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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

William Shatner shocks hosts simply by revealing his age

In a world where time ticks mercilessly onward, one man has defied the very essence of ageing: the legendary William Shatner, the man who boldly went where no nonagenarian has gone before. As Shatner prepares to celebrate his 93rd trip around the sun, fans worldwide are scratching their heads in disbelief. The reason? Well, it seems that Captain Kirk himself has stumbled upon the fountain of youth and decided to keep it all to himself. The commotion started when Shatner made a <a href="https://www.tiktok.com/@todayshow/video/7347749279865490734?_r=1&_t=8koli3bKC49" target="_blank" rel="noopener">guest appearance</a> on the US Today Show, looking fresher than a daisy in springtime. Fans took to social media to express their shock, with one incredulous viewer commenting, "Damn, he's still sharp and has his hair. I would never have guessed 93." And another chimed in with, "I would've guessed 67 or 68." Forget "live long and prosper"; it seems the new motto is "live long and confound the heck out of everyone". Even the hosts of the Today Show were left flabbergasted by Shatner's youthful glow. They couldn't resist asking the man himself for his secret to longevity. And what pearls of wisdom did he impart? "Don't tell anybody [your age]." Ah, sage advice indeed. It seems the real secret to ageing gracefully is to maintain an air of mystery. But let's rewind to 2021 when Shatner was grilled by a journalist about whether he'd had any "serious work" done. His response? A witty comeback, of course. "No, have you?" Touché, Shatner, touché. And when pressed further, he simply attributed his youthful appearance to good genes, lots of horseback riding and a healthy dose of bewilderment about the world. Despite his apparent disdain for the number 90 ("It's disgusting," he once declared in an interview), Shatner finds himself hurtling towards the ripe old age of 93 with all the grace and poise of a starship navigating through a meteor shower. And if his recent TV appearance is anything to go by, he's showing no signs of slowing down. So let's all take a leaf out of Shatner's playbook, shall we? If anyone asks for the secret to your eternal youth, just give them that trademark Shatner smirk and say: "It's classified." Images: NBC | Wikimedia | Tik Tok

Body

Longing for the ‘golden age’ of air travel? Be careful what you wish for

<a href="https://theconversation.com/profiles/janet-bednarek-144872">Janet Bednarek</a>, <a href="https://theconversation.com/institutions/university-of-dayton-1726">University of Dayton</a> Long lines at security checkpoints, tiny plastic cups of soda, small bags of pretzels, planes filled to capacity, fees attached to every amenity – all reflect the realities of 21st century commercial air travel. It’s no wonder that many travelers have become nostalgic for the so-called “golden age” of air travel in the United States. During the 1950s, airlines promoted commercial air travel as glamorous: stewardesses served full meals on real china, airline seats were large (and frequently empty) with ample leg-room, and passengers always dressed well. After jets were introduced in the late 1950s, passengers could travel to even the most distant locations at speeds unimaginable a mere decade before. An airline trip from New York to London that could take up to 15 hours in the early 1950s could be made in less than seven hours by the early 1960s. But airline nostalgia can be tricky, and “golden ages” are seldom as idyllic as they seem. Until the introduction of jets in 1958, most of the nation’s commercial planes were propeller-driven aircraft, like the DC-4. Most of these planes were unpressurized, and with a maximum cruising altitude of 10,000 to 12,000 feet, they were unable to fly over bad weather. Delays were frequent, turbulence common, and air sickness bags often needed. Some planes were spacious and pressurized: the <a href="http://everythingnice.org/wp-content/uploads/2009/07/PanAm-cutawayS.jpg">Boeing Stratocruiser</a>, for example, could seat 50 first class passengers or 81 coach passengers compared to the DC-3’s 21 passengers. It could cruise at 32,000 feet, which allowed Stratocruiser to fly above most bad weather it encountered. But only 56 of these planes were ever in service. While the later DC-6 and DC-7 were pressurized, they still flew much lower than the soon-to-appear jets – 20,000 feet compared to 30,000 feet – and often encountered turbulence. The piston engines were bulky, complex and difficult to maintain, which contributed to frequent delays. For much of this period, the old saying “Time to spare, go by air” still rang true. Through the 1930s and into the 1940s, almost everyone flew first class. Airlines did encourage more people to fly in the 1950s and 1960s by introducing coach or tourist fares, but the savings were relative: less expensive than first class, but still pricey. In 1955, for example, so-called “bargain fares” from New York to Paris were the equivalent of just over $2,600 in 2014 dollars. Although the advent of jets did result in lower fares, the cost was still out of reach of most Americans. The most likely frequent flier was a white, male businessman traveling on his company’s expense account, and in the 1960s, airlines – with young attractive stewardesses in short skirts – clearly catered to their most frequent flyers. The demographics of travelers did begin to shift during this period. More women, more young people, and retirees began to fly; still, airline travel remained financially out-of-reach for most. If it was a golden age, it only was for the very few. <figure><iframe src="https://www.youtube.com/embed/bKqQgNZylLw?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Jet planes were introduced in the late 1950s, resulting in shorter flight times. But their ticket prices out of reach for the average traveler.</figcaption></figure> People also forget that well into the 1960s, air travel was far more dangerous than it is today. In the 1950s and 1960s US airlines experienced at least a half dozen crashes per year – most leading to fatalities of all on board. People today may bemoan the crowded airplanes and lack of on-board amenities, but the number of fatalities per million miles flown has dropped dramatically since since the late 1970s, especially compared to the 1960s. Through at least the 1970s, airports even prominently featured kiosks selling flight insurance. And we can’t forget hijackings. By the mid-1960s so many airplanes had been hijacked that <a href="http://www.latinamericanstudies.org/hijackers/flying-high.htm">“Take me to Cuba”</a> became a punch line for stand-up comics. In 1971 <a href="http://nymag.com/news/features/39593/index2.html">D.B. Cooper</a> – a hijacker who parachuted from a Boeing 727 after extorting $200,000 – might have been able to achieve folk hero status. But one reason US airline passengers today (generally) tolerate security checkpoints is that they want some kind of assurance that their aircraft will remain safe. And if the previous examples don’t dull the sheen of air travel’s “golden age,” remember: in-flight smoking was both permitted and encouraged.<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/34177/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/janet-bednarek-144872">Janet Bednarek</a>, Professor of History, <a href="https://theconversation.com/institutions/university-of-dayton-1726">University of Dayton</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/longing-for-the-golden-age-of-air-travel-be-careful-what-you-wish-for-34177">original article</a>.

