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How can we improve public health communication for the next pandemic? Tackling distrust and misinformation is key

<p><em><a href="https://theconversation.com/profiles/shauna-hurley-203140">Shauna Hurley</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/rebecca-ryan-1522824">Rebecca Ryan</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a></em></p> <p>There’s a common thread linking our <a href="https://www.visualcapitalist.com/history-of-pandemics-deadliest/">experience of pandemics</a> over the past 700 years. From the black death in the 14th century to COVID in the 21st, public health authorities have put emergency measures such as isolation and quarantine in place to stop infectious diseases spreading.</p> <p>As we know from COVID, these measures upend lives in an effort to save them. In both the <a href="https://www.thinkglobalhealth.org/article/pandemic-protests-when-unrest-and-instability-go-viral">recent</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3559034/">distant past</a> they’ve also given rise to collective unrest, confusion and resistance.</p> <p>So after all this time, what do we know about the role public health communication plays in helping people understand and adhere to protective measures in a crisis? And more importantly, in an age of misinformation and distrust, how can we improve public health messaging for any future pandemics?</p> <p>Last year, we published a <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015144/full">Cochrane review</a> exploring the global evidence on public health communication during COVID and other infectious disease outbreaks including SARS, MERS, influenza and Ebola. Here’s a snapshot of what we found.</p> <h2>The importance of public trust</h2> <p>A key theme emerging in analysis of the COVID pandemic globally is public trust – or lack thereof – in governments, public institutions and science.</p> <p>Mounting evidence suggests <a href="https://www.washingtonpost.com/world/2022/02/01/trust-lancet-covid-study/">levels of trust in government</a> were <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00172-6/fulltext">directly proportional</a> to fewer COVID infections and higher vaccination rates across the world. It was a crucial factor in people’s willingness to follow public health directives, and is now a key focus for future pandemic preparedness.</p> <p>Here in Australia, public trust in governments and health authorities steadily eroded over time.</p> <p>Initial information from governments and health authorities about the unfolding COVID crisis, personal risk and mandated protective measures was generally clear and consistent across the country. The establishment of the <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1920/Quick_Guides/AustralianCovid-19ResponseManagement#_Toc38973752">National Cabinet</a> in 2020 signalled a commitment from state, territory and federal governments to consensus-based policy and public health messaging.</p> <p>During this early phase of relative unity, <a href="https://theconversation.com/inflation-covid-inequality-new-report-shows-australias-social-cohesion-is-at-crossroads-195198">Australians reported</a> higher levels of belonging and trust in government.</p> <p>But as the pandemic wore on, public trust and confidence fell on the back of conflicting state-federal pandemic strategies, blame games and the <a href="https://theconversation.com/we-lost-the-plot-on-covid-messaging-now-governments-will-have-to-be-bold-to-get-us-back-on-track-186732">confusing fragmentation</a> of public health messaging. The divergence between <a href="https://www.theaustralian.com.au/nation/tale-of-two-cities-gripped-by-covid-fear-outbreak/news-story/cf1b922610aeb0b0ee9b0b53486bf640">lockdown policies and public health messaging</a> adopted by <a href="https://www.theage.com.au/national/victoria/a-tale-of-two-cities-that-doesn-t-seem-fair-20211012-p58z79.html">Victoria and New South Wales</a> is one example, but there are plenty of others.</p> <p>When state, territory and federal governments have conflicting policies on protective measures, people are easily confused, lose trust and become harder to engage with or persuade. Many tune out from partisan politics. Adherence to mandated public health measures falls.</p> <p>Our research found clarity and consistency of information were key features of effective public health communication throughout the COVID pandemic.</p> <p>We also found public health communication is most effective when authorities work in partnership with different target audiences. In Victoria, the case brought against the state government for the <a href="https://www.abc.net.au/news/2023-07-24/melbourne-public-housing-tower-covid-lockdown-compensation/102640898">snap public housing tower lockdowns</a> is a cautionary tale underscoring how essential considered, tailored and two-way communication is with diverse communities.</p> <h2>Countering misinformation</h2> <p>Misinformation is <a href="https://reutersinstitute.politics.ox.ac.uk/hydroxychloroquine-australia-cautionary-tale-journalists-and-scientists">not a new problem</a>, but has been supercharged by the advent of <a href="https://theconversation.com/health-misinformation-is-rampant-on-social-media-heres-what-it-does-why-it-spreads-and-what-people-can-do-about-it-217059">social media</a>.</p> <p>The much-touted “miracle” drug <a href="https://www.vox.com/future-perfect/22663127/ivermectin-covid-treatments-vaccines-evidence">ivermectin</a> typifies the extraordinary traction unproven treatments gained locally and globally. Ivermectin is an anti-parasitic drug, lacking evidence for viruses like COVID.</p> <p>Australia’s drug regulator was forced to <a href="https://www.theguardian.com/australia-news/2021/sep/10/australian-drug-regulator-bans-ivermectin-as-covid-treatment-after-sharp-rise-in-prescriptions">ban ivermectin presciptions</a> for anything other than its intended use after a <a href="https://www.theguardian.com/world/2021/aug/30/australian-imports-of-ivermectin-increase-10-fold-prompting-warning-from-tga">sharp increase</a> in people seeking the drug sparked national shortages. Hospitals also reported patients <a href="https://www.theguardian.com/australia-news/2021/sep/02/sydney-covid-patient-in-westmead-hospital-after-overdosing-on-ivermectin-and-other-online-cures">overdosing on ivermectin</a> and cocktails of COVID “cures” promoted online.</p> <p>The <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01585-9/fulltext">Lancet Commission</a> on lessons from the COVID pandemic has called for a coordinated international response to countering misinformation.</p> <p>As part of this, it has called for more accessible, accurate information and investment in scientific literacy to protect against misinformation, including that shared across social media platforms. The World Health Organization is developing resources and recommendations for health authorities to address this “<a href="https://www.who.int/health-topics/infodemic#tab=tab_1">infodemic</a>”.</p> <p>National efforts to directly tackle misinformation are vital, in combination with concerted efforts to raise health literacy. The Australian Medical Association has <a href="https://www.ama.com.au/media/action-needed-tackle-health-misinformation-internet-social-media">called on the federal government</a> to invest in long-term online advertising to counter health misinformation and boost health literacy.</p> <p>People of all ages need to be equipped to think critically about who and where their health information comes from. With the rise of AI, this is an increasingly urgent priority.</p> <h2>Looking ahead</h2> <p>Australian health ministers recently <a href="https://www.cdc.gov.au/newsroom/news-and-articles/australian-health-ministers-reaffirm-commitment-australian-cdc">reaffirmed their commitment</a> to the new Australian Centre for Disease Control (CDC).</p> <p>From a science communications perspective, the Australian CDC could provide an independent voice of evidence and consensus-based information. This is exactly what’s needed during a pandemic. But full details about the CDC’s funding and remit have been the subject of <a href="https://www.croakey.org/federal-budget-must-deliver-on-climate-health-and-the-centre-for-disease-control-sector-leaders-warn/">some conjecture</a>.</p> <p>Many of our <a href="https://www.cochraneaustralia.org/articles/covidandcommunications">key findings</a> on effective public health communication during COVID are not new or surprising. They reinforce what we know works from previous disease outbreaks across different places and points in time: tailored, timely, clear, consistent and accurate information.</p> <p>The rapid rise, reach and influence of misinformation and distrust in public authorities bring a new level of complexity to this picture. Countering both must become a central focus of all public health crisis communication, now and in the future.</p> <p><em>This article is part of a <a href="https://theconversation.com/au/topics/the-next-pandemic-160343">series on the next pandemic</a>.</em><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/226718/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/shauna-hurley-203140">Shauna Hurley</a>, PhD candidate, School of Public Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/rebecca-ryan-1522824">Rebecca Ryan</a>, Senior Research Fellow, Health Practice and Management; Head, Centre for Health Communication and Participation, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-can-we-improve-public-health-communication-for-the-next-pandemic-tackling-distrust-and-misinformation-is-key-226718">original article</a>.</em></p>

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Why are we seeing more pandemics? Our impact on the planet has a lot to do with it

<p><em><a href="https://theconversation.com/profiles/olga-anikeeva-1522907">Olga Anikeeva</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/jessica-stanhope-1129888">Jessica Stanhope</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/peng-bi-1522908">Peng Bi</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/philip-weinstein-882901">Philip Weinstein</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Pandemics – the global spread of infectious diseases – seem to be making a comeback. In the Middle Ages we had the Black Death (plague), and after the first world war we had the Spanish flu. Tens of millions of people <a href="https://assets.cureus.com/uploads/review_article/pdf/69273/20211019-25919-an4y6h.pdf">died from these diseases</a>.</p> <p>Then science began to <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2011.00053/full">get the upper hand</a>, with vaccination eradicating smallpox, and polio nearly so. Antibiotics became available to treat bacterial infections, and more recently antivirals as well.</p> <p>But in recent years and decades pandemics <a href="https://assets.cureus.com/uploads/review_article/pdf/69273/20211019-25919-an4y6h.pdf">seem to be returning</a>. In the 1980s we had HIV/AIDS, then several flu pandemics, SARS, and now COVID (no, COVID isn’t over).</p> <p>So why is this happening, and is there anything we can do to avert future pandemics?</p> <h2>Unbalanced ecosystems</h2> <p>Healthy, stable ecosystems provide services that keep us healthy, such as supplying food and clean water, producing oxygen, and making green spaces available for our <a href="https://www.millenniumassessment.org/documents/document.356.aspx.pdf">recreation and wellbeing</a>.</p> <p>Another key service ecosystems provide is disease regulation. When nature is in balance – with predators controlling herbivore populations, and herbivores controlling plant growth – it’s more difficult for pathogens to emerge in a way that causes pandemics.</p> <p>But when human activities <a href="https://books.google.com.au/books?hl=en&amp;lr=&amp;id=rWozz12K1aUC&amp;oi=fnd&amp;pg=PP15&amp;dq=planetary+overload&amp;ots=c9mWuESUXN&amp;sig=-1iP3uSOWazvC2OFLk4vginWbQQ&amp;redir_esc=y#v=onepage&amp;q=planetary%20overload&amp;f=false">disrupt and unbalance ecosystems</a> – such as by way of climate change and biodiversity loss – <a href="https://academic.oup.com/bioscience/article/58/8/756/381265">things go wrong</a>.</p> <p>For example, climate change affects the number and distribution of plants and animals. Mosquitoes that carry diseases can move from the tropics into what used to be temperate climates as the planet warms, and may infect more people in the months that are normally disease free.</p> <p>We’ve studied the relationship between weather and dengue fever transmission in China, and <a href="https://pubmed.ncbi.nlm.nih.gov/27883970/">our findings</a> support the same conclusion reached by <a href="https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0008118">many other studies</a>: climate change is likely to put more people at risk of dengue.</p> <p>Biodiversity loss can have similar effects by disrupting food chains. When ranchers cleared forests in <a href="https://www.mdpi.com/1999-4915/6/5/1911">South America</a> for their cattle to graze in the first half of the 20th century, tiny forest-dwelling, blood-feeding vampire bats suddenly had a smörgåsbord of large sedentary animals to feed on.</p> <p>While vampire bats had previously been kept in check by the limited availability of food and the presence of predators in the balanced <a href="https://cir.nii.ac.jp/crid/1130000797648461952">forest ecosystem</a>, numbers of this species exploded in South America.</p> <p>These bats carry the rabies virus, which causes <a href="https://www.who.int/news-room/fact-sheets/detail/rabies">lethal brain infections</a> in people who are bitten. Although the number of deaths from bat-borne rabies has now fallen dramatically due to vaccination programs in South America, rabies caused by bites from other animals still <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168224/">poses a global threat</a>.</p> <p>As urban and agricultural development impinges on natural ecosystems, there are increasing opportunities for humans and domestic animals to become infected with pathogens that would normally only be seen in wildlife – particularly when people hunt and eat animals from the wild.</p> <p>The HIV virus, for example, <a href="https://www.tandfonline.com/doi/abs/10.1076/jmep.27.2.163.2992">first entered human populations</a> from apes that were slaughtered for food in Africa, and then spread globally through travel and trade.</p> <p>Meanwhile, bats are thought to be <a href="https://www.sciencedirect.com/science/article/pii/S0006291X20319434">the original reservoir</a> for the virus that caused the COVID pandemic, which has killed more than <a href="https://www.worldometers.info/coronavirus/">7 million people</a> to date.</p> <p>Ultimately, until we effectively address the unsustainable impact we are having on our planet, pandemics will continue to occur.</p> <h2>Targeting the ultimate causes</h2> <p>Factors such as climate change, biodiversity loss and other global challenges are the ultimate (high level) cause of pandemics. Meanwhile, increased contact between humans, domestic animals and wildlife is the proximate (immediate) cause.</p> <p>In the case of HIV, while direct contact with the infected blood of apes was the proximate cause, the apes were only being slaughtered because large numbers of very poor people were hungry – an ultimate cause.</p> <p>The distinction between <a href="https://link.springer.com/article/10.1007/BF02207379">ultimate causes and proximate causes</a> is important, because we often deal only with proximate causes. For example, people may smoke because of stress or social pressure (ultimate causes of getting lung cancer), but it’s the toxins in the smoke that cause cancer (proximate cause).</p> <p>Generally, health services are only concerned with stopping people from smoking – and with treating the illness that results – not with removing the drivers that lead them to smoke in the first place.</p> <p>Similarly, we address pandemics with lockdowns, mask wearing, social distancing and vaccinations – all measures which seek to stop the spread of the virus. But we pay less attention to addressing the ultimate causes of pandemics – until perhaps very recently.</p> <h2>A planetary health approach</h2> <p>There’s a growing awareness of the importance of adopting a “planetary health” approach to improve human health. This <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60901-1/fulltext?nr_email_referer=1">concept</a> is based on the understanding that human health and human civilisation depend on flourishing natural systems, and the wise stewardship of those natural systems.</p> <p>With this approach, ultimate drivers like climate change and biodiversity loss would be prioritised in preventing future pandemics, at the same time as working with experts from many different disciplines to deal with the proximate causes, thereby reducing the risk overall.</p> <p>The planetary health approach has the benefit of improving both the health of the environment and human health concurrently. We are heartened by the increased uptake of teaching planetary health concepts across the environmental sciences, humanities and health sciences in many universities.</p> <p>As climate change, biodiversity loss, population displacements, travel and trade continue to increase the risk of disease outbreaks, it’s vital that the planetary stewards of the future have a better understanding of how to tackle the ultimate causes that drive pandemics.</p> <p><em>This article is the first in a series on the next pandemic.</em><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/226827/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/olga-anikeeva-1522907"><em>Olga Anikeeva</em></a><em>, Research Fellow, School of Public Health, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/jessica-stanhope-1129888">Jessica Stanhope</a>, Lecturer, School of Allied Health Science and Practice, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/peng-bi-1522908">Peng Bi</a>, Professor, School of Public Health, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/philip-weinstein-882901">Philip Weinstein</a>, Professorial Research Fellow, School of Public Health, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-are-we-seeing-more-pandemics-our-impact-on-the-planet-has-a-lot-to-do-with-it-226827">original article</a>.</em></p>

