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Suspected bubonic plague case leads to epidemic fears

<p>Authorities in China have issued a warning after a suspected bubonic plague case was reported in the Inner Mongolia Autonomous Region.</p> <p>Residents in the Bayannur district have been ordered not to hunt and eat wild animals after a herdsman was confirmed to have <a href="https://www.nytimes.com/2020/07/06/world/asia/china-bubonic-plague-inner-mongolia.html">caught the disease on Sunday</a>.</p> <p>Another patient, a 15-year-old boy, was also suspected to be infected on Monday after developing a fever following contact with a marmot hunted by a dog, according to <em><a href="https://twitter.com/globaltimesnews/status/1280031821980303360">Global Times</a></em>.</p> <p>Health officials of the city of Bayan Nur have placed a third-level alert until the end of the year and asked the public to report any sick or dead marmots.</p> <p>“At present, there is a risk of a human plague epidemic spreading in this city. The public should improve its self-protection awareness and ability, and report abnormal health conditions promptly," said a local health authority, as quoted by the <a href="https://www.chinadaily.com.cn/a/202007/05/WS5f01d743a310834817257493.html"><em>China Daily</em> newspaper</a>.</p> <p>Bubonic plague is a bacterial infection commonly spread through fleas from small animals. It was the cause of the Black Death pandemic that killed an estimated 50 million people across Asia, Europe and Africa in the 14th century.</p> <p>The disease can now be treated with a number of antibiotics, such as gentamicin and doxycycline.</p> <p>Symptoms of the plague include high fever, headaches, nausea and swollen lymph nodes.</p> <p>While plague outbreaks have become increasingly rare in China, occasional cases are still reported. According to <em><a href="https://www.theguardian.com/world/2020/jul/06/suspected-case-of-bubonic-plague-found-in-city-in-inner-mongolia-china">Reuters</a></em>, China reported 26 cases and 11 deaths from 2009 to 2018.</p>

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Lockdown dangers: Young man dies of blood clot after video game binge

<p>A father has warned parents and young people to stay active during the coronavirus lockdown after his 24-year-old son died from deep vein thrombosis (DVT).</p> <p>In a post on Facebook, Stanley Greening, 56, <span>from Bedfordshire, in the UK</span> told friends about the death of his son Louis O’Neill in early June.</p> <p>“On 3rd June something so awful happened, the worst imaginable thing to happen to such a young man and the worst imaginable thing to happen to a parent,” he wrote.</p> <p>“My son, my dear boy, Louis, has gone. Not from the evil virus but because of it. His young life, barely begun, still trying to find his feet, just torn away.”</p> <p>Louis had been furloughed from his job as a soccer coach at Centre Parcs since mid-March, when the UK COVID-19 lockdown was first imposed.</p> <p>The young man then took to online gaming with friends to pass time, Stanley said.</p> <p>“Caught up in a virtual world he became less active, so easily done. Hours fly by when absorbed by the screen, I’ve done it countless times myself,” Stanley said.</p> <p>Two weeks before his death, Louis complained about a pain in his leg. He called emergency responders, who told him it could be food poisoning.</p> <p>“But no one, and I mean no one, ever in a million years would have predicted a blood clot,” Stanley said.</p> <p>“Who is warning youngsters? Who is warning anyone, of any age? No one!! So I am. My son will live on, I shall continue to spread this warning in his name.”</p> <p>Stanley said conversations with medical professionals revealed that cases of DVT in young people have been rising since the lockdown began.</p> <p>DVT is a blood clot that occurs in a deep vein, most commonly in the leg. Some of the risk factors associated with DVT include obesity, pregnancy, smoking, and certain medications as well as long periods of inactivity.</p> <p>“As more and more of us are working from home it is likely you are not getting out your chair as much as you need. Stand up, walk around, and please, warn your kids,” Stanley said.</p>

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Family fatally unplugs COVID ventilator to plug-in air cooler

<p>A man who was suspected of having coronavirus has died after family members allegedly unplugged the ventilator he was connected to so they could plug in an air cooler. </p> <p>The 40-year-old man was admitted to the intensive care unit of Maharao Bhim Singh Hospital in Kota, Rajasthan in India on 13th June.</p> <p>According to<em> </em><a rel="noopener" href="https://indianexpress.com/article/india/kota-hospital-ventilator-covid-19-6466969/" target="_blank" class="_e75a791d-denali-editor-page-rtflink"><em>The Indian Express</em></a>, he was shifted into an isolation ward on 15th June after another patient in the ICU tested positive for coronavirus.</p> <p>His family members visited and brought along an air cooler with them, but were unable to find an extra socket to plug it into.</p> <p>It's alleged that they unplugged the man's ventilator which ran out of power half an hour later.</p> <p>The family members alerted medical staff who performed CPR, but the man died.</p> <p>Hospital superintendent Dr Naveen Sazena said that a three-member hospital committee would investigate the incident and report on the patient's cause of death.</p> <p>It is currently unclear why family members were able to visit a patient in the isolation ward.</p> <p>The family had brought the air cooler as the hospital's air conditioning had been turned off to limit the spread of coronavirus. </p> <p>Temperatures inside the hospital reportedly were around the 40-degree mark as a result, but the family members did not ask medical staff for permission to use the air cooling unit. </p>

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Arctic cod liver oil: superstar for healthy ageing and immunity

<div id="primary" class="contentAreaLeft"> <div class="Maincontent"> <p><strong>We all need good nutrition for optimum wellbeing but this may be of even greater importance in our golden years.  Of the many nutrients that benefit healthy ageing, omega-3s are superstars since they are essential to the proper functioning of every cell in our bodies.</strong></p> <p>The main beneficial omega-3s, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are naturally highly concentrated in Arctic cod liver oil. The difference between Arctic cod liver oil and other fish oils is that Arctic cod liver oil generally contains 50% more DHA than EPA, whereas other fish oils are naturally higher in EPA than DHA.</p> <p>This ratio makes<span> </span><a rel="noopener noreferrer" href="http://www.therahealth.com.au/" target="_blank">Arctic cod liver oil</a><span> </span>stand out as a superfood for supporting systems that have an abundance of DHA such as the brain and eyes. In addition to this, Arctic cod liver oil contains a rare supply of naturally occurring vitamins A and D, providing further support for a range of body systems such as skin cell and immune support.</p> <p>Here are 6 ways that the nutrients found in Arctic Cod Liver Oil have been shown to support ageing &amp; immunity:</p> <p><strong>1. Heart health</strong></p> <p>Increasing levels of evidence have shown the beneficial impacts of dietary Omega 3’s against heart disease, and gaining sufficient omega-3 might be easiest done in the form of a cod liver oil supplement<span> </span><sup>(1)</sup>. Studies have indicated that dietary omega-3s appear to decrease the cardiovascular risk factors that lead to heart disease<span> </span><sup>(2,3)</sup>. This has been particularly obvious when cod liver oil supplementation has occurred in the Western diet. One particular study found that supplementing a typical Western diet with cod liver oil had positive effects on the heart health of study participants<span> </span><sup>(1)</sup>.</p> <p>This was likely due to the high concentration of omega-3’s contained in cod liver oil. As cardiovascular disease is a prominent health issue in Australia, Arctic cod liver oil may be an important addition to one’s diet in support of improving heart health<span> </span><sup>(4)</sup>.</p> <p><strong>2. Brain health</strong></p> <p>The brain tissue of humans is predominantly composed of lipids, which are made up of different fatty acids. DHA is the most abundant fatty acid in the brain. The levels of DHA in the brain increase during development and decrease with ageing. Further to this, DHA levels in the brain can be altered by dietary intake of omega-3s<span> </span><sup>(5)</sup>.</p> <p>A number of studies have suggested that low levels of DHA in the brain are linked to an increased risk of cognitive decline and dementia in older adults<span> </span><sup>(6)</sup>. Therefore, because of the rich profile of DHA in cod liver oil, supplementation of this particular fish oil may be specifically beneficial for the ageing population in support of brain health.</p> <p><strong>3. Bone strength</strong></p> <p>One of the main draw factors of cod liver oil is its naturally occurring vitamin D. While the most abundant method for increasing one’s vitamin D status is usually through sunlight exposure, sufficient and safe amounts of healthy sun exposure are increasingly difficult to achieve for many in the modern population.</p> <p>Therefore, cod liver oil supplementation may be a valuable alternative for supporting one’s required daily intake of vitamin D for optimal bone health. Osteoporosis is a bone disease characterised by decreased bone mass that occurs primarily in postmenopausal women<span> </span><sup>(7)</sup>. This disease places them at greater risk of fractures in their later life. Therefore, cod liver oil may be beneficial for supporting bone development and maintenance throughout life, and particularly in later life when the risk of bone fracture is increased.</p> <p><strong>4. Vision</strong></p> <p>Deteriorating eyesight is a common health problem in the ageing population. As with the brain, the eye is highly enriched with omega-3 fatty acids, with particularly high levels of DHA present in the retina of the eye<span> </span><sup>(8)</sup>. Therefore, DHA has an important functional role in the retina, primarily helping minimise the damage that is caused from the ongoing exposure to light throughout life<span> </span><sup>(12)</sup>.</p> <p>Therefore, people over the age of 50 are recommended a regular intake of marine fish or a food supplement that has high concentrations of DHA, such as cod liver oil, to support their eye health<span> </span><sup>(12)</sup>. In addition to this, cod liver oil is appealing because it is a good source of naturally occurring vitamin A in its most ‘active’ form, which may support individuals who have problems with night vision.</p> <p><strong>5. Skin care</strong></p> <p>Human skin plays a pivotal role in the feeling of wellbeing and physical attractiveness in an individual<span> </span><sup>(14)</sup>. Our skin is continuously exposed to internal and external influences that may alter its condition. As a result, we may experience inflammation, immune dysfunction, skin disorders, and ultimately ageing.</p> <p>The functioning and attractiveness of the skin are dependent on nutrition, as evidenced by the characteristic skin lesions that often occur from particular deficiencies in the diet.<sup><span> </span>(14)</sup><span> </span>Dietary supplementation with specific vitamins, minerals, or essential fatty acids will therefore support skin care in these situations<span> </span><sup>(15)</sup>. Many reports have suggested that the intake of omega-3s, (EPA and DHA), may provide considerable health benefits in relation to inflammatory diseases that have the potential to cause rashes, lesions or other disorders to the skin. One study found that a relatively low supplemented dose of EPA and DHA within a 4-week period was protective against UV radiation<span> </span><sup>(16)</sup>. Therefore, cod liver oil supplementation may be recommended to help and support skin care in later life.</p> <p><strong>6. Immune system</strong></p> <p>Many studies have found that the anti-inflammatory profile of cod liver oil supports the immune response of an individual. Further to this, the effect of omega-3 dietary supplementation has been shown to improve clinical variables of disease activity<span> </span><sup>(17)</sup>. One study found that cod liver oil supplementation for individuals with rheumatoid arthritis allowed these patients to decrease their NSAID (non-steroidal anti-inflammatory drugs) intake, thus improving gastrointestinal and cardiovascular health without any worsening of disease activity<span> </span><sup>(17)</sup>.</p> <p>Another study produced results that suggested a protective effect of cod liver oil supplementation against type 1 diabetes<span> </span><sup>(18)</sup>. Numerous changes occur in the immune system with advancing age, probably contributing to a decreased immune response<span> </span><sup>(20)</sup>.</p> <p>Looking at these amazing benefits for multiple body systems, you can see why Arctic cod liver oil is a superstar for immune support and healthy ageing.</p> <p>Nordic Naturals Arctic Cod Liver Oil™ is made from 100% wild Arctic cod. Unlike other “cod liver oils” on the market, no fish body oils or synthetic vitamins or additives are ever used.</p> <p>Nordic Naturals award-winning Arctic Cod Liver Oil™ is made exclusively from wild Arctic cod, and is an ideal choice to help boost immune system health during the colder months. Vertically integrated from catch to finished product, Arctic Cod Liver Oil far surpasses the strict European Pharmacopoeia Standard for fish oil purity and freshness. Simply put it’s some of freshest cod liver oil in the world.</p> <p>Nordic Naturals Arctic Cod Liver oil recently won in the ‘Bone and Joint’ category of the Good Magazine Best of Natural Awards.</p> <p>Available from all good health stores. To find a store near you visit<span> </span><a rel="noopener noreferrer" href="http://www.therahealth.com.au/store-locator" target="_blank">http://www.therahealth.com.au/store-locator</a></p> <p><em>This article is sponsored content in conjunction with<span> </span><a rel="noopener noreferrer" href="http://www.therahealth.com.au/" target="_blank">Thera Health</a>.</em></p> <p><em><sup><strong>REFERENCES</strong></sup></em></p> <ol> <li><em>Lorenz R, Spengler U, Fischer S, Duhm J and Weber PC. Platelet Function, Thromboxane Formation and Blood Pressure Control During Supplementation of the Western Diet with Cod Liver Oil. Circulation 1983;67:504-511.</em></li> <li><em>Simopoulos AP. Omega-3 fatty acids in health and disease and in growth and development. Am J Clin Nutr 1991;54:438-463.</em></li> <li><em>Hu FB, Bronner L and Willett WC. Fish and Omega-3 Fatty Acid Intake and Risk of Coronary Heart Disease in Women. JAMA 2002;287)14):1815-21.</em></li> <li><em>Heart Foundation. 2014. Data and statistics. Available at:<a href="http://www.heartfoundation.org.au/information-for-professionals/data-and-statistics/Pages/default.aspx">http://www.heartfoundation.org.au/information-for-professionals/data-and-statistics/Pages/default.aspx</a>. [Accessed 26 March 14].</em></li> <li><em>Innis SM. Dietary omega 3 fatty acids and the developing brain. Brain Res 2008;doi 10.1016.</em></li> <li><em>Sydenham E, Dangour AD and Lim W-S. Omega 3 fatty acid for the prevention of cognitive decline and dementia. Sao Paulo Med J 2012;130(6):419.</em></li> <li><em>Rajakumar K. Vitamin D, Cod-Liver Oil, Sunlight, and Rickets: A Historical Perspective. Pediatrics 2003;112;e132.</em></li> <li><em>Hodge W, Barnes D, Schachter HM et al. Effects of Omega-3 Fatty Acids on Eye Health. AHRQ 2005;117:12.</em></li> <li><em>James MJ, Gibson RA and Cleland LG. Dietary polyunsaturated fatty acids and inflammatory mediator production. Am J Clin Nutr 2000;71.</em></li> <li><em>Rodriguez de Turco EB, Gordon WC and Bazan NG. Rapid and selective uptake, metabolism, and cellular distribution of docosahexenoic acid among rod and cone photoreceptor cells in the frog retina. J Neurosci 1991;11(11):3667-78.</em></li> <li><em>Vingerling JR, Dielemans I, Bots ML et al. Age-related macular degeneration is associated with atherosclerosis. The Rotterdam Study. Am J Epidemiol 1995;142(4):404-9.</em></li> <li><em>Bryhn M. 2007. Can Omega-3 Fatty Acids Prevent Blindness? Available at:<span> </span><a href="http://www.parisan.de/fileadmin/parisan/user_upload/EPAX_-_Eye_Health.pdf">http://www.parisan.de/fileadmin/parisan/user_upload/EPAX_-_Eye_Health.pdf</a><span> </span>(Accessed 26 March 2014).</em></li> <li><em>Neuringer M. Infant vision and retinal function in studies of dietary long-chained polyunsaturated fatty acids. Am J Clin Nutr 2000;71:256-267.</em></li> <li><em>Boelsma E, Hendriks HFJ and Roza L. Nutritional skin care: health effects of micronutrients and fatty acids. Am J Clin Nutr 2001;73:853-64.</em></li> <li><em>Roe DA. Current etiologies and cutaneous signs of vitamin deficiencies. Roe Da, ed. Nutrition and the skin. Contemporary issues in clinical nutrition. New York: Alan R Liss Inc, 1986;81-98.</em></li> <li><em>Orengo IF, Black HS and Wolf JE. Influence of fish oil supplementation on the minimal erythema dose in humans. Arch Dermatol Res 1992;284:219-21.</em></li> <li><em>Galarraga B, Ho M and Youssef HM. Cod liver oil (n-3 fatty acids) as a non-steroidal anti-inflammatory drug sparing agent in rheumatoid arthritis. Rheumatology 2008;47:665-669.</em></li> <li><em>Stene LC, Ulriksen J, Magnus P and Joner G. Use of cod liver oil during pregnancy associated with lower risk of Type 1 diabetes in the offspring. Diabetologia 2000;43:1093-98.</em></li> <li><em>Stene LC, Joner G and the Norwegian Childhood Diabetes Study Group. Use of cod liver oil during the first year of life is associated with lower risk of childhood-onset type 1 diabetes: a large, population-based, case-control study. Am J Clin Nutr 2003;78:1128-34.</em></li> <li><em>Immunity &amp; Ageing. 2014. About Immunity &amp; Ageing. Available at<span> </span><a href="http://www.immunityageing.com/about">http://www.immunityageing.com/about</a><span> </span>(Accessed 27 March 2014).</em></li> </ol> </div> </div>