Travel Trouble

How long does menopause last? 5 tips for navigating uncertain times

<a href="https://theconversation.com/profiles/yvonne-middlewick-1395795">Yvonne Middlewick</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Around half of the world’s population are women or people who menstruate – yet the way their body works can be a mystery, even to them. Most women will experience periods roughly every month, many will go through childbirth and those who live into midlife will experience menopause. While menopause is a significant time of change, it isn’t talked about much, other than as a punchline. This may contribute to keeping it a <a href="https://www.theguardian.com/membership/2019/sep/21/breaking-the-menopause-taboo-there-are-vital-stories-we-should-continue-to-pursue">taboo topic</a>. So, what happens during menopause? How do you know when it is happening to you? And – the thing most women want to know – how long will it last? <h2>What is menopause?</h2> Menopause is <a href="https://www.nia.nih.gov/health/what-menopause">defined</a> as the permanent cessation of menstruation, which is medically determined to be one year after the final menstrual period. After this time women are considered to be postmenopausal. The <a href="https://pubmed.ncbi.nlm.nih.gov/26598775/">average age</a> of “natural menopause” (that is not caused by a medical condition, treatment or surgery) is considered to be around 51 years. However, natural menopause does not occur suddenly. <a href="https://www.researchgate.net/profile/Riitta-Luoto/publication/46425690_Prevalence_of_menopause_symptoms_and_their_association_with_lifestyle_among_Finnish_middle-aged_women/links/5c5704ac458515a4c7553c7b/Prevalence-of-menopause-symptoms-and-their-association-with-lifestyle-among-Finnish-middle-aged-women.pdf">Changes can begin</a> a number of years before periods stop and most often occur in a woman’s 40s but they can be earlier. Changes <a href="https://pubmed.ncbi.nlm.nih.gov/25686030/">can continue</a> for 10 years or more after periods have stopped. Using hormones such as the oral contraceptive pill or hormone intrauterine devices may make it more <a href="https://pubmed.ncbi.nlm.nih.gov/31934948/">difficult to determine</a> when changes start. Menopause that occurs <a href="https://www.womenshealth.gov/menopause/early-or-premature-menopause#:%7E:text=Menopause%20that%20happens%20before%20age,to%20come%20earlier%20than%20usual.">before 45</a> is called “early menopause”, while menopause before 40 is called “premature menopause”. <h2>What about perimenopause?</h2> Various <a href="https://www.menopause.org.au/hp/information-sheets/glossary-of-terms">terms</a> are used to describe this period of change, including “menopause” or “the menopause”, “menopausal transition”, “perimenopause” or “<a href="https://pubmed.ncbi.nlm.nih.gov/12188398/">climacteric</a>”. These terms tend to refer to the period before and after the final menstrual period, when changes are considered to be related to menopause. The difficulty with the definition of menopause is it can only be decided retrospectively. Yet women can experience changes many years before their periods stop (a lead up usually called “perimenopause”). Also, any <a href="https://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S0889854518300627/first-page-pdf">changes noticed</a> may not be associated with menopause (because people might not be aware of what to expect) or changes may be associated with a combination of factors such as stress, being busy or other health issues. <h2>So, what is going on?</h2> Through a feminist lens, menopause can be seen as a <a href="https://www.researchgate.net/publication/354652248_The_volcano_within_a_study_of_women's_lived_experience_of_the_journey_through_natural_menopause">complex and diverse experience</a>, influenced by biological, psychological, social and cultural aspects of women’s lives. However, it is usually viewed from the biomedical perspective. This sees it as a biological event, marked by the <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">decline</a> in ovarian hormone levels leading to a reduction in reproductive function. The female reproductive system operates because of a finely tuned balance of hormones managed by the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466056/#:%7E:text=The%20hypothalamic%2Dpituitary%2Dovarian%20(HPO)%20axis%20must%20be,priming%20the%20endometrium%20for%20implantation.">hypothalamic-pituitary-ovarian axis</a>. International <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340903/">experts</a> have developed a staging system for female reproductive ageing, with seven stages from “early reproductive” years to “late postmenopause”. However, female reproductive hormones do not just affect the reproductive system but <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">other aspects</a> of the body’s function. These include the <a href="https://pubmed.ncbi.nlm.nih.gov/26007613/">neurological system</a>, which is linked to hot flushes and night sweats and disrupted sleep. Hormones may also affect the <a href="https://www.nature.com/articles/nrdp20154">heart and body’s blood circulation</a>, bone health and potentially the <a href="https://www.sciencedirect.com/science/article/pii/S0091302220300418">immune system</a>. Menopausal hormone changes may <a href="https://www.thewomens.org.au/health-information/menopause-information/menopause-symptoms/">cause</a> hot flushes, night/cold sweats, mood swings, sleep disruption and tiredness, vaginal dryness. Medical confirmation of menopausal changes in women over 45 years is based on two biological indicators: vasomotor symptoms (those hot flushes and night sweats again) and an <a href="https://www.womenshealth.gov/menopause/early-or-premature-menopause#:%7E:text=Menopause%20that%20happens%20before%20age,to%20come%20earlier%20than%20usual.">irregular menstrual cycle</a>. In early perimenopause the changes to the menstrual cycle may be subtle. Women may not recognise early indicators, unless they keep a record and know what to watch for. <h2>How long does it last?</h2> The body demonstrates an amazing ability to change over a lifetime. In a similar way to adolescence where long-lasting changes occur, the outcome of menopause is also change. Research suggests it is difficult to give an exact time frame for how long menopausal changes occur – the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085137/">average</a> is between four and eight years. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085137/">Penn Ovarian Ageing Study</a> found 79% of the 259 participants experienced hot flushes starting before the age of 50, most commonly between 45 and 49 years of age. A later report on the same study found one third of women studied experienced <a href="https://womensmidlifehealthjournal.biomedcentral.com/articles/10.1186/s40695-016-0014-2">moderate to severe hot flushes</a> more than ten years after their periods had stopped. A <a href="https://journals.lww.com/menopausejournal/Abstract/2017/03000/Cultural_issues_in_menopause__an_exploratory.11.aspx">2017 study</a> found a small number of women continued to experience hot flushes and other symptoms into their 70s. So overall, the research cannot offer a specific window for perimenopause, and menopause does not appear to mark the end of changes for everyone. <h2>5 tips for uncertain times</h2> Shifts and changes can be recognised early by developing knowledge, paying attention to changes to our bodies and talking about menopause and perimenopause more openly. Here are five tips for moving from uncertainty to certainty: 1. talk to people and find out as much information as you can. The experiences of mothers and sisters may help, for some women there are familial similarities 2. notice any changes to your body and make a note of them, this will help you recognise changes earlier. There are <a href="https://www.redonline.co.uk/wellbeing/a36980118/menopause-apps/">menopause tracking apps</a> available 3. keep a note of your menstrual cycle: start date, duration, flow and note any changes. Again, an app might help 4. if you are worried, seek advice from a GP or nurse that specialises in women’s health. They may suggest ways to help with symptoms or refer to a specialist 5. remember changes are the indicator to pay attention to, not time or your age. Menopause is a natural process and although we have focused here on the time frame and “symptoms”, it can also be a time of freedom (particularly from periods!), reflection and a time to focus on yourself.<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/195211/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <figure><iframe src="https://www.youtube.com/embed/lhosPUwWhfI?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Women speak about their experiences of menopause.</figcaption></figure> <a href="https://theconversation.com/profiles/yvonne-middlewick-1395795">Yvonne Middlewick</a>, Nurse & Lecturer, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan 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-menopause-last-5-tips-for-navigating-uncertain-times-195211">original article</a>.