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Astonishing report identifies Covid’s alleged “patient zero”

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

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People with long COVID continue to experience medical gaslighting more than 3 years into the pandemic

<p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p>It’s increasingly clear that the <a href="https://www.worldometers.info/coronavirus/country/canada/">SARS-CoV-2 virus is not going away</a> any time soon. And for some patients, their symptoms haven’t gone away either.</p> <p>In January 2023, our team of researchers at the <a href="https://pipps.ca/">Pacific Institute on Pathogens, Pandemics and Society</a> published a <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">research brief</a> about how people seek out information about long COVID. The brief was based on a scoping review, a type of study that assesses and summarizes available research. Our interdisciplinary team aims to understand the experiences of people with long COVID in order to identify opportunities to support health care and access to information.</p> <h2>Lingering long COVID</h2> <p>Long COVID (also called <a href="https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms/post-covid-19-condition.html">Post COVID-19 condition</a>) is an illness that occurs after infection with COVID-19, lasting weeks to months, and even years. First coined by a <a href="https://doi.org/10.1016%2Fj.socscimed.2020.113426">patient on Twitter</a>, the term also represents a collective movement of people experiencing the long-term effects of COVID-19 and advocating for care. <a href="https://science.gc.ca/site/science/sites/default/files/attachments/2023/Post-Covid-Condition_Report-2022.pdf">Around 15 per cent</a> of adults who have had COVID still have symptoms after three months or more.</p> <p>Long COVID affects systems <a href="https://doi.org/10.1016/j.socscimed.2021.114619">throughout the body</a>. However, symptom fluctuations and limited diagnostic tools make it challenging for health-care providers to diagnose, especially with <a href="https://doi.org/10.1038/s41579-022-00846-2">over 200 symptoms</a> that may present in patients. Perhaps because long COVID presents itself in many different ways, the illness has <a href="https://doi.org/10.1016/j.socscimed.2021.114619">been contested</a> across the medical field.</p> <p>To identify opportunities to reduce barriers to long COVID care, our team has explored how patients and their caregivers access <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">information about long COVID</a>. We have found that one of the most significant barriers faced by patients is <a href="https://doi.org/10.1177/20552076211059649">medical gaslighting</a> by the people they have turned to for help.</p> <h2>Lack of validation leads to stigma</h2> <p><a href="https://doi.org/10.1136/bmj.o1974">Medical gaslighting</a> occurs when health-care practitioners dismiss or falsely blame patients for their symptoms. While new information about long COVID has become more readily available, some patients continue to face gaslighting and feel that their symptoms are <a href="https://doi.org/10.1016%2Fj.ssmqr.2022.100177">treated less seriously</a> by some health-care professionals.</p> <p>This dismissal can <a href="https://doi.org/10.1111/hex.13602">erode trust</a> in the health-care system and can also lead to <a href="https://doi.org/10.1111/hex.13518">stigma and shame</a>.</p> <p>Preliminary findings from our ongoing study with long COVID patients indicate that, when medical practitioners do not validate a patient’s condition, this extends into community networks of family and friends who may also dismiss their symptoms, contributing to further stigmatization at home.</p> <p>Medical gaslighting can present additional barriers to treatment, such as not being referred to specialists or long COVID clinics. This can, in turn, compound other symptoms such as fatigue, and <a href="https://doi.org/10.1192/bjo.2022.38">exacerbate the psychological symptoms of long COVID</a>, such as depression and anxiety.</p> <p>Medical gaslighting isn’t new. It has been documented by patients with other chronic conditions, such as <a href="https://doi.org/10.5772/intechopen.107936">myalgic encephalomyelitis or chronic fatigue syndrome</a>. And while this is common for patients with <a href="https://doi.org/10.1001/amajethics.2021.512">non-visible illnesses</a>, medical gaslighting is more commonly experienced by <a href="https://doi.org/10.1111/1467-9566.13367">women and racialized people</a>.</p> <p>Long COVID patients also note gender biases, as women with prolonged symptoms feel they are not believed. This is particularly worrisome, as studies have found that <a href="https://doi.org/10.1001/jama.2020.17709">women are disproportionately more likely to experience long COVID</a>.</p> <h2>Where do we go from here?</h2> <p>While long COVID information is constantly shifting, it’s clear that patients face many barriers, the first of which is having their illness minimized or disregarded by others. To ensure that patients have access to compassionate care, we suggest:</p> <p><strong>1. Educating physicians on long COVID</strong></p> <p>Because definitions of long COVID, and its presentation, vary widely, primary care physicians need support to recognize and acknowledge the condition. General practitioners (GPs) must also provide patients with information to help manage their symptoms. This requires actively listening to patients, documenting symptoms and <a href="https://doi.org/10.1136/bmj.m3489">paying close attention to symptoms that need further attention</a>.</p> <p>Training physicians on the full range of symptoms and referring patients to available supports would reduce stigma and assist physicians by reducing their need to gather information themselves.</p> <p><strong>2. Raise awareness about long COVID</strong></p> <p>To increase awareness of long COVID and reduce stigma, public health and community-based organizations must work collaboratively. This may include a public awareness and information campaign about long COVID symptoms, and making support available. Doing so has the potential to foster community support for patients and improve the mental health of patients and their caregivers.</p> <p><strong>3. Ensure information is accessible</strong></p> <p>In many health systems, GPs are <a href="https://doi.org/10.1186/s12913-019-4419-0">gatekeepers to specialists</a> and are considered trusted information sources. However, without established diagnostic guidelines, patients are left to <a href="https://doi.org/10.2196/37984">self-advocate</a> and prove their condition exists.</p> <p>Because of negative encounters with health-care professionals, patients turn to social media platforms, including long COVID <a href="https://doi.org/10.7861%2Fclinmed.2020-0962">online communities</a> on Facebook. While these platforms allow patients to validate experiences and discuss management strategies, patients should not rely only on social media given the <a href="https://doi.org/10.3389/fpubh.2022.937100">potential for misinformation</a>. As a result, it is crucial to ensure information about long COVID is multi-lingual and available in a wide range of formats such as videos, online media and physical printouts.</p> <p>The <a href="https://science.gc.ca/site/science/en/office-chief-science-advisor/initiatives-covid-19/post-covid-19-condition-canada-what-we-know-what-we-dont-know-and-framework-action">recent recommendations of the Chief Science Advisor of Canada</a> to establish diagnostic criteria, care pathways and a research framework for long COVID are a positive development, but we know patients need support now. Improving long COVID education and awareness won’t resolve all of the issues faced by patients, but they’re foundational to compassionate and evidence-based care.<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/203744/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, Research Associate, Health Sciences, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, Regional Deputy Director, BC Node of the Canadian Wildlife Health Cooperative; Senior Scientist, Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, Master's Student in Communication, Research Assistant for Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, Project Coordinator, Pacific Institute on Pathogens, Pandemics and Society, and the Pandemics &amp; Borders Project, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/people-with-long-covid-continue-to-experience-medical-gaslighting-more-than-3-years-into-the-pandemic-203744">original article</a>.</em></p>

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COVID is officially no longer a global health emergency – here’s what that means (and what we’ve learned along the way)

<p>World Health Organisation (WHO) experts <a href="https://www.nytimes.com/2023/05/05/health/covid-who-emergency-end.html">have officially declared</a> that COVID <a href="https://www.who.int/news/item/05-05-2023-statement-on-the-fifteenth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic">no longer constitutes</a> a public health emergency of international concern (Pheic). This coincides with the WHO’s new <a href="https://www.who.int/publications/i/item/WHO-WHE-SPP-2023.1">strategy</a> to transition from an emergency response to longer-term sustained COVID disease management. </p> <p>This may not change too much practically. COVID will still have pandemic status, and countries will continue to have their own authority as to whether to treat COVID as an emergency within their territories (some countries, <a href="https://www.npr.org/2023/04/11/1169191865/biden-ends-covid-national-emergency">including the US</a>, have already declared an end to the national emergency).</p> <p>For the global public health community, however, this is an event of monumental importance, drawing to a close the emergency response period which commenced on <a href="https://www.who.int/publications/m/item/covid-19-public-health-emergency-of-international-concern-(pheic)-global-research-and-innovation-forum">January 30 2020</a>. </p> <p>At the same time, for a large portion of the general public, it may well pass by relatively unnoticed. For many people, it’s been a long time since they viewed COVID as an emergency. In the UK for example, COVID no longer features in the regular Office for National Statistics <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/bulletins/publicopinionsandsocialtrendsgreatbritain/19aprilto1may2023">public opinion survey</a> that asks people what they think the key issues facing the country are. Even a year ago, <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/bulletins/publicopinionsandsocialtrendsgreatbritain/30marchto24april2022">only two in five Britons</a> were very or somewhat worried about COVID, according to the survey.</p> <p>Along with other behavioural scientists, I have been following <a href="https://www.swansea.ac.uk/research/research-highlights/health-innovation/public-during-pandemic/">public experiences of the pandemic</a> for the past three years. The results have yet to be peer reviewed but by summer 2022, many participants in <a href="https://psyarxiv.com/d6jcv">our research</a> described the pandemic as being like “a distant memory” or like it “never happened”.</p> <p>As we move into this next phase, it’s time to consider what we’ve learned about human behaviour during the pandemic, and what happens next.</p> <h2>Old habits die hard</h2> <p>In the early days of the pandemic, many behavioural scientists, myself included, wondered whether some of our pandemic habits <a href="https://theconversation.com/two-years-into-the-pandemic-which-of-our-newly-formed-habits-are-here-to-stay-178204">were here to stay</a>. Would <a href="https://www.itv.com/news/wales/2021-04-02/masks-to-stay-soldiering-on-through-the-common-cold-will-stop-and-the-nature-of-work-has-changed-forever-expert-says">face masks</a> become a regular wardrobe staple? Would people stop “soldiering on” and going into work when unwell?</p> <p>It turned out that for most people, the pandemic hasn’t permanently changed our behaviour and habits or created a “<a href="https://psyarxiv.com/d6jcv">new normal</a>”. Looking again at the UK, face mask use has consistently declined, with <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/datasets/publicopinionsandsocialtrendsgreatbritaincoronaviruscovid19andotherillnesses">figures from last month</a> suggesting that fewer than one in six adults had worn a face mask recently. Regular use is likely much less common. </p> <p>Social distancing has long since disappeared, except for a relatively small proportion of the public, in particular those most vulnerable to COVID.</p> <p>The COVID pandemic has taught us how adaptive behaviour can be, in particular how much people were willing to change their behaviour to keep themselves and others safe. Most people <a href="https://academic.oup.com/abm/article/56/8/781/6618645?login=false">followed the rules</a> during <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0258781">the height of the pandemic</a>, no matter how difficult. COVID has reminded us <a href="https://www.cambridge.org/core/services/aop-cambridge-core/content/view/759BE02FFE73E5C05EA429A3E1547D78/S2056467821000050a.pdf/resilience_in_the_age_of_covid19.pdf">how resilient we humans can be</a>.</p> <p>These pandemic adaptions, and the fact that our pre-pandemic behaviour bounced back so quickly, shows how important social cues and social norms are to behaviour. Putting on a mask or keeping our distance from others were habits – <a href="https://www.sciencedirect.com/science/article/abs/pii/S002210311100254X">actions triggered automatically</a> in response to contextual cues, such as seeing signs with pictures of people socially distancing.</p> <p>Social norms – what we think others are doing – were key to <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0277360">vaccine uptake</a> and to our uptake of <a href="https://www.nature.com/articles/s41562-020-0884-z">preventative measures in general</a>. As these contextual cues disappeared and the social norms started to change, and as vaccine coverage increased and the risk to the majority decreased, our behaviour changed.</p> <p>The pandemic has also demonstrated how important social connections and social, especially physical, contact can be. This is something <a href="https://theconversation.com/handshakes-and-hugs-are-good-for-you-its-vital-they-make-a-comeback-after-the-pandemic-158174">we have already argued</a> COVID couldn’t keep at bay forever. According to social safety theory, which sees stress and wellbeing as a product of biological, psychological and social factors, COVID <a href="https://www.sciencedirect.com/science/article/pii/S2352250X2200001X">posed a threat</a> to the “social fabric that makes humans resilient and keeps us alive and well”. </p> <p>It’s unsurprising that life satisfaction and happiness were <a href="https://bmjopen.bmj.com/content/10/7/e039334">lowest during lockdowns</a>, and <a href="https://www.covidsocialstudy.org/_files/ugd/064c8b_c525505ffa6b432f96dc41d6b6a985ea.pdf">recovered as people started to mix socially again</a>.</p> <h2>The emergency isn’t over for everyone</h2> <p>As we mark the end of the emergency phase it’s important to remember the <a href="https://covid19.who.int/">nearly seven million lives lost</a> due to COVID since 2020.</p> <p>And of course, we must consider that for some, especially those who are clinically vulnerable, the emergency is not yet over, and may never be.</p> <p>Although it’s no longer a Pheic, <a href="https://www.who.int/publications/i/item/WHO-WHE-SPP-2023.1">as the WHO reminds us</a>, COVID is still responsible for millions of infections and thousands of deaths each week around the world. Also, thanks to long COVID, hundreds of millions of people are in need of longer-term care.</p> <p>In the future, we need to move from relying on the resilience of individuals to building resilience in our institutions. We can all take measures to continue to protect ourselves and those around us from COVID and other respiratory viruses (such as by <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00021-1/fulltext">hand washing</a> and keeping up to date with vaccinations). But responsibility for preventing public health emergencies shouldn’t rest <a href="https://blogs.bmj.com/bmj/2020/03/17/uks-coronavirus-policy-places-too-much-responsibility-in-the-hands-of-the-public/">solely in the hands of the public</a></p> <p>Actions that governments, employers and health authorities can take now could <a href="https://www.theguardian.com/books/2022/may/11/preventable-by-devi-sridhar-review-a-resolutely-global-view-of-covid">protect against</a> future <a href="https://pubmed.ncbi.nlm.nih.gov/34872923/">public health emergencies</a>. Systematically <a href="https://joint-research-centre.ec.europa.eu/jrc-news/misinformation-covid-19-what-did-we-learn-2023-02-21_en">tackling misinformation</a>, <a href="https://www.who.int/publications/i/item/9789240021280">improving ventilation</a> in <a href="https://www.bmj.com/content/376/bmj.o327">schools</a>, workplaces and other public indoor spaces, and making longer-term improvements to paid sick leave are all good ways to start building more <a href="https://unsdg.un.org/resources/executive-summary-un-common-guidance-helping-build-resilient-societies">resilient societies</a> in preparation for the next pandemic. Hopefully this is something we will never see in our lifetimes.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/covid-is-officially-no-longer-a-global-health-emergency-heres-what-that-means-and-what-weve-learned-along-the-way-205080" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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Three years into the pandemic, it’s clear COVID won’t fix itself. Here’s what we need to focus on next

