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With COVID surging, should I wear a mask?

<p><em><a href="https://theconversation.com/profiles/c-raina-macintyre-101935">C Raina MacIntyre</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>COVID is <a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">on the rise again</a>, with a peak likely over the holiday season.</p> <p>Given this, health authorities in a number of Australian states have recommended people start <a href="https://www.thenewdaily.com.au/life/health/2023/11/15/covid-australia-eighth-wave">wearing masks again</a>. In <a href="https://www.abc.net.au/news/2023-11-17/wa-public-hospitals-mask-requirements-roger-cook-covid-19/103120580">Western Australia</a>, masks have been made mandatory in high-risk areas of public hospitals, while they’ve similarly been reintroduced in health-care settings in <a href="https://www.adelaidenow.com.au/coronavirus/mandatory-face-masks-introduced-in-lyell-mcewin-and-modbury-hospitals-as-covid-wave-hits-sa/news-story/b4bad98deb02a66dde4cf866f60b607a">other parts of the country</a>.</p> <p>Hospitals and aged care facilities are definitely the first places where masks need to be reinstated during an epidemic. But authorities are <a href="https://www.thenewdaily.com.au/life/health/2023/11/15/covid-australia-eighth-wave">differing in their recommendations</a> currently. Calls to mask up, particularly in the wider community, <a href="https://www.9news.com.au/national/queensland-covid-chief-health-officer-confirms-covid-wave/a3a92381-bd6f-4175-a366-3b8e0f627990">have not been unanimous</a>.</p> <p>So amid rising COVID cases, should you be wearing a mask?</p> <h2>COVID is still a threat</h2> <p>Unfortunately, SARS-CoV-2 (the virus that causes COVID) has not mutated into just a trivial cold.</p> <p>As well as causing symptoms in the initial phase – which can be especially serious for people who are vulnerable – the virus can lead to <a href="https://www.nature.com/articles/s41579-022-00846-2">chronic illness</a> in people of any age and health status due to its ability to affect blood vessels, <a href="https://academic.oup.com/eurheartjsupp/article/25/Supplement_A/A42/7036729">the heart</a>, lungs, brain and immune system.</p> <p>COVID and its ongoing effects are contributing to <a href="https://www.nature.com/articles/s41591-023-02521-2">substantial disability</a> in society. Loss of productivity due to long COVID is affecting <a href="https://www.mckinsey.com/industries/healthcare/our-insights/one-billion-days-lost-how-covid-19-is-hurting-the-us-workforce">workforce and economies</a>.</p> <p>While public messaging to “live with COVID” has seemingly encouraged us to move on from the pandemic, SARS-CoV-2 has other ideas. It has <a href="https://erictopol.substack.com/p/the-virus-is-learning-new-tricks">continued to mutate</a>, become <a href="https://www.ebgtz.org/resource/omicron-faqs/">more contagious</a>, and to evade the protection offered by vaccines.</p> <p>COVID is not endemic, but is <a href="https://www.cnbc.com/2022/02/02/covid-will-never-become-an-endemic-virus-scientist-warns.html">an epidemic virus</a> like influenza or measles, so we can expect waves to keep coming. With this in mind, it’s definitely worth protecting yourself – particularly when cases are rising.</p> <h2>What can we do to protect ourselves?</h2> <p>We know SARS-CoV-2 transmits <a href="https://www.thelancet.com/article/S0140-6736(21)00869-2/fulltext">through the air</a> we breathe. We also know a lot of the transmission risk is <a href="https://abcnews.go.com/Health/covid-transmission-asymptomatic/story?id=84599810">from people without symptoms</a>, so you can’t tell who around you is infectious. This provides a strong rationale for universal masking during periods of high transmission.</p> <p>The need is highest in hospitals where thousands of unsuspecting patients have caught COVID during the course of the pandemic and <a href="https://www.theage.com.au/national/victoria/a-death-sentence-more-than-600-people-die-after-catching-covid-in-hospital-20230621-p5di7x.html">hundreds have died</a> as a result in Victoria alone. Aged care facilities are similarly vulnerable.</p> <p>Masks <a href="https://theconversation.com/yes-masks-reduce-the-risk-of-spreading-covid-despite-a-review-saying-they-dont-198992">do work</a>. A Cochrane review suggesting they don’t was flawed and subject to <a href="https://www.thestar.com/news/canada/how-the-cochrane-review-went-wrong-report-questioning-covid-masks-blows-up-prompts-apology/article_80b67196-5872-5b1a-a208-b0a525f8de5b.html">an apology</a>.</p> <p>Masks work equally by protecting others and protecting you. By visualising human exhalations too tiny to see with the naked eye, my colleagues and I showed how masks <a href="https://theconversation.com/which-mask-works-best-we-filmed-people-coughing-and-sneezing-to-find-out-143173">prevent outward emissions</a> and how each layer of a mask improves this.</p> <p>The most protective kind of mask is <a href="https://theconversation.com/time-to-upgrade-from-cloth-and-surgical-masks-to-respirators-your-questions-answered-174877">a respirator or N95</a>, but any mask protects <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm">more than no mask</a>.</p> <p>Wearing a mask when visiting health-care or aged-care facilities is important. Wearing a mask at the shops, on public transport and in other crowded indoor settings will improve your chances of having a COVID-free Christmas.</p> <h2>What about vaccines?</h2> <p>Although the virus’ evolution has challenged vaccines, they remain very important. Boosters will improve protection because vaccine immunity wanes and new mutations make older vaccines less effective.</p> <p>In May 2023 the <a href="https://www.who.int/news/item/18-05-2023-statement-on-the-antigen-composition-of-covid-19-vaccines">World Health Organization</a> outlined why <a href="https://erictopol.substack.com/p/the-ba286-variant-and-the-new-booster">monovalent boosters</a> matched to a single current circulating strain gives better protection than the old bivalent boosters (which target two strains). The XBB boosters are available <a href="https://www.sbs.com.au/news/article/the-covid-19-vaccines-australians-cant-get-yet/ueac5puue">in the United States</a>, and will be available in Australia <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">from December 11</a>.</p> <p>Testing and treatment will also help. There are effective antivirals for COVID, but you cannot get them without a COVID test, and <a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">testing rates</a> are very low. Having some RAT tests on hand means you can quickly isolate and get antivirals if indicated.</p> <p>Finally, safe indoor air is key. Remember that SARS-CoV-2 spreads silently, mainly by inhaling contaminated air. Opening a window or using an air purifier can significantly reduce your risk, especially in crowded indoor settings <a href="https://iopscience.iop.org/article/10.1088/2752-5309/ace5c9">like schools</a>. A <a href="https://ozsage.org/media_releases/">multi-layered strategy</a> of vaccines, masks, safe indoor air, testing and treatment will help us navigate this COVID wave.</p> <hr /> <p><em>Editor’s note: This article has been updated to reflect the announcement that monovalent XBB 1.5 vaccines will be deployed as part of Australia’s COVID vaccination program.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/217902/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/c-raina-macintyre-101935">C Raina MacIntyre</a>, Professor of Global Biosecurity, NHMRC Principal Research Fellow, Head, Biosecurity Program, Kirby Institute, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/with-covid-surging-should-i-wear-a-mask-217902">original article</a>.</em></p>

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"What have I done?!" Sandra Sully opens up on her big Masked Singer reveal

<p>Beloved TV personality Sandra Sully <a href="https://www.dailytelegraph.com.au/entertainment/television/sandra-sully-reveals-how-she-broke-down-with-anxiety-on-the-masked-singer-australia/news-story/6b2aa31a7eab6c3c567005803937fa6d" target="_blank" rel="noopener">recently shared her candid experience</a> of battling anxiety while participating in <em>The Masked Singer Australia – </em>one of the most anticipated and highly publicised reveals in the history of the show.</p> <p>According to the Daily Mail, the 10 News presenter found herself regretting her decision to join the reality show, and contemplated ways to back out. “I literally broke down in tears after a singing lesson, thinking ‘what have I done?’,” she told the publication.</p> <p>Then, in the midst of all this turmoil and anxiety, Sully had a pivotal moment after a singing lesson. Overwhelmed by self-doubt, she broke down in tears, questioning the wisdom of her choice to be on the show at all.</p> <p>She repeatedly voiced her concerns to her husband, Symon Brewis-Weston, saying, "What have I done? I can't do it, I can't do it – what am I going to do?"</p> <p>It was Brewis-Weston who provided her with the much-needed encouragement. He had initially convinced her to participate after years of declining offers from producers. He sternly advised her to stop spiralling into negativity, reminding her of the reasons she had said yes to the show and encouraging her to embrace the experience with a sense of fun. He told her, "Just have a bit of fun. No one's going to die, including you."</p> <p>Sully took his advice to heart, realising that her anxiety was getting the best of her. She had a moment of self-reflection and decided to stop doubting herself.</p> <p>Sully's big reveal as the Fawn character, designed by Tim Chappel, was a shock to the show's panellists  Mel B, Abbie Chatfield, Dave Hughes and Chrissie Swan, who had not heard her sing during her more than 30-year career in news presentation.</p> <p>Sully's lack of singing experience surprised not only the viewers but also her husband and friends, as she never sang in the shower and only had experience as a drummer in her primary school band. She humorously admitted, "I don't sing along in the car – I probably can now because I've shown Australia I can't sing. So we can all laugh out loud together as I also laugh at myself."</p> <p>Relieved that her <em>Masked Singer</em> journey is over, Sully faced additional challenges beyond anxiety, including the need to constantly tell fibs to friends and colleagues in order to conceal her identity. She also grappled with claustrophobia, particularly once the heavy mask was placed on her head.</p> <p>Describing the experience, she said, "Your whole head is ensconced like in a balaclava, and then you have to put this mask on and it's done up under your chin, and then tightened like a bike helmet underneath it so it all fits your head." The show forced her to confront various personal fears beyond performing and singing.</p> <p>Although Sully is open to pushing her boundaries and venturing outside her comfort zone, she has firmly declined offers to appear on Ten's <em>I'm A Celebrity ... Get Me Out Of Here</em>, citing her severe claustrophobia and fear of snakes as insurmountable obstacles.</p> <p>She is grateful for choosing <em>The Masked Singer</em> as her reality show adventure, where she had the opportunity to have fun despite the challenges.</p> <p><em>Images: Network Ten</em></p>