Body

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

<a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>. Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>. If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups: <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain. Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access. <h2>More pain doesn’t mean a more serious injury</h2> Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease. There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine. Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system. The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement. The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain. <h2>Reduce your chance of lasting pain</h2> Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain: <ul> <li> understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain </li> <li> reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal. </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want. These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover. But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure. When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>. Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community. But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>.

Body

Funding for refugees has long been politicized − punitive action against UNRWA and Palestinians fits that pattern

<a href="https://theconversation.com/profiles/nicholas-r-micinski-207353">Nicholas R. Micinski</a>, <a href="https://theconversation.com/institutions/university-of-maine-2120">University of Maine</a> and <a href="https://theconversation.com/profiles/kelsey-norman-862895">Kelsey Norman</a>, <a href="https://theconversation.com/institutions/rice-university-931">Rice University</a> At least a dozen countries, including the U.S., have <a href="https://news.un.org/en/story/2024/01/1145987">suspended funding to the UNRWA</a>, the United Nations agency responsible for delivering aid to Palestinian refugees. This follows allegations made by Israel that <a href="https://www.wsj.com/world/middle-east/at-least-12-u-n-agency-employees-involved-in-oct-7-attacks-intelligence-reports-say-a7de8f36">12 UNRWA employees participated</a> in the Oct. 7, 2023, Hamas attack. The UNRWA responded by <a href="https://www.reuters.com/world/middle-east/un-palestinian-refugee-agency-investigates-staff-suspected-role-israel-attacks-2024-01-26/">dismissing all accused employees</a> and opening an investigation. While the seriousness of the accusations is clear to all, and the U.S. has been keen to <a href="https://www.nytimes.com/2024/01/30/us/politics/aid-gaza-israel.html">downplay the significance</a> of its pause in funding, the action is not in keeping with precedent. Western donors did not, for example, defund other U.N. agencies or peacekeeping operations amid accusations of <a href="https://www.hrw.org/news/2020/01/11/un-peacekeeping-has-sexual-abuse-problem">sexual assault</a>, <a href="https://www.justice.gov/usao-sdny/pr/former-un-general-assembly-president-and-five-others-charged-13-million-bribery-scheme">corruption</a> or <a href="https://www.hrw.org/legacy/summaries/s.bosnia9510.html">complicity in war crimes</a>. In real terms, the funding cuts to the UNRWA will affect <a href="https://www.unrwa.org/where-we-work/gaza-strip">1.7 million Palestinian refugees in Gaza</a> along with an additional 400,000 Palestinians without refugee status, many of whom benefit from the UNRWA’s infrastructure. Some critics have gone further and said depriving the agency of funds <a href="https://jacobin.com/2024/01/unrwa-defunding-gaza-israel">amounts to collective punishment</a> against Palestinians. Refugee aid, and humanitarian aid more generally, is theoretically meant to be neutral and impartial. But as experts in <a href="https://www.cambridge.org/core/books/reluctant-reception/558E2A93FF99B8F295347A8FA2053698">migration</a> <a href="https://www.routledge.com/UN-Global-Compacts-Governing-Migrants-and-Refugees/Micinski/p/book/9780367218836">and</a> <a href="https://press.umich.edu/Books/D/Delegating-Responsibility">international relations</a>, we know funding is often used as a foreign policy tool, whereby allies are rewarded and enemies punished. In this context, we believe the cuts in funding for the UNRWA fit a wider pattern of the politicization of aid to refugees, particularly Palestinian refugees. <h2>What is the UNRWA?</h2> The UNRWA, short for the U.N. Relief and Works Agency for Palestine Refugees in the Near East, was established two years after about <a href="https://theconversation.com/the-nakba-at-75-palestinians-struggle-to-get-recognition-for-their-catastrophe-204782">750,000 Palestinians were expelled or fled from their homes</a> during the months leading up to the creation of the state of Israel in 1948 and the subsequent Arab-Israeli war. Prior to the UNRWA’s creation, international and local organizations, many of them religious, provided services to displaced Palestinians. But after <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">surveying the extreme poverty</a> and dire situation pervasive across refugee camps, the U.N. General Assembly, including all Arab states and Israel, voted to create the UNRWA in 1949. Since that time, <a href="https://www.unrwa.org/what-we-do">the UNRWA has been the primary aid organization</a> providing food, medical care, schooling and, in some cases, housing for the 6 million Palestinians living across its five fields: Jordan, Lebanon, Syria, as well as the areas that make up the occupied Palestinian territories: the West Bank and Gaza Strip. The mass displacement of Palestinians – known as the <a href="https://theconversation.com/the-nakba-at-75-palestinians-struggle-to-get-recognition-for-their-catastrophe-204782">Nakba, or “catastrophe</a>” – occurred prior to the <a href="https://www.unhcr.org/about-unhcr/who-we-are/1951-refugee-convention">1951 Refugee Convention</a>, which defined refugees as anyone with a well-founded fear of persecution owing to “events occurring in Europe before 1 January 1951.” Despite a <a href="https://www.unhcr.org/sites/default/files/legacy-pdf/4ec262df9.pdf">1967 protocol extending the definition</a> worldwide, Palestinians are still excluded from the primary international system protecting refugees. While the UNRWA is responsible for providing services to Palestinian refugees, the United Nations also created the U.N. Conciliation Commission for Palestine in 1948 to seek a <a href="https://www.refworld.org/docid/4fe2e5672.html">long-term political solution</a> and “to facilitate the repatriation, resettlement and economic and social rehabilitation of the refugees and the payment of compensation.” As a result, the UNRWA does not have a mandate to push for the traditional durable solutions available in other refugee situations. As it happened, the conciliation commission was active only for a few years and has since been sidelined in favor of the U.S.-brokered peace processes. <h2>Is the UNRWA political?</h2> The UNRWA has been <a href="https://www.migrationpolicy.org/article/palestinian-refugees-dispossession">subject</a> to political headwinds since its inception and especially during periods of heightened tension between Palestinians and Israelis. While it is a U.N. organization and thus ostensibly apolitical, it has <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">frequently been criticized</a> by Palestinians, Israelis as well as donor countries, including the United States, for acting politically. The UNRWA performs statelike functions across its five fields – including education, health and infrastructure – but it is restricted in its mandate from performing political or security activities. Initial Palestinian objections to the UNRWA stemmed from the organization’s early focus on economic integration of refugees into host states. Although the UNRWA officially adhered to the U.N. General Assembly’s <a href="https://www.unrwa.org/content/resolution-194">Resolution 194</a> that called for the return of Palestine refugees to their homes, U.N., U.K. and U.S. <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">officials searched</a> for means by which to resettle and integrate Palestinians into host states, viewing this as the favorable political solution to the Palestinian refugee situation and the broader Israeli-Palestinian conflict. In this sense, Palestinians perceived the UNRWA to be both highly political and actively working against their interests. In later decades, the UNRWA <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">switched its primary focus</a> from jobs to education at the urging of Palestinian refugees. But the UNRWA’s education materials were <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">viewed</a> by Israel as further feeding Palestinian militancy, and the Israeli government insisted on checking and approving all materials in Gaza and the West Bank, which it has occupied since 1967. While Israel has <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">long been suspicious</a> of the UNRWA’s role in refugee camps and in providing education, the organization’s operation, which is internationally funded, <a href="https://www.crisisgroup.org/middle-east-north-africa/east-mediterranean-mena/israelpalestine/242-unrwas-reckoning-preserving-un-agency-serving-palestinian-refugees">also saves</a> Israel millions of dollars each year in services it would be obliged to deliver as the occupying power. Since the 1960s, the U.S. – UNRWA’s primary donor – and other Western countries have <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">repeatedly expressed their desire</a> to use aid to prevent radicalization among refugees. In response to the increased presence of armed opposition groups, the <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">U.S. attached a provision</a> to its UNRWA aid in 1970, requiring that the “UNRWA take all possible measures to assure that no part of the United States contribution shall be used to furnish assistance to any refugee who is receiving military training as a member of the so-called Palestine Liberation Army (PLA) or any other guerrilla-type organization.” The UNRWA adheres to this requirement, even publishing an annual list of its employees so that host governments can vet them, but it also <a href="https://www.crisisgroup.org/middle-east-north-africa/east-mediterranean-mena/israelpalestine/242-unrwas-reckoning-preserving-un-agency-serving-palestinian-refugees">employs 30,000 individuals</a>, the vast majority of whom are Palestinian. Questions over the links of the UNRWA to any militancy has led to the rise of Israeli and international <a href="https://cufi.org/issue/unrwa-teachers-continue-to-support-antisemitism-terrorism-on-social-media-un-watch/">watch groups</a> that document the social media activity of the organization’s large Palestinian staff. <h2>Repeated cuts in funding</h2> The United States has used its money and power within the U.N. to block criticism of Israel, vetoing at least <a href="https://www.un.org/depts/dhl/resguide/scact_veto_table_en.htm">45 U.N. resolutions</a> critical of Israel. And the latest freeze is not the first time the U.S. has cut funding to the UNRWA or other U.N. agencies in response to issues pertaining to the status of Palestinians. In 2011, the <a href="https://www.reuters.com/article/idUSTRE79U5ED/#:%7E:text=WASHINGTON%20(Reuters)%20%2D%20The%20United,grant%20the%20Palestinians%20full%20membership.">U.S. cut all funding to UNESCO</a>, the U.N. agency that provides educational and cultural programs around the world, after the agency voted to admit the state of Palestine as a full member. The Obama administration defended the move, claiming it was required by a 1990s law to defund any U.N. body that admitted Palestine as a full member. But the impact of the action was nonetheless severe. Within just four years, UNESCO was <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1758-5899.12459">forced to cut its staff in half</a> and roll back its operations. President Donald Trump later <a href="https://www.pbs.org/newshour/politics/u-s-and-israel-officially-withdraw-from-unesco">withdrew the U.S. completely from UNESCO</a>. In 2018, the Trump administration paused its <a href="https://www.nytimes.com/2018/08/31/us/politics/trump-unrwa-palestinians.html">US$60 million contribution to the UNRWA</a>. Trump claimed the pause would create political pressure for Palestinians to negotiate. President Joe Biden restarted U.S. contributions to the UNRWA in 2021. <h2>Politicization of refugee aid</h2> Palestinian are not the only group to suffer from the politicization of refugee funding. After World War II, states established different international organizations to help refugees but strategically excluded some groups from the refugee definition. For example, the U.S. funded the <a href="https://www.nationalww2museum.org/war/articles/last-million-eastern-european-displaced-persons-postwar-germany">U.N. Relief and Rehabilitation Administration to help resettle displaced persons after World War II</a> but resisted Soviet pressure to forcibly repatriate Soviet citizens. The U.S. also created a separate organization, <a href="https://academic.oup.com/ijrl/article-abstract/1/4/501/1598187">the precursor to the International Organization for Migration</a>, to circumvent Soviet influence. In many ways, the UNRWA’s existence and the exclusion of Palestinian refugees from the wider refugee regime parallels this dynamic. Funding for refugees has also been politicized through the earmarking of voluntary contributions to U.N. agencies. Some agencies receive funding from U.N. dues; but the UNRWA, alongside the U.N. High Commissioner for Refugees and the International Organization for Migration, receive the majority of their funding from voluntary contributions from member states. These contributions can be earmarked for specific activities or locations, leading to donors such as the <a href="https://www.peio.me/wp-content/uploads/2019/01/PEIO12_paper_107.pdf">U.S. or European Union dictating which refugees get aid and which do not</a>. Earmarked contributions amounted to nearly <a href="https://unsceb.org/fs-revenue-agency">96% of the UNHCR’s budget, 96% of the IOM’s budget and 74% of UNRWA funding in 2022</a>. As a result, any cuts to UNRWA funding will affect its ability to service Palestinian refugees in Gaza – especially at a time when so many are <a href="https://www.cnn.com/2024/01/30/middleeast/famine-looms-in-gaza-israel-war-intl/index.html">facing hunger, disease and displacement</a> as a result of war.<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/222263/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nicholas-r-micinski-207353">Nicholas R. Micinski</a>, Assistant Professor of Political Science and International Affairs, <a href="https://theconversation.com/institutions/university-of-maine-2120">University of Maine</a> and <a href="https://theconversation.com/profiles/kelsey-norman-862895">Kelsey Norman</a>, Fellow for the Middle East, Rice University's Baker Institute for Public Policy, <a href="https://theconversation.com/institutions/rice-university-931">Rice 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/funding-for-refugees-has-long-been-politicized-punitive-action-against-unrwa-and-palestinians-fits-that-pattern-222263">original article</a>.

