Search

How long will you live? New evidence says it’s much more about your choices than your genes

<div class="theconversation-article-body"> One of the most enduring questions humans have is how long we’re going to live. With this comes the question of how much of our lifespan is shaped by our environment and choices, and how much is predetermined by our genes. A study recently published in the prestigious journal <a href="https://www.nature.com/articles/s41591-024-03483-9">Nature Medicine</a> has attempted for the first time to quantify the relative contributions of our environment and lifestyle versus our genetics in how we age and how long we live. The findings were striking, suggesting our environment and lifestyle play a much greater role than our genes in determining our longevity. <h2>What the researchers did</h2> This study used data from the <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a>, a large database in the United Kingdom that contains in-depth health and lifestyle data from roughly 500,000 people. The data available include genetic information, medical records, imaging and information about lifestyle. A separate part of the study used data from a subset of more than 45,000 participants whose blood samples underwent something called “<a href="https://www.nature.com/articles/s41576-022-00511-7">proteomic profiling</a>”. Proteomic profiling is a relatively new technique that looks at how proteins in the body change over time to identify a person’s age at a molecular level. By using this method researchers were able to estimate how quickly an individual’s body was actually ageing. This is called their biological age, as opposed to their chronological age (or years lived). The researchers assessed 164 environmental exposures as well as participants’ genetic markers for disease. Environmental exposures included lifestyle choices (for example, smoking, physical activity), social factors (for example, living conditions, household income, employment status) and early life factors, such as body weight in childhood. They then looked for associations between genetics and environment and 22 major age-related diseases (such as coronary artery disease and type 2 diabetes), mortality and biological ageing (as determined by the proteomic profiling). These analyses allowed the researchers to estimate the relative contributions of environmental factors and genetics to ageing and dying prematurely. <h2>What did they find?</h2> When it came to disease-related mortality, as we would expect, age and sex explained a significant amount (about half) of the variation in how long people lived. The key finding, however, was environmental factors collectively accounted for around 17% of the variation in lifespan, while genetic factors contributed less than 2%. This finding comes down very clearly on the nurture side in the “nature versus nurture” debate. It suggests environmental factors influence health and longevity to a far greater extent than genetics. Not unexpectedly, the study showed a different mix of environmental and genetic influences for different diseases. Environmental factors had the greatest impact on lung, heart and liver disease, while genetics played the biggest role in determining a person’s risk of breast, ovarian and prostate cancers, and dementia. The environmental factors that had the most influence on earlier death and biological ageing included smoking, socioeconomic status, physical activity levels and living conditions. Interestingly, being taller at age ten was found to be associated with a shorter lifespan. Although this may seem surprising, and the reasons are not entirely clear, this aligns with <a href="https://www.sciencedaily.com/releases/2014/05/140509110756.htm">previous research</a> finding taller people are more likely to die earlier. Carrying more weight at age ten and maternal smoking (if your mother smoked in late pregnancy or when you were a newborn) were also found to shorten lifespan. Probably the most surprising finding in this study was a lack of association between diet and markers of biological ageing, as determined by the proteomic profiling. This flies in the face of the extensive body of evidence showing the crucial role of <a href="https://www.nature.com/articles/s43016-023-00868-w">dietary patterns</a> in chronic disease risk and longevity. But there are a number of plausible explanations for this. The first could be a lack of statistical power in the part of the study looking at biological ageing. That is, the number of people studied may have been too small to allow the researchers to see the true impact of diet on ageing. Second, the dietary data in this study, which was self-reported and only measured at one time point, is likely to have been of relatively poor quality, limiting the researchers’ ability to see associations. And third, as the relationship between diet and longevity is likely to be complex, disentangling dietary effects from other lifestyle factors may be difficult. So despite this finding, it’s still safe to say the food we eat is one of the most important pillars of health and longevity. <h2>What other limitations do we need to consider?</h2> Key exposures (such as diet) in this study were only measured at a single point in time, and not tracked over time, introducing potential errors into the results. Also, as this was an observational study, we can’t assume associations found represent causal relationships. For example, just because living with a partner correlated with a longer lifespan, it doesn’t mean this caused a person to live longer. There may be other factors which explain this association. Finally, it’s possible this study may have underestimated the role of genetics in longevity. It’s important to recognise genetics and environment don’t operate in isolation. Rather, health outcomes are shaped by their interplay, and this study may not have fully captured the complexity of these interactions. <h2>The future is (largely) in your hands</h2> It’s worth noting there were a number of factors such as household income, home ownership and employment status associated with diseases of ageing in this study that are not necessarily within a person’s control. This highlights the crucial role of addressing the social determinants of health to ensure everyone has the best possible chance of living a long and healthy life. At the same time, the results offer an empowering message that longevity is largely shaped by the choices we make. This is great news, unless you have good genes and were hoping they would do the heavy lifting. Ultimately, the results of this study reinforce the notion that while we may inherit certain genetic risks, how we eat, move and engage with the world seems to be more important in determining how healthy we are and how long we live.<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/251054/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, Associate Professor, Epidemiology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-will-you-live-new-evidence-says-its-much-more-about-your-choices-than-your-genes-251054">original article</a>. Image: Shutterstock </div>

Caring

5 years since COVID was declared a pandemic – how prepared are we for the next one?

<div class="theconversation-article-body"> On March 11 2020, as COVID continued to spread rapidly around the globe, the <a href="https://www.who.int/europe/emergencies/situations/covid-19">World Health Organization</a> (WHO) officially declared a pandemic. More than <a href="https://data.who.int/dashboards/covid19/deaths">7 million people</a> have since died from COVID. The virus, and the public health measures enacted to control it, have had far-reaching effects on societies around the world. Five years on, the virus continues to circulate. But, thanks to vaccines and <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10425195/">immunity acquired from infections</a>, hospitalisations and deaths due to COVID are vastly less frequent <a href="https://www.abs.gov.au/statistics/health/causes-death/provisional-mortality-statistics/latest-release">than in previous years</a>. Meanwhile, <a href="https://www.aihw.gov.au/reports/covid-19/long-covid-in-australia-a-review-of-the-literature/summary">long COVID</a> continues to have a major impact on people’s lives. Estimates suggest more than <a href="https://www.nature.com/articles/s41591-024-03173-6">400 million people</a> around the world have had or are currently living with long COVID. At this point, Australia and the world must take the lessons of COVID – in areas from surveillance, to outbreak response, to vaccines and therapeutics – to be better prepared for the next pandemic. <h2>Some areas we went right – and wrong</h2> Our diagnostic laboratories across Australia were well prepared. Laboratories at the Doherty Institute diagnosed the first case of COVID in Australia and were the first to <a href="https://www.mja.com.au/journal/2020/212/10/isolation-and-rapid-sharing-2019-novel-coronavirus-sars-cov-2-first-patient">isolate and share the virus</a> globally in early 2020. At the same time, a national public health response was quickly put in place. This involved <a href="https://academic.oup.com/cid/article/73/3/e808/6044730?login=false">measures such as</a> closing borders, setting up testing centres, and limiting gatherings. But there are several areas where we could have mobilised more effectively. During the early stages of the pandemic, there were, at times, challenges with sharing data as well as biological samples and the ingredients for COVID tests between the different states and territories. For example, there are currently restrictions in place that limit sharing of virus strains between states and territories. But when a new strain emerges, many laboratories need access to it to evaluate their testing capabilities. One recommendation from an <a href="https://www.pmc.gov.au/domestic-policy/commonwealth-government-covid-19-response-inquiry">independent 2024 review</a> of the federal government’s COVID response was an Australian Centre for Disease Control. An interim version was launched in early 2024 and the Australian government is investing <a href="https://www.health.gov.au/news/2517m-to-establish-an-independent-australian-centre-for-disease-control-cdc#:%7E:text=The%20Australian%20Government%20is%20investing,for%20Disease%20Control%20(CDC).">A$251.7 million</a> in this important initiative. The goal for the new centre for disease control will be to provide independent technical advice on infectious diseases to government. It will also facilitate rapid integration of data from all states and territories leading to a more unified response. At the start of a pandemic, we need to understand everything about the new virus and at great speed. This needs systems in place in “peace time”, ready to be mobilised in “war time”. Back in 2020, we had protocols ready for <a href="https://www.nature.com/articles/s41591-020-0819-2">hospitalised patients</a> and <a href="https://www.remapcap.org/">intensive care units</a> to collect specimens and also start new clinical trials. But we were not prepared on many other fronts, for example to collect samples or study how COVID was transmitted in the community or in different key groups. Every day counts at the start of a pandemic. <h2>Harnessing medical technologies</h2> Relatively recent technological advances in both diagnostics (RAT tests) and vaccine development (the use of <a href="https://www.genome.gov/genetics-glossary/Messenger-RNA-mRNA">messenger RNA</a>, which gives our body genetic instructions to fight COVID) have put us in a strong position to be at the cutting edge in any pandemic response. Moderna, one of the two companies that pioneered the mRNA vaccines, has established its <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/world-leading-moderna-vaccine-facility-opens-in-victoria">Asia-Pacific headquarters in Melbourne</a>. CSL, which made the AstraZeneca COVID vaccines in Australia and manufactures several other vaccines, has now incorporated <a href="https://www.aumanufacturing.com.au/csls-mrna-covid-19-vaccine-approved-for-sale-in-japan">mRNA in its repertoire</a>. This capability means Australians could have immediate access to mRNA vaccines in the event of another pandemic. We could also potentially manufacture these vaccines for low- and middle-income countries in our region. But what if we can’t make an effective vaccine to fight a future pandemic? This is a situation we must be prepared for, as we’ve seen with infections such as HIV, where after 40 years of trying and billions of dollars spent, <a href="https://www.sciencenews.org/article/aids-hiv-vaccine-anniversary-immunity-antibodies">we still don’t have a vaccine</a>. In such a situation, we will need to rely on antiviral drugs. The way we currently make antiviral drugs takes significantly longer to develop than vaccines. And although we have some <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8069527/">broad spectrum antiviral drugs</a>, the most potent antivirals are very specific – meaning one drug treats <a href="https://retrovirology.biomedcentral.com/articles/10.1186/s12977-022-00608-1">only one type of virus</a>. To be better prepared for future pandemics, many groups around the world are working on developing a library of drugs that work against whole <a href="https://theconversation.com/what-pathogen-might-spark-the-next-pandemic-how-scientists-are-preparing-for-disease-x-223193">families of viruses</a> that could cause the next pandemic. Another approach is to develop totally new technologies that are fully tested for one virus, but can be easily adapted to a new virus. This approach could allow more rapid deployment, as the details of safety and dosing would already be understood. This is one of the major goals of the recently launched <a href="https://www.doherty.edu.au/cumming-global-centre-for-pandemic-therapeutics">Cumming Global Centre for Pandemic Therapeutics</a> based at the Doherty Institute. These ambitious efforts will require global collaboration, sharing resources and engagement of the private sector. Once we have a vaccine or drug that works, we need agreed systems in place to ensure widespread equitable access. We fell seriously short of this goal with COVID. Some <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9878283/">low- and middle-income</a> countries received vaccines months or years later than high income countries. For treatments, <a href="https://www.citizen.org/article/paxlovid-procured-supply-vs-health-need-in-low-and-middle-income-countries-through-the-end-of-2022/">antivirals such as Paxlovid</a> were never available in many countries. This is one goal of an agreement led by the WHO, called the “<a href="https://www.who.int/news-room/questions-and-answers/item/pandemic-prevention--preparedness-and-response-accord">pandemic accord</a>”, to have member states agree on pandemic prevention, preparedness and response. But after years of discussion, there remains no binding agreement. <h2>Preparing for the next pandemic</h2> As COVID was (partly due to advances in technology) the most intensively studied pandemic in human history, we have a unique resource in the record of what happened to inform our response to any future pandemic. And this is likely a matter of when, not if. New infectious disease outbreaks have continued to emerge over the past five years, including mpox, which was declared a public health emergency of international concern in July 2022 and again in <a href="https://www.health.gov.au/diseases/monkeypox-mpox">August 2024</a>. Right now, there’s an outbreak of a new viral disease in <a href="https://www.aljazeera.com/news/2025/2/27/mystery-disease-kills-more-than-50-in-drc-what-we-know-so-far">the Congo</a>, the origins of which have still <a href="https://www.science.org/content/article/mysterious-congo-outbreak-likely-linked-contaminated-water-researchers-say">not been identified</a>. We know bats, thought to be <a href="https://www.nature.com/articles/s41586-020-2012-7?rel=outbound">the source</a> of the coronavirus behind the COVID pandemic, carry an enormous spectrum of viruses that potentially threaten us. But new pandemics can also arise through mosquitoes and close contact with other animals. Pandemics are global, not national, problems. We are at a pivotal time where countries including Australia must step up their commitments to this global effort. This will need politicians to rely on the evidence and lessons learned from COVID as well as private and public investment. Unfortunately, five years down the track, we still have a long way to go to be prepared for the next pandemic.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/245362/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Written by <a href="https://theconversation.com/profiles/sharon-lewin-131968">Sharon Lewin</a>, Melbourne Laureate Professor, University of Melbourne; Director, <a href="https://theconversation.com/institutions/the-peter-doherty-institute-for-infection-and-immunity-2255">The Peter Doherty Institute for Infection and Immunity</a> and <a href="https://theconversation.com/profiles/peter-c-doherty-169">Peter C. Doherty</a>, Laureate Professor Emeritus, <a href="https://theconversation.com/institutions/the-peter-doherty-institute-for-infection-and-immunity-2255">The Peter Doherty Institute for Infection and Immunity</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/5-years-since-covid-was-declared-a-pandemic-were-still-poorly-prepared-for-the-next-one-245362">original article</a>. Image: <a class="source" style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif; text-align: center;" href="https://unsplash.com/photos/white-and-black-printer-paper-OBmBHmrc3pw">Anastasiia Chepinska/Unsplash</a> </div>