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Huge news for avid cruisers

<p>Those planning to embark on a cruise can leave their masks behind, as Covid mandates on board have finally been scrapped. </p> <p>NSW premier Chris Minns announced the change of rules for cruise passengers on Monday, saying, “We need to get life back to normal.”</p> <p>Previously, the rules around cruising were quite strict in the face of several Covid outbreaks on ships around the world, with passengers over the age of 12 needing to provide proof of vaccination prior to embarking. </p> <p>Travellers also had to abide by enforced mask-wearing when embarking and disembarking the ship, and had to present a negative Covid test prior to departure.</p> <p>The NSW government announced on Monday that they had formally signed paperwork that removed the rules from the Eastern Seaboard and Western Australian Cruise Protocols, which also covers travellers embarking from Victoria, Queensland and Western Australia.</p> <p>Mr Minns said it was time to “get life back to normal”.</p> <p>“We have scrapped these rules because they aren’t needed anymore,” he said.</p> <p>“Passengers can take their own decisions to look after their health before and during a cruise.”</p> <p>Tourism Minister John Graham welcomed the change in regulations, but also thanked the government for implementing the safety rules at the height of the Covid pandemic. </p> <p>“The 2023 winter cruise season in Sydney is on track to be one of the strongest on record and it is fantastic even more people can now participate,” he said. </p> <p>“These protocols were important after Covid but were not intended to continue in perpetuity and I thank the sector for how they have handled the additional requirements placed upon them.”</p> <p>While the remaining states have yet to formally rescind the rules, the federal health body has advocated for the removal of the Covid public health measures.</p> <p><em>Image credits: Getty Images</em></p>

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Fran Drescher calls for an end to “bull***t” vaccine mandates

<p dir="ltr">Fran Drescher has divided audiences after using her platform to go on a tirade about bringing an end to “bull***t” vaccine mandates. </p> <p dir="ltr">The former star of <em>The Nanny</em> took to the stage at the 2023 Screen Actors Guild (SAG) Awards on Sunday, and used the opportunity to voice her controversial opinions about Covid-19 restrictions. </p> <p dir="ltr">“As the nation declares an end to the Covid emergency this May, I hope we will see everyone return to work in equal opportunity,” Drescher, 65, said in her speech during the telecast,<em> <a href="https://nypost.com/2023/02/27/fran-drescher-calls-for-end-to-vaccine-mandate-in-sag-speech/?utm_campaign=SocialFlow&amp;utm_medium=SocialFlow&amp;utm_source=NYPTwitter">Page Six</a></em> reports. </p> <p dir="ltr">The entertainment industry’s pandemic protocols were originally set to end on January 31st, but have been extended until April 1st. </p> <p dir="ltr">Meanwhile, more than 20 US states still enforce vaccine mandates to varying degrees.</p> <p dir="ltr">“Our industry brings billions of production dollars to states across the nation, but if they want our business, let’s wield our financial influence to make governors act in the best interest of freedom, diversity, inclusion and democracy,” Drescher said.</p> <p dir="ltr">“As my character Bobbi Flekman said in <em>This Is Spinal Tap</em> – money talks and bulls**t walks!”</p> <p dir="ltr">Her divisive comments were met with a mixed reaction online, with many viewers claiming it was “irresponsible” for Drescher to use her platform in such a way.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Fran Drescher’s comments on the <a href="https://twitter.com/hashtag/CovidVaccine?src=hash&amp;ref_src=twsrc%5Etfw">#CovidVaccine</a> were irresponsible. Using her logic, people wouldn’t be universally vaccinated against diseases like measles and tetanus. Public health is PUBLIC because it takes collective work.</p> <p>— 🇺🇦мег 🇺🇦 (@sassybibrarian) <a href="https://twitter.com/sassybibrarian/status/1630038810095648768?ref_src=twsrc%5Etfw">February 27, 2023</a></p></blockquote> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">God I love Fran Drescher, but her speech at the SAG awards could have been an email.</p> <p>— Francis (@Fusterduster) <a href="https://twitter.com/Fusterduster/status/1630022506668249088?ref_src=twsrc%5Etfw">February 27, 2023</a></p></blockquote> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Woody Harrelson and now Fran Drescher. Big weekend for anti-vaxxers.</p> <p>— 𝐓𝐨𝐦𝐚𝐬 ⁽ʷʰᵒ ⁱˢ ᵍᵃʸ⁾ (@cinema_gay) <a href="https://twitter.com/cinema_gay/status/1630021950293655554?ref_src=twsrc%5Etfw">February 27, 2023</a></p></blockquote> <p dir="ltr">Elsewhere in her speech, Drescher also discussed her efforts to help make Hollywood more environmentally friendly by joining with Green Council with a goal to eliminate single-use plastic both on camera and behind the scenes.</p> <p dir="ltr">She also applauded IMDb for “taking a stand against ageism, stereotyping and gender rigidity by allowing our members to define themselves their way on their profile page – for free.”</p> <p dir="ltr"><em>Image credits: Getty Images</em><span id="docs-internal-guid-1cf5b55a-7fff-4610-144c-c7e3ae12e9d4"></span></p>

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Yes, masks reduce the risk of spreading COVID, despite a review saying they don’t