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What she thought was RSI turned out to be a fatal disease

<p><span>A terminally ill woman has shared the heartbreaking moment she was told she had a motor neurone disease at 29 - after assuming the symptoms were originally just a repetitive strain injury.</span><br /><br /><span>Jo Knowlton, 30, says she was told the devastating news in late 2019 after going to the doctors when she struggled to use her hands properly.</span><br /><br /><span>The once-was fitness lover had been test-driving a car when she found she wasn’t able to turn on the ignition.</span><br /><br /><span>A month later she found her problem had only worsened as she was now struggling to button shirts and use zips.</span></p> <p><img style="width: 500px; height: 281.3504823151126px;" src="https://oversixtydev.blob.core.windows.net/media/7836584/daily-6.jpg" alt="" data-udi="umb://media/c1dbaf8d3c3343908a1330e2e8fbd31b" /><br /><br /><span>“By March, I noticed that I couldn’t close my fingers together and was starting to struggle with the handbrake on my car, as well as buttons and zips, so I decided to visit my GP, I felt like a bit of a hypochondriac to be honest,” she said.</span><br /><br /><span>“After showing her my hands she thought it might be repetitive strain injury or a trapped nerve.”</span><br /><br /><span>In August 2019, she began to receive tests and was admitted to hospital where possible causes were ruled out time and time again - unfortunately her optimism and hope that she was healthy was short lived.</span><br /><br /><span>“I had no idea it was terminal, without available treatment or a cure,” she admitted.</span><br /><br /><span>“I was waiting in the hospital for my result, the doctors were doing their morning rounds but no one would come near me.</span><br /><br /><span>“The neurologist eventually came and walked me to a side room. He sat me down and said ‘it’s not good news I’m afraid, you have motor neurone disease’.</span><br /><br /><span>“My initial reaction was ‘so what now, what treatment do I start, what do we need to do next?’</span><br /><br /><span>“I had no idea it was terminal, without available treatment or a cure.</span><br /><br /><span>“I was devastated. I felt fine and I didn’t understand how this could be the conclusion.</span><br /><br /><span>“I thought I had my whole life ahead of me but now I was faced with being told I had a terminal illness aged 29.”</span><br /><br /><span>Jo is the youngest person in her region to have been diagnosed with the disease.</span><br /><br /><span>Her daily habits and routine has changed completely.</span><br /><br /><span>Jo says she used to start her day at 5 am to go for a run with her dog, and then walk to the gym before work.</span><br /><br /><span>Now she struggles to walk down the steps of her flat.</span><br /><br /><span>“I really miss just walking for miles and miles with my dog. Some weeks I would have done 100,000 steps. I now struggle to walk to my car,” she said.</span><br /><br /><span>Jo added: “No one knows what causes it.</span><br /><br /><span>“It can be genetic but it can also be sporadic. That’s what mine is, incredibly bad luck.”</span><br /><br /><span>There is no treatment for MND, but Jo had been scheduled to take part in drug trials that have since been postponed due to coronavirus.</span></p>

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Dexamethasone: The cheap, old and boring drug that's a potential coronavirus treatment