Money & Banking

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

Missing boy found alive after six long years

A 17-year-old British boy named Alex Batty, who went missing in Spain in 2017 at the age of 11, has been found after six long years. On a Wednesday morning, a concerned motorist discovered Alex walking along a road in the foothills of the Pyrenees. This Good Samaritan, Fabien Accidini, picked up the young lad, offering water and kindness. Little did Fabien know, he was playing a crucial role in reuniting a family torn apart. Alex, who had been living in the remote Pyrenean valleys, was shy at first but eventually opened up to Fabien about his incredible journey. He revealed that he had been in France for two years, leading a nomadic life in an itinerant commune. His dream was to find a big city with an embassy to seek assistance. The touching part of the story was how Alex, carrying a backpack and skateboard, asked Fabien if he could borrow his phone. He then used the phone to send a message via Facebook to his grandmother back in England, Susan Caruana, telling her that he was fine and longing to see her. Susan Caruana, Alex's legal guardian, received the unexpected message, bringing tears of joy to her eyes. "I am so happy," she told The Sun newspaper. "I have spoken to him, and he is well. It is such a shock." The news of Alex's discovery spread like wildfire. As authorities worked diligently to unravel the mystery, it became apparent that Alex's mother, Melanie Batty, and grandfather, David Batty, who did not have parental guardianship, were still missing – and are still wanted by police in connection with his disappearance. The reunion also brought together international cooperation, with British police and consular staff rushing to France to bring Alex back home. Greater Manchester Police confirmed their collaboration with French authorities to ensure the safety and well-being of Batty. "This is a complex and long-running investigation," they said in a statement, "and we need to make further enquiries as well as putting appropriate safeguarding measures in place." The Foreign, Commonwealth and Development Office (FCDO) issued a statement, affirming their support for the British national in France and their ongoing communication with local authorities. Images: Greater Manchester Police

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>.

