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We finally know why some people got COVID while others didn’t

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/marko-nikolic-1543289">Marko Nikolic</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> and <a href="https://theconversation.com/profiles/kaylee-worlock-1543639">Kaylee Worlock</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> Throughout the pandemic, one of the key questions on everyone’s mind was why some people avoided getting COVID, while others caught the virus multiple times. Through a collaboration between University College London, the Wellcome Sanger Institute and Imperial College London in the UK, we set out to answer this question using the world’s first controlled <a href="https://www.nature.com/articles/s41591-022-01780-9">“challenge trial” for COVID</a> – where volunteers were deliberately exposed to SARS-CoV-2, the virus that causes COVID, so that it could be studied in great detail. Unvaccinated healthy volunteers with no prior history of COVID were exposed – via a nasal spray – to an extremely low dose of the original strain of SARS-CoV-2. The volunteers were then closely monitored in a quarantine unit, with regular tests and samples taken to study their response to the virus in a highly controlled and safe environment. For our <a href="https://www.nature.com/articles/s41586-024-07575-x">recent study</a>, published in Nature, we collected samples from tissue located midway between the nose and the throat as well as blood samples from 16 volunteers. These samples were taken before the participants were exposed to the virus, to give us a baseline measurement, and afterwards at regular intervals. The samples were then processed and analysed using single-cell sequencing technology, which allowed us to extract and sequence the genetic material of individual cells. Using this cutting-edge technology, we could track the evolution of the disease in unprecedented detail, from pre-infection to recovery. To our surprise, we found that, despite all the volunteers being carefully exposed to the exact same dose of the virus in the same manner, not everyone ended up testing positive for COVID. In fact, we were able to divide the volunteers into three distinct infection groups (see illustration). Six out of the 16 volunteers developed typical mild COVID, testing positive for several days with cold-like symptoms. We referred to this group as the “sustained infection group”. Out of the ten volunteers who did not develop a sustained infection, suggesting that they were able to fight off the virus early on, three went on to develop an “intermediate” infection with intermittent single positive viral tests and limited symptoms. We called them the “transient infection group”. The final seven volunteers remained negative on testing and did not develop any symptoms. This was the “abortive infection group”. This is the first confirmation of abortive infections, which were previously <a href="https://www.nature.com/articles/s41586-021-04186-8">unproven</a>. Despite differences in infection outcomes, participants in all groups shared some specific novel immune responses, including in those whose immune systems prevented the infection. When we compared the timings of the cellular response between the three infection groups, we saw distinct patterns. For example, in the transiently infected volunteers where the virus was only briefly detected, we saw a strong and immediate accumulation of immune cells in the nose one day after infection. This contrasted with the sustained infection group, where a more delayed response was seen, starting five days after infection and potentially enabling the virus to take hold in these volunteers. In these people, we were able to identify cells stimulated by a key antiviral defence response in both the nose and the blood. This response, called the “interferon” response, is one of the ways our bodies signal to our immune system to help fight off viruses and other infections. We were surprised to find that this response was detected in the blood before it was detected in the nose, suggesting that the immune response spreads from the nose very quickly. <h2>Protective gene</h2> Lastly, we identified a specific gene called HLA-DQA2, which was expressed (activated to produce a protein) at a much higher level in the volunteers who did not go on to develop a sustained infection and could hence be used as a marker of protection. Therefore, we might be able to use this information and identify those who are probably going to be protected from severe COVID. These findings help us fill in some gaps in our knowledge, painting a much more detailed picture regarding how our bodies react to a new virus, particularly in the first couple of days of an infection, which is crucial. We can use this information to compare our data to other data we are currently generating, specifically where we are “challenging” volunteers to other viruses and more recent strains of COVID. In contrast to our current study, these will mostly include volunteers who have been vaccinated or naturally infected – that is, people who already have immunity. Our study has significant implications for future treatments and vaccine development. By comparing our data to volunteers who have never been exposed to the virus with those who already have immunity, we may be able to identify new ways of inducing protection, while also helping the development of more effective vaccines for future pandemics. In essence, our research is a step towards better preparedness for the next pandemic.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/233063/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/marko-nikolic-1543289">Marko Nikolic</a>, Principal Research Fellow/Honorary consultant Respiratory Medicine, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> and <a href="https://theconversation.com/profiles/kaylee-worlock-1543639">Kaylee Worlock</a>, Postdoc Research Fellow, Molecular and Cellular Biology, <a href="https://theconversation.com/institutions/ucl-1885">UCL</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/we-finally-know-why-some-people-got-covid-while-others-didnt-233063">original article</a>. </div>

