid-19-gastroenteritis/103095704">gastro and COVID</a> on the Grand Princess cruise ship that docked in Adelaide on Monday <a href="https://www.theguardian.com/australia-news/2023/nov/13/grand-princess-cruise-ship-covid-gastro-outbreak-docks-adelaide-south-australia">have now been declared over</a> by the <a href="https://www.canberratimes.com.au/story/8421009/cruise-ship-doctor-declares-dual-virus-outbreaks-over/">doctor on board</a>. A spokesperson for Princess Cruises, which operates the ship, said a number of passengers had presented with symptoms <a href="https://www.9news.com.au/national/grand-princess-no-double-covid19-gastro-outbreak-on-ship-cruise-line-says/5d02d423-3289-4a2b-a580-1ed565b78027">on a previous voyage</a>. But the ship has since been disinfected and the number of people who were ill when the ship arrived into Adelaide was said to be in single digits. While this is positive news, reports of infectious outbreaks on cruise ships evoke a sense of deja vu. We probably all remember the high-profile COVID outbreaks that occurred on cruise ships in 2020. So what is it about cruise ships that can make them such hotspots for infection? <h2>First, what causes these outbreaks?</h2> Respiratory infectious outbreaks on cruise ships may be caused by <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/air-land-sea/cruise-ship-travel">a range of pathogens</a> including SARS-CoV-2 (the virus that causes COVID) and influenza viruses. These can be spread by <a href="https://www.pnas.org/doi/10.1073/pnas.2015482118">respiratory droplets and aerosols</a> released when people breathe, talk, laugh, cough and sneeze. Historically, <a href="https://jmvh.org/article/the-navy-and-the-1918-19-influenza-pandemic/">troop transport ships</a> also helped to spread the lethal 1918 flu virus between continents. Gastro outbreaks on cruise ships are similarly well documented. More than 90% of cruise ship gastro outbreaks are caused by <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/air-land-sea/cruise-ship-travel#infectious">norovirus</a>, which is spread from person to person, and through contaminated objects or contaminated food or water. Gastro can also be caused by other pathogens such as <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/air-land-sea/cruise-ship-travel">bacteria in contaminated food or water</a>. <h2>What is the risk?</h2> In 2020, around 19% of <a href="https://www.bmj.com/content/369/bmj.m1632">Diamond Princess</a> passengers and crew docked in Japan tested positive to COVID. Ultimately, nearly one in four <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739343/">Ruby Princess</a> passengers and crew docked in Sydney tested positive. However, COVID generally presents a lesser risk nowadays, with most people having some level of immunity from vaccination or previous infection. The outbreak on the Grand Princess appears to have been much smaller in scale. A <a href="https://www.sciencedirect.com/science/article/abs/pii/S1477893916300680">three-year study</a> before COVID of influenza-like illness (which includes fever), acute respiratory illness (which <a href="https://www.cdc.gov/flu/about/glossary.htm">doesn’t require fever</a> to be present) and gastro on cruise ships found these were diagnosed in 32.7%, 15.9% and 17% of ill passengers, and 10.9%, 80% and 0.2% of ill crew, respectively. An <a href="https://www.cdc.gov/mmwr/volumes/70/ss/ss7006a1.htm">analysis</a> of data from 252 cruise ships entering American ports showed the overall incidence of acute gastro halved between 2006 and 2019. Passenger cases decreased from 32.5 per 100,000 travel days to 16.9, and crew cases from 13.5 per 100,000 travel days to 5.2. This decline may be due to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382806/">combination</a> of improved hygiene and sanitation standards. The risk of getting sick with gastro was significantly higher on <a href="https://www.cdc.gov/mmwr/volumes/70/ss/ss7006a1.htm">bigger ships and longer voyages</a>. This is because the longer you are in close contact with others, the greater the chance of exposure to an infectious dose of viruses or bacteria. <h2>Why are cruise ships infection hotspots?