<p>The question of whether and to what extent face masks work to prevent respiratory infections such as COVID and influenza has split the scientific community for <a href="https://www.baltimoresun.com/news/bs-xpm-2007-03-06-0703060040-story.html">decades</a>.</p> <p>Although there is strong evidence face masks <a href="https://www.sciencedirect.com/science/article/pii/S0020748920301139?via%3Dihub">significantly reduce transmission of such infections</a> both in health-care settings and in the community, some experts do not agree.</p> <p>An updated <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub6/full">Cochrane Review</a> published last week is the latest to suggest face masks don’t work in the community.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">"Wearing masks in the community probably makes little or no difference to the outcome of laboratory‐confirmed influenza/SARS‐CoV‐2 compared to not wearing masks"<a href="https://twitter.com/CochraneLibrary?ref_src=twsrc%5Etfw">@CochraneLibrary</a> Review.<br />Published: 30 January 2023 <a href="https://t.co/zODu6QEF1M">https://t.co/zODu6QEF1M</a> <a href="https://t.co/c26yHPaSCD">pic.twitter.com/c26yHPaSCD</a></p> <p>— Robin Monotti (@robinmonotti) <a href="https://twitter.com/robinmonotti/status/1620311528523304960?ref_src=twsrc%5Etfw">January 31, 2023</a></p></blockquote> <p>However there are problems with the review’s methodology and its underpinning assumptions about transmission.</p> <p>The Cochrane Review combined randomised controlled trials (RCTs) using <a href="https://ebn.bmj.com/content/16/1/3">meta-analysis</a>. RTCs test an intervention in one group and compare it with a “control” group that doesn’t receive the intervention or receives a different intervention. A meta-analysis pools the results of multiple studies.</p> <p>This approach assumes (a) RCTs are the “best” evidence and (b) combining results from multiple RCTs will give you an average “effect size”.</p> <p>But RCTs are only the undisputed gold standard for certain kinds of questions. For other questions, a mix of study designs is better. And RCTs should be combined in a meta-analysis only if they are all addressing the same research question in the same way.</p> <p>Here are some reasons why the conclusions of this Cochrane Review are misleading.</p> <h2>It didn’t consider how COVID spreads and how masks work</h2> <p>COVID, along with influenza and many other respiratory diseases, is transmitted primarily <a href="https://theconversation.com/covid-how-the-disease-moves-through-the-air-173490">through the air</a>.</p> <p>Respirators (such as N95s) are designed and regulated to prevent airborne infections by fitting <a href="https://theconversation.com/high-filtration-masks-only-work-when-they-fit-so-we-created-a-new-way-to-test-if-they-do-155987">closely to the face</a> to prevent air leakage and by filtering out 95% or more of potential infectious particles.</p> <p>In contrast, surgical masks are designed to prevent splatter of fluid on the face and are loose-fitting, causing unfiltered air to leak in through the gaps around the mask. The filtration of a surgical mask is not regulated.</p> <p>In other words, respirators are designed for respiratory protection and cloth and surgical masks are not.</p> <p>The review starts with an assumption that masks provide respiratory protection, which is flawed. An understanding of these differences should inform both studies and reviews of those studies.</p> <h2>The studies addressed quite different questions</h2> <p>A common mistake in meta-analysis is to combine apples and oranges. If apples work but oranges don’t, combining all studies in a single average figure may lead to the conclusion that apples do not work.</p> <p>This Cochrane Review combined RCTs where face masks or respirators were worn part of the time (for example, when caring for patients with known COVID or influenza: “occasional” or “targeted” use) with RCTs where they were worn at all times (“continuous use”).</p> <p>Because both SARS-CoV-2 and influenza viruses are airborne, an unmasked person could be infected anywhere in the building and even after an infectious patient has left the room, especially since some people have <a href="https://www.pnas.org/doi/10.1073/pnas.2109229118">no symptoms</a> while contagious.</p> <p>Most RCTs of masks and N95s included in the review have not had a <a href="https://jamanetwork.com/journals/jama/fullarticle/184819">control arm</a> – therefore finding no difference could indicate equal efficacy or equal inefficacy.</p> <p><a href="https://jamanetwork.com/journals/jama/fullarticle/2749214">Studies</a> examining wearing a surgical mask or respirator (such as an N95) only when in contact with sick people or when doing a high-risk procedure (occasional use) have generally shown that, when worn in this way, there is no difference.</p> <p>An RCT comparing occasional versus continuous use of respirators in health care workers <a href="https://www.atsjournals.org/doi/10.1164/rccm.201207-1164OC?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubme">showed</a> N95 respirators and surgical masks were equally ineffective when only worn occasionally by hospital workers. They had to wear them all the time at work to be protected.</p> <p>We also combined only apples and apples in a <a href="https://onlinelibrary.wiley.com/doi/10.1111/irv.12474">meta-analysis</a> of two RCTs conducted in exactly the same way and measuring the same interventions and outcomes. We found N95 respirators provide significant protection against respiratory infections when surgical masks did not, even against infections assumed to be “droplet spread”.</p> <h2>Most trials addressed only half the question</h2> <p>Face masks and respirators work in two ways: they protect the wearer from becoming infected and they prevent an infected wearer from spreading their germs to other people.</p> <p>Most RCTs in this Cochrane Review looked only at the former scenario, not the latter. In other words, the researchers had asked people to wear masks and then tested to see if those people became infected.</p> <p>A previous <a href="https://pubmed.ncbi.nlm.nih.gov/20092668/">systematic review</a> found face masks worn by sick people during an influenza epidemic reduced the risk of them transmitting the infection to family members or other carers. Preventing an infection in one person also prevents onward transmission to others within a closed setting, which means such RCTs should use a special method called “cluster randomisation” to account for this.</p> <p>Data from a RCT of N95 respirator use by <a href="https://journals.sagepub.com/doi/full/10.1177/0300060516665491?rfr_dat=cr_pub++0pubmed&amp;url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org">health workers</a> showed even their unmasked colleagues were protected. Yet some of the trials included in the review did not use cluster randomisation.</p> <h2>The new paper combined health and community settings</h2> <p>This is another apples-plus-oranges issue. Different settings have widely differing risks of transmission, since airborne particles build up when sick patients are exhaling the virus in <a href="https://theconversation.com/heres-where-and-how-you-are-most-likely-to-catch-covid-new-study-174473">underventilated, crowded settings</a> especially if many infected people are present (such as in a hospital).</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Here’s where (and how) you are most likely to catch COVID – new study <a href="https://t.co/Ro88Shc897">https://t.co/Ro88Shc897</a> <a href="https://t.co/TlFA9EQskF">pic.twitter.com/TlFA9EQskF</a></p> <p>— Jeffrey J Davis (@JeffreyJDavis) <a href="https://twitter.com/JeffreyJDavis/status/1484210379093954564?ref_src=twsrc%5Etfw">January 20, 2022</a></p></blockquote> <p>A genuine protective effect of masks or respirators shown in a RCT in a high-risk setting will be obscured if that trial is combined in a meta-analysis with several other RCTs that were conducted in low-risk settings.</p> <p>A large <a href="https://www.science.org/doi/10.1126/science.abi9069">RCT in the community in Bangladesh</a> found face masks reduced the risk of infection by 11% overall and 35% in people over 60 years. In contrast, in <a href="https://onlinelibrary.wiley.com/doi/10.1111/irv.12474">hospitals</a>, N95 reduce risk by 67% against bacterial infections and 54% against viral infections.</p> <p>Viruses like influenza also vary substantially from year to year – some years there is very little influenza, and if a RCT is conducted during such a year, it will not find enough infections to show a difference. The review failed to account for such seasonal effects.</p> <h2>But did they actually wear the mask?</h2> <p>The authors of the Cochrane Review acknowledged compliance with masking advice was poor in most studies. In the real world, we can’t force people to follow medical advice, so RCTs should be analysed on an “intention to treat” basis.</p> <p>For example, people who are prescribed the active drug but who choose not to take it should not be shifted to the placebo group for the analysis. But if in a study of masking, most people don’t actually wear them, you can’t conclude that masks don’t work when the study shows no difference between the groups. You can only conclude that the mask advice didn’t work in this study.</p> <p>There is a great deal of <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246317">psychological evidence</a> on why people do or don’t choose to comply with advice to mask and how to improve uptake. The science of masking needs to separate the impact of the mask itself from the impact of the advice to mask.</p> <p>Mask-wearing <a href="https://www.ijidonline.com/article/S1201-9712(21)00274-5/fulltext">goes up</a> substantially to over 70% if there is an actual mandate in place.</p> <h2>It didn’t include other types of research</h2> <p>A comprehensive review of the evidence would also include other types of study besides RCTs. For example, a <a href="https://www.sciencedirect.com/science/article/pii/S0140673620311429">large systematic review</a> of 172 various study designs, which included 25,697 patients with SARS-CoV-2, SARS, or MERS, concluded masks were effective in preventing transmission of respiratory viruses.</p> <p>Well-designed <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm?s_cid=mm7106e1_w">real-world studies</a> during the pandemic showed any mask reduces the risk of COVID transmission by 50–80%, with the highest protection offered by N95 respirators.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/20095070/">Many lab-based studies</a> have shown respirators are superior to masks at preventing airborne respiratory infections and the <a href="https://thorax.bmj.com/content/75/11/1024.long">incremental superiority</a> from a single to two layered cloth mask to a three-layered surgical mask in blocking respiratory aerosols.</p> <h2>Yes, masks reduce the spread of COVID</h2> <p>There is strong and consistent evidence for the effectiveness of masks and (even more so) respirators in protecting against respiratory infections. Masks are an important protection against serious infections.</p> <p>Current COVID vaccines protect against death and hospitalisation, but do <a href="https://fortune.com/well/2023/01/06/kraken-xbb15-omicron-covid-variant-most-transmissible-yet-could-spawn-more-immune-evasive-variants-study-china-vaccine-monoclonal-antibodies-breakthrough-infection/">not prevent infection</a> well due to waning vaccine immunity and substantial immune escape from new variants.</p> <p>A systematic review is only as good as the rigour it employs in combining similar studies of similar interventions, with similar measurement of outcomes. When very different studies of different interventions are combined, the results are not informative.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/yes-masks-reduce-the-risk-of-spreading-covid-despite-a-review-saying-they-dont-198992" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Body

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COVID-19 virus-detecting mask can alert of exposure via your smartphone

<p>Move over <a href="https://cosmosmagazine.com/health/covid/rise-of-rapid-antigen-testing/" target="_blank" rel="noreferrer noopener">inaccurate RATs</a>. Get out of my nose and throat PCR swab tests. There’s a new method of COVID-19 detection and it’s wearable.</p> <p>A research team from Tongji University in China, has created a face mask that can detect COVID-19 (as well as other common respiratory viruses such as colds and influenza) and send an alert to your smartphone.</p> <p>The mask is highly sensitive, with the inbuilt sensor able to detect the virus <a href="https://cosmosmagazine.com/health/lets-clear-the-air-on-ventilation-cosmos-weekly-taster/" target="_blank" rel="noreferrer noopener">in the air</a> after only ten minute’s exposure at extremely low concentrations – far less than produced by sneezing, coughing or talking.</p> <p>“Previous research has shown face mask wearing can reduce the risk of spreading and contracting the disease. So, we wanted to create a mask that can detect the presence of virus in the air and alert the wearer,” says Yin Fang, an author of the study and a material scientist at Shanghai Tongji University.</p> <div class="newsletter-box"> <div id="wpcf7-f6-p214217-o1" class="wpcf7" dir="ltr" lang="en-US" role="form"> <form class="wpcf7-form mailchimp-ext-0.5.62 spai-bg-prepared init" action="/science/covid-19-detecting-mask-smartphone/#wpcf7-f6-p214217-o1" method="post" novalidate="novalidate" data-status="init"> <p style="display: none !important;"><span class="wpcf7-form-control-wrap referer-page"><input class="wpcf7-form-control wpcf7-text referer-page" name="referer-page" type="hidden" value="https://cosmosmagazine.com/people/" data-value="https://cosmosmagazine.com/people/" aria-invalid="false" /></span></p> <p><!-- Chimpmail extension by Renzo Johnson --></form> </div> </div> <p>The sensor on the mask has tiny synthetic molecules – called ‘aptamers’ – which are able to be tweaked to detect proteins unique to specific pathogens, such as SARS-Cov-2, H5N1 (colloquially known as ‘bird flu’) and H1N1 (‘swine flu’). Once the aptamer detects the virus, the sensor amplifies the signal via a specialised component known as an <a href="https://www.researchgate.net/publication/344400852_Ion-Gated_Transistor_An_Enabler_for_Sensing_and_Computing_Integration" target="_blank" rel="noreferrer noopener">ion-gate transistor</a> (which is highly sensitive and able to detect very low voltage signals) and sends an alert to the user’s phone.</p> <p>“Our mask would work really well in spaces with poor ventilation, such as elevators or enclosed rooms, where the <a href="https://cosmosmagazine.com/health/covid-ventilation-standards/" target="_blank" rel="noreferrer noopener">risk of getting infected is high</a>,” Fang says. The device is also highly customisable and can be swiftly modified to detect new and emerging threats.</p> <p>This is not the first time <a href="https://cosmosmagazine.com/health/smart-masks-to-detect-covid-19/" target="_blank" rel="noreferrer noopener">‘smart masks’ have been created</a> to detect COVID-19, but what sets these devices apart is their sensitivity and ‘tunability’ to different viruses.</p> <p>The team is working on reducing the detection time and increasing the sensitivity of their devices. In the future, they hope the technology could be expanded to further applications and wearables for other conditions such as cancers and heart diseases.</p> <p>“Currently, doctors have been relying heavily on their experiences in diagnosing and treating diseases. But with richer data collected by wearable devices, disease diagnosis and treatment can become more precise,” Fang says.</p> <p><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --></p> <p><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=214217&amp;title=COVID-19+virus-detecting+mask+can+alert+of+exposure+via+your+smartphone" width="1" height="1" /></p> <p><!-- End of tracking content syndication --></p> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/science/covid-19-detecting-mask-smartphone/" target="_blank" rel="noopener">This article</a> was originally published on <a href="https://cosmosmagazine.com" target="_blank" rel="noopener">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/clare-kenyon" target="_blank" rel="noopener">Clare Kenyon</a>. Clare Kenyon is a science journalist for Cosmos. An ex-high school teacher, she is currently wrangling the death throes of her PhD in astrophysics, has a Masters in astronomy and another in education. Clare also has diplomas in music and criminology and a graduate certificate of leadership and learning.</em></p> <p><em>Image: Getty Images</em></p> </div>

