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

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

Body

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

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

Travel Tips

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

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

Travel Trouble

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

Long COVID puzzle pieces are falling into place – the picture is unsettling

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ziyad-al-aly-513663">Ziyad Al-Aly</a>, <a href="https://theconversation.com/institutions/washington-university-in-st-louis-732">Washington University in St. Louis</a> Since 2020, the condition known as long COVID-19 has become a <a href="https://www.hhs.gov/civil-rights/for-providers/civil-rights-covid19/guidance-long-covid-disability/index.html">widespread disability</a> affecting the health and quality of life of millions of people across the globe and costing economies billions of dollars in <a href="https://www.oecd.org/en/publications/the-impacts-of-long-covid-across-oecd-countries_8bd08383-en.html">reduced productivity of employees and an overall drop in the work force</a>. The intense scientific effort that long COVID sparked has resulted in <a href="https://pubmed.ncbi.nlm.nih.gov/?term=%22long+covid%22+or+%22pasc%22+or+%22post-acute+sequelae+of+covid-19%22+or+%22postacute+sequelae+of+covid-19%22+or+%22post-acute+sequelae+of+SARS-CoV-2%22+or+%22postacute+sequelae+of+SARS-CoV-2%22+or+%22post+covid+condition%22+or+%22post+covid+conditions%22+or+%E2%80%9Cchronic+covid-19%E2%80%9D+or+%E2%80%9Cpost+covid-19+condition%E2%80%9D+or+%E2%80%9Cpost+covid-19+conditions%E2%80%9D+or+%E2%80%9Cpost-covid+condition%E2%80%9D+or+%E2%80%9Cpost-covid+conditions%E2%80%9D+or+%E2%80%9Clong+covid-19%E2%80%9D+or+%28%22long-term%22+and+%22COVID-19%22%29+or+%28%22longterm%22+and+%22COVID-19%22%29+or+%28%22long-term%22+and+%22SARS-CoV-2%22%29+or+%28%22longterm%22+and+%22SARS-CoV-2%22%29+or+%E2%80%9Cpostcovid+condition%E2%80%9D+or+%E2%80%9Cpostcovid+conditions%E2%80%9D+&sort=date">more than 24,000 scientific publications</a>, making it the most researched health condition in any four years of recorded human history. <a href="https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html">Long COVID</a> is a term that describes the <a href="https://www.yalemedicine.org/conditions/long-covid-post-covid-conditions-pcc">constellation of long-term health effects</a> caused by infection with the SARS-CoV-2 virus. These range from persistent respiratory symptoms, such as shortness of breath, to debilitating fatigue or brain fog that limits people’s ability to work, and conditions such as heart failure and diabetes, which are known to last a lifetime. I am a physician scientist, and I have been deeply immersed in studying long COVID since the early days of the pandemic. I have testified before the U.S. Senate as an <a href="https://www.help.senate.gov/imo/media/doc/baf4e4e7-b423-6bef-7cb4-1b272df66eb8/Al-Aly%20Testimony.pdf">expert witness on long COVID</a>, have <a href="https://scholar.google.com/citations?hl=en&user=DtuRVcUAAAAJ">published extensively on it</a> and was named as one of <a href="https://time.com/6966812/ziyad-al-aly/">Time’s 100 most influential people in health in 2024</a> for my research in this area. Over the first half of 2024, a <a href="https://www.nationalacademies.org/our-work/long-term-health-effects-stemming-from-covid-19-and-implications-for-the-social-security-administration#sl-three-columns-afa91458-20e0-42ab-9bd6-55e3c8262ecc">flurry of reports</a> and <a href="https://doi.org/10.1056/NEJMoa2403211">scientific papers</a> on long COVID added clarity to this complex condition. These include, in particular, insights into how COVID-19 can still wreak havoc in many organs years after the initial viral infection, as well as emerging evidence on viral persistence and immune dysfunction that last for months or years after initial infection. <h2>How long COVID affects the body</h2> A new study that my colleagues and I published in the New England Journal of Medicine on July 17, 2024, shows that the <a href="https://doi.org/10.1056/NEJMoa2403211">risk of long COVID declined</a> over the course of the pandemic. In 2020, when the ancestral strain of SARS-CoV-2 was dominant and vaccines were not available, about 10.4% of adults who got COVID-19 developed long COVID. By early 2022, when the omicron family of variants predominated, that rate declined to 7.7% among unvaccinated adults and 3.5% of vaccinated adults. In other words, unvaccinated people were more than twice as likely to develop long COVID. While researchers like me do not yet have concrete numbers for the current rate in mid-2024 due to the time it takes for long COVID cases to be reflected in the data, the flow of new patients into long COVID clinics has been on par with 2022. We found that the decline was the result of two key drivers: availability of vaccines and changes in the characteristics of the virus – which made the virus less prone to cause severe acute infections and may have reduced its ability to persist in the human body long enough to cause chronic disease. Despite the decline in risk of developing long COVID, even a 3.5% risk is substantial. New and repeat COVID-19 infections translate into millions of new long COVID cases that add to an already staggering number of people suffering from this condition. Estimates for the first year of the pandemic suggests that at <a href="https://doi.org/10.1038/s41579-023-00896-0">least 65 million people</a> globally have had long COVID. Along with a group of other leading scientists, my team will soon publish updated estimates of the global burden of long COVID and its impact on the global economy through 2023. In addition, a major new report by the National Academies of Sciences Engineering and Medicine details all the <a href="https://nap.nationalacademies.org/catalog/27756/long-term-health-effects-of-covid-19-disability-and-function">health effects that constitute long COVID</a>. The report was commissioned by the Social Security Administration to understand the implications of long COVID on its disability benefits. It concludes that long COVID is a complex chronic condition that can result in more than 200 health effects across multiple body systems. These include new onset or worsening: <ul> <li><a href="https://doi.org/10.1038/s41591-022-01689-3">heart disease</a></li> <li><a href="https://doi.org/10.1038/s41591-022-02001-z">neurologic problems</a> such as <a href="https://theconversation.com/mounting-research-shows-that-covid-19-leaves-its-mark-on-the-brain-including-with-significant-drops-in-iq-scores-224216">cognitive impairment</a>, strokes and <a href="https://my.clevelandclinic.org/health/diseases/6004-dysautonomia">dysautonomia</a>. This is a category of disorders that affect the body’s <a href="https://my.clevelandclinic.org/health/body/23273-autonomic-nervous-system">autonomic nervous system</a> – nerves that regulate most of the body’s vital mechanisms such as blood pressure, heart rate and temperature.