Body

"Absolutely insane": Dad's plane act goes viral

A man has gone viral on TikTok after his daughter posted a video of him sleeping on the airplane floor during a long-haul flight. "More room for everybody," she captioned the video of her dad lying down wedged between two rows where their feet would normally go. In the video she also added an overlay text which said: "you have ur airport dad I have my Asian dad." The video has since racked up over 12.4 million views, and while most were impressed by the "hack" others were appalled. "This is so smart – never thought of that," one person wrote. "Smart but I'd lay a blanket down underneath. Thank you airport dad I will steal this idea," added another. "I been alive 25 years, ain't never seen this move before," commented a third. "They do [allow it] on long flights. As long as nobody complains then they don't bother you," added a fourth. <div class="embed" style="box-sizing: inherit; margin: 0px; padding: 0px; border: 0px; font-size: 16px; vertical-align: baseline; color: #323338; font-family: Figtree, Roboto, 'Noto Sans Hebrew', 'Noto Kufi Arabic', 'Noto Sans JP', sans-serif; background-color: #ffffff; outline: none !important;"><iframe class="embedly-embed" style="box-sizing: inherit; margin: 0px; padding: 0px; border-width: 0px; border-style: initial; vertical-align: baseline; width: 580px; max-width: 100%; outline: none !important;" title="tiktok embed" src="https://cdn.embedly.com/widgets/media.html?src=https%3A%2F%2Fwww.tiktok.com%2Fembed%2Fv2%2F7290309715286904095&display_name=tiktok&url=https%3A%2F%2Fwww.tiktok.com%2F%40bynataliebright%2Fvideo%2F7290309715286904095&image=https%3A%2F%2Fp16-sign.tiktokcdn-us.com%2Fobj%2Ftos-useast8-p-0068-tx2%2FoclABAhjhvzjImA6AdbRfwsiNEqBAyICYXEzX8%3Fx-expires%3D1700780400%26x-signature%3D8dYowfoSYD7T5QgGgwn53z%252B4BI8%253D&key=5b465a7e134d4f09b4e6901220de11f0&type=text%2Fhtml&schema=tiktok" width="340" height="700" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe></div> A few others were shocked and pointed out that airplane floors aren't exactly clean. "As a past flight attendant, you don't want to know what I have seen on those carpets," wrote one person. "When I was taking my flight attendant course one thing they said to us over and over was to never walk barefoot on the aircraft... nevertheless lay down," added another. "Man made his own trundle bed," joked a third. While another eagle-eyed commenter was shocked that he would voluntarily wear jeans for 15-hours, "jeans for 15 hours is absolutely insane," they wrote. Images: TikTok

Travel Tips

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>.

Body

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

How 22 minutes of exercise a day could reduce the health risks from sitting too long

<a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> People in developed countries spend an average of <a href="https://doi.org/10.1136/bjsports-2022-106568">nine to ten hours</a> a day sitting. Whether it’s spending time in front of a computer, stuck in traffic, or unwinding in front of the TV, our lives have become increasingly sedentary. This is concerning because prolonged time spent sitting is <a href="https://bjsm.bmj.com/content/54/24/1451?s=09&int_source=trendmd&int_medium=cpc&int_campaign=usage-042019">linked to a number of health issues</a> including obesity, heart disease, and certain types of cancers. These health issues can contribute to earlier death. But a <a href="https://doi.org/10.1136/bjsports-2022-106568">new study</a> suggests that for people over 50, getting just 22 minutes of exercise a day can lower the increased risk of premature death from a highly sedentary lifestyle. <h2>What the researchers did</h2> The team combined data from two studies from Norway, one from Sweden and one from the United States. The studies included about 12,000 people aged 50 or older who wore wearable devices to track how active and sedentary they were during their daily routines. Participants were followed up for at least two years (the median was 5.2 years) during the study period, which spanned 2003-2020. Analyses took several lifestyle and health factors into account, such as education, alcohol intake, smoking status, and previous history of heart disease, cancer and diabetes. All this data was linked to national death registries. <h2>A 22 minute threshold</h2> A total of 805 participants died during follow up. The researchers found people who were sedentary for more than 12 hours a day had the highest risk of death (a 38% higher risk than people who were sedentary for eight hours). However, this was only observed in those who did less than 22 minutes of moderate to vigorous physical activity daily. So for people who did more than 22 minutes of exercise, there was no longer a significantly heightened risk – that is, the risk became generally similar to those who were sedentary for eight hours. Higher daily duration of physical activity was consistently associated with lower risk of death, regardless of total sedentary time. For example, the team reported an additional ten minutes of moderate to vigorous physical activity each day could lower mortality risk by up to 15% for people who were sedentary less than 10.5 hours a day. For those considered highly sedentary (10.5 hours a day or more), an additional ten minutes lowered mortality risk by up to 35%. <h2>The study had some limitations</h2> The team couldn’t assess how changes in physical activity or sedentary time over several months or years may affect risk of death. And the study included only participants aged 50 and above, making results less applicable to younger age groups. Further, cultural and lifestyle differences between countries may have influenced how data between studies was measured and analysed. Ultimately, because this study was observational, we can’t draw conclusions on cause and effect with certainty. But the results of this research align with a growing body of evidence exploring the relationship between physical activity, sedentary time, and death. <h2>It’s positive news</h2> Research has previously suggested <a href="https://bjsm.bmj.com/content/54/24/1499">physical activity may offset</a> health risks associated with <a href="https://www.jacc.org/doi/abs/10.1016/j.jacc.2019.02.031">high sedentary time</a>. The good news is, even short bouts of exercise can have these positive effects. In this study, the 22 minutes wasn’t necessarily done all at once. It was a total of the physical activity someone did in a day, and would have included incidental exercise (activity that’s part of a daily routine, such as climbing the stairs). Several studies using wearable devices have found short bursts of high-intensity everyday activities such as stair climbing or energetic outdoor home maintenance activities such as mowing the lawn or cleaning the windows can lower <a href="https://www.nature.com/articles/s41591-022-02100-x">mortality</a>, <a href="https://academic.oup.com/eurheartj/article/43/46/4801/6771381">heart disease</a> and <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2807734">cancer</a> risk. A recent study using wearable devices found moderate to vigorous bouts of activity <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00183-4/fulltext">lasting three to five minutes</a> provide similar benefits to bouts longer than ten minutes when it comes to stroke and heart attack risk. Several other studies have found <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2596007">being active just on the weekend</a> provides similar health benefits as <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2794038">being active throughout the week</a>. Research has also shown the benefits of <a href="https://jamanetwork.com/journals/jamaneurology/fullarticle/2795819">physical activity</a> and <a href="https://jamanetwork.com/journals/jama/article-abstract/2809418">reducing sedentary time</a> extend to cognitive health. Routines such as desk jobs can foster a sedentary lifestyle that may be difficult to shift. But mixing short bursts of activity into our day can make a significant difference towards improving our health and longevity. Whether it’s a brisk walk during lunch, taking the stairs, or even a short at-home workout, this study is yet another to suggest that every minute counts.<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/216259/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/matthew-ahmadi-1241767">Matthew Ahmadi</a>, Postdoctoral Research Fellow, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, Professor of Physical Activity, Lifestyle, and Population 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/how-22-minutes-of-exercise-a-day-could-reduce-the-health-risks-from-sitting-too-long-216259">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