Technology

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“There’s no way”: Masked Singer finale causes chaos

<p><em><strong>Warning! Spoilers ahead.</strong></em></p> <p>The fourth season of <em>The Masked Singer Australia</em> has drawn to a dramatic close, with the results of the finale causing a stir online.</p> <p>Mirrorball, Rooster and Snapdragon were the three contestants still left in the competition, with Mirrorball taking out the win. </p> <p>However, as the masks came off, fans were suspicious as to how the famously clueless Dave Hughes managed to pull a surprisingly niche and accurate guess out of the bag at the last minute. </p> <p>Mirrorball's identity was unveiled, revealing former Pussycat Dolls member Melody Thornton as the winner.</p> <blockquote class="instagram-media" 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);" data-instgrm-permalink="https://www.instagram.com/p/Chzej4qrHou/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </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;" href="https://www.instagram.com/p/Chzej4qrHou/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Melody Thornton (@melodythornton)</a></p> </div> </blockquote> <p>The 37-year-old singer was pegged as the star inside the Mirrorball costume before the season even began, as die-hard Pussycat Dolls fans could pick her voice from the teaser advertisements. </p> <p>But her name never came up among the judges all season, with Mel B instead frequently guessing she was her former PCD bandmate Nicole Scherzinger.</p> <p>Nicole was always PCD’ lead singer, with the other members (including strong vocalist Melody) barely having any solo lines.</p> <p>Which made judge Dave Hughes’ sudden guess of Thornton after her final performance come as a shock – particularly given his habit of making outlandish guesses throughout the season. </p> <p>Some viewers questioned how Hughes would suddenly pick the winner after a season of clangingly wrong guesses, asking whether Hughes was perhaps fed the guess so viewers wouldn’t ask “who?” when Thornton was unmasked. </p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Absolutely ridiculous. So obvious they’ve told Hughesy to say Melody Thornton. They’ve built it up for him to finally get one right <a href="https://twitter.com/hashtag/MaskedSingerAU?src=hash&amp;ref_src=twsrc%5Etfw">#MaskedSingerAU</a></p> <p>— 𝒥𝒥 (@AcousticAri) <a href="https://twitter.com/AcousticAri/status/1563833058171957248?ref_src=twsrc%5Etfw">August 28, 2022</a></p></blockquote> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">There’s no way Dave would know who melody Thornton is. Hell, if it wasn’t for her upstaging Nicole shersawerser, I don’t think I’d know her either and I was in peak pussycat dolls demographic. <a href="https://twitter.com/hashtag/MaskedSingerAU?src=hash&amp;ref_src=twsrc%5Etfw">#MaskedSingerAU</a></p> <p>— Georgia Duncan (@_georgiarae) <a href="https://twitter.com/_georgiarae/status/1563833332558794757?ref_src=twsrc%5Etfw">August 28, 2022</a></p></blockquote> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">The producers definitely would’ve told Dave Hughes to guess Melody Thornton because:</p> <p>a) They want him to finally get one right<br />b) It would be kind of sad if no one guessed her all season (and instead guessed Nicole)<br />c) As if Hughesy listened to Don’t Cha<a href="https://twitter.com/hashtag/MaskedSingerAU?src=hash&amp;ref_src=twsrc%5Etfw">#MaskedSingerAU</a></p> <p>— Lachlan Guertin (@LachlanGuertin) <a href="https://twitter.com/LachlanGuertin/status/1563833575870713856?ref_src=twsrc%5Etfw">August 28, 2022</a></p></blockquote> <p>Coming in second, the Snapdragon was unmasked as Sheldon Riley: the distinctively-voiced former <em>The Voice</em> and <em>The X Factor contestant</em> and Eurovision entrant. </p> <p>Third place went to the Rooster, who was unmasked as singer and actor Hugh Sheridan.</p> <p><em>Image credits: Channel Ten</em></p>

TV

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Baby wearing face mask on flight causes outrage online

<p>A photograph of a baby wearing a surgical face mask on a recent Air New Zealand has sparked a fierce online debate. </p> <div id="story-body"> <p>The photograph, which was taken on a flight from Auckland to Wellington on July 1st, shows the child wearing an adult-sized mask across its entire face, with holes cut out for the eyes.</p> <p>Jandre Opperman, who snapped the viral image and shared it on Instagram, told the <a title="www.nzherald.co.nz" href="https://www.nzherald.co.nz/travel/covid-19-omicron-outbreak-baby-in-full-face-mask-on-air-nz-flight-sparks-debate/RLWMCSYTHODKQJJPWRMD32PGAU/">New Zealand Herald</a> it was a “super-sweet interaction”.</p> <p>He said, “The baby was full of joy, jumping around and giggling away. It made the wait to get off the plane a bit more entertaining.”</p> <p>As the post gained traction, a slew of negative comments arose from those who saw the masking as unsafe and indicative of an over-reaction towards wearing masks.</p> <p>Comments flooded in from those who said the image was “so incredibly sad” and was a display of “child abuse”.</p> <p>“If I saw this on a flight I’d remove the mask from her myself,” said one irate commenter.</p> <p>“Babies need air to develop,” noted another, rather understating the importance of breathing.</p> <p>Another said it was “dangerous to cover their breathing holes like this”.</p> <p>Opperman disagreed with the flood of online haters, saying the mask wasn’t tight and the mum was attentive to the child and was ensuring its wellbeing.</p> <p>“I think it was a mix of having a laugh, and trying her best to protect her child with the equipment available to her,” he said.</p> <p>Other commenters agreed, joking that the baby’s raised fist was just “to assure you there’s enough holes and gaps in the mask to breathe properly and don’t be a Karen and complain about a picture on Facebook.”</p> <p>“Must be training as a superhero lol! The world is not yet ready for SuperBaby,” said another in jest. </p> <p><em>Image credits: Instagram</em></p> </div>

Travel Trouble

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Airport face mask mandate dropped

<p dir="ltr">Travellers and workers at Australian airports will no longer be required to wear a face mask as health officials drop the mandate. </p> <p dir="ltr">The Australian Health Protection Principal Committee (AHPPC) - a group of the nation's state and territory chief health officers - said face masks were no longer required at airports.</p> <p dir="ltr">The mandate can be dropped from June 17 but masks will still need to be worn on all flights. </p> <p dir="ltr">“The AHPPC notes that all states and territories have relaxed mask mandates in most settings within the community and considers that it is no longer proportionate to mandate mask use in airport terminals," a statement from the committee said.</p> <p dir="ltr">The federal government expects the states to drop the mandate and follow the advice soon. </p> <p dir="ltr">"We anticipate the travelling public will notice this change in the days following Friday as individual state and territory jurisdictions make the necessary changes to their public health orders," a joint statement from Health Minister Mark Butler and Transport Minister Catherine King said.</p> <p dir="ltr">"This changed advice comes after the AHPPC has reviewed the current COVID-19 situation in Australia and considers it no longer proportionate to mandate mask-wearing in the terminals. It has also noted all states and territories have relaxed mask mandates in most community settings."</p> <p dir="ltr">Despite the dropping of the mandate, Aussies are still strongly urged to wear masks to stop the spread of Covid-19 as well as the flu. </p> <p dir="ltr"><em>Image: Shutterstock</em></p>

Domestic Travel

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“It’s emotional and scary”: White Island eruption survivor removes her face mask