<p>First, we tried the antimalarial drug <a href="https://theconversation.com/could-taking-hydroxychloroquine-for-coronavirus-be-more-harmful-than-helpful-139309">hydroxychloroquine</a>. Then we tested the antiviral drug <a href="https://theconversation.com/is-remdesivir-a-miracle-drug-to-cure-coronavirus-dont-get-your-hopes-up-yet-137592">remdesivir</a>. But new UK research gives the strongest indication yet we may have found a useful treatment for COVID-19.</p> <p>This time it’s an old anti-inflammatory drug, dexamethasone, which has been <a href="https://www.heraldscotland.com/news/18521350.cheap-old-boring-drug-save-thousands-lives-approved-treatment-covid-19/">described as</a> cheap, old and boring.</p> <p>Preliminary results from a clinical trial <a href="http://www.ox.ac.uk/news/2020-06-16-dexamethasone-reduces-death-hospitalised-patients-severe-respiratory-complications">just released</a> indicate the drug seems to reduce your chance of dying from COVID-19 if you’re in hospital and need oxygen or a machine to help you breathe.</p> <p>The results were significant enough for the UK to <a href="https://www.bbc.com/news/health-53061281">recommend its use</a> for severe COVID-19.</p> <p>Before we roll it out in Australia, we need to balance the drug’s risks with its benefits after peer-review of the full trial data.</p> <p><strong>What is dexamethasone?</strong></p> <p>Dexamethasone has been used since the late 1950s, so doctors are familiar with it. It’s also inexpensive, with a packet of 30 tablets <a href="http://www.pbs.gov.au/medicine/item/2507Y">costing around A$22</a> (for general patients) under Australia’s Pharmaceutical Benefits Scheme.</p> <p>So if it does work for COVID-19, this cheap and boring drug, already available in Australia with a prescription, would be easy to add to current treatments.</p> <p>Dexamethasone belongs to a class of drugs known as corticosteroids and is used to treat a range of conditions related to inflammation. These include severe allergies, some types of nausea and vomiting, arthritis, swelling of the brain and spinal cord, severe asthma, and for breathing difficulties in newborn babies.</p> <p>And it’s dexamethasone’s application to those latter two respiratory conditions that prompted doctors to think it may also help patients severely affected by COVID-19.</p> <p><strong>What did the trial find?</strong></p> <p>The recently reported results come from the <a href="https://www.recoverytrial.net/">Randomised Evaluation of COVID-19 Therapy</a>, or RECOVERY, trial.</p> <p>The researchers put patients into one of three groups: those needing ventilation (a machine that helps them breath); those who just needed oxygen therapy; and those who needed no treatment to help them breathe.</p> <p>Patients in each of those groups were given dexamethasone (6mg once a day, either as a tablet or via intravenous injection), for ten days. A fourth group (a control group) was not given the drug.</p> <p>Dexamethasone was most useful for the ventilated patients; deaths for this group dropped by about one-third with drug treatment. In contrast, deaths only dropped by one-fifth for those patients who were only receiving oxygen therapy. There was no benefit to patients who could breathe normally.</p> <p><iframe width="440" height="260" src="https://www.youtube.com/embed/d4dXBtV2sOo?wmode=transparent&amp;start=0" frameborder="0" allowfullscreen=""></iframe> <span class="caption">Results of the dexamethasone trial have just been released.</span></p> <p>The researchers calculated that giving dexamethasone to eight ventilated patients would prevent one from dying, on average. And giving it to around 25 patients needing oxygen alone would prevent one death.</p> <p><strong>How might dexamethasone work for COVID-19?</strong></p> <p>When a patient has severe COVID-19, their immune system ramps up to catch and control the virus in the lungs.</p> <p>In doing this, their body produces more infection-fighting white blood cells. This results in inflammation and pressure on their lungs, making it very difficult for them to breath.</p> <p>It’s therefore likely dexamethasone reduces this inflammation, and so reduces pressure on the lungs.</p> <p><strong>What are the downsides?</strong></p> <p>There are potential complications with using dexamethasone.</p> <p>First, dexamethasone also suppresses the immune system when it reduces inflammation. So, it’s not usually recommended for people who are sick, or could be sick, from other infections. So doctors will need to make sure patients have no other infections before they are prescribed the drug.</p> <p>If the results of this trial are correct though, the drug doesn’t appear to compromise the patient’s ability to fight COVID-19; it might just affect their ability to fight off other diseases.</p> <p>Second, the drug is only useful for patients with difficulty breathing and needing some assistance either through ventilation in a hospital or from oxygen therapy.</p> <p>There appears to be no benefit for patients who don’t need help breathing. So we shouldn’t be giving it to everyone who tests positive to the virus.</p> <p>Third, like all drugs, dexamethasone <a href="https://www.nps.org.au/medicine-finder/dexmethsone-tablets">has side effects</a> that need to be monitored. Serious, but rare ones include: severe stomach or intestinal pain, sudden changes with vision, fits, significant psychiatric or personality changes, severe dizziness, fainting, weakness and chest pain or irregular heartbeat, and swelling of the face, lips, mouth, tongue or throat, which may cause difficulty in swallowing or breathing.</p> <p><strong>What happens next?</strong></p> <p>The results of the clinical trial are preliminary. So we need to wait for the full study data and scientific peer-review before we can make a definitive decision as to whether dexamethasone treatment is a worthwhile, and safe, addition to COVID-19 therapy in Australia.</p> <p><span><a href="https://theconversation.com/profiles/nial-wheate-96839"><em>Nial Wheate</em></a><em>, Associate Professor | Program Director, Undergraduate Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></span></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/dexamethasone-the-cheap-old-and-boring-drug-thats-a-potential-coronavirus-treatment-140932">original article</a>.</em></p>

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The Voice star Judah Kelly shows off incredible 40kg weight loss

<div class="post_body_wrapper"> <div class="post_body"> <div class="body_text "> <p>2017<span> </span><em>The Voice</em><span> </span>winner Judah Kelly has shed a shocking 40kgs through boxing training since the start of the year.</p> <p>He was hoping to record a third album this year and was set to tour around Australia until the COVID-19 pandemic hit.</p> <p>“I made a decision to take the year off and to focus on the health side of my life which obviously I had neglected for quite some time,” Judah said.</p> <p>“I’ve lost 40kg since December, but being so big already, you don’t really notice 40kg missing. There’s a long way to go yet.”</p> <p>The boxing training is done by David Turner, who represented Australia in boxing at the Commonwealth Games, so it’s clear Kelly is in good hands.</p> <p>“My coach is David Turner (who represented Australia in boxing at the Commonwealth Games),” Judah told <a rel="noopener" href="https://www.news.com.au/entertainment/celebrity-life/celebrity-selfies/voice-winner-judah-kelly-has-lost-40kg-in-the-past-six-months/news-story/023b30dd6f218f06fc9dd018fbb6ecc7#:~:text=Voice%20winner%20Judah%20Kelly%20shows%20off%20huge%2040kg%20weight%20loss" target="_blank"><em>news.com.au</em></a><em>.</em></p> <p>“I met his daughter on<span> </span><em>The Voice</em><span> </span>– she was competing the same year as me.</p> <p>“I knew he was training people and I went to catch up with him after the show and he had a session going and it piqued my interest.”</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/CBiB_YDHBHD/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/CBiB_YDHBHD/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Judah Kelly (@judah_kelly)</a> on Jun 17, 2020 at 2:48am PDT</p> </div> </blockquote> <p>It’s not the first time Kelly has lost a considerable amount of weight, as he lost a “heap” in 2014.</p> <p>“I actually lost a heap of weight in 2014 and I became quite depressed; it was weird,” he explained.</p> <p>“I didn’t really have a goal back then. I had a lot of pressure in my life and thought if I became skinnier I would become happier.</p> <p>“I became obsessed with getting skinny – and that just leads to a whole cycle of craziness. I was depressed even though I was the skinniest I’d been in ages.</p> <p>“In the end, I figured I’d rather be fat and happy rather than super skinny and hating myself.”</p> <p>Despite putting the weight back on, Kelly is confident it’s different the second time around.</p> <p>“The first time around it was just about, ‘Get skinny.’ But where does that end? It doesn’t,” he said. “This time around I have a goal of what I want to do.</p> <p>“I actually want to have a boxing fight, just amateur, but the only way to do that is to cut down to a heavyweight max … around 120kg.”</p> </div> </div> </div>

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Angela Bishop shares one simple health change to shed excess weight

<p><em>Studio 10's</em> Angela Bishop has given insight to her recent weight loss, admitting she changed one simple thing in her routine to drop her excess weight. </p> <p>The 52-year-old explained her simple lifestyle change didn’t involve altering her diet or hitting up the gym - but instead involved giving up energy drinks. </p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/CAUd5wwjMp7/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/CAUd5wwjMp7/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Angela Bishop (@angelabishop10)</a> on May 17, 2020 at 11:51pm PDT</p> </div> </blockquote> <p>“I recently gave up my sugar-free energy drink addiction,” she revealed on Studio 10. </p> <p>“'I was drinking between 2-3 cans a day and changing absolutely nothing else about my diet, I've lost two kilos in three and a half weeks.”</p> <p>Angela admitted it was a major struggle giving up her addiction. </p> <p>“The withdrawal from the drinks was very painful,” she recalled.</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/B_hV8d6jye7/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/B_hV8d6jye7/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Angela Bishop (@angelabishop10)</a> on Apr 28, 2020 at 3:20am PDT</p> </div> </blockquote> <p>“I had very very bad headaches and didn't feel good at all.”</p> <p>But since officially kicking her cravings, the star says she feels “great”. </p> <p><span>The veteran entertainment reporter lost her husband </span><span>Peter Baikie to a rare cancer in 2018, and together they share 12-year-old Amelia.</span></p> <p><span>"I don't try to keep the grief in when it hits, otherwise I'll do myself an injury. You've got to go and find somewhere to have a little cry. I do it a lot in the traffic in the car, or in the carpark at work. You just have to let it out," she told </span><em><a rel="noopener" href="https://www.nowtolove.com.au/parenting/celebrity-families/angela-bishop-husband-daughter-55207" target="_blank">Australia Women's Weekly.</a></em><span></span></p> <p><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7836548/peter-baikie-angela.jpg" alt="" data-udi="umb://media/8bf8439d51284aa59b8ddc251a55b87a" /></p> <p><em>Image: Instagram</em></p> <p><span>"You've got to quickly have a dash to the loo and have a cry then reapply the mascara and come back again."</span></p> <p>She added: "Some days I think I'm resilient, others I think I'm cactus. I haven't got enough distance to be able to look at it objectively. I don't know if I ever will. But you have to get up and put one foot in front of the other and keep going. And, of course, I've got the best reason to do that."</p>

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Should I wear a mask on public transport?

<p>As restrictions ease, many Australians will be wondering if it’s worth wearing a mask on the bus, train or tram to reduce their risk of being infected with coronavirus.</p> <p>When Deputy Chief Medical Officer Nick Coatsworth was asked about this last week, he <a href="https://www.abc.net.au/radionational/programs/breakfast/covid-19-update-with-deputy-chief-medical-officer/12334932">said</a>:</p> <blockquote> <p>If you are a vulnerable person and you have no other means of getting to work or around, it would be a very reasonable thing to do. We don’t think that general, healthy members of the community need to be considering wearing masks in that context.</p> </blockquote> <p>Earlier, Chief Medical Officer Brendan Murphy <a href="https://www.smh.com.au/politics/federal/chief-medical-officer-backs-voluntary-use-of-face-masks-on-public-transport-20200529-p54xrd.html">said</a> wearing masks on public transport “is not an unreasonable thing to do”.</p> <p>But the National Cabinet <a href="https://www.smh.com.au/politics/federal/chief-medical-officer-backs-voluntary-use-of-face-masks-on-public-transport-20200529-p54xrd.html">has stopped short</a> of making wearing masks on public transport compulsory. No wonder it can all seem a bit confusing.</p> <p>So what does fresh evidence say about the benefits of healthy people wearing masks in public? And how do you use this to decide what to do?</p> <p><strong>Yes, wearing a mask does reduce your risk</strong></p> <p>Until now, the evidence about whether wearing a mask out and about if you’re healthy reduces your risk of coronavirus infection has been uncertain.</p> <p>But a recent review in <em><a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext">The Lancet</a> </em>changes that. As expected, the researchers found wearing masks protected health-care workers against coronavirus infection. But they also found wearing masks protects healthy people in the community, although possibly to a lesser degree.</p> <p>The researchers said the difference in the protective effect was largely because health workers are more likely to use <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31183-1/fulltext">N95 masks</a>, which were found to offer greater protection than the disposable surgical masks we generally see people wearing out in the community.</p> <p>So, the take-home message is that masks, while not offering perfect protection, reduce your risk of coronavirus infection while you’re out and about.</p> <p>In light of this study, the World Health Organisation (WHO) has <a href="https://www.bbc.com/news/health-52945210">updated its advice</a> to recommend healthy people <a href="https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak">wear masks</a> in public where there is widespread transmission and where physical distancing is difficult, such as on public transport.</p> <p><strong>But how is this different to what I’ve heard before?</strong></p> <p>What this <em>Lancet</em> study adds is the best evidence we have so far that <em>healthy people</em> who wear a mask out and about can reduce their chance of infection.</p> <p>It’s important to stress, the evidence is <a href="https://www.sciencedaily.com/releases/2020/04/200403132345.htm">quite clear</a> that <em>if you’re sick</em>, wearing a mask <a href="https://www.nature.com/articles/s41591-020-0843-2">reduces your risk</a> of transmitting the coronavirus to others.</p> <p>If you’re sick or have been diagnosed with COVID-19 the clear advice is still to stay home and self-isolate. You shouldn’t be on public transport anyway!</p> <p><strong>Masks also protect others</strong></p> <p>But how about the other possible benefit of wearing masks on public transport – minimising the risk of you unwittingly transmitting the virus to others if you don’t have symptoms?</p> <p>Despite some <a href="https://www.statnews.com/2020/06/09/who-comments-asymptomatic-spread-covid-19/">confusing messages</a> from WHO earlier this week, we know “asymptomatic transmission” does occur, although we are yet to pin down its exact role.</p> <p>For instance, a recent review suggests <a href="https://www.acpjournals.org/doi/10.7326/M20-3012">as many as 40-45 per cent</a> of coronavirus infections are asymptomatic and they may transmit the virus to others for an extended period.</p> <p>So, preventing asymptomatic transmission is another reason you may choose to wear a mask. That is, rather than wearing a mask to protect yourself, you could wear a mask to protect others.</p> <p><strong>So, what should I do?</strong></p> <p>Given masks reduce your risk of infection <em>and</em> reduce the risk of you unwittingly passing on the virus to others, you could certainly make a case for routinely wearing a mask on public transport while we have coronavirus in the community.</p> <p>This case is even stronger if you are at risk of severe illness, for example if you are over 65 years old or have an underlying medical condition such as high blood pressure, heart disease or diabetes.</p> <p>Alternatively, if you are travelling on a short trip on a train and you have plenty of room to social distance, then you may decide wearing a mask may not be essential given the level of risk on that journey.</p> <p>However, if you are on a longer commute and the train is crowded and social distancing is difficult, then wearing a mask could well be sensible.</p> <p>If you do decide to wear a mask, then it’s important to make sure you know how to <a href="https://theconversation.com/are-you-wearing-gloves-or-a-mask-to-the-shops-you-might-be-doing-it-wrong-137393">put it on and take it off</a> correctly. And as no mask offers complete protection, you still need to physically distance where possible and wash your hands.</p> <p><em><a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, Associate Professor, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-i-wear-a-mask-on-public-transport-139981">original article</a>.</em></p>