</h2> On cruise ships, people tend to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739343/">crowd together</a> in confined spaces for extended periods. These include dining halls, and during social activities in casinos, bars and theatres. The risk goes up when the environment is noisy, as more droplets and aerosols are shed when people are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382806/">laughing, shouting or talking loudly</a>. Passengers may come from <a href="https://www.sciencedirect.com/science/article/abs/pii/S1477893916300680?via%3Dihub">multiple countries</a>, potentially bringing variants from different parts of the world. Influenza, which is usually seasonal (late autumn to early spring) onshore, can occur at any time <a href="https://academic.oup.com/cid/article/31/2/433/295546">on a cruise ship</a> if it has international passengers or is calling at international ports. Human behaviour also contributes to the risk. Some passengers <a href="https://academic.oup.com/jtm/article/15/3/172/1821220">surveyed</a> following cruise ship gastro outbreaks indicated they were ill when they boarded the ship, or they became ill but didn’t disclose this because they didn’t want to pay for a doctor or be made to isolate, or they thought it wasn’t serious. Those who became ill were more likely than those who did not to think that hand hygiene and isolation were not effective in preventing infection transmission, and were less likely to wash their hands after using the toilet. Given <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/norovirus.aspx">faecal contamination</a> is a major source of norovirus transmission, this is concerning. While there are usually a la carte dining options on board, many people will choose a buffet option. From personal experience, food tongs are handled by multiple people, some of whom may not have cleaned their hands. <h2>What can help?</h2> The <a href="https://www.health.gov.au/news/ahppc-statement-advice-to-support-safe-cruising">Department of Health and Aged Care</a> recommends cruise companies encourage crew and passengers to be up-to-date with flu and COVID vaccinations, and encourage anyone who becomes ill to stay in their cabin, or at least avoid crowded spaces and wear a mask in public. They also recommend cruise ships have a plan to identify and contain any outbreaks, including testing and treatment capacity, and communicate to passengers and crew how they can reduce their transmission risk. All passengers and crew should report any signs of infectious illness, and practice good hand hygiene and <a href="https://www.cdc.gov/oralhealth/infectioncontrol/faqs/respiratory-hygiene.html">respiratory etiquette</a>, such as covering their mouth if coughing or sneezing, disposing of used tissues, and washing or sanitising hands after touching their mouth or nose. South Australia’s chief health officer has <a href="https://www.abc.net.au/news/2023-11-13/grand-princess-ship-covid-gastro-docks-in-adelaide/103096836">commended</a> the Grand Princess crew for their infection protection and control practices, and for getting the outbreak under control.<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/217534/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, Professor, Nursing, School of Nursing and Midwifery, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock 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/from-covid-to-gastro-why-are-cruise-ships-such-hotbeds-of-infection-217534">original article</a>.