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The world’s longest cruises

If you’re looking for your next cruising adventure, there are a multitude of time frames you can pick from for your next holiday. While many cruise-goers tend to opt for just a week or two at sea, there are other voyages that can see you spend months travelling the world. Here are ten of the longest cruise journeys that are available for the most dedicated travellers. Queen Anne - 107 days In 2025, new Cunard ship Queen Anne will embark on her maiden World Voyage which includes her first visit to Australia and New Zealand. The 107-day journey starts with a transatlantic crossing before sailing to destinations in the Americas, Australasia, Asia, the Arabian Gulf and finally the Mediterranean. Crown Princess - 113 days The Crown Princess is set to embark on an epic around the world cruise next year, and you can get on in Australia or New Zealand. From there, the voyage will visit 49 destinations in 28 countries over 113 days, crossing the equator twice, and sailing 33,500 nautical miles. MSC Magnifica - 119 days MSC's World Cruise 2026 lasts 119 days, with options to book the entire round-the-world itinerary for the most dedicated travellers. The trip starts in Italy, and takes in the Mediterranean before heading across the Atlantic to the Caribbean and South America, before it then sails to California before crossing the Pacific for Hawaii, New Zealand and Australia. Seabourn Sojourn - 129 days Seabourn's 2026 World Cruise sets sail on January 6th 2026 from LA, before taking in Hawaii, South Pacific islands, New Zealand, Australia and the Far East and Asia before heading Alaska and concluding in Vancouver, Canada. That's a total of 63 ports in 14 countries with seven overnight stays. Volendam - 133 days Holland America’s lengthy journey, titled Pole to Pole, takes a round trip from Fort Lauderdale in Florida it visits spots as diverse as Costa Rica, Antarctica, Morocco, France and Canada. Crystal Serenity - 135 days Crystal's 2026 World Cruise is an epic 135-day journey travelling to 72 destinations throughout 27 countries. Departing Los Angeles, Crystal Serenity will traverse the waters of the Pacific taking in the Marquesas Islands, Bora Bora, New Zealand and Sydney, as well as travelling to Hong Kong, Mumbai and Dubai. Seven Seas Splendour - 140 days Guests onboard the Regent Seven Seas Cruises will visit 40 countries over six continents, spending 140 nights onboard the luxurious ship. The voyage visits locations such as Panama, Sri Lanka and Spain, visiting 71 ports around the world. Silver Dawn - 149 days Silversea Cruises' Silver Dawn will explore 80 destinations, covering 35 countries on five continents, including 11 overnight stays. Viking Sky - 163 days The cruise ship Viking Sky will sail for an impressive 163 days on its World Voyage II, taking in 34 countries, with 79 guided tours. Ports of note include Rarotonga in the Cook Islands, Darwin Australia, Colombo Sri Lanka, Cape Town, South Africa and the Shetland Islands in Scotland. Oceana Vista - 197 days The 2026 World Odyssey voyage of Vista will circumnavigate the world, visiting over 100 ports across 43 countries. The voyage visits over 80 UNESCO World Heritage sites across 101 destinations, with 11 overnight stays. Image credits: Shutterstock

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Long-serving ABC star calls it quits

Paul Barry, the veteran host of Media Watch, who has made a career out of poking the media bear, has announced his departure from the ABC show in December. After an illustrious (and occasionally infamous) tenure that would make a soap opera look like a nap, Barry is hanging up his microphone at the ripe age of 72. “I’ve been in the hot seat for 11 years and it’s time to give someone else a go,” Barry remarked, possibly while the hot seat sighed in relief. Indeed, hosting Media Watch is no small feat – it's a bit like riding a roller coaster while simultaneously refereeing a brawl. But Barry has certainly done it with aplomb, panache and a fair amount of flair. His announcement has left viewers with mixed feelings – a blend of gratitude for his unyielding service and a tinge of sadness, akin to the bittersweet end of a beloved TV series. Barry promised to stay with us until December, giving us ample time to stock up on popcorn and enjoy the remaining episodes. "Lots of fun to be had before then," he teased, hinting at some final rounds of media mischief. For those who might be wondering what Barry plans to do next, well, that's still a mystery. Perhaps he'll take up knitting, but knowing him, it’ll likely be with barbed wire. Barry first commandeered Media Watch in 2000 before returning in 2013, making a grand comeback that rivalled any reality TV show. Over the years, he has ruffled enough feathers to fill a sizeable pillow factory. Commercial media outlets, politicians and even his own network – as Media Watch famously runs independently of the ABC – have all been on the receiving end of his sharp critiques. His fearless approach has made him a hero to many and a headache to some. One of Barry’s most memorable moments came in 2013 during a spat with columnist Andrew Bolt. When Bolt provocatively asked Barry to reveal his salary on air, Barry did just that – $191,259, to be precise. It was a jaw-dropping moment that left viewers stunned and Bolt, presumably, a bit flummoxed. In between his stints at Media Watch, Barry has donned many hats – investigative reporter for the Sydney Morning Herald, correspondent for 60 Minutes, and author of several books, including a controversial unauthorised biography of James Packer. His career has been a veritable smorgasbord of journalism, controversy and unflinching honesty. An ABC spokesperson paid tribute to Barry, highlighting his “track record of independent commentary, analysis, and robust discussion about the media industry and its ethics – or lack thereof.” Barry has indeed been the watchdog’s watchdog, never shying away from calling out malpractice, no matter where it reared its head. As the ABC gears up to announce a new host, the shoes left behind are large ones to fill. Barry’s departure marks the end of an era – one filled with wit, grit and an unwavering commitment to holding the media accountable. So, here’s to Paul Barry – the feather-ruffler, the truth-seeker, the man who made us laugh, gasp and, most importantly, think. As he steps down from Media Watch, we wish him the very best in his next adventure, whether that’s taking on new journalistic endeavours or finally perfecting that tricky scarf pattern. Bravo, Mr Barry. You will be missed. Image: Media Watch

COVID vaccines saved millions of lives – linking them to excess deaths is a mistake