</li> <li><a href="https://www.cdc.gov/me-cfs/hcp/clinical-care/treating-the-most-disruptive-symptoms-first-and-preventing-worsening-of-symptoms.html">post-exertional malaise</a>, a state of severe exhaustion that may happen after even minor activity — often leaving the patient unable to function for hours, days or weeks</li> <li><a href="https://doi.org/10.1038/s41467-023-36223-7">gastrointestinal disorders</a></li> <li><a href="https://doi.org/10.1681/ASN.2021060734">kidney disease</a></li> <li>metabolic disorders such as <a href="https://doi.org/10.1016/S2213-8587(22)00044-4">diabetes</a> and <a href="https://doi.org/10.1016/S2213-8587(22)00355-2">hyperlipidemia</a>, or a rise in bad cholesterol</li> <li><a href="https://doi.org/10.1038/s41590-023-01724-6">immune dysfunction</a></li> </ul> Long COVID can affect people across the lifespan from children to older adults and across race and ethnicity and baseline health status. Importantly, <a href="https://doi.org/10.1126/science.adl0867">more than 90% of people with long COVID</a> had mild COVID-19 infections. The National Academies report also concluded that long COVID can result in the inability to return to work or school; poor quality of life; diminished ability to perform activities of daily living; and decreased physical and cognitive function for months or years after the initial infection. The report points out that many health effects of long COVID, such as post-exertional malaise and chronic fatigue, cognitive impairment and autonomic dysfunction, are not currently captured in the <a href="https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm">Social Security Administration’s Listing of Impairments</a>, yet may significantly affect an individual’s ability to participate in work or school. <figure><iframe src="https://www.youtube.com/embed/9kJ5GWb2wzw?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Many people experience long COVID symptoms for years following initial infection.</figcaption></figure> <h2>A long road ahead</h2> What’s more, health problems resulting from COVID-19 can last years after the initial infection. A large study published in early 2024 showed that even people who had a <a href="https://doi.org/10.1038/s41591-024-02987-8">mild SARS-CoV-2 infection still experienced new health problems</a> related to COVID-19 in the third year after the initial infection. Such findings parallel other research showing that the <a href="https://doi.org/10.1016/S1473-3099(24)00171-3">virus persists</a> in various organ systems for months or years after COVID-19 infection. And research is showing that immune responses to the infection are <a href="https://doi.org/10.1126/scitranslmed.adk3295">still evident two to three years</a> after a mild infection. Together, these studies may explain why a SARS-CoV-2 infection years ago could still cause new health problems long after the initial infection. Important progress is also being made in understanding the pathways by which long COVID wreaks havoc on the body. Two preliminary studies <a href="https://doi.org/10.1101/2024.06.18.24309100">from the U.S.</a> and <a href="https://doi.org/10.1101/2024.05.30.596590">the Netherlands</a> show that when researchers transfer auto-antibodies – antibodies generated by a person’s immune system that are directed at their own tissues and organs – from people with long COVID into healthy mice, the animals start to experience long COVID-like symptoms such as muscle weakness and poor balance. These studies suggest that an abnormal immune response thought to be responsible for the generation of these auto-antibodies may underlie long COVID and that <a href="https://doi.org/10.1126/science.zbzipqn">removing these auto-antibodies</a> may hold promise as potential treatments. <h2>An ongoing threat</h2> Despite overwhelming evidence of the wide-ranging risks of COVID-19, a great deal of messaging suggests that it is no longer a threat to the public. Although there is no empirical evidence to back this up, this misinformation has permeated the public narrative. The data, however, tells a different story. <a href="https://covid.cdc.gov/covid-data-tracker/#datatracker-home">COVID-19 infections</a> continue to <a href="https://www.cdc.gov/flu/weekly/index.htm">outnumber flu cases</a> and lead to <a href="https://www.cdc.gov/resp-net/dashboard/index.html">more hospitalization</a> and <a href="https://doi.org/10.1001/jama.2024.7395">death</a> than the flu. COVID-19 also leads to <a href="https://doi.org/10.1016/S1473-3099(23)00684-9">more serious long-term health problems</a>. Trivializing COVID-19 as an inconsequential cold or <a href="https://www.theatlantic.com/health/archive/2024/02/covid-anniversary-flu-isolation-cdc/677588/">equating it with the flu</a> does not align with reality.<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/233759/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ziyad-al-aly-513663">Ziyad Al-Aly</a>, Chief of Research and Development, VA St. Louis Health Care System. Clinical Epidemiologist, <a href="https://theconversation.com/institutions/washington-university-in-st-louis-732">Washington University in St. Louis</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/long-covid-puzzle-pieces-are-falling-into-place-the-picture-is-unsettling-233759">original article</a>. </div>