Cruising

We’re in a new COVID wave. What can we expect this time?

<a href="https://theconversation.com/profiles/james-wood-107417">James Wood</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>; <a href="https://theconversation.com/profiles/bette-liu-1484488">Bette Liu</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>; <a href="https://theconversation.com/profiles/katie-louise-flanagan-1066858">Katie Louise Flanagan</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>, and <a href="https://theconversation.com/profiles/stuart-turville-1273716">Stuart Turville</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Australia is now into its <a href="https://www.abc.net.au/news/2023-11-02/nsw-sydney-covid-christmas-fresh-wave/103051190">next COVID wave</a>. We’ve seen hints of this for a while. Case numbers and indicators of severe disease began rising in Victoria in August. But it has taken several months for a consistent pattern to emerge across Australia. Now we see evidence of this new wave via <a href="https://www.health.vic.gov.au/sites/default/files/2023-11/victorian-covid-19-surveillance-report-03-november-2023.pdf">wastewater surveillance</a> for traces of SARS-CoV-2, the virus that causes COVID. We also see <a href="https://www.health.gov.au/topics/covid-19/weekly-reporting">rises</a> in COVID-related hospital admissions and antiviral prescriptions. Compared to past waves, this one has built up slowly and over a longer period. Here’s what we know about this new wave and what to expect over the coming weeks. <h2>How do we know we’re in a new COVID wave?</h2> In earlier waves, when more people were testing for COVID and reporting their results, we were more confident case numbers were a reasonable reflection of how COVID was tracking. However, now, a more useful indicator for COVID nationally is to look at trends in the number of prescriptions for the antiviral medications ritonavir (Paxlovid) and molnupiravir (Lagevrio) on the Pharmaceutical Benefits Scheme (PBS). In the graph below, which is drawn from <a href="https://www.health.gov.au/topics/covid-19/weekly-reporting">national prescribing data</a>, you can clearly see script numbers rising. <iframe id="3d26e" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/3d26e/1/" width="100%" height="400px" frameborder="0"></iframe> <h2>When will we hit the peak?</h2> It has become more difficult to predict the size and timing of the peak. Reduced access to COVID testing and fewer requirements or opportunities to report test results, combined with the slow growth rate for this wave, give a wider range of possibilities. The wave is also likely to differ between states and territories, as some got off to a later start. However, given the wave’s slow growth rate and further increases in hybrid immunity (immunity from both vaccination and infection) over 2023, it’s reasonable to expect this to be the smallest Omicron wave so far. We also expect it will be over by early in the summer holiday period. That’s when rates of community contact decline significantly, as work and school contacts are much reduced. That means fewer opportunities for the virus to spread between networks of family and friends. <h2>Why now?</h2> It’s unlikely this latest COVID wave stems from changes in behaviour. People are generally out and about, fewer people are wearing masks in public. But we don’t see any dramatic shifts in this type of behaviour in 2023 compared with 2022. It’s not a seasonal cause, given respiratory viruses tend to spread better in winter, when we’re cooped up indoors with others. It’s unlikely it’s our <a href="https://www.medrxiv.org/content/10.1101/2023.08.26.23294679v1">waning immunity</a> from infection or vaccination that’s prompting these successive waves. Instead, we’re seeing the result of a constantly mutating virus. Successful SARS-CoV-2 variants are gradually acquiring mutations. Some of these changes reduce the ability of existing antibodies to bind to and neutralise the virus. So it appears it’s still the “immune escape” variants that are behind these latest waves. <h2>Which variants are to blame?</h2> The primary viral lineage in Australia this year has been XBB. Over the past six months, its two most influential mutations have been: <ul> <li> the F456L mutation that led to the rise of EG.5.1, also known as Eris </li> <li> more recently, the paired “FLip” mutations F456L+L455F. We see these in offspring of Eris and in much-less closely related lineages. This is a clear sign these mutations help the virus spread better. </li> </ul> Both the single and paired mutations make existing antibodies less effective at blocking SARS-CoV-2 from binding to critical receptors on our cells. This increases our susceptibility to infection. The novel BA.2.86 lineage – colloquially known as Pirola – was first reported in Denmark in August and has many unique mutations. It has not been influential so far in this wave in Australia. But it has continued to evolve. And we may see it play a much bigger role in Australia in 2024. <h2>Who is most at risk during this COVID wave?