Caring

Centenarian shares the secrets to a long life

A centenarian has share the few simple things she credits for her long life, just days after celebrating her 100th birthday. Sydney woman Betty Woodhams spent her milestone birthday doing one of her favourite things: buying for new plants from Bunnings. Woodhams was treated to a warm reception from staff as she perused the aisles snapping up new flowers for her small balcony garden. The mother-of-two told <a href="https://www.dailymail.co.uk/femail/article-14414941/I-just-turned-100-life-lessons-want-young-person-know-late-beauty-secret-Ive-sworn-years.html" target="_blank" rel="noopener">Daily Mail Australia</a> that she credits her age and enduring happiness down to great friends, a balanced diet, no regrets and "always wearing a hat". "Try to stay happy, even when things may seem like they are getting the better of you," Betty told the publication. "There really is something good in everything. Relaxing with a glass of wine at dinner or enjoying the odd champagne or two with friends always helps too." Betty grew up in Parramatta before moving to Bondi when she married her late husband Ron in 1951. The couple then built their dream house in Tambourine Bay, Lane Cove, while Betty immersed herself in her career as a secretary in the TV and publishing industry. Betty always surrounds herself with good friends, stays socially active and never sweats the small stuff, as she said, "don't get stuck on the negative things". "It doesn't matter what your age is, there's always something you can do to stay active whether it's walking, gardening, swimming or even a day at the races," she says. "Age is just a number. We do all age but you choose to get old!" Betty also hopes to change the perception of "getting older" and insists there's nothing "boring" about it, as she said, "People assume that life gets boring and quiet. It will if you let it!" "Yes you do slow down but that doesn't mean you stop. You can still get out and enjoy yourself... just at a slower pace!" Image credits: Daily Mail Australia

Caring

Vegemite weighs in on long-lasting Aussie debate

An American expat has reignited the age-old debate that has been plaguing Aussies for decades: how much Vegemite is the right amount? Taking to Reddit, the American shared a picture of their Vegemite toast, showing off a hefty smear of the salty spread. “I’m American, how’s my Vegemite amount?” he asked, likely unaware of the storm he was about to unleash within the Australian Reddit community. “I love salty and savoury stuff, so Vegemite is right up my alley,” he added. His bold approach earned a mix of reactions, with some praising the man, saying things like, “You could apply for citizenship with this coverage,” while others joked, “That’s pro-Aussie level spread.” Another commenter declared, “You’re not American anymore.” However, not everyone was impressed with his efforts, with some claiming he had applied far too much for a beginner Vegemite consumer. “Unless you’ve done it before, that is WAY too much for a newbie,” one remarked. Another added, “I’m a born and bred Vegemite fanatic, and that’s fine by me, but I don’t think most people would handle half that.” One commenter went as far as to say, “Slightly closer to serial killer amount than ordinary Aussie,” while another simply stated, “That would make me gag.” With the true blue debate well and truly reignited, Vegemite themselves weighed in on the topic, with The Head of Spreads at Bega sharing their opinion on the American's display of dedication. “For a first timer, this ratio of Vegemite to bread might be quite intense,” Mary Stafford told <a href="https://www.news.com.au/lifestyle/food/eat/expat-sparks-national-outrage-after-sharing-criminal-vegemite-toast/news-story/e061b746981cc11cbebf35ef494e0d7e" target="_blank" rel="noopener">news.com.au</a>. “We recommend starting with a small amount and gradually building up, but we totally understand – it’s hard for people who don’t eat Vegemite to pick up a jar and know what to do with it. There’s so many people missing out on the unmistakeable joy, simply because they haven’t been introduced to it properly … yet.” Image credits: Reddit / Shutterstock

International Travel

NSW Government refunds millions of Covid fines

Millions of dollars in fines dished out for breaches of Covid restrictions in NSW are set to be refunded, while close to 24,000 penalty notices will be officially erased. The announcement of the statewide refund by the NSW Fines Administration Commissioner on Tuesday came after legal advice cast doubt on the legal validity of the penalties handed out during Covid lockdowns. In total, more than $5.5 million will be handed back to those who have made either a full or partial payment towards paying off a Covid fine. Those in line for money, or with outstanding penalties, will be contacted by Revenue NSW within days. “Following representations made to the Commissioner of Police and myself concerning the validity of COVID-19 penalty notices, I have decided to exercise my statutory authority and withdraw these notices,” Fine Administration Commissioner Scott Johnston said. “Revenue NSW will be reaching out to all affected customers to support them through the finalisation of their matters.” At the height of the pandemic, the state government claimed they introduced the public health orders to "protect the community". Some fines have already been withdrawn, as in 2022 the Commissioner withdrew about 36,000 penalty notices tied to Covid-related offences because the information on them “made it difficult” for recipients to understand their offence. The remaining 23,539 penalty notices were believed to have provided a clearer explanation and were not withdrawn, but after further legal advice and consideration, it was considered “appropriate” to withdraw them too. Image credits: Xinhua News Agency/Shutterstock Editorial

Legal

Research reveals how long it takes Aussies to save for a holiday

Saving up for a holiday can seem like an overwhelming task, but some destinations are easier to save for than others. According to new research by <a href="http://money.com.au/">money.com.au</a>, nearly a third of travellers - or 31 percent - need on average a year to save for a trip, while 29 percent of Aussies save for up to six months before jetting off. For 18 percent of travellers, it takes more than a year to save for a trip, while just 13 percent of Aussies manage to save for a holiday in less than three months. On the flip side, 7 percent of eager travellers decide to skip saving altogether and cover their holiday expenses fully on a credit card, while just 2 percent opt for a personal loan to fund their trips. Money.com.au's Finance Expert, Sean Callery said of the survey, "Our research also shows that travel is the one expense Australians aren't willing to forgo, no matter their financial goals or income level." "Going into debt for a holiday brings additional costs and risks. It's important to have a plan for clearing the debt as quickly as possible." With these saving trends in mind, the experts have crunched the numbers to estimate how long it would take the average Aussie to save for a trip to the most popular overseas holiday destinations. The saving time for each location was calculated based on a 10 per cent savings rate of the average weekly earnings of $1,923.40 (from ABS data). Two of the quickest destinations to save for are China and Thailand, while other destinations the experts say you can save for in around half a year include New Zealand, Vietnam and Singapore. Image credits: Shutterstock