<p>On March 11 2020 the World Health Organization classified COVID as a <a href="https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020">pandemic</a>. Three years on, it remains just that.</p> <p>As much as we don’t want it to be, and as much as it is off the front pages, COVID is still very much with us.</p> <p>But how bad has it really been? And, more importantly, what have we learned that could help us accelerate a real and sustained exit?</p> <h2>COVID has hit us hard</h2> <p>There was a <a href="https://theconversation.com/too-late-already-bolted-how-a-faster-who-response-could-have-slowed-covid-19s-spread-160860">slow initial</a> global response to what we now call SARS-CoV-2, the virus that causes COVID. This allowed the virus to get a foothold, contributing to unexpectedly rapid <a href="https://theconversation.com/why-are-there-so-many-new-omicron-sub-variants-like-ba-4-and-ba-5-will-i-be-reinfected-is-the-virus-mutating-faster-182274">viral evolution</a>.</p> <p>Three years into the pandemic, with the removal of almost all mitigation measures in most countries, it’s clear the virus has hit the world very hard. <a href="https://www.worldometers.info/coronavirus/">So far</a>, almost 681 million infections and more than 6.8 million deaths have been reported.</p> <p>This is perhaps best visualised by its impact on life expectancy. There were <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/padr.12477">sharp declines</a> seen across the world in 2020 and 2021, reversing 70 years of largely uninterrupted progress. </p> <p>The excess mortality driving this drop in life expectancy has continued. This includes in Australia, <a href="https://www.actuaries.digital/2023/03/06/almost-20000-excess-deaths-for-2022-in-australia/">where over 20,000 more lives</a> than the historical average are estimated to have been lost in 2022.</p> <h2>Not just COVID deaths</h2> <p>The indirect impacts on the health systems in rich and poor countries alike continue to be substantial. Disruptions to health services have led to <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00079-6/fulltext">increases</a> in stillbirths, maternal mortality and postnatal depression.</p> <p>Routine <a href="https://www.who.int/news/item/15-07-2022-covid-19-pandemic-fuels-largest-continued-backslide-in-vaccinations-in-three-decades">child immunisation coverage</a> has decreased. Crucial malaria, tuberculosis and HIV programs have been <a href="https://www.theglobalfund.org/en/news/2021/2021-09-08-global-fund-results-report-reveals-covid-19-devastating-impact-on-hiv-tb-and-malaria-programs/#:%7E:text=GENEVA%20%E2%80%93%20The%20COVID%2D19%20pandemic,history%20of%20the%20Global%20Fund">disrupted</a>. </p> <p>A paper out this week highlights the <a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1107560/full">severe impact</a> of the pandemic on mental health globally.</p> <h2>Then there’s long COVID</h2> <p>Meanwhile, more evidence of long COVID has emerged around the world. At least <a href="https://www.nature.com/articles/s41579-022-00846-2">65 million people</a> were estimated to be experiencing this debilitating syndrome by the end of 2022. </p> <p>The Australian Institute of Health and Welfare <a href="https://www.aihw.gov.au/reports/covid-19/long-covid-in-australia-a-review-of-the-literature/summary">estimates</a> 5-10% of people who are infected with SARS-CoV-2 will develop long COVID, with symptoms persisting more than three months. That’s between 550,000 and 1.1 million Australians, based on the more than 11 million cases reported <a href="https://www.worldometers.info/coronavirus/country/australia/">so far</a>.</p> <h2>COVID highlighted inequalities</h2> <p>The pandemic has also had a huge economic impact, both directly and indirectly. </p> <p>The United States alone spent <a href="https://impact.economist.com/perspectives/economic-development/understanding-economic-consequences-covid-19-pandemic">US$4 trillion</a> on its response. Economists have estimated the pandemic will contribute an average 0.75% reduction in GDP in countries with high infection rates and high productivity in 2025.</p> <p>Studies in the <a href="https://www.local.gov.uk/health-inequalities-deprivation-and-poverty-and-covid-19">United Kingdom</a>, <a href="https://www.theguardian.com/world/2022/apr/04/us-covid-devastating-toll-poor-low-income-communities">US</a> and <a href="https://www.theguardian.com/australia-news/2022/feb/25/disease-of-disadvantage-melbournes-lower-socioeconomic-areas-suffer-most-covid-deaths-amid-omicron">Australia</a> show COVID has had a disproportionate impact – including higher death rates – in disadvantaged communities and ethnic minorities. </p> <p>The causes range from high exposure in low-paid jobs to inadequate access to health care. And <a href="https://www.brookings.edu/blog/future-development/2021/05/27/covid-19-is-a-developing-country-pandemic/">poorer countries</a> have fared terribly on all fronts from COVID, including inequitable access to vaccines.</p> <h2>There’s no end in sight</h2> <p>We cannot assume there will be a natural exit to the pandemic, where the virus reaches some benign endemicity, a harmless presence in the background. </p> <p>In fact, there is little indication anything like that is imminent.</p> <p>In Australia, since the beginning of January, <a href="https://www.worldometers.info/coronavirus/country/australia/">more than 235,000 COVID cases</a> have been reported, almost as many as in 2020 and 2021 combined. Since the start of January, there have been 2,351 COVID-related deaths, more than twice as many as in the whole of 2020 and around the same as in the whole of 2021.</p> <h2>What needs to happen next?</h2> <p>The future response can be practically distilled into three overlapping actions.</p> <p><strong>1. Politicians need to be frank</strong></p> <p>Our political leaders need to communicate frankly with the public that the pandemic is not over. They need to stress we still have an exceptional problem on our hands with acute disease as well as worrying concerns about long COVID. It’s crucial politicians acknowledge sufferers and those who have died. They need to do this while delivering the good news that addressing COVID does not require lockdowns or mandates. </p> <p>If our politicians did this, the public would be more likely to have their booster vaccines, get tested and treated, and adopt measures such as improving indoor ventilation and wearing high-quality masks.</p> <p>The health system also needs to be greatly strengthened to deal with long COVID.</p> <p><strong>2. Avoiding infections is still important</strong></p> <p>Suppressing the virus is still important. We still can and should reduce the burden of newly acquired COVID and, therefore, long COVID. We have the tools to do this. </p> <p>We need full recognition that COVID is transmitted largely through the air. As this just-published article in the journal <a href="https://www.nature.com/articles/d41586-023-00642-9">Nature</a> discusses, there are things we can do right now to ensure we all breathe air that is safer, not just from SARS-CoV-2 but from other respiratory viruses.</p> <p><strong>3. Adopt new knowledge and technology</strong></p> <p>We should be focusing on the science and be ready to adopt new knowledge and products rapidly. </p> <p>Just a few days ago we had trials of a <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4375620&amp;utm_source=substack&amp;utm_medium=email">promising new approach</a> to treat long COVID with the diabetes drug metformin. </p> <p>There is also intriguing research that has identified <a href="https://www.nature.com/articles/s41579-022-00846-2">persistent infection</a> as a potential underlying cause of organ damage and disease after COVID and in long COVID. This suggests anti-viral drugs such as Paxlovid may have an important role to play in reducing the impact of chronic disease. </p> <p>Many types of new COVID vaccines are being trialled, such as <a href="https://www.nature.com/articles/d41586-022-02824-3">versions administered by nasal sprays</a>, which may be game changers.</p> <h2>The virus won’t fix itself</h2> <p>As we enter the fourth year of the pandemic, we must not leave it up to the virus to fix itself. </p> <p>The biggest lesson of the past three years is there’s little chance that is going to work, at least without an intolerably high cost. </p> <p>Rather, we can end the pandemic by choice. We know <a href="https://theconversation.com/from-covid-control-to-chaos-what-now-for-australia-two-pathways-lie-before-us-174325">what to do</a>. But we are simply not doing it.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/three-years-into-the-pandemic-its-clear-covid-wont-fix-itself-heres-what-we-need-to-focus-on-next-201181" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Caring

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The wellbeing ‘pandemic’ – how the global drive for wellness might be making us sick

<p>Are we in the midst of a wellbeing pandemic? The question may seem curious, even contradictory. But look around, the concept is everywhere and spreading: in the media, in government institutions and transnational organisations, in schools, in workplaces and in the marketplace. </p> <p>To be clear, it’s not just wellbeing’s infectiousness in public discourse that makes it pandemic-like. It’s also the genuine malaise that can be caused by the term’s misuse and exploitation.</p> <p>Do you sense, for example, that your wellbeing is increasingly being scrutinised by peers, managers and insurance companies? Are you noticing an increasing number of advertisements offering products and services that promise enhanced wellbeing through consumption? If so, you’re not alone. </p> <p>But we also need to ask whether this obsession with wellbeing is having the opposite to the desired effect. To understand why, it’s important to look at the origins, politics and complexities of wellbeing, including its strategic deployment in the process of what we call “<a href="https://otagouni-my.sharepoint.com/personal/jacst99p_registry_otago_ac_nz/Documents/Documents/SJ-Wellness/SJ-Conversation-Wellbeing/Jackson-Sam-Dawson-Porter-Frontiers-Sociology-Wellbeing-2022.pdf">wellbeing washing</a>”.</p> <h2>The halo effect</h2> <p>While concerns about wellbeing can be traced to antiquity, the term has emerged as a central feature of contemporary social life. One explanation is that it is often conflated with concepts as diverse as happiness, quality of life, life satisfaction, human flourishing, mindfulness and “wellness”. </p> <p>Wellbeing is flexible, in the sense that it can be easily inserted into a diverse range of contexts. But it’s also surrounded by a kind of halo, automatically bestowed with a positive meaning, similar to concepts such as motherhood, democracy, freedom and liberty. </p> <p>To contest the value and importance of such things is to risk being labelled a troublemaker, a non-believer, unpatriotic or worse.</p> <p>These days, there are two main concepts of wellbeing. The first – subjective wellbeing – emphasises a <a href="https://www.frontiersin.org/articles/10.3389/fsoc.2022.950557/full#B21">holistic measure</a> of an individual’s mental, physical and spiritual health. This perspective is perhaps best reflected in the World Health Organization’s <a href="https://www.corc.uk.net/outcome-experience-measures/the-world-health-organisation-five-well-being-index-who-5/">WHO-5 Index</a>, designed in 1998 to measure people’s subjective wellbeing according to five states: cheerfulness, calmness, vigour, restfulness and fulfilment.</p> <p>Translated into more than 30 languages, the overall influence of the WHO-5 Index should not be underestimated; both governments and corporations have embraced it and implemented policy based on it. </p> <p>But the validity of the index, and others like it, has been questioned. They’re prone to oversimplification and a tendency to marginalise alternative perspectives, including Indigenous approaches to physical and mental health.</p> <h2>Individual responsibility</h2> <p>The second perspective – objective wellbeing – was a response to rising social inequality. It focuses on offering an <a href="https://www.frontiersin.org/articles/10.3389/fsoc.2022.950557/full#B60">alternative to GDP</a> as a measure of overall national prosperity. </p> <p>One example of this is New Zealand’s <a href="https://www.treasury.govt.nz/information-and-services/nz-economy/higher-living-standards/our-living-standards-framework">Living Standards Framework</a>, which is guided by four operating principles: distribution, resilience, productivity and sustainability. These new and purportedly more progressive measures of national economic and social outcomes signal societal change, optimism and hope.</p> <p>The trouble with such initiatives, however, is that they remain rooted within a particular neoliberal paradigm in which individual behaviour is the linchpin for change, rather than the wider political and economic structures around us.</p> <p>Arguably, this translates into more monitoring and “disciplining” of personal actions and activities. Intentionally or not, many organisations interpret and use wellbeing principles and policies to reinforce existing structures and hierarchies. </p> <p>Consider how the wellbeing agenda is playing out in your organisation or workplace, for example. Chances are you have seen the growth of new departments, work units or committees, policies and programs, wellness workshops – all supposedly linked to health and wellbeing. </p> <p>You may even have noticed the creation of new roles: wellbeing coaches, teams or “champions”. If not, then “lurk with intent” and be on the lookout for the emergence of yoga and meditation offerings, nature walks and a range of other “funtivities” to support your wellbeing. </p> <h2>Wellbeing washing</h2> <p>The danger is that such initiatives now constitute another semi-obligatory work task, to the extent that non-participation could lead to stigmatisation. This only adds to stress and, indeed, unwellness. </p> <p>Deployed poorly or cynically, such schemes represent aspects of “wellbeing washing”. It’s a strategic attempt to use language, imagery, policies and practices as part of an organisation’s “culture” to connote something positive and virtuous. </p> <p>In reality, it could also be designed to enhance productivity and reduce costs, minimise and manage reputational risk, and promote <a href="https://otagouni-my.sharepoint.com/personal/jacst99p_registry_otago_ac_nz/Documents/Documents/SJ-Wellness/SJ-Conversation-Wellbeing/Jackson-Sam-Dawson-Porter-Frontiers-Sociology-Wellbeing-2022.pdf">conformity, control and surveillance</a>. </p> <p>Ultimately, we argue that wellbeing now constitutes a “field of power”; not a neutral territory, but a place where parties advance their own interests, often at the expense of others. As such, it’s essential that scholars, policymakers and citizens explore, as one author <a href="https://www.google.com.au/books/edition/Measuring_Wellbeing/lWBXjk1nocIC?hl=en&amp;gbpv=1&amp;dq=%E2%80%9Cwhat+and+whose+values+are+represented,+which+accounts+dominate,+what+is+their+impact+and+on+whom%E2%80%9D&amp;pg=PA4&amp;printsec=frontcover">put it</a>, “what and whose values are represented, which accounts dominate, what is their impact and on whom”. </p> <p>Because if wellbeing is becoming a pandemic, we may well need the “vaccine” of critical reflection.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/the-wellbeing-pandemic-how-the-global-drive-for-wellness-might-be-making-us-sick-198662" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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New classified report makes bold Covid-19 origin claim

