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AstraZeneca admits to Covid vaccine's deadly side effect

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

Legal

Christina Applegate details bout of Covid and Sapovirus amid MS battle

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

Caring

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

<a href="https://theconversation.com/profiles/erik-christian-olstad-1505284">Erik Christian Olstad</a>, <a href="https://theconversation.com/institutions/university-of-california-davis-1312">University of California, Davis</a> Time outside with your dog in the spring, summer and fall can be lovely. Visiting your favorite downtown café on a cool spring morning, going to a favorite dog park on a clear summer evening or going on walks along a river when the leaves are changing color are all wonderful when the weather is favorable. But in much of the country, when winter rolls around, previously hospitable conditions can <a href="https://theconversation.com/is-winter-miserable-for-wildlife-108734">quickly turn chilly and dangerous</a> for people and pups alike. Winter brings some unique challenges for dog owners, since dogs still need activity and socialization during colder seasons. Studies have shown that dog owners are almost 50% less likely to walk their dogs <a href="https://doi.org/10.3390/ani11113302">when the weather gets cold</a>. Knowing the basics of winter safety is critical to maintaining a healthy lifestyle for your dog. I am an <a href="https://www.vetmed.ucdavis.edu/faculty/erik-olstad">assistant professor</a> at the University of California Davis School of Veterinary Medicine who weathered polar vortexes with my dog while living in Michigan early in my career. While I’ve since moved to sunny California, I’ve seen how quickly frigid temperatures can turn dangerous for pets. <h2>Breed and age differences</h2> Not all dogs have the same abilities to deal with cold weather. A short-coated dog like a Chihuahua is much more susceptible to the dangers of cold weather than a thick-coated husky. When the weather dips below 40 degrees Fahrenheit (4 degrees Celsius), the well-acclimated husky may be comfortable, whereas the Chihuahua would shiver and be at risk of hypothermia. Additionally, if your dog is used to warm weather, but you decide to move to a colder region, the dog will need time to acclimate to that colder weather, even if they have a thick coat. Age also affects cold-weather resilience. Puppies and elderly dogs can’t withstand the chill as well as other dogs, but every dog is unique – each may have individual health conditions or physical attributes that make them more or less resilient to cold weather. <h2>When is my dog too cold?</h2> Pet owners should be able to recognize the symptoms of a dog that is getting too cold. Dogs will shiver, and some may vocalize or whine. Dogs may resist putting their feet down on the cold ground, or burrow, or try to find warmth in their environment when they are uncomfortable. Just like people, <a href="https://vcahospitals.com/know-your-pet/frostbite-in-dogs">dogs can get frostbite</a>. And just like people, the signs can take days to appear, making it hard to assess them in the moment. The most common sites for frostbite in dogs are their ears and the tips of their tails. Some of the initial signs of frostbite are skin discoloring, turning paler than normal, or purple, gray or even black; red, blistered skin; swelling; pain at the site; <a href="https://www.britannica.com/science/ulcer">or ulceration</a>. Other <a href="https://vcahospitals.com/know-your-pet/frostbite-in-dogs">serious signs of hypothermia</a> include sluggishness or lethargy, and if you observe them, please visit your veterinarian immediately. A good rule to live by is if it is too cold for you, it is too cold for your dog. Getting your dog a <a href="https://www.cnn.com/cnn-underscored/pets/best-winter-dog-coats-jackets">sweater or jacket</a> and <a href="https://www.akc.org/expert-advice/vets-corner/protect-dogs-paws-snow-ice-salt/">paw covers</a> can provide them with protection from the elements and keep them comfortable. Veterinarians also recommend closely monitoring your dog and limiting their time outside when the temperature nears the freezing point or drops below it. <h2>Road salt dangers</h2> Road salt that treats ice on streets and sidewalks <a href="https://www.cbc.ca/news/canada/kitchener-waterloo/ice-salt-toxic-for-pets-1.5020088">can also harm dogs</a>. When dogs walk on the salt, the sharp, rough edges of the salt crystals can irritate the sensitive skin on their paws. Dogs will often lick their feet when they’re dirty, wet or irritated, and if they ingest any salt doing that, they may face GI upset, dehydration, kidney failure, seizures or even death. Even small amounts of pure salt can <a href="https://www.petpoisonhelpline.com/pet-tips/my-dog-ate-road-salt-will-they-be-okay/">disrupt critical body functions</a> in dogs. Some companies make pet-safe salt, but in public it can be hard to tell what type of salt is on the ground. After walking your dog, wash off their feet or boots. You can also keep their paw fur trimmed to prevent snow from balling up or salt collecting in the fur. Applying a thin layer of petroleum jelly or <a href="https://www.akc.org/expert-advice/lifestyle/how-to-make-your-own-paw-balm-for-winter/">paw pad balm</a> to the skin of the paw pads can also help protect your pet’s paws from irritation. <h2>Antifreeze risks</h2> <a href="https://www.britannica.com/science/antifreeze-chemical-substance">Antifreeze, or ethylene glycol</a>, is in most vehicles to prevent the fluids from freezing when it gets cold out. Some people pour antifreeze into their toilets when away from their home to prevent the water in the toilet from freezing. Antifreeze is an exceptionally dangerous chemical to dogs and cats, as it tastes sweet but can be deadly when ingested. If a pet ingests even a small amount of antifreeze, the substance causes a chemical cascade in their body that results in severe kidney damage. If left untreated, the pet may have <a href="https://www.petpoisonhelpline.com/pet-owner-blog/antifreeze-poisoning/">permanent kidney damage or die</a>. There are safer antifreeze options on the market that use ingredients other than ethylene glycol. If your dog ingests antifreeze, please see your veterinarian immediately for treatment. When temperatures dip below freezing, the best thing pet owners can do is keep the time spent outside as minimal as possible. Try some <a href="https://www.akc.org/expert-advice/lifestyle/great-indoor-games-to-play-with-your-dog/">indoor activities</a>, like hide-and-seek with low-calorie treats, fetch or even an interactive obstacle course. Food puzzles can also keep your dog mentally engaged during indoor time. Although winter presents some unique challenges, it can still be an enjoyable and healthy time for you and your canine companion.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221709/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/erik-christian-olstad-1505284">Erik Christian Olstad</a>, Health Sciences Assistant Professor of Clinical Veterinary Medicine, <a href="https://theconversation.com/institutions/university-of-california-davis-1312">University of California, Davis</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/dog-care-below-freezing-how-to-keep-your-pet-warm-and-safe-from-cold-weather-road-salt-and-more-this-winter-221709">original article</a>.

Family & Pets

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

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

Travel Trouble

How long does immunity last after a COVID infection?

<a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/dr-wesley-freppel-1408971">Dr Wesley Freppel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Nearly four years into the pandemic, Australia, like many other countries, is still seeing large numbers of <a href="https://nindss.health.gov.au/pbi-dashboard/">COVID cases</a>. Some 860,221 infections were recorded around the country in 2023, while 30,283 cases have already been reported in 2024. This is likely to be a significant underestimate, with fewer people testing and reporting than earlier in the pandemic. But the signs suggest parts of Australia are experiencing yet <a href="https://www.abc.net.au/news/2024-01-23/covid-19-case-numbers-from-australia-states-and-territories/103374656">another COVID surge</a>. While some lucky people claim to have never had COVID, many are facing our second, third or even fourth infection, often despite having been vaccinated. You might be wondering, how long does immunity last after a previous infection or vaccination? Let’s take a look at what the evidence shows. <h2>B cells and T cells</h2> To answer this question, we need to understand a bit about how <a href="https://theconversation.com/what-happens-in-our-body-when-we-encounter-and-fight-off-a-virus-like-the-flu-sars-cov-2-or-rsv-207023">immunity</a> to SARS-CoV-2 (the virus that causes COVID) works. After being infected or vaccinated, the immune system develops specific antibodies that can neutralise SARS-CoV-2. B cells remember the virus for a period of time. In addition, the immune system produces memory T cells that can kill the virus, and remain in the blood for some months after the clearance of the infection or a vaccination. A <a href="https://www.science.org/doi/full/10.1126/science.abf4063?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org">2021 study</a> found 98% of people had antibodies against SARS-CoV-2’s spike protein (a protein on the surface of the virus that allows it to attach to our cells) one month after symptom onset. Six to eight months afterwards, 90% of participants still had these neutralising antibodies in their blood. This means the immune system should have recognised and neutralised the same SARS-CoV-2 variant if challenged within six to eight months (if an infection occurred, it should have resulted in mild to no symptoms). <h2>But what about when the virus mutates?</h2> As we know, SARS-CoV-2 has mutated over time, leading to the emergence of new variants such as alpha, beta, delta and omicron. Each of these variants carries mutations that are new to the immune system, even if the person has been previously infected with an earlier variant. A new variant likely won’t be <a href="https://www.science.org/doi/10.1126/science.adj0070">perfectly recognised</a> – or even <a href="https://www.cell.com/cell/pdf/S0092-8674(21)01578-6.pdf">recognised at all</a> – by the already activated memory T or B cells from a previous SARS-CoV-2 infection. This could explain why people can be so readily reinfected with COVID. A recent <a href="https://www.thelancet.com/article/S0140-6736(22)02465-5/fulltext#seccestitle10">review of studies</a> published up to the end of September 2022 looked at the protection conferred by previous SARS-CoV-2 infections. The authors found a previous infection provided protective immunity against reinfection with the ancestral, alpha, beta and delta variants of 85.2% at four weeks. Protection against reinfection with these variants remained high (78.6%) at 40 weeks, or just over nine months, after the previous infection. This protection decreased to 55.5% at 80 weeks (18 months), but the authors noted there was a lack of data at this time point. Notably, an earlier infection provided only 36.1% protection against a reinfection with omicron BA.1 at 40 weeks. Omicron has been described as an <a href="https://www.nature.com/articles/s41564-022-01143-7">immune escape variant</a>. A prior infection showed a high level of protection against severe disease (above 88%) up to 40 weeks regardless of the variant a person was reinfected with. <h2>What about immunity after vaccination?</h2> So far almost 70 million COVID vaccines <a href="https://www.health.gov.au/topics/covid-19/reporting">have been administered</a> to more than <a href="https://www.health.gov.au/resources/publications/covid-19-vaccine-rollout-update-12-january-2023?language=en">22 million people</a> in Australia. Scientists estimated COVID vaccines prevented around <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00320-6/fulltext">14.4 million deaths</a> in 185 countries in the first year after they became available. But we know COVID vaccine effectiveness wanes over time. A <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2804451?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=050323">2023 review</a> found the original vaccines were 79.6% and 49.7% effective at protecting against symptomatic delta infection at one and nine months after vaccination respectively. They were 60.4% and 13.3% effective against symptomatic omicron at the same time points. This is where booster doses come into the picture. They’re important to keep the immune system ready to fight off the virus, particularly for those who are more vulnerable to the effects of a COVID infection. Plus, regular booster doses can provide immunity against different variants. COVID vaccines are constantly being <a href="https://mvec.mcri.edu.au/references/covid-19/">reviewed and updated</a> to ensure optimal protection against <a href="https://www.who.int/activities/tracking-SARS-CoV-2-variants">current circulating strains</a>, with the latest shot available designed to target <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants">the omicron variant XBB 1.5</a>. This is similar to how we approach seasonal flu vaccines. A <a href="https://www.nature.com/articles/s41598-023-50335-6">recent study</a> showed a COVID vaccination provides longer protection against reinfection than natural protection alone. The median time from infection to reinfection in non-vaccinated people was only six months, compared with 14 months in people who had received one, two or three doses of vaccine after their first infection. This is called <a href="https://www.science.org/doi/10.1126/science.abj2258">hybrid immunity</a>, and other research has similarly found it provides better protection than natural infection alone. It also seems timing is important, as receiving a vaccine too soon after an infection (less than six months) appears to be <a href="https://www.nature.com/articles/s41598-023-50335-6">less effective</a> than getting vaccinated later. <h2>What now?</h2> Everyone’s immune system is slightly unique, and SARS-CoV-2 continues to mutate, so knowing exactly how long COVID immunity lasts is complicated. Evidence suggests immunity following infection should generally last six months in healthy adults, and can be prolonged with vaccination. But there are exceptions, and all of this assumes the virus has not mutated so much that it “escapes” our immune response. While many people feel the COVID pandemic is over, it’s important we don’t forget the lessons we have learned. Practices such as wearing a mask and staying home when unwell can reduce the spread of many viruses, not only <a href="https://www.bmj.com/content/375/bmj-2021-068302">COVID</a>. Vaccination is not mandatory, but for older adults eligible for a booster under the <a href="https://www.health.gov.au/news/atagi-update-on-the-covid-19-vaccination-program">current guidelines</a>, it’s a very good idea.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221398/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, Research Leader in Virology and Infectious Disease, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/dr-wesley-freppel-1408971">Dr Wesley Freppel</a>, Research Fellow, Institute for Glycomics, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-immunity-last-after-a-covid-infection-221398">original article</a>.