Travel Tips

The latest COVID booster will soon be available. Should I get one? Am I eligible?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/nathan-bartlett-1198187">Nathan Bartlett</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Australia’s <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">Therapeutic Goods Administration</a> (TGA) has recently approved a new COVID booster. The shot was developed by Pfizer and targets <a href="https://www.sbs.com.au/news/article/what-to-know-about-the-new-covid-19-vaccine-approved-in-australia/z7ev2u8qn">the JN.1 sub-variant</a> of Omicron. This is now <a href="https://theconversation.com/new-covid-vaccines-may-be-coming-to-australia-heres-what-to-know-about-the-jn-1-shots-237652">the fifth iteration</a> of the COVID vaccines, which have been updated regularly to keep up with the rapidly evolving virus, SARS-CoV-2. But nearly five years into the pandemic, you may be wondering, why do we need yet another type of COVID booster? And do we still need to be getting boosters at all? Here’s what to consider. <h2>Targeting the spike protein</h2> Pfizer’s JN.1 booster (and Moderna’s, though the TGA has <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">not approved</a> this one at this stage) is based on mRNA technology. This technology instructs our cells to produce a specific protein – in this case SARS-CoV-2’s spike, a protein on the surface of the virus that allows it to attach to our cells. This helps the immune system produce antibodies that recognise the spike protein and interfere with the virus getting into our cells. In response to our strengthened immune responses from vaccinations and previous infections (called immune pressure), SARS-CoV-2 has continued to evolve over the course of the pandemic, modifying the shape of its spike protein so our antibodies become less effective. Most recently we’ve faced a soup of Omicron sub-variants, including JN.1. Since JN.1 was first detected <a href="https://www.gavi.org/vaccineswork/seven-things-you-need-know-about-jn1-covid-19-variant">in August 2023</a>, this Omicron sub-variant has spawned a variety of further sub-variants, such as KP.2 (known as FLiRT), KP.3 (<a href="https://theconversation.com/from-flirt-to-fluqe-what-to-know-about-the-latest-covid-variants-on-the-rise-234073">known as FLuQE</a>) and <a href="https://theconversation.com/xec-is-now-in-australia-heres-what-we-know-about-this-hybrid-covid-variant-239292">XEC</a>. The spike protein is made up of <a href="https://www.nature.com/articles/s41401-020-0485-4">1,273 amino acids</a>, a bit like molecular building blocks. Mutations to <a href="https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2023.1228128/full">the spike protein</a> change individual amino acids. Certain amino acids are important for allowing neutralising antibodies to bind to the spike protein. This means changes can give the virus an edge over earlier variants, helping it evade our immune response. Scientists keep updating the COVID vaccines in an effort to keep up with these changes. The better matched the vaccine “spike” is to the spike protein on the surface of the virus trying to infect you, the better protection you’re likely to get. <h2>So who should get vaccinated, and when?</h2> Updating vaccines to deal with mutating viruses is not a new concept. It has been happening for the flu vaccine since <a href="https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-influenza-vaccination">around 1950</a>. We’ve become accustomed to getting the annual flu vaccine in the lead-up to the winter cold and flu season. But, unlike influenza, COVID has not settled into this annual seasonal cycle. The frequency of COVID waves of infection has been fluctuating, with new waves emerging periodically. COVID is also <a href="https://academic.oup.com/jtm/article/29/8/taac108/6731971">more transmissible</a> than the flu, which presents another challenge. While numbers vary, a conservative estimate of the reproduction number (R0 – how many people will one person will go on to infect) for JN.1 is 5. Compare this to seasonal flu with an R0 of <a href="https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-14-480">about 1.3</a>. In other words, COVID could be four times more transmissible than flu. Add to this immunity from a COVID vaccination (or a previous infection) <a href="https://www.nature.com/articles/d41586-023-00124-y">begins to wane</a> in the months afterwards. So an annual COVID booster is not considered enough for some more vulnerable people. <iframe id="gOYwk" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/gOYwk/2/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> For adults <a href="https://www.health.gov.au/our-work/covid-19-vaccines/getting-your-vaccination">aged 65 to 74</a>, a booster is recommended every 12 months, but they’re eligible every six months. For adults over 75, a shot is recommended every six months. Adults aged 18 to 64 are eligible every 12 months, unless they have a severe immune deficiency. Many conditions can cause immunodeficiency, including genetic disorders, infections, cancer, autoimmune diseases, diabetes and lung disease, as well as having received an organ transplant. For this group, it’s recommended they receive a shot every 12 months, but they’re eligible every six. <h2>Making sense of the advice</h2> A vaccine that targets JN.1 should provide good protection against the Omicron sub-variants likely to be circulating in the coming months. A few things need to happen before the JN.1 shots become available, such as the Australian Technical Advisory Group on Immunisation providing guidance to the government. But we can reasonably expect they might be rolled out <a href="https://www.sbs.com.au/news/article/what-to-know-about-the-new-covid-19-vaccine-approved-in-australia/z7ev2u8qn">within the next month or so</a>. If they hit doctors’ offices and pharmacies before Christmas and you’re due for a booster, the holiday period might be added impetus to go and get one, especially if you’re planning to attend lots of family and social gatherings over summer. In the meantime, the <a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">XBB.1.5 vaccines</a> remain available. Although they’re targeted at an earlier Omicron sub-variant, they should still offer some protection. While young, healthy people might like to wait for the updated boosters, for those who are vulnerable and due for a vaccination, whether or not to hold out may be something to weigh up with your doctor. The advice on COVID boosters in Australia, with stronger wording (“recommended” versus “eligible”) used for more vulnerable groups, reflects what we know about COVID. People <a href="https://academic.oup.com/ageing/article/49/6/901/5862042">who are older</a> and medically vulnerable are more likely to become very unwell with the virus. For young, healthy people who may be wondering, “do I need a COVID booster at all?”, having one annually is sensible. Although you’re less likely to get very sick from COVID, it’s possible. And, importantly, vaccines also reduce the risk of <a href="https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(24)00082-1/fulltext">developing long COVID</a>. While COVID vaccines do a very good job of protecting against severe disease, they don’t necessarily stop you becoming infected. Evidence on whether they reduce transmission <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2116597">has been mixed</a>, and <a href="https://pubmed.ncbi.nlm.nih.gov/38820077/">changed over time</a>. We’ve come to appreciate that vaccination is not going to free us of COVID. But it’s still our best defence against severe illness.<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/239594/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nathan-bartlett-1198187">Nathan Bartlett</a>, Professor, School of Biomedical Sciences and Pharmacy, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-latest-covid-booster-will-soon-be-available-should-i-get-one-am-i-eligible-239594">original article</a>. </div>

Body

110-year-old woman reveals the secret to a long life

Perth woman Bridget Grocke, who has just celebrated her 110th birthday, has revealed the very Aussie secret to her longevity. Ms Grocke, who has lived through two World Wars, the Great Depression, the Space Race, and the Information Age, is officially one of Australia's oldest residents. For sixty years, she has credited her old age to one glass of Emu Export beer everyday, as she chose a glass of the Aussie tipple over a slice of cake at her birthday party on Wednesday. “If there was a whole heap of beer and I was asked which one is your favourite I’d have to say this,” she told 9News as she held a glass of bush chook in her hand. “I’ve always known it. It tastes good. Cheers to Emu Export.” Born in Western Australia on November 18th 1914, Bridget spent her early years in Kalgoorlie and moved all across WA as the family followed her father’s work as an engine driver. Then at the age of 18, she took the leap and moved to Perth on her own. Ms Grocke spent her years working in fashion and customer service, also building her own family of four children with her husband, Jim, who she married at St Joseph’s Catholic Church in Subiaco in 1942. Despite losing her husband in 1985 and two of her children, Ms Grocke is surrounded by the love of her remaining son and daughter, 10 grandchildren, and 10 great grandchildren. Other than one of her beloved beers a day, Ms Grocke attributed her long life to her loving family, and her word of advice to younger generations was “if you’re nice to people they will be nice to you”. Ms Grocke’s daughter Jan Robertson said her mother’s adventurous spirit and loving family had kept her young at heart. “Mum was very easy going and she was strict, of course, but she always gave you the right path,” she said. “She has always been well. The only thing she got done was her cataracts at 100, before that she hadn’t been in hospital since childbirth.” Image credits: Nine News <div class="more-coverage-v2" style="box-sizing: inherit; margin-bottom: 0px; border-top-width: 1px; border-top-style: solid; border-top-color: #e0e1e2; float: right; margin-left: 16px; max-width: 40%; padding: 16px 0px;"> </div>

Caring

Man dies after months-long wait for at-home care

A man has died after his almost year-long wait to receive his government-approved at-home care. Cyril Tooze, 86, was <a href="https://oversixty.com.au/health/caring/man-decides-to-end-his-own-life-after-waiting-for-at-home-care" target="_blank" rel="noopener">approved</a> for a Level 4 Home Care Package in January, but almost one year on, he was still waiting for access to the money to fund daily assistance with physical, medical and social tasks. After sharing his story with 7News in October, Tooze candidly admitted that he was pursuing the avenue of voluntary assisted dying, saying at the time, "There is no hope." Just weeks later, Tooze has passed away. While in hospital after suffering a fall, Mr Tooze passed away on Friday, weighing just 46kg. Independent federal Mayo MP Rebekha Sharkie, who advocated for Mr Tooze to receive his government funding, said it had been an honour to have known him. "The man that I knew, he had such courage and such dignity to the very end," she said. "To the very end he wanted his situation to shed light and provide a human story for the 76,000 other older Australians who, just like him, are deteriorating, having accidents and injuring themselves while waiting for a Home Care package that they've been assessed as needing." "Despite a new Act being passed in the House of Representatives with urgency, there is no plan from the government to address the blown-out waiting list and the reality is that people are dying while they're waiting for Home Care." Federal aged care minister Anika Wells said her thoughts were with Mr Tooze's family and friends "as we mourn their loss but appreciate Cyril's life and his commitment to helping older Australians." Image credits: Nine