<p dir="ltr">A survivor of the 2019 White Island volcano eruption who suffered burns to 70 percent of her body has finally been able to remove her face mask.</p> <p dir="ltr">Stephanie Browitt was visiting New Zealand’s northeastern Bay of Plenty region with her sister and father, who were both among the 22 people who died in the eruption.</p> <p dir="ltr">Her road to recovery has been a long and difficult one, which she has shared on social media with more than 1.6 million followers.</p> <p dir="ltr">Appearing on Nine’s <em>60 Minutes</em>, Stephanie removed her compression mask for the first time, telling host Sarah Abo that it was a “big deal” and that it felt like “this day would never come”.</p> <p dir="ltr">“It’s emotional and scary. It is actually quite daunting as much as it is exciting,” she said.</p> <p><span id="docs-internal-guid-544c330b-7fff-ab83-7c65-728b0ded1b94"></span></p> <p dir="ltr">Looking in the mirror, Stephanie said she saw a woman who was tougher than she ever thought she could be.</p> <p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/06/steph8.jpg" alt="" width="1280" height="721" /></p> <p dir="ltr"><em>Image: 60 Minutes</em></p> <p dir="ltr">“I see a person who has gone through so much more than I ever expected to go through in life. I see a very tormented person,” she continued.</p> <p dir="ltr">As much as this is exciting, it has been a long, hard journey to get here. I am tougher than I ever thought I would be.</p> <p dir="ltr"><span id="docs-internal-guid-009138d2-7fff-ca5c-152c-bf17a9b2f5ae"></span></p> <p dir="ltr">“I have learnt that the fight for survival is a real thing. I was literally fighting every day to survive, to just get back to being myself. I never knew that I had this in me.”</p> <blockquote class="instagram-media" 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);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CedLNM1vrna/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </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;" href="https://www.instagram.com/p/CedLNM1vrna/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Stephanie Coral Browitt (@stephaniecoral96)</a></p> </div> </blockquote> <p dir="ltr">Sunday’s episode also showed never-before-seen photos of Stephanie’s injuries, revealing the extent of the severe burns that covered almost her whole body.</p> <p dir="ltr">Stephanie told the program that she remembers waking up for the first time since the incident, after she was in a coma for two weeks, in bits and pieces.</p> <p dir="ltr">“I was full of tubes and surrounded by medical equipment and in a very small room with lots of noises. Those things will always stay with me, I don’t think they will ever leave. It’s just things you don’t forget,” the 26-year-old said.</p> <p dir="ltr">She said her recovery had been extremely difficult, especially in the early stages.</p> <p dir="ltr">I had to start from scratch like a baby. Sitting upright, getting out of bed, taking my first few steps, even feeding myself – I had to relearn all of those skills from scratch and they didn’t come easy at all,” she said.</p> <p dir="ltr">“It was incredibly difficult.</p> <p dir="ltr">“There have been plenty of moments where I have wanted to give up, or I have just been in tears not wanting to do anything. But I do feel I have come a long way from day one.”</p> <p dir="ltr">Stephanie is now in the process of suing Royal Caribbean, the company that ran the excursion to the island on the day of the eruption, over the physical and psychological injuries she has suffered.</p> <p dir="ltr">Her lawyer, Peter Gordan, claimed that data from the weeks prior showed that the island was a “ticking time bomb”.</p> <p dir="ltr">“It makes me furious. They let down so many people … So many people died needlessly,” he said.</p> <p dir="ltr">“I think Steph’s injuries are the worst I have ever seen. I don’t think I have ever met quite an exceptional person in the way she has battled on.”</p> <p dir="ltr">Despite the hardship she has - and continues - to overcome, Stephanie is looking to the future, telling <em>60 Minutes</em> she hopes to “go back to as normal a life as possible” and plans to return to working full-time, travelling and her social life.</p> <p dir="ltr">“I know I have got the support of so many people, and that helps me realise that this isn’t as scary as I feel it is,” she said.</p> <p dir="ltr"><span id="docs-internal-guid-128a9a3c-7fff-1315-2a8e-5a18eb83ed58"></span></p> <p dir="ltr"><em>Image: @stephaniecoral96 (Instagram)</em></p>

Caring

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Controversy over unvaccinated teachers still on leave with full pay

<p>Hundreds of unvaccinated teachers remain on full time salaries as they ride out their “gardening leave”, with news on whether they will be allowed back in the classroom yet to be confirmed.</p> <p>Currently, there are a large number of educators on forced leave, causing widespread anger and frustration all across the teaching community as the strain on understaffed public schools reaches an all-time high.</p> <p>Whether teachers who failed to comply with vaccination mandates should be permitted back into schools at all has remained a matter of contention, with the vaccine mandate end date having passed in May 2022.</p> <p>The Education Department has retained the rule that requires all teachers to have at least two vaccines, but this could change next month following the completion of a “risk assessment”.</p> <p>The outcome of the risk assessment was not set to take effect until the beginning of Term 3 in mid-July, an anonymous teacher has shared.</p> <p>In the meantime, more than 330 teachers who chose not to comply with the vaccine mandate are being paid their full salary to complete “alternative duties” from home.</p> <p>Pay backdated to May the 13th has been funnelled into the stood-down teachers’ pockets, despite them not being “expected to undertake work during this time” – a directive included in an email.</p> <p>An anonymous teacher said he had been told to stay at home and take care of himself until the risk assessment, undertaken by the Education Department, was finalised.</p> <p>Just over 330 teachers had been subject to a Professional and Ethical Standards (PES) investigation for not complying with Covid-19 directives.</p> <p>The investigation had been halted however, while the Department carried out its assessment.</p> <p><em>Image: Getty</em></p>

Legal

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The secret to keeping your skin hydrated in winter months

<p dir="ltr">With the cold winter months well and truly settling in, it’s easy to feel like our healthy summer glow has been zapped and replaced with dry, dull, dreary skin. </p> <p dir="ltr">There are many environmental factors that can have our skin looking lacklustre in winter, with the main one being dryness and chill that results in dehydrated skin. </p> <p dir="ltr">While many people already have their trusted moisturiser well and truly implemented in their daily skincare routine, sometimes our skin needs a little extra help in colder months. </p> <p dir="ltr">One of the best ways to give our skin a much needed moisture surge is a face mask, whether it's a sheet mask, clay mask, gel mask, peel-off mask or cream mask. </p> <p dir="ltr">For instant hydration, you can’t go past an overnight mask that does all the hard work to revitalise your skin while you sleep. </p> <p dir="ltr">However, a lot of overnight masks can tend to be too thick and creamy, leaving your skin feeling oily and heavy when you get into bed.</p> <p dir="ltr">Enter: Dr LeWinn’s Ultra Collagen Surge Overnight Sleep Mask. </p> <blockquote class="instagram-media" 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);" data-instgrm-permalink="https://www.instagram.com/p/Cdu23fILiZv/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </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;" href="https://www.instagram.com/p/Cdu23fILiZv/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Dr LeWinn's Skincare Australia (@drlewinns)</a></p> </div> </blockquote> <p dir="ltr">This ground-breaking mask challenges the status quo with a serum-based mask, making it lightweight and comfortable to use. </p> <p dir="ltr">The two-serums-in-one formula combines a Collagen Plumping Serum and Peptide Energising Serum to maximise this dreamy mask's efficacy for an effortless refreshed look as soon as you open your eyes.</p> <p dir="ltr">As well as delivering a much needed moisture surge, Dr LeWinn’s Ultra Collagen Surge Overnight Sleep Mask also firms and plumps up the skin for a younger looking complexion.</p> <p dir="ltr">The glossy serums are ultra-smoothing, helping to reduce fatigue, the appearance of wrinkles, and under eye bags for a silky smooth complexion.</p> <p dir="ltr">In a clinical study of the overnight mask, all 25 participants reported a huge increase in their skin’s hydration over just one week, as well as a return of their radiant summer low. </p> <p dir="ltr">Adding this revolutionary mask to your skincare routine will see you beating the winter blues so you can wake up feeling refreshed and looking at the top of your game.</p> <p dir="ltr">Dr LeWinn’s Ultra Collagen Surge Overnight Sleep Mask is available at <a href="https://www.chemistwarehouse.com.au/buy/114287/dr-lewinn-s-ultra-r4-collagen-surge-overnight-sleep-mask-30ml">Chemist Warehouse</a>, <a href="https://www.priceline.com.au/dr-lewinn-s-ultra-r4-collagen-surge-overnight-sleep-mask-30-ml">Priceline</a> and Dr. LeWinn’s <a href="https://www.drlewinns.com.au/dr.-lewinn-s/shop-our-products/range/ultra-r4/p/ultra-r4-collagen-surge-overnight-sleep-mask-30ml/74478.html?lang=en_AU&amp;utm_source=google_search&amp;utm_medium=paid_search&amp;utm_campaign=drl_ur4_overnight_sleep_mask&amp;utm_term=2022">official site</a>. </p> <p dir="ltr"><em>Image credits: Getty Images</em></p>

Beauty & Style

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The long-haul mask hack frequent fliers swear by

<p dir="ltr">When travelling, it is recommended that switching to disposable masks (either P2 or KN95) in the airport or on the plane will give you the best protection against viruses and other nasty particles. </p> <p dir="ltr">These game changing masks are not cheap, but $45 for a packet of 25, but these PPE Tech disposable P2 masks, are Australian made and owned, and come with one genius attachment. </p> <p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/05/Mask-hack2.jpg" alt="" width="674" height="337" /></p> <p dir="ltr">When traveller Jen Hewit opened the box for the first time, she found a small packet of plastic hooks inside, before she had her ‘aha’ moment. Jen had realised these hooks are, in fact, little ear-loops that allow you to hook the straps through so that they sit at the back of your head, rather than your ears. And if you prefer to wear a cloth mask, then you can still use these hooks with your own reusable one, given that the straps are stretchy enough.</p> <p dir="ltr">If you find yourself stuck on a long-haul without them, Jen recommends using her Dad’s own secret DIY hack: place the mask straps over the speakers on the airline’s headphones and your ears won’t feel like they’re about to fall off. </p> <p><span id="docs-internal-guid-19bfedcb-7fff-fa64-065f-c2663218a84c"></span></p> <p dir="ltr">Will you give this trick a go? Let us know on your next trip abroad.</p> <p dir="ltr"><em>Image: Getty</em></p>

