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What is happening with the COVID-19 vaccine?

<p>Coronavirus cases around the world have now reached over a staggering 20 million, with 737,000 tragically dying from the disease.</p> <p>And the only way to beat the illness is to create a vaccine.</p> <p>But creating a vaccine is no easy feat, as the entire process requires vigorous testing meaning it’s still a long way away.</p> <p>At the moment, there are 139 candidates in the very early stages of pre-clinical trials - which means they’re not ready to be tested on humans.</p> <p>But it’s not all doom and gloom, as there is plenty of positive progress happening.</p> <p>Twenty-five students have moved into Phase One - that means they are doing small-scale safety trials on human volunteers.</p> <p>Seventeen have progressed to Phase Two - which includes expanded safety trials.</p> <p>Phase Three involves large-scale efficacy trials - and right now, there are seven studies around the globe tracking on that level.</p> <p>For those in Phase Three, the vaccine and placebo are tested on thousands of people to ensure it’s safe and to whether or not there are any side effects.</p> <p>“The most promising one is the one in the UK with the Oxford-developed vaccine,” said Professor Peter Collignon.</p> <p>“We need a vaccine that’s about 90-plus per cent effective to really have a big impact.”</p> <p>There are also hopes that a vaccine could be approved as early as Christmas this year.</p> <p>However, Professor Collignon warned that vaccinating enough of the population to climate the virus altogether is the biggest challenge.</p> <p>“If you look at diseases where we’ve been very successful - German measles, for instance - we really still need 90 per cent of the population either having had the infection or be vaccinated to be able to eliminate the disease - in other words, to not have it circulating,” Collignon said.</p> <p>To put that in a global context, we would need close to two billion doses worldwide.</p> <p>Australia also has their own trials underway, with Dr Paul Griffin overseeing Phase One for the University of Queensland’s vaccine and promising Novavax study.</p> <p>Dr Griffin agreed with experts saying people will have to most likely wait till the end of next year before they can get vaccinated.</p> <p>And we’re yet to see how it will be distributed.</p> <p>But Dr Griffin hopes that those who are at most risk - the most vulnerable - will be the first priority.</p> <p>“I would like to think that it’s going to be a bit of a prioritisation process,” Griffin said.</p> <p>“The parts of the world and the populations that derive the greatest benefit would get access first.</p> <p>“What that might look like would be vulnerable populations and the elderly and aged care homes - and perhaps our frontline healthcare workers.”</p>

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Hugh Bonneville’s remarkable transformation

<p><span>Hugh Bonneville has surprised fans after he reappeared from quarantine looking unrecognisable from his old self.</span><br /><br /><span>The beloved <em>Downton Abbey</em> actor made waves when he appeared on UK TV show, The One Show this week in a live cross from his home after months of lockdown due to the coronavirus pandemic.</span><br /><br /><span>Bonneville, 56, also reappeared with a completely new hairstyle which added to his radical transformation.</span></p> <p><img id="__mcenew" src="https://oversixtydev.blob.core.windows.net/media/7837281/hugh-downtown-abbey-1.jpg" alt="" data-udi="umb://media/96410fbfb59448fbba851f1bfad01b2f" /><br /><br /><span>Rocking a trim buzzcut, the actor who plays Robert Crawley, Earl of Grantham in <em>Downton Abbey</em> had some fans and presenters doing a double-take.</span><br /><br /><span>Viewers took to social media to share their shock over seeing Hugh.</span><br /><br /><span>Fans wrote that he was showing off a “major glow up”.</span><br /><br /><span>“Almost didn't recognise Hugh Bonneville on #TheOneShow. Lost so much weight,” one viewer said via social media app Twitter.</span><br /><br /><span>“He looks totally different!” another said</span><br /><br /><span>“Wow, I didn't recognise Hugh Bonneville on #TheOneShow to start with! What a transformation!” gushed a third fan.</span><br /><br /><span>Hughis best known for playing Robert Crawley, Earl of Grantham in hit drama series <em>Downton Abbey.</em></span><br /><br /><span>His other notable roles include Mr Henry Brown in the <em>Paddington</em> movies and Ian Fletcher in the series <em>W1A.</em></span></p>

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New study places postmenopausal women at higher risk of COVID-19