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/paul-hunter-991309">Paul Hunter</a>, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a> A recent <a href="https://bmjpublichealth.bmj.com/content/2/1/e000282">study</a> has sparked another <a href="https://nypost.com/2024/06/06/us-news/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths-since-pandemic-study/">round of</a> <a href="https://www.telegraph.co.uk/news/2024/06/04/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths/">headlines</a> <a href="https://www.gbnews.com/health/covid-vaccine-side-effects-deaths">claiming</a> that COVID vaccines caused excess deaths. This was accompanied by a predictable outpouring of <a href="https://x.com/DrAseemMalhotra/status/1797922073798717524">I-told-you-sos</a> on social media. Excess deaths are a measure of how many more deaths are being recorded in a country over what would have been expected based on historical trends. In the UK, and in many other countries, death rates have been higher during the years 2020 to 2023 than would have been expected based on historic trends from before the pandemic. But that has been known for some time. A couple of years ago I wrote an article for <a href="https://theconversation.com/summer-2022-saw-thousands-of-excess-deaths-in-england-and-wales-heres-why-that-might-be-189351">The Conversation</a> pointing this out and suggesting some reasons. But has anything changed? The authors of the new study, published in BMJ Public Health, used publicly available data from <a href="https://ourworldindata.org/COVID-vaccinations">Our World in Data</a> to determine which countries had “statistically significant” excess deaths – in other words, excess deaths that couldn’t be explained by mere random variation. They studied the years 2020 to 2022 and found that many, but not all, countries did indeed report excess deaths. The authors did not try to explain why these excess deaths occurred, but the suggestion that COVID vaccines could have played a role is clear from their text – and indeed widely interpreted as such by certain newspapers. There is no doubt that a few deaths were associated with <a href="https://journals.sagepub.com/doi/full/10.1177/25166026211053485">the COVID vaccines</a>, but could the vaccination programme explain the large number of excess deaths – 3 million in 47 countries – that have been reported? Based on <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessdeathsinenglandandwales/march2020todecember2021">death certificates</a>, during 2020 and 2021 there were more deaths from COVID than estimated excess deaths in the UK. So during the year 2021 when most vaccine doses were administered, there were actually fewer non-COVID deaths than would have been expected. It was only in 2022 that excess deaths <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathregistrationsummarystatisticsenglandandwales/2022">exceeded COVID deaths</a>. If the vaccination campaign was contributing to the excess deaths that we have seen in recent years, then we should expect to see more deaths in people who have been vaccinated than in those who have not. The most reliable analysis in this regard was done by the UK’s <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessdeathsinenglandandwales/march2020todecember2021">Office for National Statistics (ONS)</a>. In this analysis, the ONS matched death registrations with the vaccine histories of each death recorded. They then calculated “age-standardised death rates” to account for age differences between those vaccinated and those not. What the ONS found was that in all months from April 2021 to May 2023, the death rate <a href="https://www.ons.gov.uk/redir/eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJpbmRleCI6MSwicGFnZVNpemUiOjEwLCJwYWdlIjoxLCJ1cmkiOiIvcGVvcGxlcG9wdWxhdGlvbmFuZGNvbW11bml0eS9iaXJ0aHNkZWF0aHNhbmRtYXJyaWFnZXMvZGVhdGhzL2RhdGFzZXRzL2V4Y2Vzc2RlYXRoc2luZW5nbGFuZGFuZHdhbGVzIiwibGlzdFR5cGUiOiJyZWxhdGVkZGF0YSJ9.Cot-XDe8Rr07paGllBNnVVz1nTqnXfVafn2woA3tk0c">from all causes was higher</a> in the unvaccinated than in people who had been vaccinated at least once. That deaths from all causes were lower in the vaccinated than the unvaccinated should come as no surprise given that COVID was a major cause of death in 2021 and 2022. And there is ample evidence of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492612/">protective effect of vaccines</a> against severe COVID and death. But what is even more convincing is that, even when known COVID deaths were excluded in the ONS report, the death rate in the unvaccinated was still higher, albeit not by very much in more recent months. Some COVID deaths would certainly not have been recognised as such. But, on the other hand, people with chronic conditions, such as diabetes, were a high priority for vaccination. And these people would have been at increased risk of death even before the pandemic. <h2>Possible causes</h2> If the vaccine is not the cause of the excess deaths, what was? The major cause of the excess deaths reported in the first two years of the BMJ Public Health study was deaths from COVID. But by 2022, excess deaths exceeded COVID deaths in many countries. Possible <a href="https://theconversation.com/summer-2022-saw-thousands-of-excess-deaths-in-england-and-wales-heres-why-that-might-be-189351">explanations</a> for these excess deaths include longer-term effects of earlier COVID infections, the return of infections such as influenza that had been suppressed during the COVID control measures, adverse effects of lockdowns on physical and mental health, and delays in the diagnosis of life-threatening infections as health services struggled to cope with the pandemic and its aftermath. We do need to look very carefully at how the pandemic was managed. There is still considerable debate about the effectiveness of different behavioural control measures, such as self-isolation and lockdowns. Even when such interventions were effective at reducing transmission of COVID, what were the harms and were the gains worth the harms? Nevertheless, we can be confident that the excess deaths seen in recent years were not a consequence of the vaccination campaign.<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/231776/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paul-hunter-991309">Paul Hunter</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</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/covid-vaccines-saved-millions-of-lives-linking-them-to-excess-deaths-is-a-mistake-231776">original article</a>. </div>

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AstraZeneca admits to Covid vaccine's deadly side effect

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

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Would you be happy as a long-term single? The answer may depend on your attachment style