Body

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

<a href="https://theconversation.com/profiles/andrew-baillie-646956">Andrew Baillie</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/amelia-gulliver-17440">Amelia Gulliver</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>; <a href="https://theconversation.com/profiles/lena-sanci-523666">Lena Sanci</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/lucette-cysique-1495512">Lucette Cysique</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/philip-britton-1127089">Philip Britton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> EG.5 or the Eris COVID variant is dominant in parts of <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Documents/respiratory-surveillance-20231202.pdf">Australia</a>. Eris, along with other circulating strains, are descendants of Omicron. While these strains appear less severe than the original Alpha and Delta variants, the risk of long COVID remains. So what does the latest data say about the chance of long COVID? What symptoms should you look out for? And what can be done to support people with long COVID? <h2>When COVID becomes ‘long COVID’</h2> For most people, long COVID means not getting better after a COVID infection. The World Health Organization <a href="https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1">defines long COVID</a> as continuing or new symptoms at least three months from the start of a COVID infection that last at least two months and cannot be explained by an alternative diagnosis. The most <a href="https://link.springer.com/article/10.1007/s10654-022-00962-6">common symptoms</a> include fatigue, brain fog, breathlessness, headaches and abdominal pain. But people with long COVID can experience <a href="https://www.sciencedirect.com/science/article/pii/S1684118222001864?via%3Dihub">a wide range</a> of problems including cardiovascular issues, mental health problems such as depression and anxiety, insomnia, muscle and joint pain, and gastrointestinal problems. <h2>How common is long COVID?</h2> Australian data on long COVID <a href="https://www.mja.com.au/journal/2023/218/10/long-covid-australia-achieving-equitable-access-supportive-health-care">remains limited</a> compared to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm">international data</a>, and estimates of its prevalence have varied. A report from Australia’s parliamentary inquiry into long COVID, <a href="https://parlinfo.aph.gov.au/parlInfo/download/committees/reportrep/RB000006/toc_pdf/SickandtiredCastingalongshadow.pdf">published in April</a>, suggested 2%-20% of people may develop long COVID following an infection. A recent Australian study conducted when vaccines were widely available indicates earlier Omicron variants <a href="https://doi.org/10.3390/ijerph20186756">saw 10% of people</a> who caught COVID develop long COVID. Another recent study, yet to be peer-reviewed, found <a href="https://www.medrxiv.org/content/10.1101/2023.08.06.23293706v1">18.2%</a> of those infected went on to have long COVID. The wide-ranging estimates are likely to be because of different COVID variants, differences in vaccination, and different long COVID definitions and assessment methods. The risk is lower in children. One Australian study indicated persistent symptoms in <a href="https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00124-3/fulltext">8% of children</a> who had COVID in 2020, while <a href="https://www.medrxiv.org/content/10.1101/2023.03.14.23287239v1">preliminary research</a> points to a slightly lower risk among children infected in 2021. But more research is needed, especially as the virus continues to evolve. This can be complicated because typical long COVID symptoms are common to many other health problems. As in other countries, more research is now underway <a href="https://www.apprise.org.au/broad-research-area/insights-into-long-covid/">in Australia</a> to determine the accurate prevalence of the condition using a definition and methods that carefully exclude other causes. Although research on long COVID risk factors with new variants is ongoing, we expect being female, having more severe initial disease and having other health conditions will <a href="https://doi.org/10.1001/jamainternmed.2023.0750">increase a person’s chance</a> of getting long COVID. <h2>What’s different this time?</h2> Research shows COVID vaccines offer <a href="https://www.mdpi.com/1660-4601/19/19/12422">protection</a> against long COVID. As well as vaccinations, immunity from previous COVID infections and antiviral treatments are contributing to less severe COVID and potentially <a href="https://theconversation.com/could-antivirals-reduce-your-risk-of-long-covid-where-the-research-is-up-to-on-prevention-and-treatment-216529">less long COVID</a> than we saw earlier in the pandemic. But while the Omicron waves may lead to <a href="https://www.smh.com.au/national/newer-virus-strains-less-likely-to-cause-long-covid-20231123-p5emag.html">fewer cases of long COVID</a> than the earlier Alpha and Delta variants, because so many Australians are contracting COVID, this will still result in a large number of people with long COVID. And each <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00015-eng.htm">repeat infection</a> presents a new risk of prolonged symptoms. <h2>Long COVID can affect all aspects of life</h2> Long COVID can <a href="https://doi.org/10.1093/ije/dyad033">impact</a> a person’s life in many ways. Fatigue following exertion, brain fog and other symptoms can reduce capacity to perform tasks such as concentrating at a computer, manual labour, and even normal household tasks. Many people with long COVID submitted evidence to the recent <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/LongandrepeatedCOVID/Report/Chapter_4_-_Lived_experiences_of_long_COVID">parliamentary inquiry</a> that they were unsupported, stigmatised, isolated, and not taken seriously by health professionals. Evidence suggests many symptoms <a href="https://www.thelancet.com/journals/lanepe/article/PIIS2666-77622200250-2/fulltext">will improve</a> in most people over <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00138-4/fulltext">12 to 18 months</a>, although recovery time can differ between symptoms. Some, including gastrointestinal and respiratory symptoms, tend to <a href="https://www.nature.com/articles/s41579-022-00846-2">resolve sooner than others</a>, such as cognitive symptoms. <h2>I think I have long COVID, what can I expect from my doctor?</h2> Long COVID is the kind of challenge Australia’s <a href="https://dx.doi.org/10.5694/mja2.51950">health system finds most difficult</a>. GPs are stretched and the small number of specialist <a href="https://www.abc.net.au/news/2023-12-12/long-covid-clinics-are-closing-as-us-clinic-expands/103186272">long COVID clinics</a> are struggling to maintain funding. Australia has trailed behind the US, the UK and Europe in rolling out care for long COVID, and in collecting data on the condition. As a result, support for long COVID in Australia is <a href="https://doi.org/10.3389/phrs.2023.1606084">hard to access</a>, expensive and patchy. However, there is consensus on what constitutes good care. Clinicians seeing patients with possible long COVID should: <ul> <li> validate the person’s experience of symptoms and the impact their symptoms are having on their functioning, particularly when the cause is not clear </li> <li> diagnose and treat any other health conditions that are part of the picture </li> <li> support people to minimise the impairment their symptoms cause by pacing of physical and cognitive activities. Importantly, this doesn’t involve pushing through fatigue. </li> </ul> These steps are not a cure but they may improve a person’s ability to function in their day-to-day life, at work and to fulfil their caring responsibilities. <h2>We still need to focus on reducing COVID transmission</h2> The best way to prevent long COVID is to avoid contracting – and spreading – COVID. This means: <ul> <li> getting vaccinated or boosted, if you’re eligible </li> <li> staying home if you feel unwell </li> <li> wearing a mask to protect yourself and vulnerable community members </li> <li> testing for COVID if you have symptoms and if you test positive, taking antivirals (if eligible) and isolating until your symptoms resolve. </li> </ul> Long COVID is not going away, but we all have a role to play in preventing and responding to it. Ruby Biezen from the APPRISE Network and the University of Melbourne and Andrew Lloyd from the Kirby Institute at UNSW contributed to this article.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/218808/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-baillie-646956">Andrew Baillie</a>, Professor of Allied Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/amelia-gulliver-17440">Amelia Gulliver</a>, Senior Research Fellow, ANU College of Health and Medicine, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a>; <a href="https://theconversation.com/profiles/lena-sanci-523666">Lena Sanci</a>, Professor, Department of General Practice and Primary Care, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/lucette-cysique-1495512">Lucette Cysique</a>, Senior Research Fellow, Viral Immunology Systems Program, The Kirby Institute, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>, and <a href="https://theconversation.com/profiles/philip-britton-1127089">Philip Britton</a>, Associate Professor, Child and Adolescent Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-have-covid-how-likely-am-i-to-get-long-covid-218808">original article</a>.