</h2> Since the start of the pandemic, rates of COVID-related death and severe disease have greatly declined. That’s due to <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00801-5/fulltext">widespread</a> vaccination and hybrid immunity, and a major change in the Omicron variant that’s made the virus less-likely to <a href="https://pubmed.ncbi.nlm.nih.gov/35104837/">infect the lung</a>. However, provisional statistics show there have been about <a href="https://www.abs.gov.au/statistics/health/causes-death/provisional-mortality-statistics/latest-release">3,000</a> registered COVID deaths in Australia from January to July 2023. Older people and those with weaker immune systems are expected to remain at <a href="https://www.sciencedirect.com/science/article/pii/S2468266723000798">greatest risk</a> of developing severe COVID during this current wave. This is the rationale for the Australian Technical Advisory Group on Immunisation’s (ATAGI) September <a href="https://www.health.gov.au/news/atagi-update-on-the-covid-19-vaccination-program">recommendation</a> for people aged 75 or older to get boosted if more than six months had passed since their last vaccine dose. ATAGI also recommended people aged 65-74, and people 18 years and over with severe immunocompromising conditions, consider having another booster. But, by the end of October 2023, <a href="https://www.health.gov.au/sites/default/files/2023-10/covid-19-vaccine-rollout-update-27-october-2023.pdf">it was estimated</a> only one-quarter of Australians aged 65-74, one-third of people aged 75 or over and fewer than half (45%) of people in aged care had received a COVID vaccine in the past six months. <figure class="align-center "><img src="https://images.theconversation.com/files/558309/original/file-20231108-19-5fu6vv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/558309/original/file-20231108-19-5fu6vv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=249&fit=crop&dpr=1 600w, https://images.theconversation.com/files/558309/original/file-20231108-19-5fu6vv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=249&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/558309/original/file-20231108-19-5fu6vv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=249&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/558309/original/file-20231108-19-5fu6vv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=313&fit=crop&dpr=1 754w, https://images.theconversation.com/files/558309/original/file-20231108-19-5fu6vv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=313&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/558309/original/file-20231108-19-5fu6vv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=313&fit=crop&dpr=3 2262w" alt="Woman receives vaccination" /><figcaption>People with immunocompromising conditions should get boosted. <a class="source" href="https://www.shutterstock.com/image-photo/woman-wearing-protective-face-mask-getting-1966499908">Shutterstock</a></figcaption></figure> <h2>Which vaccines are available?</h2> Currently available bivalent vaccines protect against the original ancestral strain of SARS-CoV-2 (now extinct) plus the newer BA.1 or BA.4/5 variants. These bivalent vaccines also protect us against <a href="https://assets.publishing.service.gov.uk/media/6527f0bfaea2d0000d219c69/vaccine-surveillance-report-2023-week-41.pdf">severe disease</a> from the Omicron variants circulating now, such as XBB. But we can expect newer monovalent XBB.1.5 vaccines soon, now the Therapeutic Goods Administration has <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">approved them</a>. These are expected to provide <a href="https://www.medrxiv.org/content/10.1101/2023.10.04.23296545v1.full.pdf">better protection</a> against newer Omicron variants than the currently available <a href="https://www.sciencedirect.com/science/article/pii/S2213260023003065">bivalent vaccines</a>. In the meantime, boosting with any available COVID vaccine will provide <a href="https://assets.publishing.service.gov.uk/media/6527f0bfaea2d0000d219c69/vaccine-surveillance-report-2023-week-41.pdf">good protection</a> for vulnerable people. <h2>What might we expect from COVID in 2024?</h2> The Northern Hemisphere appears to have settled into an approximate seasonal pattern of COVID infections in 2023 and it’s plausible Australia will follow suit. If so, we should plan for overlapping seasonal epidemics of our three most important respiratory viruses: SARS-CoV-2, influenza and respiratory syncytial virus (RSV). So hospitals may need to plan ahead for larger peaks in admissions. Hopefully, new <a href="https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/rsv.html">vaccines for RSV</a>, and more broadly protective <a href="https://www.nih.gov/news-events/nih-research-matters/research-context-progress-toward-universal-vaccines">flu and COVID vaccines</a> to be developed over the next decade, should help.<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/216820/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/james-wood-107417">James Wood</a>, Professor, epidemiological modelling of infectious diseases, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>; <a href="https://theconversation.com/profiles/bette-liu-1484488">Bette Liu</a>, Associate Professor and NHMRC Career Development Fellow, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>; <a href="https://theconversation.com/profiles/katie-louise-flanagan-1066858">Katie Louise Flanagan</a>, Infectious Diseases Specialist and Clinical Professor, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>, and <a href="https://theconversation.com/profiles/stuart-turville-1273716">Stuart Turville</a>, Associate Professor, Immunovirology and Pathogenesis Program, Kirby Institute, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">original article</a>.