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/christopher-pepping-1524533">Christopher Pepping</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/geoff-macdonald-1527971">Geoff Macdonald</a>, <a href="https://theconversation.com/institutions/university-of-toronto-1281">University of Toronto</a>; <a href="https://theconversation.com/profiles/tim-cronin-415060">Tim Cronin</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a>, and <a href="https://theconversation.com/profiles/yuthika-girme-1494822">Yuthika Girme</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a> Are all single people insecure? When we think about people who have been single for a long time, we may assume it’s because single people have insecurities that make it difficult for them to find a partner or maintain a relationship. But is this true? Or can long-term single people also be secure and thriving? Our <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jopy.12929">latest research</a> published in the Journal of Personality suggests they can. However, perhaps unsurprisingly, not everybody tends to thrive in singlehood. Our study shows a crucial factor may be a person’s attachment style. <h2>Singlehood is on the rise</h2> Singlehood is on the rise around the world. In Canada, single status among young adults aged 25 to 29 has increased from <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/220713/dq220713b-eng.htm">32% in 1981 to 61% in 2021</a>. The number of people <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/220713/dq220713a-eng.htm">living solo</a> has increased from 1.7 million people in 1981 to 4.4 million in 2021. People are single for many reasons: <a href="https://www.ucpress.edu/ebook/9780520971004/happy-singlehood">some choose</a> to remain single, some are focusing on <a href="https://link.springer.com/article/10.1007/s12147-020-09249-0">personal goals and aspirations</a>, some report <a href="https://www.pewresearch.org/social-trends/2020/08/20/nearly-half-of-u-s-adults-say-dating-has-gotten-harder-for-most-people-in-the-last-10-years/">dating has become harder</a>, and some become single again due to a relationship breakdown. People may also remain single due to their attachment style. Attachment theory is a popular and well-researched model of how we form relationships with other people. An <a href="https://www.amazon.com.au/s?k=attachment+theory">Amazon search for attachment theory</a> returns thousands of titles. The hashtag #attachmenttheory has been viewed <a href="https://www.cnbc.com/2022/08/20/why-attachment-theory-is-trending-according-to-dr-amir-levine.html">over 140 million times</a> on TikTok alone. <h2>What does attachment theory say about relationships?</h2> Attachment theory suggests our relationships with others are shaped by our degree of “anxiety” and “avoidance”. Attachment anxiety is a type of insecurity that leads people to feel anxious about relationships and worry about abandonment. Attachment avoidance leads people to feel uncomfortable with intimacy and closeness. People who are lower in attachment anxiety and avoidance are considered “securely attached”, and are comfortable depending on others, and giving and receiving intimacy. Single people are often stereotyped as being <a href="https://journals.sagepub.com/doi/full/10.1177/01461672231203123">too clingy or non-committal</a>. Research comparing single and coupled people also suggests single people have <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-6494.2012.00793.x?casa_token=6iiCm5PjHgkAAAAA:0kBeofx3M-72YrkVppmNxdWBIAImFwm3lAakCnuiNXL20SVP1zaW7UeDIahW_43imAjSRXgtyN0hLVI">higher levels of attachment insecurities</a> compared to people in relationships. At the same time, evidence suggests many single people are choosing to remain single and <a href="https://journals.sagepub.com/doi/full/10.1177/17456916221136119">living happy lives</a>. <h2>Single people represent a diverse group of secure and insecure people</h2> In our latest research, our team of social and clinical psychologists examined single people’s attachment styles and how they related to their happiness and wellbeing. We carried out two studies, one of 482 younger single people and the other of 400 older long-term singles. We found overall 78% were categorised as insecure, with the other 22% being secure. Looking at our results more closely, we found four distinct subgroups of singles: <ul> <li> secure singles are relatively comfortable with intimacy and closeness in relationships (22%) </li> <li> anxious singles question whether they are loved by others and worry about being rejected (37%) </li> <li> avoidant singles are uncomfortable getting close to others and prioritise their independence (23% of younger singles and 11% of older long-term singles) </li> <li> fearful singles have heightened anxiety about abandonment, but are simultaneously uncomfortable with intimacy and closeness (16% of younger singles and 28% of older long-term singles). </li> </ul> <h2>Insecure singles find singlehood challenging, but secure singles are thriving</h2> Our findings also revealed these distinct subgroups of singles have distinct experiences and outcomes. Secure singles are happy being single, have a greater number of non-romantic relationships, and better relationships with family and friends. They meet their sexual needs outside romantic relationships and feel happier with their life overall. Interestingly, this group maintains moderate interest in being in a romantic relationship in the future. Anxious singles tend to be the most worried about being single, have lower self-esteem, feel less supported by close others and have some of the lowest levels of life satisfaction across all sub-groups. Avoidant singles show the least interest in being in a romantic relationship and in many ways appear satisfied with singlehood. However, they also have fewer friends and close relationships, and are generally less satisfied with these relationships than secure singles. Avoidant singles also report less meaning in life and tend to be less happy compared to secure singles. Fearful singles reported more difficulties navigating close relationships than secure singles. For instance, they were less able to regulate their emotions, and were less satisfied with the quality of their close relationships relative to secure singles. They also reported some of the lowest levels of life satisfaction across all sub-groups. <h2>It’s not all doom and gloom</h2> These findings should be considered alongside several relevant points. First, although most singles in our samples were insecure (78%), a sizeable number were secure and thriving (22%). Further, simply being in a romantic relationship is not a panacea. Being in an unhappy relationship is linked to <a href="https://doi.org/10.1371/journal.pmed.1000316">poorer life outcomes</a> than being single. It is also important to remember that attachment orientations are not necessarily fixed. They are open to <a href="https://www.sciencedirect.com/science/article/pii/S2352250X18300113">change</a> in response to life events. Similarly, <a href="https://journals.sagepub.com/doi/full/10.1177/0963721413510933">sensitive and responsive behaviours</a> from close others and <a href="https://doi.org/10.1177/02654075231162390">feeling loved and cared about</a> by close others can soothe underlying attachment concerns and foster attachment security over time. Our studies are some of the first to examine the diversity in attachment styles among single adults. Our findings highlight that many single people are secure and thriving, but also that more work can be done to help insecure single people feel more secure in order to foster happiness.<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/227595/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christopher-pepping-1524533">Christopher Pepping</a>, Associate Professor in Clinical Psychology, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/geoff-macdonald-1527971">Geoff Macdonald</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/university-of-toronto-1281">University of Toronto</a>; <a href="https://theconversation.com/profiles/tim-cronin-415060">Tim Cronin</a>, Lecturer in Clinical Psychology, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a>, and <a href="https://theconversation.com/profiles/yuthika-girme-1494822">Yuthika Girme</a>, Associate Professor, Department of Psychology, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser 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/would-you-be-happy-as-a-long-term-single-the-answer-may-depend-on-your-attachment-style-227595">original article</a>. </div>