Travel Tips

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Want to cut your chance of catching COVID on a plane? Wear a mask and avoid business class

<p>A Florida court recently <a href="https://www.abc.net.au/news/2022-04-19/florida-judge-voids-us-mask-mandate-for-planes-other-travel/100998116">overturned mask mandates</a> on planes in the United States, saying the directive was unlawful. That decision is now <a href="https://www.9news.com.au/world/covid19-masks-on-us-flights-justice-department-appeals-easing-of-rules/a960d39c-dff4-4198-935c-c5b5c5b40551">under appeal</a>.</p> <p>Before that, Australian comedian Celeste Barber <a href="https://twitter.com/djokaymegamixer/status/1514836909620572162">told her social media followers</a> a passenger sitting next to her on a recent flight took off her mask to sneeze.</p> <p>So wearing masks on planes to limit the spread of COVID is clearly a hot-button issue.</p> <p>As we return to the skies more than two years into the pandemic, what is the risk of catching COVID on a plane? And does it really matter where on the plane you are?</p> <h2>So many variables</h2> <p>It’s impossible to give a precise answer about your risk of catching COVID on a plane as there are so many variables.</p> <p>For instance, not all countries and <a href="https://twitter.com/British_Airways/status/1503729049050353665">airlines</a> require passengers to wear masks or <a href="https://www.nationalworld.com/lifestyle/travel/where-can-i-travel-without-a-vaccine-countries-that-allow-unvaccinated-passengers-and-entry-requirements-3528913">be vaccinated</a>.</p> <p>Some countries and airlines require a negative COVID test within a certain timeframe before flying, others have <a href="https://www.homeaffairs.gov.au/covid19/vaccinated-travellers/temporary-visa-holders/leaving-australia">scrapped that requirement</a> entirely. </p> <p>Then there are different rules that may apply if you’re flying domestically or internationally, or <a href="https://www.health.gov.au/health-alerts/covid-19/international-travel/proof-of-vaccination">leaving or entering</a> a country.</p> <p>That’s before we start talking about the virus itself. We know more recent variants have emerged (Omicron and the sub-variant BA.2, for example), that are <a href="https://aci.health.nsw.gov.au/covid-19/critical-intelligence-unit/sars-cov-2-variants">much more easily transmitted</a> than the original virus or the Delta variant. We don’t know how transmissible future variants or sub-variants will be.</p> <p>So we can only talk in general terms about the risk of catching COVID on a plane. All up, your risk <a href="https://www.sciencedirect.com/science/article/pii/S1477893921001745">is very low</a>, but the measures airlines put in place help achieve that. You can also reduce your personal risk further in a number of ways.</p> <h2>Air flow and HEPA filters</h2> <p>Air flow is designed to largely <a href="https://www.sciencedirect.com/science/article/pii/S1477893920304117">travel vertically</a>, from the ceiling to the floor, to reduce the potential spread of contaminated air through the plane. </p> <p>The height of the seats acts as a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013760/">partial barrier</a> to air movement from rows in front and behind you. </p> <p>Cabin air is also replaced <a href="https://cdn1.sph.harvard.edu/wp-content/uploads/sites/2443/2020/10/HSPH-APHI-Phase-One-Report.pdf">every two to three minutes</a> with a half-half mix of recycled and fresh air.</p> <p>To see <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7588538/">how this works in real life</a>, researchers looked at how the virus spread on a long-haul flight when an infected person (the index case) sat in business class. </p> <p>Twelve of 16 people who were infected on the plane sat within a few rows of this person; another was a flight attendant. This suggests limited spread of contaminated air through the rest of the plane.</p> <p>Recycled air is also filtered through high-efficiency particulate air (or HEPA) filters. These remove <a href="https://cdn1.sph.harvard.edu/wp-content/uploads/sites/2443/2020/10/HSPH-APHI-Phase-One-Report.pdf">more than 99%</a> of viral particles, further reducing the risk of droplet or airborne transmission.</p> <h2>Masks</h2> <p>Well fitted masks or respirators (worn properly) can reduce your risk of contracting COVID on a flight. That’s why many airlines say wearing a mask is a condition of flying.</p> <p>For example, <a href="https://onlinelibrary.wiley.com/doi/10.1111/ina.12979">modelling</a> of several known transmission events on planes demonstrates an advantage if both the infected person and others around them wear masks.</p> <h2>Vaccination</h2> <p>Some countries, such as Australia, require entering travellers to be <a href="https://www.health.gov.au/health-alerts/covid-19/international-travel/proof-of-vaccination">fully vaccinated</a>. This <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00648-4/fulltext">lowers the risk</a> of someone becoming sick with COVID.</p> <h2>Pre-flight COVID testing</h2> <p>Not all flights require a negative COVID test before boarding. For those that do, the time frame before a flight varies, as does the type of test required. </p> <p>However, we know tests do not detect every single COVID case. A range of factors can influence test sensitivity (ability to detect COVID). These include the type and <a href="https://www.tga.gov.au/covid-19-rapid-antigen-self-tests-are-approved-australia">brand</a> of test you take, whether you have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8761676/">symptoms</a>, your <a href="https://ebm.bmj.com/content/early/2022/01/04/bmjebm-2021-111828">age</a>, and the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8761676/">viral variant</a>.</p> <p>You can also still test negative two days before a flight and catch COVID in the meantime.</p> <h2>Sanitisation</h2> <p>Airlines may do additional cleaning of high-touch areas, and overnight disinfection, to reduce the spread of COVID through touching contaminated surfaces. </p> <p>However, the risk of transmission by this route is <a href="https://cdn1.sph.harvard.edu/wp-content/uploads/sites/2443/2020/10/HSPH-APHI-Phase-One-Report.pdf">low</a> compared to the risk of catching COVID through breathing in infectious droplets and aerosols.</p> <h2>When and where are you most at risk?</h2> <p><strong>The closer you are to the infected person</strong></p> <p>Most transmission occurs within <a href="https://www.sciencedirect.com/science/article/pii/S1477893920304117">two to three rows</a> of an infected person. If you sit next to someone who is coughing or has other symptoms you might ask to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7665738/">move seats</a> if spare seats are available. </p> <p><a href="https://cdn1.sph.harvard.edu/wp-content/uploads/sites/2443/2020/10/HSPH-APHI-Phase-One-Report.pdf">Distance</a> yourself from others if you can, particularly when getting on and off the plane. </p> <p>You might also avoid sitting close to the toilets as passengers will hang about in the aisles waiting to use them, particularly on long flights.</p> <p><strong>The longer the flight</strong></p> <p>The risk increases with long- versus <a href="https://pubmed.ncbi.nlm.nih.gov/33650201/">short- or medium-haul</a>flights. During long-haul flights passengers are also more likely to <a href="https://onlinelibrary.wiley.com/doi/10.1111/ina.12979">recline their seats</a>. This somewhat reduces the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013760/">protection upright seats</a> provide in reducing air movement between rows. </p> <p><strong>If you or others are not wearing a mask or wearing it properly</strong></p> <p>You can breathe infectious particles in and out via your nose as well as your mouth, so don’t wear your mask under your chin or nose.</p> <p>The risk also increases when everyone takes off their masks during food service. You might choose not to eat or drink on short flights to avoid this. Alternatively you might bring a snack to eat before food service begins, or <a href="https://cdn1.sph.harvard.edu/wp-content/uploads/sites/2443/2020/10/HSPH-APHI-Phase-One-Report.pdf">eat after</a> those around you. </p> <p><strong>If you contaminate your food or your face</strong></p> <p>You can catch COVID through touching your food or face with contaminated fingers. Sanitise your hands regularly and <a href="https://ieeexplore.ieee.org/document/9176589">train yourself</a> to not touch your face.</p> <p>If you are in business class</p> <p>Based on limited reports, the transmission risk appears higher in business class. This is possibly because of <a href="https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-021-00749-6">more interruptions to mask wearing</a> due to greater service of food and drinks.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared in <a href="https://theconversation.com/want-to-cut-your-chance-of-catching-covid-on-a-plane-wear-a-mask-and-avoid-business-class-180333" target="_blank" rel="noopener">The Conversation</a>.</em></p> <div style="caret-color: #000000; color: #000000; font-style: normal; font-variant-caps: normal; font-weight: normal; letter-spacing: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; text-decoration: none; --tw-translate-x: 0; --tw-translate-y: 0; --tw-rotate: 0; --tw-skew-x: 0; --tw-skew-y: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(51,168,204,0.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; --tw-shadow: 0 0 #0000; --tw-shadow-colored: 0 0 #0000; background-color: transparent; border: 0px; font-size: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;" data-react-class="Tweet" data-react-props="{&quot;tweetId&quot;:&quot;1514836909620572162&quot;}"> <div style="--tw-translate-x: 0; --tw-translate-y: 0; --tw-rotate: 0; --tw-skew-x: 0; --tw-skew-y: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(51,168,204,0.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; --tw-shadow: 0 0 #0000; --tw-shadow-colored: 0 0 #0000; background-color: transparent; border: 0px; font-size: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; caret-color: #000000; color: #000000; font-family: 'Libre Baskerville', Georgia, Times, 'Times New Roman', serif; font-style: normal; font-variant-caps: normal; font-weight: normal; letter-spacing: normal; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration: none;"> <div style="--tw-translate-x: 0; --tw-translate-y: 0; --tw-rotate: 0; --tw-skew-x: 0; --tw-skew-y: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(51,168,204,0.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; --tw-shadow: 0 0 #0000; --tw-shadow-colored: 0 0 #0000; background-color: transparent; border: 0px; font-size: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> </div> </div> </div> <p style="caret-color: #000000; color: #000000; font-style: normal; font-variant-caps: normal; font-weight: normal; letter-spacing: normal; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: auto; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; text-decoration: none; --tw-translate-x: 0; --tw-translate-y: 0; --tw-rotate: 0; --tw-skew-x: 0; --tw-skew-y: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-ring-offset-width: 0px; --tw-ring-offset-color: #fff; --tw-ring-color: rgba(51,168,204,0.5); --tw-ring-offset-shadow: 0 0 #0000; --tw-ring-shadow: 0 0 #0000; --tw-shadow: 0 0 #0000; --tw-shadow-colored: 0 0 #0000; background-color: transparent; border: 0px; font-size: 18px; margin: 0px 0px 18px; outline: 0px; padding: 0px; vertical-align: baseline;"> </p>