Caring

Huge win for Ruby Princess passengers

The passengers of the ill-fated Ruby Princess cruise ship voyage in 2020 have won a class action lawsuit against Carnival Cruise Lines, after a judge determined it was negligent for the voyage to commence. More than 2,600 passengers were onboard the vessel when the ship left from Sydney for a 13-night journey around New Zealand, before an outbreak of Covid-19 forced the cruise ship to turn around. Almost 700 people tested positive to the virus and were held onboard, which results in 28 Covid deaths. The lawsuit alleged that Carnival, which chartered the ship, and its owner/operator Princess Cruise Lines, breached duties of care and Australian Consumer Law. On Wednesday, Justice Angus Stewart found that the cruise company was negligent in certain respects with regard to the precautions taken for passenger safety. He also found the company made misleading representations in pre-holiday communications with passengers, including by suggesting it was "reasonably safe" to take the cruise at the beginning of the pandemic. The class action lawsuit began in October 2022 after two long years of preparation, and ran for five weeks. Susan Karpik was the lead applicant in the class action seeking damages arising from a breach of the consumer guarantees and negligence by the cruise company. In a statement issued by Shine Lawyers on Wednesday, Ms Karpik said she was “pleased with the outcome” but that it was only a “partial win”. “It’s of course only a partial win as 28 lives were lost on this cruise,” she said. “There are many individuals and families who will never recover from this loss.” Shine Lawyers Joint Head of Class Actions Vicky Antzoulatos, who ran the case said, “today is a warning for cruise companies to put passengers ahead of profits. “Carnival should now do the right thing and compensate all the passengers rather than prolong the matter through further litigation,” she said. Image credits: Getty Images

International Travel

You’ve heard of long COVID, but did you know there might also be a long cold?