<div class="post_body_wrapper"> <div class="post_body"> <div class="body_text "> <p>A groundbreaking study has found that post-menopausal women with lower levels of estrogen appear to be at higher risk of developing severe coronavirus.</p> <p>The study, which was led by researchers at King's College in London found that higher levels of estrogen may have a protective effect against coronavirus.</p> <p>Estrogen interacts with the immune system in various ways, including how many immune cells are produced and how they respond to infection. </p> <p>Using data from the COVID Symptom Study App, researchers examined the rate of predicted COVID-19 among post-menopausal women, pre-menopausal women taking the combined oral contraceptive pill and post-menopausal women taking hormone replacement therapy.</p> <p>Results were taken from more than 500,000 women in the UK between May 7th and June 15th in 2020.</p> <p>Researchers hypothesised that estrogen could serve as a protectant against COVID-19.</p> <p>The study quickly found postmenopausal women had a higher rate of predicted COVID-19 than other studied women.</p> <p>Women in the 45-50 age group were most likely to be at risk, with reported symptoms of anosmia (inability to smell), fever and a persistent cough.</p> <p>Women who were using the combined oral contraceptive pill between 18-45 had a lower rate of predicted COVID-19 and corresponding reduced frequency of symptoms.</p> <p>The rate of hospitalisation was also significantly lower in this group.</p> <p>Hormone replacement theory in post menopausal women between 50-65 years was associated with an increased rate of predicted COVID-19 but not with hospitalisation. </p> <p>The researchers advised that hormone replacement therapy should be considered with caution due to the lack of information, route of administration as well as duration of treatment.</p> <p>Joint lead author Dr Karla Lee, from King’s College London, said: “We hypothesised that pre-menopausal women with higher estrogen levels would have less severe COVID-19 when compared to women of the same age and BMI who had been through the menopause, and our findings supported this.</p> <p>“Additionally, when we compared a younger group of women on the combined oral contraceptive pill (COCP) with a similar group not taking the COCP, we saw less severe COVID amongst those taking the COCP - suggesting hormones in the COCP may offer some protection against COVID-19.</p> <p>“More research is certainly needed to further our knowledge.”</p> </div> </div> </div>

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Adele shows off incredible new figure in rare post

<p>Adele has shown her support for Beyoncé’s brand-new experimental album<span> </span>Black is King<span> </span>in her latest Instagram post, however her transformation almost overshadowed the sweet sentiment.  </p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/CDWzJe8A5Xz/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/CDWzJe8A5Xz/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Adele (@adele)</a> on Aug 1, 2020 at 11:09am PDT</p> </div> </blockquote> <p>On Friday, Beyoncé’s much-anticipated visual album finally dropped at midnight on Disney+.</p> <p>The 85-minute film which is based on the music of last summer’s The Lion King: The Gift, it is a “a celebratory memoir for the world on the Black experience.”</p> <p>Adele, who is a proud fan of the performer, took to social media to broadcast her excitement.</p> <p>“Thank you Queen for always making us all feel so loved through your art,” she wrote.</p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-permalink="https://www.instagram.com/p/B_1VGc5AsoZ/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="12"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/B_1VGc5AsoZ/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Adele (@adele)</a> on May 5, 2020 at 9:38pm PDT</p> </div> </blockquote> <p>She also wore the same body suit as Beyonce in the album, which showed off her beautiful figure.</p> <p>A beach picture in January surfaced this year, revealing that the artist lost around an estimated 40 kilograms.</p>

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Fit and healthy Melbourne nurse shares unexpected COVID-19 symptom

<p>A young and health nurse who works in the emergency department at the Royal Melbourne Hospital has revealed that she suffered from an unusual symptom before testing positive for coronavirus.</p> <p>Emily Morris, 32, told <a rel="noopener" href="https://www.abc.net.au/news/2020-07-27/more-than-700-victorian-healthcare-workers-with-covid19/12494330" target="_blank" class="_e75a791d-denali-editor-page-rtflink"><em>ABC's 7:30 Report</em></a><em> </em>that she felt a strange pain in her lower legs a week and a half ago.</p> <p>She knew it was different from anything she ever experienced as she was used to being on her feet for hours on end.</p> <p>"I was at work when I developed some aching to my lower legs and I spoke to my manager and she got me tested straight away," she said.</p> <p>She said she self-isolated herself until she got her results 24 hours, which confirmed she had coronavirus.</p> <p>Other common symptoms of COVID-19 include fever, dry cough and tiredness.</p> <p>"I was absolutely devastated. I think that as a health care worker, there is a little bit of shame and stigma around being diagnosed as COVID positive," she said.</p> <p>"I'm young, I'm fit, I'm healthy. I was doing the right things and I got coronavirus."</p> <p>She is now isolating in a government apartment so she doesn't risk exposing her housemates to coronavirus.</p> <p>"I feel terrible. I haven't felt like eating and have difficulty keeping down fluids," she said.</p> <p>Morris suspects she contracted the virus within the community.</p> <p>"I work in the respiratory emergency department, which means that I wear an N95 mask. Then on top of that, I wear a face shield, hair coverings as well as a full length gown," she said.</p> <p>"Considering the high quality of the PPE that we have and the procedures that we have in place, I am very certain that this was a community acquired transmission."</p> <p>Morris is sharing her story and is urging others to follow social distancing measures as well as wearing a mask.</p> <p>"The discomfort that you think you feel wearing [a mask] does not compare to the discomfort that you will experience if you test COVID-positive," Ms Morris warned in a video posted on social media. </p> <p>"[To] become short of breath that even walking from the couch to the toilet is a mammoth effort.</p> <p>"Wear a mask, wash your hands, engage in social distancing. There is nothing more inconvenient and uncomfortable than catching corona. </p> <p>"I can tell you. I know from experience."</p>