Body

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

<a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/anne-quain-12802">Anne Quain</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Cats kept indoors can <a href="https://safeandhappycats.com.au/">live a good life</a> when they get access to a variety of positive experiences. Examples include performing natural behaviours, feeling safe at home and using their full sensory capabilities, including their sense of smell. Plants such as catnip, cat thyme and silver vine are potent smelly stimulants that can affect cat minds and moods. Ever wondered if these mind-altering substances are safe gifts for our feline friends? And importantly, is it OK to provide these, or is offering catnip to a cat like offering alcohol to a child? <h2>Catnip, cat thyme and silver vine, oh my!</h2> Owners who are concerned about their cats feeling bored and frustrated might offer them fresh or dried catnip (Nepeta cataria), silver vine (Actinidia polygama), cat thyme (Teucrium marum) or other plant materials such as valerian (Valeriana officinalis) and Tatarian honeysuckle (Lonicera tatarica). These last couple <a href="https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-017-0987-6">could offer an alternative</a> if your cat doesn’t respond to catnip. Toys filled with the leaves or extracts of these plants can cause apparently euphoric behaviour in domestic cats (as well as big cats like leopards and jaguars). Not all cats respond this way to these smells, which is <a href="https://bmcbiol.biomedcentral.com/articles/10.1186/s12915-022-01369-1">believed to have a genetic basis</a>. <h2>Are these treats safe for cats?</h2> Cats have a highly developed sense of smell. Some plants release chemical compounds to deter insects or to attract predators of insects that might otherwise destroy them. This includes <a href="https://www.science.org/doi/10.1126/sciadv.aba0721">nepetalactone</a>, an ingredient isolated from catnip and silver vine. Indeed, <a href="https://www.science.org/content/article/why-cats-are-crazy-catnip">it has been argued </a> that exposure to nepetalactone leads to an increase in feel-good hormones in cats. It may also act as a <a href="https://www.science.org/doi/10.1126/sciadv.abd9135">natural mosquito repellent</a> (note that it does not repel all mosquitoes and is not effective for flea or tick control). This may be why sniffing catnip, silver vine and some other plants causes cats to roll on their backs and rub their chins, cheeks and bodies on the plants. Other <a href="https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-017-0987-6">observed behaviours</a> include: licking, shaking their head while carrying plant material in their mouth, drooling, kicking the plant material with their hind feet, and a “wavelike” motion of the skin over their backs as muscles contract and relax. These responses <a href="https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-017-0987-6">generally don’t last long</a>, usually seconds to minutes, before cats relax or resume their normal behaviour. Rather than becoming addicted to these substances, cats are more likely to become habituated and desensitised, with the plants having less effect over time. When sniffed, these plants <a href="https://www.cell.com/iscience/fulltext/S2589-0042(23)01925-9">appear</a> to have <a href="https://bmcbiol.biomedcentral.com/articles/10.1186/s12915-022-01369-1">no adverse effects</a> on cats. <figure><iframe src="https://www.youtube.com/embed/yNUz4zQTA1E?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Cats (and a dog!) react to the active compound in catnip and silver vine, nepetalactone.</figcaption></figure> <h2>Is it ethical to alter the minds of our cats?</h2> When considering how to improve the lives of animals we care for, we tend to focus on whether the benefits outweigh the potential harms. Despite some marketing claims that these plants activates the brain’s opioid system, delivering a “natural high” for cats, there is no evidence these substances actually alter the minds of cats in the same way as alcohol or other drugs alter the minds of humans. The marketing of these cat treats as “kitty crack” or “<a href="https://www.meowijuana.com/">meowijuana</a>” and silver vine sticks as “<a href="https://www.nekopiapets.com.au/product-page/joycat-cat-cigarettes-silvervine-stick">kitty cigarettes</a>” is likely to deter some people from offering their cats <a href="https://bmcbiol.biomedcentral.com/articles/10.1186/s12915-022-01369-1">this kind of olfactory stimulation</a>. Unlike offering alcohol to a child, though, the evidence suggests our cats are OK when given access to these treats. These items won’t induce psychosis and won’t lead to addiction or withdrawal symptoms. And we don’t need to worry about our cats operating heavy machinery or making important decisions under the influence of mind-altering substances! Provided they can walk away at any time, it seems reasonable to let them opt in to a fun time. In fact, we harness the power of cats’ sense of smell in other ways by using <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435919/">synthetic feline facial pheromones</a>. This can help reduce fear, anxiety and distress in cats. These substances can come in useful in settings such as multi-cat households or when moving house. <h2>How to make sure your cat has the purr-fect time</h2> Offering a range of smells (olfactory stimulation) is just one way to ensure your cat has a varied and interesting life. Here are some tips: <ul> <li> offer cats choices to interact with treats and toys – don’t force them </li> <li> rotate the toys and experiences on offer, so every day offers something fresh </li> <li> offer items that cats can scratch – scratching posts and corrugated cardboard are popular items </li> <li> if you are concerned your cat has swallowed part of a toy or seems unwell, check in with your vet. </li> </ul> Given the short-lived effects of these plant-based olfactory stimulants on cats, it is important that we <a href="https://www.sciencedirect.com/science/article/abs/pii/S0168159119301054">optimise their environment, lifestyle and interactions</a> with humans to improve their welfare. We can’t just rely on catnip or silver vine to give our cats a good life indoors – it’s really up to us!<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/214947/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, Research Fellow, Animal Welfare Science Centre, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/anne-quain-12802">Anne Quain</a>, Senior Lecturer, Sydney School of Veterinary Science, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/are-catnip-and-treats-like-it-safe-for-cats-heres-how-they-affect-their-minds-and-moods-214947">original article</a>.

Family & Pets

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

<a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> We’re currently navigating <a href="https://www.thenewdaily.com.au/life/health/2023/11/15/covid-australia-eighth-wave">an eighth wave</a> of <a href="https://theconversation.com/were-in-a-new-covid-wave-what-can-we-expect-this-time-216820">COVID infections</a> in Australia. However the threat COVID poses to us is significantly less than it has ever been, thanks to immunity we’ve acquired through <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00801-5/fulltext">a combination</a> of prior infection and vaccination. That said, COVID is by no means behind us. The threat of severe illness remains higher for many people, and we’re all potentially at risk of developing <a href="https://www.health.gov.au/topics/covid-19/long-covid">long COVID</a>. While many people appear to be doing fewer rapid antigen tests (RATs) than they used to – if any at all – with rising cases, and as we head towards the festive season, testing continues to be important. So what do you need to know about testing in this wave? Here are four key questions answered. <h2>1. When should I do a RAT?</h2> There are a few situations where determining your COVID status is important to inform your actions, particularly during an uptick in infections. With more circulating virus, your index of suspicion that you have COVID if you’re experiencing cold-like symptoms should be higher. RATs work best when they’re used to confirm whether you have COVID when you <a href="https://www.tga.gov.au/products/covid-19/covid-19-tests/how-testing-works-covid-19">have respiratory symptoms</a> and are infectious. So the primary use of RATs should be to determine your COVID status when you’re sick. A positive test should prompt you to isolate, and if you’re eligible, to seek antivirals. Testing might also be worthwhile if you’ve come into contact with someone with COVID but you haven’t developed symptoms. If you find you have in fact contracted the virus, you can take steps to avoid spreading it to other people (you can infect others even <a href="https://www.healthline.com/health/what-is-asymptomatic-covid#prevalence">when you’re asymptomatic</a>). This is especially important if you’re going to be socialising in large groups or in contact with people who are vulnerable. Another situation in which to consider testing, particularly at this time of year, is before attending large social gatherings. While the reliability of a RAT is never perfect, do the test as close to the event as possible, because your disease status <a href="https://www.businessinsider.com/omicron-rapid-test-hour-before-party-not-day-before-expert-2021-12">can change quickly</a>. <h2>2. Should I test multiple times?</h2> Yes. RATs are not as sensitive as PCR tests, which is the trade-off we make for being able to do this test at home and <a href="https://www.wsj.com/articles/public-health-officials-pursue-covid-19-tests-that-trade-precision-for-speed-11599562800">getting a rapid result</a>. This means that while if you test positive with a RAT you can be very confident you have COVID, if you test negative, you cannot be as confident that you don’t have COVID. That is, the test may give you a false negative result. Although RATs from different manufacturers have different accuracies, all RATs approved by Australia’s Therapeutic Goods Administration must have a sensitivity of <a href="https://www.tga.gov.au/products/covid-19/covid-19-tests/covid-19-rapid-antigen-self-tests-home-use/covid-19-rapid-antigen-self-tests-are-approved-australia#:%7E:text=For%20rapid%20antigen%20tests%2C%20this,specificity%20of%20at%20least%2098%25.">at least 80%</a>. The way to increase your confidence in a negative result is to do multiple RATs serially – each negative test increases the confidence you can have that you don’t have COVID. If you have symptoms and have tested negative after your first RAT, <a href="https://www.fda.gov/medical-devices/safety-communications/home-covid-19-antigen-tests-take-steps-reduce-your-risk-false-negative-results-fda-safety">the advice</a> is to repeat the test after 48 hours, and potentially a third time after another 48 hours if the second test is also negative. <h2>3. Do RATs detect the latest variants?</h2> Since RATs <a href="https://www.healthdirect.gov.au/covid-19/testing#:%7E:text=Rapid%20antigen%20tests%2C%20or%20RATs,of%20proteins%20of%20the%20virus.">detect particular surface proteins</a> on SARS-CoV-2 (the virus that causes COVID), it’s theoretically possible that as the virus evolves, the reliability of these tests may be affected. However, RATs were designed to detect a part of the virus that is not as likely to mutate, so the hope is these tests <a href="https://www.health.com/do-covid-tests-work-new-variants-7967102">will continue to hold up</a> as SARS-CoV-2 evolves. The performance of RATs is continually being assessed by manufacturers. So far, there’s been no change reported in the ability of these tests to <a href="https://www.ama.com.au/articles/tga-updated-advice-rats-nearing-expiry-and-rats-efficacy-current-strains#:%7E:text=The%20TGA%20has%20received%20evidence,19%20RAT%20post%2Dmarket%20review.">detect the latest variants</a>. <h2>4. Can I rely on expired RATs?</h2> At this point in the pandemic, you might have a few expired tests at the back of your cupboard. Technically the most appropriate advice is to say you should never use a diagnostic test <a href="https://www.tga.gov.au/products/covid-19/covid-19-tests/covid-19-rapid-antigen-self-tests-home-use/covid-19-rapid-antigen-self-tests-are-approved-australia">past its expiry date</a>. As a general principle the performance of a test cannot be guaranteed beyond this date. The risk is that over time the components of the RAT degrade and if you use a test that’s not working optimally, it’s more likely to indicate <a href="https://www.health.com/can-you-use-expired-covid-test-6827970">you don’t have COVID</a> when you actually do, which may have consequences. However, as for all things COVID, the answer is not so black and white. Since these tests were new when they were introduced earlier in the pandemic, manufacturers didn’t have specific data on their performance over time, and so the expiry dates given were necessarily conservative. It’s likely these tests will work beyond the expiry dates on the packet, but just how long and how well they work is a bit of an unknown, so we need to be cautious. The other thing to consider is ensuring you store RATs correctly. Storage instructions should be found on the packet, but the key issue is making sure they’re not exposed to extreme temperatures. In particular, <a href="https://7news.com.au/lifestyle/health-wellbeing/how-to-properly-store-your-at-home-covid-19-rapid-antigen-tests-c-5465412">high temperatures</a> may damage the chemicals in the test which may reduce its sensitivity. <h2>The path from here</h2> Regular upticks in COVID cases are something we’re going to have to get used to. At these times, we should all be a bit more cautious about looking after ourselves and others as we go about our lives. What this looks like will vary for different people depending on their personal circumstances. However, being up to date with <a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">booster vaccinations</a>, having a plan for <a href="https://www.health.gov.au/topics/covid-19/oral-treatments">accessing antivirals</a> if you’re eligible, <a href="https://theconversation.com/with-covid-surging-should-i-wear-a-mask-217902">wearing masks</a> in high-risk settings and testing all continue to play an important role in responding to COVID.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/218016/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, Associate Professor, Epidemiology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-we-still-be-using-rats-to-test-for-covid-4-key-questions-answered-218016">original article</a>.