<p>The US Department of Energy has reached the conclusion that the Covid pandemic is most likely to have arisen from a laboratory leak, as suggested in a classified intelligence report delivered to both the White house and key members of Congress. </p> <p>The conclusion, drawn with “low confidence”, comes more than a year after the FBI declared their belief that a laboratory incident in China was the source of the Covid-19 pandemic. In contrast to the Energy Department, the FBI made their assessment with “moderate confidence”. </p> <p>Reportedly, intelligence agencies make their assessments on a scale of low to high confidence, with a low confidence grading meaning that the information is not reliable enough, is not substantial, or is not cohesive enough to make a complete and informed judgement. </p> <p>The new report demonstrates the differing opinions of the US intelligence community about the origins of the pandemic, though the Energy Department is now in line with the FBI in believing that the virus likely spread due to an accident in a Chinese laboratory. However, while two agencies remain undecided, there are still four - as well as The National Intelligence Council - that are firm on their stance that the pandemic was the result of natural transmission from an infected animal.</p> <p>The Energy Department’s findings are allegedly drawn from new intelligence, and are considered to be significant due to their expertise and network of US laboratories. Though the Energy Department oversees the US’ nuclear weapons program, some of their laboratories are said to participate in biological research.</p> <p>Officials in the US did not provide details into the new intelligence that caused the Energy Department to shift its standpoint, but according to the Wall Street Journal, added that “while the Energy Department and the FBI each say an unintended lab leak is most likely, they arrived at those conclusions for different reasons.”</p> <p>Although intelligence agencies aren’t all in agreement, the update reaffirmed existing ideas that Covid-19 was not the result of a Chinese biological weapons program. </p> <p>“There are a variety of views in the intelligence community,” Jake Sullivan - the White House’s national security adviser - said to <em>CNN’s State of the Union </em>of the ongoing investigation into the origins of Covid-19, and US President Joe Biden’s request for national labs to be brought into the assessment. </p> <p>“Here’s what I can tell you: President Biden has directed, repeatedly, every element of our intelligence community to put effort and resources behind getting to the bottom of this question.</p> <p>“And if we gain any further insight or information, we will share it with Congress, and we will share it with the American people. But right now, there is not a definitive answer that has emerged from the intelligence community on this question.”</p> <p><em>Images: Getty </em></p>

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How the pandemic affected our approach to reading and interpretation of books

<p>During the pandemic, reading took on new meaning. People turned to books for comfort. Some read to confront difficult issues, especially following the murder of George Floyd in 2020. Others used reading as a way to care for their children in locked-down houses.</p> <p><a href="https://www.theguardian.com/books/2020/mar/25/book-sales-surge-self-isolating-readers-bucket-list-novels" target="_blank" rel="noopener">Sales figures and lending data</a> showed a huge spike in people buying and borrowing books. We wanted to follow the stories of real readers and <a href="https://global.oup.com/academic/product/reading-novels-during-the-covid-19-pandemic-9780192857682?q=reading%20novels%20during%20the%20pandemic&amp;lang=en&amp;cc=dk" target="_blank" rel="noopener">our new book</a> uses a rare combination of literary analysis and qualitative interviewing to capture these dynamics of reception.</p> <p>While many commentators at the beginning of the pandemic <a href="https://www.refinery29.com/en-us/2020/03/9581961/long-books-to-read-in-quarantine" target="_blank" rel="noopener">endorsed reading</a> as a straightforward way to relax, our readers showed that the practice morphed and took on new forms and meanings.</p> <p>Based on hundreds of survey responses and hours of reader interviews from Denmark and the UK, the study makes the interpretation of literature something dynamic and ongoing. And it suggests that readers themselves are agents of meaning, even in the case of novels that seem the most stable in our culture.</p> <p>Reading during the pandemic showed how books and their meanings change. Novels that we think of as settled in their significance acquire new meaning as they are read under unfolding conditions, exposed to the vagaries of history.</p> <p>In our research we show how Albert Camus’s The Plague became an unlikely hit in 2020, how the affordances of Sally Rooney’s romantic fiction seemed suddenly to apply to the lovers unable to meet, and how long novels that had intimidated pre-pandemic readers became lifelines in their heft.</p> <h2>Tricky reading</h2> <p>For many people, reading became more difficult during this time.</p> <p>Far from giving everyone uninterrupted time to attend to long novels by authors like Tolstoy, lockdown exacerbated the separations and challenges of everyday life.</p> <p>Take Jane Eyre, a novel that many readers picked up during lockdown because it was on their shelves. Suddenly, this classic seemed to be a novel about a woman locked in small rooms and living through a cholera epidemic. Many also took it up under conditions that overlapped directly with the book’s scenes of homeschooling.</p> <p>One respondent called Phoebe, for instance, deliberately avoided rereading Jane Eyre for these reasons. Charlotte Brontë’s classic novel of loneliness and love was, in 2020, “too creepy”. The story of Jane being locked up made her feel unsafe while she lived alone through lockdown in the confines of her own room.</p> <p>Another interviewee, Alexandra, was troubled by the idea of reading Hilary Mantel’s bestseller The Mirror and the Light, explaining:</p> <blockquote> <p>I knew that I would be saying goodbye to Sir Thomas Cromwell […] I looked at it and I thought, what if I die before I get to the end of this? It will be the most unsatisfactory experience.</p> </blockquote> <p>Rather than sizing up the third part of Mantel’s intimate portrayal of the life of Thomas Cromwell as offering the ideal opportunity for narrative immersion, Alexandra viewed the very thickness of the book as problematic. Her intense fear of death in the pandemic and expectation of Cromwell’s literary demise converge on the length of narrative, which stretches into a future that had become harder to face.</p> <h2>Slipperiness of time</h2> <p>For the reader caught up in a global pandemic, a novel like The Plague, Albert Camus’s famous story of a town suffering a deadly virus, reads differently than it usually would for, say, the school student of French literature. One interviewed reader, for instance, discussed the novel’s temporal slipperiness.</p> <p>Normally, of course, the very lack of measurable time would suggest the novel as an allegory – untied to a particular time, a warning of dark political forces turning up and spreading at any moment. But in 2020, when time <a href="https://theconversation.com/a-philosophical-idea-that-can-help-us-understand-why-time-is-moving-slowly-during-the-pandemic-151250" target="_blank" rel="noopener">felt like it was moving oddly</a> The Plague’s confused sense of time felt realistic, as if it were mimicking our lived experience of a pandemic.</p> <figure></figure> <p>Yet, it would be a mistake to assume all readers suddenly ditched allegory for realism or real-life correspondence. As Kirsten, a Danish woman in her 30s, explained:</p> <blockquote> <p>I ended up buying The Plague because I was more interested in the metaphorical portrait of the occupation (of France by the Nazis) than in what epidemics do to a society.</p> </blockquote> <p>By following real readers, our study provides a snapshot of a phenomenal moment in modern history and shows the movement of readers between new purchases and books long kept in their collections. By exploring these varied experiences, we investigated the larger question of how the consumption of novels depends on and shapes people’s experience of non-work time, providing a specific lens through which to examine the experience of reading more generally.</p> <p>Perhaps most importantly, it demonstrates the dynamic process of reading and the ways in which books change depending on where and when they are read and by whom.</p> <p><strong>This article originally appeared on <a href="https://theconversation.com/how-the-pandemic-affected-our-approach-to-reading-and-interpretation-of-books-195238" target="_blank" rel="noopener">The Conversation</a>.</strong></p> <p><em>Image: Shutterstock</em></p>

Books

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Can ‘voluntourism’ outgrow the white saviour stereotype and make a positive change post-pandemic?

<p>As the tourism industry emerges from pandemic shutdowns and border closures, so too is “voluntourism”, the sometimes controversial combination of overseas volunteer work and more traditional tourist experiences.</p> <p>Although hard to measure, pre-pandemic estimates suggest voluntourism was worth <a href="https://sites.lsa.umich.edu/mje/2022/01/22/the-paradox-of-voluntourism-how-international-volunteering-impacts-host-communities/">US$2 billion annually</a>, with up to <a href="https://www.cbi.eu/market-information/tourism/save-tourism/market-potential">ten million volunteers</a> globally. While COVID shut the practice down for the duration, it remains a <a href="https://roadbook.com/opinion/negative-effects-of-voluntourism/">multi-billion-dollar industry</a>, now poised to <a href="https://www.sbs.strath.ac.uk/blogs/SBS/post.aspx?id=1420">return and rebuild</a>.</p> <p>But volunteer tourism has met with considerable criticism. Voluntourists have been accused of putting <a href="https://www.stuff.co.nz/travel/news/109983663/nz-school-students-pay-thousands-to-visit-orphanages-and-volunteer-overseas">vulnerable people at risk</a> (<a href="https://drivingchange.org/do-no-harm-the-dark-side-of-voluntourism/">including children</a>), <a href="https://tourismteacher.com/commodification-volunteer-tourism/">commodifying volunteer work</a>, perpetuating <a href="https://darbymatt.medium.com/voluntourism-is-neo-colonialism-56b6a25f6924">neo-colonialism</a> and <a href="https://www.euronews.com/travel/2022/02/21/how-white-saviour-voluntourism-gets-you-famous-on-tiktok">reinforcing</a> a “white saviour” complex.</p> <p>Voluntourism is also <a href="https://www.thenewhumanitarian.org/2021/06/14/travel-opens-again-aid-voluntourism-needs-get-real">largely unregulated</a>, raising important <a href="https://journalofethics.ama-assn.org/article/voluntourism/2019-09">ethical questions</a> about who it really aims to serve – travellers or hosts. These issues are now being felt in the Pacific, where voluntourism is a relatively new but growing industry. As <a href="https://e-tangata.co.nz/reflections/the-problem-with-white-saviours/">Simone Kaho wrote</a> of her experience in Tonga:</p> <blockquote> <p>In many cases, voluntourism asks the local community to stand back, and allow themselves to be helped. It turns helping into a business model.</p> </blockquote> <p><a href="https://blog.geographydirections.com/2019/09/03/global-encounters-voluntourism-in-fiji/">My research</a> in Fiji has also highlighted the problems associated with the commercialisation and commodification of volunteering. These are real and important issues that need close examination as tourism in general picks up.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">End voluntourism and the white saviour industrial complex <a href="https://t.co/gMHkZfTlsf">https://t.co/gMHkZfTlsf</a> via <a href="https://twitter.com/mailandguardian?ref_src=twsrc%5Etfw">@mailandguardian</a></p> <p>— NGO Watch Africa (@NGOWatchAfrica) <a href="https://twitter.com/NGOWatchAfrica/status/1582376611449491457?ref_src=twsrc%5Etfw">October 18, 2022</a></p></blockquote> <p><strong>Behind the ‘bula smile’</strong></p> <p>The Fiji case study – conducted with an international, for-profit, specialist voluntourism agency – tells a complex story about the benefits and downsides of voluntourism.</p> <p>Volunteers are hosted by local families and included in household life, attending church or religious functions, learning to cook Fijian food, and spending time with children and other family members. Through this, they gain an understanding of life behind the famous “bula” smile. As one staff member said:</p> <blockquote> <p>The host may get angry with you if you leave the light on, you may feel like you are back living with mum and dad because they may give you a lunch box, things like that. But it’s important that they see the person who is paid to smile at the Hilton, what they are like at home with their kids, how they make ends meet, how they eat.</p> </blockquote> <p>Hosts often put considerable energy into sharing their way of life and teaching volunteers Fijian culture. Most hosts and staff took pride in helping travellers find their way around and teaching them Fijian ways. In turn, this helped Fijian staff build knowledge and pride in their own culture.</p> <blockquote> <p>Also the good thing is that we keep up with our culture. Because if you are talking about it every day and you show them and try to talk about it, then the history remains […] Now when we go to the village we do the <em>sevusevu</em> [kava ceremony] and all those things, and we go with the elders. It was our mothers that did that, but now we are doing it, the next generation.</p> <p>When we have volunteers in a Fijian village we will go to any lengths to give them what they want, to try and serve them […] But of course then the volunteers change to become more Fijian!</p> </blockquote> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Are you itching to start travelling, but want to do it with care?</p> <p>Listen to this week's <a href="https://twitter.com/hashtag/WisdomWalks?src=hash&amp;ref_src=twsrc%5Etfw">#WisdomWalks</a> to discover how you can avoid traps like voluntourism and greenwashing when travelling.</p> <p>🎧 27 mins.<a href="https://t.co/f366FJcyQG">https://t.co/f366FJcyQG</a></p> <p>— Curio (@curioio) <a href="https://twitter.com/curioio/status/1587821837932797953?ref_src=twsrc%5Etfw">November 2, 2022</a></p></blockquote> <p><strong>A chance to improve voluntourism</strong></p> <p>The growth of voluntourism in Fiji follows half a century of <a href="https://medium.com/tourism-geographic/paradise-the-noble-savage-and-the-white-savior-in-fiji-7ac7e302e5ec">mass tourism</a>, in which contact between Fijians and tourists has been largely limited and manufactured. Hosts embrace the opportunity to interact with tourists more directly and to build connections across the globe.</p> <p>However, the commercial nature of the encounter has the potential to significantly undermine these connections. The large fees paid by voluntourists mean they – like any tourist – are consumers.</p> <p>Volunteers have certain expectations, ranging from the mundane (internet access, good food and logistical support) to the more profound (a sense of accomplishment, a feeling they’ve made a difference). They will complain if these expectations aren’t met.</p> <p>The pandemic also raised questions about the sustainability of voluntourism. The organisation I studied cut its global workforce significantly. In Fiji it had provided jobs for about a dozen Fijian staff, as well as home-stay income for many households.</p> <p>While there is evidence that <a href="https://theconversation.com/traditional-skills-help-people-on-the-tourism-deprived-pacific-islands-survive-the-pandemic-148987">reliance on customary knowledge, systems and practices</a> helped tourism workers to survive and even thrive during the pandemic, the future for many is uncertain.</p> <p>COVID-19 has been something of a wake-up call that we need to move beyond voluntourism as a pseudo-development practice or as a commodified, profit-making experience. This is an opportunity for the industry to take on board the criticisms, examine past practice and reassess the role and impact of volunteering.</p> <p>Rather than rush back to business as usual, this is the perfect moment to look at reconfiguring the industry in line with the principles of sustainability and <a href="https://medium.com/activate-the-future/understanding-the-opportunity-of-regenerative-tourism-894136cafd3b">regenerative tourism</a>. In the process, perhaps voluntourism’s strengths – building cross-cultural relationships, learning and solidarity – can contribute more to meaningful social and environmental change.<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/195719/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em>Writen by Sharon McLennan. Republished with permission from <a href="https://theconversation.com/can-voluntourism-outgrow-the-white-saviour-stereotype-and-make-a-positive-change-post-pandemic-195719" target="_blank" rel="noopener">The Conversation</a>.</em></p> <p><em>Image: Getty Images</em></p>