Michael Caine shares his secrets to a long life

Michael Caine has shared his top three tips for living a long, happy and healthy life. While promoting his new movie The Great Escaper, the 90-year-old Hollywood legend credited his nine decades of life to three things. He told the <a href="https://www.dailymail.co.uk/home/you/article-12540335/We-never-intimacy-coordinators-day-MICHAEL-CAINE-calls-woke-dull-says-young-man-national-service-truly-makes-man-reflects-acting-90.html" target="_blank" rel="noopener">Daily Mail</a>, "Younger wives, no snacking and wear trainers at all times." Caine then quickly added, "And you have to be careful not to fall down." "Happens all the time. You have to just get up and carry on." Elsewhere in the candid interview, Caine explained how much the business of movie making has changed since his big break, discussing the relatively new phenomenon of having intimacy coordinators on set for love scenes. Asked about the coordinators, that are not found on most film and TV sets, Caine responded, “Really? Seriously? What are they? We never had that in my day. “Thank god I’m 90 and don’t play lovers anymore is all I can say. In my day you just did the love scene and got on with it without anyone interfering. It’s all changed.” Caine shared that his love of movies came after he served in the army, which he believes every able man should do to serve their country. The actor completed national service in the military himself, serving in Iserlohn, West Germany in the aftermath of World War II and seeing action in Korea. “I think every young man should be made to do it,” he said. “It truly makes a man of you.” He added: “I only became an actor after I left the army. I did rep for nine years then got a movie and was like, ‘f*** this! I love films more.’ I liked the money and all.” Image credits: Getty Images

Caring

"You're crazy": Adele accidentally confirms long-running rumour

Adele has reignited a long-standing rumour about her relationship status during her concert in Las Vegas. During her residency show on Saturday night, one excited concertgoer jokingly proposed to the iconic singer, with the moment being captured on video by another fan. Adele, 35, replied to the fan's tongue-in-cheek proposal by saying, "You can't marry me. I'm straight, my love, and my husband's here tonight," referring to her partner of two years, NBA agent Rich Paul, 41. The female fan asked Adele if she'd be willing to "try", to which the singer quipped, "No, I don't want to try! I'm with Rich... you're crazy, leave me alone." The clip of the moment was then posted to TikTok, as fans flocked to the comments to speculate if she was joking about her relationship status, or if she had married her partner in secret. Since the pair first started dating in July 2021, they have attracted a slew of marriage rumours. She last addressed the rumours in 2022 in a candid chat with <a href="https://www.elle.com/culture/music/a40803238/adele-interview-elle-september-cover-2022/" target="_blank" rel="noopener">Elle</a> magazine, in which she said "I'm not married. I'm not married!...I'm just in loooove! I'm happy as I'll ever be." The couple first met at a mutual friend's birthday party and immediately hit it off. "I was a bit drunk," Adele revealed in a 2021 interview with <a href="https://www.vogue.co.uk/arts-and-lifestyle/article/adele-british-vogue-interview" target="_blank" rel="noopener">Vogue</a>. "I said, 'Do you want to sign me? I'm an athlete now.'" "He was dancing. All the other guys were just sitting around. He was just dancing away," the singer added. Image credits: Getty Images

Relationships

How can I get better sleep on long-haul flights?

<a href="https://theconversation.com/profiles/leigh-signal-1462806">Leigh Signal</a>, <a href="https://theconversation.com/institutions/massey-university-806">Massey University</a> For most of us, the prospect of a long-haul flight is exciting, mixed with a few nerves. We’re off somewhere different – perhaps a holiday, maybe to catch up with friends or family. Even work can be more interesting when you’re in a new location. Of course, you want to arrive fully rested and ready to go. But by its very definition, a long-haul flight involves travelling for a long period of time, often more than 12 hours. If you’re on a flight from New York to Singapore, it can be close to 19 hours. All that time you’re confined in a seat that’s supposed to recline but feels like it hardly moves, while the seat in front seems to recline ten times lower than yours. So, what can you do to get a a decent rest? <h2>Accept the situation</h2> The first tip for sleep in this setting is to relax your expectations a little. Humans are just not well designed to sleep in an almost upright position. Unless you’re lucky to fly in a class with a lie-flat seat, you’re very unlikely to step off a long-haul flight having had a solid eight hours of sleep. Research by colleagues and myself <a href="https://academic.oup.com/sleep/article/36/1/109/2656896">has shown</a> pilots – who get a bunk to sleep in during their in-flight rest breaks – have light and fragmented sleep. Despite not having great quality sleep, you can be assured <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/jsr.12071?casa_token=S_3bRlU31x8AAAAA:BDeXhWwlMUXfDvtz59M0eSRGfXiK2jm45Tsr5uzMM02t3hktXfEEzU9OjSdGwbVZ_YuCIoUvnpDaKO0">our research</a> <a href="https://www.ingentaconnect.com/content/asma/asem/2014/00000085/00000012/art00007">also shows</a> pilots remain very good at their job throughout a long-haul flight. This, <a href="https://www.tandfonline.com/doi/full/10.3109/07420528.2012.719957?casa_token=zoFj2qt5RPMAAAAA%3ANeXdd1ALMMv9zxRJF3GhpoCS3u3eT8Q_kmNqFpsWh7oz1dLyVJgDpU3vo547iGotvX5d9CCiTfi62g">plus findings</a> from <a href="https://www.sciencedirect.com/science/article/abs/pii/B9780444537027000099">many other lab-based studies</a>, tells us that even a short amount of light sleep has benefits. So, even if you can’t get your usual eight hours during the flight, any sleep you do get will help you feel and function better at your destination. Also, we’re not great at judging how much sleep we’ve had, particularly if our sleep is light and broken. So you’re likely to have slept more than you think. <h2>Time your sleep and drinks</h2> The timing of your flight, and consumption of alcohol and caffeine will directly impact your ability to sleep on an aircraft. Assuming you’re adjusted to the time zone the flight departs from, daytime flights will make sleep on board much harder, whereas nighttime flights make sleep easier. All humans have a circadian (24-hour) time-keeping system, which programs us for sleep at night and wakefulness during the day. Sleeping (or waking) against this biological time-keeping system poses significant challenges. We do have a natural decrease of alertness in the middle of the afternoon, which makes this a good time to try for sleep on a daytime flight. On nighttime flights it will be easier to sleep once the dinner service is finished, otherwise you will be battling noise, light and the movement of people around you. As a stimulant, caffeine helps us stay alert. Even if you’re a regular coffee drinker and can fall asleep after drinking caffeine, your sleep will be lighter and <a href="https://doi.org/10.1016/j.smrv.2016.01.006">you’ll be more easily woken</a>. On the other hand, alcohol makes us feel sleepy, but it interferes with our brains’ ability to have REM sleep (also known as dreaming sleep). Although you may fall asleep more easily after consuming alcohol, your sleep will be more disturbed once your body metabolises the alcohol and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821259/">attempts to catch up</a> on the REM sleep it’s missed out on. <h2>What about taking melatonin or other drugs?</h2> Some people find taking a sleeping tablet or melatonin can help on a plane. This is a very personal choice. Before taking sleeping medication or melatonin you should see your doctor, and only take what’s prescribed for you. Many sleeping medications <a href="https://www.ingentaconnect.com/content/ben/cnsnddt/2023/00000022/00000002/art00006">do not allow perfectly normal sleep to occur</a> and can make you feel <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657033">groggy and drowsy</a> after waking. Importantly, melatonin is a hormone our brains use to tell us it’s nighttime. Melatonin can assist with sleep, but depending on when and how much you take, it can also shift your circadian clock. This could shift you further away from being aligned with the destination time zone. Taking melatonin in your biological afternoon and evening will shift your circadian time-keeping system east (or earlier) and taking it toward the end of your biological night and in your biological morning will shift the circadian time-keeping system west (or later). It gets complicated very quickly! <h2>Prepare your clothes and accessories</h2> Be prepared so you can create the best possible sleep situation within the constraints of an aircraft seat. Wear comfy layers, so you can take things off if you get too hot or put things on when you cool down, and hang on to that blanket instead of losing it under your seat. Light and noise disturb sleep, so pack eye shades and earplugs (or a noise cancelling headset) to block these out. Practice with eye shades and earplugs at home, as it can take a few sleeps to get used to them. A normal and necessary part of the falling asleep process is relaxation, including our neck muscles. When sitting up, this means our heavy heads will no longer be well supported, resulting in that horrible head-dropping experience most of us have had. Try supporting your head with a neck pillow or, if you have a window seat, against the aircraft wall. (Unless you know the person in the next seat well, they are probably not a good option to prop you up.) <h2>Don’t try to force it</h2> Finally, if you wake up and are struggling to go back to sleep, don’t fight it. Take advantage of the in-flight entertainment. This is one of the few times sleep scientists will tell you it’s okay to turn on the technology – watch a movie, binge-watch a TV series, or if you prefer, listen to music or read a good book. When you feel sleepy, you can try going back to sleep, but don’t get stressed or worried about getting enough sleep. Our brains are very good at sleeping – trust that your body will catch you up when it can.<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/211821/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/leigh-signal-1462806">Leigh Signal</a>, Professor in Fatigue Management and Sleep Health/Associate Dean, Research, <a href="https://theconversation.com/institutions/massey-university-806">Massey 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/how-can-i-get-better-sleep-on-long-haul-flights-211821">original article</a>.