Caring

Can you die from long COVID? The answer is not so simple

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/rose-shiqi-luo-1477061">Rose (Shiqi) Luo</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/catherine-itsiopoulos-14246">Catherine Itsiopoulos</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/kate-anderson-1412897">Kate Anderson</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/magdalena-plebanski-1063786">Magdalena Plebanski</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>, and <a href="https://theconversation.com/profiles/zhen-zheng-1321031">Zhen Zheng</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Nearly five years into the pandemic, COVID is feeling less central to our daily lives. But the virus, SARS-CoV-2, is still around, and for many people the effects of an infection can be long-lasting. When symptoms persist for more than three months after the initial COVID infection, this is generally referred to as <a href="https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition">long COVID</a>. In September, Grammy-winning Brazilian musician <a href="https://www.abc.net.au/news/2024-09-07/brazilian-musician-sergio-mendez-dies-at-83/104323360">Sérgio Mendes</a> died aged 83 after reportedly having long COVID. <a href="https://www.abs.gov.au/articles/covid-19-mortality-australia-deaths-registered-until-31-july-2023">Australian data</a> show 196 deaths were due to the long-term effects of COVID from the beginning of the pandemic up to the end of July 2023. In the United States, the Centers for Disease Control and Prevention reported 3,544 <a href="https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20221214.htm">long-COVID-related deaths</a> from the start of the pandemic up to the end of June 2022. The symptoms of <a href="https://www.healthdirect.gov.au/long-covid">long COVID</a> – such as fatigue, shortness of breath and “brain fog” – can be debilitating. But can you die from long COVID? The answer is not so simple. <h2>How could long COVID lead to death?</h2> There’s still a lot we don’t understand about what causes long COVID. A popular theory is that “zombie” <a href="https://www.pnas.org/doi/full/10.1073/pnas.2300644120">virus fragments</a> may linger in the body and cause inflammation even after the virus has gone, resulting in long-term health problems. Recent research suggests a reservoir of <a href="https://www.sciencedirect.com/science/article/abs/pii/S1198743X24004324?via%3Dihub">SARS-CoV-2 proteins</a> in the blood might explain why some people experience ongoing symptoms. We know a serious COVID infection can damage <a href="https://covid19.nih.gov/news-and-stories/long-term-effects-sars-cov-2-organs-and-energy#:%7E:text=What%20you%20need%20to%20know,main%20source%20of%20this%20damage">multiple organs</a>. For example, severe COVID can lead to <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-long-haulers-long-term-effects-of-covid19">permanent lung dysfunction</a>, persistent heart inflammation, neurological damage and long-term kidney disease. These issues can in some cases lead to death, either immediately or months or years down the track. But is death beyond the acute phase of infection from one of these causes the direct result of COVID, long COVID, or something else? Whether long COVID can directly cause death continues to be a topic of debate. Of the <a href="https://www.cdc.gov/nchs/data/vsrr/vsrr025.pdf">3,544 deaths</a> related to long COVID in the US up to June 2022, the most commonly recorded underlying cause was COVID itself (67.5%). This could mean they died as a result of one of the long-term effects of a COVID infection, such as those mentioned above. COVID infection was followed by heart disease (8.6%), cancer (2.9%), Alzheimer’s disease (2.7%), lung disease (2.5%), diabetes (2%) and stroke (1.8%). Adults aged 75–84 had the highest rate of death related to long COVID (28.8%). These findings suggest many of these people died “with” long COVID, rather than from the condition. In other words, long COVID may not be a direct driver of death, but rather a contributor, likely exacerbating existing conditions. <h2>‘Cause of death’ is difficult to define</h2> Long COVID is a relatively recent phenomenon, so mortality data for people with this condition are limited. However, we can draw some insights from the experiences of people with post-viral conditions that have been studied for longer, such as myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). Like long COVID, <a href="https://bmjopen.bmj.com/content/12/5/e058128">ME/CFS</a> is a complex condition which can have significant and varied effects on a person’s physical fitness, nutritional status, social engagement, mental health and quality of life. Some research indicates people with ME/CFS are at <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5218818/">increased risk</a> of dying from causes including heart conditions, infections and suicide, that may be triggered or compounded by the debilitating nature of the syndrome. So what is the emerging data on long COVID telling us about the potential increased risk of death? Research from 2023 has suggested adults in the US with long COVID were at <a href="https://jamanetwork.com/journals/jama-health-forum/fullarticle/2802095">greater risk</a> of developing heart disease, stroke, lung disease and asthma. Research has also found <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9721155/">long COVID</a> is associated with a higher risk of <a href="https://www.tandfonline.com/doi/full/10.1080/21642850.2022.2164498#abstract">suicidal ideation</a> (thinking about or planning suicide). This may reflect common symptoms and consequences of long COVID such as sleep problems, fatigue, chronic pain and emotional distress. But long COVID is more likely to occur in people who have <a href="https://www.aihw.gov.au/reports/covid-19/long-covid-in-australia-a-review-of-the-literature/summary">existing health conditions</a>. This makes it challenging to accurately determine how much long COVID contributes to a person’s death. Research has long revealed <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302107/">reliability issues</a> in cause-of-death reporting, particularly for people with chronic illness. <h2>So what can we conclude?</h2> Ultimately, long COVID is a <a href="https://www.health.gov.au/topics/chronic-conditions/about-chronic-conditions">chronic condition</a> that can significantly affect quality of life, mental wellbeing and overall health. While long COVID is not usually immediately or directly life-threatening, it’s possible it could exacerbate existing conditions, and play a role in a person’s death in this way. Importantly, many people with long COVID around the world lack access to appropriate support. We need to develop <a href="https://www.mja.com.au/journal/2024/221/9/persistent-symptoms-after-covid-19-australian-stratified-random-health-survey">models of care</a> for the optimal management of people with long COVID with a focus on multidisciplinary care. Dr Natalie Jovanovski, Vice Chancellor’s Senior Research Fellow in the School of Health and Biomedical Sciences at RMIT University, contributed to this article.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239184/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rose-shiqi-luo-1477061">Rose (Shiqi) Luo</a>, Postdoctoral Research Fellow, School of Health and Biomedical Sciences, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/catherine-itsiopoulos-14246">Catherine Itsiopoulos</a>, Professor and Dean, School of Health and Biomedical Sciences, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/kate-anderson-1412897">Kate Anderson</a>, Vice Chancellor's Senior Research Fellow, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/magdalena-plebanski-1063786">Magdalena Plebanski</a>, Professor of Immunology, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>, and <a href="https://theconversation.com/profiles/zhen-zheng-1321031">Zhen Zheng</a>, Associate Professor, STEM | Health and Biomedical Sciences, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-you-die-from-long-covid-the-answer-is-not-so-simple-239184">original article</a>. </div>

Body

Readers response: What’s your top travel tip for staying comfortable on long journeys?

When it comes to a long travel day, getting comfortable can often be a mammoth task. We asked our readers to share their favourite tips and tricks to stay comfy on a long haul flight, car ride or train journey, and the response was overwhelming. Here's what they said. Amy Cardino - Long-haul journeys (to me longer than 8hrs), you need to save up or upgrade your ticket if you have mileage benefits, into business class. Ester Cibasek - My own blowup pillow and blanket (long enough to cover my head), noise reducing ear phones and keep my eyes closed so I dose in and out of sleep all the way. Valerie Keily - A neck pillow is essential and an eye shade. Keep hydrated and remember to move around if possible. Di Richardson - Memory neck pillow. Recovery sleeves on my calves. One departure drink then limit alcohol or coffee. Window seat and sleep when possible. Bliss. Anita Thornton - Go business class. Chrissie Martini - Break the journey by staying overnight in a hotel. Takes longer to get there but you practically eliminate jet lag and the worry of DVTs. On the way to Europe, two overnight stops helps me. Lyn Goodman - Keep warm and wear loose fitting clothes. June Debono - Stretch jeans and socks (as well as other clothes of course). Plus, eye shade and ear plugs. Ingrid Plueckhahn - Take a good book, break up the journey with a fave movie, and just get in the zone and relax. It’s just a day! Image credits: Shutterstock