<a href="https://theconversation.com/profiles/giulia-vivaldi-1476903">Giulia Vivaldi</a>, <a href="https://theconversation.com/institutions/queen-mary-university-of-london-1745">Queen Mary University of London</a> At least <a href="https://www.nature.com/articles/s41579-022-00846-2">10% of people</a> infected with SARS-CoV-2, the virus that causes COVID, have symptoms that last more than four weeks after the infection. With more than <a href="https://covid19.who.int/">770 million infections</a> to date, this translates to tens of millions of people living with the long-term consequences of COVID, known as “long COVID”. <a href="https://www.nature.com/articles/s41579-022-00846-2">More than 200 symptoms</a> of long COVID have been studied, with some of the most common being fatigue, breathlessness and cognitive difficulties, such as memory problems or “brain fog”. The condition can be debilitating – many people have to <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00387-5/fulltext">reduce their working hours</a> or are <a href="https://ifs.org.uk/publications/long-covid-and-labour-market">unable to work entirely</a>. But COVID may not be alone in causing long-lasting symptoms. In a <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00428-5/fulltext">new paper</a>, my colleagues and I report the findings of a study comparing long-term symptoms reported by people who experienced different types of acute respiratory infection. We asked more than 10,000 people to report on 16 symptoms commonly found in long COVID, such as fatigue, breathlessness, aches and pains, and dizziness. We then compared how common these symptoms were among three groups: people who had reported COVID, those who had reported another acute respiratory infection (but had tested negative for COVID), and those who had not reported either infection. We focused on long-term symptoms by only including people who had been infected more than four weeks earlier. We also took into account people’s general health before they were infected, and whether they had any existing respiratory conditions. Our study showed that all the symptoms considered were more common in people with previous COVID than in people with no infections, regardless of whether they reported long COVID. But this finding wasn’t unique to COVID. Almost all the symptoms we looked at were also more common in people with non-COVID respiratory infections than in those with no infection. In other words, our findings hinted towards the existence of a “long cold”: long-lasting health effects from other respiratory infections, such as colds, flu, or pneumonia, that are currently going unrecognised. Some of the most common symptoms of the long cold include coughing, stomach pain, and diarrhoea. These symptoms were reported an average of 11 weeks after the infection. While a severe initial infection seems to increase the risk of long-term symptoms, our research does not yet tell us why some people suffer extended symptoms while others do not. <h2>Important differences</h2> Importantly, we have no evidence that symptoms of the long cold have the same severity or duration as long COVID. In fact, we saw some important differences in the symptoms reported in the two groups, with those recovering from COVID more likely to experience light-headedness or dizziness and problems with taste and smell. These findings shine a light not only on the impact of long COVID on people’s lives, but also other respiratory infections. A lack of awareness, or even the lack of a common term, such as “long cold” or “long flu”, prevents both reporting and diagnosis of these conditions. And people who do report their long cold may still struggle to get a diagnosis, owing to the wide range of symptoms and <a href="https://www.nature.com/articles/s41591-022-01810-6">lack of diagnostic tests</a>. Long-lasting symptoms after respiratory infections are not a new phenomenon. Studies in survivors of two previous coronavirus outbreaks – the severe acute respiratory syndrome (Sars) pandemic and the Middle East respiratory syndrome (Mers) outbreak – have found long-term impacts on <a href="https://www.rcpjournals.org/content/clinmedicine/21/1/e68">lung function, quality of life and mental health</a>. And some people hospitalised with influenza A have experienced <a href="https://www.nature.com/articles/s41598-017-17497-6">respiratory and psychological problems</a> at least two years after being discharged from hospital. But most of the research so far has focused on people with severe disease, often severe enough to be hospitalised. Little is known about the long-term effects respiratory infections might have among people whose acute disease episode is less severe. Long COVID has bucked this trend, being studied in people with all levels of severity of the initial infection. This is in large part due to <a href="https://www.sciencedirect.com/science/article/pii/S0277953620306456">strong patient advocacy</a>, showing that it can affect even those with mild initial symptoms. In demanding recognition of their condition, people with long COVID have cast a much-needed spotlight on post-infection syndromes more generally. Now is the time to improve our understanding, diagnosis and treatment of these conditions. Let’s not wait for another pandemic.<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/214995/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giulia-vivaldi-1476903">Giulia Vivaldi</a>, , <a href="https://theconversation.com/institutions/queen-mary-university-of-london-1745">Queen Mary University of London</a> Image credits: Getty Images 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/youve-heard-of-long-covid-but-did-you-know-there-might-also-be-a-long-cold-214995">original article</a>.

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Aussies to receive $395 million cash boost just before Christmas

Health insurer Bupa has announced a massive increase to their Covid-19 savings scheme, giving eligible Aussies a cash injection right before Christmas. Bupa shared that their cash back scheme will increase by a hefty $75 million, taking the total amount handed back to Aussies to $395 million. The payments are part of Bupa's cost of living support and Covid-19 related savings. The insurer previously committed to $320 million in June, before announcing the extra $75 million earlier this week. Payments for the 1.8 million eligible policy-holders will range from $47 to $344, depending on their policy and level of cover. The first of the payments will be paid to recipients in November, with most eligible customers receiving their financial boost before Christmas. Bupa Health Insurance managing director Chris Carroll said he hoped the payments would help members deal with the inevitable extra spending around the holiday season. "The money will go directly into our members' bank accounts, giving them more choice to use the money in a way that is most valuable to them," he said. Bupa customers are urged to make sure their bank details with the insurer are up to date so they can get their payments with no issues, and start spending for the festive season. Image credits: Getty Images

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Christina Applegate details bout of Covid and Sapovirus amid MS battle

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