International Travel

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Time to remove vaccine mandates? Not so fast – it could have unintended consequences

<p>Several Australian states have used mandates to drive up COVID vaccination rates. Governments justified the mandates on the basis of <a href="https://www.facebook.com/photo.php?fbid=479962466825937&set=pb.100044365632393.-2207520000..&type=3">preventing the spread of disease</a> and <a href="https://statements.qld.gov.au/statements/93754">protecting the vulnerable</a>.</p> <p>Now many states are rolling back these mandates, with Queensland <a href="https://www.abc.net.au/news/2022-04-05/qld-coronavirus-covid19-vaccination-mandate-eased-april-14/100958850">removing the requirement to show you’re vaccinated</a> before entering cafes, pubs, galleries and other public spaces from tomorrow.</p> <p>It would be nice to think that when mandates have served their purpose, they can be removed. In practice, removing mandates may affect public attitudes about the importance of vaccination and the likelihood of getting boosters.</p> <p><strong>Remind me, what were the mandates?</strong></p> <p><a href="https://theconversation.com/vaccine-passports-are-coming-to-australia-how-will-they-work-and-what-will-you-need-them-for-167531">Public space mandates</a> involve governments mandating that venues (such as restaurants, libraries and sporting venues) check individuals’ vaccination status and <a href="https://theconversation.com/is-it-time-to-rethink-vaccine-mandates-for-dining-fitness-and-events-we-asked-5-experts-176356">exclude the unvaccinated</a>. This is facilitated by <a href="https://theconversation.com/could-a-france-style-vaccine-mandate-for-public-spaces-work-in-australia-legally-yes-but-its-complicated-165814">vaccine passports and certificates</a>.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S0264410X21015309?via%3Dihub">Government employment mandates</a> involve governments requiring workers in specific industries to be vaccinated. Businesses and organisations may also implement their own policies requiring the vaccination of their staff, their clients, or both.</p> <p>Most states and territories embraced public space mandates and all have required vaccination of aged and health-care workers.</p> <p>But many are on their way out. NSW eased its requirements last year. South Australia has recently revoked mandates for police, teachers and transport workers. Queensland’s new policy is noted above.</p> <p>Victoria, Western Australia, and the Northern Territory are sitting with their existing requirements for now.</p> <p><strong>What could happen next?</strong></p> <p>It’s unclear what impact removing vaccine mandates will have in Australia. However, we can learn from other public health measures and COVID vaccine mandates implemented overseas.</p> <p>Seat-belt laws converted a government requirement into a widespread social norm. Car manufacturers reinforced the norm with vehicles that beep at us when we don’t comply.</p> <p>But just because something has become habitual doesn’t mean we can lose the law. If governments removed the seat-belt law now and expected us to comply because we are informed, educated, and socialised, some people would still conclude that seat belts are no longer important. Removal of a requirement can send a bad message.</p> <p>The Italian government learned this when the region of Veneto suspended childhood vaccine mandates for four childhood vaccines in 2007. Officials thought the region’s wealthy and educated population would continue to vaccinate their children if the regional government provided strong education and messaging.</p> <p>They were <a href="https://doi.org/10.1007/s11077-021-09427-1">wrong</a>. Their strategy worked until there was a national vaccine scare in 2012. Vaccination rates in Veneto plummeted faster than anywhere else in the country.</p> <p>Eventually, the national government <a href="https://research-repository.uwa.edu.au/en/publications/recent-vaccine-mandates-in-the-united-states-europe-and-australia">mandated more vaccines</a> for the whole country.</p> <p>Other countries have already experimented with introducing, removing, and sometimes re-introducing mandates. Some, such as <a href="https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00063-7/fulltext">Austria</a> and the <a href="https://www.instituteforgovernment.org.uk/explainers/vaccine-mandates">United Kingdom</a>, have flip-flopped, providing little opportunity to study the impact of their mandates’ introduction or removal.</p> <p>Israel, which vaccinated its population promptly with Pfizer to the envy of the world, used a “public space” mandate (with an opt-out of a negative COVID test). The mandate has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8582817/">switched on and off</a> depending on the disease situation at the time.</p> <p>Unfortunately, Israelis’ uptake of subsequent doses has <a href="https://datadashboard.health.gov.il/COVID-19/general">dropped over time</a>, but its government still <a href="https://www.news.com.au/world/coronavirus/global/israel-rolls-back-green-pass-as-prime-minister-declares-the-covid-wave-is-breaking/news-story/b6f9ce495359166126b16c477af062b3">ended the mandate</a> in February.</p> <p>Mandates are also not without <a href="https://www.mja.com.au/journal/2021/215/11/policy-considerations-mandatory-covid-19-vaccination-collaboration-social">risks and costs</a>. They can provoke reactance, making those who are reluctant to vaccinate more determined not to do so. They may also prompt activism against vaccines and mandates.</p> <p><strong>High vaccination rates help contain COVID</strong></p> <p>One of the biggest challenges is nobody knows what the next phase of COVID will look like. Neither infection nor the current vaccines provide long-lasting immunity. We don’t know whether the next strain will continue the trajectory towards less serious symptoms started by Omicron (and helped by high vaccination rates).</p> <p>Whether we continue to be able to stay on top of COVID and whether the disease continues to remain less severe in most people infected will depend on maintaining high vaccination coverage rates.</p> <p>Governments across the nation and the world have struggled to get third doses into populations at the same level and with the same enthusiasm people showed towards the first two.</p> <p>Uptake in paediatric populations is also lagging in Australia – and there are no mandates.</p> <p>Now adults are being asked to prepare for and accept our fourth doses.</p> <p><strong>Leading the way</strong></p> <p>Western Australia has one of the highest rates of uptake in the country, with 76.7% of people aged over 16 <a href="https://www.facebook.com/photo?fbid=533610064794510&set=a.263657845123068">triple dosed</a>. This compares with the <a href="https://www.health.gov.au/sites/default/files/documents/2022/04/covid-19-vaccine-rollout-update-8-april-2022.pdf">national average</a> of 52.3%.</p> <p>It’s no coincidence the state’s employment mandates, which cover 75% of the workforce, require workers have their third dose within a month of becoming eligible.</p> <p>The WA mandate did not contain three doses to begin with, but it was very easy for the government to build it in.</p> <p>Faced with rolling back the mandate or keeping it operational for the fourth dose, the government will have to grapple with whether the population continues to support these measures – and there are definitely people who reluctantly accepted two doses and are not prepared to keep having more.</p> <p>WA’s public space mandate only covers two doses for now.</p> <p>WA’s COVID vaccination experience has shown that mandates, including for third doses, drive high levels of uptake, and are <a href="https://www.ijhpm.com/article_4210.html">easy for governments to implement</a>.</p> <p>However, much of the rest of Australia is moving in an opposite direction to WA in removing its mandates.</p> <p>As we live through the continued natural experiment of living with COVID – and not allowing it to defeat us – we now move into a new phase of making sense of what to do with the policy instruments governments used.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/180781/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/katie-attwell-94905" target="_blank" rel="noopener">Katie Attwell</a>, Associate professor, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067" target="_blank" rel="noopener">The University of Western Australia</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/time-to-remove-vaccine-mandates-not-so-fast-it-could-have-unintended-consequences-180781" target="_blank" rel="noopener">original article</a>.</em></p> <p><em>Image: Getty Images</em></p>

Domestic Travel

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5 reasons to keep wearing your face mask