Travel Tips

Lessons for the next pandemic: where did Australia go right and wrong in responding to COVID?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/adrian-esterman-1022994">Adrian Esterman</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/guzyal-hill-575966">Guzyal Hill</a>, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a>; <a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/kim-m-caudwell-1258935">Kim M Caudwell</a>, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a>; <a href="https://theconversation.com/profiles/michael-toole-18259">Michael Toole</a>, <a href="https://theconversation.com/institutions/burnet-institute-992">Burnet Institute</a>; <a href="https://theconversation.com/profiles/steven-mcgloughlin-1246135">Steven McGloughlin</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/tari-turner-7922">Tari Turner</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> With COVID still classified as <a href="https://www.who.int/europe/emergencies/situations/covid-19">an ongoing pandemic</a>, it’s difficult to contemplate the next one. But we <a href="https://theconversation.com/what-pathogen-might-spark-the-next-pandemic-how-scientists-are-preparing-for-disease-x-223193">need to be prepared</a>. We’ve seen <a href="https://theconversation.com/why-are-we-seeing-more-pandemics-our-impact-on-the-planet-has-a-lot-to-do-with-it-226827">several pandemics</a> in recent decades and it’s fair to expect we’ll see more. For the final part in a <a href="https://theconversation.com/au/topics/the-next-pandemic-160343">series of articles</a> on the next pandemic, we’ve asked a range of experts what Australia got right and wrong it its response to COVID. Here they share their thoughts on the country’s COVID response – and what we can learn for the next pandemic. <hr /> <h2>Quarantine</h2> The federal government mandated 14 days of quarantine for all international arrivals between March 2020 and November 2021. During that period, <a href="https://www.pmc.gov.au/sites/default/files/resource/download/national-review-of-quarantine.pdf">452,550 people</a> passed through the system. The states and Northern Territory were given <a href="https://quarantineinquiry.archive.royalcommission.vic.gov.au/covid-19-hotel-quarantine-inquiry-final-report-0">just 48 hours</a> to set up their quarantine systems. The states chose hotel quarantine, while the Northern Territory repurposed an old miner’s camp, <a href="https://www.aspistrategist.org.au/darwins-howard-springs-facility-a-model-for-building-national-resilience/">Howard Springs</a>, which had individual cabins with outdoor verandas. The ACT had very few international arrivals, while Tasmania only had hotel quarantine for domestic travellers. During the first 15 months of the program, <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.51240">at least 22 breaches</a> occurred in five states (New South Wales, Victoria, Queensland, Western Australia and South Australia). An inquiry into Victoria’s hotel quarantine <a href="https://au.news.yahoo.com/covid-victorias-devastating-hotel-quarantine-killed-almost-800-people-110450178.html">found</a> the lack of warning and planning to set up the complex system resulted in breaches that caused Victoria’s second COVID wave of 2020, leading to almost 800 deaths. A <a href="https://www.cnet.com/science/features/how-the-delta-variant-breached-australias-covid-fortress/">breach at Sydney airport</a> led to the introduction of the Delta variant into Australia. In the next pandemic, mistakes from COVID need to be avoided. They included failure to protect hotel residents and staff from airborne transmission through ventilation and mask usage. Protocols need to be consistent across the country, such as the type of security staff used, N95 masks for staff and testing frequency. These protocols need to be included in a national pandemic preparedness plan, which is frequently reviewed and tested through simulations. This did not occur with the pre-COVID preparedness plan. Dedicated quarantine centres like Howard Springs already exist in Victoria and Queensland. Ideally, they should be constructed in every jurisdiction. Michael Toole <hr /> <h2>Treatments</h2> Scientists had to move quickly after COVID was discovered to find effective treatments. Many COVID treatments involved repurposing existing drugs designed for other viruses. For example, the HIV drug ritonavir is a key element of <a href="https://theconversation.com/pfizers-pill-is-the-latest-covid-treatment-to-show-promise-here-are-some-more-171589">the antiviral Paxlovid</a>, while remdesivir was originally developed <a href="https://theconversation.com/the-who-has-advised-against-the-use-of-two-antibody-therapies-against-covid-heres-what-that-means-190787">to treat hepatitis C</a>. At the outset of the pandemic, there was a lot of uncertainty about COVID treatment among Australian health professionals. To keep up with the rapidly developing science, the <a href="https://www.monash.edu/medicine/partnerships/our-partnerships/projects/national-clinical-evidence-taskforce">National Clinical Evidence Taskforce</a> was established in March 2020. We were involved in its COVID response with more than 250 clinicians, consumers and researchers. Unusually for evidence-based guidelines, which are often updated only every five years or so, the taskforce’s guidelines were designed to be “living” – updated as new research became available. In April 2020 we released the first guidelines for care of people with COVID, and over the next three years <a href="https://app.magicapp.org/#/guideline/7252">these were updated</a> more than 100 times. While health-care professionals always had access to up-to-date guidance on COVID treatments, this same information was not as accessible for the public. This may partly explain why many people turned to <a href="https://theconversation.com/thinking-of-trying-ivermectin-for-covid-heres-what-can-happen-with-this-controversial-drug-167178">unproven treatments</a>. The taskforce’s benefits could have been increased with funding to help the community understand COVID treatments. COVID drugs faced other obstacles too. For example, changes to the virus itself meant some treatments <a href="https://theconversation.com/from-centaurus-to-xbb-your-handy-guide-to-the-latest-covid-subvariants-and-why-some-are-more-worrying-than-others-192945">became less effective</a> as new variants emerged. Meanwhile, provision of antiviral treatments <a href="https://grattan.edu.au/wp-content/uploads/2024/10/How-we-analysed-COVID-antiviral-uptake-Grattan-Institute.pdf">has not been equitable</a> across the country. COVID drugs have had important, though not game-changing, impacts. Ultimately, effective vaccines played a much greater role in shifting the course of the pandemic. But we might not be so fortunate next time. In any future pandemic it will be crucial to have a clear pathway for rapid, reliable methods to develop and evaluate new treatments, disseminate that research to clinicians, policymakers and the public, and ensure all Australians can access the treatments they need. Steven McGloughlin and Tari Turner, Monash University <hr /> <h2>Vaccine rollout</h2> COVID vaccines were developed <a href="https://theconversation.com/one-of-sciences-greatest-achievements-how-the-rapid-development-of-covid-vaccines-prepares-us-for-future-pandemics-228787">in record time</a>, but rolling them out quickly and seamlessly proved to be a challenge. In Australia, there were several missteps along the way. First, there was poor preparation and execution. Detailed <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/auditor-general-highlights-vaccine-rollout-failures">planning was not finalised</a> until after the rollout had begun. Then the federal government had <a href="https://theconversation.com/4-ways-australias-covid-vaccine-rollout-has-been-bungled-158225">overly ambitious targets</a>. For example, the goal of vaccinating four million people by the end of March 2021 fell drastically short, with less than one-fifth of that number actually vaccinated by that time. There were also <a href="https://theconversation.com/4-ways-australias-covid-vaccine-rollout-has-been-bungled-158225">supply issues</a>, with the European Union blocking some deliveries to Australia. Unfortunately, the government was heavily reliant on <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/auditor-general-highlights-vaccine-rollout-failures">the AstraZeneca vaccine</a>, which was found, in rare cases, to lead to <a href="https://www.health.gov.au/our-work/covid-19-vaccines/advice-for-providers/clinical-guidance/tts">blood clots</a> in younger people. Despite all this, Australia ultimately achieved high vaccination rates. By the end of December 2021, <a href="https://www.health.gov.au/sites/default/files/documents/2021/12/covid-19-vaccine-rollout-update-31-december-2021.pdf">more than 94%</a> of the population aged 16 and over had received at least one dose. This was a significant public health achievement and saved <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0299844">thousands of lives</a>. But over the past couple of years, Australia’s initially strong vaccine uptake has been waning. The <a href="https://www.health.gov.au/sites/default/files/2024-03/atagi-statement-on-the-administration-of-covid-19-vaccines-in-2024.pdf">Australian Technical Advisory Group on Immunisation</a> recommends booster doses for vulnerable groups annually or twice annually. However, only 30% of people aged <a href="https://www.health.gov.au/sites/default/files/2024-09/covid-19-vaccine-rollout-update-13-september-2024.pdf">75 and over</a> (for whom a booster is recommended every six months) have had a booster dose in the past six months. There are several lessons to be learned from the COVID vaccine rollout for any future pandemic, though it’s not entirely clear whether they are being heeded. For example, several manufacturers have developed <a href="https://theconversation.com/new-covid-vaccines-may-be-coming-to-australia-heres-what-to-know-about-the-jn-1-shots-237652">updated COVID vaccines</a> based on the JN.1 subvariant. But <a href="https://www.sbs.com.au/news/article/why-australia-could-miss-out-on-modernas-new-covid-19-vaccine/n5n0iruv1">reports indicate</a> the government will only be purchasing the Pfizer JN.1 booster. This doesn’t seem like the best approach to shore up vaccine supply. Adrian Esterman, University of South Australia <hr /> <h2>Mode of transmission</h2> Nearly five years since SARS-CoV-2 (the virus that causes COVID) first emerged, we now know <a href="https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-covid-19-how-is-it-transmitted">airborne transmission</a> plays a far greater role than we originally thought. In contrast, the risk of SARS-CoV-2 being transmitted via surfaces is <a href="https://theconversation.com/catching-covid-from-surfaces-is-very-unlikely-so-perhaps-we-can-ease-up-on-the-disinfecting-155359">likely to be low</a>, and perhaps effectively non-existent in many situations. Early in the pandemic, the role contaminated surfaces and inanimate objects played in COVID transmission was overestimated. The main reason we got this wrong, at least initially, was that in the absence of any direct experience with SARS-CoV-2, we extrapolated what we believed to be true for other respiratory viruses. This was understandable, but it proved to be inadequate for predicting how SARS-CoV-2 would behave. One of the main consequences of overestimating the role of surface transmission was that it resulted in a lot of unnecessary anxiety and the adoption of what can only be viewed in retrospect as <a href="https://theconversation.com/catching-covid-from-surfaces-is-very-unlikely-so-perhaps-we-can-ease-up-on-the-disinfecting-155359">over-the-top cleaning practices</a>. Remember the teams of people who walked the streets wiping down traffic light poles? How about the concern over reusable coffee cups? Considerable resources that could have been better invested elsewhere were directed towards disinfecting surfaces. This also potentially distracted our focus from other preventive measures that were likely to have been more effective, such as <a href="https://theconversation.com/yes-masks-reduce-the-risk-of-spreading-covid-despite-a-review-saying-they-dont-198992">wearing masks</a>. The focus on surface transmission was amplified by a number of studies published early in the pandemic that documented the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121658/">survival of SARS-CoV-2</a> for long periods on surfaces. However, these were conducted in the lab with little similarity to real-world conditions. In particular, the amounts of virus placed on surfaces were greater than what people would likely encounter outside the lab. This inflated viral survival times and therefore the perception of risk. The emphasis on surface transmission early in the pandemic ultimately proved to be a miscalculation. It highlights the challenges in understanding how a new virus spreads. Hassan Vally, Deakin University <hr /> <h2>National unity</h2> Initially, Commonwealth, state and territory leaders were relatively united in their response to the COVID pandemic. The establishment of the National Cabinet in <a href="https://federation.gov.au/national-cabinet">March 2020</a> indicated a commitment to consensus-based public health policy. Meanwhile, different jurisdictions came together to deliver a <a href="https://www.ato.gov.au/individuals-and-families/financial-difficulties-and-disasters/covid-19/jobkeeper-payment">range of measures</a> aimed at supporting businesses and workers affected by COVID restrictions. But as the pandemic continued, tensions gave way to deeper ideological fractures between jurisdictions <a href="https://link.springer.com/article/10.1186/s12888-024-05834-9">and individuals</a>. The issues of <a href="https://www.unswlawjournal.unsw.edu.au/article/covid-19-vaccine-mandates-a-coercive-but-justified-public-health-necessity">vaccine mandates</a>, <a href="https://www.abc.net.au/news/2022-01-30/wa-premier-mark-mcgowan-reopening-date-decision/100788876">border closures</a> and <a href="https://journals.sagepub.com/doi/pdf/10.1177/00048674211031489">lockdowns</a> all created fragmentation between governments, and among experts. The <a href="https://www.theguardian.com/australia-news/2020/oct/19/daniel-andrews-lashes-josh-frydenberg-over-attack-on-victorias-covid-strategy">blame game began</a> between and within jurisdictions. For example, the politicisation of <a href="https://www.9news.com.au/national/govt-playing-cruise-ship-blame-game-labor/49ad3491-2187-4991-a3a0-1c61145bc2cb">quarantine regulations on cruise ships</a> revealed disunity. School closures, on which the Commonwealth and state and territory governments <a href="https://www.smh.com.au/national/nsw/we-made-the-wrong-decisions-covid-era-mass-school-closures-condemned-20240214-p5f521.html">took different positions</a>, also generated controversy. These and other instances of polarisation undermined the intent of the newly established <a href="https://theconversation.com/with-the-covid-crisis-easing-is-the-national-cabinet-still-fit-for-purpose-202145">National Cabinet</a>. The COVID pandemic showed us that <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4859497">disunity across the country</a> threatens the collective work needed for an effective response in <a href="https://ir.law.fsu.edu/jtlp/vol30/iss1/3/">the face of emergencies</a>. The <a href="https://www.pmc.gov.au/domestic-policy/commonwealth-government-covid-19-response-inquiry">COVID response inquiry</a>, due to release its results soon, will hopefully help us work toward <a href="https://link.springer.com/book/10.1007/978-981-19-3292-2">national uniform legislation</a> that may benefit Australia in the event of <a href="https://link.springer.com/chapter/10.1007/978-981-19-3292-2_10">any future pandemics</a>. This doesn’t necessarily mean identical legislation across the country – this won’t always be appropriate. But a cohesive, long-term approach is crucial to ensure the best outcomes for the Australian federation in its entirety. Guzyal Hill and Kim M Caudwell, Charles Darwin University <hr /> This article is part of a <a href="https://theconversation.com/au/topics/the-next-pandemic-160343">series on the next pandemic</a>.<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/239819/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adrian-esterman-1022994">Adrian Esterman</a>, Professor of Biostatistics and Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/guzyal-hill-575966">Guzyal Hill</a>, Associate Professor, Faculty of Arts and Society, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a>; <a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, Associate Professor, Epidemiology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/kim-m-caudwell-1258935">Kim M Caudwell</a>, Senior Lecturer - Psychology | Chair, Researchers in Behavioural Addictions, Alcohol and Drugs (BAAD), <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a>; <a href="https://theconversation.com/profiles/michael-toole-18259">Michael Toole</a>, Associate Principal Research Fellow, <a href="https://theconversation.com/institutions/burnet-institute-992">Burnet Institute</a>; <a href="https://theconversation.com/profiles/steven-mcgloughlin-1246135">Steven McGloughlin</a>, Director, Intensive Care Unit, Alfred Health; Professor, Epidemiology and Preventative Medicine, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/tari-turner-7922">Tari Turner</a>, Director, Evidence and Methods, National COVID-19 Clinical Evidence Taskforce; Associate Professor (Research), Cochrane Australia, School of Population Health and Preventive Medicine, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/lessons-for-the-next-pandemic-where-did-australia-go-right-and-wrong-in-responding-to-covid-239819">original article</a>. </div>

Legal

Getting antivirals for COVID too often depends on where you live and how wealthy you are