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

<a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> As the COVID virus continues to <a href="https://pubmed.ncbi.nlm.nih.gov/36680207/">evolve</a>, so does our vaccine response. From <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">December 11</a>, Australians will have access to <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">new vaccines</a> that offer better protection. These “monovalent” booster vaccines are expected to be a <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">better match</a> for currently circulating strains of SARS-CoV-2, the virus that causes COVID. Pfizer’s monovalent vaccine will be <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">available</a> to eligible people aged five years and older. The Moderna monovalent vaccine can be used for those aged 12 years and older. Who is eligible for these new boosters? How do they differ from earlier ones? Do they work? Are they safe? <h2>Who’s eligible for the new boosters?</h2> The federal government has accepted the Australian Technical Advisory Group (ATAGI) recommendation to use the new vaccines, after Australia’s regulator <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">approved their use last month</a>. However, vaccine eligibility has remained the same since September. ATAGI <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">recommends</a> Australians aged over 75 get vaccinated if it has been six months or more since their last dose. People aged 65 to 74 are recommended to have a 2023 booster if they haven’t already had one. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=315&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=315&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=315&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=396&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=396&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=396&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>For people without risk factors. <a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></figcaption></figure> Adults aged 18 to 64 with underlying risk factors that increase their risk of severe COVID are also recommended to have a 2023 booster if they haven’t had one yet. And if they’ve already had a 2023 booster, they can consider an additional dose. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=311&fit=crop&dpr=1 600w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=311&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=311&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=391&fit=crop&dpr=1 754w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=391&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=391&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Advice for people with risk factors. <a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></figcaption></figure> For adults aged 18 to 64 without underlying risk factors who have already received a 2023 booster, an additional dose isn’t recommended. But if you’re aged 18 to 64 and haven’t had a booster in 2023, you can consider an additional dose. Additional doses aren’t recommended for children without underlying conditions that increase their risk of severe COVID. A primary course is not recommended for children aged six months to five years without additional risk factors. <h2>Monovalent, bivalent? What’s the difference?</h2> From monovalent The initial COVID vaccines were “monovalent”. They had one target – the original viral strain. But as the virus mutated, we assigned new letters of the Greek alphabet to each variant. This brings us to Omicron. With this significant change, we saw “immune evasion”. The virus had changed so much the original vaccines didn’t provide sufficient immunity. To bivalent So vaccines were updated to target an early Omicron subvariant, BA.1, plus the original ancestral strain. With two targets, these were the first of the “bivalent” vaccines, which were approved in Australia <a href="https://theconversation.com/omicron-specific-vaccines-may-give-slightly-better-covid-protection-but-getting-boosted-promptly-is-the-best-bet-190736">in 2022</a>. Omicron continued to evolve, leading to more “immune escape”, contributing to repeated waves of transmission. The vaccines were updated again in <a href="https://theconversation.com/havent-had-covid-or-a-vaccine-dose-in-the-past-six-months-consider-getting-a-booster-199096">early 2023</a>. These newer bivalent vaccines target two strains – the ancestral strain plus the subvariants BA.4 and BA.5. Back to monovalent Further changes in the virus have meant our boosters needed to be updated again. This takes us to the recent announcement. This time the booster targets another subvariant of Omicron known as XBB.1.5 (sometimes known as <a href="https://theconversation.com/the-kraken-subvariant-xbb-1-5-sounds-scary-but-behind-the-headlines-are-clues-to-where-covids-heading-198158">Kraken</a>). This vaccine is monovalent once more, meaning it has only one target. The target against the original viral strain has been removed. According to advice given to the World Health Organization <a href="https://www.who.int/news/item/18-05-2023-statement-on-the-antigen-composition-of-covid-19-vaccines">in May</a>, this is largely because immunity to this original strain is no longer required (it’s no longer infecting humans). Raising immunity to the original strain may also hamper the immune response to the newer component, but we’re not sure if this is occurring or how important this is. The United States <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">approved</a> XBB.1.5-specific vaccines from Pfizer and Moderna in <a href="https://www.fda.gov/news-events/press-announcements/fda-takes-action-updated-mrna-covid-19-vaccines-better-protect-against-currently-circulating">mid-September</a>. These updated vaccines have also been <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">approved in</a> places including Europe, Canada, Japan and Singapore. In Australia, the Therapeutic Goods Administration (TGA) approved them <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">in October</a>. <h2>Do these newer vaccines work?</h2> Evidence for the efficacy of these new monovalent vaccines comes from the results of research <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2023-PI-02409-1&d=20231117172310101">Pfizer</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">Moderna</a> submitted to the TGA. Evidence also comes from a <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">preprint</a> (preliminary research available online that has yet to be independently reviewed) and an update Pfizer <a href="https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-09-12/10-COVID-Modjarrad-508.pdf">presented</a> to the US Centers for Disease Control. Taken together, the available evidence shows the updated vaccines produce good levels of antibodies in <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">laboratory studies</a>, <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">in humans</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">mice</a> when compared to previous vaccines and when looking at multiple emerging variants, including EG.5 (sometimes known as <a href="https://theconversation.com/the-who-has-declared-eris-a-variant-of-interest-how-is-it-different-from-other-omicron-variants-211276">Eris</a>). This variant is the one causing high numbers of cases around the world currently, including in Australia. It is very similar to the XBB version contained in the updated booster. The updated vaccines should also cover <a href="https://theconversation.com/how-evasive-and-transmissible-is-the-newest-omicron-offshoot-ba-2-86-that-causes-covid-19-4-questions-answered-212453">BA.2.86 or Pirola</a>, according to <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">early results</a> from clinical trials and the US <a href="https://www.cdc.gov/respiratory-viruses/whats-new/covid-19-variant.html">Centers for Disease Control</a>. This variant is responsible for a rapidly increasing proportion of cases, with case numbers growing <a href="https://twitter.com/BigBadDenis/status/1725310295596560662?s=19">in Australia</a>. It’s clear the virus is going to continue to evolve. So performance of these vaccines against new variants will continue to be closely monitored. <h2>Are they safe?</h2> The <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2023-PI-02409-1&d=20231117172310101">safety</a> of the updated vaccines has also been shown to be similar to previous versions. Studies <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">comparing them</a> found no significant difference in terms of the adverse events reported. Given the availability of the updated vaccines, some countries have removed their approval for earlier versions. This is because newer versions are a closer match to currently circulating strains, rather than any safety issue with the older vaccines. <h2>What happens next?</h2> The availability of updated vaccines is a welcome development, however this is not the end of the story. We need to make sure eligible people get vaccinated. We also need to acknowledge that vaccination should form part of a comprehensive strategy to limit the impact of COVID from now on. That includes measures such as mask wearing, social distancing, focusing on ventilation and air quality, and to a lesser degree hand hygiene. Rapidly accessing antivirals if eligible is also still important, as is keeping away from others if you are infected.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/217804/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, Professor, Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">original article</a>.

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"32 years of safe landings": Pilot's surprise speech reduces passengers to tears

A pilot has brought his passengers to tears with an emotional speech on his final flight after 32 years in the skies. Jeff Fell, an American Airlines pilot, took off from Chicago on his retirement flight as he stood in front of his passengers and delivered a heartfelt message. At first, his message seemed routine, informing travellers of the weather and and flight time, before acknowledging it was strange for him to deliver the address from outside the cockpit. “I normally don’t stand up in front of everybody like this, I usually just stay in the cockpit and talk on the PA. If I get a little emotional please forgive me for that,” he said in the speech, which was captured on video by a passenger. With passengers still unaware of what was to come, he pointed out a group of “very important people” to him sitting at the back of the plane. “They’re the majority of my family who have come along with me on my retirement flight,” Mr Fell said. The plane was filled with applause as the pilot's voice wavered with emotion. “They’re on-board with me on my retirement flight after 32 years with American,” he said. He continued, fighting back tears, “Thank you all for coming along with me tonight and celebrating this very memorable time in my life. I love all of you." With another round of applause from his passengers, Mr Fell added:, “I didn’t want to get emotional but goodness gracious.” “Finally, for my wonderful wife Julie who has been at my side for the majority of my 32 years at American. She has been the rock, the solid rock in the foundation in our lives and our marriage. Her faith in the Lord, wisdom, strength and love has guided our marriage and family throughout these years. I love you and look forward to the next chapter in our lives. And welcome aboard everybody.” The video was uploaded to TikTok and has since gone viral, raking up millions of views, and you can watch the full video <a href="https://www.tiktok.com/@realjharrison/video/7299484162648509738" target="_blank" rel="noopener">here</a>. Thousands of social media users left comments of support, with many confessing the clip had brought them to tears. “As soon as he said retirement flight my tears came,” one person wrote, while another added, "32 years of safe landings also. God bless him and all pilots.” “To think of the amount of families, people, and cultures he has single-handedly connected throughout the world. Thank you!” penned a third person. “32 years of bringing people closer together. I’m crying!” agreed another. Image credits: TikTok