<p>Mask mandates in most indoor settings <a href="https://www.abc.net.au/news/2022-02-25/covid-mask-rules-australian-states-territories/100854564" target="_blank" rel="noopener">have been dropped</a> in New South Wales, Victoria and the ACT, with Queensland to follow later this week.</p> <p>Without a mandate, <a href="https://www.ijidonline.com/article/S1201-9712(21)00274-5/fulltext" target="_blank" rel="noopener">mask use tends to drop</a>, so we can expect only a minority of people to be masked in public indoor spaces.</p> <p>With thousands of cases a day and <a href="https://www.theguardian.com/australia-news/datablog/ng-interactive/2022/feb/21/covid-19-vaccine-rollout-australia-vaccination-rate-progress-how-many-people-vaccinated-percent-tracker-australian-states-number-total-daily-live-data-stats-updates-news-schedule-tracking-chart-percentage-new-cases-today" target="_blank" rel="noopener">just over half</a> (57%) of Australians having received a third COVID vaccine dose and children still under-vaccinated, we may see a surge in infections.</p> <p>While masks are a small inconvenience, they remain vital in preventing SARS-CoV-2, because the virus <a href="https://theconversation.com/the-pressure-is-on-for-australia-to-accept-the-coronavirus-really-can-spread-in-the-air-we-breathe-160641" target="_blank" rel="noopener">spreads</a> through the air we breathe.</p> <p>Some people will continue to wear masks to stay safe and achieve a more normal life through the pandemic. Here are five reasons to keep wearing yours.</p> <p><strong>1. Masks reduce your chance of getting COVID</strong></p> <p>Many studies <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm" target="_blank" rel="noopener">have shown</a> masks protect against COVID. While N95 respirators offer the greatest protection, even cloth masks are beneficial. N95s respirators <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm" target="_blank" rel="noopener">lower the odds</a> of testing positive to COVID by 83%, compared with 66% for surgical masks and 56% for cloth masks.</p> <p>The protection when everyone wears a mask is much greater, because it <a href="https://theconversation.com/which-mask-works-best-we-filmed-people-coughing-and-sneezing-to-find-out-143173" target="_blank" rel="noopener">reduces the likelihood</a> of well people inhaling the virus and prevents infected people from exhaling the virus into the air. If everyone wears a mask, the viral load in the air is much lower.</p> <p>When we lose the protection of universal masking, it’s a good idea to wear a <a href="https://www.npr.org/sections/goatsandsoda/2022/02/25/1083046757/coronavirus-faq-im-a-one-way-masker-what-strategy-will-give-me-optimal-protectio" target="_blank" rel="noopener">high protection</a> N95 or P2 respirator.</p> <p><strong>2. You might not know you have COVID</strong></p> <p>Transmission of the virus without symptoms is a major driver of spread, and we cannot know who around us is infected.</p> <p>Infected people may be asymptomatic or may not know they’re infected. This is <a href="https://www.news-medical.net/news/20220103/Very-high-rates-of-asymptomatic-infection-with-Omicron-compared-to-prior-SARS-CoV-2-variants.aspx" target="_blank" rel="noopener">especially so</a> for Omicron.</p> <p>Overall, about one in four infections are <a href="https://bmjopen.bmj.com/content/11/12/e049752.long" target="_blank" rel="noopener">asymnptomatic</a>. But even people with symptomatic infection are contagious before the symptoms start.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/449353/original/file-20220301-23-73zihg.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/449353/original/file-20220301-23-73zihg.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/449353/original/file-20220301-23-73zihg.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/449353/original/file-20220301-23-73zihg.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/449353/original/file-20220301-23-73zihg.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/449353/original/file-20220301-23-73zihg.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/449353/original/file-20220301-23-73zihg.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" alt="Business woman wears a mask." /><figcaption><span class="caption">You might not know you’re infectious.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/virus-mask-asian-woman-travel-wearing-1629206074" target="_blank" rel="noopener">Shutterstock</a></span></figcaption></figure> <p><strong>3. Wearing a mask protects others, including those at risk of severe COVID</strong></p> <p>Wearing a mask protects others, including those at greatest risk of severe COVID: people with disability, chronic illnesses and <a href="https://www.theatlantic.com/health/archive/2022/02/covid-pandemic-immunocompromised-risk-vaccines/622094/" target="_blank" rel="noopener">suppressed immune systems</a>.</p> <p>COVID disproportionately affects <a href="https://www.sbs.com.au/language/english/covid-19-update-being-a-migrant-increases-risk-of-dying-from-covid-19-in-australia" target="_blank" rel="noopener">migrants</a> and people from lower socioeconomic groups who are more likely to work in customer-service roles. If you wear a mask, you’re protecting workers, commuters and others you interact with.</p> <p>Rates of vaccination also <a href="https://www1.racgp.org.au/ajgp/coronavirus/aboriginal-communities-covid-vaccination" target="_blank" rel="noopener">lag</a> among Aboriginal and Torres Strait Islander people, leaving them more vulnerable to COVID in the absence of masks.</p> <p>Masks also protect children who are vulnerable to COVID, with only <a href="https://www.theguardian.com/australia-news/datablog/ng-interactive/2022/feb/21/covid-19-vaccine-rollout-australia-vaccination-rate-progress-how-many-people-vaccinated-percent-tracker-australian-states-number-total-daily-live-data-stats-updates-news-schedule-tracking-chart-percentage-new-cases-today" target="_blank" rel="noopener">half of five to 11 year olds</a> partially vaccinated and under-fives not yet eligible for vaccination.</p> <p>Children who wear masks can also protect their peers. In the United States, the <a href="https://www.cdc.gov/mmwr/volumes/70/wr/mm7039e1.htm#T1_down" target="_blank" rel="noopener">risk of outbreaks</a> was nearly four times higher in schools without mask mandates compared to those with mandates.</p> <p>Omicron is not the flu or a cold, and has accounted for <a href="https://www.seattletimes.com/seattle-news/health/omicron-wave-accounts-for-more-u-s-deaths-than-delta-surge/" target="_blank" rel="noopener">17% more deaths than Delta</a> in the United States. While Omicron generally causes less severe disease than Delta, it has claimed more lives because of vastly higher case numbers.</p> <p>There is also growing evidence SARS-COV-2 <a href="https://assets.researchsquare.com/files/rs-1139035/v1_covered.pdf?c=1640020576" target="_blank" rel="noopener">persists in the body after infection</a>, which may result in long-term heart, lung and brain damage.</p> <p><strong>4. Masks protect your colleagues</strong></p> <p>Many workplaces are insisting on people returning to face-to-face work, some without providing safe indoor air – and now without mask mandates.</p> <p>The risk of COVID transmission is <a href="https://theconversation.com/time-to-upgrade-from-cloth-and-surgical-masks-to-respirators-your-questions-answered-174877" target="_blank" rel="noopener">greatest when indoors for prolonged periods without adequate airflow</a>. So sitting in an office for eight hours without a mask is a risk, especially if safe indoor air has not been addressed.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/449130/original/file-20220301-13-1tuox9w.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/449130/original/file-20220301-13-1tuox9w.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=255&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/449130/original/file-20220301-13-1tuox9w.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=255&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/449130/original/file-20220301-13-1tuox9w.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=255&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/449130/original/file-20220301-13-1tuox9w.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=321&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/449130/original/file-20220301-13-1tuox9w.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=321&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/449130/original/file-20220301-13-1tuox9w.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=321&amp;fit=crop&amp;dpr=3 2262w" alt="Man in a mask sits at his work desk, next to his female colleagues." /><figcaption><span class="caption">Wearing a mask reduces your risk of contracting COVID from co-workers.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/panoramic-group-business-worker-team-wear-1792685398" target="_blank" rel="noopener">Shutterstock</a></span></figcaption></figure> <p>At the same time as dropping many workplace mask mandates, NSW has <a href="https://www.begadistrictnews.com.au/story/7629871/nsw-virus-compo-burden-of-proof-opposed/?cs=12" target="_blank" rel="noopener">moved to remove automatic workers’ compensation</a> for people who catch COVID at work.</p> <p>This is a double disadvantage for workers returning to workplaces with fewer protections and facing greater obstacles to workers’ compensation should they get infected.</p> <p><strong>5. Others might follow your lead</strong></p> <p>Being one of the few people wearing a mask when others aren’t, such as in a supermarket, is a daunting prospect for those of us who wish to continue masking. There are <a href="https://www.newstalkzb.co.nz/news/national/covid-19-convoy-protest-mask-wearing-17-year-old-egged-by-aggressive-convoy-protesters/" target="_blank" rel="noopener">reports</a> of masked people being abused and bullied.</p> <p>However a NSW <a href="https://www.smh.com.au/politics/nsw/more-comfortable-with-masks-voters-want-some-covid-restrictions-to-stay-20220225-p59zs4.html" target="_blank" rel="noopener">survey showed</a> the majority of people in that state wanted mask mandates to remain. The more we normalise masks and the more we see them, the better protected the community will be.</p> <p>As much as we wish it so, the pandemic is not over and new variants will <a href="http://www.businessinsider.com.au/who-warns-of-covid-19-continuation-and-more-dangerous-variants-2022-2?r=US&amp;IR=T" target="_blank" rel="noopener">likely emerge</a>.</p> <p>A layered, multi-pronged strategy which includes vaccines, masks, ventilation, testing and tracing is the best way to protect health, the economy and a resumption of normal activities. <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/177824/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/c-raina-macintyre-101935" target="_blank" rel="noopener">C Raina MacIntyre</a>, Professor of Global Biosecurity, NHMRC Principal Research Fellow, Head, Biosecurity Program, Kirby Institute, <a href="https://theconversation.com/institutions/unsw-sydney-1414" target="_blank" rel="noopener">UNSW Sydney</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/covid-mask-mandates-might-be-largely-gone-but-here-are-5-reasons-to-keep-wearing-yours-177824" target="_blank" rel="noopener">original article</a>.</em></p> <p><em>Image: Getty Images</em></p>

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