Body

Attempted assassination of Trump: The long history of violence against U.S. presidents

<a href="https://theconversation.com/profiles/thomas-klassen-1171638">Thomas Klassen</a>, <a href="https://theconversation.com/institutions/york-university-canada-1610">York University, Canada</a> Political assassinations in the United States have a long and disturbing history. The <a href="https://apnews.com/article/trump-vp-vance-rubio-7c7ba6b99b5f38d2d840ed95b2fdc3e5">attempted assassination of Donald Trump</a>, who narrowly escaped death when a bullet grazed his right ear while he was speaking at a campaign rally in Pennsylvania on Saturday, highlights the danger of those seeking votes in a country whose constitution guarantees citizens the right to bear arms. Trump joins a not-so-exclusive club of U.S. presidents, former presidents and presidential candidates who have been the target of bullets. Of the 45 people who have served as president, four have been <a href="https://abcnews.go.com/US/wireStory/us-presidents-assassinated-targeted-presidential-candidates-111920908">assassinated while in office</a>. Given the near mythic status of U.S. presidents, and the nation’s superpower role, political assassinations strike at the very heart of the American psyche. <a href="https://www.loc.gov/collections/abraham-lincoln-papers/articles-and-essays/assassination-of-president-abraham-lincoln/">Abraham Lincoln</a>’s killing in 1865 and that of <a href="https://theconversation.com/jfk-assassination-60-years-on-seven-experts-on-what-to-watch-see-and-read-to-understand-the-event-and-its-consequences-216203">John F. Kennedy</a> in 1963 are key moments in the history of the United States. <a href="https://www.history.com/news/the-assassination-of-president-james-a-garfield">James Garfield</a> (1881) and <a href="https://www.history.com/news/the-assassination-of-president-william-mckinley">William McKinley</a> (1901) are less remembered, but their deaths nonetheless rocked the nation at the time. <h2>Secret Service provides protection</h2> It was after McKinley’s assassination that the U.S. Secret Service was given <a href="https://www.secretservice.gov/about/history/150-years#:%7E:text">the job of providing full-time protection to presidents</a>. The last American president to be shot was Ronald Reagan, <a href="https://www.reaganlibrary.gov/permanent-exhibits/assassination-attempt">who was seriously wounded and required emergency surgery in 1981</a>. Reagan was leaving a Washington hotel after giving a speech when gunman John Hinckley Jr. fired shots from a .22-calibre pistol. One of the bullets ricocheted off the president’s limousine and hit him under the left armpit. Reagan spent 12 days in hospital before returning to the White House. Other presidents have been shot at, but luckily, not injured. In 1933, <a href="http://www.fdrlibraryvirtualtour.org/page03-06.asp">a gunman fired five shots at the car of then President-Elect Franklin D. Roosevelt</a>. Roosevelt wasn’t hit but the mayor of Chicago, Anton Cermak, who was speaking to Roosevelt after the newly elected president had made some brief remarks to the public, was injured and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297642/">died 19 days later</a>. <h2>Two attempts in one month</h2> In September of 1975, President Gerald Ford survived <a href="https://www.fordlibrarymuseum.gov/avproj/assassinations.asp">two separate assassination attempts — both by women</a>. The first came on Sept. 5 when Lynette (Squeaky) Fromme, a follower of cult leader Charles Manson, tried to shoot Ford as he was walking through a park in Sacramento, Calif., but her gun misfired and didn’t go off. On Sept. 22, Sara Jane Moore, a woman with ties to left-wing radical groups, got one shot off at Ford as he left a hotel in San Francisco but it missed the president. Presidential candidates have not been exempt from assassination attempts, including most notably Senator <a href="https://www.npr.org/2023/06/05/1179430014/robert-kennedy-rfk-assassination-anniversary">Robert F. Kennedy</a> killed in 1968 and <a href="https://www.wsfa.com/2024/07/14/son-late-alabama-gov-george-wallace-reacts-trump-rally-shooting/">George Wallace</a> shot and left paralyzed in 1972. In 1912, former president Theodore Roosevelt <a href="https://blogs.loc.gov/headlinesandheroes/2019/07/the-pocket-items-that-saved-the-life-of-theodore-roosevelt/">was hit in the chest by a .38-calibre bullet</a> as he was campaigning to regain the White House. But most of the impact of the bullet was absorbed by objects in the chest pocket of Roosevelt’s jacket. Even though he had been shot, Roosevelt went on to make a campaign speech with the bullet still in his chest. <h2>The violence of 1968</h2> Other figures with significant — if unelected — political power have also had their lives cut short by gunfire, most notably <a href="https://theconversation.com/mlks-vision-matters-today-for-the-43-million-americans-living-in-poverty-92380">Martin Luther King Jr.</a> in 1968, just a few months before Bobby Kennedy’s death. In a country with <a href="https://www.washingtonpost.com/news/wonk/wp/2018/06/19/there-are-more-guns-than-people-in-the-united-states-according-to-a-new-study-of-global-firearm-ownership/">more guns than people</a>, and with firearms easily available, it is not surprising that invariably shootings are the preferred means of killing or attempting to kill political office holders. Like Trump, most assassination attempts occur when candidates and politicians are in public spaces with crowds of people nearby. There is a long history of politicians insisting, against the advice of their security advisers, to “press the flesh” in events that jeopardize their safety. Trump was extraordinarily fortunate to escape with only minor injuries.<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/234630/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/thomas-klassen-1171638">Thomas Klassen</a>, Professor, School of Public Policy and Administration, <a href="https://theconversation.com/institutions/york-university-canada-1610">York University, Canada</a> Image credits: Xinhua News Agency/Shutterstock Editorial 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/attempted-assassination-of-trump-the-long-history-of-violence-against-u-s-presidents-234630">original article</a>.