International Travel

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

<a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Dual outbreaks of <a href="https://www.abc.net.au/news/2023-11-12/grand-princess-ship-adelaide-covid-19-gastroenteritis/103095704">gastro and COVID</a> on the Grand Princess cruise ship that docked in Adelaide on Monday <a href="https://www.theguardian.com/australia-news/2023/nov/13/grand-princess-cruise-ship-covid-gastro-outbreak-docks-adelaide-south-australia">have now been declared over</a> by the <a href="https://www.canberratimes.com.au/story/8421009/cruise-ship-doctor-declares-dual-virus-outbreaks-over/">doctor on board</a>. A spokesperson for Princess Cruises, which operates the ship, said a number of passengers had presented with symptoms <a href="https://www.9news.com.au/national/grand-princess-no-double-covid19-gastro-outbreak-on-ship-cruise-line-says/5d02d423-3289-4a2b-a580-1ed565b78027">on a previous voyage</a>. But the ship has since been disinfected and the number of people who were ill when the ship arrived into Adelaide was said to be in single digits. While this is positive news, reports of infectious outbreaks on cruise ships evoke a sense of deja vu. We probably all remember the high-profile COVID outbreaks that occurred on cruise ships in 2020. So what is it about cruise ships that can make them such hotspots for infection? <h2>First, what causes these outbreaks?</h2> Respiratory infectious outbreaks on cruise ships may be caused by <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/air-land-sea/cruise-ship-travel">a range of pathogens</a> including SARS-CoV-2 (the virus that causes COVID) and influenza viruses. These can be spread by <a href="https://www.pnas.org/doi/10.1073/pnas.2015482118">respiratory droplets and aerosols</a> released when people breathe, talk, laugh, cough and sneeze. Historically, <a href="https://jmvh.org/article/the-navy-and-the-1918-19-influenza-pandemic/">troop transport ships</a> also helped to spread the lethal 1918 flu virus between continents. Gastro outbreaks on cruise ships are similarly well documented. More than 90% of cruise ship gastro outbreaks are caused by <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/air-land-sea/cruise-ship-travel#infectious">norovirus</a>, which is spread from person to person, and through contaminated objects or contaminated food or water. Gastro can also be caused by other pathogens such as <a href="https://wwwnc.cdc.gov/travel/yellowbook/2024/air-land-sea/cruise-ship-travel">bacteria in contaminated food or water</a>. <h2>What is the risk?</h2> In 2020, around 19% of <a href="https://www.bmj.com/content/369/bmj.m1632">Diamond Princess</a> passengers and crew docked in Japan tested positive to COVID. Ultimately, nearly one in four <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739343/">Ruby Princess</a> passengers and crew docked in Sydney tested positive. However, COVID generally presents a lesser risk nowadays, with most people having some level of immunity from vaccination or previous infection. The outbreak on the Grand Princess appears to have been much smaller in scale. A <a href="https://www.sciencedirect.com/science/article/abs/pii/S1477893916300680">three-year study</a> before COVID of influenza-like illness (which includes fever), acute respiratory illness (which <a href="https://www.cdc.gov/flu/about/glossary.htm">doesn’t require fever</a> to be present) and gastro on cruise ships found these were diagnosed in 32.7%, 15.9% and 17% of ill passengers, and 10.9%, 80% and 0.2% of ill crew, respectively. An <a href="https://www.cdc.gov/mmwr/volumes/70/ss/ss7006a1.htm">analysis</a> of data from 252 cruise ships entering American ports showed the overall incidence of acute gastro halved between 2006 and 2019. Passenger cases decreased from 32.5 per 100,000 travel days to 16.9, and crew cases from 13.5 per 100,000 travel days to 5.2. This decline may be due to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382806/">combination</a> of improved hygiene and sanitation standards. The risk of getting sick with gastro was significantly higher on <a href="https://www.cdc.gov/mmwr/volumes/70/ss/ss7006a1.htm">bigger ships and longer voyages</a>. This is because the longer you are in close contact with others, the greater the chance of exposure to an infectious dose of viruses or bacteria. <h2>Why are cruise ships infection hotspots?</h2> On cruise ships, people tend to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739343/">crowd together</a> in confined spaces for extended periods. These include dining halls, and during social activities in casinos, bars and theatres. The risk goes up when the environment is noisy, as more droplets and aerosols are shed when people are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382806/">laughing, shouting or talking loudly</a>. Passengers may come from <a href="https://www.sciencedirect.com/science/article/abs/pii/S1477893916300680?via%3Dihub">multiple countries</a>, potentially bringing variants from different parts of the world. Influenza, which is usually seasonal (late autumn to early spring) onshore, can occur at any time <a href="https://academic.oup.com/cid/article/31/2/433/295546">on a cruise ship</a> if it has international passengers or is calling at international ports. Human behaviour also contributes to the risk. Some passengers <a href="https://academic.oup.com/jtm/article/15/3/172/1821220">surveyed</a> following cruise ship gastro outbreaks indicated they were ill when they boarded the ship, or they became ill but didn’t disclose this because they didn’t want to pay for a doctor or be made to isolate, or they thought it wasn’t serious. Those who became ill were more likely than those who did not to think that hand hygiene and isolation were not effective in preventing infection transmission, and were less likely to wash their hands after using the toilet. Given <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/norovirus.aspx">faecal contamination</a> is a major source of norovirus transmission, this is concerning. While there are usually a la carte dining options on board, many people will choose a buffet option. From personal experience, food tongs are handled by multiple people, some of whom may not have cleaned their hands. <h2>What can help?</h2> The <a href="https://www.health.gov.au/news/ahppc-statement-advice-to-support-safe-cruising">Department of Health and Aged Care</a> recommends cruise companies encourage crew and passengers to be up-to-date with flu and COVID vaccinations, and encourage anyone who becomes ill to stay in their cabin, or at least avoid crowded spaces and wear a mask in public. They also recommend cruise ships have a plan to identify and contain any outbreaks, including testing and treatment capacity, and communicate to passengers and crew how they can reduce their transmission risk. All passengers and crew should report any signs of infectious illness, and practice good hand hygiene and <a href="https://www.cdc.gov/oralhealth/infectioncontrol/faqs/respiratory-hygiene.html">respiratory etiquette</a>, such as covering their mouth if coughing or sneezing, disposing of used tissues, and washing or sanitising hands after touching their mouth or nose. South Australia’s chief health officer has <a href="https://www.abc.net.au/news/2023-11-13/grand-princess-ship-covid-gastro-docks-in-adelaide/103096836">commended</a> the Grand Princess crew for their infection protection and control practices, and for getting the outbreak under control.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/217534/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, Professor, Nursing, School of Nursing and Midwifery, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/from-covid-to-gastro-why-are-cruise-ships-such-hotbeds-of-infection-217534">original article</a>.

Cruising

What is the OMAD diet? Is one meal a day actually good for weight loss? And is it safe?

<a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> What do British Prime Minister <a href="https://www.sciencefocus.com/the-human-body/one-meal-a-day-diet-omad">Rishi Sunak</a> and singer <a href="https://theconversation.com/one-meal-a-day-diet-popular-with-celebrities-could-do-more-harm-than-good-heres-why-203086">Bruce Springsteen</a> have in common? They’re among an ever-growing group of public figures touting the benefits of eating just one meal a day. As a result, the one meal a day (OMAD) diet is the latest attention-grabbing weight loss trend. Advocates claim it leads to fast, long-term weight loss success and better health, including delaying the ageing process. Like most weight-loss programs, the OMAD diet makes big and bold promises. Here’s what you need to know about eating one meal a day and what it means for weight loss. <h2>The OMAD diet explained</h2> Essentially, the OMAD diet is a type of intermittent fasting, where you fast for 23 hours and consume all your daily calories in one meal eaten within one hour. The OMAD diet rules are presented as simple and easy to follow: <ol> <li> You can eat whatever you want, provided it fits on a standard dinner plate, with no calorie restrictions or nutritional guidelines to follow. </li> <li> You can drink calorie-free drinks throughout the day (water, black tea and coffee). </li> <li> You must follow a consistent meal schedule, eating your one meal around the same time each day. </li> </ol> Along with creating a calorie deficit, resulting in weight loss, advocates believe the OMAD diet’s extended fasting period <a href="https://www.frontiersin.org/articles/10.3389/fphys.2021.771944/full">leads to physiological changes</a> in the body that promote better health, including boosting your metabolism by triggering a process called ketosis, where your body burns stored fat for energy instead of glucose. <h2>What does the evidence say?</h2> Unfortunately, research into the OMAD diet is limited. Most studies have examined its impact on <a href="https://www.cell.com/cell-metabolism/pdf/S1550-4131(18)30512-6.pdf">animals</a>, and the <a href="https://pubmed.ncbi.nlm.nih.gov/35087416/">primary study</a> with humans involved 11 lean, young people following the OMAD diet for a mere 11 days. Claims about the OMAD diet typically rely on research into intermittent fasting, rather than on the OMAD diet itself. There is <a href="https://www.cfp.ca/content/66/2/117.short">evidence</a> backing the efficacy of intermittent fasting to achieve weight loss. However, <a href="https://www.nature.com/articles/s41574-022-00638-x">most studies</a> have focused on short-term results only, typically considering the results achieved across 12 weeks or less. One <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2114833">longer-term study from 2022</a> randomly assigned 139 patients with obesity to either a calorie-restricted diet with time-restricted eating between 8am and 4pm daily, or to a diet with daily calorie restriction alone for 12 months. After 12 months, both groups had lost around the same weight and experienced similar changes in body fat, blood sugar, cholesterol and blood pressure. This indicates long-term weight loss achieved with intermittent fasting is not superior and on a par with that achieved by traditional dieting approaches (daily calorie restriction). <h2>So what are the problems with the OMAD diet?</h2> 1. It can cause nutritional deficiencies and health issues. The OMAD diet’s lack of nutritional guidance on what to eat for that one meal a day raises many red flags. The meals we eat every day should include a source of protein balanced with wholegrain carbs, vegetables, fruits, protein and good fats to support <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071223/">optimum health, disease prevention and weight management</a>. Not eating a balanced diet will result in nutritional deficiencies that can result in poor immune function, fatigue and a decrease in bone density, leading to osteoporosis. Fasting for 23 hours a day is also likely to lead to extreme feelings of hunger and uncontrollable cravings, which may mean you consistently eat foods that are not good for you when it’s time to eat. 2. It’s unlikely to be sustainable. You might be able to stick with the OMAD diet initially, but it will wear thin over time. Extreme diets – especially ones prescribing extended periods of fasting – aren’t enjoyable, leading to feelings of deprivation and social isolation during meal times. It’s hard enough to refuse a piece of office birthday cake at the best of times, imagine how this would feel when you haven’t eaten for 23 hours! Restrictive eating can also lead to an unhealthy relationship with food, making it even harder to achieve and maintain a healthy weight. 3. Quick fixes don’t work. Like other popular intermittent fasting methods, the OMAD diet appeals because it’s easy to digest, and the results appear fast. But the OMAD diet is just another fancy way of cutting calories to achieve a quick drop on the scales. As your weight falls, things will quickly go downhill when your <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766925/">body activates its defence mechanisms</a> to defend your weight loss. In fact, it will regain weight – a response that stems from our hunter-gatherer ancestors’ need to survive periods of deprivation when food was scarce. <h2>The bottom line</h2> Despite the hype, the OMAD diet is unsustainable, and it doesn’t result in better weight-loss outcomes than its predecessors. Our old habits creep back in and we find ourselves fighting a cascade of physiological changes to ensure we regain the weight we lost. Successfully losing weight long-term comes down to: <ul> <li> losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight </li> <li> making gradual changes to your lifestyle to ensure you form habits that last a lifetime. </li> </ul> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-the-omad-diet-is-one-meal-a-day-actually-good-for-weight-loss-and-is-it-safe-207723">original article</a>.