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Coronavirus and asthma: What we know so far

<p>When the new coronavirus arrived in early 2020, people with asthma were identified as being at <a href="https://www.gov.uk/government/publications/staying-alert-and-safe-social-distancing/staying-alert-and-safe-social-distancing">higher risk</a> from the disease. Judgements about who was at increased risk had to be made on the best available evidence – which wasn’t much. Data from China was only just emerging and COVID-19 had yet to reach pandemic status.</p> <p>Given that <a href="https://www.nhs.uk/conditions/asthma/">asthma is a lung disease</a> and <a href="https://www.theguardian.com/world/2020/apr/15/what-happens-to-your-lungs-with-coronavirus-covid-19">COVID-19 targets the lungs</a>, it made sense that people with asthma would be considered at higher risk, as they are from <a href="https://www.cdc.gov/flu/highrisk/asthma.htm#:%7E:text=Flu%20infection%20in%20the%20lungs,who%20do%20not%20have%20asthma.">other respiratory illnesses</a>. But as more data emerged, the picture became less clear.</p> <p>Hospital data represents the tip of the iceberg when it comes to COVID-19 infections. Most people who are infected won’t be ill enough to be sent to hospital. Some <a href="https://www.acpjournals.org/doi/10.7326/M20-3012">won’t even know they have the disease</a>. But without sustained and widespread testing, it’s the only data available.</p> <p>Early studies from <a href="https://pubmed.ncbi.nlm.nih.gov/32294485/">China</a> and <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6913e2.htm">the US</a> showed that the proportion of people with asthma coming to hospital with COVID-19 was lower than the proportion of people with asthma in the general population. Yet <a href="https://www.medrxiv.org/content/10.1101/2020.04.23.20076042v1.full.pdf">data from the UK</a> suggests people with asthma are neither over nor underrepresented in hospitalised patients with COVID-19.</p> <p>It is still possible that people with asthma are more likely to be admitted to hospital with COVID-19 than people without asthma, but issues with the studies are providing an inaccurate picture. It is also possible that the early findings might be genuine, and due to differences in immune responses or protective effects of certain asthma medications.</p> <p>It is clear that risks from COVID-19 depend on a lot more than whether or not you have asthma, but most of the available data doesn’t go into this very much. People with <a href="https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/asthma.html">more severe forms of asthma</a> are considered at higher risk. There is hardly any information on how asthma might affect COVID-19 infection in young people because so few children become seriously ill with COVID-19.</p> <p>Once in hospital, <a href="https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v1.full.pdf">preliminary data from the UK</a> shows that asthma is associated with an increased risk of dying with COVID-19.</p> <p>Risks appear higher in people recently prescribed <a href="https://www.asthma.org.uk/advice/inhalers-medicines-treatments/steroids/?gclid=EAIaIQobChMIrqCJxMzi6QIVBbTtCh3TdgTNEAAYASAAEgIewPD_BwE">oral corticosteroids</a>, which is one type of medication used for asthma. This does not necessarily mean oral corticosteroids themselves increase COVID-19 risk. People with more severe asthma are more likely to be prescribed these medications than people with less severe asthma and, as noted above, people with more severe asthma are considered at higher risk from COVID-19. In fact, some have speculated that oral corticosteroids might help protect against COVID-19, but the <a href="https://www.cebm.net/covid-19/inhaled-steroids-in-asthma-during-the-covid-19-outbreak/">evidence for this is unclear</a>.</p> <p><strong>What the guidance says</strong></p> <p>As well as the direct risks that COVID-19 infection poses to people with asthma, disruptions and changes brought on by the pandemic may affect asthma outcomes. Diagnosing and routinely monitoring asthma relies on a range of tests administered in face-to-face visits. But, to cut the risks of virus transmission, a lot of these services have been reduced.</p> <p><a href="https://www.asthma.org.uk/advice/triggers/coronavirus-covid-19/what-should-people-with-asthma-do-now/#AsthmaCare">Asthma UK</a> has guidance on what people might expect from their usual asthma care at the moment. <a href="https://www.cebm.net/covid-19/asthma-and-covid-19-risks-and-management-considerations/">The advice</a> is that people manage their asthma as well as possible to reduce risk from COVID-19. This includes restarting or continuing prescribed medications and avoiding known triggers, such as air pollution and cigarette smoke.</p> <p>Some countries now recommend that people wear a face covering (not a surgical mask) in certain settings. Wearing a face covering may be difficult for some people with asthma, and the UK government has advised that people with respiratory conditions don’t need to wear face coverings <a href="https://www.asthma.org.uk/advice/triggers/coronavirus-covid-19/what-should-people-with-asthma-do-now/">if it is difficult for them to do so</a>.</p> <p>Finally, it’s worth noting that this pandemic has the potential to affect <a href="https://www.nhs.uk/oneyou/every-mind-matters/coronavirus-covid-19-staying-at-home-tips/">mental health and wellbeing</a> and that this may be even more of a risk for people with <a href="https://www.cebm.net/covid-19/supporting-people-with-long-term-conditions-ltcs-during-national-emergencies/">long-term conditions</a>, such as asthma. Anxiety and depression are associated with worse asthma control.</p> <p>The charity, <a href="https://www.asthma.org.uk/coronavirus/">Asthma UK</a>, recommends people with asthma stay active, look after their health, stay social, and ask for support.</p> <p>While research continues to establish who is at high risk from COVID-19 infection, it’s important not to lose sight of the broader ways in which this pandemic may affect people with asthma – and the fact that some groups of people will be <a href="https://www.asthma.org.uk/dd78d558/globalassets/get-involved/external-affairs-campaigns/publications/health-inequality/auk-health-inequalities-final.pdf">more affected than others</a>. Both asthma and COVID-19 disproportionately affect people from more deprived communities and people from non-white ethnic groups. New ways of managing asthma will need to be found and they must be designed to minimise the impact of this double burden wherever possible.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/139693/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><em><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/jamie-hartmann-boyce-528029">Jamie Hartmann-Boyce</a>, Departmental Lecturer and Co-Director of Evidence-Based Healthcare DPhil programme, Centre for Evidence-Based Medicine, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/coronavirus-and-asthma-what-we-know-so-far-139693">original article</a>.</em></p>

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Doctor’s disturbing find in man’s bladder

<p><span>Doctors have made a disturbing yet remarkable discovery inside of a man’s bladder.</span><br /><br /><span>X-ray scans showed the 30-year-old man, who was treated in Guwahati Hospital, India had a 61 cm-long charger cable that became entangled in his bladder.</span><br /><br /><span>The medical professionals believe it may have been swallowed or inserted for "sexual gratification".</span><br /><br /><span>The adult male, who is said to have a “history of accidental ingestion of headphones”, visited the doctors after complaints of incessant abdominal pain.</span><br /><br /><span>He was given a two-day course of laxatives in a bid to alleviate the stomach pain before doctors decided to made a small incision into his gastrointestinal tract.</span><br /><br /><span>It was then that doctors had the disturbing realisation that there was the charger cord in the man’s bladder.</span></p> <p><img style="width: 500px; height: 281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7836435/doctor-bladder-1.jpg" alt="" data-udi="umb://media/e676a4c5383142cd824218d7a82baa5d" /></p> <p><em><span class="CmCaReT" style="display: none;">�</span>Image: Yahoo</em><br /><br /><span>Five medics performed a 45 minute surgery to remove it.</span><br /><br /><span>Surgeon Wallie Islam, who says he had not seen anything of the sort in his 25-year career, went on to say that surgeons didn’t want to jump straight into surgery and that’s why he was given laxatives.</span><br /><br /><span>"The patient's stool was examined, but nothing came out,” Dr Islam said.</span><br /><br /><span>"We decided to do a small incision and check the gastrointestinal tract.”</span><br /><br /><span>The doctor added the male “might have been uncomfortable telling the truth”, leading to the team searching his gastrointestinal tract.</span><br /><br /><span>"Though I'm not exactly sure about his mental health, some people do things for sexual gratification, but this man took things a little too far,” he said.</span><br /><br /><span>The man spent three days recovering in hospital before he was released.</span></p>

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Scientists around the world are already fighting the next pandemic