Relationships

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

Peter Brock's long-time partner passes away aged 77

The motorsport community is mourning the loss of Bev Brock, a formidable figure whose unwavering support and dedication were instrumental in the legendary career of her former long-time partner, Peter Brock. Bev, aged 77, passed away at her Melbourne home on Sunday morning after bravely battling stage 4 cancer for two years. For almost three decades, Bev stood as a steadfast presence by Peter's side, both on and off the racetrack. While they were never married, their bond was undeniable, marking a partnership that transcended mere labels. From 1977 until their separation in 2005, Bev played an integral role in shaping Peter's remarkable motorsport journey, becoming synonymous with his successes and enduring legacy. Born on January 15, 1947, just outside Perth, Bev's early years hinted at the strength of character and resilience that would define her life. Among seven siblings, she cultivated a spirit of determination and compassion that would later leave an indelible mark on those around her. Following her passion for education, Bev pursued a career in teaching, imparting knowledge in science and home economics to countless students. Bev's life took a new trajectory when she met Peter Brock. Together, they navigated the highs and lows of motorsport, sharing a journey that was as exhilarating as it was demanding. Despite the challenges, Bev remained a pillar of support, balancing multiple roles with grace, intelligence and purpose. Her commitment to Peter's racing career was unwavering, whether she was managing logistics, offering counsel, or simply cheering from the sidelines. Beyond her contributions to motorsport, Bev's philanthropic endeavours reflected her generous spirit and compassionate nature – and her involvement with various charities culminated in the prestigious Order of Australia in 2016. From supporting The Skyline Foundation to her active engagement with Melbourne Rotary, Bev's impact extended far beyond the confines of the racetrack. In a heartfelt tribute, Bev's son, James Brock, honoured his mother's legacy: “Bev was a dedicated parent, always making time to make a costume for a play or help out on a school camp,” he wrote. “She dedicated her life to helping Peter’s racing career taking on multiple roles, all met with skill, smarts and purpose. “Bev was also involved with multiple charities earning her an Order of Australia in 2016. “Over the last few years she focused her time and passion on The Skyline Foundation, Melbourne Rotary, public speaking and her ever expanding family. “She leaves behind her three children, seven cherished grandchildren and a host of loved ones she wrapped into her life as though they were her own. “Her loss will be immense as her presence, wisdom and support can never be matched.” Universally known as "Bevo," she was not only the driving force behind Peter's success but also a cherished friend who selflessly cared for others. Despite her own battle with cancer, Bev remained a source of strength and inspiration, offering support and guidance to countless friends and acquaintances. As the motorsport community comes together to mourn Bev's passing, we reflect on a life lived with purpose, passion and unwavering dedication. Bev Brock may have left this world, but her spirit will forever race on in the hearts of those who knew and loved her. Images: 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

Dad awarded compensation after developing heart issue from mandatory vaccine

An Adelaide father is set to receive hefty compensation after a mandatory Covid jab left him with a debilitating health condition. In 2021 at the height of the Covid pandemic in Australia, 44-year-old Daniel Shepherd was required to receive tow Covid vaccinations, due to his hands on role at an aged care facility. After having two Pfizer vaccines, he suffered some adverse effects, but dismissed his symptoms as nothing serious. In the months after, Shepherd was required to have a booster shot when he began a new job with the Department of Child Protection in October of the same year. In January 2022, the father was told if we wanted to keep his job as a health and childcare worker, he needed to have the jab. After eventually agreeing to the booster, Shepherd has his third dose of Pfizer in late February 2022, but began suffering from chest pains just hours later. "It felt like someone had their knee right on my chest," he told <a href="https://www.9news.com.au/national/adelaide-news-covid-vaccine-man-to-get-government-compensation-after-developing-heart-condition/55cc0fbf-4631-4cf0-b395-8c8b6c71a43f" target="_blank" rel="noreferrer noopener">9News.</a> The pain kept getting worse until he was rushed to hospital a few weeks later when he thought he was having a heart attack. There he was diagnosed with post-vaccine pericarditis: an inflammation of the membrane around the heart. His illness meant he was unable to work full time, and also meant he was unable to keep up with his young son. "Even today with just mild exertion [I get] chest pains and then it's followed by fatigue, like severe fatigue," Shepard said. "It's heartbreaking to have to say 'sorry buddy, daddy's tired'." Mr Shepherd decided to take legal action after he was unable to work, launching a workers compensation claim against the government. In a landmark ruling in mid-January, the South Australian Employment Tribunal agreed to pay weekly compensation and medical bills to Shepherd. Doctors were unanimous in his case that the vaccine was the cause of his inability to work, but the government argued emergency directions that were in place at the time trumped the laws around workplace injury. Pericarditis is meant to clear within a few months, but Shepherd's symptoms have plagued him for almost two years. Image credits: 9News

Legal

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

It’s 4 years since the first COVID case in Australia. Here’s how our pandemic experiences have changed over time