Legal

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

Cruising

‘Sleep tourism’ promises the trip of your dreams. Beyond the hype plus 5 tips for a holiday at home

<a href="https://theconversation.com/profiles/charlotte-gupta-347235">Charlotte Gupta</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/dean-j-miller-808724">Dean J. Miller</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Imagine arriving at your hotel after a long flight and being greeted by your own personal sleep butler. They present you with a pillow menu and invite you to a sleep meditation session later that day. You unpack in a room kitted with an AI-powered smart bed, blackout shades, blue light-blocking glasses and weighted blankets. Holidays are traditionally for activities or sightseeing – eating Parisian pastry under the Eiffel tower, ice skating at New York City’s Rockefeller Centre, lying by the pool in Bali or sipping limoncello in Sicily. But “<a href="https://www.smh.com.au/traveller/inspiration/pillow-menus-and-sleep-gummies-the-new-hotel-trend-that-s-putting-guests-to-sleep-20230823-p5dyu5.html">sleep tourism</a>” offers vacations for the sole purpose of getting good sleep. The emerging trend extends out of the global wellness tourism industry – reportedly worth more than <a href="https://www.forbes.com/sites/rogersands/2023/11/17/the-global-wellness-tourism-sector-surpasses-814-billion-market-share/">US$800 billion globally</a> (A$1.2 trillion) and <a href="https://www.statista.com/statistics/1018497/global-market-size-of-the-wellness-tourism-industry/">expected to boom</a>. Luxurious sleep retreats and sleep suites at hotels are popping up <a href="https://www.countryandtownhouse.com/style/health-and-beauty/sleep-retreats/">all over the world</a> for tourists to get some much-needed rest, relaxation and recovery. But do you really need to leave home for some shuteye? <h2>Not getting enough</h2> The rise of sleep tourism may be a sign of just how chronically sleep deprived we all are. In Australia more than one-third of adults are not achieving the recommended <a href="https://www.sciencedirect.com/science/article/pii/S2352721816301292?via%3Dihub">7–9 hours</a> of sleep per night, and the estimated cost of this inadequate sleep is <a href="https://academic.oup.com/sleep/article/41/8/zsy083/5025924">A$45 billion</a> each year. Inadequate sleep is linked to <a href="https://www.tandfonline.com/doi/full/10.2147/NSS.S134864">long-term health problems</a> including poor mental health, heart disease, metabolic disease and deaths from any cause. <h2>Can a fancy hotel give you a better sleep?</h2> Many of the sleep services available in the sleep tourism industry aim to optimise the bedroom for sleep. This is a core component of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4400203/?ref=askdoctorjad.com">sleep hygiene</a> – a series of healthy sleep practices that facilitate good sleep including sleeping in a comfortable bedroom with a good mattress and pillow, sleeping in a quiet environment and relaxing before bed. The more people follow sleep hygiene practices, the better their <a href="https://www.tandfonline.com/doi/abs/10.1080/08964280209596396">sleep quality and quantity</a>. When we are staying in a hotel we are also likely away from any stressors we encounter in everyday life (such as work pressure or caring responsibilities). And we’re away from potential nighttime disruptions to sleep we might experience at home (the construction work next door, restless pets, unsettled children). So regardless of the sleep features hotels offer, it is likely we will experience improved sleep when we are away. <h2>What the science says about catching up on sleep</h2> In the short-term, <a href="https://theconversation.com/is-it-possible-to-catch-up-on-sleep-we-asked-five-experts-98699#:%7E:text=We%20can%20catch%20up%20on,and%20we%20cannot%20resist%20sleep.">we can catch up on sleep</a>. This can happen, for example, after a short night of sleep when our brain accumulates “<a href="https://www.tandfonline.com/doi/abs/10.3109/07420528.2012.675256">sleep pressure</a>”. This term describes how strong the biological drive for sleep is. More sleep pressure makes it easier to sleep the next night and to sleep for longer. But while a longer sleep the next night can relieve the sleep pressure, it does not reverse the <a href="https://jcsm.aasm.org/doi/pdf/10.5664/jcsm.26918">effects of the short sleep on our brain and body</a>. Every night’s sleep is important for our body to recover and for our brain to process the events of that