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Rebel Wilson sparks controversy after “appalling” stunt

<p><span>Rebel Wilson has been making headlines for her rigorous fitness routine as she works towards her weight loss goal.</span></p> <p><span>But her latest workout has caused outrage after she used wombats instead of dumbbells in a video posted by Sydney Zoo.</span></p> <p><span>While many loved the adorable addition, the World Animal Protection organisation critiqued the star. </span><br /><span>Speaking to </span><em>news.com.au</em><span>, the World Animal Protection expressed their concern and said the native Aussie animal “experience distress when handled by humans” and slammed the actresses “disregard” for their wellbeing.</span></p> <p><span>The video sees Wilson doing “15 kilo squats” while holding a large wombat close to her chest as she faces the camera.</span></p> <p><span>“Wombat squats! Thanks to the team @thesydneyzoo for organizing this fun workout and education sesh about some amazing rescue animals,” the actress wrote to her 8 million followers.</span></p> <p><span>Executive director Simone Clarke said wildlife experts from World Animal Protection were “disappointed” to see the footage.</span></p> <p><span>“We are disappointed to see Rebel Wilson handling Australian wildlife with such disregard for their wellbeing,” she wrote in a statement.</span></p> <p><span>“Wombats are not a photo prop or plaything; they are sentient beings, and experience distress when handled by humans.</span></p> <p><span>She went on to condemn the zoo for allowing the workout content to be filmed.</span></p> <p><span>“It’s appalling that Sydney Zoo endorse this type of promotion – quite frankly they should know better.”</span><br /><span>Some people in the comments shared the same thoughts. </span></p> <p><span>“Is it really needed to grab a hold of a wombat!?!,” one said.</span></p> <p><span>“Yeah....I felt a little uncomfortable for it....,” another responded, while one more weighed in: “(100 per cent) animal exploitation. I thought better of her. Maybe just a silly mistake and not thinking!”</span><br /><span>Rebel has not currently issued a statement on the matter.</span></p>

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Another strange symptom linked to COVID-19

<p><span>Spanish researchers are suggesting there is another symptom of COVID-19 not previously considered.</span><br /><br /><span>Health experts believe rash-like mouth lesions are another side effect of having coronavirus, after 21 patient’s mouths with COVID-19 were examined at Ramon y Cajal University Hospital in Madrid.</span><br /><br /><span>They were investigating whether each patient who had rashes on their skin would determine if they might have enanthem - a rash inside the body on the mucous membrane.</span><br /><br /><span>The study's findings - published in JAMA Dermatology - found six of the patients with skin rash had some form of enanthem in their mouths.</span><br /><br /><span>The patients were aged between 40 and 69 and four of the six were female.</span><br /><br /><span>"This work describes preliminary observations and is limited by the small number of cases and the absence of a control group," researchers wrote in the study.</span><br /><br /><span>"Despite the increasing reports of skin rashes in patients with COVID-19, establishing an etiological diagnosis is challenging.</span><br /><br /><span>“However, the presence of enanthem is a strong clue that suggests a viral etiology rather than a drug reaction, especially when a petechial pattern is observed.”</span><br /><br /><span>Researchers noted many patients suspected or confirmed to have COVID-19 have not had their mouths examined due to the worrying safety concerns around the infection.</span><br /><br /><span>The study noted enanthems were previously found in some Italian COVID-19 patients.</span><br /><br /><span>The mouth lesions join a growing list of strange coronavirus symptoms detected by health experts.</span><br /><br /><span>They follow the discovery of clumsiness disturbance in mental functioning, loss of taste and smell and migraine as odd COVID-19 side effects.</span></p>