International Travel

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Elizabeth Strout’s Lucy By the Sea: a claustrophobic portrait of a terrible pandemic year

<p>In her latest novel, Lucy by the Sea, Elizabeth Strout captures the bewilderment of us all at the onset of the pandemic. Her character Lucy Barton admits not only did she not see it coming, but even when she did notice the virus’s existence, she did not really believe it would ever reach New York.</p> <p>It is March, 2020, and Lucy, a writer, had been scheduled to travel to Italy and Germany, a book tour which she had, with fortuitous prescience, cancelled back in December. Lucy is a woman who is given to sudden flashes of insight – much like her mother, who was known for having “visions” – which is why, looking back at those early days of the pandemic, not having sensed its threat surprises her.</p> <p>Even when her ex-husband William’s oldest friend is put on a ventilator and subsequently dies, it is still difficult for her to accept that this is happening to people she knows. With hindsight, Lucy remarks: “It’s odd how the mind does not take in anything until it can.”</p> <p>William has been quicker to spot the looming danger. He pleads with their two daughters Becka and Chrissy to leave New York city with their husbands, before hastily scooping up Lucy from her apartment and carrying her away to the town of Crosby on the coast of Maine.</p> <p>At this point in the book, devotees of Strout’s Pulitzer Prize-winning novel Olive Kitteridge, will experience a shiver of recognition and anticipation, for the fictional coastal town of Crosby is “Olive territory”. With this one deft move, Strout draws together the separate threads of much of the fiction she has written since Olive Kitteridge was published in 2008.</p> <p>Before establishing herself as a successful writer in New York, Lucy Barton’s territory was the small Midwest town of Amgash, Illinois. The deprivation of her Amgash childhood has haunted Lucy through Strout’s earlier novels, My Name is Lucy Barton, and Oh William! (the latter now <a href="https://www.abc.net.au/news/2022-10-01/booker-prize-shortlist-best-books-2022/101482730" target="_blank" rel="noopener">shortlisted for the 2022 Booker Prize</a>) and in two of the short stories in Anything is Possible. Now it continues to tug at her in the house beside the sea in Maine.</p> <p>In My Name is Lucy Barton, Lucy is told by a writer she admires:</p> <blockquote> <p>You will have only one story … You’ll write your one story many ways don’t ever worry about story. You will have only one.</p> </blockquote> <p>The story Lucy has to tell, over and over, and in many different ways, is the story of her childhood, its poverty and isolation, and her complex relationship with a mother who was unable to tell her own child that she loved her.</p> <p>Even as an adult, Lucy does not know her mother’s story. In Lucy by the Sea she has invented for herself a “nice mother” she can talk to in private as distinct from the real mother with whom the silences that fell between them were necessarily more poignant than words.</p> <h2>Emotional lockdown</h2> <p>Locked down in a house on a cliff with a view of the waves, Lucy and William endeavour to fill their days. Lucy struggles to read, and as for writing, she believes she will never write another word. This sense of being frozen and unable to concentrate was all too common at that uncertain and anxiety-inducing point in the pandemic, especially among writers. But for Lucy there is the realisation that this is a state she recognises, having spent her childhood in a kind of emotional lockdown.</p> <p>In Maine, unable to retreat into the activities that usually soothe her, Lucy is also grieving for her husband David, a cellist with the New York Philharmonic, who has died only a year earlier. William, too, is unexpectedly single since his wife, Estelle, walked out and took their daughter Bridget, along with a good bit of their furniture.</p> <p>With no escape from the monotony of their self-isolation, Lucy, who in ordinary circumstances is endearingly quick to declare her love – especially for people – finds herself continually finding things to hate: she hates being in other people’s houses, hates the smell; she hates being cold, but hates sitting inside a house with a coat on; she hates the jigsaw puzzle of Van Gogh William insists they try; she hates snow, and she hates William after dinner when she suspects he is not really listening to her. With extraordinary patience, William tells Lucy to stop hating everything.</p> <p>To make matters worse, far from being welcome in Maine, some locals are so antagonistic towards the couple that a message urging them to go back to New York is anonymously attached to their car. Then, on a visit to a grocery store, a woman shouts at Lucy: “You goddamn New Yorkers! Get the hell out of our state!”</p> <p>When Lucy reproaches William for not being nice to her after the woman yelled, William, becoming uncharacteristically emotional, answers that hers is the life he has wanted to save.</p> <blockquote> <p>‘My own life I care very little about these days. But Lucy, if you should die from this, it would –’ He shook his head with weariness. ‘I only wanted to save your life, and what if some woman yelled at you.’</p> </blockquote> <p>When their daughters experience difficulties – one still in New York, the other in Connecticut – Lucy and William must support them as best they can from Maine. Many readers will recognise the torment of handling family crises at arm’s length, and of not being able to hug loved ones even when distance is finally overcome.</p> <h2>Not Olive</h2> <p>Elizabeth Strout has captured perfectly the fear, frustration, and boredom experienced by so many of us during the first year of Covid. Even her fragmentary writing style adds authenticity to a time when few of us could concentrate, when we flicked from news broadcast to news broadcast, to tallies of the latest case numbers, and deaths, while feeling that the very air we breathed carried risk.</p> <p>Among Strout fans Lucy Barton is a much-loved character, but it is Olive Kitteridge who has most often made headlines, with the <a href="https://www.imdb.com/title/tt3012698/" target="_blank" rel="noopener">television mini-series</a> based on the book, starring Frances McDormand, winning multiple awards. The polarising nature of Olive’s character stirs a strong response in readers, whereas the more reticent Lucy speaks quietly, like someone whispering in the reader’s ear.</p> <p>Strout’s extraordinary achievement as a writer has been to illuminate so many flawed, ordinary, yet far from unremarkable lives, through a series of interconnected stories and novels. Though each book is complete, they work satisfyingly together as a cohesive whole, so that reading them we come to know not just a handful of characters but entire communities in a few small towns on the coast of Maine, and in New York and Illinois.</p> <p>Olive Kitteridge and its sequel are elegantly wrought, with their third-person (and at times omniscient) point of view allowing for more nuanced storytelling. Lucy Barton’s intimate, first-person voice in the reader’s ear, with its tendency to speak in run-on sentences that often end with ‘"… is what I mean"’ or “‘… is what I’m saying"’, can become tiresome.</p> <p>In the end, one feels as if one has spent a year in lockdown inside the head of a small, loving, anxious, slightly neurotic person named Lucy Barton.</p> <p>Lucy By the Sea is a pitch-perfect portrait of a terrible year, and oh, how sweet it is to get out and about, to breathe fresh air, and to see the world from other, less claustrophobic angles, both for Lucy Barton and the reader.</p> <p><strong>This article originally appeared in <a href="https://theconversation.com/elizabeth-strouts-lucy-by-the-sea-a-claustrophobic-portrait-of-a-terrible-pandemic-year-191073" target="_blank" rel="noopener">The Conversation</a>.</strong></p> <p><em>Images: Yahoo/Penguin</em></p>

Books

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Did our personalities change during the pandemic?

<p dir="ltr">While we might think our personality won’t change that easily, it turns out that might not be the case after a new study reported measurable changes following the COVID-19 pandemic.</p> <p dir="ltr">The study, published in the journal <em><a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0274542#sec010" target="_blank" rel="noopener">PLOS One</a></em>, found that the personalities of people they surveyed before and after the pandemic changed - and that several particular traits were affected.</p> <p dir="ltr">A total of 7,109 people, ranging from 18 to 109 years old, took part in the Understanding America Study, which saw them take surveys before the pandemic, in 2020, and between 2021-2022.</p> <p dir="ltr">They found that extraversion, openness, agreeableness and conscientiousness declined when they compared results from 2021-2022 and pre-pandemic, with younger adults seeming particularly affected.</p> <p dir="ltr">Interestingly, the researchers reported that levels of neuroticism declined significantly in 2020, and that older adults showed the largest change in this trait. </p> <p dir="ltr">“There was limited personality change early in the pandemic but striking changes starting in 2021,” they write. </p> <p dir="ltr">“Of most note, the personality of young adults changed the most, with marked increases in neuroticism and declines in agreeableness and conscientiousness. That is, younger adults became moodier and more prone to stress, less cooperative and trusting, and less restrained and responsible.”</p> <p dir="ltr">They concluded that, if these changes are enduring, stressful events that affect a wider population could slightly change the trajectory of our personalities over time.</p> <p dir="ltr">But, they stress that other significant nationwide events were also occurring during this period, such as the highly publicised death of George Floyd and resulting protests, and the January 6th Capitol riots.</p> <p dir="ltr">With most of the changes to our personalities occurring while we are adolescents and young adults, it’s not surprising that the impact of the pandemic was seen most strongly in younger people.</p> <p dir="ltr">Even though previous research has indicated that our personalities stabilise around the age of 30, the researchers found similar disruptions to personality among middle-aged participants that were absent in the oldest participants. They argue that this could be due to greater malleability of personality during middle age or because of different stressors and strains that this age group experienced in comparison to older adults.</p> <p dir="ltr"><strong>Why this matters</strong></p> <p dir="ltr">We like to think our personality is who we are, and certain traits are even associated with our health and trajectory of our life.</p> <p dir="ltr">Previous studies have found that people who are more conscientious have a lower risk of dementia, develop fewer chronic illnesses, and tend to achieve more in education, while a higher level of neuroticism is a risk factor for mental health conditions such as anxiety and depression.</p> <p dir="ltr">“It is especially worrying that the largest changes in these two traits were among younger adults, as the implications of these changes may ripple throughout their adult lives,” the authors write.</p> <p><span id="docs-internal-guid-2b82fcee-7fff-00ee-6449-a94894c48cfa"></span></p> <p dir="ltr"><em>Image: Getty Images</em></p>

Mind

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The mental health toll of Covid-19 lockdowns

<p dir="ltr">During 2021, most people around the world were subject to a period of lockdown to contain the spread of Covid-19. </p> <p dir="ltr">With lockdowns in Australia lasting several months, the personal effects of these isolation periods are not to be underestimated. </p> <p dir="ltr">According to a new report by the <a href="https://www.nswmentalhealthcommission.com.au/">Mental Health Commission of NSW</a>, one in eight people have emerged from the pandemic with a new mental health condition.</p> <p dir="ltr">As a result, the nation-wide mental health system is facing immense pressure, with wait times for mental health specialists stretching to more than six months in some parts of New South Wales alone. </p> <p dir="ltr">NSW Mental Health Commissioner Catherine Lourey told the <a href="https://www.smh.com.au/national/nsw/lockdown-toll-one-in-eight-have-new-mental-health-condition-20220513-p5al4v.html?fbclid=IwAR0ARZsPxwdkWuRbZoEGRmgXCQM8EF3QjXASs50dTw6keMn2KAKHV0kxa7M">Sydney Morning Herald</a> that Australia will need to recruit from abroad to boost its depleted and exhausted mental health workforce, as demand far outweighs supply for services after two years of lockdowns and pandemic distress.</p> <p dir="ltr">Data from the Australian Institute of Health and Welfare show a dramatic 25 percent increase in those seeking mental health services compared to the same time pre-pandemic.</p> <p dir="ltr">“As demand on services rises, waiting lists for specialists are blowing out to more than six months, particularly in regional parts of NSW,” Lourey said.</p> <p dir="ltr">“Our biggest obstacle is getting nurses and specialists on the ground now. We need intense focus on growing our existing workforce, re-training and looking overseas to recruit more psychologists, peer workers, social workers, nurses and counsellors,” Lourey said.</p> <p dir="ltr">A commission into the ongoing impact of the pandemic shows that the lockdowns of 2021 had a more detrimental effect on mental health than the first year of the pandemic. </p> <p dir="ltr">A survey of more than 2,000 NSW residents in November and December of 2021 found one in eight experienced a new mental health condition, the most common being anxiety and depression. </p> <p dir="ltr">People aged 18 to 29 were the most likely to experience a new mental health issue.</p> <p dir="ltr">Sixty-one percent said their mental health was negatively impacted by COVID-19 in 2021, up from 55 percent in 2020.</p> <p dir="ltr">Professor Ian Hickie, co-director of the University of Sydney’s Brain and Mind Centre, said the report indicated a need for ongoing support as the community realises Covid-19 will still cause disruption in their lives, even though lockdowns have ended.</p> <p dir="ltr">“2020 was bad, 2021 was worse, and 2022 could be at least better than last year, but we are not back to pre-pandemic yet,” he said.</p> <p dir="ltr">“We wouldn’t expect that until at least 2023, and that is assuming nothing else goes wrong.”</p> <p dir="ltr"><em>Image credits: Getty Images</em></p>