day. Spending a holiday “catching up” on sleep could help you feel more rested, but it is not a substitute for prioritising regular healthy sleep at home. All good things, including holidays, must come to an end. Unfortunately the perks of sleep tourism may end too. Our bodies do not like variability in the time of day that we sleep. The most common example of this is called “<a href="https://www.mdpi.com/2072-6643/13/12/4543">social jet lag</a>”, where weekday sleep (getting up early to get to work or school) is vastly different to weekend sleep (late nights and sleep ins). This can result in a sleepy, grouchy start to the week on Monday. Sleep tourism may be similar, if you do not come back home with the intention to prioritise sleep. So we should be mindful that as well as sleeping well on holiday, it is important to optimise conditions at home to get consistent, adequate sleep every night. <h2>5 tips for having a sleep holiday at home</h2> An AI-powered mattress and a sleep butler at home might be the dream. But these features are not the only way we can optimise our sleep environment and give ourselves the best chance to get a good night’s sleep. Here are five ideas to start the night right: 1. avoid bright artificial light in the evening (such as bright overhead lights, phones, laptops) 2. make your bed as comfortable as possible with fresh pillows and a supportive mattress 3. use black-out window coverings and maintain a cool room temperature for the ideal sleeping environment 4. establish an evening wind-down routine, such as a warm shower and reading a book before bed or even a “<a href="https://theconversation.com/turns-out-the-viral-sleepy-girl-mocktail-is-backed-by-science-should-you-try-it-222151">sleepy girl mocktail</a>” 5. use consistency as the key to a good sleep routine. Aim for a similar bedtime and wake time – even on weekends.<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/231718/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/charlotte-gupta-347235">Charlotte Gupta</a>, Senior postdoctoral research fellow, Appleton Institute, HealthWise research group, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> and <a href="https://theconversation.com/profiles/dean-j-miller-808724">Dean J. Miller</a>, Adjunct Research Fellow, Appleton Institute of Behavioural Science, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity 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/sleep-tourism-promises-the-trip-of-your-dreams-beyond-the-hype-plus-5-tips-for-a-holiday-at-home-231718">original article</a>.

Travel Trouble

"Ruined our trip": Mum shell-shocked by $130k fine

A mother has been slapped with a hefty fine after her children were caught in a seemingly innocent act while on a beach holiday. Charlotte Russ took her five kids on a trip to Pismo Beach in California, where her children started enthusiastically collecting what they thought were ordinary seashells. "My kids they thought they were collecting seashells, but they were actually collecting clams, 72 to be exact," Russ told local news outlet <a href="https://abc7.com/post/fresno-woman-fined-88k-after-kids-collect-clams/14859295/" target="_blank" rel="nofollow noreferrer noopener">ABC 7</a>. Clamming is highly regulated in California, meaning if you don't have a fishing license, you cannot catch the small sea creatures. She received a citation right there on the beach and was later notified she has to pay close to $89,000, or $133,000 AUD, for her kids' seemingly innocent treasure hunt. "It made me really sad and depressed, and it kind of ruined our trip," said Russ. Department of Fish and Wildlife's Lieutenant Matthew Gil defended the fine, saying there are rules in place for a reason. "The reason we got it we have these regulations is because we have to let them get to 4 and a half inches so they can spawn so they can have they can have offspring every year, and they have juvenile clams," said Lt. Gil. Russ said her kids have learned their lesson, saying, "They know now at the beach don't touch anything, but they know now what a clam is, compared to what a seashell is now, I've had to explain that to them." The mother was able to plead her case with a San Luis Obispo County Judge, who reduced her fine to $500 dollars, and after she "won" her case, Russ got a shellfish tattoo to commemorate the incident. "It was definitely one expensive trip to Pismo, unforgettable," said Russ. Image credits: ABC 7

Travel Trouble

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

<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>.