<p>If a two-year-old child living in poverty in India or Bangladesh gets sick with a common bacterial infection, there is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4775002/">more than a 50%</a> chance an antibiotic treatment will fail. Somehow the child has acquired an antibiotic resistant infection – even to drugs to which they may never have been exposed. How?</p> <p>Unfortunately, this child also lives in a place with limited clean water and less waste management, bringing them into frequent contact with faecal matter. This means they are regularly exposed to millions of resistant genes and bacteria, including potentially <a href="https://www.thelancet.com/pdfs/journals/lanplh/PIIS2542-5196(18)30186-4.pdf">untreatable superbugs</a>. This sad story is shockingly common, especially in places where pollution is rampant and clean water is limited.</p> <p>For many years, people believed antibiotic resistance in bacteria was primarily driven by imprudent use of antibiotics in clinical and veterinary settings. But <a href="https://www.sciencedirect.com/science/article/pii/S016041201832587X?via%3Dihub">growing evidence</a> suggests that environmental factors may be of equal or greater importance to the spread of <a href="https://theconversation.com/to-defeat-superbugs-everyone-will-need-access-to-clean-water-95202">antibiotic resistance</a>, especially in the developing world.</p> <p>Here we focus on antibiotic resistant bacteria, but drug resistance also occurs in types of other microorganisms – such as resistance in pathogenic viruses, fungi, and protozoa (called antimicrobial resistance or AMR). This means that our ability to treat all sorts of infectious disease is increasingly hampered by resistance, potentially including coronaviruses like SARS-CoV-2, which causes COVID-19.</p> <p>Overall, use of antibiotics, antivirals, and antifungals clearly must be reduced, but in most of the world, improving water, sanitation, and hygiene practice – a practice known as WASH – is also critically important. If we can ensure cleaner water and safer food everywhere, the spread of antibiotic resistant bacteria will be reduced across the environment, including within and between people and animals.</p> <p>As <a href="https://www.who.int/water_sanitation_health/publications/wash-wastewater-management-to-prevent-infections-and-reduce-amr/en/">recent recommendations on AMR</a> from the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE), and World Health Organization (WHO) suggest, to which David contributed, the “superbug problem” will not be solved by more prudent antibiotic use alone. It also requires global improvements in water quality, sanitation, and hygiene. Otherwise, the next pandemic might be worse than COVID-19.</p> <p><strong>Bacteria under stress</strong></p> <p>To understand the problem of resistance, we must go back to basics. What is antibiotic resistance, and why does it develop?</p> <p>Exposure to antibiotics puts stress on bacteria and, like other living organisms, they defend themselves. Bacteria do this by sharing and acquiring defence genes, often from other bacteria in their environment. This allows them to change quickly, readily obtaining the ability to make proteins and other molecules that block the antibiotic’s effect.</p> <p>This <a href="https://www.ncbi.nlm.nih.gov/pubmed/21711367">gene sharing process</a> is natural and is a large part of what drives evolution. However, as we use ever stronger and more diverse antibiotics, new and more powerful bacterial defence options have evolved, rendering some bacteria resistant to almost everything – the ultimate outcome being untreatable superbugs.</p> <p>Antibiotic resistance has existed <a href="https://www.nature.com/articles/nature10388">since life began</a>, but has recently accelerated due to human use. When you take an antibiotic, it kills a large majority of the target bacteria at the site of infection – and so you get better. But antibiotics do not kill all the bacteria – some are naturally resistant; others acquire resistance genes from their microbial neighbours, especially in our digestive systems, throat, and on our skin. This means that some resistant bacteria always survive, and can pass to the environment via inadequately treated faecal matter, spreading resistant bacteria and genes wider.</p> <p>The pharmaceutical industry initially responded to increasing resistance by developing new and stronger antibiotics, but bacteria evolve rapidly, making even new antibiotics lose their effectiveness quickly. As a result, new antibiotic development has almost stopped because it garners <a href="https://theconversation.com/big-pharma-has-failed-the-antibiotic-pipeline-needs-to-be-taken-under-public-ownership-126058">limited profit</a>. Meanwhile, resistance to existing antibiotics continues to increase, which especially impacts places with <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196%2818%2930186-4/fulltext">poor water quality and sanitation</a>.</p> <p>This is because in the developed world you defecate and your poo goes down the toilet, eventually flowing down a sewer to a community wastewater treatment plant. Although treatment plants are not perfect, they typically reduce resistance levels by well over 99%, substantially reducing resistance released to the environment.</p> <p>In contrast, over <a href="https://www.unicef.org/reports/progress-on-drinking-water-sanitation-and-hygiene-2019">70% of the world</a> has no community wastewater treatment or even sewers; and most faecal matter, containing resistant genes and bacteria, goes directly into surface and groundwater, often via open drains.</p> <p>This means that people who live in places without faecal waste management are regularly exposed to antibiotic resistance in many ways. Exposure is even possible of people who may not have taken antibiotics, like our child in South Asia.</p> <p><strong>Spreading through faeces</strong></p> <p>Antibiotic resistance is everywhere, but it is not surprising that resistance <a href="https://www.ncbi.nlm.nih.gov/pubmed/30177008%20and%20https://www.thelancet.com/pdfs/journals/lanplh/PIIS2542-5196(18)30186-4.pdf">is greatest</a> in places with poor sanitation because factors other than use are important. For example, a fragmented civil infrastructure, political corruption, and a lack of centralised healthcare also play key roles.</p> <p>One might cynically argue that “foreign” resistance is a local issue, but antibiotic resistance spread knows no boundaries – superbugs might develop in one place due to pollution, but then become global due to international travel. Researchers from Denmark compared antibiotic resistance genes in long-haul airplane toilets and found <a href="https://www.nature.com/articles/srep11444">major differences in resistance carriage</a> among flight paths, suggesting resistance can jump-spread by travel.</p> <p>The world’s current experience with the spread of SARS-CoV-2 shows just how fast infectious agents can move with human travel. The impact of increasing antibiotic resistance is no different. There are no reliable antiviral agents for SARS-CoV-2 treatment, which is the way things may become for currently treatable diseases if we allow resistance to continue unchecked.</p> <p>As an example of antibiotic resistance, the “superbug” gene, blaNDM-1, was first detected in <a href="https://www.ncbi.nlm.nih.gov/pubmed/21478057">India</a> in 2007 (although it was probably present in other regional countries). But soon thereafter, it was found in a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2786356/">hospital patient in Sweden</a> and then <a href="https://academic.oup.com/jac/article/66/9/1998/768777">in Germany</a>. It was ultimately detected in 2013 in Svalbard in <a href="https://www.sciencedirect.com/science/article/pii/S016041201832587X?via%3Dihub">the High Arctic</a>. In parallel, <a href="https://www.ncbi.nlm.nih.gov/pubmed/24521347">variants</a> of this gene appeared locally, but have evolved as they move. Similar evolution has occurred as <a href="https://www.pnas.org/content/early/2020/04/07/2004999117">the COVID-19 virus</a> has spread.</p> <p>Relative to antibiotic resistance, humans are not the only “travellers” that can carry resistance. Wildlife, such as migratory birds, can also acquire resistant bacteria and genes from contaminated water or soils and then fly great distances carrying resistance in their gut from places with poor water quality to places with good water quality. During travel, they defecate along their path, potentially planting resistance almost anywhere. The global trade of foods also facilitates spread of resistance from country to country and across the globe.</p> <p>What is tricky is that the spread by resistance by travel is often invisible. In fact, the dominant pathways of international resistance spread <a href="https://www.ncbi.nlm.nih.gov/pubmed/30924539">are largely unknown</a> because many pathways overlap, and the types and drivers of resistance are diverse.</p> <p>Resistant bacteria are not the only infectious agents that might be spread by environmental contamination. SARS-CoV-2 has been found in faeces and inactive virus debris found in sewage, but all evidence suggests water is <a href="https://www.who.int/publications-detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations">not a major route</a> of COVID-19 spread – although there are limited data from places with poor sanitation.</p> <p>So, each case differs. But there are common roots to disease spread – pollution, poor water quality, and inadequate hygiene. Using fewer antibiotics is critical to reducing resistance. However, without also providing safer sanitation and improved water quality at global scales, resistance will continue to increase, potentially creating the next pandemic. Such a combined approach is central to the new WHO/FAO/OIE recommendations on AMR.</p> <p><strong>Other types of pollution and hospital waste</strong></p> <p>Industrial wastes, hospitals, farms, and agriculture are also possible sources or drivers of antibiotic resistance.</p> <p>For example, about ten years ago, one of us (David) studied metal pollution in a Cuban river and <a href="https://pubs.acs.org/doi/abs/10.1021/es102473z">found</a> the highest levels of resistant genes were near a leaky solid waste landfill and below where pharmaceutical factory wastes entered the river. The factory releases clearly impacted resistance levels downstream, but it was metals from the landfill that most strongly correlated with resistance gene levels in the river.</p> <p>There is a logic to this because toxic metals can stress bacteria, which makes the bacteria stronger, incidentally making them more resistant to anything, including antibiotics. We saw the same thing with metals in <a href="https://pubs.acs.org/doi/full/10.1021/acs.est.7b03797">Chinese landfills</a> where resistance gene levels in the landfill drains strongly correlated with metals, not antibiotics.</p> <p>In fact, pollution of almost any sort can promote antibiotic resistance, including metals, biocides, pesticides, and other chemicals entering the environment. Many pollutants can promote resistance in bacteria, so reducing pollution in general will help reduce antibiotic resistance – an example of which is reducing metal pollution.</p> <p>Hospitals are also important, being both reservoirs and incubators for many varieties of antibiotic resistance, including well known resistant bacteria such as Vancomycin-resistant Enterococcus (VRE) and Methicillin-resistant Staphylococcus aureus (MRSA). While resistant bacteria are not necessarily acquired in hospitals (most are brought in from the community), resistant bacteria can be enriched in hospitals because they are where people are very sick, cared for in close proximity, and often provided “last resort” antibiotics. Such conditions allow the spread of resistant bacteria easier, especially superbug strains because of the types of antibiotics that are used.</p> <p>Wastewater releases from hospitals also may be a concern. <a href="https://www.ncbi.nlm.nih.gov/pubmed/31295654">Recent data</a> showed that “typical” bacteria in hospital sewage carry five to ten times more resistant genes per cell than community sources, especially genes more readily shared between bacteria. This is problematic because such bacteria are sometimes superbug strains, such as those resistant to <a href="https://www.ncbi.nlm.nih.gov/pubmed/28949542">carbapenem antibiotics</a>. Hospital wastes are a particular concern in places without effective community wastewater treatment.</p> <p>Another critical source of antibiotic resistance is agriculture and aquaculture. Drugs used in veterinary care can be very similar (sometimes identical) to the antibiotics used in human medicine. And so resistant bacteria and genes <a href="https://www.ncbi.nlm.nih.gov/pubmed/30924539">are found</a> in animal manure, soils, and drainage water. This is potentially significant given that animals produce <a href="https://www.nature.com/articles/s41893-018-0167-0?WT.feed_name=subjects_environmental-sciences">four times more</a> faeces than humans at a global scale.</p> <p>Wastes from agricultural activity also can be especially problematic because waste management is usually less sophisticated. Additionally, agricultural operations are often at very large scales and less containable due to greater exposure to wildlife. Finally, antibiotic resistance can spread from farm animals to farmers to food workers, which has been seen in <a href="https://doi.org/10.2807/1560-7917.ES.2015.20.37.30021">recent European studies</a>, meaning this can be important at local scales.</p> <p>These examples show that pollution in general increases the spread of resistance. But the examples also show that dominant drivers will differ based on where you are. In one place, resistance spread might be fuelled by human faecal contaminated water; whereas, in another, it might be industrial pollution or agricultural activity. So local conditions are key to reducing the spread of antibiotic resistance, and optimal solutions will differ from place to place – single solutions do not fit all.</p> <p>Locally driven national action plans are therefore essential – which the new <a href="https://www.who.int/water_sanitation_health/publications/wash-wastewater-management-to-prevent-infections-and-reduce-amr/en/">WHO/FAO/OIE guidance</a> strongly recommends. In some places, actions might focus on healthcare systems; whereas, in many places, promoting cleaner water and safer food also is critical.</p> <p><strong>Simple steps</strong></p> <p>It is clear we must use a holistic approach (what is now called “<a href="https://www.cdc.gov/onehealth/basics/index.html">One Health</a>”) to reduce the spread of resistance across people, animals, and the environment. But how do we do this in a world that is so unequal? It is now accepted that clean water is a human right embedded in the UN’s 2030 <a href="https://sustainabledevelopment.un.org/sdg6">Agenda for Sustainable Development</a>. But how can we achieve affordable “clean water for all” in a world where geopolitics often outweigh local needs and realities?</p> <p>Global improvements in sanitation and hygiene should bring the world <a href="https://www.who.int/water_sanitation_health/publications/wash-wastewater-management-to-prevent-infections-and-reduce-amr/en/">closer to solving the problem of antibiotic resistance</a>. But such improvements should only be the start. Once improved sanitation and hygiene exist at global scales, our reliance on antibiotics will decline due to more equitable access to clean water. In theory, clean water coupled with decreased use of antibiotics will drive a downward spiral in resistance.</p> <p>This is not impossible. We know of a village in Kenya where they simply moved their water supply up a small hill – above rather than near their latrines. Hand washing with soap and water was also mandated. A year later, antibiotic use in the village was negligible because so few villagers were unwell. This success is partly due to the remote location of the village and very proactive villagers. But it shows that clean water and improved hygiene can directly translate into reduced antibiotic use and resistance.</p> <p>This story from Kenya further shows how simple actions can be a critical first step in reducing global resistance. But such actions must be done everywhere and at multiple levels to solve the global problem. This is not cost-free and requires international cooperation – including focused apolitical policy, planning, and infrastructure and management practices.</p> <p>Some well intended groups have attempted to come up with novel solutions, but those solutions are often too technological. And western “off-the-shelf” water and wastewater technologies are rarely optimal for use in developing countries. They are often too complex and costly, but also require maintenance, spare parts, operating skill, and cultural buy-in to be sustainable. For example, building an advanced activated sludge wastewater treatment plant in a place where 90% of the population does not have sewer connections makes no sense.</p> <p>Simple is more sustainable. As an obvious example, we need to reduce open defecation in a cheap and socially acceptable manner. This is the best immediate solution in places with limited or unused sanitation infrastructure, such as <a href="https://blogs.lse.ac.uk/southasia/2018/08/08/book-review-where-india-goes-abandoned-toilets-stunted-development-and-the-costs-of-caste-by-diane-coffey-and-dean-spears/">rural India</a>. Innovation is without doubt important, but it needs to be tailored to local realities to stand a chance of being sustained into the future.</p> <p>Strong leadership and governance is also critical. Antibiotic resistance is <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(18)30186-4/fulltext">much lower</a> in places with less corruption and strong governance. Resistance also is lower in places with greater public health expenditure, which implies social policy, community action, and local leadership can be as important as technical infrastructure.</p> <p><strong>Why aren’t we solving the problem?</strong></p> <p>While solutions to antibiotic resistance exist, integrated cooperation between science and engineering, medicine, social action, and governance is lacking. While many international organisations acknowledge the scale of the problem, unified global action is not happening fast enough.</p> <p>There are various reasons for this. Researchers in healthcare, the sciences, and engineering are rarely on the same page, and experts <a href="https://theconversation.com/why-we-should-expect-scientists-to-disagree-about-antibiotic-resistance-and-other-controversies-82609">often disagree</a> over what should be prioritised to prevent antibiotic resistance – this muddles guidance. Unfortunately, many antibiotic resistance researchers also sometimes sensationalise their results, only reporting bad news or exaggerating results.</p> <p>Science continues to reveal probable causes of antibiotic resistance, which shows no single factor drives resistance evolution and spread. As such, a strategy incorporating medicine, environment, sanitation, and public health is needed to provide the best solutions. Governments throughout the world must act in unison to meet targets for sanitation and hygiene in accordance with the UN Sustainable Development Goals.</p> <p>Richer countries must work with poorer ones. But, actions against resistance should focus on local needs and plans because each country is different. We need to remember that resistance is everyone’s problem and all countries have a role in solving the problem. This is evident from the COVID-19 pandemic, where some countries have displayed <a href="https://ec.europa.eu/international-partnerships/topics/eu-global-response-covid-19_en">commendable cooperation</a>. Richer countries should invest in helping to provide locally suitable waste management options for poorer ones – ones that can be maintained and sustained. This would have a more immediate impact than any “toilet of the future” technology.</p> <p>And it’s key to remember that the global antibiotic resistance crisis does not exist in isolation. Other global crises overlap resistance; such as climate change. If the climate becomes warmer and dryer in parts of the world with limited sanitation infrastructure, greater antibiotic resistance might ensue due to higher exposure concentrations. In contrast, if greater flooding occurs in other places, an increased risk of untreated faecal and other wastes spreading across whole landscapes will occur, increasing antibiotic resistance exposures in an unbounded manner.</p> <p>Antibiotic resistance will also impact on the fight against COVID-19. As an example, secondary bacterial infections are common in seriously ill patients with COVID-19, especially when admitted to an ICU. So if such pathogens are resistant to critical antibiotic therapies, they will not work and result <a href="https://www.medpagetoday.com/infectiousdisease/covid19/86192">in higher death rates</a>.</p> <p>Regardless of context, improved water, sanitation, and hygiene must be the backbone of <a href="https://www.who.int/water_sanitation_health/publications/wash-wastewater-management-to-prevent-infections-and-reduce-amr/en/">stemming the spread of AMR, including antibiotic resistance</a>, to avoid the next pandemic. Some progress is being made in terms of global cooperation, but efforts are still too fragmented. Some countries are making progress, whereas others are not.</p> <p>Resistance needs to be seen in a similar light to other global challenges – something that threatens human existence and the planet. As with addressing climate change, protecting biodiversity, or COVID-19, global cooperation is needed to reduce the evolution and spread of resistance. Cleaner water and improved hygiene are the key. If we do not work together now, we all will pay an even greater price in the future.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/115246/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><span><a href="https://theconversation.com/profiles/david-w-graham-473578"><em>David W Graham</em></a><em>, Professor of Ecosystems Engineering, <a href="https://theconversation.com/institutions/newcastle-university-906">Newcastle University</a> and <a href="https://theconversation.com/profiles/peter-collignon-61">Peter Collignon</a>, Professor of Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a></em></span></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/scientists-around-the-world-are-already-fighting-the-next-pandemic-115246">original article</a>.</em></p>