<a href="https://theconversation.com/profiles/deborah-lupton-9359">Deborah Lupton</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> It might be hard to believe, but four years have now passed since the <a href="https://www.health.gov.au/topics/covid-19/about">first COVID case</a> was confirmed in Australia on January 25 2020. Five days later, the <a href="https://www.who.int/publications/m/item/covid-19-public-health-emergency-of-international-concern-(pheic)-global-research-and-innovation-forum">World Health Organization</a> (WHO) declared a “public health emergency of international concern”, as the novel coronavirus (later named SARS-CoV-2) began to spread worldwide. On March 11 the WHO would declare COVID a pandemic, while around the same time Australian federal and state governments hastily <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/pubs/rp/rp2021/Chronologies/COVID-19StateTerritoryGovernmentAnnouncements">introduced measures</a> to “stop the spread” of the virus. These included shutting Australia’s international borders, closing non-essential businesses, schools and universities, and limiting people’s movements outside their homes. I began my project, <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2023.1092322/full">Australians’ Experiences of COVID-19</a>, in May 2020. This research has continued each year to date, allowing me to track how Australians’ attitudes around COVID have changed over the course of the pandemic. <h2>Evolving pandemic experiences</h2> We recruited participants from across Australia, including people living in regional cities and towns. Participants range in age from early adulthood to people in their 80s. The first three stages of the project each involved 40 interviews with separate groups of participants (so 120 people in total). These interviews were done in May to July 2020 (stage 1), September to October 2021 (stage 2), and September 2022 (stage 3). Stage 4 was an online survey with 1,000 respondents, conducted in September 2023. Limitations of this project include the small sample sizes for the first three stages (as is common with qualitative interview-based research). This means the findings from those phases are not generalisable, but they do provide rich insights into the experiences of the interviewees. The quantitative stage 4 survey, however, is representative of the Australian population. The findings show that as the conditions of the pandemic and government management have changed across these years, so have Australians’ experiences. In the <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10743-7">early months of the pandemic</a>, some people reported becoming confused, distressed and overwhelmed by the plethora of information sources and the fast-changing news environment. On the other hand, seeking out information provided reassurance and comfort in response to their anxiety and uncertainty about this new disease. Australians <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781003280644-28/covid-19-crisis-communication-deborah-lupton">continued to rely heavily</a> on news reports and government announcements in the first two years of the pandemic. Regular briefings from premiers and <a href="https://theconversation.com/chief-health-officers-are-in-the-spotlight-like-never-before-heres-what-goes-on-behind-the-scenes-166828?utm_source=twitter&utm_medium=bylinetwitterbutton">chief health officers in particular</a> were highly important for how they learned what was happening, as were updates in the media on case numbers, hospitalisations, deaths and progress towards vaccination targets. <h2>Trust has eroded</h2> Australians appear to have lost a lot of trust in COVID information sources such as news media reports, health agencies and government leaders. Early strong support of federal, state and territory governments’ pandemic management in <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10743-7">2020</a> and <a href="https://www.tandfonline.com/doi/full/10.1080/14649365.2023.2240290">2021</a> has given way to much lower support more recently. My <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023 survey</a> (this is published as a report, not peer-reviewed) found doctors were considered the most trustworthy sources of COVID information, but even they were trusted by only 60% of respondents. After doctors, participants trusted other experts in the field (53%), Australian government health agencies (52%), global health agencies (49%), scientists (45%) and community health organisations (35%). Australian government leaders were towards the lower end of the spectrum (31%). In <a href="https://academic.oup.com/heapro/article/38/1/daac192/7026242?login=false">2021</a>, Australians responded positively to the vaccine targets and “<a href="https://www.premier.vic.gov.au/victorias-roadmap-delivering-national-plan">road maps</a>” set by governments. These clear guidelines, and especially the promise that the initial doses would remove the need for lockdowns and border closures, were strong incentives to get vaccinated in 2021. Unfortunately, the prospect that vaccines would control COVID was shown to be largely unfounded. While COVID vaccines were and continue to be very effective at protecting against severe disease and death, they’re less effective at <a href="https://coronavirus.jhu.edu/vaccines/vaccines-faq">stopping people becoming infected</a>. Once very high numbers of eligible Australians became vaccinated against the delta variant, <a href="https://pubmed.ncbi.nlm.nih.gov/37068078/">omicron reached Australia</a>, resulting in Australia’s first big wave of infection. This led to disillusionment about vaccines’ value for many participants. In the <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023 survey</a>, respondents reported a high uptake of the first three COVID shots. But when asked whether they planned to get another vaccine in the next 12 months, almost two-thirds said they did not, or they were unsure. <h2>Enter complacency</h2> Complacency now seems to have set in for many Australians. This can be linked to the progressive withdrawal of strong public health measures such as quarantine, mandatory isolation when infected, and testing and tracing regimens. Meanwhile, the media, government leaders and health agencies have played less of an active public role in conveying COVID information. This has led to uncertainty about the extent to which COVID is still a risk and lack of incentive to take protective actions such as mask wearing. In <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023</a>, after mandates had ended, only 9% of respondents said they always wore a mask in indoor public places. Only a narrow majority of respondents even supported compulsory masking for workers in health-care facilities. The <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023 survey</a> confirmed many Australians no longer feel at risk from COVID. Some 17% of respondents said COVID was definitely still posing a risk to Australians, while a further 42% saw COVID as somewhat of a risk. This left 28% who did not view COVID as much of a continuing risk, and 13% who thought it was not a risk at all. <h2>COVID is still a risk</h2> Whether or not people feel at continuing risk from COVID, the pandemic is still significantly affecting Australians. The <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4626720">2023 survey</a> found more than two-thirds of respondents (68%) reported having had at least one COVID infection to their knowledge, including 13% who had experienced three or more. Of those who’d had COVID, 40% said they experienced ongoing symptoms, or long COVID. If the pandemic loses visibility in public forums, people have no way of knowing the risk of infection continues, and are therefore unlikely to take steps to protect themselves and others. Updated case, hospitalisation, death and vaccination numbers should be communicated regularly, as <a href="https://theconversation.com/covid-is-surging-in-australia-and-only-1-in-5-older-adults-are-up-to-date-with-their-boosters-220839">used to be the case</a>. To combat confusion, complacency and misinformation, all health advice should be based on the latest robust science. Australians are operating in a vacuum of information from trusted sources. They need much better and more frequent public health campaigns and risk communication from their leaders.<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/220336/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/deborah-lupton-9359">Deborah Lupton</a>, SHARP Professor, Vitalities Lab, Centre for Social Research in Health and Social Policy Centre, and the ARC Centre of Excellence for Automated Decision-Making and Society, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW 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/its-4-years-since-the-first-covid-case-in-australia-heres-how-our-pandemic-experiences-have-changed-over-time-220336">original article</a>.