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> Medical experts <a href="https://www.health.gov.au/health-alerts/covid-19/treatments/eligibility">recommend</a> antivirals for people aged 70 and older who get COVID, and for other groups at risk of severe illness and hospitalisation from COVID. But many older Australians have missed out on antivirals after getting sick with COVID. It is yet another way the health system is failing the most vulnerable. <h2>Who missed out?</h2> We <a href="https://grattan.edu.au/wp-content/uploads/2024/10/How-we-analysed-COVID-antiviral-uptake-Grattan-Institute.pdf">analysed</a> COVID antiviral uptake between March 2022 and September 2023. We found some groups were more likely to miss out on antivirals including Indigenous people, people from disadvantaged areas, and people from culturally and linguistically diverse backgrounds. Some of the differences will be due to different rates of infection. But across this 18-month period, many older Australians were infected at least once, and rates of infection were higher in some disadvantaged communities. <h2>How stark are the differences?</h2> Compared to the national average, Indigenous Australians were nearly 25% less likely to get antivirals, older people living in disadvantaged areas were 20% less likely to get them, and people with a culturally or linguistically diverse background were 13% less likely to get a script. People in remote areas were 37% less likely to get antivirals than people living in major cities. People in outer regional areas were 25% less likely. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=329&fit=crop&dpr=1 600w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=329&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=329&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=413&fit=crop&dpr=1 754w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=413&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/620627/original/file-20240920-20-yc7sq5.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=413&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Dispensing rates by group. Grattan Institute</figcaption></figure> Even within the same city, the differences are stark. In Sydney, people older than 70 in the affluent eastern suburbs (including Vaucluse, Point Piper and Bondi) were nearly twice as likely to have had an antiviral as those in Fairfield, in Sydney’s south-west. Older people in leafy inner-eastern Melbourne (including Canterbury, Hawthorn and Kew) were 1.8 times more likely to have had an antiviral as those in Brimbank (which includes Sunshine) in the city’s west. <h2>Why are people missing out?</h2> COVID antivirals should be taken when symptoms first appear. While awareness of COVID antivirals is generally strong, people often <a href="https://link.springer.com/article/10.1007/s40121-024-01003-3">don’t realise</a> they would benefit from the medication. They <a href="https://www.phrp.com.au/?p=43363">wait</a> until symptoms get worse and it is too late. Frequent GP visits make a big difference. Our analysis found people 70 and older who see a GP more frequently were much more likely to be dispensed a COVID antiviral. Regular visits give an opportunity for preventive care and patient education. For example, GPs can provide high-risk patients with “COVID treatment plans” as a reminder to get tested and seek treatment as soon as they are unwell. Difficulty seeing a GP could help explain low antiviral use in rural areas. Compared to people in major cities, people in small rural towns have about 35% <a href="https://hwd.health.gov.au/resources/data/gp-primarycare.html">fewer</a> GPs, see their GP about half as often, and are 30% more likely to <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release">report</a> waiting too long for an appointment. Just like for <a href="https://grattan.edu.au/wp-content/uploads/2023/11/A-fair-shot-How-to-close-the-vaccination-gap-Grattan-Institute-Report.pdf">vaccination</a>, a GP’s focus on antivirals probably matters, as does providing care that is accessible to people from different cultural backgrounds. <h2>Care should go those who need it</h2> Since the period we looked at, evidence has emerged that raises <a href="https://url.au.m.mimecastprotect.com/s/FmjFC91ZVBSmBpXpZSEh9CqMtQx?domain=nejm.org">doubts</a> about how effective antivirals are, particularly for people at lower risk of severe illness. That means getting vaccinated is more important than getting antivirals. But all Australians who are eligible for antivirals should have the same chance of getting them. These drugs have cost more than A$1.7 billion, with the vast majority of that money coming from the federal government. While dispensing rates have fallen, more than <a href="http://medicarestatistics.humanservices.gov.au/statistics/do.jsp?_PROGRAM=%2Fstatistics%2Fpbs_item_standard_report&itemlst=%2712910L%27%2C%2712996B%27&ITEMCNT=2&LIST=12910L%2C12996B&VAR=SERVICES&RPT_FMT=6&start_dt=202201&end_dt=202408">30,000</a> packs of COVID antivirals were dispensed in August, costing about $35 million. Such a huge investment shouldn’t be leaving so many people behind. Getting treatment shouldn’t depend on your income, cultural background or where you live. Instead, care should go to those who need it the most. People born overseas have been <a href="https://www.abs.gov.au/articles/covid-19-mortality-australia-deaths-registered-until-31-january-2024#deaths-due-to-covid-19-country-of-birth">40% more likely</a> to die from COVID than those born here. Indigenous Australians have been <a href="https://www.abs.gov.au/articles/covid-19-mortality-australia-deaths-registered-until-31-january-2024#covid-19-mortality-among-aboriginal-and-torres-strait-islander-people">60% more likely</a> to die from COVID than non-Indigenous people. And the most disadvantaged people have been <a href="https://www.abs.gov.au/articles/covid-19-mortality-australia-deaths-registered-until-31-january-2024#deaths-due-to-covid-19-socio-economic-status-seifa-">2.8 times</a> more likely to die from COVID than those in the wealthiest areas. All those at-risk groups have been more likely to miss out on antivirals. It’s not just a problem with antivirals. The same groups are also disproportionately missing out on COVID <a>vaccination</a>, compounding their risk of severe illness. The pattern is repeated for other important preventive health care, such as <a href="https://www.aihw.gov.au/getmedia/54a38a6a-9e3c-4f58-b2f6-cdef977a7d60/aihw-can-155_15sept.pdf?v=20230915162104&inline=true">cancer</a> <a href="https://www.aihw.gov.au/getmedia/27f32443-5206-4189-8775-0c1f55a26bc4/aihw-can-160.pdf?v=20240617095924&inline=true">screening</a>. <h2>A 3-step plan to meet patients’ needs</h2> The federal government should do three things to close these gaps in preventive care. First, the government should make Primary Health Networks (PHNs) responsible for reducing them. PHNs, the regional bodies responsible for improving primary care, should share data with GPs and step in to boost uptake in communities that are missing out. Second, the government should extend its <a href="https://www.health.gov.au/our-work/mymedicare">MyMedicare</a> reforms. MyMedicare gives general practices flexible funding to care for patients who live in residential aged care or who visit hospital frequently. That approach should be <a href="https://grattan.edu.au/report/a-new-medicare-strengthening-general-practice/">expanded</a> to all patients, with more funding for poorer and sicker patients. That will give GP clinics time to advise patients about preventive health, including COVID vaccines and antivirals, before they get sick. Third, team-based pharmacist prescribing should be introduced. Then pharmacists could quickly dispense antivirals for patients if they have a prior agreement with the patient’s GP. It’s an approach that would also <a href="https://theconversation.com/pharmacists-should-be-able-to-work-with-gps-to-prescribe-medicines-for-long-term-conditions-212359">work</a> for medications for chronic diseases, such as cardiovascular disease. COVID antivirals, unlike vaccines, have been <a href="https://theconversation.com/covid-wave-whats-the-latest-on-antiviral-drugs-and-who-is-eligible-in-australia-218423">keeping up</a> with new variants without the need for updates. If a new and more harmful variant emerges, or when a new pandemic hits, governments should have these systems in place to make sure everyone who needs treatment can get it fast. In the meantime, fairer access to care will help close the big and persistent <a href="https://www.aihw.gov.au/getmedia/0cbc6c45-b97a-44f7-ad1f-2517a1f0378c/hiamhbrfhsu.pdf?v=20230605184558&inline=true">gaps</a> in health between different groups of Australians. <a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, Program Director, Health and Aged Care, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/getting-antivirals-for-covid-too-often-depends-on-where-you-live-and-how-wealthy-you-are-239497">original article</a>. </div>

Caring

I have a stuffy nose, how can I tell if it’s hay fever, COVID or something else?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/deryn-thompson-1449312">Deryn Thompson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Hay fever (also called allergic rhinitis) affects <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-state-and-territory-findings/latest-release">24%</a> of Australians. <a href="https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/allergic-rhinitis-or-hay-fever">Symptoms</a> include sneezing, a runny nose (which may feel blocked or stuffy) and itchy eyes. People can also experience an itchy nose, throat or ears. But COVID is still <a href="https://theconversation.com/xec-is-now-in-australia-heres-what-we-know-about-this-hybrid-covid-variant-239292">spreading</a>, and <a href="https://theconversation.com/i-feel-sick-how-do-i-know-if-i-have-the-flu-covid-rsv-or-something-else-234266">other viruses</a> can cause cold-like symptoms. So how do you know which one you’ve got? <h2>Remind me, how does hay fever cause symptoms?</h2> <a href="https://www.allergy.org.au/hp/papers/allergic-rhinitis-clinical-update">Hay fever</a> happens when a person has become “sensitised” to an allergen trigger. This means a person’s body is always primed to react to this trigger. Triggers can include allergens in the air (such as pollen from trees, grasses and flowers), mould spores, animals or house dust mites which mostly live in people’s mattresses and bedding, and feed on shed skin. When the body is exposed to the trigger, it produces IgE (immunoglobulin E) antibodies. These cause the release of many of the body’s own chemicals, including histamine, which result in hay fever symptoms. People who have asthma may find their asthma symptoms (cough, wheeze, tight chest or trouble breathing) worsen when exposed to airborne allergens. Spring and sometimes into summer can be the worst time for people with grass, tree or flower allergies. However, animal and house dust mite symptoms usually happen year-round. <h2>What else might be causing my symptoms?</h2> Hay fever does not cause a fever, sore throat, muscle aches and pains, weakness, loss of taste or smell, nor does it cause you to cough up mucus. These symptoms are likely to be caused by a virus, such as COVID, influenza, respiratory syncytial virus (RSV) or a “cold” (often caused by rhinoviruses). These conditions can occur all year round, with some overlap of symptoms: <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=582&fit=crop&dpr=1 600w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=582&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=582&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=731&fit=crop&dpr=1 754w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=731&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/624085/original/file-20241007-16-xf6euv.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=731&fit=crop&dpr=3 2262w" alt="" /></a><figcaption><a class="source" href="https://theconversation.com/i-feel-sick-how-do-i-know-if-i-have-the-flu-covid-rsv-or-something-else-234266">Natasha Yates/The Conversation</a></figcaption></figure> COVID still <a href="https://theconversation.com/xec-is-now-in-australia-heres-what-we-know-about-this-hybrid-covid-variant-239292">surrounds</a> us. <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/health+statistics/surveillance+of+notifiable+conditions/respiratory+infections+dashboard">RSV and influenza</a> rates appear higher than before the COVID pandemic, but it may be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10888990/#:%7E:text=Increases%20in%20RSV%20patient%20volume,with%20an%20RSV%20diagnosis%20occurred">due to more testing</a>. So if you have a fever, sore throat, muscle aches/pains, weakness, fatigue, or are coughing up mucus, stay home and avoid mixing with others to limit transmission. People with COVID symptoms can take a rapid antigen test (<a href="https://www.health.gov.au/sites/default/files/2024-04/coronavirus-covid-19-rapid-antigen-tests.pdf">RAT</a>), ideally when <a href="https://www.cochrane.org/CD013705/INFECTN_how-accurate-are-rapid-antigen-tests-diagnosing-covid-19">symptoms start</a>, then isolate until symptoms disappear. <a href="https://www.mja.com.au/journal/2023/219/11/covid-19-rapid-antigen-tests-approved-self-testing-australia-published">One negative RAT alone</a> can’t rule out COVID if symptoms are still present, so test again 24–48 hours after your initial test if symptoms persist. You can now test yourself for COVID, RSV and influenza in a <a href="https://www.tga.gov.au/sites/default/files/2024-02/covid-19-rapid-antigen-self-tests-are-approved-australia-ifu-406813.PDF">combined RAT</a>. But again, a negative test doesn’t rule out the virus. If your symptoms continue, <a href="https://www.tga.gov.au/sites/default/files/2024-02/covid-19-rapid-antigen-self-tests-are-approved-australia-ifu-406813.PDF">test again</a> 24–48 hours after the previous test. <h2>If it’s hay fever, how do I treat it?</h2> Treatment involves blocking the body’s histamine release, by taking antihistamine medication which helps reduce the symptoms. Doctors, nurse practitioners and pharmacists can develop a <a href="https://www.allergy.org.au/images/pc/ASCIA_Allergic_Rhinitis_Treatment_Plan_2024.pdf">hay fever care plan</a>. This may include using a nasal spray containing a topical corticosteroid to help reduce the swelling inside the nose, which causes stuffiness or blockage. Nasal sprays need to delivered <a href="https://allergyfacts.org.au/are-you-using-your-nasal-spray-correctly/">using correct technique</a> and used over several weeks to work properly. Often these sprays can also help lessen the itchy eyes of hay fever. Drying bed linen and pyjamas inside during spring can <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-minimisation">lessen symptoms</a>, as can putting a <a href="https://www.nps.org.au/consumers/managing-hay-fever">smear of Vaseline</a> in the nostrils when going outside. Pollen sticks to the Vaseline, and gently blowing your nose later removes it. People with asthma should also have an <a href="https://asthma.org.au/manage-asthma/asthma-action-plan/">asthma plan</a>, created by their doctor or nurse practitioner, explaining how to adjust their asthma reliever and preventer medications in hay fever seasons or on allergen exposure. People with asthma also need to be <a href="https://www.nationalasthma.org.au/living-with-asthma/resources/patients-carers/factsheets/thunderstorm-asthma">alert for thunderstorms</a>, where pollens can burst into tinier particles, be inhaled deeper in the lungs and cause a severe asthma attack, and even death. <h2>What if it’s COVID, RSV or the flu?</h2> Australians aged 70 and over and others with underlying health conditions who test positive for COVID are <a href="https://www.healthdirect.gov.au/covid-19/medications#at-home">eligible for antivirals</a> to reduce their chance of severe illness. Most other people with COVID, RSV and influenza will recover at home with rest, fluids and paracetamol to relieve symptoms. However some groups are at greater risk of serious illness and may require additional treatment or hospitalisation. For <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/respiratory-syncytial-virus.aspx">RSV</a>, this includes premature infants, babies 12 months and younger, children under two who have other medical conditions, adults over 75, people with heart and lung conditions, or health conditions that lessens the immune system response. For influenza, people at <a href="https://www.health.nsw.gov.au/Infectious/Influenza/Pages/at-risk.aspx">higher risk</a> of severe illness are pregnant women, Aboriginal people, people under five or over 65 years, or people with long-term medical conditions, such as kidney, heart, lung or liver disease, diabetes and decreased immunity. If you’re concerned about severe symptoms of COVID, RSV or influenza, consult your doctor or call 000 in an emergency. If your symptoms are mild but persist, and you’re not sure what’s causing them, book an appointment with your doctor or nurse practitioner. Although hay fever season is here, we need to avoid spreading other serious infectious. For more information, you can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria); use the <a href="https://www.healthdirect.gov.au/symptom-checker">online Symptom Checker</a>; or visit <a href="http://healthdirect.gov.au/">healthdirect.gov.au</a> or the <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-minimisation">Australian Society of Clinical Immunology and Allergy</a>.<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/240453/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/deryn-thompson-1449312">Deryn Thompson</a>, Eczema and Allergy Nurse; Lecturer, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-have-a-stuffy-nose-how-can-i-tell-if-its-hay-fever-covid-or-something-else-240453">original article</a>. </div>