Relationships

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?

Body

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

<a href="https://theconversation.com/profiles/nicholas-r-micinski-207353">Nicholas R. Micinski</a>, <a href="https://theconversation.com/institutions/university-of-maine-2120">University of Maine</a> and <a href="https://theconversation.com/profiles/kelsey-norman-862895">Kelsey Norman</a>, <a href="https://theconversation.com/institutions/rice-university-931">Rice University</a> At least a dozen countries, including the U.S., have <a href="https://news.un.org/en/story/2024/01/1145987">suspended funding to the UNRWA</a>, the United Nations agency responsible for delivering aid to Palestinian refugees. This follows allegations made by Israel that <a href="https://www.wsj.com/world/middle-east/at-least-12-u-n-agency-employees-involved-in-oct-7-attacks-intelligence-reports-say-a7de8f36">12 UNRWA employees participated</a> in the Oct. 7, 2023, Hamas attack. The UNRWA responded by <a href="https://www.reuters.com/world/middle-east/un-palestinian-refugee-agency-investigates-staff-suspected-role-israel-attacks-2024-01-26/">dismissing all accused employees</a> and opening an investigation. While the seriousness of the accusations is clear to all, and the U.S. has been keen to <a href="https://www.nytimes.com/2024/01/30/us/politics/aid-gaza-israel.html">downplay the significance</a> of its pause in funding, the action is not in keeping with precedent. Western donors did not, for example, defund other U.N. agencies or peacekeeping operations amid accusations of <a href="https://www.hrw.org/news/2020/01/11/un-peacekeeping-has-sexual-abuse-problem">sexual assault</a>, <a href="https://www.justice.gov/usao-sdny/pr/former-un-general-assembly-president-and-five-others-charged-13-million-bribery-scheme">corruption</a> or <a href="https://www.hrw.org/legacy/summaries/s.bosnia9510.html">complicity in war crimes</a>. In real terms, the funding cuts to the UNRWA will affect <a href="https://www.unrwa.org/where-we-work/gaza-strip">1.7 million Palestinian refugees in Gaza</a> along with an additional 400,000 Palestinians without refugee status, many of whom benefit from the UNRWA’s infrastructure. Some critics have gone further and said depriving the agency of funds <a href="https://jacobin.com/2024/01/unrwa-defunding-gaza-israel">amounts to collective punishment</a> against Palestinians. Refugee aid, and humanitarian aid more generally, is theoretically meant to be neutral and impartial. But as experts in <a href="https://www.cambridge.org/core/books/reluctant-reception/558E2A93FF99B8F295347A8FA2053698">migration</a> <a href="https://www.routledge.com/UN-Global-Compacts-Governing-Migrants-and-Refugees/Micinski/p/book/9780367218836">and</a> <a href="https://press.umich.edu/Books/D/Delegating-Responsibility">international relations</a>, we know funding is often used as a foreign policy tool, whereby allies are rewarded and enemies punished. In this context, we believe the cuts in funding for the UNRWA fit a wider pattern of the politicization of aid to refugees, particularly Palestinian refugees. <h2>What is the UNRWA?</h2> The UNRWA, short for the U.N. Relief and Works Agency for Palestine Refugees in the Near East, was established two years after about <a href="https://theconversation.com/the-nakba-at-75-palestinians-struggle-to-get-recognition-for-their-catastrophe-204782">750,000 Palestinians were expelled or fled from their homes</a> during the months leading up to the creation of the state of Israel in 1948 and the subsequent Arab-Israeli war. Prior to the UNRWA’s creation, international and local organizations, many of them religious, provided services to displaced Palestinians. But after <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">surveying the extreme poverty</a> and dire situation pervasive across refugee camps, the U.N. General Assembly, including all Arab states and Israel, voted to create the UNRWA in 1949. Since that time, <a href="https://www.unrwa.org/what-we-do">the UNRWA has been the primary aid organization</a> providing food, medical care, schooling and, in some cases, housing for the 6 million Palestinians living across its five fields: Jordan, Lebanon, Syria, as well as the areas that make up the occupied Palestinian territories: the West Bank and Gaza Strip. The mass displacement of Palestinians – known as the <a href="https://theconversation.com/the-nakba-at-75-palestinians-struggle-to-get-recognition-for-their-catastrophe-204782">Nakba, or “catastrophe</a>” – occurred prior to the <a href="https://www.unhcr.org/about-unhcr/who-we-are/1951-refugee-convention">1951 Refugee Convention</a>, which defined refugees as anyone with a well-founded fear of persecution owing to “events occurring in Europe before 1 January 1951.” Despite a <a href="https://www.unhcr.org/sites/default/files/legacy-pdf/4ec262df9.pdf">1967 protocol extending the definition</a> worldwide, Palestinians are still excluded from the primary international system protecting refugees. While the UNRWA is responsible for providing services to Palestinian refugees, the United Nations also created the U.N. Conciliation Commission for Palestine in 1948 to seek a <a href="https://www.refworld.org/docid/4fe2e5672.html">long-term political solution</a> and “to facilitate the repatriation, resettlement and economic and social rehabilitation of the refugees and the payment of compensation.” As a result, the UNRWA does not have a mandate to push for the traditional durable solutions available in other refugee situations. As it happened, the conciliation commission was active only for a few years and has since been sidelined in favor of the U.S.-brokered peace processes. <h2>Is the UNRWA political?</h2> The UNRWA has been <a href="https://www.migrationpolicy.org/article/palestinian-refugees-dispossession">subject</a> to political headwinds since its inception and especially during periods of heightened tension between Palestinians and Israelis. While it is a U.N. organization and thus ostensibly apolitical, it has <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">frequently been criticized</a> by Palestinians, Israelis as well as donor countries, including the United States, for acting politically. The UNRWA performs statelike functions across its five fields – including education, health and infrastructure – but it is restricted in its mandate from performing political or security activities. Initial Palestinian objections to the UNRWA stemmed from the organization’s early focus on economic integration of refugees into host states. Although the UNRWA officially adhered to the U.N. General Assembly’s <a href="https://www.unrwa.org/content/resolution-194">Resolution 194</a> that called for the return of Palestine refugees to their homes, U.N., U.K. and U.S. <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">officials searched</a> for means by which to resettle and integrate Palestinians into host states, viewing this as the favorable political solution to the Palestinian refugee situation and the