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Calls for new COVID symptom to be officially recognised

<p>A skin rash can be the only symptom shown on people infected with COVID-19, a new study has found.</p> <p>Researchers at <a href="https://www.selectscience.net/industry-news/kcl-study-suggests-skin-rash-should-be-considered-the-fourth-key-symptom-of-covid-19/?&amp;artID=51982">King’s College London</a> said skin rashes and ‘COVID fingers and toes’ can occur in the absence of any other symptoms, and should be considered as key diagnostic signs of the virus.</p> <p>Data collected from 336,000 people on the COVID Symptom Study app revealed that 8.8 per cent of people testing positive for the disease in the UK had experienced skin rash.</p> <p>An additional online survey of nearly 12,000 individuals with skin rashes found that 17 per cent of those with COVID-19 reported a rash as their first symptom of the disease. About one in five (21 per cent) of the people who were diagnosed with the virus had rash as their only symptom.</p> <p>The rashes can come in three forms: hive-type rash with itchy, raised bumps; chickenpox-type rash with small, itchy red bumps; and ‘COVID fingers and toes’ with sore, reddish or purplish bumps on fingers or toes.</p> <p>“Many viral infections can affect the skin, so it’s not surprising that we are seeing these rashes in COVID-19,” said Dr Veronique Bataille, consultant dermatologist at King’s College London and the study’s lead author.</p> <p>“However, it is important that people know that in some cases, a rash may be the first or only symptom of the disease. So if you notice a new rash, you should take it seriously by self-isolating and getting tested as soon as possible.”</p> <p>The recognised symptoms of COVID-19 by the <a href="https://www.who.int/health-topics/coronavirus#tab=tab_3">World Health Organisation</a> currently include fever, tiredness and dry cough along with loss of taste or smell, skin rash and discolouration of fingers or toes.</p>

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Mum forced to have all limbs amputated after getting COVID-19

<p>A coronavirus survivor ended up having all of her hands and feet amputated after contracting life-threatening sepsis.</p> <p>Caroline Coster, 58, showed symptoms for coronavirus at the end of March and spent "two horrible weeks" trying to fight off the virus.</p> <p>She initially started to recover, but took a turn for the worse and was diagnosed with a chest infection.</p> <p>After a quick call to her GP, she was rushed to Bedford Hospital in the UK and was told she had developed sepsis.</p> <p>She was placed in a medically induced coma for almost a month, where her heartbroken family were twice told that the hospital was going to withdraw care if Caroline didn't improve.</p> <p>Writing on her blog, Caroline likened her experience of being in a coma to being “trapped in a video game”.</p> <p>“When the game was switched off, so was I,” she wrote.</p> <p>“When the game was switched on, my experience was disembodied white heads coming towards me and telling me ‘Caroline, Caroline, wake up’.”</p> <p>Much to the hospital's surprise, Caroline started to recover with her vitals starting to heal after a month in the coma.</p> <p>However, as she had been in the coma for so long, her limited blood flow was directed to her brain and vital organs. This means her hands and feet had turned black and died.</p> <p>“They were now a source of pain and a hindrance as she could not use them anymore, so had to be amputated,” Her daughter Hannah, 24, wrote.</p> <p>Caroline explained to the<em> BBC</em> that her hands looked like an "Egyptian mummy".</p> <p>“They were black and shrivelled. I was so grateful to have my life that it wasn’t a huge jolt to lose those,” She said.</p> <p>As her family have been forced to fundraise for Caroline to afford the massive amount of adaptions and specialist equipment that she now needs for her daily life, they started a <a rel="noopener" href="https://www.justgiving.com/crowdfunding/caroline-coster" target="_blank" class="_e75a791d-denali-editor-page-rtflink">JustGiving</a> page.</p> <p>“She is at peace with the loss of her hands and feet, as they are not what make her the person she is,” writing on a JustGiving page, Caroline’s daughter Hannah said.</p> <p>“She has faced this challenge with a positivity and determination that few of us could match.</p> <p>“However, the reality is that she will require a huge amount of adaptations and specialised equipment in order to be able to live a normal, independent life, return to hobbies and stay in the home she loves.</p> <p>“Sadly, government and NHS funding for many of the items we need is very limited.</p> <p>“The money raised will go towards lots of things, including adaptations around the home, a bathroom she can use independently, private hand prosthetics, and mobility aids.”</p> <p>In just over a month, Caroline's JustGiving page has raised over $95,246.</p>

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How to stay active and help keep joints strong as you age