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Pregnant New Zealand woman dies after drinking 3 litres of soft drink a day

<div class="post_body_wrapper"> <div class="post_body"> <div class="body_text "> <p>A pregnant woman who drank an excessive amount of Coca-Cola and energy drinks has passed away, and according to recent coroner reports, this caffeine consumption may have contributed to her death.</p> <p>Amy Louise Thorpe died of an epileptic seizure at her home on December 4, 2018.</p> <p>According to findings released by coroner David Robinson, Thorpe, who was 15 weeks pregnant at the time of her death, had a history of epilepsy and other conditions.</p> <p>Since she was pregnant, her seizures had increased in frequency to about once a week.</p> <p>She was also consuming two litres of Coca-Cola and between 500mls to one litre of energy drinks per day.</p> <p>Thorpe’s partner said that she was “addicted” to soft drink and a friend told police in a statement after her death that she consumed “more energy drinks in a day than people have coffee”.</p> <p>A month before her death, Thorpe was referred to a neurologist, Graeme Hammond-Tooke, who recommended she change her epilepsy medication.</p> <p>However, according to the coronial inquest, Thorpe was reluctant to change medication or undergo testing.</p> <p>Associate Professor Hammond Took provided advice for the coroner’s report, saying that it was possible that her excessive caffeinated drink intake had contributed to her death.</p> <p>“In the case of Ms Thorpe, I think it is possible that excessive caffeine contributed to poor seizure control,” he told<span> </span><em>The Sun</em>.</p> <p>“While modest intake of caffeine contained in drinks is not likely to affect seizure control, large amounts probably do increase seizures, and may have other adverse effects on health.”</p> <p>Robinson said that making Thorpe’s case public should serve to raise awareness of the consequences of excessive caffeine use, especially for people who had epilepsy.</p> <p><em>Hero photo credits:<a rel="noopener" href="https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&amp;objectid=12337029" target="_blank"> Otago Daily Times</a></em></p> </div> </div> </div>

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Could taking hydroxychloroquine for coronavirus be more harmful than helpful?