Travel Tips

Oldest living Aussie reveals her secrets to long life

Catherina van der Linden, the oldest living Aussie, is preparing to celebrate her 111th birthday this week, a milestone that she passes on August 26. The great-grandmother, who was born in the Netherlands in 1912, was informed that she was the oldest living person in the country last year when her family received an email on her 110th birthday. She is also believed to be the oldest known Dutch person in the world. The great-grandmother lives in Southern Cross Care's West Beach residential facility in Adelaide and credits her longevity to her active lifestyle, including multiple gym sessions and weekly walks. "Keep on moving, and don't sit still," she said. "I push myself sometimes when I'm getting a bit tired and I think it's about time to do something to yourself to see that you still have that energy that you had before," she said. The centenarian is celebrating her birthday on Saturday, and has also said that aside from a healthy lifestyle, being happy and content with what life has to offer is another factor that helped her live a long life. "I've lived a normal life," she said. "Sometimes it's not very good and sometimes it's better but you have to take the bad with the good as well and it's possible to make living a joy." The residential care's manager Catherine Willoughby also said that van der Linden was an inspiration to staff and other residents. "She's still doing regular walks around the facility, opens the exit doors and around she goes, we've actually got a couple of other new residents that have started doing the same routine," she said. "She also loves the gym. She goes to the gym two or three times a week. She loves doing her exercises." "I think it's amazing that she's 111 and the fact that she's still so mobile and still very much alert and oriented to what's happening around her." The great-grandmother first migrated to Australia with her husband and young family in 1955 and she had various jobs including a grape picker, nursing assistant and typist. Images: Southern Cross Care / ABC News

Caring

Ozempic is in the spotlight but it’s just the latest in a long and strange history of weight-loss drugs