Caring

Jimmy Barnes shares updates on "long road ahead"

Jimmy Barnes has shared another update about his recovery from open-heart surgery, saying that there is "a long road ahead" following his latest check-up. The 67-year-old was admitted into hospital for <a href="https://www.oversixty.com.au/health/caring/bad-news-jimmy-barnes-rushed-into-emergency-open-heart-surgery" target="_blank" rel="noopener">emergency heart surgery</a> after complications from a bacterial infection just weeks before Christmas. Since then, Barnes and his wife Jane have been keeping fans updated on his recovery progress. “Always good to leave the hospital smiling. There’s still a long road ahead and many more check ups,” the Aussie Rocker shared to his Instagram followers on Thursday. “There was a team of seven specialists working on me, so there is a lot to follow up on.” The Flame Trees singer shared that he'd had enough of intravenous medications and couldn't wait to have his peripherally inserted central catheter removed. “Another set of good bloods and it’s off with the ‘PICC Line’,” he wrote. “I’m sure it’s saved my life but I cannot wait to be free.” Despite everything, Barnes still looks on the bright side, and showed his gratitude for his wife Jane and her excellent cooking skills. “Thai beef curry is just what the doctor ordered,” he concluded the post, with a picture of Jane's homemade dish. Fans took to the comments to share their support. “Great stuff! As Rocky would say ‘It’s not how hard you hit, but how hard you get hit and keep getting up again’, wrote one fan. “You can do it Jimmy,” another commented. “That’s great news Jimmy. You are in the best hands both on a medical and personal level," a third added. “Great news and good to see you’re recovering well, nurse Jane is doing a fantastic job with all your meals,” wrote a fourth. Images: Instagram

Caring

COVID is surging in Australia – and only 1 in 5 older adults are up to date with their boosters