broader Israeli-Palestinian conflict. In this sense, Palestinians perceived the UNRWA to be both highly political and actively working against their interests. In later decades, the UNRWA <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">switched its primary focus</a> from jobs to education at the urging of Palestinian refugees. But the UNRWA’s education materials were <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">viewed</a> by Israel as further feeding Palestinian militancy, and the Israeli government insisted on checking and approving all materials in Gaza and the West Bank, which it has occupied since 1967. While Israel has <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">long been suspicious</a> of the UNRWA’s role in refugee camps and in providing education, the organization’s operation, which is internationally funded, <a href="https://www.crisisgroup.org/middle-east-north-africa/east-mediterranean-mena/israelpalestine/242-unrwas-reckoning-preserving-un-agency-serving-palestinian-refugees">also saves</a> Israel millions of dollars each year in services it would be obliged to deliver as the occupying power. Since the 1960s, the U.S. – UNRWA’s primary donor – and other Western countries have <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">repeatedly expressed their desire</a> to use aid to prevent radicalization among refugees. In response to the increased presence of armed opposition groups, the <a href="https://cup.columbia.edu/book/refuge-and-resistance/9780231202855">U.S. attached a provision</a> to its UNRWA aid in 1970, requiring that the “UNRWA take all possible measures to assure that no part of the United States contribution shall be used to furnish assistance to any refugee who is receiving military training as a member of the so-called Palestine Liberation Army (PLA) or any other guerrilla-type organization.” The UNRWA adheres to this requirement, even publishing an annual list of its employees so that host governments can vet them, but it also <a href="https://www.crisisgroup.org/middle-east-north-africa/east-mediterranean-mena/israelpalestine/242-unrwas-reckoning-preserving-un-agency-serving-palestinian-refugees">employs 30,000 individuals</a>, the vast majority of whom are Palestinian. Questions over the links of the UNRWA to any militancy has led to the rise of Israeli and international <a href="https://cufi.org/issue/unrwa-teachers-continue-to-support-antisemitism-terrorism-on-social-media-un-watch/">watch groups</a> that document the social media activity of the organization’s large Palestinian staff. <h2>Repeated cuts in funding</h2> The United States has used its money and power within the U.N. to block criticism of Israel, vetoing at least <a href="https://www.un.org/depts/dhl/resguide/scact_veto_table_en.htm">45 U.N. resolutions</a> critical of Israel. And the latest freeze is not the first time the U.S. has cut funding to the UNRWA or other U.N. agencies in response to issues pertaining to the status of Palestinians. In 2011, the <a href="https://www.reuters.com/article/idUSTRE79U5ED/#:%7E:text=WASHINGTON%20(Reuters)%20%2D%20The%20United,grant%20the%20Palestinians%20full%20membership.">U.S. cut all funding to UNESCO</a>, the U.N. agency that provides educational and cultural programs around the world, after the agency voted to admit the state of Palestine as a full member. The Obama administration defended the move, claiming it was required by a 1990s law to defund any U.N. body that admitted Palestine as a full member. But the impact of the action was nonetheless severe. Within just four years, UNESCO was <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1758-5899.12459">forced to cut its staff in half</a> and roll back its operations. President Donald Trump later <a href="https://www.pbs.org/newshour/politics/u-s-and-israel-officially-withdraw-from-unesco">withdrew the U.S. completely from UNESCO</a>. In 2018, the Trump administration paused its <a href="https://www.nytimes.com/2018/08/31/us/politics/trump-unrwa-palestinians.html">US$60 million contribution to the UNRWA</a>. Trump claimed the pause would create political pressure for Palestinians to negotiate. President Joe Biden restarted U.S. contributions to the UNRWA in 2021. <h2>Politicization of refugee aid</h2> Palestinian are not the only group to suffer from the politicization of refugee funding. After World War II, states established different international organizations to help refugees but strategically excluded some groups from the refugee definition. For example, the U.S. funded the <a href="https://www.nationalww2museum.org/war/articles/last-million-eastern-european-displaced-persons-postwar-germany">U.N. Relief and Rehabilitation Administration to help resettle displaced persons after World War II</a> but resisted Soviet pressure to forcibly repatriate Soviet citizens. The U.S. also created a separate organization, <a href="https://academic.oup.com/ijrl/article-abstract/1/4/501/1598187">the precursor to the International Organization for Migration</a>, to circumvent Soviet influence. In many ways, the UNRWA’s existence and the exclusion of Palestinian refugees from the wider refugee regime parallels this dynamic. Funding for refugees has also been politicized through the earmarking of voluntary contributions to U.N. agencies. Some agencies receive funding from U.N. dues; but the UNRWA, alongside the U.N. High Commissioner for Refugees and the International Organization for Migration, receive the majority of their funding from voluntary contributions from member states. These contributions can be earmarked for specific activities or locations, leading to donors such as the <a href="https://www.peio.me/wp-content/uploads/2019/01/PEIO12_paper_107.pdf">U.S. or European Union dictating which refugees get aid and which do not</a>. Earmarked contributions amounted to nearly <a href="https://unsceb.org/fs-revenue-agency">96% of the UNHCR’s budget, 96% of the IOM’s budget and 74% of UNRWA funding in 2022</a>. As a result, any cuts to UNRWA funding will affect its ability to service Palestinian refugees in Gaza – especially at a time when so many are <a href="https://www.cnn.com/2024/01/30/middleeast/famine-looms-in-gaza-israel-war-intl/index.html">facing hunger, disease and displacement</a> as a result of war.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222263/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nicholas-r-micinski-207353">Nicholas R. Micinski</a>, Assistant Professor of Political Science and International Affairs, <a href="https://theconversation.com/institutions/university-of-maine-2120">University of Maine</a> and <a href="https://theconversation.com/profiles/kelsey-norman-862895">Kelsey Norman</a>, Fellow for the Middle East, Rice University's Baker Institute for Public Policy, <a href="https://theconversation.com/institutions/rice-university-931">Rice University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/funding-for-refugees-has-long-been-politicized-punitive-action-against-unrwa-and-palestinians-fits-that-pattern-222263">original article</a>.