Body

Incredible reason behind Aussie woman's 5,500km outback ride

Sarah Wheeler has been travelling through the New South Wales outback for the last four and a half months, doing it entirely on horseback. The 26-year-old Aussie plans to ride 5,500 kilometres through outback Queensland and New South Wales to raise awareness about the rare cancer that killed her mum in 2022, a little over a decade after her father passed away. With around four months left on her trip, Wheeler and her two horses, Shifty and Sally, are slowly trekking across some of the most remote and rugged parts of the country in a trip that has never been done before. "I'd always thought about doing something like this throughout my life," Wheeler told Yahoo News. "So after my parents died, I went out and bought two horses and, yeah, set off on a five-and-a-half-thousand-kilometre horse ride to honour and remember, and grieve." Wheeler set off with her horses from her hometown Rowena in western NSW in May, and has since travelled across long stretches of highways, desolate plains and rocky terrain and has now passed the halfway mark. She explained that in recent weeks she has also been trekking on foot and has contact with other people only when she stops in towns for supplies or when she feeds her horses, using a support vehicle. "The car travels 10 kilometres at a time so that I can keep replenishing my horses, with both food and water. Ten kilometres takes me two hours, sometimes a bit longer, and I'm usually in the saddle for six to eight hours a day," she told the publication. <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/reel/C89KIgsxb_A/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <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/reel/C89KIgsxb_A/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Sarah Wheeler - The Outback Long Ride (@_beneaththebrim)</a> </div> </blockquote> "The most challenging thing has probably been the saddles and saddle pads and cleanliness — that's all so important. I have to wash my saddle blankets every second day. Otherwise, things just start happening, like fungus type of stuff." She added that while "this has been one of the hardest things I have ever done", the friendliness and support of locals has been a highlight of her trip. "Everyone's so lovely and inviting and, yeah, I just I didn't think that I was going to see that to this extent," she said. "People want to invite me in and feed me, they just want to help me as much as they can." Remembering her late parents' legacy, Wheeler said she wants everyone to know just how "remarkable" they both were. "They were like everything this world needed and more," she said. "They were very kind and genuine and humble." Wheeler's ride is raising awareness and funds for two key charities: <a href="https://pancare-gi-cancer.raisely.com/sarah-wheeler" target="_blank" rel="noopener">Pancare Foundation</a>, the lead organisation supporting families and funding research for upper gastrointestinal (GI) cancer, which claimed the life of her mother, and A Daughter’s Way, her own charity supporting rural families experiencing grief. Images: Instagram

Domestic Travel

Snakes are waking up. What should you do if you’re bitten? And what if you’re a long way from help?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/hamish-bradley-2217649">Hamish Bradley</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>; <a href="https://theconversation.com/profiles/alice-richardson-252002">Alice Richardson</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>, and <a href="https://theconversation.com/profiles/breeanna-spring-1545193">Breeanna Spring</a>, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a> From the creeks that wind through inner city Melbourne to the far outback in Western Australia, snake season is beginning. Over the cooler months snakes have been in state of <a href="https://youtu.be/FjXOzNjZjoU?si=Mc0eeayVk4VU9906">brumation</a>. This is very similar to hibernation and characterised by sluggishness and inactivity. As warmer conditions return both snakes and humans become more active in the outdoors, leading to an increased likelihood of interaction. This may happen when people are hiking, dog-walking or gardening. The risk of being bitten by a snake is exceptionally small, but knowing basic first aid could potentially save your, or another person’s, life. <h2>When a snake bites</h2> Snake bite envenomation (when venom enters the blood stream) is a significant issue in Australia, with <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja17.00094">3,000 cases annually and an average of two deaths</a>. Snake bite should always be <a href="https://stjohnwa.com.au/online-resources/first-aid-information-and-resources/snake-bite">treated</a> as a life-threatening emergency, and if you are bitten in rural or remote Australia, you will often receive an air medical emergency pick up to a regional or metropolitan hospital for advanced care. The effects of snake bites vary, depending on the species of snake and first aid measures undertaken. Australian <a href="https://www.healthdirect.gov.au/snake-bites">standard first aid guidelines</a> include: <ul> <li>calling for help (dialing 000 or activating an emergency beacon)</li> <li>applying a pressure immobilisation bandage</li> <li>resting.</li> </ul> <h2>Why pressure is important</h2> Snake venom is carried within the <a href="https://theconversation.com/what-are-lymph-nodes-and-can-a-massage-really-improve-lymphatic-drainage-209334">lymphatic system</a>. This is a collection of tiny tubes throughout the body that return fluid outside of blood vessels back to the blood stream. Muscles act as a “<a href="https://theconversation.com/pneumatic-compression-therapy-can-it-really-help-olympians-or-you-recover-after-exercise-236228">pump</a>” to help the fluid move through this system. That’s why being still, or immobilisation, is vital to slow the spread of venom. A firm pressure immobilisation bandage, applied as tight as you would for a sprained ankle, will compress these tubes and help limit the venom’s spread. Ideally bandage the entire limb on which the bite occurred and apply a splint to help further with immobilisation. It is very important that the blood supply to the limb is not limited by this bandage. Never attempt to capture or kill the snake for identification. This risks further bites and is not required for specialist care. The decision about when to give antivenom (if any) is based on the geographical location, symptoms, the results of blood tests and discussion with a toxicologist. <h2>The tyranny of distance</h2> People living in rural and remote locations may also have limited access to health care, including access to ambulance services, <a href="https://www.tandfonline.com/doi/full/10.1080/10871209.2020.1769778">snake bite first aid</a> such as bandages and splints, and to antivenom. Availability and the prompt use of antivenom have been identified as <a href="https://www.sciencedirect.com/science/article/pii/S2590171022000558">crucial factors in the effective treatment</a> of snake envenomation – but not studied in detail. Over one year (as a component of a larger three-year study) we collected information on the pre-hospital care and in-flight care with the Royal Flying Doctors Service Western Operations. During this time, 85 people from regional, rural, remote and very remote Western Australia were flown by Royal Flying Doctor Service to hospital for suspected or confirmed snake bites. Reassuringly, only five of these patients (6%) ultimately received a toxicologist’s diagnosis of envenomation. <h2>To move or not to move?</h2> Troublingly, 38 (45%) of the 85 snake bite victims continued to move around and be active following their suspected snake bite. This raises questions about whether people lack knowledge of first-aid guidelines, or whether this is a consequence of being isolated, with limited access to health care. Either way, our as-yet-unpublished research highlights the vulnerability of Australia’s rural and remote people. All patients eventually received a pressure immobilisation bandage, with an average time from bite to application of 38 minutes. Three quarters of the patients made their way to health-care site by foot, or private car, arriving on average 65 minutes after the bite. <h2>What needs to change?</h2> Our results indicate rural and remote Australians need innovative health-care solutions beyond the metropolitan guidelines, particularly when outside ambulance service areas. Basic snake bite first aid education needs to be not only reiterated but also a pragmatic approach is required in these geographically isolated locations. This would involve being vigilant, staying safe and, when isolated, always carrying emergency technology to call for help. <hr /> The authors wish to acknowledge the efforts required through this research project as it continues, including by Fergus Gardiner, Kieran Hennelly, Rochelle Menzies, James Anderson, Alex McMillan and John Fisher. Hamish Bradley is an Aeromedical Retrieval Specialist and Principal Investigator in this project.<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/234365/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hamish-bradley-2217649">Hamish Bradley</a>, Adjunct Lecturer, Anaesthetist and Aeromedical Retrieval Specialist, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>; <a href="https://theconversation.com/profiles/alice-richardson-252002">Alice Richardson</a>, Associate professor and lead of Statistical Support Network, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>, and <a href="https://theconversation.com/profiles/breeanna-spring-1545193">Breeanna Spring</a>, PhD student, Molly Wardaguga Institute for First Nations Birth Rights, Faculty of Health, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/snakes-are-waking-up-what-should-you-do-if-youre-bitten-and-what-if-youre-a-long-way-from-help-234365">original article</a>. </div>