Mind

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The pandemic’s gardening boom shows how gardens can cultivate public health

<p>As lockdowns went into effect in the spring of 2020 to slow the spread of the coronavirus, reports emerged of a <a href="https://www.sfchronicle.com/culture/article/A-comeback-for-victory-gardens-amid-Bay-Area-15177272.php">global gardening boom</a>, with plants, flowers, vegetables and herbs sprouting in backyards and on balconies around the world.</p> <p>The data backs up the narrative: An analysis of Google Trends and infection statistics found that during the first few months of the COVID-19 pandemic, country-by-country interest in gardening, from Italy to India, <a href="https://www.bostonglobe.com/2021/11/26/opinion/covid-inspired-gardening-was-worldwide-phenomenon/">tended to peak just as infections peaked</a>.</p> <p>Why did so many people find themselves being pulled toward the earth in a time of crisis? And what sort of effect did gardening have on them?</p> <p><a href="https://doi.org/10.1016/j.ufug.2022.127483">In a new study</a> conducted with a team of environmental and public health scholars, we highlight the extent to which gardening became a coping mechanism during the early days of the pandemic.</p> <p>Even as restrictions related to COVID-19 have eased, we see some real lessons for the way gardening can continue to play a role in people’s lives.</p> <h2>Dirt, sweat, tranquility</h2> <p>To conduct our study, we used an online questionnaire to survey more than 3,700 respondents who primarily lived in the U.S., Germany and Australia. The group included experienced gardeners and those who were new to the pursuit.</p> <p>More than half of those we surveyed said they felt isolated, anxious and depressed during the early days of the pandemic. Yet more than 75% also found immense value in gardening during that same period. Whether done <a href="https://doi.org/10.3733/ucanr.6720">in cities or out in the country</a>, gardening was almost universally described as a way to either relax, socialize, connect with nature or stay active.</p> <p>More than half of the respondents reported a significant increase in the amount of time they were able to spend gardening. Other respondents found some value in growing their own food, but few felt financially compelled to do so. </p> <p>Instead, most respondents saw gardening as a way to connect with their community and get some exercise.</p> <p>People with more personal difficulties due to COVID-19, like the inability to work or struggling with child care, were more likely to spend more time gardening in their spare time than they had in the past.</p> <h2>The garden as a refuge</h2> <p>In our analysis of written responses to the survey, most gardeners seemed to either experience a heightened sense of joy and reassurance or feel more attuned to the natural world. This seemed to have positive therapeutic and psychological benefits, regardless of age or location.</p> <p>To many people, <a href="https://doi.org/10.1016/j.wss.2021.100055">gardening became a sort of safe space – a haven from daily worries</a>. One German gardener started seeing their garden as a sanctuary where even “birds felt louder.” </p> <p>“Gardening has been my salvation,” a respondent from the U.S. noted. “I’m very grateful I can surround myself with beauty as a buffer to the depressing news COVID brings each day.”</p> <p>Another German gardener wrote that their garden became their “little safe universe in a very uncertain and somewhat dangerous time. … We have learned to appreciate the so far very high value of ‘own land, own refuge’ even more.”</p> <h2>A green prescription</h2> <p>As life returns to normal, work ramps up and obligations mount, I wonder how many pandemic gardens are already being neglected.</p> <p>Will a hobby born out of unique circumstances recede into the background?</p> <p>I hope not. Gardening shouldn’t be something that’s only taken up in times of crises. If anything, the pandemic showed how gardens serve a public health need – that they’re not only places of beauty or sources of food, but also conduits for healing. </p> <p>In fact, several countries like New Zealand, Canada and some in Europe now allow “<a href="https://www.weforum.org/agenda/2022/02/green-prescriptions-health-wellbeing/">green prescriptions</a>” to be issued as alternatives to medication. These are directives from doctors to spend a certain amount of time outdoors each day or month – an acknowledgment of the very real health benefits, from lowered stress to better sleep and improved memory, that venturing into nature can offer.</p> <p>I also think of the people who never had a chance to garden in the first place during the pandemic. Not everyone has a backyard or can afford gardening tools. Improving access to home gardens, urban green spaces and <a href="https://theconversation.com/not-all-community-gardens-are-environmental-equals-10485">community gardens</a>could be an important way to boost well-being and health.</p> <p>Making seeding, planting, pruning and harvesting part of your daily routine seems to open up more opportunities, too.</p> <p>“I never previously had the time to commit to a garden,” one first-time gardener told us, “but [I’ve] found such satisfaction and happiness in watching things grow. It has been a catalyst for making other positive changes in my life.”</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/the-pandemics-gardening-boom-shows-how-gardens-can-cultivate-public-health-181426" target="_blank" rel="noopener">The Conversation</a>.</em></p>

Home & Garden

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Global emissions almost back to pre-pandemic levels after unprecedented drop in 2020, new analysis shows

<p>Global carbon dioxide emissions have bounced back after COVID-19 restrictions and are likely to reach close to pre-pandemic levels this year, <a href="https://essd.copernicus.org/preprints/essd-2021-386/">our analysis</a> released today has found.</p> <p>The troubling finding comes as world leaders meet at the COP26 climate talks in Glasgow in a last-ditch bid to keep dangerous global warming at bay. The analysis was undertaken by the <a href="https://www.globalcarbonproject.org/carbonbudget">Global Carbon Project</a>, a consortium of scientists from around the world who produce, collect and analyse global greenhouse gas information.</p> <p>The fast recovery in CO₂ emissions, following last year’s <a href="https://theconversation.com/global-emissions-are-down-by-an-unprecedented-7-but-dont-start-celebrating-just-yet-151757">sharp drop</a>, should come as no surprise. The world’s strong economic rebound has created a surge in demand for energy, and the global energy system is still heavily dependent on fossil fuels.</p> <p>Most concerning is the long-term upward trends of CO₂ emissions from oil and gas, and this year’s growth in coal emissions, which together are far from trending towards net-zero by 2050.</p> <p><img src="https://images.theconversation.com/files/429724/original/file-20211102-28770-1s1j889.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="people seated around U-shaped table" /> <span class="caption">The troubling findings come as world leaders meet at the COP26 climate summit in Glasgow.</span> <span class="attribution"><span class="source">Evan Vucci/AP</span></span></p> <h2>The global emissions picture</h2> <p>Global CO₂ emissions from fossil fuels dropped by 5.4% in 2020, compared to the previous year. But they are set to increase by about 4.9% above 2020 levels this year, reaching 36.4 billion tonnes. This brings them almost back to 2019 levels.</p> <p>We can expect another 2.9 billion tonnes of CO₂ emissions this year from the net effect of everything we do to the land, including deforestation, degradation and re-vegetation.</p> <p>This brings us to a total of 39.4 billion tonnes of CO₂ to be emitted by the end of this year.</p> <p>The fast growth in emissions matches the corresponding large increase in energy demand as the global economy opens up, with the help of <a href="https://www.f4b-initiative.net/post/majority-of-17-2-trillion-covid-stimulus-packages-doing-more-harm-than-good-to-environment">US$17.2 trillion</a> in economic stimulus packages around the world.</p> <p>CO₂ emissions from all fossil fuel types (coal, oil and natural gas) grew this year, with emissions from coal and natural gas set to grow more in 2021 than they fell in 2020.</p> <p>Emissions from global coal use were declining before the pandemic hit in early 2020 but they surged back this year. Emissions from global gas use have returned to the rising trend seen before the pandemic.</p> <p>CO₂ emissions from global oil use remain well below pre-pandemic levels but are expected to increase in coming years as road transport and aviation recover from COVID-related restrictions.</p> <p><a href="https://images.theconversation.com/files/429469/original/file-20211031-17-1pa5f0i.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/429469/original/file-20211031-17-1pa5f0i.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /></a> <span class="caption">Global fossil CO₂ emissions.</span> <span class="attribution"><span class="source">Source: Global Carbon Project, https://www.globalcarbonproject.org/carbonbudget</span></span></p> <h2>Nations leading the emissions charge</h2> <p>Emissions from China have recovered faster than other countries. It’s among the few countries where emissions grew in 2020 (by 1.4%) followed by a projected growth of 4% this year.</p> <p>Taking these two years together, CO₂ emissions from China in 2021 are projected to be 5.5% above 2019 levels, reaching 11.1 billion tonnes. China accounted for 31% of global emissions in 2020.</p> <p>Coal emissions in China are estimated to grow by 2.4% this year. If realised, it would match what was thought to be China’s peak coal emissions in 2013.</p> <p>India’s CO₂ emissions are projected to grow even faster than China’s this year at 12.6%, after a 7.3% fall last year. Emissions this year are set to be 4.4% above 2019 levels – reaching 2.7 billion tonnes. India accounted for 7% of global emissions in 2020.</p> <p>Emissions from both the US and European Union are projected to rise 7.6% this year. It would lead to emissions that are, respectively, 3.7% and 4.2% below 2019 levels.</p> <p>US and EU, respectively, accounted for 14% and 7% of global emissions in 2020.</p> <p>Emissions in the rest of the world (including all international transport, particularly aviation) are projected to rise 2.9% this year, but remain 4.2% below 2019 levels. Together, these countries represent 59% of global emissions.</p> <p><a href="https://images.theconversation.com/files/429471/original/file-20211031-75805-1jh07jf.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/429471/original/file-20211031-75805-1jh07jf.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /></a> <span class="caption">Regional fossil CO₂ emissions 2019-2021.</span> <span class="attribution"><span class="source">Source: Global Carbon Project, https://www.globalcarbonproject.org/carbonbudget</span></span></p> <h2>The remaining carbon budget</h2> <p>The relatively large changes in annual emissions over the past two years have had no discernible effect in the speed at which CO₂ accumulates in the atmosphere.</p> <p>CO₂ concentrations, and associated global warming, are driven by the accumulation of greenhouse gases – particularly CO₂ – since the beginning of the industrial era. This accumulation has accelerated in recent decades.</p> <p>To stop further global warming, global CO₂ emissions must stop or reach net-zero – the latter meaning that any remaining CO₂ emissions would have to be compensated for by removing an equivalent amount from the atmosphere.</p> <p>Carbon budgets are a useful way of measuring how much CO₂ can be emitted for a given level of global warming. In our latest analysis, we updated the carbon budget outlined by the Intergovernmental Panel on Climate Change (<a href="https://templatelab.com/climate-change-report-2021/">IPCC</a>) in August this year.</p> <p>From the beginning of 2022, the world can emit an additional 420 billion tonnes of CO₂ to limit global warming to 1.5℃, or 11 years of emissions at this year’s rate.</p> <p>To limit global warming to 2℃, the world can emit an additional 1,270 billion tonnes of CO₂ – or 32 years of emissions at the current rate.</p> <p><a href="https://images.theconversation.com/files/429886/original/file-20211103-19-fl69o8.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/429886/original/file-20211103-19-fl69o8.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="" /></a> <span class="caption">The remaining carbon budgets to limit warming to 1.5℃ and 2℃. Updated from IPCC 2021.</span> <span class="attribution"><span class="source">Source: Global Carbon Project, https://www.globalcarbonproject.org/carbonbudget</span></span></p> <p>These budgets are the compass to net-zero emissions. Consistent with the pledge by <a href="https://eciu.net/netzerotracker">many countries</a> to reach net-zero emissions by 2050, CO₂ emissions need to decline by 1.4 billion tonnes each year, on average.</p> <p>This is an amount comparable to the drop during 2020, of 1.9 billion tonnes. This fact highlights the extraordinary challenge ahead and the need to increase short- and long-term commitments to drive down global emissions.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/170866/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/pep-canadell-16541">Pep Canadell</a>, Chief research scientist, Climate Science Centre, CSIRO Oceans and Atmosphere; and Executive Director, Global Carbon Project, <em><a href="https://theconversation.com/institutions/csiro-1035">CSIRO</a></em>; <a href="https://theconversation.com/profiles/corinne-le-quere-315624">Corinne Le Quéré</a>, Royal Society Research Professor of Climate Change Science, <em><a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a></em>; <a href="https://theconversation.com/profiles/glen-peters-114835">Glen Peters</a>, Research Director, <em><a href="https://theconversation.com/institutions/center-for-international-climate-and-environment-research-oslo-707">Center for International Climate and Environment Research - Oslo</a></em>; <a href="https://theconversation.com/profiles/pierre-friedlingstein-903247">Pierre Friedlingstein</a>, Chair, Mathematical Modelling of Climate, <em><a href="https://theconversation.com/institutions/university-of-exeter-1190">University of Exeter</a></em>; <a href="https://theconversation.com/profiles/robbie-andrew-422668">Robbie Andrew</a>, Senior Researcher, <em><a href="https://theconversation.com/institutions/center-for-international-climate-and-environment-research-oslo-707">Center for International Climate and Environment Research - Oslo</a></em>, and <a href="https://theconversation.com/profiles/rob-jackson-213135">Rob Jackson</a>, Professor, Department of Earth System Science, and Chair of the Global Carbon Project, <em><a href="https://theconversation.com/institutions/stanford-university-890">Stanford University</a></em></p> <p>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/global-emissions-almost-back-to-pre-pandemic-levels-after-unprecedented-drop-in-2020-new-analysis-shows-170866">original article</a>.</p> <p><em>Image: Shutterstock</em></p>

Travel Trouble

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“Please come back”: Bali’s plea over pandemic fallout