<a href="https://theconversation.com/profiles/adrian-esterman-1022994">Adrian Esterman</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Do you have family members or friends sick with a respiratory infection? If so, there’s a good chance it’s COVID, caused by the JN.1 variant currently circulating in Australia. In particular, New South Wales is reportedly experiencing its <a href="https://www.abc.net.au/news/2024-01-09/nsw-sydney-covid-variant-virus-pandemic-hospitalisations/103298610">highest levels</a> of COVID infections in a year, while Victoria is said to be facing a “<a href="https://www.9news.com.au/national/victoria-in-midst-of-double-wave-of-covid19--as-jn1-triggers-infections-surge/4dada2cb-7d56-436a-9490-cad1d908a29a">double wave</a>” after a surge late last year. But nearly four years into the pandemic, data collection is less comprehensive than it was, and of course, fewer people are testing. So what do we know about the extent of this wave? And importantly, are we adequately protected? <h2>Difficulties with data</h2> Tracking COVID numbers was easier in the first half of last year, when each state and territory provided a weekly update, giving us data on case notifications, hospitalisations, ICU numbers and deaths. In the second half of the year some states and territories switched to less frequent reporting while others stopped their regular updates. As a result, different jurisdictions now report at different intervals and provide varying statistics. For example, <a href="https://www.health.vic.gov.au/infectious-diseases/victorian-covid-19-surveillance-report">Victoria</a> still provides weekly reports, while NSW publishes <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Documents/respiratory-surveillance-20240106.pdf">fortnightly updates</a>. While each offer different metrics, we can gather – particularly from data on hospitalisations – that both states are experiencing a wave. We’re also seeing high levels of COVID <a href="https://www.health.vic.gov.au/infectious-diseases/victorian-covid-19-surveillance-report">in wastewater</a>. Meanwhile, <a href="https://health.nt.gov.au/covid-19/data">Northern Territory Health</a> simply tell you to go to the Australian government’s Department of Health website for COVID data. This houses the only national COVID <a href="https://www.health.gov.au/topics/covid-19/reporting?language=und">data collection</a>. Unfortunately, it’s not up to date, difficult to use, and, depending on the statistic, often provides no state and territory breakdowns. Actual case notifications are provided on a separate <a href="https://nindss.health.gov.au/pbi-dashboard/">website</a>, although given the lack of testing, these are likely to be highly inaccurate. The <a href="https://www.health.gov.au/topics/covid-19/reporting?language=und">Department of Health website</a> does provide some other data that gives us clues as to what’s happening. For example, as of one month ago, there were 317 active outbreaks of COVID in aged care homes. This figure has been generally rising since September. Monthly prescriptions for antivirals on the Pharmaceutical Benefits Scheme were increasing rapidly in November, but we are not given more recent data on this. It’s also difficult to obtain information about currently circulating strains. Data expert Mike Honey provides a regularly updated <a href="https://github.com/Mike-Honey/covid-19-genomes?tab=readme-ov-file#readme">snapshot</a> for Australia based on data from GISAID (the Global Initiative on Sharing All Influenza Data) that shows JN.1 rising in prevalence and accounting for about 40% of samples two weeks ago. The proportion is presumably higher now. <h2>What’s happening elsewhere?</h2> Many other countries are currently going through a COVID wave, probably driven to a large extent by JN.1. These include <a href="https://www.rnz.co.nz/news/national/506301/covid-19-complacency-waning-immunity-contribute-to-fifth-wave-epidemiologist">New Zealand</a>, <a href="https://www.independent.co.uk/news/world/europe/facemasks-mandatory-spain-hospitals-b2475563.html">Spain, Greece</a> and the United States. According to cardiologist and scientist Eric Topol, the US is currently experiencing its <a href="https://www.latimes.com/opinion/story/2024-01-04/covid-2024-flu-virus-vaccine">second biggest wave</a> since the start of the pandemic, linked to JN.1. <h2>Are vaccines still effective?</h2> It’s expected the current COVID vaccines, which target the omicron variant XBB.1.5, are still <a href="https://www.gavi.org/vaccineswork/seven-things-you-need-know-about-jn1-covid-19-variant">effective</a> at reducing hospitalisations and deaths from JN.1 (also an omicron offshoot). The Australian Technical Advisory Group on Immunisation (ATAGI) updated their <a href="https://www.health.gov.au/news/atagi-update-on-the-covid-19-vaccination-program">advice</a> on booster shots in September last year. They recommended adults aged over 75 should receive an additional COVID vaccine dose in 2023 if six months had passed since their last dose. They also suggest all adults aged 65 to 74 (plus adults of any age who are severely immunocompromised) should consider getting an updated booster. They say younger people or older adults who are not severely immunocompromised and have already had a dose in 2023 don’t need further doses. This advice is very confusing. For example, although ATAGI does not recommend additional booster shots for younger age groups, does this mean they’re not allowed to have one? In any case, as of <a href="https://www.health.gov.au/resources/publications/covid-19-vaccine-rollout-update-8-december-2023?language=en">December 6</a>, only 19% of people aged 65 and over had received a booster shot in the last six months. For those aged 75 and over, this figure is 23%. Where is the messaging to these at-risk groups explaining why updating their boosters is so important? <h2>Should we be concerned by this wave?</h2> That depends on who we mean by “we”. For those who are vulnerable, absolutely. Mainly because so few have received an updated booster shot and very few people, including the elderly, are wearing masks. For the majority of people, a COVID infection is unlikely to be serious. The biggest concern for younger people is the risk of long COVID, which research suggests <a href="https://www.nature.com/articles/s41591-022-02051-3">increases</a> with each reinfection. <h2>What should we expect in 2024?</h2> It’s highly likely we will see repeated waves of infections over the next 12 months and beyond, mainly caused by waning immunity from previous infection, vaccination or both, and new subvariants. Unless a new subvariant causes more severe disease (and at this stage, there’s no evidence JN.1 does), we should be able to manage quite well, without our hospitals becoming overwhelmed. However, we should be doing more to protect our vulnerable population. Having only one in five older people up to date with a booster and more than 300 outbreaks in aged care homes is not acceptable. For those who are vulnerable, the usual advice applies. Make sure you’re up to date with your booster shots, wear a P2/N95 mask when out and about, and if you do get infected, take antivirals as soon as possible.<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/220839/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adrian-esterman-1022994">Adrian Esterman</a>, Professor of Biostatistics and Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> 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/covid-is-surging-in-australia-and-only-1-in-5-older-adults-are-up-to-date-with-their-boosters-220839">original article</a>.

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"That is NOT a goanna": Family stumbles upon metre-long croc in their chicken coop

A Central Queensland family got the croc-shock of their lives when what they thought was a seemingly innocent goanna having a nap in their chicken coop turned out to be a rather laid-back, metre-long reptile houseguest. The unsuspecting family from Cape Hillsborough stumbled upon the scaly interloper during their morning routine and, upon closer inspection, they realised that their "goanna" was actually a pint-sized crocodile with a hunger for adventure and perhaps a penchant for farm-fresh eggs. They immediately called upon the services of the wildlife officers from the Department of Environment, Science and Innovation (DESI) to handle the unexpected guest. DESI staff, armed with their best PVC tube, swooped in to relocate the confused crocodile to a more suitable venue – a facility in Mackay. There, the croc will wait patiently until wildlife officers can find it a new home, possibly at a licensed farm or zoo where it can continue its culinary escapades under professional supervision. Senior Wildlife Officer Jane Burns commented on the incident, saying, "While it isn't unusual to see crocs around Mackay, it is unusual to find one in someone's backyard." Well, Jane, they say every family has a skeleton in the closet, but in Mackay, it seems they might have a croc in the coop. This peculiar episode follows hot on the heels of recent reports of a crocodile deciding to test its high jump skills, attempting to land in a fisherman's tinnie at Jane Creek in nearby St Helen's Beach. Witnesses say the crocodile executed a perfect swan dive, narrowly avoiding a career in aquatic acrobatics. As the good people of Mackay navigate this unexpected croc invasion, wildlife authorities are reminding everyone to be "<a href="https://www.qld.gov.au/environment/plants-animals/animals/living-with/crocodiles/becrocwise" target="_blank" rel="noopener">Crocwise in Croc Country</a>". Tips include expecting crocs in all waterways (yes, even in your neighbour's kiddie pool), obeying warning signs (they're not just fancy decorations), and refraining from using canoes and kayaks (apparently, crocs have a thing for watercraft). So, the next time you suspect a goanna is admiring your chicken coop, remember – it might just be a crocodile in disguise, ready for a culinary adventure and a chance at stardom. Images: DISA

Travel Trouble

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>.

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We finally know why some people got COVID while others didn’t

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