Body

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

<a href="https://theconversation.com/profiles/giulia-vivaldi-1476903">Giulia Vivaldi</a>, <a href="https://theconversation.com/institutions/queen-mary-university-of-london-1745">Queen Mary University of London</a> At least <a href="https://www.nature.com/articles/s41579-022-00846-2">10% of people</a> infected with SARS-CoV-2, the virus that causes COVID, have symptoms that last more than four weeks after the infection. With more than <a href="https://covid19.who.int/">770 million infections</a> to date, this translates to tens of millions of people living with the long-term consequences of COVID, known as “long COVID”. <a href="https://www.nature.com/articles/s41579-022-00846-2">More than 200 symptoms</a> of long COVID have been studied, with some of the most common being fatigue, breathlessness and cognitive difficulties, such as memory problems or “brain fog”. The condition can be debilitating – many people have to <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00387-5/fulltext">reduce their working hours</a> or are <a href="https://ifs.org.uk/publications/long-covid-and-labour-market">unable to work entirely</a>. But COVID may not be alone in causing long-lasting symptoms. In a <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00428-5/fulltext">new paper</a>, my colleagues and I report the findings of a study comparing long-term symptoms reported by people who experienced different types of acute respiratory infection. We asked more than 10,000 people to report on 16 symptoms commonly found in long COVID, such as fatigue, breathlessness, aches and pains, and dizziness. We then compared how common these symptoms were among three groups: people who had reported COVID, those who had reported another acute respiratory infection (but had tested negative for COVID), and those who had not reported either infection. We focused on long-term symptoms by only including people who had been infected more than four weeks earlier. We also took into account people’s general health before they were infected, and whether they had any existing respiratory conditions. Our study showed that all the symptoms considered were more common in people with previous COVID than in people with no infections, regardless of whether they reported long COVID. But this finding wasn’t unique to COVID. Almost all the symptoms we looked at were also more common in people with non-COVID respiratory infections than in those with no infection. In other words, our findings hinted towards the existence of a “long cold”: long-lasting health effects from other respiratory infections, such as colds, flu, or pneumonia, that are currently going unrecognised. Some of the most common symptoms of the long cold include coughing, stomach pain, and diarrhoea. These symptoms were reported an average of 11 weeks after the infection. While a severe initial infection seems to increase the risk of long-term symptoms, our research does not yet tell us why some people suffer extended symptoms while others do not. <h2>Important differences</h2> Importantly, we have no evidence that symptoms of the long cold have the same severity or duration as long COVID. In fact, we saw some important differences in the symptoms reported in the two groups, with those recovering from COVID more likely to experience light-headedness or dizziness and problems with taste and smell. These findings shine a light not only on the impact of long COVID on people’s lives, but also other respiratory infections. A lack of awareness, or even the lack of a common term, such as “long cold” or “long flu”, prevents both reporting and diagnosis of these conditions. And people who do report their long cold may still struggle to get a diagnosis, owing to the wide range of symptoms and <a href="https://www.nature.com/articles/s41591-022-01810-6">lack of diagnostic tests</a>. Long-lasting symptoms after respiratory infections are not a new phenomenon. Studies in survivors of two previous coronavirus outbreaks – the severe acute respiratory syndrome (Sars) pandemic and the Middle East respiratory syndrome (Mers) outbreak – have found long-term impacts on <a href="https://www.rcpjournals.org/content/clinmedicine/21/1/e68">lung function, quality of life and mental health</a>. And some people hospitalised with influenza A have experienced <a href="https://www.nature.com/articles/s41598-017-17497-6">respiratory and psychological problems</a> at least two years after being discharged from hospital. But most of the research so far has focused on people with severe disease, often severe enough to be hospitalised. Little is known about the long-term effects respiratory infections might have among people whose acute disease episode is less severe. Long COVID has bucked this trend, being studied in people with all levels of severity of the initial infection. This is in large part due to <a href="https://www.sciencedirect.com/science/article/pii/S0277953620306456">strong patient advocacy</a>, showing that it can affect even those with mild initial symptoms. In demanding recognition of their condition, people with long COVID have cast a much-needed spotlight on post-infection syndromes more generally. Now is the time to improve our understanding, diagnosis and treatment of these conditions. Let’s not wait for another pandemic.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/214995/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giulia-vivaldi-1476903">Giulia Vivaldi</a>, , <a href="https://theconversation.com/institutions/queen-mary-university-of-london-1745">Queen Mary University of London</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/youve-heard-of-long-covid-but-did-you-know-there-might-also-be-a-long-cold-214995">original article</a>.

Body

10 driving tips to stay safe in wet weather

Driving in the rain? Follow these tips for safe driving in wet weather This should go without saying, but reducing your speed – as long as you continue to keep with the flow of traffic, of course – is imperative when driving in the rain. After all, between the downpour and spray from other vehicles, heavy rain reduces visibility in all directions, and you need more time to react. Keep your distance Driving in the rain can be hazardous, and if ever there is an incident that requires you – or the driver in front you – to brake unexpectedly, you’ll want to have ample stopping distance on wet roads. Avoid heavy breaking While driving in the rain, you may find yourself in situations – whether you’re hydroplaning or finding yourself in a skid – that will tempt you to hit the brakes abruptly. Do your best to curb that impulse. Brakes can be affected greatly by water, losing a bit of their power when wet, which can be disastrous in an emergency. Easing off the brakes, slowing down and maintaining control of your vehicle is your best bet. Keep both hands on the wheel Control is of utmost importance when driving in the rain. After all, you need to be in command of your vehicle should an incident occur, and having both hands on the wheel while driving in the rain (no snacking or fiddling with the radio!) will ensure you can get out of a sticky situation quickly and efficiently. Keep windows from fogging up When driving in rain, windows tend to fog up as a result of the difference in temperatures inside and outside the car and can lead to decreased visibility. To stay safe and avoid accidents, simply press your car’s defrost button to clear-up the window. Turn on your A/C or roll down the windows by a couple of centimetres to remove the humidity from the vehicle and lower the temperature inside the car. If the issue persists, you may want to purchase a windshield cleaner and defogger. Beware of hydroplaning Hydroplaning happens when your car travels above the water without touching the ground. Given that a driver is left with little-to-no grip with the road and, thus, less control, this can be a dangerous set of circumstances. If you find yourself in such a situation, stay calm, ease off the brakes and do not turn your steering wheel; let your car slow down and the tires reattach to the road surface. Avoid puddles Windshield wipers should always be in working condition. Be vigilant about replacing them once per year, or whenever they start to leave streaks on the glass. Having wipers blades in tip-top shape ensures the best possible visibility when driving in the rain. Stay home if you can If you have no choice but to head outside during a heavy downpour, be sure to follow these driving tips. However, if you don’t have anywhere pressing to be, consider staying home and waiting it out until the storm subsides. Keep your headlights on With wet weather often comes fog and overall gloominess. With your surroundings slightly darkened, turning on your headlights ensures that you can see the road in front of you, and that other drivers can see you. Ensure windshield wipers are in working order Windshield wipers should always be in working condition. Be vigilant about replacing them once per year, or whenever they start to leave streaks on the glass. Having wipers blades in tip-top shape ensures the best possible visibility when driving in the rain. Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.co.nz/food-home-garden/home-tips/10-driving-tips-to-stay-safe-in-wet-weather" target="_blank" rel="noopener">Reader's Digest</a>.

Travel Tips

"My brother and I are safe and alive": Lil Tay speaks out

Rising to online stardom at the tender age of nine, rapper Lil Tay, the child prodigy, has defied widespread reports of her demise, as confirmed by her recent statement following a <a href="https://www.oversixty.co.nz/news/news/death-announced-of-child-star-and-her-brother-at-just-14" target="_blank" rel="noopener">death announcement that appeared on her official Instagram page</a>. Speaking to TMZ, the 14-year-old social media sensation expressed her relief, saying: "I want to make it clear that my brother and I are safe and alive, but I'm completely heartbroken, and struggling to even find the right words to say. "It's been a very traumatising 24 hours. All day yesterday I was bombarded with endless heartbreaking and tearful phone calls from loved ones – all while trying to sort out this mess." Those past 24 hours have certainly been harrowing for Lil Tay, having to deal with a barrage of anguished and tearful phone calls from concerned relatives. Lil Tay has come forward to explain that her Instagram account, which initially held 3.3 million followers and now exceeds 3.5 million, was subjected to a hack before the now-deleted misleading announcement was posted. "My Instagram account was compromised by a 3rd party and used to spread jarring misinformation and rumours regarding me, to the point that even my name was wrong. My legal name is Tay Tian, not 'Claire Hope'." Early on the morning of Thursday August 10, a message surfaced on the official Instagram account, proclaiming the "sudden and tragic" passing of the artist – the first post to surface since 2018. In the heartfelt message, it was conveyed, "Words fail to capture the insurmountable void and inexpressible anguish. This outcome took us by complete surprise, leaving us all in a state of disbelief." "We have no words to express the unbearable loss and indescribably pain. This outcome was entirely unexpected, and has left us all in shock." It was also claimed in the statement that Jason Tian, Lil Tay's 21-year-old brother, had also died. "Her bother's passing adds an even more unimaginable depth to our grief," the statement continued. "During this time of immense sorrow, we kindly ask for privacy as we grieve this overwhelming loss, as the circumstances surrounding [Lil Tay] and her brother's passing are still under investigation." "[Lil Tay] will forever remain in our hearts, her absence leaving an irreplaceable void that will be felt by all who knew and loved her." Following the announcement, Variety initially reported Lil Tay's management as confirming her demise. Nonetheless, Insider revealed that Lil Tay's father, Christopher Hope, refrained from commenting on the Instagram post and declined to address queries regarding her current state. During her brief yet impactful three-month presence in the social media landscape, Lil Tay found herself entangled in various controversies, most notably offering an apology after employing a racial slur in one of her videos. Yet, as swiftly as her rise to virtual stardom unfolded, Lil Tay faded from view. Lil Tay's ultimate Instagram post before the now-deleted death notice emerged on June 19, 2018. This post was a tribute to the late rapper XXXTentacion, who tragically lost his life at 20 years old the preceding day. Image: Instagram

News

What is POTS? And how is it related to long COVID?