Body

Parents under fire for taking their sick toddler on a long-haul flight

A couple has come under fire after documenting their experience online of boarding a long-haul flight with their toddler, despite the child being sick. Alina and her husband were excited to go on their long-awaited holiday to Thailand with their one-year-old son in tow, taking off on their first big family trip. However, shortly before they were set to take off, their child developed a raging fever, and they decided to go on the trip anyway. Taking the experience to social media, Alina said her son’s temperature soared to around 40 degrees, with their little boy’s condition escalating so rapidly that the parents were considering calling off their entire trip. “My husband and I even wanted to cancel the flight,” she confessed in the video, which has received around 1.4 million views. However, after realising they would be out of pocket by several thousands of dollars if they cancelled the trip at such short notice, they decided to take the risk and board the plane. “Our tickets would have been wasted, and the trip that cost us $3,000 would have been wasted,” the mum wrote. "One plus of this flight was that the flight was at night, and the child could sleep and recover.” In the clip, the parents were seen walking their son around the plane, cradling the sick toddler as he cried uncontrollably. Luckily, the parents “managed to bring down the temperature”, but they weren’t convinced their son would keep quiet for the rest of the trip. “We were so worried about how the baby would feel on an eight-hour flight,” she continued, walking the baby up and down the corridors of the airport, trying to calm him down. As they tried to settle the child, they realised that their hopes that he would sleep the whole way were misguided. “The flight turned out to be difficult,” Alina confessed. “The baby kept waking and crying.” In the middle of the night, their son’s fever returned, which forced the parents to “bring the temperature down again” and left them “very worried” about their son’s health. Their baby’s fever took a toll on the parents as well, who complained of feeling “squeezed like a lemon” while trying to keep his temperature down, as Alina recalled, “We took turns looking after the baby so each of us could sleep.” In a later video, the parents defended their choice to take their son on the flight despite his intense fever and blamed it on his teething, not sickness. “Our baby wasn’t sick, he was teething, and that’s why he had a fever,” she said. “If our child had been sick, we would have cancelled everything … I consider myself a wonderful mother.” Despite the mother's clarification of her son's fever, the parents were slammed for even considering taking a sick child on such a long flight. “It’s OK, don’t worry about making anyone else on that flight sick,” a sarcastic comment read. “This is so tremendously selfish, you are appalling for doing this to him and others.” “I was in the same situation,” another parent said. “I lost all bookings, but who cares, my daughter comes first always and forever, no matter the amount of money!” “Trips come and go; your baby’s health is priceless!” read another comment. “Forty degrees is a hospital admission! Not a flight to Thailand!” However, not everyone was as judgmental, with many parents extending their sympathies to the first-time parents, as one person wrote, “You know what’s best for your baby. Everyone will say things. But only you will know when you are in that situation.” “Everyone is a first-time parent,” another defended. “This was a lesson learned. A baby’s health is of utmost importance. No holiday is more important than that. I hope he is OK now.” Image credits: TikTok

Travel Trouble

"No show": Wild reason couple denied refund on flights scheduled during Covid

A Melbourne couple, who had booked flights with Qantas during the state's fifth lockdown, were left furious after they were told they were ineligible for a refund because they were a "no show". Kieran McGregor told news.com.au that he and his partner had originally booked the flights to Darwin for July 18, 2021 through travel giant Expedia. When the number of Covid cases started rising, he moved the flights forward to fly out on the 16th of July, hoping that they would be able to get out before another lockdown, but the day before their flight, Victorian Premier Daniel Andrews announced the state's fifth lockdown. Three years later, McGregor was still stuck between trying to get the refund from Expedia, who said Qantas had the money, and Qantas, who said the travel agent had it. Last year, McGregor contacted Expedia on their X account to try to resolve the issue, but the company said: “We just got off the phone with the airline, and as per advised, the ticket shows suspended on their end due to a no show." “Your ticket is no (sic) eligible for a refund, and has no value as per the airline. We apologize for the inconvenience.” He was "incredulous" when he received the message. “How could I fly if the state of Victoria was in lockdown and I couldn’t move more than 5km from the house?” he told news.com.au. When he contacted Qantas, the airline claimed “the funds will still remain with the agency that you’ve booked with” and to contact them directly for a refund. McGregor told news.com.au the ordeal was “utterly disgraceful” and that he was unaware if the flight went ahead or not. The publication reportedly contacted Expedia and Qantas and on Tuesday morning they finally said that a refund would be issued, but McGregor said he was yet to be contacted. “For flight bookings at Expedia, we generally follow the policies of our travel partners, so any refund is determined by the airline,” an Expedia spokeswoman said. “We have looked into this case with Qantas, and we will be contacting the traveller to process the refund.” While a Qantas spokesman said: “We apologise for the extended delay in resolving this issue and are processing a full refund for their bookings.” It is unclear which company held McGregor's funds, which was reported to be around $2,500. Adam Glezer from Consumer Champion told news.com.au that McGregor came to him recently when he felt he had nowhere else to turn. He said that these situations were quite common. “What Kieran has gone through with Expedia and Qantas is extremely common where the third party says the airline has the money and the airline says the third party has the money. I call it the blame game and there’s only one loser out of it and that’s the customer," he said. “Transparency in these situations is of utmost importance and unfortunately it just doesn’t exist.” Images: news.com.au/ DLeng / Shutterstock.com

Travel Trouble

How long does back pain last? And how can learning about pain increase the chance of recovery?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>. Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>. If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups: <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain. Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access. <h2>More pain doesn’t mean a more serious injury</h2> Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease. There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine. Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system. The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement. The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain. <h2>Reduce your chance of lasting pain</h2> Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain: <ul> <li> understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain </li> <li> reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal. </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want. These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover. But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure. When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>. Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community. But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<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/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>. </div>

Body

John Boland’s battle against prostate cancer and the urgent need for reform

John Boland, a 74-year-old retired Navy Reserve Lieutenant Commander, found himself at a crossroads – a place where hope and despair often meet in the lives of those battling life-threatening illnesses like prostate cancer. Diagnosed five years ago, John’s journey has been a relentless fight against a disease that, despite medical advancements, still claims the lives of 10 men in Australia every day. After undergoing surgery and 37 rounds of radiation therapy, John’s battle was far from over. His PSA (Prostate-Specific Antigen) levels, an indicator of prostate cancer activity, were not dropping sufficiently, signalling that the fight was only getting tougher. It was then that John was introduced to a groundbreaking treatment: Lutetium-177 PSMA therapy (LuPSMA), a targeted radionuclide therapy with pinpoint accuracy to attack cancer cells. This innovative treatment offered a glimmer of hope, a chance to strike at the heart of the disease that had disrupted his life. But there was a catch – the cost. Each round of LuPSMA treatment costs $10,000, and while some patients may require up to eight rounds, John’s doctors recommended two based on his response. Even so, the financial burden was immense, forcing John to dip into his superannuation, ultimately spending $60,000 on the treatment that was not covered by insurance. Despite the financial strain, the results were nothing short of miraculous. After just the first round, John’s PSA levels dropped by a staggering 95%. After the second, they fell to nearly zero. The treatment had not only attacked the cancer but had also restored his quality of life, allowing him to once again enjoy the simple pleasures – time with family, daily activities and even golf. It was a victory that brought renewed hope and confidence for the future, a victory that made the $60,000 investment worth every cent. “My case was remarkably successful after the second treatment, which are eight weeks apart, after the scan had no cancer, and my PSA was effective to zero. So it was a reliable result for me and a huge boost, but unfortunately, they're $10,000 a time, and you can require up to eight treatments,” says John. “Fortunately we were able to fund it from our superannuation pension account, the $20,000, but I imagine that a lot of people, they can’t find that $20,000.” But John’s story, while inspiring, also highlights a grim reality: many Australians are not as fortunate. The LuPSMA treatment that worked so well for John remains out of reach for many others due to its prohibitive cost. And this isn’t just an isolated issue; it’s a systemic problem affecting thousands of men across the country. A new report, the <a href="https://www.pcfa.org.au/media/nbennwom/aus-np-1123-80001-amgen-access-gap-report_april-2024-data-final-approved.pdf" target="_blank" rel="noopener">Australian Patient Access Gap Report</a>, has shed light on the alarming delay in the public availability of new medicines in Australia. The report reveals that Australians with life-threatening illnesses are waiting an average of 591 days – more than 18 months – for access to new, potentially life-saving medicines. For some, the wait can be as long as three years. These delays are not just statistics; they represent real people, real lives hanging in the balance. The Prostate Cancer Foundation of Australia (PCFA), the country’s leading organisation in the fight against prostate cancer, is calling for urgent reform. They argue that the current system, which often requires multiple rounds of review before new treatments are approved for public use, is failing Australians. PCFA CEO Anne Savage points out that while 10 men die from prostate cancer every day, the approval process for new treatments drags on, leaving patients like John Boland to fend for themselves – often at great financial and emotional cost. “In almost every instance, Australians are being denied access to new medicines that can extend and save their lives, simply because our approval systems have not kept up with the pace of change,” she says. “In relation to prostate cancer, applications typically undergo two or three rounds of review before achieving a positive recommendation, while 10 men die a day from the disease. It’s simply not good enough.” John’s story serves as a strong call to action. His successful treatment with LuPSMA is a testament to the power of modern medicine, but it also underscores the urgent need for change. No one should have to choose between their life savings and their life; it’s time for Australia to modernise its pharmaceutical benefits scheme, ensuring that all Australians, regardless of their financial situation, have access to the treatments they need. As we move forward, the PCFA is urging Australians to take part in initiatives like <a href="https://www.thelongrun.org.au/" target="_blank" rel="noopener">The Long Run</a> during Prostate Cancer Awareness Month in September, raising awareness and funds to support the fight against this devastating disease. For John Boland, and for the thousands of others who share his struggle, we must work towards a future where no one is left behind in the fight against cancer. Image: Courtesy of John Boland.

Caring

News

Shop

Catalogues

Contests

Entertainment

Travel

Health

Lifestyle

Finance

Property

Games

Information

Keep up to date

Search

How long will you live? New evidence says it’s much more about your choices than your genes

5 years since COVID was declared a pandemic – how prepared are we for the next one?

Centenarian shares the secrets to a long life

Vegemite weighs in on long-lasting Aussie debate

NSW Government refunds millions of Covid fines

Research reveals how long it takes Aussies to save for a holiday

The latest COVID booster will soon be available. Should I get one? Am I eligible?

110-year-old woman reveals the secret to a long life

Man dies after months-long wait for at-home care

Can you die from long COVID? The answer is not so simple

Readers response: What’s your top travel tip for staying comfortable on long journeys?

Lessons for the next pandemic: where did Australia go right and wrong in responding to COVID?

Getting antivirals for COVID too often depends on where you live and how wealthy you are

I have a stuffy nose, how can I tell if it’s hay fever, COVID or something else?

Incredible reason behind Aussie woman's 5,500km outback ride

Snakes are waking up. What should you do if you’re bitten? And what if you’re a long way from help?

Parents under fire for taking their sick toddler on a long-haul flight

"No show": Wild reason couple denied refund on flights scheduled during Covid

How long does back pain last? And how can learning about pain increase the chance of recovery?

John Boland’s battle against prostate cancer and the urgent need for reform

Our Partners