<p>A <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext">paper published in <em>The Lancet</em></a> has cast fresh controversy on the use of the malaria drug hydroxychloroquine as a potential treatment for COVID-19.</p> <p>The study’s authors reported they were “unable to confirm a benefit” of using the drug, while also finding COVID-19 patients in hospital treated with hydroxychloroquine were more likely to die or suffer life-threatening heart rhythm complications.</p> <p>The publication prompted the World Health Organisation to <a href="https://www.abc.net.au/news/2020-05-26/who-pauses-trial-of-hydroxychloroquine-for-coronavirus-patients/12285652">suspend its testing of hydroxychloroquine to treat COVID-19</a>, while a <a href="https://www.ascot-trial.edu.au/blogs/news/statement-on-the-status-of-australasian-covid-19-trial-ascot">similar Australian trial</a> has paused recruitment.</p> <p><strong>A bit of background</strong></p> <p>Hydroxychloroquine has been used since the 1940s to treat malaria, but has been making headlines as a <a href="https://www.nps.org.au/media/hydroxychloroquine-and-covid-19">potential treatment for COVID-19</a>. US President Donald Trump recently declared <a href="https://theconversation.com/donald-trump-is-taking-hydroxychloroquine-to-ward-off-covid-19-is-that-wise-139031">he was taking it daily</a>, while Australian businessman and politician Clive Palmer <a href="https://www.sbs.com.au/news/the-feed/clive-palmer-has-bought-30-million-doses-of-an-anti-malaria-drug-to-fight-covid-19-but-experts-warn-this-may-not-be-the-cure-all">pledged to create a national stockpile</a> of the drug.</p> <p>The drug alters the human immune system (it’s an <a href="https://www.nps.org.au/hcq-and-covid-19">immunomodulator, not an immunosuppressant</a>) and has an important role in helping people with rheumatoid arthritis and lupus.</p> <p>It does have a range of serious <a href="https://www.tga.gov.au/alert/new-restrictions-prescribing-hydroxychloroquine-covid-19">possible side-effects</a>, including eye damage and altered heart rhythm, which require monitoring.</p> <p><a href="https://www.nature.com/articles/s41421-020-0156-0">Laboratory studies</a> suggest hydroxychloroquine may disrupt replication of the SARS-CoV-2 virus that causes COVID-19. It’s also possible hydroxychloroquine could reduce “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161506/">cytokine storm</a>” – the catastrophic immune system overreaction that happens in some people with severe COVID-19.</p> <p>A huge global effort is underway to investigate whether hydroxychloroquine is safe and effective for preventing or treating COVID-19, especially to improve recovery and reduce the risk of death. Previous studies have been inconclusive as they were anecdotal, observational or small randomised trials.</p> <p>Doubts about hydroxychloroquine’s effectiveness have been increasing, with a large observational study from New York <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2012410">showing it had no benefit</a> in treating people with COVID-19.</p> <p>The new <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext"><em>Lancet</em> study</a>, published last week, has found it could increase the risk of death among COVID-19 patients in hospital. But there’s more to the story.</p> <p><strong>What did the new study do?</strong></p> <p>The <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext"><em>Lancet</em> study</a> collected real-world data on more than 96,000 hospitalised patients with COVID-19 from more than 600 hospitals across six continents.</p> <p>About 15,000 patients were treated with hydroxychloroquine (or a closely related drug, chloroquine) alone or in combination with an antibiotic.</p> <p>Using a global registry the researchers investigated the safety of these treatments. They looked at whether people died in hospital, as well as the risk of developing life-threatening heart rhythm problems (called ventricular arrhythmias).</p> <p><strong>What did the study find?</strong></p> <p>Treatment with hydroxychloroquine was associated with increased rates of death in people with COVID-19, even after the researchers adjusted for other factors (age, other health conditions, suppressed immune system, smoking, and severity of the COVID-19 infection) that might increase the risk of death.</p> <p>About 18% of people who received hydroxychloroquine died in hospital, compared with 9% of people with COVID-19 who did not receive these treatments. The risk of death was even higher (24%) in people receiving hydroxychloroquine in combination with either of the antibiotics azithromycin or clarithromycin.</p> <p>Hydroxychloroquine (6%) and chloroquine (4%) treatment was also associated with more cases of dangerous heart rhythm problems when compared with untreated people with COVID-19 (0.3%).</p> <p>Any evidence of benefit, while not the focus of this study, was unclear.</p> <p><strong>How can we interpret the results?</strong></p> <p>This was an observational study, so it can only explore the association between treatments and death – rather than telling us hydroxychloroquine <em>caused</em> these patients to die.</p> <p>It is <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31174-0/fulltext">unclear</a> why the death rate for patients treated with hydroxychloroquine and chloroquine was double that of those who weren’t, as the cause of death was not reported in this study.</p> <p>Importantly, the study cannot account for all the factors that might contribute to death in these hospitalised patients and how these factors interact with each other. However, the researchers did a good job of “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144483/">matching</a>” the characteristics of people who were receiving hydroxychloroquine with those who were not receiving the drug, which makes the results more reliable.</p> <p>But there may still be other factors, or medicines, that contributed to these findings. So there remains uncertainly about whether hydroxychloroquine causes, or even contributes to, the death of people with COVID-19.</p> <p>Further, it was not possible to have careful control over the hydroxychloroquine dose people received – or other medicines people might be taking such as antivirals or other medicines for heart conditions (which potentially interact in sick hospitalised patients).</p> <p>The average dose of hydroxychloroquine in this study was at the upper end of the regular recommended dose range for rheumatoid arthritis and lupus. But the wide range of hydroxychloroquine (and chloroquine) doses in this study makes interpretation of the findings difficult, especially when we know <a href="https://www1.racgp.org.au/ajgp/coronavirus/hydroxychloroquine-use-during-the-covid-19-pandemi">harmful effects</a> are associated with larger doses.</p> <p><strong>Broader implications</strong></p> <p>This study provides important information about the safety of hydroxychloroquine in treating vulnerable people with COVID-19 receiving hospital care.</p> <p>While the implications for using hydroxychloroquine to treat COVID-19 in the community or for prevention of COVID-19 remain unclear, if nothing else this study highlights the need to carefully monitor people receiving the drug.</p> <p>Some hydroxychloroquine trials are continuing, such as the very large <a href="https://www.recoverytrial.net/for-site-staff/site-staff/#alert">RECOVERY trial</a> in the UK.</p> <p>This new information must be considered when balancing harm and potential benefit of these trials and will likely result in renewed safety monitoring.</p> <p>We’ll need to see results from <a href="https://www.mja.com.au/journal/2020/clinical-trials-prevention-and-treatment-coronavirus-disease-2019-covid-19-current">ongoing</a> high-quality randomised controlled trials to truly know if hydroxychloroquine is effective and safe in treating or preventing COVID-19.</p> <p>Further questions about what dose should be used, and which patients will benefit most, are topics under active investigation.</p> <p>You <a href="https://www.tga.gov.au/alert/new-restrictions-prescribing-hydroxychloroquine-covid-19">should not take hydroxychloroquine</a> for COVID-19 unless you’re part of a clinical trial. <strong>– Andrew McLachlan and Ric Day</strong></p> <p><strong>Blind peer review</strong></p> <p>This is a fair and reasonable review of the Lancet paper, its relationship to previous studies, and its impact on ongoing clinical trials.</p> <p>As stated in the review the Lancet article adds to the body of knowledge, including recent substantial studies in the <em><a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2012410">New England Journal of Medicine</a> </em>and the <em><a href="https://www.bmj.com/content/369/bmj.m1849">British Medical Journal</a></em>, that hydroxychloroquine is without significant effect in treatment trials.</p> <p>The high death rate is concerning but not unprecedented, given that a clinical trial in Brazil was <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2765499">halted</a> because of adverse effects on the heart. However, recent <a href="https://www.theguardian.com/science/2020/may/28/questions-raised-over-hydroxychloroquine-study-which-caused-who-to-halt-trials-for-covid-19?CMP=share_btn_tw">media reports</a> suggest the data may have to be revised due to <a href="https://statmodeling.stat.columbia.edu/2020/05/25/hydroxychloroquine-update/">misclassification</a> of the participating hospitals. <strong>– Ian Musgrave</strong></p> <hr /> <p><em>Research Checks interrogate newly published studies and how they’re reported in the media. The analysis is undertaken by one or more academics not involved with the study, and reviewed by another, to make sure it’s accurate.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/139309/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/andrew-mclachlan-255312">Andrew McLachlan</a>, Head of School and Dean of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/ric-day-14406">Ric Day</a>, Professor of Clinical Pharmacology, <a href="https://theconversation.com/institutions/unsw-1414">UNSW</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-taking-hydroxychloroquine-for-coronavirus-be-more-harmful-than-helpful-139309">original article</a>.</em></p>

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The potato trick to help get rid of neck pain and migraines

<p>An expert has revealed an unlikely item that serves to relieve neck pain and migraines.</p> <p>Those dealing with neck stiffness could use humble potatoes to treat themselves, said Stephen Makinde, the clinical director of Perfect Balance Clinic in London.</p> <p>“We’ve seen an increase in the number of clients with neck problems and migraines associated with neck stiffness since the start of the coronavirus lockdown,” Makinde told the <em><a href="https://www.dailystar.co.uk/health/bizarre-baking-potato-trick-could-22096583">Daily Star</a></em>.</p> <p>The problem could be attributed to increased use of electronic devices during the pandemic, which affects the upper back, he said.</p> <p>“If you are looking down, which you do when working on a laptop, what tends to happen is the head starts to hang forward and that puts a lot of strain on the upper back,” he said.</p> <p>“This can often cause a burning sensation in the trapezius muscles and affects other muscles in the neck, the spine and the nerves.”</p> <p>Makinde said lying down with tennis balls placed underneath the back of the head can help loosen muscles, release tension and help “reset the neck position”.</p> <p>“Tennis balls are really useful for this, but most people don’t have tennis balls at home,” he said.</p> <p>“So baking potatoes work well, too. You just sellotape them together and lie down flat, with the potatoes placed underneath the back of your head.</p> <p>“This is a really easy and useful thing people can do at home to release their neck tension and the pressure around there themselves.”</p> <p>In an interview with <em><a href="https://7news.com.au/sunrise/on-the-show/coronavirus-australia-how-to-prevent-back-and-neck-pain-when-working-from-home-c-1059473">Sunrise</a></em>, Australian Chiropractors Association President Dr Anthony Coxon also recommended getting up and moving every half an hour as well as increasing the height of the screens we are using.</p>

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Rebel Wilson gets real about weight loss journey: “I’m working hard”

<p>Rebel Wilson has not been afraid to share the highs and lows of her health journey to her loyal followers, and has remained committed to staying on the right path. </p> <p>The Australian actress has recently been seen showing off her healthy figure, but has gotten real with her fans about what exactly keeps her motivated. </p> <p>“I’ll be honest with you guys - with my ‘Year of Health’ mission I’m trying to get to 75kg’s and career wise am trying to get one of my movies into production before the end of the year!” the star wrote in a post to Instagram. </p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/CAoYTmWpAYU/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/CAoYTmWpAYU/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Rebel Wilson (@rebelwilson)</a> on May 25, 2020 at 5:27pm PDT</p> </div> </blockquote> <p>“Both of these things are requiring a daily effort and there’s constant setbacks - but I’m working hard x.”</p> <p>Wilson left her followers with some words of encouragement to help motivate others who may need a hand during difficult times.</p> <p>“Even if you have to crawl towards your goals, keep going x it will be worth it. Try and give a little bit of effort each day…” the 40-year-old said. </p> <p>“I know some days are frustrating as hell, you feel like giving up, you get annoyed at the lack of progress...but good things are coming your way.”</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/B_zPYMcpiNq/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/B_zPYMcpiNq/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Rebel Wilson (@rebelwilson)</a> on May 5, 2020 at 2:11am PDT</p> </div> </blockquote> <p>In January, Wilson announced that she would be making 2020 the year she changed her life around. </p> <p>In 2016, the actress admitted she didn’t feel any pressure to lose weight while working in Hollywood. </p> <p>“You know what? People say, ‘Don’t lose weight,’” Wilson told E! News. </p> <p>“You don’t want to be in that weird range of ‘are you skinny or are you fat’? Because how do you class yourself then? Weirdly, a lot of people say don’t.</p> <p>“But then I guess when you’re doing movies with actresses who are super skinny and whatever and you got to do a photo shoot side by side … then you notice you’re twice the weight they are.”</p> <p>Wilson says she is just focussing on her happiness: “You never want to be, like, too unhealthy because that’s bad. But you just want to be comfortable with who you are, whatever your size.”</p>

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How to stay safe in restaurants and cafes