<a href="https://theconversation.com/profiles/marie-claire-seeley-1364457">Marie-Claire Seeley</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/celine-gallagher-1454881">Celine Gallagher</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> POTS or “postural orthostatic tachycardia syndrome” is a poorly recognised condition we’ve been <a href="https://www.smh.com.au/lifestyle/life-and-relationships/what-is-pots-and-how-is-it-related-to-covid-20230529-p5dc3v.html">hearing more</a> about recently. When people stand up, get out of bed or off the sofa, their heart races and they feel dizzy and fatigued, severely impacting their quality of life. Everyday tasks, such as washing their hair in the shower or working, become challenging because people cannot stay upright. Before COVID, this debilitating condition was not widely talked about. But during the pandemic, we’ve been learning about the strong similarities with long COVID. In fact, our recent research shows more than <a href="https://www.amjmed.com/article/S0002-9343(23)00402-3/fulltext">three-quarters</a> of people with long COVID we studied had POTS. <h2>What triggers it?</h2> <a href="https://onlinelibrary.wiley.com/doi/10.1111/joim.12895">Multiple studies</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/37338634/">including our own</a>, have shown viral infection is the most common trigger for POTS. Then came the pandemic, with <a href="https://covid19.who.int">almost 800 million people</a> infected so far with SARS-CoV-2, the virus that causes COVID. The World Health Organization <a href="https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition">says</a> 10-20% of people infected with COVID are likely to develop long COVID – when unexplained symptoms persist three months or more after the infection. Now, more research is showing how long COVID resembles POTS. Many people with long COVID show similar symptoms. <h2>What we and others have found</h2> Our recent study found <a href="https://www.amjmed.com/article/S0002-9343(23)00402-3/fulltext">nearly 80%</a> of people with long COVID had POTS. In people who had both and were of similar age, symptoms were indistinguishable from those who got POTS from other causes. The people in our study either attended a specialist cardiology clinic for people with POTS or long COVID, or came via a long COVID support group on social media. So we cannot generalise our results to people managing their long COVID at home or with their GP. Earlier this year, a <a href="https://www.nature.com/articles/s41569-023-00842-w">review</a> said about 30% of people with people with “highly symptomatic” long COVID also had POTS. <a href="https://www.onlinecjc.ca/article/S0828-282X(22)01091-1/fulltext">Most (73%)</a> met criteria for POTS and other types of dysfunction of the autonomic nervous system. Taken together, we can conclude that many, but not all, cases of long COVID can be explained by POTS – a condition we’ve known about for years and know how to manage. <h2>What happens if you have POTS?</h2> We suspect some cases of POTS result from a hyper-vigilant immune response to an invading pathogen, such as a virus. This, or another trigger, affects the autonomic nervous system. This part of the nervous system balances a vast array of functions including maintaining blood flow to vital organs, digestion, temperature control, sweating and even sexual function. Even if the autonomic nervous system is marginally disturbed, it leads to the physiological equivalent of anarchy. The simplest of daily tasks – such as washing your hair in the shower – can result in profound symptoms of dizziness, a racing heart, breathlessness, brain fog and general exhaustion. In other research <a href="https://link.springer.com/article/10.1007/s10286-023-00955-9">published</a> earlier this year, we found people with POTS have a poor quality of life – poorer than people with chronic illnesses such as HIV, cancer, or cardiovascular and kidney disease. <h2>A long path to diagnosis</h2> Many patients are also forced to negotiate a diagnostic odyssey littered with tales of disbelief and dismissal by medical professionals, friends and family. Diagnosis can <a href="https://onlinelibrary.wiley.com/doi/10.1111/joim.12895">take years</a>. In our <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/LongandrepeatedCOVID/Submissions">submission</a> to the parliamentary inquiry into long COVID, we shared the experiences of people with POTS symptoms and their frustration at the lack of recognition by the medical profession. One health worker said: "I am a nurse myself and specifically brought up that I believed I had POTS after COVID infection. I was treated like a hypochondriac and told I had anxiety, which was absolutely ludicrous as I had physical symptoms […] I had many presentations to [the emergency department] with no help or diagnosis whatsoever." <h2>We can do better</h2> Prompt diagnosis is vital in the face of what we suspect are rising numbers of newly diagnosed cases associated with long COVID. Although many people with POTS report they were referred to <a href="https://onlinelibrary.wiley.com/doi/10.1111/joim.12895">multiple specialists</a> before they were diagnosed, this is not always necessary. GPs can ask you to do a <a href="https://potsfoundation.org.au/wp-content/uploads/2023/03/NASA-Lean-Test-vFinal.pdf">ten-minute standing test</a> to help diagnose it. They can also exclude other common causes of POTS symptoms, such as lung and heart conditions. There is no known cure for POTS. However, once diagnosed, there are <a href="https://www.ausdoc.com.au/therapy-update/postural-orthostatic-tachycardia-syndrome/">multiple things</a> that can improve and manage the condition. A <a href="https://potsfoundation.org.au/wp-content/uploads/2023/03/Malmo-POTS-Score-vFinal.pdf">questionnaire</a> your GP can give you can help prioritise which symptoms to manage. You then work with your trusted GP to manage these. Increasing fluid and salt intake (under the supervision of your GP), and using full-length compression tights is recommended. These help control heart rate and blood pressure, and reduce dizziness. Avoiding triggers is important. These include avoiding standing still for extended periods, hot showers, large meals high in carbohydrates, and hot environments. Many people also benefit from <a href="https://www.ausdoc.com.au/therapy-update/postural-orthostatic-tachycardia-syndrome/">medicines</a> to help control their blood pressure and heart rate. <h2>How about referral?</h2> If referral to specialist services are required, this can be complex and expensive. There are no specialised clinics for POTS in public hospitals. Instead, POTS is mainly managed in the private sector. Referral options can be overwhelming. People may benefit from referral to a range of health professionals to manage their symptoms, including a physiotherapist, psychologist, occupational therapist or exercise physiologist – ideally ones familiar with POTS. All these barriers means access to diagnosis and treatment largely depends on someone having sufficient money, or being confident enough to navigate the health system. <hr /> If you have symptoms such as those we’ve described, see your GP for assessment. For more information about the condition, see the Australian POTS Foundation <a href="https://potsfoundation.org.au">website</a>, which also <a href="https://potsfoundation.org.au/clinician-directory/">lists</a> doctors and allied health professionals who are “POTS aware”.<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/208280/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/marie-claire-seeley-1364457">Marie-Claire Seeley</a>, PhD Candidate, Australian Dysautonomia and Arrhythmia Research Collaborative, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/celine-gallagher-1454881">Celine Gallagher</a>, Postdoctoral Fellow, Australian Dysautonomia and Arrhythmia Research Collaborative, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-pots-and-how-is-it-related-to-long-covid-208280">original article</a>.

Body

Got no COVID-19 symptoms? A gene mutation might be the reason

<div class="copy"> A global study has unearthed a possible genetic reason why some people infected with the virus that causes COVID-19 show no symptoms. Human leukocyte antigens – or HLAs – are important genes that support immune function in the human body, particularly in identifying viral pathogens. And a particular variation in the HLA-B complex has been found to at least double the likelihood that a person infected with SARS-CoV-2 will be asymptomatic. For people who inherit a copy of the HLA-B15 variant from one parent, there was a 2.4 times greater chance of avoiding symptoms. Homozygous carriers — born with copies of the variant from each parent — were 8.5 times more likely to avoid symptoms. It’s a somewhat common variant among certain ethnicities – about 1 in 10 people with European ancestry are potential carriers – but having the gene is not a guaranteed protector against coronavirus symptoms. The findings, <a href="https://doi.org/10.1038/s41586-023-06331-x" target="_blank" rel="noreferrer noopener" data-type="URL" data-id="https://doi.org/10.1038/s41586-023-06331-x">published</a> in Nature, have emerged from a joint study between researchers at the University of California San Fransisco and Australian institutions including Latrobe University, Monash University and the QIMR Berghofer Centre. The research came about almost by accident. <div class="in-content-area content-third content-right"> </div> Co-lead authors Professor Stephanie Gras from Latrobe and Jill Hollenbach from UCSF first met at a research conference in May 2022 and pooled their resources to track the association of possible gene variations with COVID-19 symptoms. Their teams narrowed a group of 30,000 people with high-quality HLA data to a cohort of about 1,500 unvaccinated people who tested positive for the virus. They then focussed on five locations of interest in the HLA genes while monitoring the emergence of symptoms to determine which variants, if any, might have a greater linkage to being COVID asymptomatic. “The [SARS-CoV-2] virus gets inside cells and ‘presents’ some small part of the virus on the surface via the HLA molecule,” Gras explains. “Those act as a red flag for T cells. The cell sends the signal to the T cell that it has been infected with the virus, and the T cells get activated and kill that [infected] cell. “HLA-B15 can actually present a small part of the spike protein that is very similar between SARS-CoV-2 and seasonal coronaviruses… [that] circulate every year in the population and give us the common cold during winter most of the time. They share some similarities.” The understanding provides a possible application for future treatments. Now an association between the variant and asymptomatic cases has been identified, the Gras and Hollenbach teams have begun to study the interaction between HLA-B15 and the SARS-CoV-2 spike protein at the atomic level. That research is already underway, including at the Australian Synchrotron at the Australian Nuclear Science and Technology Organisation. “We’re doing atomic-level models of proteins to understand the interaction,” Gras says. “We want to compare the T cells within people who are asymptomatic with HLA-B15 and people who are not asymptomatic with HLA-B15. Actually, HLA-B15 is not a magic bullet, you can have it and still have severe COVID.” Image credits: Getty Images </div> <div id="contributors"> <a href="https://cosmosmagazine.com/health/covid/got-no-covid-19-symptoms-a-gene-mutation-might-be-the-reason/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/matthew-agius">Matthew Ward Agius</a>. </div>

Body

Who’s taking COVID antivirals like Paxlovid? Hint: it helps if you’re rich

<a href="https://theconversation.com/profiles/nicole-allard-1349026">Nicole Allard</a>, <a href="https://theconversation.com/institutions/the-peter-doherty-institute-for-infection-and-immunity-2255">The Peter Doherty Institute for Infection and Immunity</a> When it comes to COVID, people living in disadvantaged communities are hit with a triple whammy. First, they’re <a href="https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/covid-19/overview">more likely</a> to get infected, and when sick, are more likely to have serious disease. Second, they’re <a href="https://theconversation.com/first-covid-hit-disadvantaged-communities-harder-now-long-covid-delivers-them-a-further-blow-183908">more likely</a> to develop long COVID. Third, our <a href="https://www.mja.com.au/journal/2023/218/10/access-oral-covid-19-antivirals-community-are-eligibility-criteria-and-systems">recent research</a> suggests they’re less likely to get antivirals and when they do, it’s on average later. We’ve just <a href="https://www.mja.com.au/journal/2023/218/10/access-oral-covid-19-antivirals-community-are-eligibility-criteria-and-systems">published the data</a> to map how disadvantage is linked with access to COVID antiviral drugs you can take at home. Here’s why our findings matter and what we can do to level the playing field for this critical part of Australia’s COVID response. <h2>What we did and what we found</h2> Our team looked at Victorian and national prescribing data trends for the oral antiviral medications eligible Australians can take at home – Paxlovid (nirmatrelvir/ritonavir) and Lagevrio (molnupiravir). My health department colleagues linked data from the Pharmaceutical Benefits Scheme with information from the Victorian health department’s COVID surveillance database. They then matched levels of socioeconomic disadvantage by postcode, according to criteria from the Australian Bureau of Statistics. Their analysis showed people living in the most disadvantaged postcodes were 15% less likely to receive oral antivirals compared with those in the most advantaged postcodes. Those in the most disadvantaged postcodes were supplied with the antivirals on average a day later (three days versus two days) than those in the most advantaged postcodes. There are some limitations to our analysis. Not everyone who tests for COVID reports their positive result. And we suspect there may be more under-reporting of infections in disadvantaged areas. Nevertheless, our findings about the influence of disadvantage on antiviral supply are not surprising. In the United States, there have been <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7125e1.htm?utm">similar results</a>. <h2>Why has this happened?</h2> We know <a href="https://www.health.gov.au/health-alerts/covid-19/treatments/eligibility">early access to antivirals</a>, within the first five days of symptoms starting, is important to reduce the chances of severe disease and hospitalisation in those at risk. So why are people in disadvantaged areas less likely to have access to COVID antivirals? The answers are multiple and complex. Some relate to <a href="https://link.springer.com/article/10.1007/s11069-019-03584-6/tables/1">disadvantage</a> that existed before the pandemic – for instance, poverty, homelessness, lower levels of English or formal education, and being less likely to have a regular GP. Some factors relate specifically to antivirals. For instance, to access antivirals, you first have to know they exist and whether you might be eligible, then know how to access them and when. There may be out-of-pocket costs to see a GP to be assessed, then there’s the cost of filling the prescription, even with a concession card. <h2>How can we address this?</h2> We have an opportunity to address this inequity, whether that’s by addressing social determinants of health more broadly, or specifically related to antivirals access. Equity depends on continuing to address the structural inequalities in our health system that create barriers to people accessing primary health services, and tailoring responses to communities. For instance, earlier in the pandemic we saw funding to house homeless people, provide COVID-related health care to non-English speaking communities, and for people isolated at home. These initiatives need to continue. Other countries have also recognised the need for more equitable access to COVID antivirals. Initiatives have included: <ul> <li> COVID medicine <a href="https://phlgroup.co.uk/our-services/cmdu/">delivery units</a> in the United Kingdom. These identify, triage and arrange for high-risk people to receive antivirals at home </li> <li> <a href="https://covid19.govt.nz/testing-and-isolation/if-you-have-covid-19/medicines-to-treat-covid-19">pharmacists prescribing antivirals</a> in New Zealand, and </li> <li> “<a href="https://aspr.hhs.gov/TestToTreat/Pages/default.aspx#:%7E:text=To%20find%20a%20participating%20Test%20to%20Treat%20site%20near%20you%3A&text=Call%20the%20Centers%20for%20Disease,more%20than%20150%20other%20languages.">test to treat</a>” services in the US. This is where people can get tested, assessed and access antivirals in one spot, in one visit. </li> </ul> <h2>What needs to happen next?</h2> As <a href="https://theconversation.com/were-in-another-covid-wave-but-its-not-like-the-others-206493">COVID waves continue</a>, we must focus on reducing deaths and hospitalisations. Antiviral treatments are part of our armour and equity must drive our response. Our ongoing COVID response should be designed with consumer input, supported by an adequately funded public health system and be data driven. Here’s what needs to happen next: <ul> <li> encourage a tired public to see COVID testing as an important first step to accessing antiviral treatment, and why they should consider treatment </li> <li> address the health care inequality in primary care (for instance, boosting timely access to a GP people can afford to visit) by increasing resourcing in areas where we know there are gaps </li> <li> provide culturally safe health care, delivered in community languages, co-designed with community input </li> <li> evaluate current and future antiviral medications </li> <li> communicate up-to-date information to the public and health professionals about antivirals, particularity GPs </li> <li> access more data on the coverage and equity of antiviral COVID treatments, to help direct us to the gaps in the health system that need to be plugged. </li> </ul> <h2>Why this matters now</h2> For many of us in the past year, COVID has become another “cold” we encounter and may not even bother testing. Yet, we continue to see <a href="https://www.health.gov.au/health-alerts/covid-19/weekly-reporting">deaths and hospitalisations</a> across the country. Serious COVID infections continue to affect our most vulnerable people. These include elderly people, especially those over 80, First Nations people, people living with a disability and people who are socioeconomically disadvantaged. We have a chance to ensure antivirals are used to reduce existing disparities in hospitalisation and death – not to make them worse.<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/207822/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nicole-allard-1349026">Nicole Allard</a>, Post doctoral researcher and medical epidemiologist, <a href="https://theconversation.com/institutions/the-peter-doherty-institute-for-infection-and-immunity-2255">The Peter Doherty Institute for Infection and Immunity</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whos-taking-covid-antivirals-like-paxlovid-hint-it-helps-if-youre-rich-207822">original article</a>.