<a href="https://theconversation.com/profiles/laura-dawes-1445353">Laura Dawes</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a> Losing weight conveniently, cheaply, safely. That’s been the holy grail of weight-loss ever since 19th century English undertaker and weight-loss celebrity William Banting’s 1863 <a href="https://www.gutenberg.org/files/57545/57545-h/57545-h.htm">Letter on Corpulence</a> spruiked his “miraculous” method of slimming down. Since then, humans have tried many things – diet, exercise, psychotherapy, surgery – to lose weight. But time and again we return to the promise of a weight-loss drug, whether it’s a pill, injection, or tonic. A “diet drug”. The <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674281448#:%7E:text=Childhood%2520Obesity%2520in%2520America%2520traces,problem%2520facing%2520American%2520children%2520today.">history of diet drugs</a> is not a glowing one, however. There have been so many popular drug treatments for excess weight over the years. All, however, have eventually lost their shine and some have even been banned. <h2>Ozempic is a recent arrival</h2> <a href="https://www.novonordisk.com/our-products/our-medicines.html">Ozempic and its sister drug Wegovy</a>, both manufactured by Novo Nordisk, are the latest offerings in a long history of drug treatments for people who are overweight. They contain the same active ingredient – semaglutide, which mimics a hormone, <a href="https://www.sciencedirect.com/science/article/abs/pii/S1544319118303273">GLP-1</a> (glucagon-like peptide-1) that acts on the hypothalamus (the brain’s “hunger centre”) to regulate appetite. As an obesity treatment, semaglutide appears to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573908/">work</a> in part by reducing appetite. These are injections. And there can be <a href="https://www.novonordisk.com.au/content/dam/nncorp/au/en/pdfs/Ozempic-1mg-cmi-v3.0.pdf%22%22">side effects</a>, most commonly nausea and diarrhoea. Although marketed as treatments for chronic obesity and diabetes, they have <a href="https://www.forbes.com/health/body/ozempic-for-weight-loss/#footnote_1">exploded in popularity</a> as diet drugs, largely thanks to social media. This has helped drive a <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023#:%7E:text=Why%2520the%2520Ozempic%2520shortage%2520happened,label%2520prescribing%2520for%2520weight%2520loss.">shortage of Ozempic</a> for diabetes treatment. <h2>From ‘gland treatment’ to amphetamines</h2> But Ozempic is not the first weight-loss drug. For example, organotherapy (gland treatment) was <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674281448#:%7E:text=Childhood%20Obesity%20in%20America%20traces,problem%20facing%20American%20children%20today.">hugely popular</a> in the 1920s to 1940s. It rode on a wave of enthusiasm for endocrinology and specifically the discovery that “ductless glands” – such as the thyroid, pituitary and renal glands – secreted chemical messengers (or “hormones”, as they came to be known). These hormones coordinate the activities and growth of different parts of the body. Doctors prescribed overweight people extracts of animal glands – either eaten raw or dried in pill form or injected – to treat their <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674281448#:%7E:text=Childhood%20Obesity%20in%20America%20traces,problem%20facing%20American%20children%20today.">supposedly “sluggish glands”</a>. For slaughterhouse companies, this was a lucrative new market for offal. But organotherapy soon fell from favour. There was no evidence excess weight was usually caused by underperforming glands or that gland extracts (thyroid in particular) were doing anything other than <a href="https://my.clevelandclinic.org/health/diseases/21741-thyrotoxicosis">poisoning you</a>. <a href="https://nyupress.org/9780814776391/on-speed/">Amphetamines</a> were first used as a nasal decongestant in the 1930s, but quickly found a market for weight-loss. Why they worked was complex. The drug operated on the hypothalamus but also had an effect on mental state. Amphetamine is, of course, an “upper”. The theory was it helped people feel up to dieting and gave pleasure not found on a plate. Amphetamines too, <a href="https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2007.110593">fell from treatment use</a> in the 1970s with Nixon’s “war on drugs” and recognition they were addictive. <h2>Another decade, another drug</h2> Each decade seems to produce its own briefly popular weight-loss drug. For example, the popular <a href="https://www.nytimes.com/1997/09/23/science/how-fen-phen-a-diet-miracle-rose-and-fell.html">diet drug</a> of the 1980s and 90s was fen-phen, which contained appetite suppressants fenfluramine and phentermine. During the height of its craze, vast numbers of users testified to dramatic weight loss. But after users experienced heart valve and lung disease, fen-phen was <a href="https://pubmed.ncbi.nlm.nih.gov/9688104/">withdrawn</a> from the market in 1997. Its producer allocated a <a href="https://www.bloomberg.com/news/articles/2012-08-23/pfizer-asks-end-to-fen-phen-suits-linked-to-lung-ailment">reported US$21 billion</a> to settle the associated lawsuits. The hormone <a href="https://www.webmd.com/obesity/features/the-facts-on-leptin-faq">leptin</a> aroused excitement in the mid-1990s. Leptin seemed, for a brief moment, to hold the key to how the hypothalamus regulated fat storage. Pharmaceutical company Amgen <a href="https://www.science.org/doi/10.1126/science.7732366">wagered millions</a> buying the <a href="https://pubmed.ncbi.nlm.nih.gov/30532682/">rights</a> to the research in the hope this discovery could be turned into a treatment, only to discover it didn’t translate from mice into people. Far from not having enough leptin, people with obesity tend to be <a href="https://www.healthline.com/nutrition/leptin-101">leptin-resistant</a>. So taking more leptin doesn’t help with weight-loss. Amgen <a href="https://news.harvard.edu/gazette/story/2009/01/obesity-reviving-the-promise-of-leptin/">sold</a> the rights it had paid so much for. <a href="https://www.healthline.com/nutrition/ephedra-sinica">Ephedra</a> was popular as a weight-loss treatment and as a stimulant in the 1990s and 2000s, finding buyers among athletes, body builders and in the military. But the US Food and Drug Administration <a href="https://ods.od.nih.gov/HealthInformation/Ephedra.aspx">banned</a> the sale of dietary supplements containing ephedra in 2004 after it was linked to <a href="https://www.nejm.org/doi/full/10.1056/nejmc1502505">health problems</a> ranging from heart attacks and seizures to strokes and even death, and in Australia ephedra is <a href="https://www.legislation.gov.au/Details/F2023L00864">prescription-only</a>. Now we have Ozempic. Just because the history of diet drugs has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3362858/">been so dire</a>, we shouldn’t jump to conclusions about new ones – Ozempic is not a drug of the 1920s or 1960s or 1990s. And as <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674281448#:%7E:text=Childhood%2520Obesity%2520in%2520America%2520traces,problem%2520facing%2520American%2520children%2520today.">history recognises</a>, multiple complexities can combine to push a drug into popularity or damn it to history’s rubbish bin. These include patients’, physicians’ and industry interests; social attitudes about drug treatment; evidence about safety and efficacy; beliefs and knowledge about the cause of excess weight. One noticeable contrast with past diet drug experiences is that now, many people are <a href="https://www.nytimes.com/2022/11/22/well/ozempic-diabetes-weight-loss.html">happy to talk</a> about using Ozempic. It seems to be increasingly socially acceptable to use a drug to achieve weight-loss for primarily aesthetic reasons. (Due to Ozempic shortages in Australia, though, doctors have been <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/ozempic-semaglutide-supply-update">asked</a> to direct current supplies to people with type 2 diabetes who satisfy certain criteria. In other words, it’s not really meant to be used just to treat obesity). <h2>Our enduring search for weight-loss drugs</h2> Ozempic is predicted to earn Novo Nordisk <a href="https://www.pharmaceutical-technology.com/comment/novo-nordisk-ozempic/">US$12.5 billion this year alone</a>, but it’s not just industry interests stoking this enduring desire for weight-loss drugs. Patients on an endless cycle of dieting and exercise want something more convenient, with a more certain outcome. And doctors, too, want to offer patients effective treatment, and a drug prescription is a workable option given the constraints of appointment times. The body positivity movement has not yet ousted anti-fat bias or stigma. And despite <a href="https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference">decades of recognition</a> of the major role our physical and social environment plays in human health, there’s little political, public or industry appetite for change. Individuals are left to personally defend against an obesogenic environment, where economic, cultural, social, health and urban design policies can conspire to make it easy to gain weight but hard to lose it. It is no wonder demand for weight-loss drugs continues to soar.<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/209324/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/laura-dawes-1445353">Laura Dawes</a>, Research Fellow in Medico-Legal History, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National 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/ozempic-is-in-the-spotlight-but-its-just-the-latest-in-a-long-and-strange-history-of-weight-loss-drugs-209324">original article</a>.

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How 22 minutes of exercise a day could reduce the health risks from sitting too long

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

Michael Caine shares his secrets to a long life

"You're crazy": Adele accidentally confirms long-running rumour

How can I get better sleep on long-haul flights?

Oldest living Aussie reveals her secrets to long life

Ozempic is in the spotlight but it’s just the latest in a long and strange history of weight-loss drugs

News

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Catalogues

Travel

Health

Lifestyle

Finance

Entertainment

Property

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Keep up to date

Search

Christina Applegate details bout of Covid and Sapovirus amid MS battle

William Shatner shocks hosts simply by revealing his age

Longing for the ‘golden age’ of air travel? Be careful what you wish for

How long does menopause last? 5 tips for navigating uncertain times

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

Funding for refugees has long been politicized − punitive action against UNRWA and Palestinians fits that pattern

How long does immunity last after a COVID infection?

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

Missing boy found alive after six long years

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

"Absolutely insane": Dad's plane act goes viral

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

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

How 22 minutes of exercise a day could reduce the health risks from sitting too long

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

Michael Caine shares his secrets to a long life

"You're crazy": Adele accidentally confirms long-running rumour

How can I get better sleep on long-haul flights?

Oldest living Aussie reveals her secrets to long life

Ozempic is in the spotlight but it’s just the latest in a long and strange history of weight-loss drugs

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