<p dir="ltr">Before the world was struck with Covid-19, Bali was a thriving holiday hotspot for millions of global travellers each year. </p> <p dir="ltr">The sandy beaches and bustling nightlife saw more than 1.3 million Australians descend on Bali in 2019 alone, injecting billions into the local economy. </p> <p dir="ltr">However, two years later, the pandemic has had a devastating effect on the Indonesian island, with local businesses struggling to survive. </p> <p dir="ltr">The busy streets of Seminyak, which were once filled with boutiques and shops, are now dead and devoid of people. </p> <p dir="ltr">Shop windows are boarded up, while other businesses have been abandoned all together. </p> <p dir="ltr">An employee at a local jewellery shop, whose store was the only one open in the street, told news.com.au, that the past two years had “not been good”.</p> <p dir="ltr">“We barely see anybody, it’s so quiet. Nothing is open. Most of the people I know haven’t been able to work. We are one of the only places that managed to stay open,” she said.</p> <p dir="ltr">A local tour guide said she had spent the last years of the pandemic doing whatever she could to survive, by making snacks and selling them to local shops. </p> <p dir="ltr">“Please, please come back to Bali,” she said.</p> <p dir="ltr">“We are ready for Aussies.”</p> <p dir="ltr">The guide also asked travellers to be patient and understanding of the Balinese people when they return for holidays. </p> <p dir="ltr">“Before the pandemic, the shops would charge maybe four or five times the price but now they’re not. They know they need to build that trust and relationship back with the Aussies so you can barter a little bit but please don’t do it too much,” she said.</p> <p dir="ltr">On March 15th, the first flight from Australia to Bali was packed full of eager travellers, with the people of Bali welcoming tourists back to their home to reinvigorate their economy. </p> <p dir="ltr"><em>Image credits: Getty Images</em></p>

International Travel

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"We’ve got a pandemic baby and a flood baby": Mum’s twin miracles

<p dir="ltr">A woman trapped by flood waters was rescued by a heroic neighbour in his kayak just in time for her to give birth.</p> <p dir="ltr">Krystle Henry was stranded in her home in Taringa, Brisbane, after flood waters surged up the driveway - preventing her from leaving to go to the hospital.</p> <p dir="ltr">But her quick-thinking neighbour Rob came to the rescue, kayaking Ms Henry to dry land on Sunday afternoon.</p> <p dir="ltr">She and her partner Matt Bridges welcomed their newborn son, Angus, into the world at Mater Mothers’ Hospital Brisbane on Tuesday morning.</p> <p dir="ltr">Mr Bridges said he would be forever grateful to his neighbour for helping their son arrive safely.</p> <p><span id="docs-internal-guid-d7bec5d6-7fff-1b1e-d4d5-32ff681a8afa">“We didn’t know Bob, but he was more than happy to help us out and I’m so thankful Angus arrived safely,” he <a href="https://7news.com.au/lifestyle/parenting/mum-gives-birth-to-baby-boy-after-she-was-rescued-in-a-kayak-from-flood-waters-in-brisbane-c-5911798" target="_blank" rel="noopener">said</a>.</span></p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2022/03/krystle.jpg" alt="" width="1280" height="720" /></p> <p dir="ltr"><em>Krystle Henry and Matt Bridges with their newborn son, Angus. Image: Krystle Henry</em></p> <p dir="ltr">“I’m so glad I got to the delivery room in time.</p> <p dir="ltr">Angus is the couple’s second child, after Ms Henry gave birth to their daughter Olive in 2020.</p> <p dir="ltr">“We’ve got a pandemic baby… and now we have a flood baby,” Mr Bridges said.</p> <p dir="ltr">Mater obstetrician Dr Paul Conaghen said he had never delivered a baby in such a chaotic situation, and praised the couple for their calm attitude.</p> <p dir="ltr">“Considering the situation, Krystle and Matt remained very calm,” he said.</p> <p dir="ltr">“I couldn’t imagine being 39 weeks pregnant stuck in flood waters.”</p> <p><span id="docs-internal-guid-5ed40b1b-7fff-3e60-4fe4-22eba811394b"></span></p> <p dir="ltr">But Angus isn’t the only flood baby to be born in such circumstances, after another couple were rescued by kayak, this time by the SES.</p> <p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/03/felicity-jacques.jpg" alt="" width="1280" height="720" /></p> <p dir="ltr"><em>Felicity and Alex were rescued by SES volunteers before going on to welcome their newborn son into the world. Image: Felicity Jacques</em></p> <p dir="ltr">Sherwood couple Felicity and Alex Jacques called the SES for help when their cars flooded in the underground carpark of Alex’s parents home, where they were staying.</p> <p dir="ltr">The couple stayed in a hotel near the hospital overnight, before Ms Jacques went into labour early on Monday morning.</p> <p dir="ltr">Their baby son, Andrew Jacques, was also born on Tuesday, weighing 3.35 kg.</p> <p dir="ltr">“I hate to think what would have happened if we weren’t close to the hospital,” Ms Jacques said.</p> <p dir="ltr">“I’m so relieved our little one is here. He is definitely a little miracle.”</p> <p dir="ltr">Paula Foley, the chief operating officer at Mater Mothers’ Hospital, said the past week had seen many mums and families going to extraordinary lengths to get to the hospital to give birth.</p> <p dir="ltr">“It’s been an incredibly stressful time for many of our new mums and dads,” she said.</p> <p dir="ltr">“But we’ve had 188 babies born at Mater Mothers’ South Brisbane in the past week, despite the flooding.”</p> <p dir="ltr"><span id="docs-internal-guid-db22e156-7fff-5997-fa8e-9066a18ab3b8"></span></p> <p dir="ltr"><em>Image: Krystle Henry</em></p>

News

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Two years on from the first COVID case, New Zealand’s successful pandemic response still faces major challenges

<p>Two years ago today, the first confirmed case of COVID-19 was reported in Aotearoa New Zealand. Few of us could have imagined the huge impact this pandemic would still be having two years later.</p> <p>As New Zealand enters its third year of the pandemic, we are facing widespread community transmission as an epidemic wave of the Omicron variant sweeps across the country. A majority of New Zealanders <a href="https://cpb-ap-se2.wpmucdn.com/blogs.auckland.ac.nz/dist/c/828/files/2021/07/omicron-preliminary.pdf" target="_blank" rel="noopener">may become infected</a> in coming months, but many with few or no symptoms.</p> <p>Australian experience suggests we might see a peak of around <a href="https://blogs.otago.ac.nz/pubhealthexpert/covid-19-hospitalisation-peaks-in-australian-states-since-omicron-emerged-potential-relevance-to-aotearoa-nz/" target="_blank" rel="noopener">1,100 people with COVID-19 in hospitals</a> during March and April.</p> <p>We have previously written about the challenges apparent after <a href="https://theconversation.com/6-months-after-new-zealands-first-covid-19-case-its-time-for-a-more-strategic-approach-144936" target="_blank" rel="noopener">six months</a> and <a href="https://theconversation.com/a-year-on-from-the-arrival-of-covid-19-in-nz-5-lessons-for-2021-and-beyond-155367" target="_blank" rel="noopener">one year</a> of the pandemic. Today, we examine what we’ve learned — the major challenges that have persisted or emerged and how New Zealand can manage them to achieve the best possible outcomes.</p> <p><strong>Shifting strategies</strong></p> <p>New Zealand has demonstrated the benefits of a science-informed response with a <a href="https://www.bmj.com/content/371/bmj.m4907" target="_blank" rel="noopener">strong strategic focus</a>. During the first year of the pandemic when there were no vaccines available, the <a href="https://journal.nzma.org.nz/journal-articles/new-zealands-elimination-strategy-for-the-covid-19-pandemic-and-what-is-required-to-make-it-work" target="_blank" rel="noopener">elimination strategy</a> protected people and the economy.</p> <p>Following the emergence of the Delta variant, <a href="https://journal.nzma.org.nz/journal-articles/the-next-phase-in-aotearoa-new-zealands-covid-19-response-tight-suppression-may-be-optimal-for-health-equity-and-wellbeing-in-the-months-ahead" target="_blank" rel="noopener">tight suppression</a> was also highly effective. Now, with the growing surge driven by the Omicron variant, New Zealand has been forced to shift to a <a href="https://blogs.otago.ac.nz/pubhealthexpert/preparing-for-omicron-a-proactive-government-response-is-urgently-needed-to-minimise-harms/" target="_blank" rel="noopener">mitigation strategy</a>.</p> <p>New Zealand’s strategic approach has supported the country in achieving some of the world’s <a href="https://blogs.otago.ac.nz/pubhealthexpert/mortality-declines-in-aotearoa-nz-during-the-first-two-years-of-the-covid-19-pandemic/" target="_blank" rel="noopener">lowest COVID-19 mortality rates and increased life expectancy</a>. New Zealand has also had a relatively small amount of time in lockdown and comparatively <a href="https://www.oecd.org/economy/new-zealand-economic-snapshot/" target="_blank" rel="noopener">good economic performance</a>.</p> <p>To achieve these successes, New Zealand has had to deliver major public health interventions very rapidly and their limitations have become apparent over time.</p> <p>Border quarantine is <a href="https://www.mja.com.au/journal/2021/215/7/failures-quarantine-systems-preventing-covid-19-outbreaks-australia-and-new" target="_blank" rel="noopener">difficult to maintain</a> if not done well and creates <a href="https://www.nzherald.co.nz/nz/its-a-case-of-wait-and-see-grounded-kiwis-wrap-up-two-day-bid-for-judicial-review/X43JEMEEEL47I7JBPHTZIBJPFI/" target="_blank" rel="noopener">severe consequences for some</a>. The vaccine rollout has been <a href="https://www.bmj.com/content/376/bmj.o180" target="_blank" rel="noopener">highly inequitable</a>. Mandates for vaccine and mask use have been divisive and <a href="https://www.theguardian.com/world/2022/feb/09/lets-remember-why-we-are-here-new-zealand-anti-vax-protest-splinters-into-jibes-and-jabs" target="_blank" rel="noopener">sometimes vigorously opposed</a> by a vocal minority.</p> <p><strong>Challenges and opportunities ahead</strong></p> <p>The experience of the last two years highlights five major opportunities to enhance New Zealand’s pandemic response and achieve lasting benefits for our ability to manage other major public health threats.</p> <p><strong>1. Taking a precautionary approach in the face of uncertainty</strong></p> <p>Possibly the biggest challenge has been the changing nature of the pandemic threat itself. The virus <a href="https://www.nature.com/articles/s41586-021-03792-w" target="_blank" rel="noopener">continues to evolve</a> and new variants of concern with increased infectiousness have emerged. We do not know whether future variants will be <a href="https://www.theguardian.com/world/2022/jan/11/will-covid-19-become-less-dangerous-as-it-evolves" target="_blank" rel="noopener">more or less virulent</a>.</p> <p>Omicron shows a <a href="https://www.nature.com/articles/d41586-022-00438-3" target="_blank" rel="noopener">high capacity for reinfection</a> which will need to be managed if this variant remains dominant. Optimistically, we may see the <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00100-3/fulltext?s=09" target="_blank" rel="noopener">end of the pandemic</a> though not the end of COVID-19. The full population impact of <a href="https://www.nature.com/articles/d41586-020-02598-6" target="_blank" rel="noopener">post-acute illness</a> (long COVID) is not yet known and evidence about <a href="https://www.nature.com/articles/d41586-022-00177-5" target="_blank" rel="noopener">prevention</a> and management is still at an early stage.</p> <p><strong>2. Enhancing equity and better protecting the most vulnerable</strong></p> <p>The move to mitigation (from elimination and suppression) shifts protection away from the collective, population-level focus to individual measures like vaccination, mask use and self-isolation.</p> <p>Despite a strongly stated commitment to equity, Māori and Pasifika have <a href="https://thespinoff.co.nz/business/23-02-2022/the-spinoff-covid-tracker-the-live-graphs-that-tell-the-story-of-delta-in-aotearoa" target="_blank" rel="noopener">lower vaccine and booster coverage rates</a>. They are also <a href="https://www.health.govt.nz/covid-19-novel-coronavirus/covid-19-data-and-statistics" target="_blank" rel="noopener">over-represented among COVID-19 cases and hospitalisations</a>.</p> <p>Mitigation aims to flatten the epidemic curve to protect the healthcare system from being overwhelmed. During such periods, there is potential for the most vulnerable (people who are Māori, Pasifika, low-income, living with other illnesses and disabilities) to miss out on care.</p> <p>There are multiple ways of improving equity in the response. These include greater support for Māori and Pasifika <a href="https://www.waitangitribunal.govt.nz/assets/Documents/Publications/Covid-Priority-W.pdf" target="_blank" rel="noopener">health providers</a>, further efforts to <a href="https://www.newsroom.co.nz/ideasroom/eliminating-maori-inequities-in-covid-19-outcomes" target="_blank" rel="noopener">raise vaccine coverage for Māori</a> in particular, policies to <a href="https://www.stuff.co.nz/business/125804726/sick-leave-increase-what-you-need-to-know" target="_blank" rel="noopener">support sick workers staying at home</a> and a <a href="https://blogs.otago.ac.nz/pubhealthexpert/making-the-most-of-masks/" target="_blank" rel="noopener">national mask strategy</a> that makes effective masks freely available.</p> <p>We also need a stronger focus on protecting children’s health and well-being, including a pivot to a whānau-centred approach and efforts to reduce transmission in <a href="https://blogs.otago.ac.nz/pubhealthexpert/tag/ventilation-schools/" target="_blank" rel="noopener">schools</a> and <a href="https://blogs.otago.ac.nz/pubhealthexpert/strengthening-omicron-mitigation-strategies-in-early-childhood-education-settings/" target="_blank" rel="noopener">early childhood education</a>.</p> <p><strong>3. Improving communication, policy responsiveness and trust</strong></p> <p>Pandemics are different from other public health emergencies because the behaviour of individuals directly affects the level of risk for the wider population. Inevitably, after two years, the response has become more contested and social cohesion has weakened. Some of this shift appears fuelled by the global pandemic of <a href="https://www.theguardian.com/world/2022/feb/26/so-many-rabbit-holes-even-in-trusting-new-zealand-protests-show-fringe-beliefs-can-flourish" target="_blank" rel="noopener">disinformation</a>.</p> <p>The New Zealand government can enhance public trust by showing that the response is risk-based, for example by phasing out travel restrictions and border isolation requirements now that Omicron infection is widespread. Some mandates are needed for critical public health interventions but require continuing review to ensure they are proportionate.</p> <p>Trust and <a href="https://informedfutures.org/social-cohesion/" target="_blank" rel="noopener">social cohesion</a> will also be improved by maximising transparency around the pandemic response, with clear statements about the rationale and level of risk, supported with evidence and local surveillance data presented in meaningful ways. We also need <a href="https://www.newsroom.co.nz/cracking-the-misinformation-code" target="_blank" rel="noopener">specific strategies</a> to reduce misinformation and disinformation on social media.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/448759/original/file-20220227-95880-851xvy.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" alt="Tent and sign from an anti-mandate protest." /><figcaption><span class="caption">Anti-mandates protests have been partly fuelled by misinformation.</span> <span class="attribution">Adam Bradley/SOPA Images/LightRocket via Getty Images</span></figcaption></figure> <p><strong>4. Improving evidence-informed leadership and adaptability</strong></p> <p>While New Zealand’s science-informed strategic response has been generally successful, it has at times been reactive rather than proactive in rapidly adapting to changes in the pandemic. We need better mechanisms, such as the multi-party <a href="https://www.parliament.nz/en/visit-and-learn/history-and-buildings/special-topics/epidemic-response-committee-covid-19-2020/" target="_blank" rel="noopener">epidemic response committee</a> of parliamentarians, and advisory processes that ensure high-level science input into the all-of-government response. This could include the formation of a COVID-19 science council/rōpu.</p> <p>Other measures include a <a href="https://www.mbie.govt.nz/science-and-technology/science-and-innovation/research-and-data/nzris/covid-19-research-database/" target="_blank" rel="noopener">well-resourced research strategy</a> to provide high-quality scientific evidence and an <a href="https://blogs.otago.ac.nz/pubhealthexpert/five-key-reasons-why-nz-should-have-an-official-inquiry-into-the-response-to-the-covid-19-pandemic/" target="_blank" rel="noopener">official inquiry</a> to assess the pandemic response and drive wider system improvements.</p> <p><strong>5. Investing in public health infrastructure</strong></p> <p>The current <a href="https://dpmc.govt.nz/our-business-units/transition-unit/response-health-and-disability-system-review/information" target="_blank" rel="noopener">health sector reforms</a> are an opportunity to establish essential infrastructure, including a Public Health Agency and Māori Health Authority.</p> <p>Investment in the national immunisation register may help with reversing the recent <a href="https://www.immune.org.nz/sites/default/files/publications/Coverage%20Report%20-%20July%202021.pdf" target="_blank" rel="noopener">decline in childhood immunisations</a>. The pandemic also demonstrates that <a href="https://www.newsroom.co.nz/rethinking-rebreathing-how-to-end-the-pandemic" target="_blank" rel="noopener">clean indoor air</a> is as essential to health as clean drinking water.</p> <p>We should learn from other countries that have also delivered effective responses. <a href="https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(20)30044-4/fulltext" target="_blank" rel="noopener">Taiwan is an example</a> we have previously documented.</p> <p>In summary, New Zealand is well placed to navigate the pandemic and the Omicron wave successfully. As we enter our third pandemic year, we can improve the effectiveness of our response by maintaining a precautionary approach in the face of uncertainty. We also need to improve equity, communication and trust, and evidence-informed leadership, as well as investing in public health infrastructure.</p> <p>These improvements will provide legacy benefits that <a href="https://ojs.victoria.ac.nz/pq/article/view/6550/5715" target="_blank" rel="noopener">prepare us well for other public health challenges</a> we face.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/177134/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/michael-baker-169808" target="_blank" rel="noopener">Michael Baker</a>, Professor of Public Health, <a href="https://theconversation.com/institutions/university-of-otago-1304" target="_blank" rel="noopener">University of Otago</a>; <a href="https://theconversation.com/profiles/amanda-kvalsvig-1143399" target="_blank" rel="noopener">Amanda Kvalsvig</a>, Senior Research Fellow, Department of Public Health, <a href="https://theconversation.com/institutions/university-of-otago-1304" target="_blank" rel="noopener">University of Otago</a>; <a href="https://theconversation.com/profiles/matire-harwood-1323164" target="_blank" rel="noopener">Matire Harwood</a>, Associate Professor Department of General Practice and Primary Care, <a href="https://theconversation.com/institutions/university-of-auckland-1305" target="_blank" rel="noopener">University of Auckland</a>, and <a href="https://theconversation.com/profiles/nick-wilson-133898" target="_blank" rel="noopener">Nick Wilson</a>, Professor of Public Health, <a href="https://theconversation.com/institutions/university-of-otago-1304" target="_blank" rel="noopener">University of Otago</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/two-years-on-from-the-first-covid-case-new-zealands-successful-pandemic-response-still-faces-major-challenges-177134" target="_blank" rel="noopener">original article</a>.</em></p> <p><em>Image: Getty Images</em></p>