Caring

Man living in a tent after partner “gave up” on Covid restrictions

A hyper-vigilant man has resorted to living in a “pressurised” tent in a garage to avoid contracting Covid, after his girlfriend relaxed about restrictions. The Aussie man named Jason, who is a self-proclaimed “Covid education activist” caused a stir online after he posted a photo of his unusual sleeping arrangements. The now-viral post shared by Jason featured a picture of the peculiar tent he claims to be sleeping in, with an air purifier sticking out of the door, igniting a firestorm of reactions on Twitter, ranging from agreeance, to humour, to concern. Despite the media storm, Jason defended his decision to maintain strict pandemic precautions, despite never having contracted Covid-19. “This is my bed in the garage because my partner has dropped precautions. I take precautions 100 per cent of the time. Don’t tell me that this hasn’t upended every f**king second of my life,” Jason declared in his original post, which included the image of his extraordinary sleeping arrangement. Taking his precautions to the next level, Jason also revealed that he has experimented with sleeping in a face mask, but he admitted that he found it uncomfortable and could not sleep properly with it. “I’ve tried to sleep in a mask, and I can’t. I know people sleep in CPAP masks all the time, so it’s possible, but I can’t do it,” he shared on Twitter. Despite the flurry of reactions to Jason’s living arrangement, he did receive some support for his precautionary measures, while some even suggested Jason leave his partner, to which he admitted the thought “had occurred to me”. Another Twitter user commended the tent and air filter idea, considering it a cost-effective and potentially effective solution to avoid contracting Covid. “I like the tent+filter idea. It’s cheap and should be effective,” another agreed. A few people shared that they empathised with Jason, and are also maintaining strict pandemic precautions. One person wrote, “Initially didn’t think much of the pic, but this is infuriating. I spend all my salary in-flo mask, enovid (antiviral nasal spray), no social life, so yes, I take precautions 100 per cent of the time.” “I’m sorry you have to live like this. I no longer see my family since they stopped masking,” another added. However, not everyone empathised with Jason’s living arrangements, saying he was being unrealistic about the future of Covid. “I work in senior living, and in the two years we’ve been open, we’ve lost zero to Covid. Even the (85-year-olds) getting it now are mild cases. Why? They’re boosted, so they don’t panic or sleep in a garage,” one commenter explained. “The vaccine is meant to enable you to live normally without worrying. Covid is endemic, so you will be in the tent for the rest of your life, lol.” posted another. In response to the viral post, one Twitter user humorously remarked, “We’re a few years away from a really good documentary on how this virus broke people’s brains.” Image credits: Getty Images / Twitter

Real Estate

Astonishing report identifies Covid’s alleged “patient zero”

A bombshell report has claimed the infamous Covid-19 "patient zero” was a Wuhan scientist carrying out experiments on souped-up coronaviruses. The scientist in question, Ben Hu, was conducting risky tests at the Wuhan Institute of Virology with two colleagues, Ping You and Yan Zhu, the report states. It is understood that all three suffered Covid-like symptoms and required hospital care weeks before China broke the news of the virus outbreak to the rest of the world. The Sun reported that the name of “patient zero" has never been disclosed until now. Many US government officials have now identified the three scientists in a shocking report by journalists Michael Shellenberger and Matt Taibbi. Writing in the Substack newsletter Public, the pair alleged the scientists were experimenting with coronaviruses when they fell ill in 2019. Several experts and intelligence officials have long suspected scientists at the lab accidentally spread the virus during so-called “gain of function” experiments on bat coronaviruses. The naming of “patient zero” could prove to be the smoking gun, only adding to mounting circumstantial evidence of a lab leak. It is unclear who in the US government had the intelligence about the sick lab workers, how long they had it, and why it was not shared with the public. The Australian journalist and Sky News host Sharri Markson spoke to The Sun about the lab leak theory in 2021 and dubbed it an “explosive development”. Jamie Metzl, a former member of the World Health Organisation advisory committee on human genome editing, described it as a possible “game changer”. “It’s a game changer if it can be proven that Hu got sick with Covid before anyone else,” he said. “That would be the ‘smoking gun’. Hu was the lead hands-on researcher in (virologist Shi Zhengli’s) lab.” DRASTIC, an international team of scientists and sleuths attempting to piece together Covid-19’s origins, researched the three scientists in 2021. The Wuhan Institute of Virology’s website lists Hu’s biography showing he was working as an assistant researcher. He was said to be the “star pupil” of virologist Shi Zhengli — the virologist at the lab who became known as “batwoman” for her research on bat coronaviruses. Markson, the author of What Really Happened in Wuhan, said that Hu was running a state-funded project in 2019 to test if new coronaviruses could infect humans. The study involved souping up the viruses and experimenting with them on humanised mice. However, the results were never published and the study’s existence was erased from the internet as Covid-19 was spreading around the globe, which raised suspicion of a possible lab leak. A source told The Sun that footage from 2017 that was aired by Chinese state-run TV showed Hu working in the lab without protective gear. The same video shows scientists from the Wuhan lab searching for bat viruses with inadequate protective gear. Alina Chan, a molecular biologist at MIT and Harvard, told Public, “Ben Hu is essentially the next Shi Zhengli. “He was her star pupil. He had been making chimeric SARS-like viruses and testing these in humanised mice. “If I had to guess who would be doing this risky virus research and most at risk of getting accidentally infected, it would be him.” She noted, “If this info had been made public in May of 2020, I doubt that many in the scientific community and the media would have spent the last three years raving about a raccoon dog or pangolin in a wet market.” US scientist Dr Steven Quay, “He was always my first choice for one of the infected Wuhan Institute of Virology workers but it seemed too simple.” A bill signed by US President Joe Biden in 2023 called for the release of the names of the sick scientists, their symptoms, and whether they had been involved with or exposed to coronavirus research. The US is currently preparing to release previously classified material, which could include the names of the three Wuhan scientists. Earlier in 2023, FBI director Christopher Wray said, “the FBI has for quite some time now assessed that the origins of the pandemic are most likely a potential lab incident in Wuhan”. China has long been accused of attempting to cover up or distort its involvement with Covid-19, but they continue to deny claims. In March 2023, China’s former government scientist confessed the Wuhan lab leak theory shouldn’t be ruled out, sparking uproar in Beijing. Professor George Gao, the former chief of China’s Centre for Disease Control, played a key role in the efforts to trace the origins of Covid-19, insisting scientists should “suspect anything”. Speaking to the BBC Radio 4 podcast Fever: The Hunt for Covid’s Origin, Professor Gao said, “You can always suspect anything. That’s science. “Don’t rule out anything.” Professor Gao retired from the CDC in 2022 after playing a key role in the pandemic response and efforts to find the mysterious origin of the virus. He would have had access to highly classified government information on the outbreak of Covid-19. According to Professor Gao, a formal investigation into the Wuhan Institute of Virology was carried out by a government department. The government scientist claimed the “lab was double-checked by the experts in the field”. Investigators believe scientists were working with the Chinese military to develop a mutant virus and pursue bioweapons just as the pandemic began. The findings followed a team of US investigators who combed through top-secret intercepted communications and research. In 2016, researchers discovered a new fatal type of coronavirus in a mineshaft in Mojiang, Yunnan province. However, they kept it under wraps, with the sample then transported to the Wuhan lab and dubbed as classified work. The virus is the only known immediate relative of Covid-19 known to exist prior to the pandemic. Speaking to The Times, one US investigator said, “The trail of papers starts to go dark. “That’s exactly when the classified program kicked off. “My view is that the reason it was covered up was due to military secrecy related to the army’s pursuit of dual-use capabilities in virological biological weapons and vaccines.” The findings came after a scientist who worked closely with the Wuhan lab claimed the virus was genetically engineered and leaked from the facility. Image credit: Getty

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AstraZeneca admits to Covid vaccine's deadly side effect

Christina Applegate details bout of Covid and Sapovirus amid MS battle

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

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

How long does immunity last after a COVID infection?

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

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

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

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

"32 years of safe landings": Pilot's surprise speech reduces passengers to tears

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

What is the OMAD diet? Is one meal a day actually good for weight loss? And is it safe?

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

10 driving tips to stay safe in wet weather

"My brother and I are safe and alive": Lil Tay speaks out

What is POTS? And how is it related to long COVID?

Got no COVID-19 symptoms? A gene mutation might be the reason

Who’s taking COVID antivirals like Paxlovid? Hint: it helps if you’re rich

Man living in a tent after partner “gave up” on Covid restrictions

Astonishing report identifies Covid’s alleged “patient zero”

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Travel

Health

Lifestyle

Finance

Entertainment

Property

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AstraZeneca admits to Covid vaccine's deadly side effect

Christina Applegate details bout of Covid and Sapovirus amid MS battle

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

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

How long does immunity last after a COVID infection?

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

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

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

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

"32 years of safe landings": Pilot's surprise speech reduces passengers to tears

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

What is the OMAD diet? Is one meal a day actually good for weight loss? And is it safe?

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

10 driving tips to stay safe in wet weather

"My brother and I are safe and alive": Lil Tay speaks out

What is POTS? And how is it related to long COVID?

Got no COVID-19 symptoms? A gene mutation might be the reason

Who’s taking COVID antivirals like Paxlovid? Hint: it helps if you’re rich

Man living in a tent after partner “gave up” on Covid restrictions

Astonishing report identifies Covid’s alleged “patient zero”

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