Money & Banking

How long does immunity last after a COVID infection?

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

Body

Couple who found love in chemotherapy raise funds for final trip

Ainslie Plumb, 22, and Joe Fan, 29, found love in an unexpected place, at the Royal Brisbane and Women’s Hospital. The couple met in 2022 while they were both undergoing leukaemia treatment. “We met at an event for young people with cancer and became friends following that,” Plumb told 7News. “(We) would hang out during our hospital stays, I asked him out in October 2022 and (we) have been together ever since.” While Plumb successfully entered remission, last October, Fan was told that he was now terminal, as doctors had run out of options to treat his Philadelphia chromosome positive acute lymphoblastic leukaemia. With only months left to live, Fan, who has actively given back to the hospital and cancer community by playing his violin for patients and staff and worked with the Queensland Youth Cancer Service, has one final wish - to travel. The couple have set a <a href="https://www.gofundme.com/f/help-joe-live-his-dreams" target="_blank" rel="noopener">GoFundMe</a>, to help raise funds which cover flights, accommodation and specialised travel insurance, for Fan's final trip. “I go through my cancer treatments and observe the toll that takes on my physical and mental wellbeing,” Fan said. “The end of a trip can hopefully mark the start of another — and I have held onto hope, looked forward and dreamed for one more trip, more time, one more experience with that someone I love.” Their first destination will be Taiwan and Hong Kong, where Fan's parents are from and where he spent a majority of his childhood. They also intend to travel to New Zealand and Western Australia to swim with whale sharks at Ningaloo in the state’s north. “We’re aiming at going at the end of February to give us time to co-ordinate with his doctors around his appointments and infusions, which are all booked in advance,” Plumb said. “We recently reached 75 per cent on the fundraiser and are hoping to hit 100 per cent perhaps by the end of January.” As of today, the couple have successfully raised over $21,000 from their $20,000 goal, and have thanked everyone in their community and strangers for their support. “Truly, words do not suffice,” the couple said. Images: 7News

Relationships

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

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

Body

Missing boy found alive after six long years

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

Family & Pets

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

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

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