Domestic Travel

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Mental health under-treated worldwide

<div class="copy"> <p>A meta-analysis of 149 studies from around the world shows that treatment rates for <a href="https://cosmosmagazine.com/science/biology/what-causes-depression-what-we-know-dont-know-and-suspect/" target="_blank" rel="noreferrer noopener" data-type="URL" data-id="https://cosmosmagazine.com/science/biology/what-causes-depression-what-we-know-dont-know-and-suspect/">major depressive disorder</a> (MDD) remain low worldwide. According to the review, one in three people with major depressive disorder in high-income countries, and less than one in 12 in low to middle-income countries, receive treatment. Researchers from the University of Queensland and their international collaborators <a href="https://journals.plos.org/plosmedicine/article/citation?id=10.1371/journal.pmed.1000097" target="_blank" rel="noreferrer noopener">published the findings</a> in the open-access journal <em>PLOS Medicine</em>.</p> <p>“Overall, we estimated that treatment rates for this disorder remain low, especially in low and middle-income countries,” says Dr Alize Ferrari, an epidemiologist at the University of Queensland and leading author of the study. “Even in high-income countries where treatment rates are comparatively higher, many individuals do not receive a level of care consistent with practice guideline recommendations.”</p> <p>Ferrari and colleagues included data from 84 countries between 2000 and 2021. The team applied a statistical method known as Bayesian meta-regression analysis to combine the data and examine depression treatment rates worldwide.</p> <p>The team found an apparent disparity between countries with different resources. In particular, 33% of people with MDD in high-income countries and just 8% in low and middle-income countries had access to mental health services.</p> <p>But the researchers estimated that only 23% of people with MDD received appropriate treatment in high-income countries. The percentage dropped to 3% in low and middle-income countries. </p> <p>“Major depressive disorder is a mental disorder that imposes a large amount of disability on the population’s health. Our findings highlight the importance for governments and policymakers to reconsider the availability of appropriate care for this disorder,” Ferrari says.</p> <p>According to a <a href="https://www.scimex.org/newsfeed/the-world-is-failing-to-tackle-depression/multimedia/global-depression_lancet_paper.pdf" target="_blank" rel="noreferrer noopener"><em>Lancet</em> and World Psychiatric Association Commission on depression</a>, “the world is failing to tackle the persisting and increasingly serious global crisis of depression.” </p> <p>The international commission, which includes Australian experts, called for concerted and collaborative efforts by governments, healthcare providers, researchers, people living with depression, and their families to improve care and prevention, fill knowledge gaps, and increase awareness to tackle one of the leading causes of avoidable suffering and premature death worldwide.</p> <p>“Evidence has accumulated over decades that depression is a leading cause of avoidable suffering in the world. Yet not enough is done to avoid and alleviate the suffering and disadvantages linked with depression, and few governments acknowledge the brake that depression places on social and economic development,” they write.</p> <p>“It is important for us to reconsider what services would have the most impact in reducing the burden due to major depressive disorder, and how best to deliver these to those in the population who need treatment the most,” says Ferrari. “It is also important for us to have access to more high-quality mental health survey data from low and middle-income countries that would allow us to understand better and track treatment for major depressive disorder.”</p> <p>MDD can affect people of any age and is caused by genetic, environmental, psychological and social factors. Behavioural and physical symptoms of MDD may include changes in sleep, appetite, energy level, concentration, daily behaviour or self-esteem.</p> <p><a href="https://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/1-facts_figures.pdf" target="_blank" rel="noreferrer noopener">According to The Black Dog Institute</a>, one in seven people experience depression in their lifetime in Australia. Depression has the third-highest burden of all diseases (13%) and is the number one cause of non-fatal disability in Australia (23%).</p> <p>The WHO estimates that 3.8% of the population is affected, with approximately 280 million people worldwide experiencing depression. When untreated, depression can cause great suffering and loss of function at work, school and home. At its worst, depression can lead to suicide. Every year, over 700,000 people die due to suicide, making it the fourth leading cause of death in 15 to 29-year-olds.</p> <p>In the past two years, several studies have highlighted how the COVID-19 pandemic has further exacerbated the global mental health crisis and hindered access to appropriate treatment.</p> <p>One <a href="https://www.scimex.org/newsfeed/lockdowns-may-not-have-been-as-bad-for-mental-health-as-we-thought/multimedia/covid-wellbeing_plos_paper.pdf" target="_blank" rel="noreferrer noopener">study published this week</a> in <em>PLOS ONE</em> by researchers at the University of Tasmania and Cambridge University, UK, found that COVID-19 death rates and fear caused by the pandemic may have contributed to poor mental health in the UK even more than lockdowns.</p> <p>Another <a href="https://link.springer.com/epdf/10.1186/s12992-022-00807-7?sharing_token=GOUNEgWIhZeVF_NaIvCSE2_BpE1tBhCbnbw3BuzI2RPIJUFuplJVDGtWKK1bwemFwU7DX_LUkT5qkx6Y1YLmYBcboJpAapN57vhiB0c_ZPTaklKkLuIyWvr61rrIAMLcp884PDr_O1mT5UHFhwgZbjTE28kinWgX7HGVsEM4YoM%3D" target="_blank" rel="noreferrer noopener">study published this week</a> in the open-access journal <em>Globalization and Health</em> found that Australia’s extended international border closures during the pandemic might have led to high levels of psychological distress across the community.</p> <p>Of the almost 4,000 participants in the survey, the vast majority, over 81%, reported that waiting to be reunited with partners, family and friends harmed their mental health.  </p> <p>“The vast majority of participants reported being negatively affected by the restrictions and showed high or very high levels of psychological distress,” says Flinders University researcher Dr Kathina Ali, a co-author of the study.  </p> <p>“A fifth of respondents believed they needed help for mental health problems,” she says. “Health and mental healthcare providers should be aware of this crisis and provide appropriate support options and practical strategies to mitigate the risk of further deterioration.”</p> <p><em>Image credits: Getty Images</em></p> <p><em><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=182301&amp;title=Mental+health+under-treated+worldwide" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em></div> <div id="contributors"> <p><em>This article was originally published on <a href="https://cosmosmagazine.com/health/body-and-mind/depression-treatment-rates/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Manuela Callari. </em></p> </div>

Mind

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Did the pandemic make us lose our hair?

<p dir="ltr">Over the past five years, there has been a steady increase in searches for hair loss treatment all around the world. </p><p dir="ltr">In more recent times, the search terms peaked during the middle of the pandemic, reflecting how the mental health and stress effects of Covid-19 have manifested physically. </p><p dir="ltr">Unsurprisingly, more than two thirds of people with hair loss issues have cited stress as the number one reason for the thinning and lack of volume in their hair, ahead of factors such as age, illness and medication, and hormonal changes. </p><p dir="ltr">With hair loss affecting both men and women equally, this physical change can often be stigmatised, with people often afraid to reach out to find a solution. </p><p dir="ltr">There are multiple solutions available for hair loss, which can often be fraught with risk and include dangerous or invasive procedures or harsh drugs. </p><p dir="ltr">Luckily, Nioxin is a non-invasive solution to hair loss, with thousands of people turning to the simple three step treatment to deliver a newfound confidence though thicker and fuller looking hair.</p><p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/02/Nioxin-1.jpg" alt="" width="1280" height="720" /></p><p dir="ltr"><em><span id="docs-internal-guid-98b3a7ae-7fff-f032-a67a-7a24be2a52c2">Before and after pictures from dedicated Nioxin customers. Image credit: Instagram</span></em></p><p dir="ltr"><em><img src="https://oversixtydev.blob.core.windows.net/media/2022/02/Nioxin-2.jpg" alt="" width="1280" height="720" /></em></p><p dir="ltr"><em><span id="docs-internal-guid-a46a929c-7fff-7846-aabf-9495bb3201aa">Before and after pictures from dedicated Nioxin customers. Image credit: Instagram</span></em></p><p dir="ltr">The cleansing shampoo, scalp therapy conditioner and leave-in treatment targets the scalp, roots and strands of the hair, helping to remove oil and residue, hydrate hair from root to tip and increase volume in every strand. </p><p dir="ltr">Nioxin’s tailored systems provide a solution for all hair types, at any stage of the hair loss process. </p><p dir="ltr">If you have progressive thinning and your hair is natural, you need the System Two Kit.</p><p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/02/Nioxin-system-2.jpg" alt="" width="1280" height="720" /></p><p dir="ltr"><span id="docs-internal-guid-45f00ccc-7fff-d413-08a5-efd24a776107">If your hair is progressively thinning and your hair is coloured, the System Four Kit is here to help.</span></p><p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/02/Nioxin-system-4.jpg" alt="" width="1280" height="720" /></p><p dir="ltr">If your hair is only just starting to thin and your hair is natural, look no further than the System One kit. </p><p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/02/Nioxin-system-1.jpg" alt="" width="1280" height="720" /></p><p dir="ltr">If your hair is only just starting to thin and your hair is coloured, the System Three kit has you covered. </p><p dir="ltr"><span id="docs-internal-guid-1fc84a9e-7fff-f1b0-c865-767854c58c52"><img src="https://oversixtydev.blob.core.windows.net/media/2022/02/Nioxin-system-3.jpg" alt="" width="1280" height="720" /></span></p><p dir="ltr">With dedicated customers all over the world, Nioxin has helped to change the lives of many. </p><p dir="ltr">Customers have even reported how their hair helped to grow back fuller and stronger than before after undergoing extensive medical treatment that saw them lose their luscious locks. </p><p dir="ltr">Nioxin is the non-invasive answer to hair loss, with loyal customers being completely converted to the simple system that helped them gain control of their hair and rediscover their confidence. </p><p dir="ltr">Nioxin is available at <a href="https://au.wella.professionalstore.com/comingsoon/">Wella Store</a>, <a href="https://www.adorebeauty.com.au/nioxin.html">Adore Beauty</a>, <a href="https://www.ozhairandbeauty.com/collections/nioxin">Oz Hair &amp; Beauty</a> and other international retailers. </p><p dir="ltr"><em>All image credits: Instagram @nioxin</em><span id="docs-internal-guid-2efc9068-7fff-5fc0-fb6d-120896acff5b"></span></p>

Beauty & Style