<p>If you’ve been working and striving for most of your life, retirement can be a wonderful time to change your lifestyle and pursue new, rewarding endeavours. However, this opportune period often coincides with age-related changes to the body that can hit harder than you expect.</p> <p>One of the most common problems encountered at this transitional stage of life is joint stiffness. Often dismissed or tolerated as “creaking bones”, it nevertheless may lead to a loss of flexibility as we get older – and can even be exacerbated by other factors to become more serious conditions such as osteoarthritis.</p> <p>Taking precautionary steps now may help reduce health risks and could also help with maintaining an active lifestyle going forward.</p> <p><strong>Supporting joint mobility</strong></p> <p>As joints get older, their movement becomes stiffer due to thinning cartilage and decreased lubricating fluid. However, there are some very simple and effective steps you can take to support joint mobility.</p> <p>Aside from exercising and maintaining a healthy weight, maintaining an anti-inflammatory diet can also help keep joint stiffness at bay. <a href="https://seatome.co.nz/blogs/about-inflammation/inflammation-what-is-it-exactly">Chronic inflammation</a>, which can result from the stresses of modern lifestyles and poor diet, may not only affect our energy levels and cognitive ability, but also contribute to conditions such as rheumatoid arthritis and other joint and muscle problems.</p> <p>Eating more dark leafy greens, legumes, healthy fats and cold-water fish and shellfish among others can also help reduce inflammation and improve wellbeing.</p> <p>Supplements are also an incredibly effective way to help complement a healthy diet, with one of the best options found right here on our shores, New Zealand Greenshell Mussels. They have been <a href="https://mro.massey.ac.nz/bitstream/handle/10179/14931/The%20Preventive%20Effects%20of%20Greenshell%20Mussel%20%28Perna%20canaliculus%29%20on%20Early-Stage%20Metabolic%20Osteoarthritis%20in%20Rats%20with%20Diet-Induced%20Obesity.pdf?sequence=1&amp;isAllowed=y">found to successfully reduce symptoms such as cartilage degradation in a recent Massey University study</a>. They are a good source of long-chain omega-3 fatty acids such as EPA and DHA as well as GAGs (glycosaminoglycans), which serve as <a href="https://seatome.co.nz/blogs/about-inflammation/inflammation-joint-health">shock absorbers and lubricant</a> to keep cartilage around joints flexible, elastic and strong.</p> <p>According to Sabrina Tian, research science manager at New Zealand fishing company Sanford, “Greenshell mussels contain many health benefits but are particularly helpful in the management of inflammation, bone loss and cartilage breakdown.”</p> <p><img style="width: 500px; height: 281.25px; display: block; margin-left: auto; margin-right: auto;" src="https://oversixtydev.blob.core.windows.net/media/7836894/stm2.jpg" alt="" data-udi="umb://media/beab7337f17147a2be4d597d44ff7bf2" /></p> <p><strong>Sea To Me</strong></p> <p>Sea To Me* provides the benefits of Greenshell Mussels in a capsule format with the highest quality and sustainability at every step of the process. From coast to capsule, Sea To Me prepares its Greenshell Mussel Powder capsules from start to finish right here in New Zealand.</p> <p>The mussels – rated as one of the world’s most sustainable seafood products by the <a href="http://www.seafoodwatch.org/seafood-recommendations/groups/mussels?type=new-zealand-green&amp;q=Mussels,%20New%20Zealand%20Green&amp;t=green%20l&amp;o=1422637138,1361924471#tab=seafood-watch">Monterey Bay Seafood Watch Programme</a> – are grown and harvested in pristine New Zealand waters before being powdered in a natural flash dry process, encapsulated and packaged – all locally.</p> <p>Two capsules a day of the 100 per cent natural wholefood product can help manage inflammation effectively throughout adult life and allow you to keep doing what you love.</p> <p> Available in selected pharmacies. For more information, visit <a href="https://seatome.co.nz/">Sea To Me</a>.</p> <p><strong><em>This is a sponsored article produced in partnership with </em></strong><a href="https://seatome.co.nz/"><strong><em>Sea To Me</em></strong></a><strong><em>.</em></strong></p> <p><strong><em>*Dietary supplement </em></strong><em>Always read the label and use as directed. If symptoms persist, see your health professional. Dietary Supplements are not a replacement for a balanced diet. </em></p>

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Suspected bubonic plague case leads to epidemic fears

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

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

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

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Family fatally unplugs COVID ventilator to plug-in air cooler

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

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

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

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Coronavirus and asthma: What we know so far

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

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Doctor’s disturbing find in man’s bladder

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

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Scientists around the world are already fighting the next pandemic

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

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

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

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