<p>Now we have fewer cases of COVID-19, and restrictions are lifting, many of us are thinking of rejuvenating our social lives by heading to our local cafe or favourite restaurant.</p> <p>What can we do to reduce the risk of infection? And what should managers be doing to keep us safe?</p> <p>COVID-19 is an infectious disease <a href="https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/what-you-need-to-know-about-coronavirus-covid-19#:%7E:text=The%20virus%20can%20spread%20from,your%20mouth%20or%20face">spread</a> directly from person to person, carried in droplets from an infected person’s breath, cough or sneeze. If the droplets come into contact with another person’s eyes or are breathed in, that person may develop the disease.</p> <p>Those droplets can also fall onto surfaces, where the virus can survive <a href="https://www.nejm.org/doi/full/10.1056/NEJMc2004973">for up to 72 hours</a>. If someone touches these surfaces, then touches their face, they can also become infected.</p> <p><strong>Eating out has led to several clusters</strong></p> <p>We know people around the world have become infected while eating out.</p> <p>Back in late January and early February, <a href="https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article#tnF1">three clusters</a> of COVID-19 cases in China were connected to dining in a single restaurant. A total of 10 people became ill over the next three weeks.</p> <p>The air-conditioning had apparently carried contaminated droplets from an infectious diner to nearby tables. This prompted the researchers to recommend restaurants increase their ventilation and sit customers at tables further apart.</p> <p>In Queensland, more than 20 people connected with a <a href="https://www.abc.net.au/triplej/programs/hack/coronavirus-covid-19-infected-noosa-sails-restaurant-stayed-open/12097336">private birthday party</a> at a Sunshine Coast restaurant contracted the virus. Four were staff, the rest guests. We don’t know the source of infection.</p> <p>Other outbreaks have been linked with restaurants in <a href="https://www.hawaiinewsnow.com/2020/04/14/authorities-investigate-cluster-coronavirus-cases-tied-kona-restaurant/">Hawaii</a>, <a href="https://la.eater.com/2020/5/4/21246555/morning-briefing-restaurant-news-los-angeles-covid-19-coronavirus-restaurant-cases-list">Los Angeles</a> and a <a href="https://www.muswellbrookchronicle.com.au/story/6759018/victoria-virus-cases-up-11-caution-urged/?cs=7">fast food restaurant in Melbourne</a>.</p> <p style="text-align: center;"><iframe width="440" height="260" src="https://www.youtube.com/embed/kGQEuuv9R6E?wmode=transparent&amp;start=0" frameborder="0" allowfullscreen=""></iframe></p> <p style="text-align: center;"><span class="caption">Here’s how the coronavirus can spread in a restaurant.</span></p> <p><strong>The path to infection</strong></p> <p>Let’s consider the risk of infection from the moment you arrive at a restaurant or cafe.</p> <p>When you open the door, you may have to put your hand on a door handle. If that handle has been touched by a person while infectious, they may leave behind thousands of individual virus particles. If you then touch your face, you run the risk of the virus entering your body and establishing an infection.</p> <p>If you avoid the doorknob trap, you may pick up the virus when you take your seat at the table, by touching the chair or the tabletop. Again, if you touch your face, you are risking infection. Similarly, you risk exposure by touching the menu or the cutlery.</p> <p>When the waiter comes to take your order, they will likely enter your breathing space. This is usually considered to be a circular zone of about <a href="https://theconversation.com/coronavirus-why-should-we-stay-1-5-metres-away-from-each-other-134029">1.5 metres</a> around your body.</p> <p>If the waiter is infected but not yet showing symptoms, you may be exposed to droplets containing the virus on their breath or the breath may contaminate the tableware in front of you.</p> <p>Now, your food is delivered and there’s good news. The virus <a href="https://www.google.com/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=&amp;ved=2ahUKEwjl1cOhotPpAhUC63MBHS5pAt4QFjANegQIBxAB&amp;url=https%3A%2F%2Fapps.who.int%2Firis%2Frest%2Fbitstreams%2F1274400%2Fretrieve&amp;usg=AOvVaw2XBucHbnVtIWNHQnwm8cmV">is <em>not</em> transmitted</a> through food.</p> <p>But wait. The air-conditioning can help the virus travel through the air from the infected person at the next table who has just choked on a crumb and is coughing uncontrollably.</p> <p>Later, on a quick trip to the bathroom, you again open yourself to the risk of infection by touching the door and other surfaces. However, this trip allows you to take one very important step to prevent infection. You wash your hands with soap, taking care to hum Happy Birthday twice as you scrub and rinse.</p> <p>Unfortunately, you fail to dry your hands thoroughly. Wet hands <a href="https://journals.sagepub.com/doi/abs/10.1177/1757177418815549">are much more likely</a> to pick up microbes, so you may recontaminate your hands as you open the door and go back to your table.</p> <p>When you go to pay your bill, you may be worried that cash may be a source of infection. While there were concerns about this initially, there is no evidence to date of any cases linked to handling money. Just in case, you use your credit card, but inadvertently transfer the virus to your finger as you type in your PIN.</p> <p>On your way out the door, you not only pick up more virus from the doorknob, but transfer some of the ones on your hand in return, ready for the next unwary diner.</p> <p><strong>How can I protect myself?</strong></p> <p>There are some simple (and familiar) things you can do to protect yourself as venues reopen.</p> <p>Keep washing and drying your hands, thoroughly and regularly. If you don’t have access to soap and water, use alcohol-based hand sanitiser. Wash or sanitise after handling money, touching surfaces, before eating and after visiting the bathroom. Avoid touching your face, including wiping your eyes or licking juice off your fingers. If you must touch your face, use hand sanitiser first.</p> <p>Maintain a distance of at least 1.5 metres from other people, unless they are people you share close contact with.</p> <p>Sit outside if you can. Direct transmission is <a href="https://www.medrxiv.org/content/10.1101/2020.02.28.20029272v2">much more likely</a> indoors.</p> <p>Finally, think about using a credit or debit card with a contactless transaction, rather than having to enter a PIN.</p> <p>To avoid infecting other people, stay home if you have any symptoms or suspect you might have been in contact with a person who has tested positive.</p> <p><strong>What should cafes and restaurants be doing?</strong></p> <p>Regulations about the number of patrons allowed in cafes and restaurants vary between states and territories. But there are certain common rules of thumb.</p> <p>First, tables need to be spaced at reasonable distances. This allows patrons to be outside others’ 1.5-metre breathing zones and also takes into account the potential effect of air conditioning.</p> <p>While COVID-19 doesn’t appear to be spread through air conditioning systems, they do boost air flow. This means droplets may travel a little further than 1.5 metres. This spacing will also reduce the number of people in the venue at the same time.</p> <p>Some venues <a href="https://www.scmp.com/news/hong-kong/hong-kong-economy/article/3050085/coronavirus-hong-kong-restaurants-install-physical">overseas</a> are using plastic screens to separate diners to try to reduce the risk of person-to-person spread. This should not be used as a substitute for correct distancing if there is sufficient space.</p> <p>Tables and chairs need to be sanitised, <a href="https://www.qld.gov.au/health/conditions/health-alerts/coronavirus-covid-19/industry-and-businesses/resources-and-fact-sheets-for-industry/covid-19-cleaning-and-disinfection-recommendations">using a chemical sanitiser such as diluted bleach</a>, between patrons.</p> <p>Cutlery and tableware cannot be left ready on the table. They must be stored to prevent contamination in the kitchen and brought to the patron with their meal. Afterward, they need to be cleaned and sanitised as usual.</p> <p>Disposable cutlery should never be left out for self-service; it should only be provided with food or on request.</p> <p>All frequently touched surfaces must be regularly sanitised – including door handles, refrigerator and freezer doors, taps, light switches, hand rails, PIN pads and touch screens.</p> <p>Staff must maintain safe distances from patrons at all times and must <em>never</em> be allowed to work if they have respiratory symptoms or are suspected to have had contact with a COVID-19 positive person.</p> <p><strong>We need to be vigilant</strong></p> <p>Coronavirus cases in most states and territories are now very low. So, the chance of coming into contact with an infectious person is unlikely and is why restrictions are now gradually being lifted.</p> <p>However, we musn’t become complacent. We need to continue to take precautions to reduce the risk of infection via our cafes and restaurants. It only takes one instance of carelessness to start the viral ball rolling again.</p> <p><em><a href="https://theconversation.com/profiles/lisa-bricknell-1043565">Lisa Bricknell</a>, Senior Lecturer in Environmental Health, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-stay-safe-in-restaurants-and-cafes-139117">original article</a>.</em></p>

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7 questions answered on how to socialise safely as coronavirus restrictions ease

<p>You can almost hear the collective sigh of relief as coronavirus restrictions are <a href="https://www.theguardian.com/australia-news/2020/may/20/social-distancing-rules-australia-when-will-end-guidelines-coronavirus-laws-physical-covid-19-restrictions-signs-posters-nsw-victoria-qld-queensland-act-sa-wa-nt-tasmania">eased across Australia</a>.</p> <p>But as we emerge from our bunkers and dust off our social skills, we must think about how to navigate this transition safely.</p> <p>The winding back of restrictions does not mean the pandemic is over, although it is a recognition of how well we have done to control the spread of COVID-19 in Australia. There is still a long way to go, and it’s everyone’s responsibility to limit the chances of the coronavirus spreading.</p> <p>So what should a social gathering look like now we’re allowed to get together? Here are answers to some common questions.</p> <p><strong>How big should my gathering be?</strong></p> <p>At the time of writing, you can have <a href="https://www.theguardian.com/australia-news/2020/may/20/social-distancing-rules-australia-when-will-end-guidelines-coronavirus-laws-physical-covid-19-restrictions-signs-posters-nsw-victoria-qld-queensland-act-sa-wa-nt-tasmania">five visitors in your home</a> and gatherings of up to ten outdoors in Queensland, New South Wales and Victoria. In Tasmania you can only have two visitors to your home; in the ACT, South Australia and the Northern Territory you can have ten, while in Western Australia you can have 20.</p> <p>Whatever the restrictions in your state or territory, it’s important not to crowd too close together. You need to use common sense in deciding how many people to invite.</p> <p><strong>Do we still need to socially distance and wash hands regularly?</strong></p> <p>We should carry on doing the things that have so far proved successful in curbing the coronavirus.</p> <p>This includes staying at least 1.5 metres from other people, and being vigilant about hand hygiene.</p> <p>Make sure you have plenty of hand sanitiser available if you are hosting or attending a social gathering, so you can disinfect your hands regularly without having to go to the bathroom repeatedly.</p> <p><strong>How should we greet each other?</strong></p> <p>The same rules about physical contact still apply, so we should not be hugging for now. We could adopt some of the new ways of greeting, such as the elbow bump or the foot shake. Or just stick to saying hello for the moment.</p> <p><strong>Should I bring my own cutlery to a dinner party?</strong></p> <p>Assuming you trust the general hygiene standards of your friends (which I sincerely hope you do), this is not necessary. Cutlery should be washed properly with detergent in hot water and handled only with freshly washed hands.</p> <p>Cutlery is no different to any other food surface such as crockery, glassware or chopping boards – just make sure it’s as clean as possible.</p> <p><strong>Can we share food?</strong></p> <p>Although there is no evidence coronavirus is spread through food, there is still a risk of cross-contamination while eating food from a shared plate. So this is probably not a sensible thing to do right now.</p> <p>While it might feel less sociable, avoiding shared grazing plates is a simple tactic to limit the risk of virus transmission. It might even stop your friend scoffing all the dip.</p> <p>Similarly, avoid the temptation to clink glasses with your friends. It’s only a small risk but we should take every opportunity to reduce the virus’s chances.</p> <p><strong>Should I wear a mask?</strong></p> <p>A mask is not essential for social gatherings, assuming you maintain a safe distance and wash your hands regularly. Having said that, a mask can give people some extra reassurance so they can relax a bit more.</p> <p>That’s assuming it is worn (and taken off) correctly, and that people understand a mask does not guarantee protection from infection. There is no harm in wearing one, but remember to be extra friendly as your friends can’t see your smile!</p> <p><strong>I don’t feel 100% – should I take a raincheck?</strong></p> <p>It is important to factor in your personal health and risk factors in determining how you navigate your newly reinstated freedoms. For example, a 75-year-old with a pre-existing health condition, such as a heart condition or asthma, should still be very careful about limiting their contact with others, as the implications of getting sick are very serious.</p> <p>You should also consider your responsibility to other people. A 25-year-old who feels slightly unwell should err on the side of caution and not socialise, to protect others.</p> <p>Despite the lockdown lifting, we still need to take responsibility for our own health and also be considerate about the health of others. That way we can all start to enjoy one of the most rewarding aspects of humanity: being sociable.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/139109/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><em><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, Associate Professor, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/7-questions-answered-on-how-to-socialise-safely-as-coronavirus-restrictions-ease-139109">original article</a>.</em></p>

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